黄连与吴茱萸不同比例组成的方剂的不同药理作用研究

目的：探讨黄连与吴茱萸不同比例组成的方剂的不同药理作用。方法：用党参与黄芪给大鼠灌胃造成类热证模型，观察不同比例配伍的黄连与吴茱萸对它们的影响。结果：黄连与吴茱萸比例为6：1的左金丸和2：1的甘露散有显著的消除类热证的作用，1：1的茱萸丸对肝细胞超微结构的影响中表现出有减轻类热证的作用，而体温（t）、血清皮质醇（Cor）、17－羟皮质类固醇（17－OHCS）的改变则未见减轻类热证或增强类热证的作用。结论：认为不同比例配伍的黄连与吴茱萸对类热证的病理改变有不同的影响。     

芦沙坦和苯那普利对高血压大鼠左室肥厚的抑制作用

目的：研究芦沙坦及苯那普利对老龄前期自发性高血压大鼠（SHR）左室肥厚及丝裂素活化蛋白激酶（MAPK）的抑制作用。方法：将老龄前期SHR随机分为SHR对照组，苯那普利（10mg.kg^-1.d^-1）及芦沙坦（30mg.kg^-1.d^-1）治疗组，治疗期为3个月，每月测压一次，治疗结束后处死动物，测定心肌肥厚指标、血中及心肌中内皮素（ET）、血管紧张素AⅡ及MAPK。结果：苯那普利及芦沙治疗后血压、心肌肥厚指标、血中及心肌中内皮素（ET）及MAPK明显低于SHR相对照组（P＜0．01），芦沙坦组血中及心肌中AⅡ无下降。结论：AⅡ、ET及MAPK参与了SHR的血压升高及心肌肥厚的形成。苯那普利及芦沙坦有抑制AⅡ、ET及MAPK的活性，从而达到降压及逆转心肌肥厚的作用。     

非孕期子宫肌瘤红色变性40例分析

目的 了解非孕期子宫肌瘤红色变性的临床特征。方法 本组回顾分析了1993年1月～2001年2月间住院手术治疗40例非孕期子宫肌瘤红色变性的临床病理特征。结果 非孕期子宫肌瘤红色变性发生率为2.3%。生育年龄多见，绝经后也可发生。有典型表现者2例，占5%，非典型下腹隐痛而无发热者7例，占17.5%，肌瘤结节局部压痛者12例，占30%，无任何症状者30例，占75%，白细胞升高占10例，25%。90%的红色变性肌瘤直径在5cm以上，77.5%为壁间肌瘤。68.6%有典型牛肉样改变，54.8%旋涡状结构存在。65%为单纯红色变性，余35%可合并其他类型变性。结论 非孕期子宫肌瘤红色变性临床过程缓和，症状不典型，易漏诊，不作为手术指征，但因子宫肌瘤往往较大，多需手术治疗。     

TAXUS支架治疗急性冠状动脉综合症的疗效评价

目的评价紫杉醇洗脱冠状动脉支架(TAXUStmBoston公司产品)应用于急性冠状动脉综合症病人的临床疗效及安全性。方法自2003年5月至2004年12月接受TAXUS支架治疗的94例急性冠状动脉综合症患者,观察术后即刻效果、术后6个月心脏性死亡、心肌梗塞、再次血管重建及冠状动脉造影复查情况。病例中包括ST段抬高的急性心肌梗塞27例,非ST段抬高的急性心肌梗死8例,不稳定心绞痛59例。结果支架植入成功率为99%,术中和随访期间无死亡,术后1例出现亚急性血栓,1例晚期血栓致心肌梗塞,另有5例随访中进行了血管重建术,6个月主要心脏不良事件(MACE)发生率7.4%。术后6～7个月23例的冠状动脉造影复查再狭窄率为13.0%(支架内为8.6%),靶病变重建率为2.7%。结论应用TAXUS支架治疗急性冠状动脉综合症是安全和有效的,支架内再狭窄率明显低于普通金属支架。     

组织多肽特异性抗原在原发性肝癌中的临床应用

OBJECTIVE: To evaluate the clinical value of serum tissue polypeptide specific antigen (TPS) for primary hepatic cancer in comparison with alpha-fetoprotein (AFP). METHODS: TPS and AFP were measured by enzyme-linked immunosorbent assay (ELISA) in 85 patients with primary hepatic cancer, 19 with metastatic hepatic cancer, 35 with liver cirrhosis, 22 with chronic hepatitis and 50 healthy control subjects. RESULTS: Serum AFP levels were elevated in patients with hepatocellular carcinoma in comparison with that in cholangiocarcinoma patients (P=0.037), but the difference was not significant (P=0.737). Serum TPS levels were significantly correlated with the tumor size (P=0.001), but not with the number of the tumors, portal invasion, extrahepatic metastasis, clinical stage or histological differentiation (P>0.05). A significant correlation was observed between AFP level and tumor size (P=0.028), portal invasion(P=0.005), and histological differentiation (P=0.000). CONCLUSION: TPS alone offers no more clues than AFP for the diagnosis of primary hepatic cancer, though it can be helpful for the diagnosis of cholangiocarcinoma. It has only limited clinical utility as a marker for primary hepatic cancer.     

全程冷敷加巨刺治疗急性踝外侧韧带损伤35例

目的:探讨全程冷敷加巨刺法对急性踝外侧韧带损伤的治疗作用.方法:将66例急性踝外侧韧带损伤患者随机分为治疗组和对照组,在常规治疗方法休息、加压包扎、抬高患肢治疗外,治疗组给予全程冷敷和巨刺,对照组只采用全程冷敷.结果:治疗组在疗效和痊愈所需时间上明显优于对照组(P＜0.05).结论:全程冷敷和巨刺治疗急性踝外侧韧带损伤疗效确切.     

