伴与不伴精神病性症状的抑郁症临床特征的对照研究

目的探讨伴与不伴精神病性症状(Psychoticsymtoms,PS)的抑郁症患者临床特征的差异。方法对64例伴PS的抑郁症患者(研究组)与118例不伴PS的抑郁症患者(对照组)的人口学特征、主要临床症状及治疗情况进行对照分析。结果研究组的阳性家族史、焦虑激越、自责自罪、绝望和自杀行为等出现率显著高于对照组(P<0.05或P<0.01),研究组的自杀危险性为对照组的2.2倍。结论伴PS的抑郁症可能是抑郁症的一个独特的亚型,通常需要抗抑郁药物与抗精神病或电痉挛(ECT)联合治疗。     

食管癌患者手术切除前后SA、CEA和SCP检测的临床意义

目的　探讨食管癌患者手术切除前后血清 SA、CEA、SCP水平的变化。方法　应用放免法测定 4 3例食管癌患者血清 CEA含量 ,化学法测定 SA和 SCP含量 ,并以 35名正常健康人作对照。结果　食管癌患者在手术切除前血清 SA、CEA、SCP水平非常显著地高于正常人组 (P<0 .0 1) ,手术切除后 6个月转移者血清 SA、CEA、SCP水平持续异常 ,未转移者血清 SA、CEA、SCP在正常水平。结论　血清 SA、CEA、SCP含量测定的变化与食管癌患者的病情和预后密切相关 ,有一定的临床应用价值     

The effect of megestrol acetate on growth of HepG2 cells in vitro and in vivo.

PURPOSE: Hepatocellular carcinoma (HCC) is generally considered as a sex hormone-dependent tumor, and hormonal therapy has been proposed as a strategy for the treatment of HCC. The aim of the study is to investigate the effect of megestrol acetate, a synthetic progesteronal agent, on growth of HepG2 cells in vitro and in vivo. EXPERIMENTAL DESIGN: Cell growth in vitro was assessed by a colormetric method, and cell growth in vivo was assessed by tumor volumetrics. RESULTS: Megestrol acetate was shown to inhibit the growth of HepG2 cells in vitro in dose- and time-dependent manners with an IC (50) of 260 microm (24-h incubation). The growth of HepG2 cell-transplanted tumors in nude mice was also inhibited by i.p. injection of megestrol acetate (10 mg/kg/day). The tumor volumes of the megestrol acetate-treated group regressed to 59% of controls by week 6 and to 41% of controls by week 13. Apoptosis following G(1) arrest was observed in megestrol acetate-treated cells and may be a mechanism through which megestrol acetate inhibits HepG2 cells. Megestrol acetate was also demonstrated to have a beneficial effect on the weight gain of tumor-bearing nude mice, and the mean weight of the megestrol acetate-treated animals was higher than that of controls from week 4 of the treatment period, and the differences were statistically significant in week 5 and 6 (P < 0.05, compared with controls). No significant survival advantage was, however, demonstrated in the treatment group. CONCLUSIONS: This study showed that megestrol acetate inhibited the growth of HepG2 cells grown in vitro and in vivo. These data provide useful information for clinical study of megestrol acetate for the treatment of HCC.     

Transjugular liver biopsy effecting changes in clinical management

Although transjugular liver biopsies are frequently performed in patients with impaired blood coagulation, their impact on effecting changes in clinical management has not been assessed. We reviewed our experience with 43 consecutive transjugular liver biopsies performed over 3 years (1998?2000) at Westmead Hospital, Sydney, Australia. The technical success, procedural complication rates and subsequent management of these patients were ascertained from the medical case records. Forty‐two (28 men) patients were studied. The indications for liver biopsy were as follows: assessment of hepatitis/cirrhosis status (n = 21), evaluation of liver dysfunction following bone marrow transplantation (n = 19) and miscellaneous (n = 2). All liver biopsies were performed with a Cook 20‐G transjugular cutting needle device. Adequate histological samples were obtained in 42 (98%) of the 43 biopsies performed. The pre‐biopsy diagnoses were confirmed by histology in 28 cases (65%). A change in clinical diagnosis was observed in 12 (28%) patients, and there were changes to subsequent management in all 12 patients. Four patients developed procedural complications, including small neck haematomas in two patients and a self‐limiting biliary fistula in one. The only major complication was an extracapsular bleed from a hepatic laceration. This patient required emergency surgery but recovered. Transjugular liver biopsies can be effectively and safely performed in high‐risk patients with impaired coagulation. They aid accurate histological appraisal of liver dysfunction in these patients and influence clinical decision‐making.     

