神经内镜治疗脑室内病变

目的探讨脑室内病变的神经内镜治疗。方法应用神经内镜对68例脑室内病变进行治疗,其中松果体区肿瘤16例,囊性颅咽管瘤15例,丘脑肿瘤14例,脑室内囊肿16例,侵及室管膜下的胼胝体肿瘤3例,侧脑室脉络丛乳头状瘤2例,侧脑室猪囊尾蚴病1例,侧脑室内分流管脱落1例。结果随访17～69个月,56例有效,12例死于肿瘤扩散。无严重并发症。结论对脑室内病变选择性应用神经内镜治疗安全、有效。     

不同光凝接触镜填充液对中央角膜厚度的影响

目的　比较在行氩激光全视网膜光凝治疗中使用不同接触镜填充液对中央角膜厚度的影响 ,以寻找最适用于该治疗的填充液。方法　对 4 6例 (5 2眼 )患者进行氩激光全视网膜光凝治疗 ,每次分别随机使用 0 2 5 %氯霉素、1%羧甲基纤维素及医用透明质酸钠组作为安放全眼底激光角膜接触镜填充液 ,在治疗前及治疗后均用角膜测厚仪测量患者中央角膜厚度。结果　治疗后使用 0 2 5 %氯霉素组中央角膜平均增厚 (31 4± 10 2 ) μm ,1%羧甲基纤维素组中央角膜平均增厚 (10 6± 4 3) μm ,医用透明质酸钠组中央角膜平均增厚 (8 0± 3 5 ) μm。方差分析显示 :氯霉素组与另两组差异有极显著性意义 (P <0 0 1) ,羧甲基纤维素组与透明质酸钠组差异无显著性意义 (P >0 0 5 )。结论　 1%羧甲基纤维素及医用透明质酸钠作为安放全眼底激光角膜接触镜的填充液对角膜水肿程度的影响明显小于0 2 5 %氯霉素 ,是可供选用的优良填充液     

口服谷氨酰胺颗粒对烧创伤患者的疗效及安全性分析

目的观察口服谷氨酰胺(Gln)颗粒对烧(创)伤及大手术患者的疗效及可能发生的不良反应.方法采用随机双盲、安慰剂对照法,将受试患者分为Gln组和对照组,每组60例,两组患者采用等氮、等热量的营养支持.Gln组口服或管饲Gln 0.5 g·kg-1·d-1,对照组使用同等剂量的安慰剂甘氨酸,疗程均为7 d.比较用药前后两组患者肠黏膜屏障功能、蛋白代谢、免疫功能、肝和肾功能的变化及不良反应等. 结果伤后两组患者血浆Gln浓度明显低于正常值,而血浆二胺氧化酶(DAO)活性、内毒素含量、肠黏膜通透性[尿乳果糖/甘露醇(L/M)]及尿氮排量均明显增高;但Gln组用药7 d后血浆Gln浓度与用药前比较增加38.04%(P＜0.01).Gln组血浆前白蛋白、转铁蛋白及白细胞介素2(IL-2)含量均显著高于对照组(P＜0.01),升幅分别为21.19%、51.11%、57.54%.血浆DAO活性、L/M比值、内毒素含量及尿氮排量明显低于对照组,降幅分别为47.26%、52.18%、22.22%、27.78%(P＜0.05或0.01).两组患者的血浆总蛋白、白蛋白、血尿常规及肝、肾功能在用约前后变化不明显(P＞0.05).用药后有少数患者出现轻微不良反应如恶心、腹泻和便秘等,2～3 d后自行缓解,两组间比较,差异无显著性意义(P＞0.05).结论口服Gln能显著提高患者血浆Gln浓度,明显减轻伤后肠黏膜受损程度,并能促进机体蛋白合成,降低蛋白分解,提高机体免疫功能,且临床应用无明显不良反应.     

肾上腺皮质腺癌的诊断与治疗

目的 探讨肾上腺皮质腺癌的早期诊断、手术及围手术期处理。方法 回顾分析了1990年至2001年间31例肾上腺皮质腺癌临床资料．并与1978年至1989年同种病例作比较。结果 近10年患者病理分期更趋向早期，更易行根治性切除，5年的存活率明显提高。结论 影像学的发展，使患者易早期诊断；围手术期的充分准备是减少手术并发症及死亡率的关键。     

Dose-rate scaling factor estimation of THOR BNCT test beam.

