芦沙坦和苯那普利对高血压大鼠左室肥厚的抑制作用

目的：研究芦沙坦及苯那普利对老龄前期自发性高血压大鼠（SHR）左室肥厚及丝裂素活化蛋白激酶（MAPK）的抑制作用。方法：将老龄前期SHR随机分为SHR对照组，苯那普利（10mg.kg^-1.d^-1）及芦沙坦（30mg.kg^-1.d^-1）治疗组，治疗期为3个月，每月测压一次，治疗结束后处死动物，测定心肌肥厚指标、血中及心肌中内皮素（ET）、血管紧张素AⅡ及MAPK。结果：苯那普利及芦沙治疗后血压、心肌肥厚指标、血中及心肌中内皮素（ET）及MAPK明显低于SHR相对照组（P＜0．01），芦沙坦组血中及心肌中AⅡ无下降。结论：AⅡ、ET及MAPK参与了SHR的血压升高及心肌肥厚的形成。苯那普利及芦沙坦有抑制AⅡ、ET及MAPK的活性，从而达到降压及逆转心肌肥厚的作用。     

滋肾通利胶囊治疗泌尿系感染临床研究

目的：观察滋肾通利胶囊治疗泌尿系感染的临床疗效。方法：随机设对照组（120例）和治疗组（136例）,对照组根据药敏选用抗生素口服或静脉滴注,治疗组在上述基础上加用滋肾通利胶囊治疗。2周为1疗程,两个疗程后统计疗效;1年后对复发率进行比较。结果：治疗组总缓解率96.3%,对照组81.7%（P〈0.05）;1年后治疗组复发率4.4%,对照组30.0%（P〈0.01）。结论：滋肾通利胶囊对泌尿系感染有良好作用,长期疗效尤其显著。     

概念式教学法实施中临床教师态度与行为调查

目的探讨概念式教学法实施中临床教师的态度与行为状况。方法将2001级33名护生分为对照组，2002级、2003级27名护生分为观察组。对照组采用传统教学法，即理论授课毕后再行临床实习；观察组采用概念式教学法，即理论授课与临床实习同期进行。采用临床教师态度和行为调查问卷评价临床教师的态度与行为。结果观察组专业胜任、人际关系、人格特质、教学能力等4项内容评价结果．显著低于对照组（均P〈0．01）。结论概念式教学模式给临床护理教师提出了更高的要求，临床教师应从专业胜任、人际关系、人格特质、教学能力等方面进行态度与行为的修正和自我完善。     

17β-雌二醇对大鼠脊髓损伤后神经保护作用的研究

目的：探讨17β-雌二醇（E2）对大鼠脊髓损伤（SCI）后的神经保护作用及其机制。方法：应用改良的Allen′s重物打击法建立大鼠急性脊髓损伤模型,将大鼠随机分为两组：A组（PBS对照组）和B组（E2治疗组）,每组42只,B组造模成功后15min及24h腹腔注射E2（4.0mg/kg,以PBS溶解）,A组在相同时间给予等量无菌PBS。分别于伤后7d、14d、21d及28d,应用改良Tarlov评分法和Rivlin斜板试验评价大鼠脊髓神经功能恢复情况。于伤后6h、24h、3d、7d、14d及28d时处死动物,以损伤部位为中心取材,HE染色观察脊髓组织病理变化,TUNEL法染色检测细胞凋亡,免疫组化染色检测caspase-3、Bcl-2的表达情况。结果：从伤后14d起,B组Tarlov评分和斜板试验角度与A组相比差异有显著性（P〈0.01）。TUNEL法检测表明,大鼠SCI后存在细胞凋亡,3d时达高峰,与caspase-3的表达基本一致,B组伤后24h、3d及7d时凋亡细胞比率显著低于A组（P〈0.01或P〈0.05）。免疫组化结果显示B组伤后24h、3d、7d、14d及28d时caspase-3表达低于A组（P〈0.01或P〈0.05）,而Bcl-2表达高于A组（P〈0.01或P〈0.05）。结论：E2能促进大鼠SCI后的神经功能恢复,具有一定的神经保护作用;E2可能是通过减少SCI后继发性细胞凋亡的机制发挥作用的。     

血半胱氨酸蛋白酶抑制剂C水平对急性脑血管病患者早期肾损害的诊断价值

目的探讨急性脑血管病患者早期肾损害的机制及早期监测指标。方法对194例急性脑血管病患者(包括脑梗死129例,脑出血65例)及60例正常对照者同时测定血半胱氨酸蛋白酶抑制剂C(Cys-C)和血肌酐(SCr)浓度,对其中血Cys-c浓度增高但SCr浓度正常的48例急性脑血管病肾早期损害患者用甘露醇治疗,并检测治疗前后血Cys-c浓度。结果在早期肾损害组,血Cys-c浓度明显高于对照组(P<0.001),而SCr浓度2组无显著性差异(P>0.05)。48例急性脑血管病肾早期损害者经甘露醇治疗后,血Cys-c浓度较治疗前明显降低(P<0.001)。结论血清Cys-c测定有助于早期发现肾功能损害,治疗脑血管病的同时应注意监测肾功能。     

Contribution of genetic factors for melanoma susceptibility in sporadic US melanoma patients

