原发性输尿管癌31例临床分析

目的：提高原发性输尿管癌的术前诊断水平。方法：对南京医科大学第一附属医院1989-2002年间收治的31例原发性输尿管癌的临床资料进行回顾性分析。结果：31例中，肉眼血尿22例(71．0％)，腰痛11例(35，5％)。B超、静脉肾盂造影(IVU)、CT和逆行造影检查的阳性率分别为输尿管腔内占位4例(13．0％)、输尿管腔内占位3例(11．5％)、膀胱或合并膀胱占位8例(36．4％)，输尿管充盈缺损6例(40．0％)。29例患者经手术治疗，其中13例行患侧肾、输尿管、膀胱袖状切除。结论：老年患者反复发作的腰痛及血尿应考虑原发性输尿管癌的可能，造影诊断对本病有较高价值，应作CT及MRU无创检查。     

49Sibutramine accelerates gastric emptying, inhibits intestinal motility in conscious dogs

Fasting interdigestive myoelectric complex (IMC) and postprandial gastroduodenal myoelectric activities are regulated by motilin and leptin, respectively (L. Zhou 2005). This study is to observe whether electrical acupuncture points could increase fasting gastroduodenal IMC and postprandial activities, as well as increase the release of motilin and leptin. Methods: Bipolar platinum electrodes were implanted on the serosa of antrum and duodenum in 10 conscious Wistar rats to record IMC and postprandial digestive myoelectric activities. We acupunctured Points Zusanli (S‐36), Tianshu (S‐25), and Liangmen (S‐21) during phase I of IMC (Frequency 20~100 Hz, Strengthen 12~16 mA, period 90 min) and compared with non‐specific electric stimulation (sham acupuncture) group. Serum motilin and leptin level was measured by RIA. Results: (1) Acupuncture points could shorten markedly phase I of antroduodenal IMC and increase the period of phase III (P < 0.01). Acupuncture points also increased the number of spike burst of antral and duodenal slow wave by (121.24 ± 20.0)% and (97.34 ± 15.20)% (compared with control group, P < 0.01). In postprandial period, acupuncture points could increase the number of spike burst of antral and duodenal slow wave by (142.52 ± 23.50)% and (102.48 ± 13.25)% (compared with control group, P < 0.01). (2) When acupuncture points increased the number of spike burst of IMC in fasting state, serum motilin concentration also increased, which was (74.56 ± 8.20)% more than control group (P < 0.01). When acupuncture points with meal, serum leptin concentration increased with myoelectric activity, which was (139.84 ± 20.25)% more than control group (P < 0.01). There was no change of motilin and leptin concentration in non‐specific electric stimulation group. (3) Cutting off subphrenic vagus nerves could totally block the effect of acupuncture points on antroduodenal myoelectric activities and release of motilin and leptin. Conclusions: Acupuncture points could effectively increase fasting and postprandial antroduodenal myoelectric activities. This effect is mediated by motilin and leptin, respectively.     

血管重塑对大鼠血管成形术后再狭窄的影响

目的：建立大鼠颈动脉再狭窄模型，原位灌注固定取材。评价PTA后血管重塑（VR）的动态变化规律，定量分析血管重塑在血管再狭窄过程中的变化及作用。方法：制作70只SD雄性大鼠颈总动脉再狭窄模型，分原位灌注实验组、对照组，于术后1h、3、7、14、28和42天原位灌注固定取材，行HE染色、Masson染色，观察标本血管狭窄情况。结果：①血管重塑指数（VRI）在PTA后即刻最大，3天组明显降低，7天组稍有增大，其后不断减小，剩余血管腔面积百分比同VRI的变化曲线基本一致。②FFA后，血管腔面积总体呈逐渐缩小趋势，内弹力板围绕面积（IELA）1h组较对照组明显增大，3天组较1h组明显缩小，14、28、42天组较对照组明显缩小。外弹力板围绕面积（EELA）逐渐缩小。EELA、IELA的变化与血管腔面积变化呈正相关。③VRI与血管腔面积的变化呈正相关，新生内膜面积与剩余狭窄率、血管腔面积无直线相关。结论：再狭窄过程中存在扩张性重塑和收缩性重塑现象，管腔的狭窄与否取决于血管重塑指数的变化，而不是新生内膜的变化，新生内膜的形成是血管重塑过程中的一部分。IELA和EELA可作为判断管腔狭窄及评价血管重塑的指标。     

BIOEQUIVALENCE BETWEEN rhGH FOR RECONSTITUTION AND READY-TO-USE rhGH IN TWO LIQUID FORMULATIONS

Objective To evaluate the bioequivalence between recombinant human growth hormone （rhGH） for reconstitution, and two dosages of liquid formulation of rhGH [ （151U） 5mg or （301U） lOmg per 3ml ]. Methods The study drugs were tested in a randomized, single-blind and three-period crossover studies in 24 healthy male subjects. The three drugs were administered by subcutaneous injection at a dose of O. 21U/kg body weight. A continuous somatostatin infusion was given in order to suppress the secretion of endogenous GH. The ve- nous blood samples were drawn at different time points to test the serum concentration of GH. The pharmacokinetic parameters were analyzed by statistical methods. Results 90% confidence intervals （CI） of AUC0-24h among three products were all within 80% - 125% interval （ 103. 4% - 116. 5%, 105. 7% - 119. 6% and 91.9% - 103. 7%, respectively）, and the Cls of C,~ among three products were all within 70% - 143% interval （91.9% - 114. 0%, 103. 7% -127. 2% and 81.6% -97. 4%, respectively）. There was no statisitical difference of tmax among all the three products. Conclusion These data demonstrate that there is bioequivalence between rhGH for reconstitution and two liquid formulations of rhGH.     

