Intensive chemotherapy for peripheral T-cell lymphomas.

Forty-two patients with previously untreated peripheral T-cell lymphomas (PTCL) were treated with an intensive chemotherapy protocol. Either the BACOP or the m-BACOD regimen was used for induction. Patients achieving complete clinical remission after three courses were given intensive consolidation and maintenance chemotherapy similar to the L10/L17M protocol designed by the Memorial Sloan-Kettering Group for acute lymphoblastic leukemia and lymphoblastic lymphoma. There were 27 (64 per cent) males and 15 (36 per cent) females. The median age was 54 years (mean 53, range 15 to 68). Seven of them (17 per cent) had stage I disease, four (10 per cent) stage II, seven (17 per cent) stage III and 24 (57 per cent) stage IV. Eighteen patients (43 per cent) had B symptoms and four (10 per cent) had bulky disease. According to the Working Formulation, the histology was diffuse mixed in 16 patients (38 per cent), diffuse large cell in 18 (43 per cent), diffuse immunoblastic in four (10 per cent) and unclassifiable in four (10 per cent). According to a modified Japanese Lymphoma Study Group's classification, the histology in 24 patients (57 per cent) was the pleomorphic type, in 13 (31 per cent) immunoblastic-lymphadenopathy-like (IBL-like), and in five (12 per cent) unclassifiable. The overall complete remission rate was 67 per cent. Twenty-five per cent of the complete responders relapsed and the DFS of the CR patients was 62 per cent at three years. The overall survival of all patients at three years was 52 per cent. Patients with stage I, II and III disease had significantly better CR rate (100 per cent versus 42 per cent, p = 0.001) and overall survival (82 per cent versus 35 per cent at three years, p = 0.01) than those with stage IV disease but the relapse rate and DFS of CR patients were similar. This study shows that the prognosis of patients with PTCL can be improved by intensive therapy.     

Duchenne型肌营养不良症

作者综述了１０年来对Ｄｕｃｈｅｎｎｅ型肌营养不良症（ＤＭＤ）的研究概况。主要包括①ＤＭＤ的临床研究。②血清生化研究表明ＣＫ、ＬＤＨ、Ｍｂ是诊断ＤＭＤ病人和携带者的敏感指标。③心脏无创性检测和肌肉超微结构研究。④部分抗肌萎缩蛋白基因ＹＡＣ物理图谱，精细限制酶图谱和缺失热区的核苷酸顺序分析，首次发现内含子中ＡＴ富集区的同源顺序与ＤＭＤ断裂有关。⑤抗肌萎缩蛋白的缺失热区疏水肽段存在与否与ＤＭＤ发病密切相关。     

京剧器乐的听力损伤（附55例调查报告）

本文对从事京剧打击乐的55人（110耳）进行了听力调查及动态观察。利用图表进行对比分析，发现110耳中高频听力损伤89耳，占81％；语频听力损伤32耳，占29.1%；其中伴有高频耳鸣78耳，占70．9％。动态观察30人（60耳），均为永久性听阈阈移。高频听力损伤最早出现的频率是4kHz，并见典型“V”谷，符合噪声性聋的诊断。     

Clinical characteristics of patients in studies of left ventricular dysfunction (SOLVD).

The Studies of Left Ventricular Dysfunction (SOLVD) trials were designed to evaluate the effects of enalapril on long-term mortality in patients with severe left ventricular (LV) dysfunction. Patients with LV ejection fractions less than or equal to 0.35 and symptoms of congestive heart failure (CHF) were enrolled in the treatment trial, whereas those with no history of overt CHF and taking no treatment directed for LV dysfunction were enrolled in the prevention trial. The baseline clinical characteristics of SOLVD patients were compared to characterize differences between patients in these 2 separate but concurrent trials. From over 70,000 patients screened with LV dysfunction, 4,228 patients were enrolled in the prevention trial and 2,569 patients in the treatment trial. Ischemic heart disease was the primary cause of LV dysfunction in both prevention (83%) and treatment (71%) trial patients. Prior myocardial infarction was present in 80% of the prevention and 66% of the treatment trial patients (p less than 0.001). In the prevention trial, infarction was recent (less than or equal to 6 months) in 27% patients and remote (greater than 6 months) in 57% patients. Treatment trial patients had proportionately more women (20 vs 13%; p less than 0.001) and non-Caucasians (20 vs 14%; p less than 0.001), as well as the coexisting risk factors of hypertension (42 vs 37%; p less than 0.001) and diabetes (26 vs 15%; p less than 0.001) than did prevention trial patients. Clinical characteristics of patients in both trials were influenced by the gender and race of enrolled patients. Similarly, coronary artery bypass surgery was performed less often in women and non-Caucasians.(ABSTRACT TRUNCATED AT 250 WORDS)     

