成纤维细胞生长因子对兔纤维环细胞转化生长因子β2的调节

目的:观察成纤维细胞生长因子对培养兔纤维环细胞转化生长因子β2表达的调节作用。方法:实验于2005-03/2006-04在华中科技大学同济医学院附属协和医院骨科实验室完成。培养4月龄雌性日本大白兔的纤维环细胞,在每次换液时加入成纤维细胞生长因子100μg/L,铺满后收集细胞,作纤维环细胞转化生长因子β2常规免疫组织化学研究,细胞呈棕黄色染色为阳性表达信号,同时为进一步明确纤维环细胞转化生长因子β2的定位进行免疫胶体金标记电镜观察。结果:光镜下细胞明显呈棕色,电镜下细胞膜表面有明显的胶金颗粒粘附。结论:成纤维细胞生长因子能促进纤维环细胞转化生长因子β2的表达。     

Long-term follow-up of a phase III study of recombinant human granulocyte-macrophage colony-stimulating factor after autologous bone marrow transplantation for lymphoid malignancies

One hundred and twenty-eight patients with non-Hodgkin's lymphoma (NHL), Hodgkin's disease (HD), and acute lymphoblastic leukemia (ALL) previously reported from a phase III trial of rhGM-CSF or placebo following autologous bone marrow transplantation (ABMT) were investigated for the development of late toxicities. Median follow-up is 36 months. No apparent long-term deleterious effects on BM function were observed. Moreover, disease-free survival and overall survival were similar for patients on both treatment arms, arguing for the long- term safety of recombinant human granulocyte macrophage-colony- stimulating factor (rhGM-CSF). The only factors predictive for both a high risk of relapse over time and mortality were having the diagnosis of ALL and/or undergoing ABMT in resistant relapse. We attempted to identify clinical variables before BM harvest, at the time of marrow infusion, or events within the first 100 days posttransplant, which might predict speed of neutrophil recovery in the setting of placebo or rhGM-CSF administration after ABMT. Only previous exposure to agents that deplete stem cells led to a significant delay in neutrophil recovery, suggesting their avoidance in patients who may undergo ABMT. Nevertheless, even those patients benefited from rhGM-CSF. For all patients, rhGM-CSF and agents that deplete stem cells were the strongest independent predictors for neutrophil engraftment. With the increasing use of newer hematopoietic growth factors both alone and in combination, long-term follow-up is essential to confirm the same safety that we report with rhGM-CSF.     

先天性无肛直肠舟状窝瘘手术186例

1临床资料1988-06/2003-12我院共186例,均为女性,无肛门,其中0～6月龄21例,0.5～1岁96例,1～3岁53例,3～8岁15例,13岁1例.以大便从会阴部舟状窝瘘口处排出而就诊,患儿有不同程度的排便困难,严重时伴腹胀呕吐,多数患儿有营养不良性贫血.瘘口直径0.3～0.6 cm,直肠盲端到肛穴皮肤之间的距离1.0～2.5 cm,属于中、低位肛门直肠畸形.本组有3例合并先天性心脏病-室间隔缺损,2例合并骶前囊肿,1例合并脐疝.     

Radiation‐induced brain disorders in patients with pituitary tumours

Radiation‐induced brain disorders (RIBD) are uncommon and they are grave sequelae of conventional radiotherapy. In the present report, we describe the clinical spectrum of RIBD in 11 patients who received post‐surgery conventional megavoltage irradiation for residual pituitary tumours. Of these 11 patients (nine men, two women), seven had been treated for non‐functioning pituitary tumours and four for somatotropinomas. At the time of irradiation the age of these patients ranged from 30 to 59 years (mean, 39.4 ± 8.3; median, 36) with a follow‐up period of 6?96 months (mean, 18.3 ± 26.4; median, 11). The dose of radiation ranged from 45 to 90 Gy (mean, 51.3 ± 13.4; median, 45), which was given in 15?30 fractions (mean, 18.6 ± 5.0; median, 15) with 2.8 ± 0.3 Gy (median, 3) per fraction. The biological effective dose calculated for late complications in these patients ranged from 78.7 to 180 Gy (mean, 99.1 ± 27.5; median, 90). The lag time between tumour irradiation and the onset of symptoms ranged from 6 to 168 months (mean, 46.3 ± 57.0; median, 57). The clinical spectrum of RIBD included new‐onset visual abnormalities in five, cerebral radionecrosis in the form of altered sensorium in four, generalized seizures in four, cognitive dysfunction in five, dementia in three and motor deficits in two patients. Magnetic resonance imaging (MRI)/CT of the brain was suggestive of radionecrosis in eight, cerebral oedema in three, cerebral atrophy in two and second neoplasia in one patient. Associated hormone deficiencies at presentation were hypogonadism in eight, hypoadrenalism in six, hypothyroidism in four and diabetes insipidus in one patient. Autopsy in two patients showed primitive neuroectodermal tumour (PNET) and brainstem radionecrosis in one, and a cystic lesion in the left frontal lobe following radionecrosis in the other. We conclude that RIBD have distinctive but varying clinical and radiological presentations. Diabetes insipidus and PNET as a second neoplastic disorder in adults following pituitary irradiation have not been reported previously.     

学报发展之我见

国家最新的统计数据显示,在我国5000种科技期刊中,高等院校所办的期刊已经达到1347种,其中绝大多数为学报;在我国1124种医学期刊中,学报也占有较大的比例．尽管学报的数量不少,但从期刊的综合评价体系来看,其中高质量者寥寥无几;而获得过“首届国家期刊奖,第二届国家期刊奖提名奖”的第四军医大学学报无疑是其中的佼佼者、尽管我们取得过辉煌的成绩,但依旧无法回避今日严峻的现实．要使学报能够健康地发展,我认为以下几点不容忽视．