腋淋巴结阴性乳腺癌TGFβl和VEGF表达与预后的相关性研究

目的：探讨转化生长因子(TGF)βl和血管内皮生长因子(VEGF)与腋淋巴结阴性乳腺癌(ANNBC)临床病理及强后的关系。方法：应用免疫组化技术(LDP法)，对56例随访资料完整的女性ANNBC根治标本进行TGFβl和VEGF检测，分析其表达与ANNBC的预后关系。结果：TGFβl和VEGF、表达与ANNBC的年龄、肿瘤大小、病理类型、组织学分级等一般临床病理因素无相关(P＞0．05)，而与肿瘤复发、转移密切相关，TGFβl和VEGF阳性表达的肿瘤复发转移率明显高于阴性表达者(P＜0．01)；TGFβl和VEGF表达呈正相关(P＜0．05)；Cox比例风险模型多因素分析表明，TGFβl和VEGF是影响ANNBC的预后因子，TGFβl和VEGF表达的ANNBC病人预后差。结论：①测定TGFβl和VEGF的表达，对判断ANNBC病人预后及指导治疗有较大的帮助；②TGFβl和VEGF阳性表达与ANNBC血管生成密切相关，是ANNBC复发、转移的重要促进因素。     

经皮顺行交锁钉治疗股骨干骨折

目的:评价经皮顺行交锁钉治疗股骨干骨折的临床疗效.方法:对79例82处股骨干骨折采用髋部小切口经皮顺行交锁钉治疗,观察疗效.结果:75例(92%)获得了良好的解剖对位并达到一期愈合,6例(8%)迟缓愈合.另外,由于再次手术1例(1%)发生了深部感染.失血量较少(平均小于100 mL),切口平均长25 mm.1年后随访只有10%髋部疼痛.结论:与传统手术方式相比,经皮技术术中出血少、对周围组织创伤少,是一个安全又有效的方法.     

Adrenalectomy abolishes antagonism of alpha-adrenoceptor-mediated hypotension by a beta-blocker in conscious rats.

1. The effects of a single bolus injection of propranolol, atenolol or ICI 118,551, non-selective beta-, selective beta 1- and selective beta 2-adrenoceptor antagonists, respectively, on mean arterial pressure (MAP) and plasma catecholamine concentrations were examined in seven groups of conscious and unrestrained adrenalectomized rats receiving a continuous infusion of the alpha-adrenoceptor antagonist phentolamine. In all rats adrenaline was undetectable in the plasma four days after adrenalectomy. 2. In the first three groups, phentolamine significantly decreased MAP and increased the plasma concentrations of noradrenaline. The injection of propranolol, atenolol or ICI 118,551 in Groups I, II and III, respectively, caused a small increase in MAP and a small, but not significant, decrease in plasma noradrenaline concentrations. 3. Groups IV, V and VI were given a continuous infusion of adrenaline for 1 h prior to the infusion of phentolamine, followed by a bolus injection of propranolol, atenolol or ICI 118,551, respectively. Group VII was treated similarly to IV, but was also given daily cortisone replacement after adrenalectomy. Adrenaline slightly, but not significantly, decreased MAP while phentolamine significantly decreased MAP and increased plasma noradrenaline concentrations in all groups. A subsequent injection of a beta-blocker caused a significant increase in MAP in each group and a slight decrease in the plasma level of noradrenaline which reached statistical significance in group VII. The pressor effect of propranolol was significantly greater in the cortisone-treated rats (Group VII) than in Group IV. 5. The results suggest that adrenaline and adrenocortical steroids are both involved in the antagonism of alpha-adrenoceptor-induced hypotension by a beta-blocker.     

动脉栓塞治疗产后出血的临床应用研究

目的评价经导管动脉栓塞术(TAE)治疗产后出血的血管造影表现及疗效。方法65例产后出血患者采用右股动脉Seldinger's穿刺技术,选择性插管至双侧髂内动脉或子宫动脉,行数字减影血管造影(DSA)明确出血原因、部位后用庆大霉素浸泡过的明胶海绵颗粒或条栓塞。结果插管成功率100%,手术时间30～60min,平均45.2±4.8min,术后止血总有效率98.46%。术后随访3～60个月,均无严重并发症发生,子宫体按期复旧,转经后月经正常。结论TAE创伤小,疗效快速肯定,对危及生命的产后出血是一种有效的治疗措施。     

论以服务对象为中心的医院管理道德原则

以服务对象为中心，就是医院管理者在医院工作管理过程中，从维护病人和服务对象的利益出发，将以为服务对象服务，满足服务对象合理医疗保健需求作为医院各项工作的中心，把服务对象至上、一切为了病人和服务对象的医院管理道德要求落实到各项管理措施之中。     

Factors affecting penetration of zona-free hamster ova

The sperm penetration assay is an expensive, time-consuming test to assess male fertility in vitro. Although some investigators are enthusiastic in its application, others feel that it is not sensitive or specific enough to be used as part of the routine infertility evaluation. Indeed, this bioassay is not a faithful reproduction of in vivo conditions. However, if the SPA is abnormal, it is unlikely that sperm will fertilize a human ovum in vivo. Conversely, a normal SPA does not guarantee successful in vivo fertilization. No bioassay can be absolute in its predictive value, but false-negative results must be kept to a minimum for this bioassay to be of any clinical significance. Each laboratory performing the SPA should optimize the assay for sensitivity, reproducibility, and minimization of false-negative results and then establish normal and abnormal ranges of its own. If the limitations of the SPA are kept in mind, and if we employ it very selectively, it may still be useful.     

小剂量芬太尼和氟哌啶静注对吸入七氟醚快速麻醉诱导的影响

为观察小剂量芬太尼和氟哌啶对吸入七氟醚快速麻醉诱导的影响。分别于吸入七氟醚后５ｍｉｎ（第１组）和吸前２ｍｉｎ（第２组）静注小剂量芬太尼（２μｇ／ｋｇ）及氟哌啶（０．１ｍｇ／ｋｇ）。结果：病人意识消失时间第１组（８７±３７）ｓ，第２组（３９±１１）ｓ（Ｐ＜０．０１）；深呼吸次数第１组（１４．０±５．３）次；第２组（４．０±０．７）次（Ｐ＜０．０１）。２组病人诱导及插管过程中循环反应相对较小。提示：在小剂量芬太尼及氟哌啶静注基础上吸入七氟醚继续行麻醉诱导其临床效果更佳，插管反应更小     

Empty sella syndrome in childhood

The empty sella syndrome is common in middle-aged women, usually presenting with headache, and only occasionally associated with endocrine or visual abnormalities. It is rare in childhood. Childhood cases tend to present either with endocrine disturbances, visual symptoms, or with craniofacial syndromes. We present three cases of complete empty sella with childhood onset, each discovered unexpectedly during evaluation of endocrine or visual dysfunction.