Developmental changes of glutamate acid decarboxylase 67 in mouse brain after hypoxia ischemia

Objective To study the developmental changes of glutamic acid decarboxylase-67 (GAD-67, a GABA synthetic enzyme) in normal and hypoxic ischemic (HI) brain. Methods C57/BL6 mice on postnatal day (P) 5, 9, 21 and 60, corresponding developmentally to premature, term, juvenile and adult human brain were investigated by using both Western blot and immunohistochemistry methods either in normal condition or after hypoxic ischemic insult. Results The immunoreactivity of GAD67 was up regulated with brain development and significant difference was seen between mature (P21, P60) and immature (P5, P9) brain. GAD67 immunoreactivity decreased in the ipsilateral hemisphere in all the ages after hypoxia ischemia (HI) insult, but, significant decrease was only seen in the immature brain. Double labeling of GAD67 and cell death marker, TUNEL, in the cortex at 8h post-HI in the P9 mice showed that (15.6±7.0)% TUNEL positive cells were GAD67 positive which was higher than that of P60 mice. Conclusion These data suggest that GABAergic neurons in immature brain were more vulnerable to HI insult than that of mature brain.     

重组2型腺相关病毒-转化生长因子β3对实验性肝纤维化大鼠肝脏组织病理学和Ⅰ型胶原表达的影响

Objective To investgate the effects of TGF β 3 on rat hepatic fibrosis. Methods The TGF β 3 cDNA was cloned into rAAV2 vector. Rats were randomly divided into four groups: normal control group, model group, negative control group and TGF β 3 group. Hepatic fibrosis was induced by hypodermic injection of 40% CCI4. Recombinant AAV2-TGF β 3 viral particles were injected via the vena caudalis one week before CCh treatment. Rats were executed 8 weeks after CCI4 treatment, global histological change was observed after HE staining, the distribution of the collagen fibers was observed after masson staining, his-tochemistry was done to observe the expression of collagen Ⅰ; The positive area rate of the collagen fibers and the average optical rate of collagen Ⅰ were quantified. Results HE staining indicated that collagen fibers were reduced in the TGF β 3 group. Masson staining shown that the collagen fibers were distributed around the blood vessel, in the portal area and disse space. Compared to the model group (13.2%±2.2%) and negative control group (12.3%±1.5%), the collagen fibers in liver tissues of TGF β3 group (7.7% ± 1.5%) were significantly decreased (q = 9.456, P < 0.01; q = 8.217, P < 0.01). Histochemistry indicated that the collagen fibers of liver tissues of TGF 15 3 group (0.185±0.033) were significantly higher than those in the model group (0.252±0.042) and the negative control group (0.230±0.029), (q = 6.228, P < 0.01; q = 4.346, P < 0.01). Conclusion TGF β 3 alleviates the damage to hepatic cell and the level offibrosis in CCI4 treated rats and inhibits the expression of collagen Ⅰ.     

联合应用口服水剂和水灌肠肠道充盈法的MSCT研究

目的：评价口服水剂、水灌肠及两者联合应用充盈肠道后,使用MSCT显示成人正常肠道的能力。材料和方法：将43名非肠道病变志愿者分别采用口服水剂法(21例)、水灌肠法(12例)、双重法(口服水剂和水灌肠联合应用,10例)充盈肠道,然后行MSCT平扫和增强扫描并进行图像重建,对小肠和大肠各肠段充盈状态进行评价。结果：口服水剂法回肠充盈良好,水灌肠法大肠充盈良好,双重法回肠及大肠均充盈良好。口服水剂法小肠充盈优于水灌肠法,与双重法无显著差异,大肠充盈状态水灌肠法明显优于口服水剂法,与双重法无显著差异。结论：口服水剂和水灌肠联合应用可以在MSCT同时较好地充盈显示小肠和大肠,而两种方法单独使用则仅能分别充盈显示小肠和大肠,需要根据显示目的选择相应的充盈方法。     

人PD-L2基因克隆及其在大肠杆菌中的表达

目的 克隆人PD-L2基因并构建PD-L2胞外区的原核表达载体，在大肠杆菌中进行表达。方法 以RT-PCR方法从活化的人外周血单个核细胞总RNA中克隆PD-L2基因的cDNA，构建PD-L2胞外区的原核表达载体，在大肠杆菌BL21(ED3)中进行表达并鉴定。结果 克隆到PD-L2基因cDNA编码区全长序列，经DNA测序证明其与已报道的序列一致。进而构建了PD-L2胞外区的原核表达载体，并在大肠杆菌表达，免疫印迹分析表明在IPTG诱导后表达PD-L2胞外区蛋白，相对分子质量Mr为22000，与理论值大小相符。结论 成功克隆PD-L2基因，其胞外区蛋白在大肠杆菌中获得表达，为进一步研究PD-L2功能提供了条件。     

卡维地洛配伍螺内酯治疗老年难治性高血压的临床观察

目的：评价卡维地洛联合螺内酯对老年难治性高血压的临床疗效及安全性，以指导临床工作。方法：老年难治性高血压患者200例分成两组，观察组（120例）经安慰剂洗脱2周后口服卡维地洛配伍螺内酯治疗，对照组（80例）在原有用药基础上加用螺内酯，治疗后共观察8周，探讨疗效。结果：观察组不良反应发生少，且观察组总有效率明显高于对照组，观察组对改善左心室射血分数和左心室舒张末期内径效果明显。结论：卡维地洛联合螺内酯对老年难治性高血压控制较好，并能改善心室结构，临床应用效果好。