CT导向下125I种子源植入治疗恶性肿瘤

目的:探讨CT导向下125I种子源植入治疗恶性肿瘤的安全性及临床疗效。方法:11例患者14个病灶行CT导向下125I种子源植入,其中原发肿瘤5例,转移瘤6例(9个病灶)。根据治疗计划系统(TPS)计算布源,在CT导向下将18.5~29.6MBq活度的125I种子源相隔1.0~1.5cm多层面植入肿瘤内。术后1~10个月复查CT观察种子源在瘤体内的分布、疗效及有无并发症。结果:随诊CT复查,14个病灶完全缓解(CR)5个;明显缓解(OR)7个;部分缓解(PR)2个;无效(P)0。治疗前后病灶平均大小分别为4.23cm和2.07cm(t=5.018,P<0.01)。未见急性并发症和治疗相关的放射损伤。结论:CT导向下125I种子源植入治疗恶性肿瘤是一种安全、有效的方法,近期疗效肯定。     

An analysis of the paradoxical effect of morphine on runway speed and food consumption

A previously reported paradigm in which rats run down a runway for food reward followed by morphine injection was analyzed to assess the utility of the paradigm in studies of opiate reinforcement. One experiment replicated the original report that post-trial morphine caused both an increase in runway speed and a decrease in food consumption (taste aversion) over successive trials, and showed in addition that the increase in runway speed did not occur as a result of food deprivation alone, but required the animals to have consumed food in the goal box. A second study using the quaternary opiate antagonist methyl naltrexone to block the peripheral effects of morphine suggested that the increase in runway speed has a peripheral locus while the taste aversion has a central one. A third experiment in which morphine was microinjected into either the lateral ventricle or the ventral tegmental area supported these observations, in that intracranial morphine failed to result in an increased runway speed, but did produce taste aversion after microinjection into either site. These findings also suggest that the increase in runway speed caused by post-trial morphine in this experiment has a peripheral locus of effect, which is probably distinct from the central effect that supports morphine self-administration and conditioned place preference. Offprint requests to: W.A.CorrigallThe views expressed in this publication are those of the authors and do not necessarily reflect those of the Addiction Research Foundation     

农村院前急救死亡病例调查分析

目的 分析农村院前急救死亡病例的现状及特点，以建立适合农村情况的紧急救援系统。方法 采用本院自行设计的出诊登记表及病历档案，对302例院前急救死亡患者病因、性别、病种，死亡发生的距离及地点等相关因素进行分析。结果 院前急救患者主要死亡原因为创伤（颅脑、复合、脑外伤）96例（31．79％），心血管疾病58例（19．20％），脑血管疾病44例（14．57％），中毒性疾病（有机磷、毒鼠强）40例（13．25％），溺水24例（7．95％），原因不明12例（3．97％），呼吸系统疾病10例（3．31％），新生儿窒息及产后出血10例（3．31％），中署、电击伤、自缢8例（2．65％）。死亡时距市急救中心距离〈5km62例（20．52％），5～km92例（30．50％），16～km108例（35．76％），〉30km40例（13．24％）。结论 需加强农村院前急救建设，合理配置医疗资源，加强基层医护人员全科医学知识和急救医学理论及实践操作的技能培训，以提高农村院前急救患者抢救的成功率。     

上颌骨Le Fort I型截骨进路切除巨大鼻咽纤维血管瘤

目的:探讨上颌骨LeFortI型截骨进路切除累及翼腭凹、颞下凹巨大鼻咽纤维血管肿瘤的可行性。方法:采用矫正上颌骨先天或后天畸形的LeFortI型截骨术式进路,切除位于鼻咽部、筛窦等深在部位的纤维血管瘤。结果:该进路术野显露充分,取得了理想的治疗效果。结论:上颌骨LeFortI型截骨进路是切除鼻咽、颅底部纤维血管瘤的理想进路。     

Nerve growth factor and tyrosine kinase A in human salivary adenoid cystic carcinoma: expression patterns and effects on in vitro invasive behavior.

