心肌造影超声心动图评估心肌缺血程度的实验研究

本实验制作不同程度心肌缺血的动物模型，以声处理５％人血白蛋白为超声造影剂进行心肌灌注造影，探讨ＭＣＥ时间－强度曲线各指标与心肌缺血程度间的关系。结果表明：心肌显影的峰值强度和曲线下面积均与缺血程度呈显著负相关（相关系数分别为ｒ＝－０．９８，Ｐ值＜０．００５；ｒ＝－０．９４，Ｐ值＜０．０５），且能区分轻度、中度和重度三种程度的心肌缺血；而三项时间指标与心肌缺血程度间未发现显著性差异。本实验的初步结果表明，ＭＣＥ是一项活体评估局部心肌血流灌注的有效方法。     

Renal growth after neonatal urinary tract infection

This study presents the result of 12–21 years' follow-up in a group of children with neonatal urinary tract infection (onset within 1 month after birth) in whom early renal growth retardation was noted without concomitant classical renal scarring. In all cases the neonatal infection was diagnosed and treated within a few days of onset and the patients were closely supervised thereafter. Renal length, parenchymal thickness and area were measured at urography. At first follow-up (22 children, mean age 4.1 years) a significant reduction of renal parenchymal thickness was noted. Long-term follow-up (18 patients, mean age 17 years) demonstrated a normalization of renal size in the entire group, although less complete in the subgroup with reflux. There were two major findings in the present study. Firstly, renal growth retardation was seen after neonatal infection, both with and without reflux. Secondly, normalization of renal size in previously small kidneys was demonstrated, suggesting that growth retardation can be a reversible phenomenon. The tendency for such normalization was slightly more marked in children without reflux. Reduction of parenchymal thickness without calyceal deformity, therefore, does not necessarily mean irreversible damage, and differentiation between permanent scarring and temporary growth retardation can thus only be made at later follow-up, possibly not until after puberty. The demonstration of renal growth retardation in spite of early diagnosis and treatment emphasizes the great vulnerability of the kidney in the newborn.     

Effects of galanin on insulin and glucagon secretion in the rat

Galanin-like immunoreactivity has been visualized in nerve fibers in the islets of Langerhans, suggesting an involvement of galanin in the neural regulation of islet function. In this study, we investigated the effects of galanin on basal and stimulated insulin and glucagon secretion by infusing the peptide at three different dose rates in rats. We also studied the direct effect of galanin on insulin secretion from freshly isolated rat islets. At 320 pmol/kg/min, but not at 20 or 80 pmol/kg/min, galanin lowered basal plasma insulin levels. In contrast, basal plasma glucagon levels were lowered by galanin already at 20 and 80 pmol/kg/min. Furthermore, galanin inhibited both glucose- and arginine-induced insulin release at all three dose levels, whereas arginine-induced glucagon release was not affected by galanin. Glucose-stimulated insulin secretion from isolated rat islets was dose-dependently suppressed by galanin (10^-6-10^-8M). Therefore, it is concluded that galanin in rats inhibits insulin secretion, both in vivo and in vitro, and that at lower dose levels, the peptide also inhibits basal glucagon release.     

大鼠MMP-13重组腺病毒载体的构建

目的　构建大鼠MMP1 3重组腺病毒载体。方法　将MMP1 3cDNA目的片段插入腺病毒柯氏质粒中 ,再将此质粒与腺病毒DNA末端蛋白复合物共转染 2 93细胞 ,通过同源重组构建MMP1 3 重组腺病毒载体。结果　MMP1 3 重组腺病毒载体经PCR鉴定正确 ,包装纯化后 ,检测病毒滴度为 4× 1 0 9PFU/ml。结论　成功地构建了RatMMP1 3 重组腺病毒载体 ,为下一步行MMP 1 3转基因治疗低顺应性膀胱的研究提供了条件     

放射线联合p53基因及内皮抑素治疗小鼠前列腺癌皮下移植瘤

Objective To test the hypothesis that p53 gene therapy combined with endostatin can enhance tumor response to radiation therapy of RM-1 mouse xenograft prostate cancer and to investigate its mechanism. Methods A mouse prostate cancer model was established. Then mice with xenograft tumor were randomly divided into group A (control), B (radiation), C (radiation and rAdp53), D (radiation and rh-endostatin) and E (radiation and rAdp53 and rh-endostatin). On day 1, rAdp53 was injected intra-tumorously with 1 × 1010 vp per animal to group C and E. From day 1 to 14, rh-endostatin was given 15 mg/kg intraperitoneally daily to group D and E. On day 4 single fraction of 15 Gy was given to tumors in groups B, C, D and E. Normal saline was injected intra-tumorously or intraperitoneaUy accordingly as control. No treatment was done to group A. Tumor volume was measured daily. Samples were collected on Days 5, 10 and 15. Ki67, CD31, p53 and VEGF were detected by means of immunohistochemistry. Results (1) Radiation alone, radiation combined with intra-tumorous injection of Adp53 and/or intraperitoneal injection of rh-endostatin resulted in tumor growth arrest of RM-1 cells in vivo (P = 0.000). Radiation combined with both rAdp53 and rh-endostatin was the most effective treatment (P < 0.05). (2) All the four treatment groups had a decreased expression of mutant type P53 (P = 0.000). The expression of Ki67 in groups B and C were equal (P 0.05) and increasing (P = 0.000), respectively. Group D had a up-down-up curve (P < 0.05), but group E had a up-down one. On day 5 the expresion of VEGF in group E was the lowest (P < 0.05). An increased expression of MVD compared with the control was shown, and MVD in groups C, D and E were always higher than that in the control (P < 0.05). Conclusions The limitation of radiotherapy could be overcome by combination with beth p53 gene therapy and endostatin on the growth of mouse prostate cancer cell. Radiation, rAdp53 and endostatin have their own role but they can be interacted with each other.     