D4S1647、D6S2414基因座在中国汉族、蒙古族、藏族的遗传多态性

目的 调查D4S1647、D6S2414基因座在中国汉族、蒙古族、藏族群体中的遗传分布规律。方法 采集308份血及唾液标本应用PCR技术，扩增产物用非变性聚丙酰胺凝胶电泳分离，银染显色分析。结果 两位点各群体基因型频率分布均符合Hardy-Weinberg平衡，每一位点等位基因频率分布在各群体间无显著差异；通过对10个汉族家系的遗传模式分析，证实了两位点等位基因传递遵循孟德尔遗传规律。结论 D4S1647、D6S2414基因座在中国汉族，蒙古族，藏族群体均具有高度遗传多态性。     

幕上星形细胞肿瘤MRI表现与VEGF、P16、Ki-67相关性研究

探讨星形细胞肿瘤MRI表现与P16、Ki—67、血管内皮生长因子(vascular endothelial growth factor，VEGF)表达的相关性。材料和方法：收集我院术前经MRI诊断并经手术病理证实的幕上星形细胞肿瘤53例，行常规平扫描后静脉注射Gd—DTPA增强成像；同时采用HE染色及链菌素生物素—过氧化酶连接法进行VEGF、Ki—67、P16的免疫组织化学染色，测定它们的表达指数。结果：星形细胞肿瘤的信号不均匀性、坏死、水肿、占位效应、强化程度与VEGF、Ki—67、P16的表达相关，且随着星形细胞肿瘤恶性程度的增高VEGF、Ki—67的表达增加；P16的表达率降低。结论：星形细胞肿瘤的MRI表现与VEGF、Ki—67、P16的表达密切相关，MRI可以间接判断星形细胞肿瘤的某些生物学行为。     

动态监测胃黏膜内pH值对胆源性胰腺炎外科治疗的价值

目的探讨胃黏膜内pH值对胆源性胰腺炎病情预后评估及在决定手术冶疗中应用的价值。方法对确诊的146例胆源性胰腺炎患者经鼻插入胃黏膜二氧化碳张力计（TRIP-NGS导管）测定胃黏膜内pH值，每隔12小时测定一次，并进行APACHEⅡ评分，将2组数据与外科治疗进行相关分析。结果①pH值变化反映胆源性胰腺炎病情发展变化，与器官衰竭数呈负相关；②外科干预治疗与内科治疗比较差异有统计学意义（P〈0．05）；③pHI〉7．25与pH〈7．25患者开腹手术病死率和细菌培养阳性率比较差异有统计学意义（P〈0．05）。结论pH值对胆源性胰腺炎外科治疗有指导意义。外科处理原则是：①胆道无梗阻，以内科保守治疗为主；②伴胆道梗阻，先行经内镜十二指肠乳头括约肌切开术、经内镜鼻胆管引流术、B超导引引流、腹腔灌洗等，如胆道引流不畅或pH值持续下降，则开腹手术。     

正常家兔胃饲不同剂量中药大黄前后的血液流变学观察

本文通过动物实验,比较研究了不同剂量大黄(即临床治疗剂量3g 和超临床剂量6g)的血液流变学作用。结果表明,临床治疗剂量引起以血液粘度降低为主的双相变化,而超临床治疗剂量则引起血液粘度的显著增高。在上述两种情况下,血浆渗透压均表现为明显增高,提示不同剂量大黄所引起的血液粘度降低和增高的双相变化可能是由于血浆渗透压增高具有抗利尿和利尿两种不同的水代谢调节作用所致。