良、恶性脑膜瘤性激素受体和外源凝集素受体的检测

采用 ABC 免疫组化技术对82例脑膜瘤活检组织(良性脑膜瘤67例、恶性脑膜瘤15例)进行了三种性激素受体和12种 LR 的测定.结果证实脑膜瘤是性激素的靶组织,ER阳性率74.4%,PR 阳性率75.6%。AR 阳性率29.3%.ER 阳性率与性别有关,女性高于男性;PR 阳性率与组织类型有关,脑膜内皮型阳性率最高,过渡型居中,而纤维母细胞型及砂粒体型阳性率较低;AR 阳性率与组织分化程度有关,恶性脑膜瘤中 AR 阳性率高于良性脑膜瘤中 AR 阳性率.这些结果为进一步探讨性激素受体在脑膜瘤的生物学行为上所起的作用及对脑膜瘤实施内分泌治疗提供理论依据.12种 LR 中只有 PSA 受体在良性脑膜瘤中的阳性率高于恶性脑膜瘤,故这一结果可作为良、恶性脑膜瘤诊断的依据.三种性激素受体与 LR 染色结果经配对卡方检验证明无相关性,因此 LR 的测定不能代替性激素受体的测定.     

电视胸腔镜胸腺切除治疗重症肌无力症

目的探讨电视胸腔镜手术(video-assisted thoracoscopic surgery,VATS)胸腺切除治疗重症肌无力症(myasthenia gravis,MG)的可行性. 方法 18例MG采用VATS经右胸前侧径路行胸腺切除联合纵隔脂肪清扫. 结果 17例顺利完成手术,1例因电凝钩伤及左头臂静脉干而中转开胸止血.平均手术时间105 min,术中失血量平均80 ml.全组无术后死亡及危象发生.18例随访1～20个月,平均11.3个月.按Osserman疗效评价,缓解5例(27.8%),明显改善6例(33.3%),部分改善4例(22.2%),无变化3例(16.7%),有效率83.3%(15/18). 结论 VATS经右胸前侧径路行完全胸腺切除可行,且具有创伤小、恢复快等优点.     

50例冠心病某些生化基础观测的临床诊断意义

对５０例冠心病患者进行某些生化基础观测，发现冠心病肾阴虚与糖耐量减低有关，肾阳虚患者尿１７－羟低於正常；而冠心病标证有其生化基础，与甘油三酯增高有密切相关。     

汉族、哈萨克族Graves病患者血清CoL IV、LN和HA测定分析

用放免法(单克隆抗体)测定汉、哈萨克族Graves病未经治疗患者66例及正常对照组55例血清中Ⅳ型胶原(CoLⅣ)、板层素(IN)和透明质酸(HA),结果Graves病患者血清CoLⅣ、LN浓度明显升高,HA浓度明显降低,与正常对照组相比均有显著性差异(分别P<0.001、P<0.05、P<0.05),汉族与哈萨克族患者之间、对照组之间相比均无显著性差异(P>0.05),它反映了Graves病患者体内基底膜合成和分解代谢紊乱。     

Analysis of deaths in patients awaiting heart transplantation: impact on patient selection criteria.

OBJECTIVE: To analyse the clinical characteristics of patients who died on the Stanford heart transplant waiting list and to develop a method for risk stratifying status 2 patients (outpatients). METHODS: Data were reviewed from all patients over 18 years, excluding retransplants, who were accepted for heart transplantation over an eight year period from 1986 to 1994. RESULTS: 548 patients were accepted for heart transplantation; 53 died on the waiting list, and 52 survived on the waiting list for over one year. On multivariate analysis only peak oxygen consumption (peak VO2: 11.7 (SD 2.7) v 15.1 (5.2) ml/kg/min, P = 0.02) and cardiac output (3.97 (1.03) v 4.79 (1.06) litres/min, P = 0.04) were found to be independent prognostic risk factors. Peak VO2 and cardiac index (CI) were then analysed in the last 141 consecutive patients accepted for cardiac transplantation. All deaths and 88% of the deteriorations to status 1 on the waiting list occurred in patients with either a CI < 2.0 or a VO2 < 12. In those with a CI < 2.0 and a VO2 < 12, 38% died or deteriorated to status 1 in the first year on the waiting list. Patients with CI > or = 2.0 and a VO2 > or = 12 all survived throughout follow up. Using a Cox's proportional hazards model with CI and peak VO2 as covariates, tables were constructed predicting the chance of surviving for (a) 60 days and (b) 1 year on the waiting list. CONCLUSIONS: These data provide a basis for risk stratification of status 2 patients on the heart transplant waiting list.     

