脐动脉血PCT、CRP检测在早产儿早期感染中的作用

目的:为进一步提高早产儿重症感染的早期诊断率探讨一种快速、可靠的方法。方法:用LUMITestPCT方法检测我院出生的有感染可能的早产儿的脐动脉血清降钙素原(PCT)。同时检测脐动脉血C反应蛋白(CRP);由新生儿专业的医师对其病情进行观察,在不知道PCT值时做出病情的临床诊断,52例病例分为:重症感染组(n=28)和对照组(n=24)。进行回顾性对比分析。结果:早期开始的早产儿感染与CRP、PCT浓度在出生时的增加相关,差异有极显著性(P<0.001);脐动脉血中,PCT浓度的增加与CRP水平变化呈正相关(r=0.88)。PCT的敏感性(96.4%)和特异性(95.8%)均高于CRP(敏感性75%,特异性91.6%)。结论:PCT可作为早产儿早期感染的早期、快速检测指标,与CRP相比,PCT敏感性、特异性均高。本研究方法对早产儿无创伤。     

原发性肝癌患者乙型及丙型肝炎病毒感染的检测

目的　调查原发性肝癌患者乙型及丙型肝炎病毒感染情况。　方法　采用免疫组织化学 SP法检测15 7例原发性肝癌患者乙型肝炎病毒 (HBV)及丙型肝炎病毒 (HCV)感染情况 ,每例患者均有血清学检测资料 ,另取 30例良性肝病组织作对照 ,所有数据用卡方检验。　结果　 15 7例原发性肝癌患者中 HBV感染阳性率为31.8% (5 0 / 15 7) ,HCV感染阳性率为 5 1.0 % (80 / 15 7) ,其中 10 7例原发性肝细胞癌 HBV、HCV感染阳性率分别为39.3% (42 / 10 7) ,4 5 .8% (49/ 10 7) ,5 0例胆管细胞癌 HBV、 HCV感染阳性率分别为 16 .0 % (8/ 5 0 ) ,6 2 .0 %(31/ 5 0 ) ,原发性肝细胞癌、胆管细胞癌 HBV、HCV重叠感染率分别为 2 7.1% (2 9/ 10 7) ,14 .0 % (7/ 5 0 ) ,良性肝病组HBV、HCV感染阳性率分别为 16 .7% (5 / 30 ) ,30 .0 % (9/ 30 )。原发性肝细胞癌 HBV感染、胆管细胞癌 HCV感染率高于良性肝病组 ,差异均有显著性 (P<0 .0 5 )。原发性肝细胞癌 HBV、HCV血清学检测阳性率分别为 87.8%(94 / 10 7) ,13.1% (14 / 10 7) ,胆管细胞癌 HBV、HCV血清学检测阳性率分别为 6 8.0 % (34/ 5 0 ) ,16 .0 % (8/ 5 0 )。　结论　原发性肝癌与 HBV、HCV的感染有密切关系     

两种石油加工残油对制备可纺丝中间相沥青的影响

用常压液相炭化法制备中间相沥青，并用熔融法检验中间相沥青的可纺性，研究了汽油裂解残油和催化裂化重柴油参混比的不同对中间相沥青的制备速率，产率，中间相含量，显微结构以及可纺性的影响，指出最佳配比。     

保留肾单位手术治疗早期小肾癌21例临床分析

OBJECTIVE: To evaluate the clinical effects of nephron-sparing surgery in patients with early-stage small renal cell carcinoma. METHODS: Nephron-sparing surgery was performed in 21 patients with renal cell carcinoma including 1 with solitary kidney, 3 with unilateral tumor and contralateral renal compromise, and 17 with unilateral tumor and normal contralateral kidney. The diameter of the tumors ranged from 1.5 to 6.0 cm, with a mean of 2.8 cm. The tumor diameter in 17 patients with normal contralateral kidney was less than 4 cm (mean 2.5 cm) and the average diameter in 4 patients with contralateral renal compromise was 4.2 cm. Sixteen cases were in stage T(1), 4 in stage T(2), and 1 in stage T(3). Of the 21 patients, 4 underwent tumor enucleation, 10 polar nephrectomy and 7 wedge resection. RESULTS: All patients were followed up for an average of 40.8 months (7 to 66 months). One patient suffered a right lung and mediastinum metastasis 3 years after the surgery later and 1 with chronic glomerulonephritis required dialysis 27 months after the operation. No surgical complication or local recurrence were found in other patients. CONCLUSION: As a safe and effective therapy for early-stage small renal cell carcinoma, nephron-sparing surgery can be considered as the gold-standard therapy for patients with lesions less than 4 cm in T(1) and T(2) stages of localized unilateral tumor with normal contralateral kidney.     

