血管性痴呆小鼠海马NMDA受体mRNA表达特征及喜得镇的影响

目的观察喜得镇对血管性痴呆(vascular dementia,VD)小鼠海马神经元N-甲基D-天门冬氨酸(N-methyl-D-aspartate,NMDA)受体原位杂交变化的影响,并探讨NMDA受体原位杂交变化特征及喜得镇对其变化的影响.方法双侧颈总动脉结扎,反复缺血-再灌注法制备模型,药物组用喜得镇溶液灌胃,跳台试验和水迷宫试验观察其行为学改变,采用原位杂交技术观察小鼠海马神经元NMDA受体的表达变化.结果药物组小鼠学习、记忆成绩优于模型组(P＜0.01),其海马N-甲基-D-天门冬氨酸受体表达也明显增高(P＜0.01).结论喜得镇能改善血管性痴呆小鼠模型的学习、记忆功能,这可能与N-甲基D-天门冬氨酸受体mRNA水平正常化有关.     

垂体腺瘤中血管生成及其与肿瘤侵袭性关系的研究

目的：研究CD34（Cluster of differentiation，白细胞分化抗原)蛋白在垂体腺瘤中表达，探讨抗CD34单抗标记肿瘤血管生成与腺瘤侵袭性的关系及其临床意义。方法：集近年我科经手术切除的44例垂体腺瘤标本及6例正常垂体组织，均经4％的福尔马林固定、石蜡包埋。回顾这些病例的详细临床资料，联合运用Knosp影像学标准及任祖渊标准，参考术中情况，将肿瘤标本分为侵袭组与非侵袭组；然后运用免疫组化的方法检到这50例标本中抗CD34单抗标记肿瘤血管生成(其指标为微血管密度—Microvascular Density,MVD)的情况；分析肿瘤血管生成与垂体腺瘤侵袭性的内在关系。结果：免疫组化实验结果显示既物蛋白在侵袭性垂体膝瘤组中显著高表达，在非侵袭性腺瘤组及正常垂体组中也有一定表达，抗CD34单抗标记的肿瘤血管生成情况与全体腺瘤侵袭性密切相关(P＜0．001)，非侵袭组及正常垂体组表达无统计学差异。结论：抗CD34单抗标记的肿瘤血管生成情况与垂体腺瘤侵袭性密切相关，可作为腺瘤侵袭性的分子标志。     

规范化试卷和试题库的设计与实施

目前在高等医学院校实施规范化试卷及试题库的建立与应用,对于科学评价医学生的知识和能力,从而提高教学质量,有着重要意义。本文结合教学实践,讨论了规范化试卷的设计及命题原则,提出了试题库建立的条件,并建议在全国范围内协作建立高质量的试题库。     

沙漠干热环境下猪腹部肠管火器伤后肝组织中NF-κB、TNF-α的表达

目的探讨沙漠干热环境下猪腹部肠管火器伤后肝脏组织中核因子-κB(NF-κB)和肿瘤坏死因子-α(TNF-α)的表达及其与肝损伤的关系。方法健康长白仔猪42头随机等分为对照组和伤后1、2、4、8、12 h和24 h组,在沙漠干热环境下建立腹部肠管火器伤模型后,用免疫组化及图像分析法测定各组肝脏组织内NF-κB和TNF-α的表达,同时测定血清中ALT水平,在光镜下观察各组肝脏组织学变化。结果伤后各组肝内NF-κB、TNF-α表达明显高于对照组(P<0.05),NF-κB于伤后1 h和4 h出现2个高峰(P<0.05);TNF-α于伤后1h和8 h出现2个高峰(P<0.05);血清ALT水平在伤后明显升高,也于伤后1 h和8 h出现2个高峰(P<0.05);伤后1、2 h组出现逐渐加重的肝细胞水肿、变性,伤后4 h组开始出现逐渐加重的肝细胞点状坏死、灶状坏死和炎细胞浸润,对照组光镜下未见明显的损伤性变化;NF-κB与TNF-α的表达在2 h组和4 h组均有正相关关系(P<0.05)。结论沙漠干热环境下腹部肠管火器伤后肝内NF-κB、TNF-α表达一致性升高,二者在伤后早期表达密切相关,并与肝脏结构和功能损伤变化基本一致,提示NF-κB和TNF-α在沙漠干热环境下腹部肠管火器伤后肝损伤过程中起重要作用。     

目标值法在医疗器械非随机对照临床试验中的应用

目的 探讨目标值法在医疗器械非随机对照临床试验中的应用.方法 系统探讨目标值法的应用过程.由于样本含量在试验设计阶段的重要性,根据其统计思想演绎和推导出部分与其对应的样本量估计公式.结果 应用目标值法完成的临床试验符合相关的统计学临床试验要求.结论 目标值法可以用于医疗器械临床性能的评价研究,尤其适用于医疗器械的非随机对照临床试验.     