Abstract:  The risks of developing malignant melanoma (MM) include ultraviolet irradiation and genetic factors. To examine the contribution of rare and common variation within known MM genes in sporadic US MM patients, coding regions of known MM susceptibility genes [cyclin-dependent kinase inhibitor 2A ( CDKN2A ), cyclin-dependent kinase 4, melanocortin 1 receptor ( MC1R ) and tyrosinase ( TYR )] were resequenced in 109–135 MM cases. The significance of variants was examined by comparing their frequencies in 390 cancer-free controls. Potential deleterious mutations in CDKN2A were found in two patients and two others had variants of unknown significance. Cases were more likely than controls to harbour the MC1R 'R' variants known or predicted to alter its function ( P  = 0.002), particularly the R160W variant ( P  = 0.0035). The associated TYR R402Q variant (rs1126809*A) was found in 29% of cases, similar to what has been described previously. One MM patient with a family history of MM, who had developed other skin cancers, was homozygous for a novel TYR variant (P406L) of unknown significance. Hence, rare variants in TYR may be important risk factors for skin cancer.     

病理性瘢痕裸鼠模型的建立

目的 验证所构建裸鼠瘢痕疙瘩和增生性瘢痕模型在病理性瘢痕研究中的可行性。方法 将0．8cm×0．8cm×0．5cm的人瘢痕疙瘩和增生性瘢痕组织块移植到裸鼠皮下，大体观察裸鼠及植入物情况。移植后第16天取出移植物与原标本进行下列指标的比较：体积、瘢痕的镜下特征、酸性黏多糖含量及Ⅰ、Ⅱ型胶原含量。结果 移植后裸鼠全部存活且创面愈合良好。瘢痕疙瘩、增生性瘢痕组织块的酸性黏多糖含量移植前分别为3448±1452、1940±509，移植后分别为3237±1871、1809±552，移植前后比较，差异无统计学意义（P〉0．05）。植入物保持着原有的胶原特性及含量，未检测到细胞变性坏死。结论 增生性瘢痕和瘢痕疙瘩以适当体积移植到裸鼠皮下，其生物学特性可在一定时间内保持稳定，该动物模型适用于病理性瘢痕的临床研究。     

增生性瘢痕中血管内皮细胞生物学功能的研究

目的 探讨增生性瘢痕中血管内皮细胞的生物学功能及其与瘢痕形成的关系。方法 取人增生性瘢痕组织和正常皮肤组织，进行组织学观察。分离和纯化2种标本中的血管内皮细胞，应用酶联免疫吸附测定法分别检测单个血管内皮细胞中转化生长因子β1，（TGF-β1）、成纤维细胞生长因子2（FGF2）、血小板源性生长因子（PDGF）、内皮素1（ET-1）和血管内皮生长因子（VEGF）的水平。结果光学显微镜下可见正常皮肤微血管数目较少；增生性瘢痕微血管数目增多，血管狭长扭曲甚至闭塞。透射电镜可见增生性瘢痕中毛细血管管腔狭窄，有内皮细胞脱落。增生性瘢痕中血管内皮细胞分泌TGF-β1、PDGF、ET-1、VEGF、FGF2的水平分别为（60±8）、（30±4）、（0．12±0．03）、（52±5）、（18．1±1．2）μg／个细胞，明显低于正常皮肤（P〈0．05）。结论 增生性瘢痕中血管内皮细胞生物学功能减退，可能与瘢痕中胶原的大量产生和缺氧有关。     

CD44v7/8基因表达与宫颈癌关系的探讨

目的探讨宫颈癌组织中CD44v7/8基因的异常表达及临床意义。方法1986～2000年沈阳医学院附属中心医院采用免疫组化的方法随机测定59例宫颈癌、18例尖锐湿疣和18例慢性宫颈炎组织中CD44v7/8基因的表达情况。结果宫颈癌、尖锐湿疣及慢性宫颈炎3种疾病中CD44v7/8表达阳性率分别为76.27%、11.11%和11.11%,宫颈癌组的CD44v7/8表达分别高于慢性宫颈炎组及尖锐湿疣组,且差异非常显著(P<0.01)。慢性宫颈炎组及尖锐湿疣组比较差异无显著性(P>0.05)。结论CD44v7/8蛋白的表达增强与宫颈癌的发生、发展及和局部浸润转移有关。     

SNAP-II predicts mortality among infants with congenital diaphragmatic hernia.

OBJECTIVE: Outcomes analysis in congenital diaphragmatic hernia (CDH) requires a validated risk-adjustment tool. The purpose of this study was to use the Canadian Neonatal Network (CNN) database to validate the Score for Neonatal Acute Physiology, Version II (SNAP-II) for prediction of mortality among CDH infants admitted to a neonatal intensive care unit (NICU), and to compare this to the predictive equation recently developed by the Congenital Diaphragmatic Hernia Study Group (CDHSG). STUDY DESIGN: Infants with CDH in the CNN database were identified. Bivariate and multivariable logistic regression models were used to identify risk factors predictive of mortality. Model predictive performance and calibration were assessed using the area under the receiver operator characteristic curve and the technique of Hosmer-Lemeshow, respectively, and compared with the CDHSG predictive equation. RESULTS: There were 88 patients with CDH among 19,507 admissions to CNN hospitals. The mortality rate among CDH patients surviving to NICU admission was 17%, and 12.5% received extracorporeal membrane oxygenation therapy. Gestational age and admission SNAP-II score predicted mortality. Model predictive performance and calibration were optimized with these variables combined. The CDHSG equation was equally predictive of mortality, but was only marginally calibrated. CONCLUSIONS: SNAP-II is highly predictive of mortality among patients with CDH, and can be used to risk-adjust these patients.