Turner综合征矮身材的治疗

This study was aimed to examine the growth-promoting effects of recombinant human growth hormone (r-hGH) and low dose of thyroid hormone on short stature in girls with Turner syndrome. 8 girls with Turner syndrome, at the chronological age of 8.5-14.5 years (12.3 +/- 2.1 years) and bone age of 8.3-12.7 years (9.8 +/- 1.7 years) were observed. The maximum serum GH levels in 3 patients out of 5 with provocative testing available were > or = 10 ng/ml (10.0, 10.0 and 15.52 ng/ml, respectively), and in the other 2 of the 5 patients were < 10 ng/ml (9.3 and 9.5 ng/ml). Thyroid function including T3, T4 and TSH were measured in 5 patients. The TSH in one patient was slightly higher; the T3, T4 and TSH in other patients were normal. All patients were treated with r-hGH 1.0 IU/(kg.wk) and thyroideum 15 mg/d for 6-36 months. The results showed that the growth rate after treatment was remarkably higher than that before treatment (2.2 +/- 1.1 cm/yr). The growth rates in the first 6 month, the first year, the second year and the third year were 7.9 +/- 1.6 cm/yr, 7.5 +/- 1.2 cm/yr, 6.9 +/- 0.2 cm/yr and 5.0 +/- 0.2 cm/yr, respectively. Height standard deviation score (HSDS) increased 1.3 +/- 1.1 SD, compared with that pretreatment. The annual bone age growth rate after treatment was 0.6 +/- 0.2 yr/yr (0.43-0.8 yr/yr). These data indicated that r-hGH and low dose of thyroid hormone had remarkable effects of growth-promoting in the girls with Turner syndrome.     

中药“拮新康”对白血病细胞凋亡的影响

为探讨中药“拮新康”对白血病细胞凋亡的影响。采用形态学及ＤＮＡ凝胶电泳方法观察其对白血病细胞株ＨＬ－６０及Ｋ５６２细胞凋亡的影响,结果示：①电镜观察可见凋亡细胞和凋亡小体,ＤＮＡ凝胶电泳可见典型的梯形带改变;②一定浓度范围内的拮新康经适当作用时间后可诱导白血病ＨＬ－６０,Ｋ５６２细胞凋亡,但诱导Ｋ５６２细胞凋亡所需时间较ＨＬ－６０长且剂量较大。提示拮新康可诱导白血病细胞凋亡,与剂量和时间有一定的关     

经皮腔内冠状动脉成形术对心脏自主神经活动的影响

目的：观察经皮腔内冠状动脉成形术（ＰＴＣＡ）后心率变异（ＨＲＶ）的变化,探讨ＰＴＣＡ和ＨＲＶ的影响。方法：ＰＴＣＡ患者１２０例,２４ｈ动态心电图（ＤＣＧ）记录ＰＴＣＡ术前１周、术后１周、术后６个月的心电信息并进行ＨＲＶ分析。结果：ＰＴＣＡ术后６个月ＨＲＶ指标中的２４ＲＲ间期标准差（ＳＤＮＮ（和高频段的功率谱密度（ＨＦＰ）较术前明显增高（Ｐ分别不小于０．０５及０．０１）;ＰＴＣＡ术后冠状动脉再狭窄患     

儿童体外循环心脏手术对甲状腺功能的影响

目的 观察儿童体外循环心脏手术前后甲状腺激素的变化,了解体外循环心脏手术对儿童甲状腺功能的影响并探讨其临床意义。方法 用放射免疫方法测定２５例外循环心脏手术儿童术前、术中、术后甲状腺激素和促甲状腺激素的含量。结果 体外循环期间血浆三碘甲状腺原氨酸（ｔｅｔｒｏｄｏｔｈｙｒｏｎｉｎｅ,Ｔ３）、游离三碘甲状腺原氨酸（ｆｒｉｉ ｔｒｉｉｏｄｏｔｈｙｒｏｎｉｎｅ,ＦＴ３）、四碘甲状腺原氨酸（ｔｅｔｒａｉｏｄ     