In 1998, an epithermal neutron test beam was designed and constructed at the Tsing Hua Open-Pool Reactor (THOR) for the purpose of preliminary dosimetric experiments in boron neutron capture therapy (BNCT). A new epithermal neutron beam was designed at this facility, and is currently under construction, with clinical trials targeted in late 2004. Depth dose-rate distributions for the THOR BNCT test beam have been measured by means of activation foil and dual ion chamber techniques. Neutron and structure-induced gamma spectra measured at the test beam exit were configured into a source function for the Monte Carlo-based treatment planning code NCTPlan. Dose-rate scaling factors (DRSFs) were determined to normalize computationally derived dose-rate distributions with experimental measurements in corresponding mathematical and physical phantoms, and to thus enable accurate treatment planning using the NCTPlan code. A similar approach will be implemented in characterizing the new THOR epithermal beam in preparation for clinical studies. This paper reports the in-phantom calculated and experimental dosimetry comparisons and derived DRSFs obtained with the THOR test beam.     

Genetic contributions to Parkinson's disease

Sporadic Parkinson's disease (PD) is a common neurodegenerative disorder, characterized by the loss of midbrain dopamine neurons and Lewy body inclusions. It is thought to result from a complex interaction between multiple predisposing genes and environmental influences, although these interactions are still poorly understood. Several causative genes have been identified in different families. Mutations in two genes [α-synuclein and nuclear receptor-related 1 (Nurr1)] cause the same pathology, and a third locus on chromosome 2 also causes this pathology. Other familial PD mutations have identified genes involved in the ubiquitin–proteasome system [parkin and ubiquitin C-terminal hydroxylase L1 (UCHL1)], although such cases do not produce Lewy bodies. These studies highlight critical cellular proteins and mechanisms for dopamine neuron survival as disrupted in Parkinson's disease. Understanding the genetic variations impacting on dopamine neurons may illuminate other molecular mechanisms involved. Additional candidate genes involved in dopamine cell survival, dopamine synthesis, metabolism and function, energy supply, oxidative stress, and cellular detoxification have been indicated by transgenic animal models and/or screened in human populations with differing results. Genetic variation in genes known to produce different patterns and types of neurodegeneration that may impact on the function of dopamine neurons are also reviewed. These studies suggest that environment and genetic background are likely to have a significant influence on susceptibility to Parkinson's disease. The identification of multiple genes predisposing to Parkinson's disease will assist in determining the cellular pathway/s leading to the neurodegeneration observed in this disease.     

肺粘液表皮样癌2例分析

肺的粘液表皮样癌是一种非常罕见的原发于气管大支气管的肿瘤 ,其生物学行为表现出低度恶性。综合文献研究报道 ,肺的粘液表皮样癌在影像学上有一定的特点 ,我院近年来遇到 2例 ,都经手术病理证实 ,并结合文献分析其临床特点和影像学表现 ,以期提高对其认识及诊断水平。例 1　患者　女 ,37岁。随访 4 4个月 ,低热、咳嗽 10余日来我院就诊 ,胸部CT发现左下肺炎症 ,行抗炎治疗后症状消失 ,2周后复查胸部CT示两肺正常 ,炎症完全吸收消失 ,未见明确肿块影。 1周后再次出现咳嗽 ,予纤支镜检查 ,见左下叶支气管新生物 ,连续 2次活检不能定性。后…     

不同时期军队疗养员消化性溃疡的流行病学调查分析和对比

目的分析对比不同时期军队疗养员消化性溃疡（PU）的患病情况。方法采用相同的病史采集和问卷调查法，以胃镜检查资料为确诊手段，对1990年和2005年两个年度的疗养员进行消化性溃疡流行病学调查。结果1990年军队疗养员消化性溃疡的患病率为158／1168人（13．53％）；2005年为56／1239人（4．52％），二者相比有显著性差异P〈0．01。结论由于保健意识、生活方式和药物治疗的干预，十五年间，军队疗养员消化性溃疡的发病率显著下降。     

二十二碳六烯酸对神经细胞生长发育的影响

目的：观察二十二碳六烯酸（DHA）对神经细胞生长发育的影响。方法：将无血清培养的新生大鼠大脑神经细胞分为实验组和对照组，实验组加入0.33mol/L乳化DHA 40μl。对两组细胞进行形态学观察及蛋白质含量测定。结果：实验组大脑神经细胞的突起生长速度、胞体面积和直径、神经细胞存活率及蛋白质含量均显著高于对照组。结论：DHA对神经细胞的生长有促进作用，这一作用可能与促进神经细胞蛋白质合成有关。     

输卵管积液影响体外培养胚胎质量的实验研究

目的：分析输卵管积液的形成及其化学成分，探讨输卵管积液对体外培养胚胎生长发育的影响及其机制。方法：建立输卵管积液动物模型，测定其成分；用不同浓度输卵管积液培养小鼠2-细胞胚胎，观察胚胎形态。结果：输卵管积认中K^ 、HCO3^-和表皮生长因子（EGF）含量明显低于输卵管液；pH值明显增高。输卵管积液组囊胚形成率和胚胎孵化率均明显低于输卵管液。结论：结扎兔输管两端能诱导输卵管积液形成；机械诱导的输卵管积液成分改变能影响早期胚胎的质量。