宫颈癌的治疗进展

官颈癌是最常见的妇科恶性肿瘤之一,其发病率及死亡率仅次于乳腺癌。对官颈癌的治疗,除应力求根除疾病,提高生存率外,还应尽可能争取保留患者的生殖内分泌功能,特别是对年轻的患者。为提高宫颈癌患者的治疗效果,化疗已成为中、晚期的重要治疗手段。     

核苷类衍生物的合成

以尿嘧啶核苷和HIV-逆转录酶抑制剂扎西他宾为先导化合物,对其5-羟基进行磷酸化修饰,然后以磷原子为桥,引入各种氨基酸酯及取代苯环,从而试图克服这类药物对核苷激酶的依赖性,提高药物的生物活性,降低药物对细胞的毒性,以此为设计思路合成了7个新的核苷类衍生物,其结构经IR,1HNMR,13CNMR,MS分析确定.     

Comparison of clinical outcomes of frozen-thawed blastocysts transfer in natural and hormonally controlled cycles

Objectives:To assess the clinical outcomes of frozen-thawed blastocysts transfer in natural and hormonally controlled cycles.Methods:A retrospective analysis of natural and hormonally controlled cycle for 246 frozen-thawed blastocyst transfer cycles,the clinical pregnancy rate,implantation rate,early abortion rate were compared.Results:Of the 192 hormonally controlled cycles,the cancel rate,clinical pregnancy rate per ET,implantation rate and abortion rate were 7.3%(14/192),53.9%(96/178),38.8%(131/338)and 11.5%(11/96)respectively,whereas in 54 natural cycles,these rates were 16.7%(9/54),68.9%(31/45),52.9%(45/85)and 16.1%(5/31)respectively.There was no significant difference between the two groups with regard to the clinical pregnancy and abortion rate per ET,but the cancel rate and implantation rate were higher in natural cycles.However,the pregnancy and implantation rates of patients without PCOS in hormonal control cycles(57.2%,40.9%)were similar with those in natural cycles(P>0.05).Conclusion:These findings suggested that both hormonally controlled and natural cycles had similar pregnancy outcomes in frozen-thawed blastocysts transfer.     

类风湿性关节炎患者氧化还原物水平的测定

OBJECTIVE: To examine the oxidation or reduction products in patients with rheumatism arthritis (RA), and investigate the relationship between oxidation or reduction products and occurrence and development of RA. METHODS: The serum levels of total ascorbic acid (TAA), dehydroascorbic acid (DHAA)/TAA, vitamin E, advanced oxidation protein products (AOPP) and malondialdehyde (MDA) were detected by high-performance liquid chromatography with electrochemical detection in 83 RA patients and 30 healthy adults. Correlation analysis of AOPP, MDA and hs-CRP was performed. RESULTS: Compared with normal control group, significantly higher serum MDA, DHAA/TAA, and AOPP levels were detected in RA patients (P<0.05), but vitamin E showed no significant difference (P<0.05). Linear regression analysis showed that MDA (P<0.01) was positively but AOPP (P>0.05) negatively correlated to hs-CRP. CONCLUSIONS: Oxidation or reduction products in serum of RA patients increases significantly, which may be an important mechanism for the occurrence and development of RA. Serum AOPP and MDA levels can reflect the oxidation status in RA patients.     

