功能性消化不良患者的心理测评及抗抑郁治疗

目的：探讨心理异常与功能性消化不良(FD)发病的关系，并探讨抗抑郁治疗对FD患者的疗效。方法：采用焦虑自评量表(SAS)和抑郁自评量表(SDS)对100例FD患者及100名健康对照组进行心理测评，比较2组焦虑、抑郁的发生率；采用评分法对FD患者进行症状评分，随机将心理测评异常的FD患者分为常规组及综合组，分别给予抗消化不良药物及在此基础上加用抗抑郁药文拉法辛治疗，比较2种治疗方法的总有效率；将综合治疗有效的病例随机分成维持组及停药组，维持组继续给予文拉法辛维持量治疗，观察6mo中2组的复发率。结果：FD组患者焦虑及抑郁状态发生率明显高于健康组；综合组有效率高于常规组；文拉法辛6mo维持治疗复发率低于疗程结束后即停药者。结论：焦虑、抑郁的心理异常是FD发病的危险因素，但用抗抑郁治疗可提高FD患者常规治疗的有效率，6mo维持治疗能有效降低FD复发率。     

藏药花锚中新化学成分的鉴定

目的 分离并鉴定高原植物椭圆叶花锚Halenia elliptica全草中的化学成分。方法 采用元素分析（EA），核磁共振波谱（NMR），质谱（MS），红外光谱（IR），紫外光谱（UV），差示扫描量热（DSC）等分析方法，测定其理化常数和波谱数据，鉴定其化学结构，结果 确证从椭圆叶花锚中所得到的两种针状结晶化合物，分别为1-羟基-3，7，8-三甲氧基Shan酮（1-hydroxy-3,7,8-trimethoxyxanthone)和1，7-二羟基-3，8-二甲氧基Shan酮（1，7-dihydroxy-3,8-dimethoxyxanthone)。结论 上述两种Shan酮衍生物为首次从藏药花锚中分离得到。     

前庭水管扩大综合征患者的人工耳蜗植入术

目的 评价前庭水管扩大综合征患者人工耳蜗植入术的安全性和可行性。方法 1995年5月1日～2002年6月1日因双耳重-极重度感音神经性聋在北京协和医院接受人工耳蜗植入术的患者312例中诊断为双耳前庭水管扩大者10例(3．2％)，其中语前聋7例，语后聋3例。回顾性分析这10例患者的临床资料。结果 10例患者人工耳蜗电极植入顺利，8例耳蜗底回开窗时发生轻度井喷，迅速用颞肌筋膜牢固封闭圆窗制止井喷。全部患者术后未出现脑脊液漏、颅内感染、面瘫、中耳炎等并发症。开机6个月时8例患者具有开放性言语识别力，已进入普通学校(幼儿园、小学、大学)就读。另2例语前聋的幼儿视觉强化测听听阈达40dB HL，与其他无内耳畸形的全聋儿童术后效果差异无显著性。全聋前语言能力较好的5例患者术后语言能力明显好于语前聋的患者，语言交流基本听不出聋人特有的语音特征。另5例患者语言均有不同程度的进步。结论 尽管前庭水管扩大患者在人工耳蜗植入术中可能出现井喷，但术后未出现并发症且听力-言语康复效果好，因此重-极重度聋的前庭水管扩大综合征患者行人工耳蜗植入术是安全可行的。     

口服抗病毒新药——缬更昔洛韦

缬更昔洛韦 (valganciclovir)是抗病毒药更昔洛韦的前体药物 ,用于治疗AIDS病人发生的巨细胞病毒 (CMV)视网膜炎。缬更昔洛韦口服后迅速吸收 ,并水解为更昔洛韦 ,其口服给药的生物利用度较高 (60 % )。试验表明 ,口服缬更昔洛韦 (90 0mg)与静脉注射更昔洛韦 (5mg·kg-1) ,bid,3wk后改为 qd ,治疗 1 60例AIDS病人发生的CMV视网膜炎有相同疗效 ,且耐受性相似。缬更昔洛韦维持治疗中最常见的不良反应为中性粒细胞减少症、贫血、胃肠道反应 (腹泻、恶心、呕吐 )、发热、头痛和失眠等     

Anticancer Drug Resistance of HeLa Cells Transfected With Rat Glutathione S-transferase pi Gene

Objective To establish a cytologic expressing system of rat glutathione S-transferase pi (GST-pi) cDNA for detecting the resistance of HeLa cells to anticancer drugs. Methods The assessment was made with various anticancer drugs (adriamycin, mitomycin, cisplatinum and vincristine) that showed different cytotoxicities in transfectant HeLa cells with pSV-GT containing rat GST-pi cDNA (HeLa/pSV-GT) or control pSV-neo (HeLa/pSV-neo). Expression levels of GST-pi mRNA in HeLa/pSV-GT and HeLa/pSV-neo were measured by in situ hybridization using Digoxin-labelled cDNA probe. Results HeLa/pSV-GT expressed significantly high degree of GST-pi mRNA, whereas both HeLa/pSV-neo and HeLa cells had very low expression. Cytotoxicities of HeLa/pSV-GT and HeLa/pSV-neo with 4 anticancer drugs were measured by MTT assay. Drug concentrations for yielding 50% inhibition (IC50) in HeLa/pSV-GT by adriamycin, mitomycin and cisplatinum were 70.13μg/mL, 10.95μg/mL and 16.52μg/mE respectively. In contrast, IC50 in HeLa/pSV-neo was 10.34μg/mL, 7.48μg/mL and 13.70μg/mE respectively. The cytotoxicities of vincristine on both HeLa/pSV-GT and HeLa/pSV-neo were not significantly different. Conclusions Our findings suggest that HeLa/pSV-GT containing rat GST-pi cDNA is resistant to some anticancer drugs due to overexpression of GST-pi. Also, HeLa/pSV-GT cell line could serve as a useful cytogenetic model for further research.     

