儿童多米诺肝移植初步报告

目的探讨儿童多米诺肝移植的可行性和安全性。方法将一成人左外叶移植给家族性高胆固醇血症3岁男性患儿，同时采用多米诺肝移植技术将该患儿的肝脏移植给先天性胆道闭锁4个月女性患儿。结果家族性高胆固醇血症患儿的血清总胆固醇及低密度脂蛋白于术后第三天降至正常范围，手术后第8天死于心力衰竭。先天性胆道闭锁患儿随访16个月，肝肾功能化验正常，血清总胆固醇及低密度脂蛋白分别为8．87mmol／L和6．21mmol／L，明显低于多米诺供体患儿的术前水平。结论尽管术后多米诺受者出现获得性高胆固醇血症，但FHC可以作为多米诺供肝，近期效果满意，远期效果需进一步观察。     

TLR4与糖尿病肾病的研究进展

糖尿病肾病(diabetic nephropathy,DN)的发病机制尚不明确,近年来大量研究表明,Toll样受体4(Toll-like receptor 4,TLR4)与DN密切相关.TLR4通过髓样分化因子88(myeloid differentiation factor 88,MyD88)依赖性和非依赖性等途径激活下游信号分子,引发一系列的炎症反应,最终导致DN的发生与发展.     

乳腺微浸润癌的临床病理学特征及生物学特性

目的探讨乳腺微浸润癌（microinvasive carcinoma,MIC）的临床病理学特征及生物学特性和其病理诊断标准。方法回顾性研究40例MIC,按文献报道诊断标准分为两个亚型,并对病理学特征、分子生物学指标及预后进行比较。结果MIC占同期乳腺癌的1．5％,乳腺钼靶拍片85．0％的病例（34例／40例）显示不同程度的泥沙样钙化。粉刺型和高核分级的导管内癌更易形成间质浸润。淋巴结转移2．5％（1例／40例）。31例平均8个月随访显示无复发及转移。两亚型各指标比较结果差异均无显著性。结论MIC是一种少见、淋巴结转移率低、预后较好的恶性肿瘤。建议诊断标准：单个浸润灶时,最大径应〈2mm;出现几个浸润灶时,其中单个浸润灶的最大径应〈1mm,且几个浸润灶面积总和不应超过整个肿瘤组织面积的10％。     

探讨乙肝病毒转录体在母婴传播中的意义

目的探讨乙型肝炎病毒(HBV)转录体的检测在母婴传播中的意义。方法自母亲及其婴儿血清中提取核酸,经PCR及RT-PCR分别扩增HBVDNA和RNA,琼脂糖凝胶电泳显示产物,Southern-blotting验证反应的特异性,取代表性产物克隆、测序。结果HBeAg( )母亲的XDNA(75%)和fRNA的表达(65%)显著(P<0.05)高于HBeAg(-)的母亲;所有表达fRNA的母亲也同时表达trRNA,在20例XDNA(-)fRNA(-)的母亲中,仍有8个可检测到trRNA。婴儿XDNA(4.55%)和fRNA(6.81%)的表达较其母亲显著降低;占优势表达的是trRNA(52.27%),且与其母亲trRNA的表达状态密切相关。母亲为trRNA( )的婴儿trRNA的表达显著高于母亲为trRNA(-)者。15例HBsAb( )的婴儿均未检出XDNA和fRNA,但11例仍可检测到trRNA。结论与HBVDNA及其表达产物相比,trRNA在HBV母婴垂直传播过程中有可能是一个出现更早期的可检测指标,它有助于更精确的确定新生儿HBV感染的状态。     

呼吸不同氧浓度混合气对迟发性耳气压伤的影响

目的 观察呼吸不同氧浓度混合气对低压舱实验后人耳气压功能和听力的迟发影响.方法 实验采用自身对照平衡设计,5名被试者分别在不同时间内(间隔2周以上)参加呼吸纯氧、60％氧气(含60％氧气和40％氮气)和空气3组试验.每次均在呼吸1h实验用气之后进行耳气压功能低压舱试验,观察3组被试者在不同时间点的主观症状、鼓膜充血程度、声导抗和纯音听阈等指标变化.结果 纯氧组、60％氧气组和空气组被试者出舱即刻出现主观症状的耳数分别为8、2和3耳,纯氧组个别被试在出舱后3h耳闷与耳痛症状有所反复.出舱即刻3组被试者鼓膜充血程度为Ⅲ度的耳数分别为5、2和3耳,但未出现随时间延长而加重的现象.实验后3组被试者维持为A型鼓室图的耳数分别为5、6和6耳,各组鼓室图相关指标数值和声反射不全引出率随时间延长而趋向初始值,未出现明显的迟发性数据回弹.纯氧组被试者中耳压和各倍频程听阈之和在低压舱试验后改变较多,恢复较慢.结论 呼吸纯氧较长时间会使参加低压舱实验的被试者耳气压伤发病率增加,症状加重,且容易诱发24h内症状反复.     

