肾恶性肿瘤肾外供血动脉的来源及临床意义

目的研究肾恶性肿瘤肾外动脉供血的形成机制，以指导介入治疗。方法对141例肾恶性肿瘤患者，常规进行腹主动脉造影及选择性可疑供血动脉造影，分析其肾外供血动脉的特征及形成机制。结果141例患者中51例有肾外供血动脉（共87支），这些患者肿瘤均突破肾包膜；90例无肾外供血动脉，其中50例肿瘤突破肾包膜，40例肿瘤未突破肾包膜，两者差异有统计学意义（X^2=31．64，P＜0．01）。肾外供血动脉的来源与肿瘤发生的部位有关。结论明确肾恶性肿瘤肾外供血动脉的来源，对于指导临床治疗具有重要的意义。     

B超引导下经皮肝穿刺肝静脉成形术 在布-加综合征介入治疗中的应用

目的 探讨B超引导下经皮肝穿刺肝静脉成形术在布-加综合征的介入治疗中的应用价值和疗效。方法 对7例下腔静脉狭窄同时合并肝静脉狭窄或闭塞的布-加综合征患者，在施行下腔静脉成形术后，采用B超引导下经皮肝静脉穿刺的方法，实施肝静脉球囊扩张术或支架植入术。结果 7例患者在单独实施下腔静脉成形术效果不显著的情况下，在B超引导下实施肝静脉成形术，2例单纯球囊扩张，5例植入支架，无严重并发症，术后腹水、下肢水肿等症状有不同程度改善。结论 B超引导下的经皮肝静脉穿刺肝静脉成形术，定位准确，实施快捷，对合并肝静脉狭窄或梗阻的布-加综合征患者症状的缓解有明显效果。     

单侧唇裂功能性修复320例护理体会

目的:探讨单侧唇裂功能性修复的护理特点和方法。方法:对我院320例行单侧唇裂功能性修复患儿的护理行回顾性分析和总结。结果:患儿及家属能积极配合,患儿术后恢复良好,家属满意。结论:在常规护理的基础上,患儿特别是家属对疾病和手术方案的认识将对手术和护理效果产生重要影响。     

子宫畸形患者HOXA13基因同源结构域分析

目的探讨中国子宫畸形患者中HOXA13基因同源结构域是否存在突变及其相关性分析。方法国外文献报道手-足-生殖器综合征（hand-foot-genital syndrome,HFGS）患者中发现HOXA13基因2号外显子同源结构域存在点突变,而此综合征的女性患者部分症状表现为子宫畸形,因此对58例中国子宫畸形患者和54例正常对照者进行HOXA13基因同源结构域检测,PCR扩增目的片断后自动化测序分析基因2号外显子同源结构域区域。结果HOXA13基因同源结构域直接自动化测序分析结果显示,在患者和对照者中均没有突变发生。结论中国妇女子宫畸形的发生可能与HOXA13基因同源结构域突变无关。     

New evidence from magnetic resonance imaging of brain changes after climbs at extreme altitude

The aim of the present study was to look for anatomical changes in climbers' brains, using magnetic resonance imaging (MRI), after extremely high-altitude climbs and to relate them to possible associated risk factors. Clinical history, neurological examinations and MRI were carried out on a group of nine climbers before and after climbing to over 7500 m without the use of supplementary oxygen. None of the subjects showed any neurological dysfunctions. In five climbers MRI abnormalities (high signal areas, cortical atrophy) were observed before the expedition. After the descent, two of them showed new high intensity signal areas recorded by MRI. Both subjects suffered severe neurological symptoms during the climb. The present study suggested that the brain changes observed by MRI could be related to the severity of clinical events at high altitude. However, we do not know the exact meaning of such MRI findings or the reason for their location, predominantly in posterior regions of the brain. The new evidence that a high percentage of climbers show MRI brain abnormalities, and especially the appearance of changes after the ascent, reinforces the possibility of a potential neurological risk in high-altitude climbing.     

Sonic Hedgehog蛋白在帕金森病模型大鼠黑质中的表达

目的检测Sonic Hedgehog蛋白(Shh)在帕金森病(Parkinson's disease,PD)大鼠中脑黑质的表达。方法将健康SD大鼠(雌雄不拘)随机分成3组:正常组大鼠不实施任何处理;应用脑立体定位技术,在大鼠右侧纹状体两针道内4点定位注射含0.2g/L抗坏血酸的生理盐水4μL(假手术组)或6-羟基多巴(6-OHDA)12μg/4μL(模型组)。术后1、2、4、6周以阿朴吗啡检测其异常旋转行为,左侧旋转的圈数大于7r/min者为合格的帕金森病模型大鼠。6周后在激光共聚焦显微镜下观察黑质Shh及酪氨酸羟化酶(TH)的免疫荧光双重染色结果,用Leica Confocal Software对Shh的荧光强度进行定量分析。结果Shh蛋白在正常对照组和假手术组大鼠中脑黑质中无明显表达,而在模型组表达显著。结论PD模型大鼠黑质中Shh蛋白的明显表达,提示Shh在PD模型大鼠中脑多巴胺能神经元(DA神经元)修复过程中可能发挥着一定的作用。     

