238例复治肺结核病人耐药状况分析

目的 了解复治肺结核病人形成原因和耐药状况，分析结核病控制策略的效果。方法 分析1999年湖北省耐药监测入选238例复治涂阳培阳病例既往病史和耐药状况；药敏试验采用比例法，培养基中药物浓度分别为S 4μg/ml、H 0．2μg/ml、R 40μg/ml和E 2μg/ml；结果 总耐药率为44．5％，耐多药率为21．8％，在综合医院、乡镇卫生院和结防专业机构治疗造成的耐药率和耐多药率(含H和R)分别为56．4％、31．3％、46．3％和30．8％、15．0％、20．8％。结论 治疗不规范是导致耐药率和耐多药率升高的原因，建议加强结核病人归口、化疗和全程督导管理，进一步完善结核病控制策略，减少复治病例和耐药的产生。     

富氧水防治急性高原病的效果观察

目的:观察饮用富氧水防治急性高原病的效果。方法:36名受试者自海拔1400m驻地乘汽车2天到达海拔3700m当日随机分两组,实验组(18人)口服5%葡萄糖注射液制成的富氧水,对照组(18人)口服5%葡萄糖注射液,均每次500mL,一日2次,直至进入海拔5200m某哨卡第6天,共服液8天。以军用卫生标准GJB1098-91"急性高原反应的诊断和处理原则"随访记录受试者进入哨卡第2天、4天、6天急性高原反应症状,然后分度与评分。同时检测血氧饱和度(SaO2)和脉率。结果:进驻哨卡第2天和第4天实验组较对照组急性高原反应分值减少,而SaO2增高(P<0.05或P<0.01),进驻哨卡第2天实验组较对照组脉率降低(P<0.05)。结论:饮用富氧水有防治急性高原病的效果。     

改进的内眦赘皮矫治术联合重睑成形术Ⅰ期成形

目的 探讨改进的内眦赘皮矫治术联合切开法重睑成形术的方法及临床效果。方法 根据内眦赘皮的轻重程度及方向，采用改良的“Z”成形术，切除或切断内眦部形成赘皮的异位眼轮匝肌及皮下筋膜组织，联合切开法重睑成形术行Ⅰ期成形。结果 本组68例患者，术后赘皮消失，泪阜显露适中，内眦间距缩短，重睑外形美观自然。其中，36例随访3个月至3年，术后皮肤切口无可见瘢痕，形态稳定，内眦赘皮无复发，效果满意。结论 该手术方法能够充分矫正内眦赘皮的异常结构，而与重睑成形术同期施术效果稳定，具有一定的临床应用价值。     

Long-term application of diethylstilbestrol upregulates expressions of μ- and m-calpains in pituitary intermediate lobe of female Wistar rats