吉西他滨联合铂类药物治疗晚期胰腺癌的疗效观察

目的 观察吉西他滨(健择)联合顺铂/草酸铂(GP/GEM-OX方案)治疗晚期不能手术或手术后复发的胰腺癌患者的疗效与不良反应。方法 28例患者分别给予GP或GEM-OX方案2～13周期。按WHO标准评定疗效和不良反应。结果 26例可评价疗效，无一例完全缓解(CR，0％)，部分缓解(PR)7例(26．9％)，稳定(SD)10例(38．5％)，进展(PD)9例(34．6％)。可评价临床受益反应(CBR)27例，有效率为70．4％(19／27)。中位疾病进展时间为4．2个月，中位生存时间为9．3个月。结论 健择联合顺铂/草酸铂是治疗晚期胰腺癌患者的安全有效方案，并能较好改善疾病相关症状，毒副反应可以耐受。     

未破裂型输卵管妊娠136例阴道超声声像分析

目的 探讨未破裂型输卵管妊娠阴道超声声像特征及误诊原因。方法 回顾性分析经临床和病理对比的136例未破裂型输卵管妊娠病例的F)1道超声声像特征。结果 宫外胚囊声像35例，卵巢旁小包块58例，盆腔一侧橄榄形或管状包块43例，误诊5例。结论 未破裂型输卵管妊娠阴道超声声像有一定特征，其共性为卵巢旁境界清晰，形态规则不均质包块。     

静脉注射硝酸甘油诱导大鼠脑膜核因子-κB表达增强

目的观察偏头痛大鼠模型不同时相脑膜核因子-κB(NF-κB)的表达特征.方法采用静脉注射硝酸甘油(GTN)法建立大鼠偏头痛模型,应用免疫组织化学法观察对照组、GTN iv 后0.5,1.0, 1.5, 2.0, 4.0 h组脑膜NF-κB阳性染色细胞的分布,采用Western印迹法观察相应时间点脑膜核NF-κB的蛋白表达量.结果 GTN iv后0.5 h即出现大鼠脑膜NF-κB核阳性反应和核NF-κB蛋白表达量增高,1.5 h核NF-κB蛋白表达量达高峰,然后逐渐回落,至4 h接近正常水平.结论 GTN iv后早期脑膜呈时限性核NF-κB蛋白表达增强,提示NF-κB蛋白表达增强可能与偏头痛有关.     

国际海员疾病发生与治疗的社会因素浅析

从３０００例国际海员疾病发生率原因着手,结合国际海员群体工作游动性和成员多国性的特点,从社会医学和心理医学角度,分析国际海员健康工作中存在的问题,并对如何实现国第员“人人享有卫生保健”提出初步见解。国际海员群体的特殊性及他们的健康问题值得中国及国际航海医学界和社会医学界的关注。     

腺病毒介导的肿瘤血管靶向的体外自杀基因治疗研究

本工作在血管内皮细胞中分别建立了HSV-tk/GCV和EC-cd/5-FC自杀基因系统,用于抑制实体肿瘤中血管生成的研究.构建含自杀基因的重组腺病毒AdCMVtk和AdCMVcd,滴度均1×10~(12)pfu/ml.病毒感染小鼠血管内皮细胞lGll(MOI=100),并鉴定自杀基因的表达,测定原药对它们的杀伤.生长抑制试验表明,GCV对lGll/Ad-tk细胞杀伤的IG_(50)为0.2μmol/ L,5-FC对lGll/Ad-cd细胞杀伤的IC_(50)为20μmol/L.电镜下显示被原药杀伤的血管内皮细胞有明显的细胞凋亡现象.同时混合细胞实验证明两系统均存在明显的旁杀伤效应.从而在体外水平证明了HSV-tk/GCV和EC-cd/5-FC自杀基因系统杀伤增生血管内皮细胞的有效性.     

潘妥拉唑及奥美拉唑对健康人胃内pH的影响

探讨潘妥拉唑及奥美拉唑对健康人２４ｈ胃内ＰＨ的影响。方法：２８例健康志愿者随机分为３组,其中ＰＡＮ组１０例,ＯＭＥ组８例,分别静脉滴注ＰＡＮ８０ｍｇ,ＯＭＥ８０ｍｇ,１次／ｄ,连续２ｄ,第２天给药后进行胃内ＰＨ２４ｈ监测;对照组１０例,直接进行胃内ＰＨ２４ｈ监测。结果：ＰＡＮ及ＯＭＥ均能明显提高２４ｈ胃内ＰＨ平均值,ＰＨ〉４总时间百分比及２４ｈ胃内ＰＨ变化,工线下面积（Ｐ〈０．０１）;用药后２４ｈ