胸锁乳突肌肌皮瓣在舌癌根治术后舌缺损修复中的应用

目的:总结中晚期舌癌根治性切除即时进行舌再造的经验。方法:对1988年1月至2004年12月间舌癌根治术后即刻修复采用的胸锁乳突肌皮瓣的临床资料进行分析。结果:14例皮瓣全部成活。再造舌外形大部分良好,语言和吞咽功能基本恢复。结论:以胸锁乳突肌肌皮瓣修复中晚期舌癌根治性切除后的舌缺损,可较好恢复舌的形态和功能,提高生存质量。     

两种不同方法定位肌间沟臂丛神经阻滞的临床观察

目的 观察经肩胛舌骨肌定位和运用神经刺激器定位肌间沟臂丛神经阻滞两种方法的临床效果。方法 选择ASAⅠ-Ⅱ级的择期上肢手术患者60例，随机分为两组：I组（30例）通过肩胛舌骨肌定位穿刺点寻找异感；Ⅱ组（30例）使用神经刺激器定位肌间沟臂丛神经，观察肌肉节律性收缩。两组分别观察进针深度，阻滞效果及不良反应。I组还同时观察肩胛舌骨肌触摸难易度，穿刺部位以及一次异感获得率等。结果 I组肩胛舌骨肌触摸容易者27例（90％），穿刺部位距锁骨上缘1.6-3.1cm，进针深度0.5-1.5cm，一次获得异感26例（87％），阻滞效果完善，无不良反应。Ⅱ组有28例阻滞完善，另2例阻滞不全，2例出现不良反应。结论 运用神经刺激器定位肌间沟臂丛神经阻滞切实可行。而以肩胛舌骨肌定位肌间沟臂丛神经阻滞定位明确，效果满意，简单易行。     

网络化人类精子库管理信息系统的建立与应用

目的 :建立网络化人类精子库管理信息系统。　方法 :用SQLServer2 0 0 0和PowerBuilder 8.0开发人类精子库管理信息系统。　结果 :系统形成了档案管理、体检与检查管理、检验与冷冻管理、供应与随访管理 4个模块 ,系统以远程传输与实时监控的方法控制和管理供应点。　结论 :本系统具有数据容量大、安全性能好、保密性能强 ,具有远程传输与实时监控功能     

干细胞动员对骨创伤大鼠免疫功能的保护作用

目的：观察自体干细胞动员对骨创伤大鼠的免疫功能的保护作用，为战创伤后的免疫抑制及继发性感染、系统性炎症反应等治疗提供依据。方法：挤压折断法复制大鼠双后肢股骨骨折模型，于致伤后0、24、48h连续给模型动物肌肉注射GM—CSF20μg／kg，致伤后72h细胞增殖法检测T、B淋巴细胞活性，ELISA法检测血清IL-1、IL-2、IFN-7、TNF—α浓度，自动系列化分析法检测C3、CA、IgM、IgG浓度，称重法观察脾重与体重的比例变化。结果：股骨骨折模型大鼠致伤后72h，GM—CSF动员骨髓干细胞组大鼠的T、B淋巴细胞活性和血清IFN-γ、IL-2浓度高于对照组（P〈0．01），IL-1、TNF—α浓度低于对照组（P〈0．01），血清C3、CA、IgM、IgG浓度及脾／体重比值高于对照组（P〈0．01）。结论：GM—CSF动员自体干细胞动员对大鼠骨创伤诱导的免疫功能抑制具有保护作用。     

Differential risks of subsequent vascular events for transient ischaemic attack and minor ischaemic stroke.

Using a prospective hospital-based registry, 146 patients with transient ischaemic attack (TIA) were compared with 376 patients with minor first-ever ischaemic stroke with respect to the 3-month risk of subsequent vascular events, in order to clarify the distinctions between the disease entities. All patients were enrolled within 48 h of onset. The risk factor distribution for the two groups was comparable, except that the TIA patients had more previous TIAs. Large artery atherosclerosis (34%) and small vessel occlusion (32%) were the main aetiologies in the TIA group, whereas small vessel occlusion (49%) was the major cause in the stroke group. The 3-month risk of combined endpoints of stroke, myocardial infarction, and vascular death for TIA patients was higher than that for the minor stroke group (15.1% vs. 3.2%; hazard ratio 4.6, 95% confidence interval 2.3-9.3 in multivariate analysis). Large artery atherosclerosis and male sex were the other significant predictors. TIA may demand more urgent management than minor stroke. The fact that aetiology is a predictor, highlights the need for rapid diagnostic tests to establish pathogenesis.     

Analysis of Implantation in Assisted Reproduction Through the Use of Serial Human Chorionic Gonadotropin Measurements

Purpose: Our purpose was to examine implantation of singleton pregnancies achieved following various assisted reproductive technologies (ARTs) through the appearance and rising titers of serum human chorionic gonadotropin (hCG) levels. Methods: A total of 114 singleton pregnancies resulting from in vitro fertilization and intrauterine insemination was analyzed. Patients were divided into five groups according to the type of ovarian stimulation protocol [gonadotropin stimulation with/without the use of gonadotropin-releasing hormone agonist (GnRHa), long protocol, or flare-up technique] and to the day of embryo transfer (day 2 or day 3 after oocyte retrieval). Serial serum hCG levels were measured between 10 and 25 days after fertilization and log-transformed. Linear regression analyses were performed and extrapolated to hCG = 10 mIU/ml (hCG ₁₀ ), which was used as an estimate of detectable implantation. The slopes of the regression lines were used to estimate the rising speed of hCG. Results: There were no significant differences in the days of hCG in maternal serum to reach 10 mIU/ml (implantation) or in the slopes of the regression lines for all five studied groups. Conclusions: The appearance of hCG in maternal serum was used to assess the time of clinically detectable implantation. Furthermore, because hCG production is a marker of trophoblastic activity, its serum doubling time was used as an indicator of embryo quality. Results showed that in various ART protocols with and without GnRHa, there were no significant differences in implantation time or embryo quality. Embryo development in early pregnancy follows a preprogrammed-timing schedule and depends mainly on the embryonic age of the health, successfully implanted conceptus.     