Role of a non-natural beta-C-nucleotide unit in DNA as a template for DNA and RNA syntheses and as a substrate for nucleolytic digestion.

A non-natural beta-C-nucleoside bearing a 3,4-dibenzyloxyphenyl group as a nucleobase (X) was synthesized and incorporated into a 34-mer oligomer with the sequence 5'-dTTTTTAAAAAAXATATAGCAGCGACATGTCACCG-3'. This synthetic oligonucleotide was examined for template activity in the enzymatic syntheses of DNA by the Klenow fragments of Escherichia coli DNA polymerase I and the recombinant DNA polymerase I, and in the synthesis of RNA by the E. coli RNA polymerase core enzyme. As a result, the template-directed polymerization of both DNA and RNA was precisely terminated at the position of X. The X-containing oligonucleotide was also tested for digestion by an exonuclease, Exo III nuclease (Exo III), and an endonuclease, Mung Bean nuclease (MB). The results indicate that the artificial nucleobase X acts as a terminator for digestion by Exo III, whereas the site X becomes susceptible to digestion by MB. These findings provide a useful tool for the size control of products in the synthesis and degradation of nucleic acids.     

Brick tea fluoride as a main source of adult fluorosis.

An epidemiological survey was conducted in Naqu County, Tibet in September 2001 to investigate the manifestations of fluorosis in adults caused by the habitual consumption of brick tea. Profiles were obtained for the total daily fluoride intake, environmental fluoride levels and average urinary fluoride concentration, and a physical examination and a skeletal radiographic study were conducted. One hundred and eleven 30-78-year-old adults were enrolled. It was found that the fluoride level of water sources in Naqu County was 0.10+/-0.03 mg/l; no evidence of fluoride air pollution was found, but the brick tea water processed foods--zamba and buttered tea--had fluoride contents of 4.52+/-0.74 mg/kg and 3.21+/-0.65 mg/l, respectively. The adult daily fluoride intake reached 12 mg, of which 99% originated from the brick tea-containing foods. The positive rate of clinical symptoms by physical examination was 89%; furthermore, 42 of the 111 subjects were diagnosed by X-ray. The positive examination rate was 83%. Although the osteosclerosis-type skeletal fluorosis (overall increased bone matrix density) affected 74%, arthropathy and arthritis affected a significant number of the patients, resulting in functional disability. The results suggest that this brick tea-type fluorosis had even more severe adverse effects on human health compared with both the water-type and coal combustion-type fluorosis that occurred in other areas of China.     

15例产科DIC肝素应用探讨

目的 探讨产科弥漫性血管内凝血(DIC)中肝素的合理应用。方法 对本院近十二年来收治产科DIC 15例(其中应用肝素13例)进行临床分析。结果 孕产妇抢救成功14例，死亡1例，死亡率6．6％。结论 在产科DIC的救治中，早期诊断、及时去除病因以及肝素的合理使用是抢救成功的关键。     

63例宫颈腺癌临床治疗和预后分析

目的:了解影响宫颈腺癌预后的相关因素,探讨宫颈腺癌比较理想的治疗方法.方法:对天津医科大学附属肿瘤医院1980年1月至2000年1月间收治的63例宫颈腺癌进行分析,占同期宫颈癌的4.65%,并随机选取同期治疗的80例宫颈鳞癌作为对照进行比较.患者平均发病年龄53.7岁,绝经后患者占55.6%.主要症状为阴道不规则出血和/或白带增多.其中Ⅰ期17例,Ⅱ期33例,Ⅲ期13例.20例采用单纯放射治疗,43例采用放射治疗与手术相结合的综合治疗.结果:收治的宫颈腺癌占宫颈癌的比例从80年代的3.5%(38/1087)上升至90年代的7.36%(34/462),其5年总的生存率为56.9%(33/63-5),低于同期宫颈鳞癌5年生存率.单纯放疗组5年生存率50%;手术放疗组5年生存率为60.5%,两组间无统计学差异.行根治性手术的Ⅰ、Ⅱ期患者5年生存率为80%,而行全宫切除的同期患者5年生存率仅为39.3%,但二者差异尚无统计学意义.宫颈肿瘤≥4cm和＜4cm者5年生存率分别为34.3%(12/35)和60.7%(17/28)具有明显差异(P＜0.05).Ⅰ、Ⅱ期5年生存率62%(31/50),而Ⅲ期5年生存率为7.7%(1/13),二者差异显著(P＜0.01).结论:宫颈腺癌的发病比例呈上升趋势,宫颈腺癌的预后与临床分期、肿瘤大小、治疗方式关系密切.以根治性手术为主的综合治疗是宫颈腺癌的主要治疗方法.     

肺癌患者GSTM1基因型与p53基因突变的相关关系研究

目的:探索肺癌患者Ⅱ相代谢酶主要亚型GSTM1的基因型与p53基因突变的关系.方法:应用双重PCR和PCR-SSCP(单链构像多态性分析)技术,检测了63例肺癌患者和47例健康对照中GSTM1基因缺失及肺癌组织p53基因突变的情况,并分析其相关关系.结果:肺癌组GSTM1基因缺失率为71.4%(45/63),对照组为51.1%(24/47),差异有显著统计学意义,OR为2.40(95%CI为1.09-5.29).p53基因突变率在63例肺癌组织中为49.2%(31/63),在15例对照组织中仅为6.6%(1/18).58.1%肺癌病例同时存在p53基因突变和缺失GSTM1基因(P＜0.05).结论:GSTM1基因缺失与p53基因突变相关,GSTM1基因缺失可能增加p53基因突变的几率,从而导致肺癌患病危险性的增加.