社会能力评定量表的编制及信效度检验

目的：编制社会能力评定量表并检测其信度和效度。方法：在全国五大行政区用社会能力评定量表评估1605例正常人(男性814名，女性791名)，分析量表的信效度。结果：全量表的Cronbach's α系数为0．88-0．92，三个分量表的d系数为0．81～0．88；量表的分半信度为0．76～0．87，量表的重测信度为0．67～0．86，量表评分者信度为0．91～0．97，表明量表具有较好的内部一致性和稳定性；各条目与总分的相关系数0．49-0．80，分量表与总分的相关系数为0．76～0.89，通过因子分析，证实了量表的结构效度；全量表总分和职业能力得分与被试单位提供的实际社会能力评分呈高度相关，与韦氏智商呈中低度相关。结论：量表编制符合心理测量学要求，具有良好的信度和效度。     

真性延髓麻痹并发咽憩室报告1例

真性延髓麻痹主要表现为吞咽困难、构音障碍、饮水呛咳等,严重的影响患者的生活质量.真性延髓麻痹病程超过2个月,尤其身体消瘦者,常发生咽憩室,主要表现为食物返流.因为真性延髓麻痹是下运动神经元损伤,可以引起咽肌肌力和肌张力低下、肌萎缩,因此使梨状隐窝加深而形成咽憩室,在临床上报道少见.     

38例视网膜母细胞瘤的临床和误诊分析

目的 探讨视网膜母细胞瘤（retinoblastoma，RB）的临床特征、病理分类和误诊原因，尽可能减少错误的临床诊治。方法 对我科于1999-2004年间收集的38例临床诊断为视网膜母细胞瘤（retinoblastoma，RB）的病例资料进行回顾性分析。结果在38例疑似病例中，34例病理诊断为视网膜母细胞瘤，4例为Coats病。结论掌握相关的影像学知识和综合分析疑难病例的临床资料将有助于视网膜母细胞瘤的正确诊断和处理。     

放射线联合p53基因及内皮抑素治疗小鼠前列腺癌皮下移植瘤

Objective To test the hypothesis that p53 gene therapy combined with endostatin can enhance tumor response to radiation therapy of RM-1 mouse xenograft prostate cancer and to investigate its mechanism. Methods A mouse prostate cancer model was established. Then mice with xenograft tumor were randomly divided into group A (control), B (radiation), C (radiation and rAdp53), D (radiation and rh-endostatin) and E (radiation and rAdp53 and rh-endostatin). On day 1, rAdp53 was injected intra-tumorously with 1 × 1010 vp per animal to group C and E. From day 1 to 14, rh-endostatin was given 15 mg/kg intraperitoneally daily to group D and E. On day 4 single fraction of 15 Gy was given to tumors in groups B, C, D and E. Normal saline was injected intra-tumorously or intraperitoneaUy accordingly as control. No treatment was done to group A. Tumor volume was measured daily. Samples were collected on Days 5, 10 and 15. Ki67, CD31, p53 and VEGF were detected by means of immunohistochemistry. Results (1) Radiation alone, radiation combined with intra-tumorous injection of Adp53 and/or intraperitoneal injection of rh-endostatin resulted in tumor growth arrest of RM-1 cells in vivo (P = 0.000). Radiation combined with both rAdp53 and rh-endostatin was the most effective treatment (P < 0.05). (2) All the four treatment groups had a decreased expression of mutant type P53 (P = 0.000). The expression of Ki67 in groups B and C were equal (P 0.05) and increasing (P = 0.000), respectively. Group D had a up-down-up curve (P < 0.05), but group E had a up-down one. On day 5 the expresion of VEGF in group E was the lowest (P < 0.05). An increased expression of MVD compared with the control was shown, and MVD in groups C, D and E were always higher than that in the control (P < 0.05). Conclusions The limitation of radiotherapy could be overcome by combination with beth p53 gene therapy and endostatin on the growth of mouse prostate cancer cell. Radiation, rAdp53 and endostatin have their own role but they can be interacted with each other.     

