多囊卵巢综合征患者卵巢间质胰岛素样生长因子受体的表达

目的：探讨肥胖及非肥胖多囊卵巢综合征（ＰＣＯＳ）患者卵巢间质胰岛素样生长因子（ＩＧＦ－Ⅰ）受体基因的定量表达。方法：用逆转录基因扩增技术（ＲＴ－ＰＣＲ），检测３５例ＰＣＯＳ患者（肥胖组１５例，非肥胖组２０例）及２０例正常妇女（对照组）卵巢间质细胞ＩＧＦ－Ⅰ受体ｍＲＮＡ的表达量（灰度比值）。并对ＩＧＦ－Ⅰ受体基因ｍＲＮＡ逆转录的ｃＤＮＡ产物进行限制性内切酶酶切分析。结果：ＰＣＯＳ两组ＩＧＦ－Ⅰ受体基因的表达量显著高于对照组，ＰＣＯＳ两组灰度比值为１．１８４±０．２４０，对照组灰度比值为０．９９９±０．０８６（Ｐ＜０．００１）。非肥胖组（１．２３８±０．３８７）明显大于肥胖组（１．０５８±０．１０９，Ｐ＜０．１）。酶切分析证实，３组ＩＧＦ－Ⅰ受体基因扩增片段相同，ＰＣＯＳ两组未发现明显的碱基突变存在。结论：ＰＣＯＳ患者卵巢间质ＩＧＦ－Ⅰ受体基因呈过度表达。且ＰＣＯＳ非肥胖患者局部ＩＧＦ－Ｉ受体表达高于ＰＣＯＳ肥胖患者。     

实习时间提前对专科护生就业率的影响

目的：避免护生实习与就业在时间上的冲突，提高护生的就业率。方法：将46名护生的临床实习时间由7月1日提前至4月1日，原第4学期课程压缩在前3个学期完成。结：果护生6月底就业率100％。结论：专科护生临床实习时闻提前，可避免临床实习与就业在时间上的冲突，有利于提高就业率。     

腮腺外面神经颊支的应用解剖研究

目的:观测面神经颊支出腮腺后的各级分支,为相关外科手术提供解剖学依据。方法:10例(20侧)防腐人头标本,描述面神经颊支出腮腺后的走行、定位及层次。结果:面神经颊支出腮腺后分为2～4支,均走行在SMAS筋膜下;颊Ⅰ、颊Ⅱ恒定出现,其一级分支距腮腺导管分别为(1.1±0.5)cm及(0.5±0.3)cm,且分别向前走行(1.3±0.9)cm及(1.8±0.5)cm后发出二级分支。结论:面神经颊支较为恒定,在面瘫治疗中健侧面神经颊支的二级分支可以作为受体神经,可不损伤面神经颊支主干。面神经颊支的分布及走行也可指导除皱术、扩张器植入、瘢痕切除等手术的剥离范围,不致产生并发症。     

Loss of cables, a novel gene on chromosome 18q, in ovarian cancer.

Cables, a cyclin-dependent kinase (cdk) interacting protein, has recently been identified and mapped to human chromosome 18q11. Cables appears to be primarily involved in cell cycle regulation and cell proliferation. Overexpression of Cables in Hela and other cell lines inhibits cell proliferation and tumor formation. We hypothesize that loss of Cables expression is associated with ovarian cancer. To test our hypothesis, we examined Cables expression in the four most common subtypes of ovarian carcinomas: serous, endometrioid, mucinous, and clear cell. In addition, mucinous and serous borderline tumors were also included. Loss of Cables expression was observed at high frequency in ovarian serous (11 of 14 cases, 79%) and endometrioid (5 of 10 cases, 50%) carcinomas. In contrast, strong Cables staining was detected in all clear cell carcinomas (10 cases) and mucinous tumors (5 carcinomas and 5 borderline tumors). The majority of serous borderline tumors (11 of 14 cases, 79%) showed positive Cables staining, with the rest showing focal loss of Cables expression. Furthermore, RT-PCR revealed the lack of Cables mRNA in a human ovarian cancer xenograft. No correlation was noted between loss of Cables and histologic grade, tumor stage, and survival. In conclusion, our results indicate that loss of Cables is common in ovarian serous and endometrioid carcinomas and imply that Cables may be involved in the pathogenesis of these two types of ovarian carcinomas.     

