经颅多普勒频谱参数与急性颅脑损伤患者颅内压的关系

目的探讨急性颅脑损伤患者的经颅多普勒频谱参数与颅内压的关系。方法应用TCD检测20例急性中、重型颅脑损伤患者双侧大脑中动脉,同时行颅内压监测。结果经颅多普勒频谱参数cf、PI、af、RI、ae均和ICP正相关,Vd、ac和ICP负相关,其中cf与ICP的相关系数最大。建立TCD相关参数与ICP的多元线性回归方程:ICP=0.312MAP-1.531Vd+21.437PI-15.059ac+38.722cf(P<0.001,R2=0.920估计值的标准差=4.0972mmHg)。结论经颅多谱勒频谱参数可以反应颅脑损伤患者的颅内压的改变。综合研究经颅多谱勒频谱参数、血压与颅内压的关系是应用经颅多普勒无创监测颅内压的方向。     

不同剂量体外冲击波治疗肱骨外上髁炎的疗效对比

目的 比较不同能流密度的体外冲击波(extracorporeal shock wave, ESW)治疗肱骨外上髁炎(lateral epicondylitis, LE)的短期临床疗效,探索ESW的最佳治疗剂量。方法 将120例LE患者分为A、B、C和D 4组,均使用ESW治疗4周,各组的能流密度分别为0.06、0.08、0.10、0.12 mJ/mm²。分别在治疗前及治疗后4、24及48周,比较4组患者疼痛视觉模拟量表(visual analogue scale, VAS)评分、肱骨外上髁炎功能评估(patient-rated tennis elbow evaluation, PRTEE)评分及末次随访患者满意度和复发率。结果 按时间点比较,各组VAS评分治疗前最高,治疗后48周降至最低(P<0.05),4组患者满意度及复发率比较差异无统计学意义(P>0.05),但C组患者满意度(96.67%)明显高于A组(80%),差异具有统计学意义(P=0.04)。按组间比较观察,治疗前各组患肘VAS评分差异无统计学意义(P>0.05);治疗后4、24和48...     

The contraceptive sponge: factors in initiation and discontinuation of use

This study examined characteristic of the contraceptive sponge that were important in women's decisions to use the contraceptive sponge and reasons why women discontinued sponge use. A sample of 385 current sponge users and 407 former sponge users participated in a national telephone survey on sponge use. Important reasons for trying the sponge were effectiveness, comfort, convenience and ease of use and it "would not interfere with sexual pleasure." The media and physicians were of considerable influence in women's decisions to initiate sponge use, but sexual partners, friends, parents and relatives exerted little influence. The most important reasons for discontinuing use of the sponge were pregnancy, both planned and accidental, and irritation, discomfort or vaginal infection. Women may decide to use the sponge because they have unrealistically positive perceptions of sponge characteristics.     

GMP法玻璃化冷冻人胚胎的效果观察

目的探索GMP法玻璃化冷人胚胎的可行性。方法选用IVF中多精受精的4-10细胞阶段的胚胎为研究对象，先后在玻璃化1液（10％乙二醇＋10％二甲亚砜）和玻璃化2液（20％乙二醇＋20％二甲亚砜＋0．3M蔗糖）中分别平衡1mim和0．5mim，然后用GMP管虹吸胚胎直接浸入液氮。其结果与常规的程序化慢冻进行比较。结果GMP法的存活率、胚胎完整率、卵裂球存活率比程序化慢冻法更高（分别为94．4％对73．9％，P〈0．01；79．6％对33．9％，P〈0．01；91．6％对67．8％；P〈0．01），但卵裂球完全死亡率更低（0％对10、4％；P〈0．01）。结论GMP法玻璃化冷冻人胚胎是可行的。     

不孕及反复流产患者血清抗心磷脂抗体的检测

目的检测不孕及反复流产患者血清中的抗心磷脂抗体(ACA),探讨ACA的临床意义.方法应用酶联免疫吸附(ELISA)法检测105例原发或继发不孕患者(不孕组)、171例反复流产或有胚胎停育史患者(流产组)及40例正常对照组血清中的IgG、IgM及IgA-ACA 3种抗体.结果不孕组ACA总阳性率为44.76%,流产组为35.09%,均显著高于对照组(P＜0,01).不孕组及流产组的单纯IgG阳性率亦明显高于对照组(P＜0.05);而两组的单纯IgM阳性率与对照组相比,差异均无显著性意义(P＞0.05).结论ACA是导致不孕及反复流产的免疫学因素之一,IgG型的ACA比IgM型的更具临床意义     