关于社区卫生服务人力资源开发的思考与探讨

基于北京市朝阳区大力发展社区卫生服务３年多的实践,就发展社区卫生服务的关键所在－人力资源开发,在配置卫生资源,实施全科医学培训工程,制定相应政策保障,充分展示社区卫生服务功能等方面的现状及其对策进行了充分的论述和有益的探讨。     

GNAS gene mutations affecting XLαs and bone health: A long neglected relationship

The GNAS locus is an imprinted site. The α-subunit of the stimulatory G protein (Gsα) and extralarge variant (XLαs) are the two important products of the GNAS locus. The abnormal expression of Gsα is associated with pseudohypoparathyroidism (PHP) and related disorders, including Albright hereditary osteodystrophy (AHO), pseudopseudohypoparathyroidism (PPHP), and progressive osseous heteroplasia (POH). XLαs protein can mimic the catalytic intracellular synthesis of cyclic adenosine monophosphate (cAMP) by Gsα in response to parathyroid hormone (PTH) stimulation, which may be involved in the pathogenesis of PPHP and POH in patients with paternal GNAS defects. A paternally inherited nonsense variant in the first exon of XLαs in an adult patient may be associated with fractures and osteopetrosis. The relationship between the XLαs product of the GNAS locus and bone remodeling may have been overlooked. Here, we summarize the phenotypes of genetic mouse models and clinical cases of XLαs variations and suggest that the abnormal paternal expression of XLαs may be associated with the development of POH and affect osteoblast and osteoclast differentiation.     

中国人不同年龄和性别正常人心电图QRS波

目的：建立中国人不同年龄和性别正常心电图ＱＲＳ波标准。方法：４３２２例自出生至８５岁不同年龄和性别健康人１４导联心电图ＱＲＳ波,分１１个年龄组进行分析统计。结果：ＱＲＳ波振幅及心电轴均有明显的年龄和性别差异。ＱＲＳ波振幅随年龄的增减女性出现早于男性。新生儿阶段,ＱＲＳ波振幅女婴〉男婴,青春期及中年人男性〉女性,婴幼儿及老年人笥别差异相对不明显。     

改良Bjork手术治疗三尖瓣闭锁12例

目的 观察改良Ｂjord手术治疗三尖瓣闭锁的效果。方法 自１９９６年３月至１９９９年６月,对１２例三尖瓣闭锁患儿实施了改良Ｂjord手术,即应用剖开的带瓣肺动脉片作前壁的右房右室连接术。结果 术后患儿中心静脉压（ＣＶＰ）低、胸液量少;术后血流动力学监测肺动脉为搏动性血流;超声心动图发现残存的右心室腔有收缩功能、右室腔有所增大、同种瓣叶有一定的抗反流作用。结论 改良Ｂjord手术 ,术后同种瓣有一定的抗反流作用     

羊水过少的B超诊断性试验分析

目的 探讨产前Ｂ超测定羊水平段诊断羊水过少的最佳界值。方法 对妊娠≥３６周的孕妇进行Ｂ超测定羊水最大平段,剖宫产时实际测定羊水量,确定２．０ｃｍ、２．３ｃｍ、２．６ｃｍ、３．０ｃｍ、３．３ｃｍ、３．８ｃｍ等７个界点,分别计算其敏感性、特异性、阳性预测值和阴性预测值,对各界点的敏感性和（１－特异性）作受试者工作特性曲线。结果 当Ｂ超测定羊水平段界点为３．３ｃｍ,可获得较高的诊断敏感性和特异性,其值为８０．５６％和７８．７９％。结论 Ｂ超测定羊水平段界点值为３．３ｃｍ时,可产前诊断为羊水过少。     

单臂多功能外固定支架治疗不稳定性胫腓骨骨折

目的 评估单臂多功能外固定支架治疗不稳定性胫腓骨骨折的疗效。方法 使用单臂多功能外固定支架治疗不稳定性胫腓骨骨折４２例。结果 骨折均愈合,患肢功能恢复良好,愈合平均时间６．２个月。钉道感染率１２％。结论 单臂多功能外固定支架可纵轴方向滑动,起延长加压作用,两端有球状万向关节,可做各方向调节,使用灵活和容许早期活动。单臂多功能外固定支架是治疗不稳定性胫腓骨骨折较好的方法。