BACKGROUND: During formation of prolactin neoplasia, how cells and its structure in adenohypophysis affect prolactin cells should be further studied. Intermediate lobe can be regarded as a driving region to release prolactin (PRL) and may promote formation of prolactin neoplasia in pituitary anterior lobe. OBJECTIVE: To observe the effect of diethylstilbestrol (DES) on the expressions of μ and m-calpains in pituitary intermediate lobe of female Wistar rats. DESIGN: Observational contrast animal study. SETTING: Beijing Neurosurgical Institute. MATERIALS: A total of 21 female Wistar rats, 3 weeks old weighing 70–80 g were housed with free access to tap water and standard pellet food. They were kept in a CL-grade condition, at (24±1)℃ and a humidity of (55±5)%, and with a 12 hours day-night cycle. Caprine anti-μ- and m-calpains antibodies were provided by Santa Cruz Biotechnology, CA, USA; rabbit-anti-PRL antibodies by Dako, Denmark; rabbit-anti-ACTH antibody by Boster Company, Wuhan. METHODS: The experiment was carried out in Pathophysiological Department and Animal Laboratory, Beijing Neurosurgical Institute from August 2006 to January 2007. ① Rats were randomly divided into groups with 7 in each group, including vehicle control group, in which rats were injected intraperitoneally with sun-flower seed oil (1 mL/kg, twice a week) for 16 weeks; DES group, where animals were administered with DES (5 mg/kg, twice a week) for 16 weeks; DES + vehicle control group, in which DES was administered for 12 weeks at the same dose with those in DES group, and then was discontinued and replaced by sun-flower seed oil (1 mL/kg, twice a week) for the following 4 weeks. ② At 16 weeks later, pituitary tissue was dealt with HE staining and PRL immunohistochemical examination to observe evoke of tumor; meanwhile, immunohistochemical examination was used to observe expression of PRL of pituitary anterior lobe, expressions of μ- and m-calpains of pituitary intermediate lobe and distribution of adrenocorticotropin. MAIN OUTCOME MEASURES: ① Expression of PRL of pituitary anterior lobe, expressions of μ- and m-calpains of pituitary intermediate lobe and distribution of adrenocorticotropin. ② Morphological observation of pituitary tissue. RESULTS: All 21 rats were involved in the final analysis. ① Results of immunohistochemical examination: Morphological changes of neoplasia in DES group were strongly positive to PRL, and this suggested that formation of prolactin adenoma was observed in pituitary tissue. As compared with vehicle control group, expression of adrenoeorticotropic hormone (ACTH) was increased in both DES group and DES + vehicle control group. In addition, expressions of μ- and m-calpains in pituitary intermediate lobe were higher in DES group than that in vehicle control group. Otherwise, expressions of m-calpains in pituitary intermediate lobe was decreased in DES + vehicle control group, but expression of μ-calpains was still increased. ② Morphological observation of pituitary tissue: Gland tubes were orderly arranged in rats in vehicle control group. Anterior pituitary gland in rats of DES group demonstrated an apparent disappearance of gland tubes and a relatively large-scaled vasculature formation, namely the vascular lake lined by tightly arranged endothelial cells. Local integrated tumor cell arrangements were also detected. In addition, the border between the IL and the anterior lobe was locally blurred. The definite tumor-like changes in pituitary tissues were confirmed in 6 of 7 female Wistar rats in DES group, and one spontaneous occurrence of tumor formation was found in vehicle control group. In DES + vehicle control group, DES withdrawal led to the subtile emergence of gland tube cavity, although tumor-like cells still existed in 4 of 7 rats, suggesting occurrence of the tumor regression due to the withdrawal of DES. CONCLUSION: A long-term application of DES can enhance the expressions of ubiquitours neutral cysteine protease in pituitary intermediate lobe and this suggests that both of them play a key role in release of hormone and formation of prolactin neoplasia through directly promoting PRL expression and release of neighboring pituitary intermediate lobe.     

肾移植术后并发卡氏肺孢子虫病活检的病理学研究

报告肾移植术后５例并发卡氏肺孢子虫肺炎。采用纤维支气管镜活检，分别对印片及组织进行银染和ＨＥ染色。病变为上皮细胞脱落，有时增生呈立方状；炎症反应；各种类型渗出物（包括泡沫状渗出物、泡沫细胞团及絮状蛋白渗出物）等３种改变。重点讨论了本病的组织病理学特征，并对不典型病变形成机理加以讨论。     

肾脏疾病患者治疗前后血浆内皮素水平动态变化及其意义

目的 为了探讨肾脏疾病患者血浆内皮素水平与肾脏疾病病情程度的关系,为肾脏疾病治疗效果的评价提供依据.方法 采用放射免疫分析(RIA)观察了77例肾脏疾病患者治疗前后血浆内皮素水平的动态变化,并与60例正常对照组比较.结果 正常对照组血浆内皮素浓度为43.1±15.2ng/L,肾脏疾病患者治疗前血浆内皮素水平为161±83.8ng/L,治疗后为97.4±52.7ng/L,均高于正常对照组(P值均<0.001).肾脏疾病治疗后内皮素水平明显下降(P<0.001),与BUN,Cr水平的下降具有一定的相关性(相关系过分别为0.54,0.55).结论血浆内皮素水平随着肾脏疾病严重程度的增加而升高,血浆内皮素水平可作为肾脏疾病治疗效果评定的指标之一     

