地尔硫卓对失血性休克犬肾脏的保护作用

目的：探讨地尔硫卓（Ｄｉｌｔｉａｚｅｍ,Ｄｉｌ）对失血性休克犬肾脏的保护作用及机理。方法：动脉放血,使血压降低至５３３～６６７ｋＰａ（４０～５０ｍｍＨｇ）,维持９０ｍｉｎ后回输血液进行复苏。在休克３０ｍｉｎ时,分别给动物输注盐水和（或）Ｄｉｌ。结果：Ｄｉｌ能明显提高失血性休克动物的平均动脉压（ＭＡＰ）;降低肾脏组织中的丙二醛（ＭＤＡ）含量和超氧化物歧化酶（ＳＯＤ）的活性;保护肾脏组织的超微结构。结论：Ｄｉｌ对失血性休克犬的肾脏具有保护作用。     

增生性瘢痕和瘢痕疙瘩组织中Ⅰ、Ⅲ型前胶原及TGF-β_1 mRNA的表达

目的：探讨增生性瘢痕（Ｈ）和瘢痕疙瘩（Ｋ）组织中Ⅰ、Ⅲ型前胶原及ＴＧＦ－β１基因表达改变的相互关系及临床意义。方法：总ＲＮＡ抽提试剂盒抽提总ＲＮＡ,斑点杂交检测Ⅰ、Ⅲ型前胶原及ＴＧＦ－β１ｍＲＮＡ稳态水平的改变。结果：Ｈ和Ｋ组织中ＴＧＦ－β１ｍＲＮＡ（１．１９７±０．２３７,１．２０４±０．２４３）表达均高于正常瘢痕和正常皮肤（０．３２７±０．０８１,０．３３１±０．０７８）,Ｐ＜０．０１;Ｋ选择性地Ⅰ型前胶原ｍＲＮＡ表达增强,而Ｈ组织中Ⅰ、Ⅲ前胶原ｍＲＮＡ表达均增强,导致ＫⅠ、Ⅲ前胶原ｍＲＮＡ比值明显高于Ｈ（８．１６４±０．３００,１．６６６±０．２０１,Ｐ＜０．０１）。结论：Ｋ和Ｈ组织中胶原蛋白基因表达类型及强度不同,提示在Ｋ和Ｈ发生发展中具有不同的分子机理：ＴＧＦ－β１在增生性瘢痕疙瘩的发病机理中具有不同的分子机理;ＴＧＦ－β１在增生性瘢痕和瘢痕疙瘩的发病机理中具有一定作用。     

择期剖宫产339例临床分析

目的：探讨择期剖宫产的安全性及其率的降低方法;方法：对３３９例择期剖宫产手术指征及母儿并发症进行回顾性分析;结果：①择期剖宫产占剖宫产总数的３３．３７％;②择期剖宫产围产儿死亡率为５．９０‰,明显低于同期围产儿死亡总率（Ｐ〈０．０１）;③在产时出血、产褥期感染等近期母体并发症方面与同期急症剖宫产无显著差异;结论：择期剖宫产是安全的,但应严格掌握手术指征以期使剖宫产率进一步降低。     

鼻咽癌中与已知基因同源的差异表达cDNA序列

采用新近发展的ｃＤＮＡ代表性差异分析法筛选鼻咽癌中不表达的或表达降低的ｃＤＮＡ序列。结果显示：有９个与已知基因高度同源的ｃＤＮＡ序列。通过对这些已知基因的结构和功能分析,发现有与细胞骨架成分相关的基因：αａｃｔｉｎｉｎ,ｅｚｒｉｎ和细胞角蛋白１３;直接与瘤基因和抑瘤基因相互作用的基因：鲨烯合成酶和ＴＲＩＰ１基因;直接参与ＤＮＡ合成以及调控基因转录和翻译的基因：ＴＡＦⅡ６８和组蛋白Ｈ１０;另外还有人类补体因子Ｂ及类转运ＲＮＡ合成酶的基因。这些基因大多具有相当于抑瘤基因的功能。从而进一步说明鼻咽癌的发生是多基因相互作用的结果。     

