血管紧张素转换酶抑制剂在急性心肌梗塞早期的应用

对２５例急性心肌梗塞（ＡＭＩ）并左心功能不全患者早期应用血管紧张素转换酶抑制剂（ＡＣＥＩ）治疗的对照性临床分析，结果：用小剂量的ＡＣＥＩ治疗对患者心率、血压无显著的影响〔治疗前后心率分别为８９．９０±１０．２２次／分与８９．４２±８．１９次／分，血压分别为１５．３７±３．４６／９．７４±２．３２ｋＰａ（１ｋＰａ＝７．５ｍｍＨｇ）〕和１４．９６±２．６０／９．４６±１．７６ｋＰａ〕；对合并轻、中度泵衰竭患者的疗效显著，但对重度泵衰竭的疗效与对照组比较无显著性差异；治疗组恶性心律失常的发生率较对照组减低１３．３８％，警告性室早的发生率治疗组较对照组减少２６．３９％，但Ⅱ°～Ⅲ°房室传导阻滞的发生率治疗组高于对照组；两组４周病死率比较无显著性差异。作者认为：ＡＣＥＩ治疗ＡＭＩ并轻、中度泵衰竭安全有效；ＡＣＥＩ有一定抗心律失常作用，但应注意传导系统的并发症，使用中应注意各种副作用的发生。     

中国蒙,汉族酒依赖与醇脱氢酶和醛脱氢酶基因多态性的相关研究

为探讨醇脱氢酶（ＡＤＨ）基因和醛脱氢酶（ＡＬＤＨ）基因多态性与酒依赖患病的相互关系，用耳血干血痕聚合酶链反应、等位基因特异性寡核苷酸探针方法，检测乙醇代谢酶ＡＤＨ和ＡＬＤＨ基因型在我国蒙、汉民族酒依赖与非酒依赖者中分布频率。结果显示在酒依赖组（汉族５２例，蒙族３１例）与正常对照组（汉族４８例，蒙族３５例）之间：汉族的ＡＬＤＨ２基因型频率与等位基因频率的分布差异有非常显著性（Ｐ＜０．０１），而蒙族则表示为ＡＤＨ２基因型频率与等位基因频率的分布差异有非常显著性（Ｐ＜０．０１）。这提示汉族酒依赖的发病与ＡＬＤＨ２基因有关，蒙族则与ＡＤＨ２基因有关。     

金尔伦治疗急性颅脑损伤的剂量效应研究

目的探讨金尔伦(盐酸纳洛酮)在治疗大鼠液压脑损伤后神经功能恢复和病理损害程度的剂量效应.方法将104只SD大鼠随机分为4组,伤后早期分别腹腔注射0.03 mg/Kg(小剂量组)、0.3 mg/Kg(中剂量组)、3 mg/Kg(大剂量组)金尔伦和等量生理盐水(对照组),连续7 d.结果中、大剂量组动物伤后脑神经功能恢复、脑水肿减轻程度及光、电镜检查显著优于对照组及小剂量组.结论伤后早期使用中剂量和大剂量金尔伦(盐酸纳洛酮)对大鼠液压颅脑损伤有明显的治疗效果.     

刍议特色学校

特色是学校发展的关键，是学校在当今竞争激烈的职教市场上取得胜算的法宝。特色学校必须有特色专业、特色师资，发现、培养有特长的学生和有特殊技能的人才。     

Genome-wide scan identified QTLs underlying femoral neck cross-sectional geometry that are novel studied risk factors of osteoporosis.

A genome-wide screen was conducted using a large white sample to identify QTLs for FNCS geometry. We found significant linkage of FNCS parameters to 20q12 and Xq25, plus significant epistatic interactions and sex-specific QTLs influencing FNCS geometry variation. INTRODUCTION: Bone geometry, a highly heritable trait, is a critical component of bone strength that significantly determines osteoporotic fracture risk. Specifically, femoral neck cross-sectional (FNCS) geometry is significantly associated with hip fracture risk as well as genetic factors. However, genetic research in this respect is still in its infancy. MATERIALS AND METHODS: To identify the underlying genomic regions influencing FNCS variables, we performed a remarkably large-scale whole genome linkage scan involving 3998 individuals from 434 pedigrees for four FNCS geometry parameters, namely buckling ratio (BR), cross-sectional area (CSA), cortical thickness (CT), and section modulus (Z). The major statistical approach adopted is the variance component method implemented in SOLAR. RESULTS: Significant linkage evidence (threshold LOD = 3.72 after correction for tests of multiple phenotypes) was found in the regions of 20q12 and Xq25 for CT (LOD = 4.28 and 3.90, respectively). We also identified eight suggestive linkage signals (threshold LOD = 2.31 after correction for multiple tests) for the respective geometry traits. The above findings were supported by principal component linkage analysis. Of them, 20q12 was of particular interest because it was linked to multiple FNCS geometry traits and significantly interacted with five other genomic loci to influence CSA variation. The effects of 20q12 on FNCS geometry were present in both male and female subgroups. Subgroup analysis also revealed the presence of sex-specific quantitative trait loci (QTLs) for FNCS traits in the regions such as 2p14, 3q26, 7q21 and 15q21. CONCLUSIONS: Our findings laid a foundation for further replication and fine-mapping studies as well as for positional and functional candidate gene studies, aiming at eventually finding the causal genetic variants and hidden mechanisms concerning FNCS geometry variation and the associated hip fractures.     