肝硬化患者的脑电活动地形图

对２０例无临床肝性脑病的失代偿期肝硬化患者进行脑电活动地形图（ＢＥＡＭ）检查，并与３３例正常人作对照，以探讨亚临床肝性脑病（ＳＨＥ）的诊断价值。结果表明，２０例肝硬化患者中，ＢＥＡＭ正常５例，轻度异常５例，轻￣中度异常５例，中度异常５例，总异常率为７５％（１５／２０）。ＢＥＡＭ异常的分布特点以弥漫性分布为主要表现，主要为慢频域（δ．θ．δ＋θ／α＋β）活动增强，Ｚ值增高，只有３例波及α频域。提示：     

Bronchial hyperresponsiveness, epithelial damage, and airway eosinophilia after single and repeated allergen exposure in a rat model of anhydride-induced asthma

Bronchial hyperresponsiveness (BHR) and damage of the epithelium, as well as eosinophilia in the airway wall, induced by trimellitic anhydride (TMA) in sensitized brown Norway rats were studied. Rats were challenged once or seven times with aerosol of TMA conjugated to rat serum albumin (TMA-RSA) 3 weeks after intradermal TMA sensitization. Airway responsiveness (-log PC₃₀₀ of acetylcholine i.v.) was measured 24 h after allergen challenge. Epithelial lesion and eosinophil infiltration in the airway walls were quantified under light microscopy, and TMA-specific IgE and IgG in serum were evaluated with ELISA. High levels of TMA-specific IgE and IgG were found in all rats in the sensitized groups compared to nonsensitized groups ( P < 0.001). Repeated allergen challenges of 0.03% TMA-RSA for 7 consecutive days enhanced the level of TMA-specific IgG, compared to single challenge ( P < 0.05). Single allergen challenge of 0.3% TMA-RSA had a nonsignificant tendency to produce BHR in sensitized rats compared to nonsensitized rats ( P =0.06). However, repeated allergen challenges (0.003% and 0.03% TMA-RSA for 7 consecutive days) produced significant BHR in sensitized rats ( P < 0.05). Furthermore, repeated low-dose (0.003%) TMA-RSA challenge produced more BHR than a 10 times higher single dose (0.03%) ( P < 0.05). Slight damage of the airway epithelium was seen in sensitized and repeat-challenged groups. However, bronchial eosinophilia was found in the sensitized and single-challenged groups, but not in nonsensitized nonchallenged, and sensitized repeat-challenged groups ( P < 0.005). We conclude that the brown Norway rat can be sensitized with TMA, and that repeated low-dose allergen challenges produce slight epithelial damage and BHR which is independent of ongoing eosinophilia in the airway wall.     

人胚肺细胞对人冠状病毒的敏感性

人冠状病毒72-62和73-50干燥毒种,用人胚器官和原代人胚肾细胞合管培养未能引起细胞病变,而将病毒液接种到人胚器官细胞或人胚肺传代细胞第一代就能引起明显的细胞病变。新传代病毒经电镜及中和试验鉴定确属人冠状病毒。实验结果证明人胚肺传代细胞比原代人胚肾细胞敏感,为进一步研究人冠状病毒提供了一株敏感的细胞。     

人右心室肌纤维方向的解剖

对１１个人心标本沿右心室流入道和流出道各壁长轴纵行切开，再将各壁横切为上、中、下３份，各份按１ｍｍ厚度逐层切开，观察其各层肌纤维方向的角度并绘成坐标图。结果表明，右心室流入、流出道游离壁的肌纤维方向由浅入深基本上是渐变的。流入道游离壁的下１／３和流出道的上１／３，浅中层与内层之间可有纤维方向的突变。流入道隔壁的纤维方向从右向左逐渐移行，偶在左、右室内膜面有方向的改变。流出道右室面的中上部有一纤维方向变动较大的层次。对右心室各壁肌纤维方向的排列特或、分层、功能及其临床意义进行了探讨。