Integrating PET and CT information to improve diagnostic accuracy for lung nodules: A semiautomatic computer-aided method.

Our objective was to develop and evaluate 3 semiautomatic computer-aided diagnostic (CAD) schemes for distinguishing between benign and malignant pulmonary nodules by use of features extracted from CT, 18F-FDG PET, and both CT and 18F-FDG PET. METHODS: We retrospectively collected 92 consecutive cases of pulmonary nodules (<3 cm) in patients who underwent both thoracic CT and whole-body PET/CT. Forty-two of the nodules were malignant and 50 benign, as confirmed by pathologic examination and clinical follow-up. The interval between CT and PET was less than 1 mo. Four clinical parameters, including patient age, sex, smoking status, and history of previous malignancy, were used for the CAD schemes. Sixteen CT features based on size, shape, margin, and internal structure of nodules were independently rated subjectively by 2 chest radiologists. Four PET features were viewed on a PET/CT workstation. CAD schemes based on clinical parameters together with CT features, PET features, and both CT and PET features were then used to differentiate benign from malignant nodules. Finally, the output from the CAD schemes was evaluated by use of receiver-operating-characteristic analysis. RESULTS: When we used clinical parameters and CT features as input units (CAD scheme 1), the area under the receiver-operating-characteristic curve (A(z) value) of the CAD scheme was 0.83. When we used clinical parameters and PET features as input units (CAD scheme 2), the A(z) value for the computer output was 0.91. However, when we used all data as input units (CAD scheme 3), the A(z) value for the computer output was 0.95. The performance of CAD scheme 3 was better than that of CAD scheme 1 or 2. A statistically significant difference existed between the A(z) values of CAD schemes 3 and 2 (P = 0.037) and between those of CAD schemes 3 and 1 (P = 0.015). CONCLUSION: Our CAD scheme based on both PET and CT was better able to differentiate benign from malignant pulmonary nodules than were the CAD schemes based on PET alone and CT alone.     

Turner氏综合征的临床与骨改变分析(附15例报告)

目的通过对15例有详细的临床及影像资料的Turner氏综合征分析,探讨先天性卵巢发育不良综合征(Turner)的临床与骨改变特点。方法收集15例Turner氏综合征临床及骨骼X线平片,分析其表现。结果染色体核型分3型,第1型45,X,8例;第2型46,XX,5例;第3型46,XX/45,X,2例。X线表现有:骨质稀疏14例,掌骨征阳性8例,指骨优势9例,肘外翻10例,脊柱骨化不良5例,足趾趾节短9例,颅底凹陷11例。结论Turner氏综合征患者最终身高明显低于正常人群,智力低下,性发育不全。X线表现典型,骨改变对临床的诊断具有主要参考价值。     

Differences in SLE disease activity between patients of Caucasian and South‐East Asian/Chinese background in an Australian hospital

Aim: We performed a semiprospective and retrospective review of all admissions to a single institution of systemic lupus erythematosus (SLE) patients, admitted due to active disease. The aim was to describe differences in disease activity as a cause of hospital admissions between patients originating from South‐East Asia/China (SAC) and Caucasians. Method: There were 210 patients admitted for active disease, with a total of 567 admissions for active SLE over a 16‐year period. Allowing for patients who had left our database, there was a total of 3415 patient years of observation. Results: Patients from SAC with a flare requiring admission presented earlier in their disease course and with more active disease than did Caucasians (median SLE Disease Activity Index 13 vs. 8, P= 0.002). They had longer inpatient stays (7 vs. 5 days P = 0.03). There was a trend to higher rates of re‐presentation to hospital for flare (59% in SAC patients vs. 41% in Caucasians, P = 0.09) with more subsequent admissions (3 vs. 2 P = 0.06) despite a shorter period of observation. Conclusions: South‐East Asian/Chinese were more likely to be diagnosed with class III/IV glomerulonephritis and require cyclophosphamide both at presentation and subsequent admissions. More patients from SAC were readmitted to hospital for severe central nervous system disease after their first hospital admission. In this population, lupus patients had more severe flares and more frequently required admission for these than Caucasians.     

端粒酶逆转录酶、环氧化酶-2在乳腺癌中的表达及其意义

目的 探讨端粒酶逆转录酶(hTERT)和环氧化酶(cox)-2在乳腺浸润性导管癌中的表达及其临床意义.方法 使用免疫组织化学法分别检测45例乳腺浸润性导管癌和22例乳腺良性病变标本的hTERT和COX-2蛋白表达情况.结果 hTERT在乳腺浸润性导管癌中阳性表达率fig71.11%,明显高于乳腺良性病变9.09%,两者比较差异有统计学意义(P<0.05).hTERT阳性表达与乳腺浸润性导管癌患者的年龄、肿瘤大小、腋窝淋巴结转移情况及雌、孕激素表达水平无相关性(P>0.05),与Her-2表达存在显著相关性(P<0.05).COX-2在乳腺浸润性导管癌中的阳性表达率为82.22%,明显高于乳腺良性病变50.00%,两者比较差异有统计学意义(P<0.05).COX-2阳性表达与乳腺浸润性导管癌患者腋窝淋巴结转移情况、Her-2、ER阳性表达有关(P<0.05).在乳腺浸润性导管癌中hTERT阳性表达与COX-2阳性表达呈正相关(r=0.557,P<0.01).结论 hTERT与COX-2在乳腺浸润性导管癌中的表达显著高于在乳腺良性病变中的表达,hTERT与COX-2在乳腺癌的发生、发展中起重要作用.hTERT表达与COX-2表达存在显著相关性,COX-2的过度表达可能是端粒酶激活和调节的机制之一.