女性压力性尿失禁的微创治疗

目的探讨女性压力性尿失禁的发病机制和微创治疗方法。方法女性压力性尿失禁患者25例,经临床、尿动力学检查或膀胱尿道造影确诊,均为稳定性膀胱,无膀胱出口梗阻。采用无张力阴道吊带术(TVT),将吊带无张力置于尿道中段。结果手术时间平均(40±5)min;术中出血量平均(43±10)mL;术后平均留置导尿1.5 d;术后平均住院3 d。23例患者术后尿失禁症状均消失,其中2例患者术后出现尿潴留,留置导尿1周后好转,尿潴留症状消失,尿失禁未复发;2例尿失禁症状显著改善。结论TVT等微创术式因简单、微创、疗效好、并发症少等,目前是女性压力性尿失禁外科手术治疗的发展方向。     

双侧丘脑底核电刺激治疗原发性肌张力障碍

目的 研究双侧丘脑底核（STN）脑深部电刺激术（DBS）治疗原发性肌张力障碍的长期疗效：方法 比较15例行舣侧STN—DBS治疗的原发性肌张力障碍患者，手术前后的Burke—Fahn—Marsden肌张力障碍评分改善程度及长期改善效果。结果 15例原发性肌张力障碍患者中12例在开启刺激器后症状即刻得到部分缓解，以不自主运动、异常姿势及躯体的扭转改善为主，其中9例在刺激1—3d后、3例刺激1，周后改善75％以上，6个月后平均改善92％；1例在2个月后开始改善，6个月后改善90％以上；2例在1个月开始出现轻微改善，6个月后改善了76％：15例患者的长期随访结果显示其疗效稳定，经过1—3次程控后不需经常调整刺激参数：所有患者未出现手术相关并发症及永久性副作用。结论 双侧丘脑底核脑深部电刺激术对原发性肌张力障碍有显著的治疗效果，且疗效持久、稳定，无并发症及永久性副作用。比较GPi—DBS而言，STN—DBS起效快、最件刺激化点及参数易于确定、刺激参数水平低、长期疗效稳定，可能是原发性肌张力障碍DBS治疗的理想靶点。     

显微外科技术在尿道下裂修复中的应用

采用显微外科技术行阴囊纵膈皮瓣尿道下裂修复术18例，均获成功。其手术要点为：将阴茎腹侧纤维索条切除，充分伸展阴茎，皮瓣保留足够长度与宽度，克保血运；在显微镜下采用7－0尼龙丝线缝合，形成皮管，不缝皮肤，只缝皮下。硅胶管支架引流，加压包扎阴茎。本文对手术成功的原因进行了初步讨论。     

Variation of Apolipoprotein A-I in Cirrhosis and its Clinical Value

The serum apolipoprotein A- I (apo A-I) Concentrations in 39 patients with posthepatitis cirrhosis were reported to be 0.87±0.27 g/L lower than that of controls 1.15±0.14 g/L P<0.01. The, decrease of apo. A-I was correlated with the severityof impaired liver function. Apo A- I concentrations in serum correlated positively with decrease of serum albumin (r=0.503 P< 0.01) and negatively with serum bilirubin increase (r=- 0.508 P <0.01) . The data indicate that decreasing of apo A- I concentration may be regarded as one of the reliable indices reflecting the degree of liver function impairment.     

Studies on monoclonal anti-isotypic and anti-idiotypic antibodies against leukemia and myeloma: IV modulation of membrane fluidity of leukemic cell lines and tonsillar cell stimulated with McAbs

Summary In this study the technique of labelling the cell membrane with DPH fluorescence polarization was used to observe the membrane fluidity of B lymphocytic cell lines and tonsillar cells from healthy persons; the modulation effect on membrane-fluidity induced by McAbs against isotypic and idiotypic determinants of IgM from patients with leukemia was studied as well. The expression of the corresponding isotypic and idiotypic determinants of IgM on the cell membrane was determined. The results show that the membrane fluidity of leukemic cell lines is remarkably higher than that of tonsillar cells from healthy persons, and McAbs against isotypic determinants of leukemic IgM can enhance the membrane fluidity of all kinds of cells mentioned above. However, the anti-idiotypic monoclonal antibody increased only the membrane fluidity of leukemic cell lines. These results indicated that there was a close relationship between the effect of McAbs on cell membrane fluidity and the expression of corresponding isotypic and idiotypic determinants of IgM on the cell membrane.