PURPOSE: Perineural invasion is a frequent occurrence in salivary adenoid cystic carcinoma (ACC) and may prevent complete surgical resection. Studies have indicated that nerve growth factor (NGF) and its high-affinity receptor tyrosine kinase A (TrkA) may play a role in perineural invasion in several malignancies in which perineural invasion is observed. The present study was conducted to investigate the expression of NGF and TrkA in salivary ACC and to examine the effects of NGF on adhesion, migration and invasion capacities of a salivary ACC cell line (SACC-83) in vitro. PATIENTS AND METHODS: Expression of NGF and TrkA was explored using immunohistochemistry in paraffin-embedded tissues of 32 cases of salivary ACC. The effects of NGF on in vitro adhesion, migration, and invasion capacities of the SACC-83 cell line were examined using an MTT assay and a modified Boyden chamber assay respectively. RESULTS: In ACC specimens, 31 (96.9%) and 32 (100%) tumors showed immunoreactivity for NGF and TrkA respectively. Significant correlations were found between NGF/TrkA expression levels and perineural invasion (P < .05). In cell adhesion assay, the percent adherences of SACC-83 cells co-cultured with 25 ng/ml NGF at 1.5 hours and 5, 25 ng/ml NGF at 6 hours were significantly higher than that co-cultured with 0 ng/ml NGF (P < .05). However, high concentration of NGF (500 ng/ml) resulted in a significant inhibition of invasion (P < .05). CONCLUSION: Overexpression of NGF and TrkA in human salivary ACC tissues may constitute a reason for perineural invasion in salivary ACC.     

反相高效液相色谱法测定洛氟沙星的血药浓度

采用反相ＨＰＬＣ法测定洛氟沙星的血药浓度，血浆样品用二氯甲烷在ｐＨ７．０条件下提取后进样，流动相为１０ｍ ｍｏｌ／Ｌ磷酸二氢钾－１０ｍ ｍｏｌ／Ｌ溴化四丁铵－乙腈－三乙胺（４５：４４：１０：１，磷酸调节ｐＨ２．８），紫外检测器λ＝２９５ｎｍ，最低检测浓度１０μｇ／Ｌ，线性范围：０．１￣６．０ｍｇ／Ｌ，ｒ＝０．９９９９，日内ＲＳＤ为１．３８％￣３．４２％，日间ＲＳＤ为１．１１％￣２．８９％。     

老年男性心肌缺血患者心率变异分析（附67例报告）

采用正常搏动ＲＲ间期的标准差（ＳＤ）及心率变异指数（ＨＲＶ ｉｎｄｅｘ）作为指标，分析６７例老年男性心肌缺血患者的心率变异，并与正常老年男性组及正常青壮年男性组进行了对比，发现前组的ＲＲ间期ＳＤ、ＨＲＶｉｎｄｅｘ均明显低于后两组，其结果有显著性差异（Ｐ均〈０．０１）。提示心肌缺血可破坏交感与迷走神经的均衡性，造成心率变异降低。     

5km重复低压缺氧对小鼠肝脏及脾脏中微量元素的影响

目的 探讨5km重复低压缺氧对小鼠肝脏及脾脏中微量元素的影响。方法 将小白鼠分为5km重复低压缺氧实验组及地面对照组。实验组每天进行5km重复低压缺氧30min,连续7d后，处死小鼠，取肝脏、脾脏烘干至恒重，采用火焰原子吸收法测定锌、铜、铁。结果 5km重复低压缺氧小鼠肝脏中Cu、Fe含量与对照组比较有显差异(P＜0．05)；脾脏中微量元素Fe的含量与对照组比较有显性差异(P＜0．05)。结论 5km重复低压缺氧，使肝脏中Fe、Cu含量降低，脾脏中Fe含量升高。     

脐带缠绕与新生儿窒息及分娩方式

目的 探讨脐带缠绕与新生儿窒息及分娩方式的关系。方法 回顾性分析2001年5月于2002年4月脐带缠绕246例，与同期分娩的无脐带缠绕者800例进行对照性研究。结果 脐带缠绕组新生儿窒息和剖宫产率高于对照组，差异有显著性（P＜0．05，P＜0．01）；脐带越长，脐带缠绕率越高；脐带长度正常，新生儿窒息率低，脐带过长及过短，新生儿窒息率高；脐带缠绕周数越多，新生儿窒息率越高，差异有显著性（P＜0．01）。结论 脐带缠绕与脐带长度有关，脐带缠绕可导致新生儿窒息，故对脐带缠绕者应加强产前诊断及产时监护。     

肾脂肪肉瘤(附三例报告及文献复习)

本文报道三例肾脂肪肉瘤,并结合文献复习,讨论了其病理,临床表现、影像学特征、诊断和治疗。