科技进步与心血管病学的50年展望

本文主要阐述未来50年心血管病学领域内的各种进步,包括基因诊断和治疗、心脏外科手术的发展等等.     

玉米浆用量、渗透压和耗糖速率对甘油发酵的影响

Candida krusei发酵生产甘油过程中,菌体生长由玉米浆限制,菌体对玉米浆的得率为1．63g/g,培养其中玉米浆浓度相同时,增加渗透压或通过流加补料限制生长阶段的菌体生长,可使甘油生产阶段的比耗糖速率减慢,比耗糖速率保持在不很高的水平,可以因消耗的葡萄糖用于生长,维持,甘油和副产物形成所占比例的变化而提高甘油得率。     

人膀胱癌上皮细胞株T24分泌LAK细胞诱导因子（LAK—IF）

从人膀胱上皮癌细胞株T24的亚克隆株T24-8的无血清培养上清液经55%硫酸铵沉淀,再对无离子水透析,得到了有诱导LAK 细胞活性的粗提品。有此作用的因子称为LAK 细胞诱导因子(LAK-IF)。它的分子量为67KD,等电点为pH3.1～3.5。抗人IL-6单抗不能阻断LAK-IF 的作用。LAK-IF 粗提品经Mono-Q 柱快速蛋白液相层析见3个峰。第2峰蛋白质有LAK-IF 活性。     

Relationship between age and effect of early and long-term captopril treatment in patients with acute myocardial infarction

Objective To analyse the relationship between age and treatment with captopril after acute myocardial infarction (AMI). Methods In a randomized trial, 822 patients with a first AMI received conventional medic al treatment, including intravenous thrombolytic therapy and oral aspirin or metoprolol, and then were randomly allocated to captopril ［dosage fr om the first 6.25 mg to 25 mg/t.i.d, 209 younger patients (≤64 years), 269 elderly patients (65-75 years)］ or conventional treatment only (131 younger p atients, 213 elderly). Survival in the four groups was calculated with the Kapl an-Meier method. Multivariate analysis was performed to understand the degree that multi-variables (including age) affect survival in patients taking captopr il in the hospital or during long term follow-up. Results The survival of patients who took captopril correlated significantly with age ( P<0.001). The survival of the elderly patients on captopril treatment did increase (P<0.0001), but not of the younger ones (P>0.05) during hosp italization. During follow-up, the survival of patients who took captopril cor related insignificantly with age (P>0.05), but both the elderly and the you n ger patients have good survival rates (all P<0.01) and lower cardiac events (all P<0.01) when they took captopril.Conclusions Captopril exerts a weak effect on the younger patients but a beneficial effect o n the elderly patients during hospitalization after AMI. However, there is no d ifference between the younger and the elderly in the prognosis, both having good survival and lower cardiac events when they take captopril long term during fol low-up.     

Clinicopathologic features and survival of patients with colorectal mucinous, signet-ring cell or non-mucinous adenocarcinoma:experience at an institution in southern China

Background Previous studies have shown conflicting results on the relation between clinicopathologic features and prognosis of patients with colorectal mucinous, signet-ring cell, or non-mucinous adenocarcinoma; only few such studies have been performed in China. This retrospective study analyzed data from our department to investigate clinicopathologic characteristics, prognosis and possible correlations of three histologic types -- colorectal mucinous,signet-ring cell, and non-mucinous adenocarcinoma, to clarity the bases for observed differences which may lead to development of targeted therapies Methods Of 2079 patients diagnosed with colorectal cancer between 1994 and 2007, 144 had mucinous, 25 had signet-ring cell, and 1837 had non-mucinous adenocarcinoma. Their clinicopathologic parameters and survival were analyzed using established statistical methodologies.Results Mucinous and signet-ring cell adenocarcinomas were common in younger patients (P <0.001). Location, size and disease stage differed significantly among the three types. Signet-ring cell tumors were more commonly found in the rectum than mucinous and non-mucinous adenocarcinoma (P <0.001). Mucinous and signet-ring cell tumors presented in a later stage in life more often than non-mucinous adenocarcinoma, with lymph node involvement, serosal infiltration, peritoneal dissemination, and adjacent organ invasion (P <0.01). The rate of radical resection, hepatic metastasis and local recurrence did not differ among types (P ＞0.05). Compared with patients with non-mucinous adenocarcinoma, patients with mucinous and signet-ring cell tumors who underwent potentially curative resections or stage Ⅱ/Ⅲ disease had poorer long-term overall survival. Survival did not differ by type for patients with either stage Ⅰor Ⅳ disease (P ＞0.05). Conclusions Mucinous and signet-ring cell adenocarcinoma have unique carcinogenesis and similar biologic behavior.Our study confirms that both histologic types, especially signet-ring cell tumors, are independent, negative prognostic factors for patients with colorectal cancer. Type does not appear to have a significant effect on survival when disease is either stage Ⅰ or Ⅳ at presentation.     