Laparoscopic Local Resection Based on Sentinel Node Evaluation for Early Gastric Cancer: A Preliminary Report

We previously reported that lymphatic mapping using isosulfan blue can be used to identify sentinel nodes (SNs). This study was undertaken to evaluate the feasibility of using the SN technique in treating early gastric cancer and to explore its usefulness for minimal invasive surgery. Twenty-three patients with early gastric cancer who underwent SN biopsy were retrospectively evaluated. Based on SN evaluation, individualized surgery was performed in five patients with T1N0M0 gastric cancer. When pathological examination of frozen sections revealed metastasis in SNs, we performed a standard D2 gastrectomy. Laparoscopic local resection was applied when the SN biopsy was negative. Our results showed that the success rate with SN biopsy in early gastric cancer was 100%, as were the accuracy, sensitivity, and specificity. All five patients with early gastric cancer had SNs negative for metastases both by frozen section and by postoperative pathology. Thus, all these patients underwent laparoscopic local resection without extended lymphadenectomy. We conclude that SN biopsy is a useful tool to individualize the operative procedure, and laparoscopic local resection can be safely performed using SN guidance in selected patients with early gastric cancer.     

医学文献检索课中期刊论文分类标引的教学

针对当前的医学文献检索课中忽略期刊论文分类标引教学的问题,总结了几点教学实践,分别从期刊论文分类标引准确的重要性、期刊论文分类标引的步骤及原则、医学期刊论文分类标引的注意事项几个方面进行阐述.     

女性吸毒者心理防御机制及心理健康状况研究

目的探讨女性吸毒者的心理防御机制与心理状况及二者的关系.方法分别用防御方式问卷(DSQ)和症状自评量表(SCL-90),对110名女性吸毒者(研究组)和41名女大学生(对照组)进行调查.结果研究组不成熟防御机制、中间型防御机制和掩饰因子评分(4.83±0.97,4.99±0.75,5.98±1.17)显著高于对照组(3.95±0.68,4.26±0.73,5.41±1.34)(P＜0.01或P＜0.05);研究组SCL-90中9个因子评分均显著高于对照组(P＜0.01);相关分析发现,研究组不成熟防御机制与SCL-90中9个因子均存在非常显著正相关(P＜0.01),中间型防御机制与SCL-90中的强迫、偏执、躯体化、抑郁存在显著正相关(P＜0.01或P＜0.05),掩饰因子与SCL-90中的敌对、偏执、强迫呈显著正相关(P＜0.01或P＜0.05).结论女性吸毒者过多地使用不成熟防御机制及中间型防御机制,心理状况差,且二者存在明显的相关性.     

儿童安装永久性心脏起搏器方法的临床探讨

目的总结儿童永久性心脏起搏器植入、随访和并发症处理的经验。方法(1)对III度房室传导阻滞儿童植入永久性心脏起搏器,术后1周,1、3、6、12个月及此后每年均进行随访,随访时行心电图、胸片、心脏超声心动图检查,并对起搏器参数和起搏阈值进行检测。(2)对随诊中出现的6例并发症(其中囊袋感染2例、固定胶套磨破皮肤感染2例、绝缘层破损1例、重度三尖瓣反流1例)分别进行处理。结果对27例植入永久性心脏起搏器的儿童进行7个月~8年随访,平均(5.2±1.5)年;其中6例并发症经处理后,感知和起搏功能良好,随访6个月~5年无异常。结论(1)儿童安装永久性心脏起搏器要严格掌握适应证,尽量采用生理性起搏;(2)心外膜手术创伤大,术后并发症少,适合超声心动图显示锁骨下静脉内径小于5 mm的患儿;(3)心内膜植入时要注意儿童的心脏结构和生长发育特点。     

性别对骨关节炎患者全膝关节置换术后康复效果的影响

目的 探讨性别因素对接受人工全膝关节表面置换术的膝骨关节炎患者术后功能的影响. 方法 前瞻性研究了 2003年 3月～ 2005年 8月期间行单侧人工全膝关节表面置换术(均使用不保留后交叉韧带后稳定型固定平台假体)的 40例 (40髋 )膝关节骨关节炎患者,男女各 20例( 20膝),对其相关的临床因素用 t检验和χ 2检验进行分析. 结果平均年龄:男 72.6岁、女 70.8岁;病程:男 10.4年、女 9.7年;体重指数:男 26、女 26;术后平均住院时间:男 17 d、女 18 d;止血带使用时间:男 104 min、女 94 min;引流量:男 806 mL、女 742 mL;术前、术后 1周、 2周和 1年的膝关节伸屈度数男分别为 7.0°～ 114.0°、 3.0°～ 91.0°、 0.4°～ 103.0°和 0～ 125.0°,女分别为 8.0°～ 111.0°、 2.0°～ 86.0°、 1.0°～ 98.0°和 0～ 122.0°;术前、术后 1周、 2周和 1年的膝关节活动度:男分别为 108°、 89°、 109°和 123°,女分别为 104°、 87°、 101°和 126°;术前和术后 1年的 HSS评分:男分别为 57、 89分,女分别为 53、 87分.两性别组各时间点的伸屈度数、活动范围及术前和术后 1年的 HSS评分差异无统计学意义 (P >0.05);而同一患者术前和术后 1年的伸屈度数及 HSS评分则差异有统计学意义 (P >0.05). 结论 性别对行全膝关节置换的骨关节炎患者术后功能无明显影响,全膝关节置换能有效缓解骨关节炎相关的疼痛并改善膝关节的功能.