Complications associated with transcatheter closure of perimembranous ventricular septal defects

Objectives : To identify the complications associated with transcatheter closure of perimembranous ventricular septal defects (PmVSD) using the Amplazter PmVSD occluder (AGA Medical, USA). Methods : Between October 2002 and November 2006, transcatheter closure PmVSD was attempted in 210 patients and performed in 206 patients. Those patients were followed‐up for 6–24 months (mean, 10.6 ± 3.9 months) to identify the complications. Results : Device implantation was successfully accomplished in 206 of the 210 patients (98%). Serious complications such as high degree atrioventricular block (AV block), infective endocarditis, and device embolization occurred in eight cases (3.8%). Other complications including mild aortic or tricuspid regurgitation, femoral pseudoaneurysm, and femoral arteriovenous fistula occurred in four cases. Conclusions : Transcathter closure of PmVSD can be performed safely and successfully. But further studies should continue to evaluate the potential complications associated with this procedure. © 2008 Wiley‐Liss, Inc.     

经直肠高强度聚焦超声(HIFU)治疗良性前列腺增生的临床研究

目的探讨经直肠高强度聚焦超声（high-intensity focused ultrasound，HIFU）治疗良性前列腺增生（BPH）的有效性和安全性。方法对150例BPH患者采用Sonablate 500型“经直肠超声聚能刀”进行前列腺消融术。在术前、术后30min，1、2、6和12个月，经直肠超声观察前列腺和前列腺部尿道的影像学变化，通过尿液分析、国际前列腺症状评分（IPSS）、生活质量评分（QOL）、最大尿流率（Qmax）和残余尿量（PVR）进行疗效评估，同时观察术后并发症。23例术后12个月行排尿期膀胱尿道造影。结果对143例进行了12个月的观察随访，术后IPSS评分和QOL评分降低，PVR减少，Qmax明显提高（P〈0．01），前列腺体积缩小（P〈0．05）。前列腺消融时间25—90min。术后留置尿管时间为3—19d，7例术后反复排尿困难、药物治疗效果不佳者行TURP手术，3例患者出现附睾炎，1例术后15d发生尿道直肠瘘。术后经直肠超声观察和膀胱尿道造影，证实术后前列腺部尿道较术前明显增宽。结论“经直肠超声聚能刀”前列腺消融术，能对前列腺组织进行选择性破坏，具有微创（无血手术）、安全和并发症少等优点。对前列腺中叶增生明显者可联合TURP治疗。“经直肠超声聚能刀”治疗BPH近期疗效满意，远期疗效有待进一步观察。     

The radiosensitizing effect of doranidazole on human colorectal cancer cells exposed to high doses of irradiation

Background  

This paper investigates the effects of a new radiosensitizer, doranidazole, and enhancing irradiation on colorectal cancer cells.     

从雷公藤中分离出一种新成分——雷藤三萜酸A

从雷公藤(Tripterygium wilfordii Hook f.)的根皮中分离出一种新的单体。该单体系由柱层析分离出的一种粗结晶,经用无水乙醇重结晶,得白色针状结晶,mp 304～308℃ (分解)。根据其化学反应、红外光谱、核磁共振氢谱以及高分辨质谱等数据,确定其分子量为472,分子式为C_(30)H_(48)O_4,并推定其化学结构为3β,15β     

Participation of epoxygenase activation in saikogenin D-induced inhibition of prostaglandin E(2) synthesis

We examined the effect of saikogenin D on arachidonic acid metabolism in C6 rat glioma cells to clarify its anti-inflammatory mechanism. Incubation of C6 cells with saikogenin D for 20 min resulted in the inhibition of prostaglandin E(2) production and the accumulation of an arachidonic acid metabolite that was found to be 11,12-dihydroxyeicosatrienoic acid, a metabolite of 11,12-epoxyeicosatrienoic acid. C6 cells expressed rat epoxygenase mRNAs, CYP1A1, CYP2B1 and CYP2J3, which converted arachidonic acid to epoxyeicosatrienoic acids. 11,12-Epoxyeicosatrienoic acid inhibited A23187-induced prostaglandin E(2) production and SKF-525A, an inhibitor of epoxygenase, attenuated the saikogenin D-induced inhibition of prostaglandin E(2) production in C6 cells. Furthermore, 11,12-epoxyeicosatrienoic acid and 11,12-dihydroxyeicosatrienoic acid, but not saikogenin D, inhibited the activity of cyclooxygenase in a cell-free condition. These data suggest that saikogenin D activates epoxygenases that rapidly convert arachidonic acid to epoxyeicosanoids and dihydroxyeicosatrienoic acids, and then the metabolites secondarily inhibit prostaglandin E(2) production.