均匀设计和回归分析法用于小鼠耳廓肿胀优化实验条件探索的研究

目的：规范筛选小鼠耳片肿胀模型的造模最佳条件。方法：采用均匀设计法设计试验方案,以二甲苯为造模药物,以小鼠耳片肿胀率为指标,考察二甲苯用量和造模时间对此指标的影响程度,用直线回归分析法对实验结果进行处理,寻找最佳实验条件。结果：小鼠耳片肿胀模型的最佳条件为：二甲苯用量25μl,造模时间90min。结论：联合应用均匀设计和回归分析法筛选小鼠耳廓肿胀模型的实验条件,科学可行,将推进该实验的规范化研究。     

多层螺旋CT后处理技术对肝癌动脉的显示价值

目的：探讨多层螺旋CT后处理技术对于肝癌动脉的显示价值。方法：173例肝癌患者中,男131例,女42例;年龄33～82岁。采用多层螺旋CT机进行增强扫描。将动脉期图像数据以多平面重建、最大密度投影及容积再现等模式对血管进行显示分析。曲面重组和曲面最大密度投影技术也被应用。结果：在评价肝动脉解剖识别方面,容积再现技术和最大密度投影显著优于多平面重建（P〈0．001）,且容积再现技术优于最大密度投影（P〈0．001）。在评价肿瘤病灶供血动脉方面,最大密度投影显著优于多平面重建和容积再现技术（P〈0．001）,且容积再现技术优于多平面重建（P〈0．05）。在评价肿瘤血管的连续性和血管形态方面,MIP优于VRT（P〈0．001）;MIP优于MPR（P〈0．001）;VRT优于MPR（P〈0．001）。结论：多层螺旋CT血管成像技术是一种重要的对肝癌供血动脉的评价方法。MIP为评价肝脏血管的最佳模式,有助于外科手术和介入治疗。     

人工富氧环境改善急进高原人员睡眠效果的研究

Objective To study the effects of the artificial oxygen-enriched environment (is called "oxygen-enriched room" in short) on sleep efficiency of the people who participate in the mission on plateau with hurry-up entry,and to investigate the anti-hypoxia effect of oxygen-enriched room to plateau acclimatization. Methods Eighteen subjects were randomly and averagety allocated into plain group,oxygen-enriched group and hypoxia group.Only the later two groups were dispatched to plateau by air.Molecular sieve oxygenerator was used to supply the room with oxygen on 3500 m plateau.The oxygen-enriched group and hypoxia group got into the oxygen-enriched rooms and normal rooms respectively at 22 o' clock and took rest till to 9 o' clock next morning.The changes of heart rate (HR) and the saturation of blood oxygen (SaO2) of three groups were recorded and compared between the states of with and without oxygen enrichment.The subjects were monitored by sleep respiration recording and analysis system. Results ①The SaO2 of the oxygen-enriched group was 92.3%±1.0%,and it was significant higher than the state before oxygen enrichment (82.9%±4.2%) and than that of hypoxia group (79.3%±5.9%,P<0.01),but lower than that of plain group (97.3%±0.8%,P<0.05).②There were less deep sleep and more slight sleep in hypoxia group and oxygen-enriched group than in plain group.The hypopnea and apnea hypopnea index (AHI) of plain group was significant lower than that of hypoxia group and oxygen-enriched group (P<0.05).The AHI of the oxygen-enriched group was 28.1±11.9,and it was significant lower than that of hypoxia group (53.2±23.4)(P<0.05).③The normalized low-frequency (Ln) and the ratio of low-frequency to high-frequency (LF/HF) measured in sleep was respectively 89.3±2.9 and 6.4±1.4 in oxygen-enriched group comparing to 90.2±1.8 and 9.9±1.9 in hypoxia group but without statistical difference.The corresponding Ln and LF/HF of plain group was 85.8±2.9 and 6.4±1.4 respectively,significantly higher than those of other two groups (P<0.05).Plain group also showed higher normalized high-frequency than others(P<0.05). Conclusions Oxygen-enriched environment can effectively improve the sleep quality but significantly change heart rate variation (HRV) of the people who participate in the mission with hurry-up entry to plateau.Further studies are still needed to reveal the quantitative effectiveness of oxygen-enriched room to plateau acclimatization.     

扁平疣患者的抑郁情绪和细胞免疫功能的研究

Objective To evaluate the possible association between depression and cellular immunologic status in patients with verruca planea. Methods Depression was assessed with the Self-rating Depression Scale (SDS), and the inteleukin-2 (IL-2)produced by peripheral blood mononuclear cells (PBMC) and the activity of natural killer (NK) cells were measured in 68 patients with verruca planea. Results The SDS scores in patients with verruca planea(46. 08 ± 12.76) were significantly higher than those in the controls(41.88 ± 10. 57, t = 3.71, P ＜ 0. 01 ), and 38% of the patients were affected by depression. The mean scores of depression (48.89 ± 11. 52 ) and the rate ( 29% ) of depressive disorder among patients unmarried (single) were significantly higher than those married [(43. 16 ± 10. 17 ), 9%;t = 2. 28, x2 = 4. 86, P ＜ 0. 05] . The mean scores of depression among female patients (49. 01 ± 11.36 )were significantly higher than male patients [(41.96 ± 10.48 ) ,t =2. 21 ,P ＜0. 05] . In patients affected by depression, the level of the IL-2[(46. 64 ± 12. 28) × 103 U/L] produced by PBMC and the activity of NK cells[( 19. 23 ±5.60)%] were significantly decreased than those in undepressive group[(56. 15 ± 18. 32) ×103 U/L, (24.65 ± 6. 89)%; t = 3.18, 3. 32, P ＜ 0.01] . The differences above were all significant. Conclusions Patients with vermca planea are partly affected by depression and the cellular immunologic status may be abnormal among the patients with depression.     

非遗传性良性毛细血管扩张症

报告1例非遗传性良性毛细血管扩张症.患者女,39岁.出生后面颈部、躯干及双上肢即有散在细小毛细血管扩张,并逐渐增多.无出血倾向及系统受累症状,亦无家族史.体检可见面颈部、躯干及双上肢广泛分布大小不等的毛细血管扩张,右前臂近手腕部可见一25 mm×40 mm毛细血管扩张性红斑.颈部皮损组织病理检查示真皮浅层毛细血管扩张,诊断为非遗传性良性毛细血管扩张症.