血管内氧合器的研制

为了探索呼吸辅助的新方法，我们采用国产聚丙烯中空纤维，自行设计、制造模具，研制出一种血管内氧合器。该氧合器是一个小的、细长的可经单侧股静脉或颈静脉切开，置入腔静脉内的装置。氧合器有效长度４０ｃｍ，膜交换面积０．０９ｍ＾２。经负压调节通过血管内氧合器的氧流量，以防止纤维破裂造成的血管内气栓的危险。一根双腔导气管使气体经同一静脉切开部位循环，气体经内芯管流经血管内氧合器尖端，然后经中空纤维束流出。目前     

Characterization of adhesive interactions between human endothelial cells and megakaryocytes.

Cell-cell adhesion is essential for many immunological functions and is believed to be important in the regulation of hematopoiesis. Adhesive interactions between human endothelial cells and megakaryocytes were characterized in vitro using the CMK megakaryocytic cell line as well as marrow megakaryocytes. Although there was no adhesion between unactivated human umbilical vein endothelial cells (HUVEC) and megakaryocytes, treatment of HUVEC with inflammatory cytokines such as IL-1 beta, tumor necrosis factor alpha, INF-gamma, or the phorbol ester phorbol myristate acetate (PMA) resulted in a time- and dose-dependent increase in adhesion. Stimulation of marrow megakaryocytes or CMK cells with the cytokines IL-1 beta, GM-CSF, IL-6, IL-3, or PMA augmented their adhesion to endothelium. Monoclonal antibodies against the LFA-1 subunit of the leukocyte adherence complex CD18 inhibited the binding of marrow megakaryocytes or CMK cells to HUVEC. Adhesion blocking experiments also demonstrated that the VLA-4/VCAM-1 pathway was important for megakaryocyte attachment to HUVEC. Adhesion promoted maturation of megakaryocytic cells as measured by increased expression of glycoproteins GpIb and GpIIb/IIIa and by increased DNA content. These observations suggest that alterations in megakaryocyte adhesion may occur during inflammatory conditions, mediated by certain cytokines, resulting in augmented megakaryocyte maturation.     

El Tor型霍乱弧菌L型的某些生物学性状

本研究主要对El Tor型霍乱弧菌(Vibrio cholerae biotvpe eltor,EVC)L型的某些生物学特性如生化反应、抗生素敏感性及超微结构等进行了探讨.研究发现EVC不稳定L型的生化性状与EVC流行株的非常相似,而稳定L型则变化很大.抗生素敏感性试验显示EVC稳定L型对某些作用于细胞壁的抗生素的敏感性减弱,而对大多数作用于蛋白质合成的抗生素的敏感性增强.与流行株相比,EVC稳定L型和不稳定L型的超微结构的改变很明显.此外,本文还讨论了产生这些改变的可能机制.     

原发性干燥综合征与人类组织相容性抗原—DRβ基因

原发性干燥综合征（ＰＳＳ）的病因未明，其中可能涉及遗传因素。用序列特异性引物聚合酶链反应（ＰＣＲ－ＳＳＰ）法对７０例ＰＳＳ患者和１３６名正常人进行人类组织相容性抗原（ＨＬＡ）－ＤＲβ基因分型。发现ＰＳＳ患者群体的ＨＬＡ－ＤＲ３、ＤＲ５２及ＤＲ２的基因频率明显高于正常对照组，而ＨＬＡ－ＤＲ５及ＤＲ９的基因频率则相反，提示ＰＳＳ的发病与ＤＲ３、ＤＲ５２及ＤＲ２呈正相关；而和ＤＲ９、ＤＲ５呈负相关。２个ＰＳＳ患者家族的姐妹与患者具有相同的遗传因素，且和ＰＳＳ患者群体测定的正相关基因相一致。ＰＳＳ患者的主要自身抗体（抗ＳＳＡ抗体及抗ＳＳＢ抗体）与ＨＬＡ－ＤＲ５２之间有明显的相关性，因而表明ＰＳＳ的发病和遗传因素有关。     

Population toxicokinetics of tetrachloroethylene

 In assessing the distribution and metabolism of toxic compounds in the body, measurements are not always feasible for ethical or technical reasons. Computer modeling offers a reasonable alternative, but the variability and complexity of biological systems pose unique challenges in model building and adjustment. Recent tools from population pharmacokinetics, Bayesian statistical inference, and physiological modeling can be brought together to solve these problems. As an example, we modeled the distribution and metabolism of tetrachloroethylene (PERC) in humans. We derive statistical distributions for the parameters of a physiological model of PERC, on the basis of data from Monster et al. (1979). The model adequately fits both prior physiological information and experimental data. An estimate of the relationship between PERC exposure and fraction metabolized is obtained. Our median population estimate for the fraction of inhaled tetrachloroethylene that is metabolized, at exposure levels exceeding current occupational standards, is 1.5% [95% confidence interval (0.52%, 4.1%)]. At levels approaching ambient inhalation exposure (0.001 ppm), the median estimate of the fraction metabolized is much higher, at 36% [95% confidence interval (15%, 58%)]. This disproportionality should be taken into account when deriving safe exposure limits for tetrachloroethylene and deserves to be verified by further experiments. Received: 20 April 1995/Accepted: 24 August 1995