伊曲康唑间歇冲击疗法治疗甲真菌病

用伊曲康唑短程间歇冲击疗法治疗甲真菌病５４例（指甲真菌病２６例,趾甲真菌病２８例）,并随访９个月。结果显示：患者指甲临床治愈率为８８５％,真菌学治愈率为９６１％;趾甲临床治愈率为８２１％,真菌学治愈率为９６１％;仅有７４％的患者出现恶心、胃肠道不适等轻微副作用。本疗法疗效高、副作用小和安全性好     

三氧化二砷诱导K562细胞凋亡的初步研究

目的：探讨三氧化二砷（Ａｓ２Ｏ３） 治疗慢性粒细胞性白血病（ＣＭＬ） 的机制。方法：以ＣＭＬ细胞系Ｋ５６２ 为模型,通过细胞增殖、活力检测、形态学观察、肿瘤集落形成的琼脂糖凝胶电泳等检验。结果：经≥２．５μｍｏｌ／ＬＡｓ２Ｏ３ 处理的Ｋ５６２ 细胞可出现增殖受抑和凋亡的形态学改变及ＤＮＡ片段化。结论：Ａｓ２Ｏ３ 能有效地诱导Ｋ５６２ 细胞凋亡。     

抗人尿激酶受体单克隆抗体的制备与鉴定

目的　制备抗人尿激酶受体单克隆抗体,为今后ｕＰＡＲ 病理生理作用及临床意义的研究提供新的手段。方法　利用杂交瘤技术,用经ＰＭＡ刺激的Ｕ９３７ 细胞与可溶性尿激酶受体（ｓｕＰＡＲ）免疫Ｂａｌｂ／ｃ 小鼠,与ＳＰ２／０ 细胞融合。结果　获得国内第１ 组４ 株抗人尿激酶受体（ｕＰＡＲ）单抗,分别命名为ＳＺ－ ９８、ＳＺ－ ９９ 、ＳＺ－ １００ 、ＳＺ－ １０１。结论　４ 株单抗均能与ｕＰＡＲ 特异性结合,能与Ｕ９３７ 细胞及经ＰＭＡ作用的Ｋ５６２ 细胞反应。ＳＺ－ １０１ 与国外抗ｕＰＡＲ单抗３９３６ 有相同的ｕＰＡＲ 结合位点;而ＳＺ－９８、ＳＺ－ ９９ 与ＳＺ－ １００ 在ｕＰＡＲ上有不同的结合位点     

Heterogeneous cardiac sympathetic denervation and decreased myocardial nerve growth factor in streptozotocin-induced diabetic rats: implications for cardiac sympathetic dysinnervation complicating diabetes

Heterogeneous myocardial sympathetic denervation complicating diabetes has been invoked as a factor contributing to sudden unexplained cardiac death. In subjects with diabetic autonomic neuropathy (DAN), distal left ventricular (LV) denervation contrasts with preservation of islands of proximal innervation, which exhibit impaired vascular responsiveness. The aims of this study were to determine whether this heterogeneous pattern of myocardial sympathetic denervation occurs in a rat model of diabetes and to explore a potential association with regional fluctuations in myocardial nerve growth factor (NGF) protein. Myocardial sympathetic denervation was characterized scintigraphically using the sympathetic neurotransmitter analog C-11 hydroxyephedrine ([11C]HED) and compared with regional changes in myocardial NGF protein abundance and norepinephrine content after 6 and 9 months in nondiabetic (ND) and streptozotocin-induced diabetic (STZ-D) rats. In ND rats, no difference in [11C]HED retention or norepinephrine content was detected in the proximal versus distal myocardium. After 6 months, compared with ND rats, myocardial [11C]HED retention had declined in the proximal segments of STZ-D rats by only 9% (NS) compared with a 33% decrease in the distal myocardium (P < 0.05). Myocardial norepinephrine content was similar in both ND and STZ-D rats. At 6 months, LV myocardial NGF protein content in STZ-D rats decreased by 52% in the proximal myocardial segments (P < 0.01 vs. ND rats) and by 82% distally (P < 0.01 vs. ND rats, P < 0.05 vs. proximal segments). By 9 months, [11C]HED retention had declined in both the proximal and distal myocardial segments of the STZ-D rats by 42% (P < 0.01 vs. ND rats), and LV norepinephrine content and NGF protein were decreased in parallel. Therefore, 6 months of STZ-induced diabetes results in heterogeneous cardiac sympathetic denervation in the rat, with maximal denervation occurring distally, and is associated with a proximal-to-distal gradient of LV NGF protein depletion. It is tempting to speculate that regional fluctuations of NGF protein in the diabetic myocardium contribute to heterogeneous cardiac sympathetic denervation complicating diabetes.     