环氧化酶-2基因启动子甲基化及表达与胃黏膜病变的关系

目的 探讨环氧化酶2(COX-2)基因启动子区甲基化水平和蛋白表达与胃黏膜病变的关系,并对其相关的影响因素进行研究.方法 以1201例患有不同胃黏膜病变的高危人群为研究对象,采用免疫组织化学方法榆测COX-2表达,用亚硫酸氢钠-变性高效液相色谱(DHPLC)对COX-2启动子甲基化率进行定量分析,采用13C尿素呼气实验(13C-UBT)对幽门螺旋杆菌(H priori)感染状况进行测定.结果 COX-2甲基化率中位数随胃黏膜病变的加重逐渐升高,在浅表性胃炎和慢性萎缩性胃炎(SG/CAG)、肠上皮化生(IM)及不确定性异型增生和异璎增生(Ind DYS/DYS)病变中分别为10.6%、11.8%、13.8%,各病变组之间差异有统计学意义(X2=8.312,P=0.016).分层分析显示,在H pylori感染阴性病例中,COX-2甲基化率仍随病变加重明显升高,在SG/CAG、IM、Ind DYS/DYS病变中其中位数分别为8.8%、10.6%、14.1%(X2=6.629,P=0.036).进一步分析发现,COX-2甲基化率随着COX-2表达强度的增强而降低,由COX-2弱阳性表达的13.3%降至强阳性表达的7.6%(X2=10.400,P=0.015).结论 COX-2启动子甲基化水平与胃黏膜病变程度及H pylori感染状况密切相关,并与COX-2表达强度呈负相关,说明COX-2启动子区异常甲基化可能在胃黏膜病变的演变过程中起重要作用.     

构建玻片蛋白质芯片的实验研究

目的:探讨玻片蛋白质芯片的构建方法及其中间操作条件的选择与优化。方法:利用生物芯片点样仪将超微量蛋白质点到经特殊处理的玻璃片表面,然后选用不同的化学试剂对玻片背景进行封闭;再用荧光素标记的蛋白质与点样蛋白杂交;最后用生物芯片分析仪扫描成像并进行分析,比较不同条件下芯片的显示效果。结果:蛋白质样品与片基稳定结合,并保持原活性状态;封闭试剂选用酪蛋白或明胶效果较佳;点样探针与其特异蛋白质抗体可稳定结合,结合效果与点样蛋白浓度在一定范围内呈正相关;在1.6 cm×1.6 cm的玻璃片面积上,构建了36×36=1269点的蛋白质芯片。结论:本实验条件下,蛋白质抗原或抗体可以稳定地固定于经过处理的玻璃片表面.制成免疫型蛋白芯片,并可通过随后的抗原抗体反应与荧光素标记的相应抗体或抗原结合,用生物芯片分析仪可对其荧光信号进行检测分析。     

TSG-6基因在3T3-L1脂肪细胞诱导分化中表达水平的变化

[目的] 探讨TSG-6基因在3T3-L1脂肪细胞诱导分化中表达水平的变化。[方法] 采用细胞培养和RT-PCR技术，检测细胞诱导分化不同时段脂肪细胞中TSG-6基因的表达水平。[结果] ①随着脂肪细胞逐渐分化成熟，TSG-6基因mRNA表达水平逐渐升高；②TSG-6基因表达水平除在细胞分化第0-2d、第3-5d和第7-10d各时段内差异无显著性(P＞0.05)外，其余各时段之间表达水平差异均有显著性(P＜0.05)。[结论] TSG-6基因与细胞分化以及脂原形成可能相关。     

经蝶垂体腺瘤手术后残留原因分析

目的：探讨经蝶切除垂体腺瘤手术后残留的原因，提高治疗效果；方法：回顾性分析自1992年10月至2003年1月，在我院及外院经蝶手术治疗后，MRI检查证实仍有残留的118例垂体腺瘤。结果：肿瘤主体残留在海绵窦占46．6％，鞍内37．3％，鞍上5．1％，混合9．3％，颅外1．7％；影响肿瘤根除的主要因素，肿瘤侵袭海绵窦46．6％，术者经验不足36．4％，肿瘤侵润生长9．3％，肿瘤体积巨大3．4％，出血多4．2％。针对残余瘤组织再手术者为10．1％，普通放射治疗39．0％，r刀治疗38．2％，药物治疗11．0％。结论：经蝶手术残瘤的主要原因是肿瘤侵袭海绵窦，这些病例不能或很难单纯手术根除；其次是术者经验不足和技术问题而造成。在有残瘤的病例中，有半数以上病例可以通过提高技术水平达到肿瘤的全切或次全切除。