Chronic Kidney Isograft and Allograft Rejection

In this study antigen-independent factor in the pathogenesis of chronic rejection of organ transplants was examined.Kidney isografts and allografts were transplanted orthotopically into bilaterally nephroectomized rat recipients and studied functionaaly,morphologically and immunohistologically,at serial intervals up to 52 weeks after transplantation.Allograft recipients developed progressive proteinuria after 12 weeks,with gradual renal failure ultimately leading to death.At the same time,morphological changes,including progressive arteriosclerosis and glomerulosclerosis ,tubular atrophy and interstitial fibrosis,developed.Immunohistologically,macrophages infiltrated glomeruli during this period and cytokines became unregulated.Our results showed that antigen-independent functional and morphological changes occurred in long-tern kidney isografts and mimicked those appearing much earlier in allografts that reject chronically.Initial injury and extent of functioning renal mass is suggested to be important factor for such late changes.     

Breast Volume Measurement in Young Chinese Women and Clinical Applications

The authors carried out research on breast volume and body surface anatomy of 125 women. As a result, an average breast volume for Chinese women was obtained (325.36 ± 12.66 ml), and a table with several linear equations for calculating breast volume was derived. The authors applied these results to their clinical work and succeeded in making mammaplasty more precise in 178 patients.     

直接冠状动脉内支架安置术和r-SK静脉溶栓治疗急性心肌梗死的对比研究

①目的　比较急性心肌梗死 (AMI)病人直接冠状动脉内支架安置和重组链激酶 (r SK)静脉溶栓治疗的临床疗效。②方法　对初次发病 1 2h以内的 1 0 5例AMI病人 ,随机给予直接冠状动脉内支架安置 (支架组 ,6 0例 )和静脉r SK溶栓 (溶栓组 ,5 5例 )治疗。观察两组梗死相关血管再通成功率、心肌梗死溶栓试验 (TIMI)Ⅲ级血流发生率、平均住院天数、住院病死率 ,出院前二维超声心动图测定并推算左心室射血分数 (LVEF)和梗死区室壁运动指数 (RWMI) ,出院后 6个月病死率、LVEF和RWMI。③结果　支架组与溶栓组相比较 ,梗死相关血管再通率显著提高、TIMIⅢ级血流发生率显著增加、平均住院天数显著缩短、住院病死率显著降低 (χ2 =5 .4 2 4～2 8.931 ,t=7.90 1 ,P <0 .0 5、0 .0 1 ) ;出院前LVEF和RWMI ,两组间存在显著差异 (t =3.2 91、2 .1 2 7,P <0 .0 5、0 .0 1 ) ;出院后 6个月病死率、LVEF和RWMI ,两组比较无显著差异。出院后 6个月LVEF、RWMI与出院前比较 ,支架组与溶栓组均有显著改善 (t=2 .1 92～ 4 .6 1 1 ,P <0 .0 5、0 .0 1 )。④结论　与静脉r SK溶栓治疗相比 ,直接冠状动脉内支架安置术治疗AMI,可更有效地再通梗死相关血管、降低住院病死率、更有效地保护病人心脏功能     

伽玛刀治疗功能性垂体瘤初步报告

目的 对伽玛刀治疗分泌型垂体瘤的疗效和并发症发生的相关因素进行探讨。方法 1997年9月至2001年11月，248例垂体瘤经伽玛刀治疗。其中．73例年龄在16至61岁的分泌型垂体瘤获得详细随访，53例为PRL型，11例GH型，2例为ACTH型，6例为PRL合并GH型，1例为PRL合并ACTH型。7例为术后复发和残留。23例曾接受过嗅隐亭治疗。平均肿瘤容积为5．83cm^3(0．14～25．20cm^3)。边缘剂量为8～35Gy。结果 平均随访时间21个月。36例(49.3％)内分泌恢复正常。内分泌恢复正常的比率3个月后1．4％，6个月后16．4％．1年后45．2％，2年后49．3％。3例(4、1％)发生垂体瘤功能低下。1例复发二次治疗。无病例发生视路受损。结论 伽玛刀治疗分泌型垂体瘤是安全有效的治疗方法。其长期疗效和并发症的发生仍需进一步的随访观察。     

联合应用口服水剂和水灌肠肠道充盈法的MSCT研究

目的：评价口服水剂、水灌肠及两者联合应用充盈肠道后,使用MSCT显示成人正常肠道的能力。材料和方法：将43名非肠道病变志愿者分别采用口服水剂法(21例)、水灌肠法(12例)、双重法(口服水剂和水灌肠联合应用,10例)充盈肠道,然后行MSCT平扫和增强扫描并进行图像重建,对小肠和大肠各肠段充盈状态进行评价。结果：口服水剂法回肠充盈良好,水灌肠法大肠充盈良好,双重法回肠及大肠均充盈良好。口服水剂法小肠充盈优于水灌肠法,与双重法无显著差异,大肠充盈状态水灌肠法明显优于口服水剂法,与双重法无显著差异。结论：口服水剂和水灌肠联合应用可以在MSCT同时较好地充盈显示小肠和大肠,而两种方法单独使用则仅能分别充盈显示小肠和大肠,需要根据显示目的选择相应的充盈方法。