外伤性脾切除术后中医证候及免疫功能的研究

目的:研究外伤性脾切除术后中医辨证与免疫功能变化的关系.方法:选择15例脾切除和15例非脾切除患者作为观察对象,以其症状、舌苔、脉象及免疫功能的测定作为观察指标,观察其中医辨证与免疫功能变化.结果:脾切除组在术后早期可出现脾胃虚弱的证候群,同时免疫功能测定补体C3、免疫球蛋白IgG、免疫球蛋白IgM的水平明显降低,与非脾切除组有显著性差异.结论:脾切除容易造成患者术后出现的脾胃虚弱症候群,并降低患者的免疫功能.     

闭孔疝的诊断和治疗

目的探讨闭孔疝的诊治方法。方法对15例闭孔疝病例诊治经过结合相关文献进行回顾性分析。结果15例中．术前确诊率仅20％（3／15），误诊率80％（12／15），全组均行疝环修补术，采用剖腹探查切口。本组治愈率100％，术后切口感染及愈合不良4例（21．67％），随访8例至今无复发。结论术前易误诊、漏诊；对年老体弱、多胎生育伴有不明原因肠梗阻表现的妇女，应高度考虑闭孔疝，Howship—Romberg征及Hannington—Kiff征阳性可确诊。疝环修补术是惟一有效的方法，首选腹腔内入路。早确诊．及时手术是减少并发症、降低死亡率的关键。     

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.     

肿瘤物理治疗技术及设备

简要介绍了肿瘤的放射治疗和热治疗的技术及设备，介绍了各种技术及设备的特点。     

33例肝占位性病变MRI误诊的分析

我院１９８８年以来４０００余例腹部ＭＲＩ中，发现肝占位性病变误诊３３例。所用机型为美国Ｄｉｓｏｎｉｃｓ公司０．５Ｔ超导ＭＲＩ，自旋回波序列（ＳＥ序列）、常规Ｔ１加权（Ｔ１ＷＩ）、质子加权（ＰＤＷＩ）、Ｔ２加权（Ｔ２ＷＩ），覆盖全肝。其中，ＰＨＣ误诊为ＭＨＣ５例、ＭＨＣ误诊为ＰＨＣ６例、ＰＨＣ误为ＨＨＥ５例、ＭＨＣ误诊为ＨＨＥ２例、ＨＨＥ误诊为ＰＨＣ６例、肝硬化结节误诊为ＰＨＣ２例、炎性假瘤误诊为ＰＨＣ３例、肝结核误诊为ＰＨＣ１例、ＨＣＹ误诊为ＨＨＥ３例。本文从病变的影像学特征和扫描技术方面详细探讨了误诊的原因和鉴别诊断要点。     

浙江医科大学附二院门诊处方中精神药物使用调查

本文对浙江医科大学附属二院１９９３年７月间３１３７８张合格处方进行统计分析，并用限定日剂量（ＤＤＤ）和药物使用指数（ＤＵＩ）为指标，分析镇静催眠药物使用情况。结果表明苯二氮　类药方２０６７张，占总处方量的６．５９％，巴比妥类药方４９张，占０．１６％，麻醉药方１１１张；占０．３５％。苯二氮　类药方中．女性处方量１２０２张，男性处方量８６５张，男、女组间比较有显著性差异。苯二氮　类药方多分布在神经内科，常用的药有舒乐安定和阿普唑仑。九种常用的苯二氮　类药和麻醉性镇痛药的ＤＵＩ均小于１。提示药物滥用现象少见，该院对这类药物的管理比较严格。麻醉性镇痛药中二氢埃托啡处方占６７．５７％。     

冲动症及其司法精神鉴定(附1例报告)

作者通过对1例冲动症案例的分析,结合文献报道,初步阐述了冲动症的概念范围、临床特征与诊断标准。并讨论了其与强迫症、性心理障碍、正常性犯罪之间的区别和责任能力的评定。     

顺丁烯二酸水溶液的热反应动力学

研究了不同温度、浓度条件下，顺丁烯二酸（顺酸）非催化反应网络，即顺酸可生成反丁烯二酸（反酸）和苹果酸，反酸与苹果酸存在可逆反应。建立了该反应网络的动力学模型。测定了不同反应条件下顺酸、反酸和苹果酸浓度随时间变化的规律，据此，动力学参数进行了估值。     

Attenuation of myocardial injury due to oxygen free radicals(OFR) by pretreatment with OFR or calcitonin gene-related peptide

目的：研究氧自由基（ＯＦＲ）及降钙素基因相关肽（ＣＧＲＰ）预处置对ＯＦＲ所致离体大鼠心脏损伤的拮抗作用．方法：Ｌａｎｇｅｎｄｏｒｆ法灌流心脏，电解ＫＨ液产生ＯＦＲ．结果：ＣＧＲＰ或ＯＦＲ预处置减轻ＯＦＲ所致心脏收缩功能下降，冠脉流量减少和肌酸激酶（ＣＫ）释放增加．蛋白激酶Ｃ（ＰＫＣ）抑制剂Ｈ７可取消ＯＦＲ预处置的心脏保护作用（对照组，ＯＦＲ损伤组，ＯＦＲ预处置组，Ｈ７加ＯＦＲ预处置组及Ｈ７组的ＣＫ释放量分别是１１０±７，２１５±２３，１６９±１４，２４０±３０，１１３±１９Ｕ·Ｌ－１）．结论：ＯＦＲ或ＣＧＲＰ预处置对ＯＦＲ所致心肌损伤具有拮抗作用，该作用与ＰＫＣ激活有关．     

碱性成纤维细胞生长因子受体基因在牛眼晶体上皮细胞内的表达

目的探讨碱性成纤维细胞生长因子（ｂａｓｉｃｆｉｂｒｏｂｌａｓｔｇｒｏｗｔｈｆａｃｔｏｒ，ｂＦＧＦ）对晶体上皮细胞促增殖作用的机理。方法从培养的第二代牛眼晶体上皮细胞提取ＲＮＡ，经逆转录反应合成ｃＤＮＡ。借助从人体胎盘纤维细胞ｂＦＧＦ受体序列合成的寡核苷酸引物，聚合酶链反应体外扩增ｃＤＮＡ。扩增的ｃＤＮＡ片段克隆后，Ｓａｎｇｅｒ双脱氧链终止法测定其序列。结果探测出牛眼晶体上皮细胞ｂＦＧＦ受体的ｍＲＮＡ，测序后发现其氨基酸序列片段中仅３个氨基酸与人体不同。结论晶体上皮细胞存在ｂＦＧＦ受体，当ｂＦＧＦ与其受体结合后，对促进晶体上皮细胞的增殖以及白内障术后后囊混浊具有重要作用。