鼻内镜治疗颅底疾病112例报告

目的探讨鼻内镜径路治疗颅底疾病的价值。方法2002年5月~2006年12月,对112例颅底疾病行鼻内镜径路手术,其中脑脊液鼻漏39例,垂体瘤4例,脑膜膨出或脑膜脑膨出3例,蝶筛囊肿9例,蝶窦炎伴息肉2例,真菌性蝶窦炎12例,内翻性乳头状瘤11例,鼻咽纤维血管瘤6例,骨化纤维瘤2例,骨纤维异常增殖2例,脊索瘤7例,颅咽管瘤2例,鳞癌10例,未分化癌1例,乳头状瘤癌变2例。结果全组均在鼻内镜下处理,其中20例病变为次全切除,包括鳞癌8例、未分化癌1例、脊索瘤7例、颅咽管瘤2例、骨纤维异常增殖2例。脑脊液鼻漏1次手术成功31例(79.5%),2次成功4例,3次成功4例,最终成功率100%。1例脑膜脑膨出术后2个月复发并伴脑脊液漏,内镜下再次手术成功。1例内翻性乳头状瘤术后11个月复发,改行鼻侧切开术。1例真菌性蝶窦炎术后4个月复发行再次内镜手术。1例脑脊液鼻漏术后颅内感染。结论鼻内镜径路可以处理多种颅底疾病,是一种安全、有效、微创的手术方式,但仍需严格掌握手术适应证,特别是恶性肿瘤。     

458例尿路结石成分分析

目的 探讨西安地区尿路结石的成分状况，为临床防治提供帮助。方法对458例尿路结石标本进行化学成分测定，并结合临床资料进行比较。结果尿路结石男性发病多于女性，男、女比为2．1：1，20一50岁为高发年龄，上尿路结石明显多于下尿路结石，上、下尿路结石之比为10．5：1。结石成分以混合结石占多数，为325例（71％），其中以草酸钙，磷酸钙与尿酸的混合结石为主。对比混合性结石及单纯性结石发现，各种成分所占比例基本一致。结论结石成分分析对于了解结石成因、预防结石形成和复发具有重要的意义。     

改良面神经额支的体表定位

目的:通过改良的方法对面神经的额支进行体表定位,为临床手术提供更加适用的寻找面神经额支的方法.方法:对20侧防腐成人头部标本进行大体和显微解剖,测量在耳轮上点与外眦上点的连线上和耳屏上切迹点与外眦点的连线上,面神经的额支所经过的相对位置.结果:额支在耳轮上点-外眦上点的连线后段(3/10～4/5)±1/10的范围内跨过,在耳屏上切迹点-外眦点的连线后段(1/5-1/2)±1/9的范围内跨过.结论:面神经额支在两条标志线的特定区域跨过,手术中,切口应避开该危险区域.     

AIDS致进行性多灶性脑白质病的MRI诊断及鉴别

获得性免疫缺陷综合征（acquired immunodeficiency syndrome，AIDS），又称为艾滋病，自美国1981年首次报道以来，艾滋病病毒在全球范围内的传播速度惊人，目前，艾滋病防治已成为我国乃至全球关注的重要公共卫生和社会热点问题。AIDS患者中约40％～50％有神经系统受累，尸检中73％～83％的患者有神经病理异常，其中以神经系统损害为首发症状者约占10％。AIDS引起CNS损害机制有两种：a）人体免疫缺陷病毒（HIV）对神经系统的直接侵犯；b）HIV感染人体后致免疫缺陷造成的机遇性感染或产生继发性肿瘤。     

富氧水防治急性高原病的效果观察

目的:观察饮用富氧水防治急性高原病的效果。方法:36名受试者自海拔1400m驻地乘汽车2天到达海拔3700m当日随机分两组,实验组(18人)口服5%葡萄糖注射液制成的富氧水,对照组(18人)口服5%葡萄糖注射液,均每次500mL,一日2次,直至进入海拔5200m某哨卡第6天,共服液8天。以军用卫生标准GJB1098-91"急性高原反应的诊断和处理原则"随访记录受试者进入哨卡第2天、4天、6天急性高原反应症状,然后分度与评分。同时检测血氧饱和度(SaO2)和脉率。结果:进驻哨卡第2天和第4天实验组较对照组急性高原反应分值减少,而SaO2增高(P<0.05或P<0.01),进驻哨卡第2天实验组较对照组脉率降低(P<0.05)。结论:饮用富氧水有防治急性高原病的效果。