RNA干扰基因敲除MAGE-1在恶性胶质瘤U87细胞中的初步研究

目的：通过构建抑制MAGE-1的短片段双链核糖核酸（siRNA）表达载体，鉴定其在人恶性胶质瘤细胞系U87细胞中对MAGE．1基因表达的干涉作用。方法：化学合成2对编码短发夹RNA序列的靶向MAGE—1基因寡核苷酸链，克隆至经BglⅡ、HindⅢ双酶切的pSUPER载体上，重组构建核糖核酸干扰（RNAi）质粒载体。利用RT-PCR、流式细胞术和荧光显微镜，检测经稳定转染后胶质瘤U87细胞中MAGE-1的表达，以了解siRNA的干涉效果。结果：重组构建的pSUPER—MAGE—1载体经双酶切、电泳及插入基因片段序列分析，表明寡核苷酸链成功地插入至预计位点，且序列与预期完全一致。稳定转染后G418筛选出的U87多克隆细胞MAGE-1的表达经RT—PCR、流式细胞术和荧光显微镜检测，2对siRNA均有较明显的干扰作用。结论：载体的成功构建并能对U87细胞中的MAGE—1分子进行RNAi，为进一步研究MAGE—1在肿瘤中的作用，分析基因功能，展开肿瘤基因治疗奠定了基础。     

自制32P敷贴器治疗瘢痕疙瘩

目的：观察自制32P敷贴器局部敷贴治疗不同类型瘢痕疙瘩的临床疗效。 方法：105例瘢痕疙瘩患者中，39例病变厚度≤ 0.3 cm的行单纯敷贴治疗，病变厚度> 0.3 cm的66例随机分为2组，单纯敷贴组36例，手术+敷贴组30例。单纯敷贴根据病变表面积大小及形状剪取敷贴片，根据剂量率和衰变校正计算每天敷贴时间，直接贴于病变表面，每天4.0~5.0 Gy/(部位•次)，连续4 d为一疗程，每疗程间隔4周，总治疗4~6个疗程。幼儿单次剂量控制在每天4 Gy/(部位•次)以下。手术+敷贴组患者手术切除瘢痕疙瘩，待手术伤口无渗出后根据伤口形状剪取敷贴片对准伤口敷贴，剂量及疗程同单纯敷贴组。 结果：单纯敷贴治疗对病变厚度≤0.3 cm的39例瘢痕疙瘩治愈32例(82%)，总有效率98%；对病变厚度> 0.3 cm的瘢痕疙瘩单纯敷贴和手术+敷贴两组治疗总有效率分别为56%和93% ，两组差异有显著性意义(P < 0.01)，其中病程< 9个月的患者治疗有效率分别为25%和75%，病程较长患者治疗有效率分别为13%和77%。治疗过程中有26例在敷帖过程中出现局部皮肤烧灼和刺痛感，均以炉甘石洗剂局部外用处理后缓解；5例出现Ⅰ度放射性皮炎，2例出现Ⅱ度放射性皮炎，以百多邦软膏局部外用后缓解，无出现Ⅲ度以上放射性皮炎病例。治愈患者局部皮肤均有不同程度的色素沉着或皮肤颜色改变。 结论：32P敷贴治疗瘢痕疙瘩治疗安全有效，对病程较短或病变厚度小于0.3 cm的患者可单纯敷贴治疗，病程较长或病变厚度大于0.3 cm患者建议先手术后再敷贴治疗。