医院做好社会服务承诺制工作的体会

在医院加强行风建设中，从就诊群众需要、加强医院管理出发，把医院置于群众的监督中，认真推行社会服务承诺制，有利于医院提升社会形象，有利于医务人员自觉增强自身的责任感。在实行社会服务承诺制中，要采取一系列切实可行的措施，才能保证承诺制的顺利实施。     

18例胸骨后甲状腺肿瘤的外科治疗

目的 探讨胸骨后甲状腺肿瘤切除手术入路及方法。方法 对18例胸骨后甲状腺肿瘤患采用手术治疗．其中15例采用颈部低领切口入路切除肿瘤．3例颈部低领入路 正中劈胸切除肿瘤。并观察术后有无并发症发生。结果 全部患手术均获成功。术后伤口出血2例(占11％)。结论 颈部低领切口入路切除胸骨后甲状腺肿瘤是可行的，该手术操作简单，安全可靠，又具有损伤小、并发症少等优点，值得临床进一步探讨。     

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目的　探讨腹腔镜食道裂孔疝修补术的可行性及安全性。方法　回顾性分析 2 0 0 1年 3月至 2 0 0 3年12月天津南开医院行腹腔镜食道裂孔疝修补术 11例病人的临床资料。结果　 10例行裂孔疝修补后同时行胃底折叠术 ,其中 7例行Nissen胃底折叠术 ,3例行Toupet胃底折叠术 ,1例仅行裂孔修补术。术后症状完全缓解。食道下段压力由 (8 6± 2 4 )mmHg(1mmHg =0 133kPa)提高到 (18 2 0± 3 4 3)mmHg(P <0 0 1) ,2 4hpH值监测评分由 5 3 4± 39 7降低到 8 0 4± 2 12 (P <0 0 1) ,较手术前有明显改善 ,并达到正常范围。无手术并发症 ,无中转开腹及死亡病例。结论　对于食道裂孔疝 ,腹腔镜食道裂孔疝修补术是一种安全、有效的治疗方法     

Effect of Sirpα1 on the expression of nuclear factor-kappa B in hepatocellular carcinoma

BACKGROUND:Signal regulatory protein alpha1(Sirpα1) is a member of Sirps families containing four immunoreceptor tyrosine-based inhibitory motifs(ITIMs) domains in the cytoplasm of and an activated substrate of receptor tyrosine kinase(RTK),that negatively regulates the RTK-dependent cell proliferating signal transduction pathway.Previously we found that Sirpα1 was closely associated with the occurrence and development of hepatocellular carcinoma(HCC)as well as liver regeneration.Since it is unclear about the regulatory mechanisms,we established the cell line transfected Sirpα1 gene and preliminarily clarified the mechanisms by which Sirpα1 negatively regulates the carcinogenesis and development of HCC. METHODS:Liver cancer Sk-Hep1 cell was respectively transfected with plasmids of pLXSN,pLXSN-Sirpα1 and pLXSN-Sirpα1Δ4Y 2 ,screened with the drug of G418(1200 μg/ml),and various transfected Sk-Hep1 cell lines were obtained.The protein expressions of P65,P50,IκBα,cyclin D1 and Fas in various Sk-Hep1 cell lines were determined by Western blotting,and P65 and P50 were localized by the immunofluorescence technique. RESULTS:Sirpα1 could significantly upregulate the protein expression of IκBα(vs.other cell lines,P<0.05) in the Sk-Hep1 cell,and downregulate the protein expressions of P65,P50 and cyclin D1(vs.other cell lines, P<0.05)in the Sk-Hep1 cell.P65 protein expression was mainly localized in the cytoplasm in the pLXSN Sk-Hep1 cell,and in the nucleus of the Sk-Hep1 cell with mutantSirpα1Δ4Y 2 ,but in nucleus of the Sk-Hep1 cell with wild Sirpα1.P50 protein expression was localized in the cytoplasm and nucleus of the pLXSN Sk-Hep1 cell,but in the nucleus of the Sk-Hep1 cell with wild Sirpα1 and mutant Sirpα1Δ4Y 2 plasmid. CONCLUSIONS:Sirpα1 might negatively regulate and control the abnormal proliferation of liver cancer cells by influencing the protein content and localization of nuclear factor-kappa B,then influence the expression of cyclins such as cyclin D1 in the signal transduction pathway.It may be one of the important mechanisms by which Sirpα1 negatively regulates the carcinogenesis and development of HCC.     