The effect of oral hormone replacement therapy on lipoprotein profile, resistance of LDL to oxidation and LDL particle size

Objectives: To disclose if oral estradiol (E₂), alone or in combination with natural progesterone (P) or medroxyprogesterone acetate (MPA), may modify the oxidizability of low density lipoprotein (LDL), and if the effect is achieved at physiological dosages. LDL oxidizability was assessed by the resistance to oxidation by copper and by the particle size profile, since small particles have increased oxidation susceptibility. Methods: Thirty-three women received two consecutive, two-month length doses of 1 and 2 mg/day of oral E₂. They were then randomly assigned to a fourteen-day treatment of 2 mg/day E₂ plus either 300 mg/day P or 5 mg/day MPA. A parallel group of experiments was performed on a pool of baseline plasma, where hormones were added at the desired concentration. Lipoprotein levels, resistance of LDL to oxidation, and LDL particle diameter, were measured at baseline and after each treatment. Results: Estradiol reduced LDL levels and increased high density lipoprotein (HDL) and triglycerides. P abolished these changes, whereas MPA only reversed the increase of HDL. Estradiol protected LDL from oxidation in a dose-dependent manner, although only at pharmacological concentrations (1 μM or higher). Both P and MPA were inert at either physiological or pharmacological concentrations. The size of the LDL particles remained unaffected except under MPA, in which it was reduced. Conclusions: Estradiol has a protective effect against LDL oxidation, although only at pharmacological dosages. P and MPA did not limit the E₂ action. The size of the LDL particles remained unaltered after each E₂ dose, but MPA, and not P, was associated with a diminution.     

SHP-1和JAK1基因在初治急性白血病患者中的表达

目的：探讨SHP-1和JAK1基因在初治急性白血病（AL）细胞的转录表达及其与初治AL患者化疗效果的关系。方法：采用半定量逆转录-聚合酶链反应（RT-PCR）方法检测60例初治AL患者骨髓单个核细胞及20例健康人外周血单个核细胞中SHP-1和JAK1 mRNA的表达。结果：60例初治AL患者SHP-1和JAK1的mRNA表达阳性率分别为30%，100%；初治AL患者SHP-1 mRNA表达水平明显低于正常对照组（P<0.001），JAK1 mRNA表达水平较正常对照组略增高，但差异无统计学意义（P=0.180）,初治AL患者SHP-1 mRNA阳性组的诱导化疗完全缓解（CR）率为88.9%，阴性患者组CR率为54.8%，差异有统计学意义（P=0.005）。SHP-1与JAK1 mRNA表达呈负相关（P=0.046）。结论：SHP-1可能是白血病潜在的抑制基因，可望作为判断初治急性白血病患者疗效和预后的指标。     

流行性脑脊髓膜炎的流行趋势变化与其疫苗接种

在过去几十年,随着疫苗的广泛使用,不同国家和区域引起流行性脑脊髓膜炎(简称流脑)病原体的血清群也发生了变迁。本文将脑膜炎球菌疫苗免疫接种、感染人群、不同区域和国家流脑的流行趋势及其内在机制研究进展进行综述,为进一步了解流脑流行趋势变化与其疫苗接种和后续制定免疫策略提供参考。     

急性心脑血管血栓性疾病患者血浆FⅦ：C、FⅧ：C、凝血酶原及纤维蛋白原的变化

目的检测凝血因子Ⅶ、Ⅷ、Ⅱ、Ⅰ的活性,研究其在急性心脑血管血栓性疾病中的变化.方法分别采用凝血活酶时间、部分凝血活酶时间、发色底物法及凝血酶时间法测定了急性心肌梗死(AMI)和急性缺血性脑卒中(AIS)病人血浆FⅦC、FⅧC、凝血酶原及纤维蛋白原相对活性.结果AMI病人血浆FⅦC为98.3%±36.7%,与青年组的104.0%±29.4%和老年组的114.9%±23.6%比较无明显差异(P值均＞0.05),而AIS病人为152.9%±30.3%,较青年组和老年组显著升高(P值均＜0.001).AMI病人血浆FⅧC为234.2%±57.9%,明显高出青年组的101.2%±32.6%和老年组的116.4%±35.7%(P值均＜0.001).但AIS病人FⅧC±为85.5%±32.6%,低于老年组(P＜0.05).AMI和AIS病人血浆凝血酶原活性分别为130.2%±¨.7%和128.0%±29.4%,高于青年组的108.0%±7.7%(P＜0.001和0.01)和老年组的106.1%±19.4%(P值均＜0.001).AMI和AIS病人血浆纤维蛋白原活性分别为207.2%±53.0%和174.3%±28.5%,二者均显著高于正常青年组的103.3%±¨.6%(P值均＜0.001)和老年组的143.8%±16.8%(P＜0.001和0.01).结论AMI病人FⅧC增高,AIS病人FⅧC增高;二者血浆凝血酶原和纤维蛋白原活性均高于正常水平.