Principle of evidence-based medicine and its application in clinical trial practice for glutamine and gut permeability

Evidence-based medicine (EBM) was developed from the progress of traditional clinical model trial patterns. EBM was based on well-designed, randomized, double blind, controlled, multiple center trails in order to assess end pont parameters, prognosis parameters (as: mortality, morbidity of complications and hospital stay etc.), quality of life and cost/effect ratio. It has been accepted in developed countries and could be the guidelines for Chinese clinical trials in the future. This article summarized the principle of EBM and attached with a clinical trial sample about effects of glutamine dipeptide on gut barrier function, post-operative complications and the hospital stay.     

大鼠睾丸支持细胞雄激素结合蛋白mRNA在生精周期中的 …

目的 研究大鼠睾丸支持细胞（ｓｅｒｔｏｌｉ ｃｅｌｌ,ＳＣ）雄激素结合蛋白（ＡＢＰ）ｍＲＮＡ水平与曲细精管上皮周期的相关关系。方法 以地高辛标记的大鼠ＡＢＰ ｃＤＮＡ探针在ＳＤ大鼠睾丸冰冻切片上进行原位杂交,应用激光密度扫描系统对阳性信号进行定量。结果 ＡＢＰ ｍＲＮＡ在１－６期维持低水平,７－８期迅速升高达到高峰,９～１１期骤然下降,但仍高于１～４期水平,７－１６期略有回升,随后迅速下降 至１～     

与人类免疫缺陷病毒相关性耳鼻咽喉部卡波济肉瘤21例报告

报告２１例与人类免疫缺陷病毒（ＨＩＶ）相关性耳鼻咽喉部卡波济肉瘤，其主要局部表现是鼻出血、鼻塞、咽喉干燥、异物感及结节状新生物，并对ＨＩＶ感染与卡波济肉瘤的关系、病例特点及诊断依据进行讨论。     

声门癌术后会厌喉成形术改良的经验

为客观评价声门癌的会厌喉成形（Ｋ－Ｓ－Ｔ）术的远期根治性及功能性效果，总结１００例会厌喉成形术的十年改良经验。改良要点为：①会厌瓣侧缘与环状软骨杓区缝合，形成代杓状软骨，以缩小过大的声门。②另侧会厌上缘和杓会厌襞与声室带断缘缝合，而不与甲状软骨断缘缝合，这样，两侧会厌的游离缘和杓会厌襞尽可能下移达声门水平，以形成代声带。③纵行切开会厌舌面软骨，但保留会厌喉面粘骨膜完整，以形成一锐角的代前连合。３、     

听神经瘤的再手术（附11例分析）

为进一步提高听神经瘤手术的临床疗效，对１５８例听神经手术后１１例再次手术患者进行临床分析，发现肿瘤大小，切除方式以及手术进路与临床症状复发密切相关，肿瘤越大，复发机会越多；大部切除；次全切除及全切除的复发再手术率分别是１９．４％、１３．２％和０，迷路后进路手术复发再手术率最高，达３３．３％，防止临床复发最根本的措施是术中尽量减少肿瘤残留，力争全切。为达此目的要求早期诊断，选择适当的手术进路，对不能     

肿瘤合并颈动脉切除术的探讨

肿瘤固着于颈动脉在临床实践中并非少见，如能将肿瘤与受累动脉一并切除，仍不无救治机会。通过体外或体内对患侧颈动脉压迫训练，促使大脑侧枝循环的建立，并采用脑血管造影或／和经颅多普勒血流检测仪（ＴＣＤ）检测证实合格后，可将肿瘤及受累段颈动脉作整块切除。本文报告１９８７～１９９５年间，我们按上述方法给７位患者施行本术，取得较好的效果，无手术死亡及脑血管并发症。     

Detection of Serum Transforming Growth Factor-α in Patients of Primary Epithelial Ovarian Cancers by Enzyme Immunoassay

Transforming growth factor-α (TGF-α) is a potent mitogenic polypeptide. It is secreted by a variety of transformed cells and tumors, modifying tumor growth through autocrine or paracrine mechanism. In the present study, serum levels of TGF-α were determined by enzyme-linked immunosorbent assay (ELISA) in 27 normal females, 116 patients with benign ovarian tumors, and 42 patients with epithelial ovarian cancers (10 with stage I, 7 with stage II, 19 with stage III, and 6 with stage IV). The ELISA assay could detect a minimum level of serum TGF-α concentration at 10 pg/ml. Serum samples were obtained from normal females and from patients with benign or malignant ovarian tumors before initial surgery. The detectable rates were 11% (3/27) in normal females, 28% (32/116) in benign ovarian tumors, and 62% (26/42) in ovarian cancers. The detectable rates in serous and endometrioid ovarian cancers were 71 and 70%, respectively, which were higher than the rate of 33% in mucinous type. However, there was no obvious relationship between the detectability of serum TGF-α and the stages of ovarian cancers. The mean concentration of TGF-α in ovarian cancer was 159.8 pg/ml, which was significantly higher than 27.7 pg/ml in benign ovarian tumors (P< 0.001) as well as 15 pg/ml in normal females (P< 0.001). The mean concentrations of serum TGF-α in stages I to IV ovarian cancers were 133.5, 96.2, 194.8, and 178.3 pg/ml, respectively. The mean concentration of serum TGF-α in any two stages of ovarian cancers was not statistically different. In conclusion, measurement of serum TGF-α can be used as a supplementary tumor marker to differentiate a malignant ovarian tumor from a benign one. However, the concentration of serum TGF-α has no special relation with the stage of ovarian cancer itself. Because of the small number of stage I ovarian cancers with detectable TGF-α in the present investigation, it would probably not be feasible to differentiate a stage I ovarian cancer from a benign ovarian tumor based only on the level of TGF-α in serum.