野生型p53基因抑制舌鳞癌细胞株Tca8113在裸鼠体内生长及增殖研究

为考察野生型ｐ５３基因转移入舌鳞癌细胞株Ｔｃａ８１１３后，癌株在裸鼠体内的生长及增殖状态，作者采用电穿孔方法分４组进行了如下基因转移：野生型ｐ５３基因，空白对照质粒，突变型ｐ５３基因和未转移任何基因的空白对照。在基因转移进入舌鳞癌细胞株Ｔｃａ８１１３后，分别接种于１６只裸鼠体内。成瘤后分别进行常规病理学、定量病理学和免疫组织化学研究。结果：转染野生型ｐ５３基因组与其余３组比较，其形成的肿瘤重量明显为轻；肿瘤异常核分裂相减少；定量病理学显示肿瘤坏死区面积所占瘤体总面积的百分比明显降低；免疫组织化学显示非坏死区增殖细胞核抗原明显更低。上述结果提示肿瘤细胞获取了功能完好的外源性野生型ｐ５３基因后，其基因表达并产生了新的负性调节因子，抑制了肿瘤的生长和增殖。并从理论上证明了利用野生型ｐ５３基因口腔粘膜鳞癌进行基因治疗是可能的。     

20％甘露醇灌肠治疗新生儿高胆红素血症的临床观察

本文观察不同方法治疗新生儿高胆红素血症的疗效，旨在探索退黄迅速，廉价，副作用极少的治疗方法，现报告如下：     

成人腰椎峡部裂型滑脱症的微创治疗

Objective To investigate the clinical experiences and technical skills of adult isthmic spondylolisthesis. Methods Twenty-one patients with adult isthmic spondylolisthesis underwent minimally invasive surgery. There were 12 men and 9 women, with the mean age of 51.7 years. Isthmic spondylolisthe-sis occurred at the L4.5 in 7 patients, and at the L5S1 in 14 patients. According to Meyerding classification, 13 cases were of Grade Ⅰ, 7 of Grade Ⅱ, 1 of Grade Ⅲ. Under general anesthesia, guiding by fluoroscopy, the surgeries performed minimally invasive microendoscopic(METRx) techniques for posterior decompression, interbody cage fusion and novel Sextant-R percutaneous pedicle screw techniques for deformity reduction and fixation. Results Seventeen cases were followed up 1 year postoperatively. The average low back pain VAS reduced from preoperative 6.0±2.6 to postoperative 2.9±2.5. The average leg pain VAS decreased from preoperative 6.7±3.3 to postoperative 2.8±1.6. The average ODI decreased from preoperative 44.3% to post-operative 27.1%. The Nakai good and excellent rate was 90%. The mean operative time 170 min, blood loss 160 ml, and postoperative stay in bed 7.5 d. The sagittal spondylolisthesis rate significantly decreased from preoperative 35.5%±2.5% to postoperative 8.3%±7.5%. The lordotic angle from preoperative 11.5°±1.7° in-creased to postoperative 16.8°±9.5°; the intervertebral disc height from preoperative (5.4±2.5) mm increased to postoperative (9.1±3.0) mm. According to Lenke judgement for fusion, complete fusion rate was 76%, in-complete fusion rate was 12%, nonfusion rate was 12%. Conclusion The minimally invasive microendo-scopic (METRx) assisted with a novel Sextant-R percutaneous pedicle screw systems for deformity reduction and fixation to treat adult isthmic spondylolisthesis, is not only a minimally invasive and safe surgical tech-nique, also an effective treatment for deformity reduction and fixation.     

先心病婴儿心内直视术的麻醉(附160例分析)

目的 总结先心痛婴儿心内直视术的麻醉。方法 回顾性分析了160例先心病婴儿的麻醉前用药、麻醉诱导、循环管理、重要器官保护和并发症防治等问题。结果 本组患儿膜式氧合器的比例为67．5％，喉头水肿需再次插管11例(占6．875％)，3例法乐四联症患儿麻醉前出现缺氧发作(1．875％)、占法乐四联症患儿的11．1％，术后早期死亡的9例患儿(5．625％，9／160)外，术后仅2例患儿出现RDS(1．25％，2／160)。结论 合理麻醉术前用药、麻醉诱导和气管插管的选择，维持适当的麻醉深度和血流动力学稳定，重要脏器功能的维护，水、电解质平衡和酸碱紊乱的纠正是麻醉成功的重要环节。     

火麻助长寿之谜有望揭开

5月24日，中国人民解放军中药研究所和广西巴马常春藤生命科技发展有限公司在京启动研发项目，火麻长寿之谜有望被科学揭示。[第一段]     

小儿喉乳头状瘤18例临床分析

目的：提高对小儿喉乳头状瘤临床特点的认识，探讨有效的治疗方法。方法：详细地分析我科1995—2003年间治疗的18例小儿喉乳头状瘤的临床特征及疗效。结果：所有病例均行手术治疗，治愈率66．7％(12／18)，有效率100％，有明确复发者5例(27．8％)，平均复发时间8.1月。所有复发者均再次手术，平均手术次数4，5次。结论：小儿喉乳头状瘤复发率高，喉显微手术加激光治疗是目前较为有效的治疗方法。     