Epidemiological features and diagnostic evaluation of intracranial aneurysms

Female gender and cigarette smoking appear to be risk factors for the development of multiple intracranial aneurysms. An acquired nature is likely in this form. The mechanism of aneurysm formation in patients with sickle cell anemia is apparently different. These patients also present multiple aneurysms that show propensity for vertebrobasilar territory and appear at a younger age. Familial cerebral aneurysms are diagnosed once heritable connective tissue disorders have been excluded. The age of patients tends to be lower and the size of aneurysm to be smaller at the time of rupture in the familial form. These aneurysms are less frequently found in the anterior communicating artery than the sporadic aneurysms. A high incidence of asymptomatic familial aneurysms was detected in people with family histories of intracranial aneurysms studied by means of magnetic resonance angiography. Furthermore, familial aneurysms are more likely to rupture in families having members with aneurysmal subarachnoid hemorrhage (SAH) than in those without. The results of an interesting study using color "power" transcranial Doppler ultrasound in patients with aneurysmal SAH suggest that as the intracranial pressure diminished, the size of the aneurysm increased, and there was relatively little change between maximum and minimum dimensions during the cardiac cycle, i.e., the pulsatility is reduced. The use of postoperative angiography after clipping is a matter of debate. The indication more widely accepted is in large aneurysms with a wide neck, in which incomplete clipping can be suspected. Taking into account the current low risk of angiography in centers of excellence, its routine use may be recommended. Aneurysm remnants, vessel occlusion, vasospasm, and newly identified aneurysms are the main findings that were reported.     

Hematocrit level and associated mortality in hemodialysis patients

Although a number of clinical studies have shown that increased hematocrits are associated with improved outcomes in terms of cognitive function, reduced left ventricular hypertrophy, increased exercise tolerance, and improved quality of life, the optimal hematocrit level associated with survival has yet to be determined. The association between hematocrit levels and patient mortality was retrospectively studied in a prevalent Medicare hemodialysis cohort on a national scale. All patients survived a 6-mo entry period during which their hematocrit levels were assessed, from July 1 through December 31, 1993, with follow-up from January 1 through December 31, 1994. Patient comorbid conditions relative to clinical events and severity of disease were determined from Medicare claims data and correlated with the entry period hematocrit level. After adjusting for medical diseases, our results showed that patients with hematocrit levels less than 30% had significantly higher risk of all-cause (12 to 33%) and cause-specific death, compared to patients with hematocrits in the 30% to less than 33% range. Without severity of disease adjustment, patients with hematocrit levels of 33% to less than 36% appear to have the lowest risk for all-cause and cardiac mortality. After adjusting for severity of disease, the impact of hematocrit levels of 33% to less than 36% is vulnerable to the patient sample size but also demonstrates a further 4% reduced risk of death. Overall, these findings suggest that sustained increases in hematocrit levels are associated with improved patient survival.