Assisted reproductive technology and complex chromosomal rearrangements: the limits of ICSI

Complex chromosomal rearrangements are very rare events in the human population. According to our knowledge on the consequences of simple reciprocal translocations for male fertility, translocations involving three or more chromosomes are thought to lead to severe reproductive impairments in terms of meiotic disturbance or chromosomal imbalance of gametes. We report the case of a 48 year old man whose sperm count revealed either oligozoospermia (<10(3) spermatozoa/ml) or azoospermia. He was referred to the laboratory for in-vitro fertilization after intracytoplasmic sperm injection. Cytogenetic investigations showed a complex chromosomal rearrangement involving firstly a translocation between the short arm of chromosome 7 and the long arm of chromosome 13 and secondly a translocation between the short arm of the same chromosome 13 and the short arm of chromosome 9. Diagnosis was ascertained by fluorescence in-situ hybridization and staining of the nucleolar organizer regions. Theoretical study of the translocated chromosomes predicted a 'chain' configuration of the hexavalent at the pachytene stage of meiosis. In all, 32 modes of segregation were considered and only one resulted either in a normal or a balanced gamete karyotype. Genetic counselling and choice of appropriate artificial reproduction technique are discussed.      

物理学在医学影像中的应用

物理学对医学的贡献是巨大的，物理学与医学等学科的交叉碰撞在医学领域中产生了许多丰硕成果，现代的医学影像就是其中的成果之一。本文阐述了物理学在现代四大医学影像中的应用。     

Ad5F35-LMP2重组腺病毒免疫效果的研究

目的了解含有EB病毒潜伏膜蛋白2的非复制型重组腺病毒(Ad5F35-LMP2),免疫恒河猴的特异性细胞和体液免疫的效果。方法分别使用高剂量(1.5×1010TCID50/只)、中剂量(1.5×109TCID50/只)、低剂量(1.5×108TCID50/只)Ad5F35-LMP2重组腺病毒,同时设对照组(PBS4.0ml/只)。肌内注射免疫恒河猴,每个月一次,共免疫3次,第0、4、8、12周时使用Elispot方法检测猴外周血EBV-LMP2细胞毒性T细胞应答,同时应用免疫酶方法检测血清中LMP2抗体。结果3个剂量Ad5F35-LMP2腺病毒免疫恒河猴均可以诱导出有效的细胞免疫应答及一定的抗体应答,免疫应答水平的高低与病毒剂量的高低有一定的关系,较高剂量产生的细胞及体液免疫应答水平比低剂量的高。结论Ad5F35-LMP2非复制型重组腺病毒疫苗可以有效的诱导恒河猴产生EBV-LMP2特异性细胞和体液免疫反应。     

Structure, genomic DNA typing, and kinetic characterization of the D allozyme of placental alkaline phosphatase (PLAP/ALPP)

The D allozyme of placental alkaline phosphatase (PLAP) displays enzymatic properties at variance with those of the common PLAP allozymes. We have deduced the amino acid sequence of the PLAP D allele by PCR cloning of its gene, ALPP. Two coding substitutions were found in comparison with the cDNA of the common PLAP F allele, i.e., 692C>G and 1352A>G, which translate into a P209R and E429G substitution. A single nucleotide primer extension (SNuPE) assay was developed using PCR primers that enable the amplification of a 1.9 kb PLAP fragment. Extension primers were then used on this PCR fragment to detect the 692C>G and 1352A>G substitution. The SNuPE assay on these two nucleotide substitutions enabled us to distinguish the PLAP F and D alleles from the PLAP S/I alleles. Functional studies on the D allozyme were made possible by constructing and expressing a PLAP D cDNA, i.e., [Arg209, Gly429]PLAP, into wild-type Chinese hamster ovary cells. We determined the k(cat) and K(m), of the PLAP S, F, and D allozymes using the non-physiological substrate p-nitrophenylphosphate at an optimal pH (9.8) as well as two physiological substrates, i.e., pyridoxal-5-phosphate and inorganic pyrophosphate at physiological pH (7.5). We found that the biochemical properties of the D allozyme of PLAP are significantly different from those of the common PLAP allozymes. These biochemical findings suggest that a suboptimal enzymatic function by the PLAP D allozyme may be the basis for the apparent negative selective pressure of the PLAP D allele. The development of the SNuPE assay will enable us to test the hypothesis that the PLAP D allele is subjected to intrauterine selection by examining genomic DNA from statistically informative population samples.