仿生髓核组织工程支架材料的在体组织性能研究

[目的]初步评价自行设计构建的仿生髓核组织工程支架材料-CHCS支架的在体组织性能。[方法]以单层培养的传1代髓核细胞为种子细胞,体外初步构建细胞-CHCS支架复合体,并植入摘除髓核的椎间盘内,观察椎间隙的高度、相应节段生物力学性能以及组织学改变。[结果]成功构建了细胞-CHCS支架复合体,植入摘除髓核的椎间盘内,髓核细胞能够成功地合成和分泌PG等细胞外基质。在12周时,细胞-支架复合体初步形成了解剖学上的髓核样结构。8周后能有效缓解椎间隙高度的下降和抗压、屈曲、伸直强度的降低。[结论]所构建的细胞-支架复合体对于椎间盘的退变有一定的延缓作用。同时表明所构建的CHCS支架具有良好的在体组织性能。     

QCT骨密度测量的准确性试验方法和意义

目的 目前国内尚未对QCT(定量CT法)骨密度测量作准确性误差校正，笔者介绍了QCT准确度试验方法和为什么必须校正准确性误差。方法 用东芝CT机自带参考骨体模(称东芝体模)和软件为测量工具，对四川大学华西骨质疏松研究中心等研制的QCT骨体模(称四川体模)进行骨密度测量。将四川体模模拟被测人腰椎，置于15cm深水浴中，东芝体模置于水浴和扫描台之间作参考标准。按照对人的腰2、3、4椎骨扫描测量的条件，东芝QCT骨密度测量的方法进行操作，直至测量出骨密度值和显现出QCT图像为止。由于四川QCT体模内3管羟磷灰石实际密度值为50mg/cm^3、100mg／cm^3和200mg／cm^3，因而可以求出每管骨体模的测量值偏离实际值的％大小。测量值大于实际值误差为正，反之为负。由于四川体模内有由大到小3管骨密度呈线性分布，可以求得回归方程，用回归方程校正准确性误差较好。结果 测量四川体模从小到大3管骨密度分别的准确性误差为-13．0％、-5．26％和 3．85％，其分别的校正系数为1．149、1．055和0．963，相关系数r=0．998，回归方程为Y=12．075 0．907X(X为测量骨密度，Y为校正后骨密度)。在准确性试验期间T机更换球管一支，更换球管后，四川体模从小到大3管骨密度的准确性误差变为-30．54％、-9．97％、和-0．0l％．回归方程为Y=18．43 0．910X。结论 从准确性误差分布特殊性看密度低端误差明显大于高端(低端误差高达30％)，密度低端是病人集中的区域，以回归方程校正，可以照顾高密度及低密度端优于用校正系数。所以必须重视QCT的质量控制，否则资料缺乏可比性和一致性，病人则因此出现过多的假阳性、假阴性。目前四川大学已研制出自己的QCT体模，能够满足作骨密度测量参考体模和质控要求用。     

补中益气汤治愈阴吹症

阴吹,阴中出声,如大便矢气频转之状。《金匮》论本病为“胃气下泄,阴吹而正喧。此谷气之实也”,故予“膏发煎导之”,引病从大便出以止。笔者认为有非谷气实而为中气下陷所致者,故不用润肠而以补中益气汤加减治疗。患者林××,女,23岁,工人。因难产分娩,会阴缝合6针。1周后腹部有气作响,2周后不时感觉前阴出气作响而不臭,气出腹舒。治疗2月余,症状更甚。1979年6月13日请余诊治。其面色苍白,气短     

成人腰椎峡部裂型滑脱症的微创治疗

Objective To investigate the clinical experiences and technical skills of adult isthmic spondylolisthesis. Methods Twenty-one patients with adult isthmic spondylolisthesis underwent minimally invasive surgery. There were 12 men and 9 women, with the mean age of 51.7 years. Isthmic spondylolisthe-sis occurred at the L4.5 in 7 patients, and at the L5S1 in 14 patients. According to Meyerding classification, 13 cases were of Grade Ⅰ, 7 of Grade Ⅱ, 1 of Grade Ⅲ. Under general anesthesia, guiding by fluoroscopy, the surgeries performed minimally invasive microendoscopic(METRx) techniques for posterior decompression, interbody cage fusion and novel Sextant-R percutaneous pedicle screw techniques for deformity reduction and fixation. Results Seventeen cases were followed up 1 year postoperatively. The average low back pain VAS reduced from preoperative 6.0±2.6 to postoperative 2.9±2.5. The average leg pain VAS decreased from preoperative 6.7±3.3 to postoperative 2.8±1.6. The average ODI decreased from preoperative 44.3% to post-operative 27.1%. The Nakai good and excellent rate was 90%. The mean operative time 170 min, blood loss 160 ml, and postoperative stay in bed 7.5 d. The sagittal spondylolisthesis rate significantly decreased from preoperative 35.5%±2.5% to postoperative 8.3%±7.5%. The lordotic angle from preoperative 11.5°±1.7° in-creased to postoperative 16.8°±9.5°; the intervertebral disc height from preoperative (5.4±2.5) mm increased to postoperative (9.1±3.0) mm. According to Lenke judgement for fusion, complete fusion rate was 76%, in-complete fusion rate was 12%, nonfusion rate was 12%. Conclusion The minimally invasive microendo-scopic (METRx) assisted with a novel Sextant-R percutaneous pedicle screw systems for deformity reduction and fixation to treat adult isthmic spondylolisthesis, is not only a minimally invasive and safe surgical tech-nique, also an effective treatment for deformity reduction and fixation.