腹腔镜在原因不明性腹水的诊断中的应用

为了探讨腹腔镜在原因不明性腹水的病因诊断中的价值，对１１例经过Ｂ超、ＣＴ、腹水各种检查等仍然未明确诊断，并除外有心肝肺肾的疾病引起的腹水，在全麻下做腹腔镜检查、并取病变组织做病理学检查，１１例患者全部被确诊，结果表明：腹腔镜检查是诊断原因不明性腹水的有效方法，且并发症轻，可作为腹水病因诊断的一种常规检查     

北京石景山地区孕妇女婴幼儿血铅动态研究

在严格的质量保证措施下，北京石景山地区２７０名孕妇及其婴儿进行了血铅的追瞎调查。结果显示：孕３月血铅水平为４５．０μｇ／Ｌ，分娩前血铅水平为６４．８μｇ／Ｌ，孕期血铅呈升高趋势，其中后３月升高明显，分娩前血铅约为孕３月血铅的１．５倍；脐带血铅水平为５１．９μｇ／Ｌ，其中有１０．４％的胎儿脐血铅高于１００μｇ／Ｌ；     

Effects of Vagal and Sympathetic Nerves on Transmembrane Potential of Cardiac Ventricular Cells of Toad

The effects of vagal and sympathetic nerves on the transmembranepotentials of cardiac cells of toad were observed by means of microelectrodetechnique.The vagal nerve was stimulated there would be an increase in restingpotential and acceleration in repolarization of action potential(AP).However,ifatropine was used before stimulation the above-mentioned phenomena woulddisappear.When the sympathetic nerve was stimulated the AP amplitudeincreased,but resting potential(RP)remained the same.The increase of APresulted from the increases of overshoot.When the sympathetic nerve wasstimulated although the heart rate increased and the duration of AP wasshortened,the plateau phase of AP was prolonged.These results suggest that theeffects of vagal and sympathetic nerves on the transmembrane potential of cardiacventricular cells are coordinated and the normal characteritics of transmembranepotential are maintained by both the vagal and sympathetic nerves.     

肾康宁对肾小球肾炎治疗作用的实验及临床研究

目的:观察中药肾康宁对家兔实验性肾炎黏附分子及细胞因子表达的影响,以及临床肾小球肾炎治疗前后尿蛋白的变化.方法:检测牛血清白蛋白所致急性实验性肾炎动物肾组织ICAM-1表达、血清IL-6水平的变化,以及临床肾小球肾炎肾康宁治疗前后血清IL-6水平、尿蛋白的变化.结果:肾康宁能明显降低实验动物血清IL-6含量,降低急性实验性肾炎模型中ICAM-1阳性细胞表达率,同时减轻肾小球基底膜(GBM)增厚及炎症细胞浸润,阻止毛细血管内微血栓的形成;在临床肾小球肾炎中,肾康宁能减少肾小球肾炎患者血清IL-6水平及24 h尿蛋白含量.结论:肾康宁通过降低细胞因子IL-6水平和黏附分子ICAM-1的表达,从而抑制免疫细胞的趋化、浸润、活化和增殖、减少免疫复合物的沉积,使肾小球炎症反应减轻,有效缓解家兔急性实验性和临床肾小球肾炎,使肾功能得以改善.     

大鼠脂肪干细胞复合胶原-壳聚糖-硫酸软骨素三维支架构建组织工程软骨

Objective To evaluate the character of the collagen-chitosan-chondroitin sulfate scaffold seeded with rat adipose tissue-derived stromal cells. Methods A dipose tissue were harvested from 6 weeks old Wistar rats and the stromal cells were harvested by type Ⅰ collagenase and then cultured in vitro. Type Ⅰ collagen was fully mixed with chitosan, freeze-dried and cross-linked with chondroitin sulfate, then freeze-dried again and sterilized by ethylene oxide. The pore diameter, water content, porosity of the scaffold were tested. The adipose tissue-derived stromal cells were digested, seeded into the plates, scaffold, and cen-trifuged into pellet, and then induced into cartilage. MTT detection for cell proliferation was done. After 3 weeks, the cell morphology, and cell proliferation and adhesion were observed, and chondrngenic differenti-ation was also analyzed. Results The pore diameter, water content, porosity tested for the scaffold showed an appropriate form. Cell proliferation showed faster in the scaffold and pellet culture system after 5 day, there was still cell proliferation in the scaffold system after 14 days but no obvious changes in the pellet cul-ture system; ceils on the scaffold proliferated densely showed by histological staining, but there was a scaf-fold structure residues in the inner layer. The finding of type Ⅱ immunohistochemistry stain showed that cells express strong positive for type Ⅱ collagen in the scaffold and pellet culture system whereas it was weakly positive in the plate culture system; the specific mRNA for cartilage, type Ⅱ collagen, aggrecan and SOX-9 were expressed in all three systems showed by RT-PCR, but type X collagen was expressed continu-ously in the plate culture system and expressed after 21 days in the pellet culture system, whereas it was not detected in the collagen-chitosan-chondroitin sulfate scaffold system. Conclusion The parameters of the collagen-chitosan-chondroitin sulfate scaffold were suitable in our study. The results suggested that it can promote the adipose tissue-derived stromal cells proliferation and chondrogenic differentiation better than the plate and pellet culture systems and maintain the phenotype of chondrocytes well; it is the optimal choice for cartilage tissue engineering in the future.     

假单胞菌胆固醇酯酶的生产Ⅰ.菌种筛选和发酵条件的研究

通过平板初筛和摇瓶复筛,从371株菌中筛得一株有工业生产价值的胆固醇酯酶产生菌,并对它进行了发酵条件的研究。用所获得的胆固醇酯酶配制的三酶试剂具有良好的稳定性,适用于临床检测。