Early operation for fulminant acute pancreatitis: a possible way to decrease mortality

Background Although the indication and the timing for surgery in fulminant acute pancreatitis (FAP) are still controversial, our experience of surgical treatment for fulminant acute pancreaUtis may help improve the outcome for patients.Methods The clinical data of twenty-six patients with FAP from January 1, 2001 to October 1,2005 were analyzed. The diagnostic criteria fitted the 2007 Guidelines for the Management of Severe Acute Pancreatitis by the Chinese Medical Association.Results Twenty-six patients with FAP received surgical debridement, with a mortality rate of 42.3% (11/26). The postoperative mortalities in the ＞72 hour operation group and the <72 hour operation group were highly significantly different (7/8 vs 22.2% (4/18), respectively).Conclusions Early surgery may reduce the intraabdominal pressure and prevent the deterioration of FAP. An operation within 72 hours from the onset of symptoms might decrease the mortality of the disease.     

降低隧道施工机械尾气污染的几项措施

目的　研究降低无轨运输方式施工隧道中空气污染的措施。方法　采用燃油添加剂 ,定期对施工机械进行维修和保养 ,减少发动机空档排气 ,将压入式通风口设置于距掌子面 8～ 10m处 ,保持通风管道密闭通畅致使有效送风。结果　隧道中有害气体CO、NOx及黑烟浓度至少降低 4 6 % ,55%和 4 2 %。结论　采取以上措施能明显改善施工环境的污染状况并减轻对施工人员身体健康的危害     

梨状窝癌局部扩展的病理学研究

目的　探讨梨状窝癌局部扩展的规律 ,为梨状窝癌的手术治疗提供病理学依据。方法　应用石蜡包埋大体标本连续切片的方法 ,对 2 6例梨状窝癌全喉及次全喉切除的标本进行了观察。结果　位于梨状窝外侧壁的肿瘤 ( 4例 )主要向外侧咽侧壁扩展 ,位于梨状窝内侧壁的肿瘤 ( 5例 )容易向喉腔及对侧梨状窝扩展。累及整个梨状窝 17例。声门旁间隙及甲状软骨是最易受侵犯的喉结构 ,环状软骨受侵较少 ;会厌及会厌前间隙的侵犯未见超过中线 ,声门旁间隙及会厌前间隙的侵犯途径有2个 ,肿瘤沿杓会厌襞向前及在甲状软骨板内侧直接向前侵犯声门旁间隙 ;肿瘤沿杓会厌襞向内上方及在甲状软骨板内侧上部侵入会厌前间隙。结论　会厌前间隙的受侵并不是喉部分切除的禁忌证 ,大部分位于梨状窝外侧壁的肿瘤及部分梨状窝内侧壁的肿瘤保留喉功能是可行的 ;位于梨状窝内侧壁及环后区的肿瘤易在环后区向对侧侵犯 ,对累及环后区的梨状窝癌 (Ⅰ ,Ⅲ型 ) ,应注意肿瘤在环后区粘膜下向对侧侵犯。     

定量PCR检测缺失型DMD/BMD携带者的研究

研究DMD/BMD携带者临床诊断的有效手段。方法 :运用双重定量PCR及剂量系数分析 ,检测 2 6例正常对照 ,7例肯定携带者和 2 1例可疑携带者 ,部分结果与短片段重复顺序多态性方法及CK值作了比较。结果 :确定了判定参考标准 ,可疑携带者中 ,患儿母亲检测阳性率为 5 7.9% ,8例经短串联重复顺序多态性分析 ,得到了完全验证。结论 :定量PCR检测DMD/BMD携带者快速、敏感、准确 ,可在临床诊断中应用。     

氧化铝颗粒大小对PEO—NaSCN络合物电导率的影响

研究分散第二相Ａｌ２Ｏ３的含量及颗粒大小对ＰＥＯ－ＮａＳＣＮ络合物电导的影响,结果表明：当颗粒度为０．７μｍ时,电导率比纯ＰＥＯ－ＮａＳＣＮ提高了一个半数量级。颗粒度较大时,电导率均比纯ＰＥＯ－ＮａＳＣＮ低,并在ｗＡｌ２Ｏ３＝０．２５时,存在电导率最大的峰值。