Evaluation of the effects of opioid agonists and antagonists under a delayed matching-to-sample procedure in pigeons

The effects of several opioid agonists and antagonists were examined in pigeons performing under a delayed matching-to-sample procedure. The mu agonists morphine and l-methadone, the kappa agonists U 50,488 and ethylketocyclazocine, and the opioid antagonist naloxone had no effect on the accuracy of responding. These drugs were, however, behaviorally active as evidenced by the dose-dependent decreases in rates of responding associated with their administration. In contrast, the sigma agonists (+) N-allylnormetazocine and phencyclidine decreased the accuracy of responding in a dose-dependent fashion. The relative magnitude of these drug-induced decreases in accuracy were similar across the no delay (0-s), short (2-s), and long (8-s) delay intervals. For these drugs, accuracy-decreasing effects were obtained only at doses that reduced rates of responding. The results of the present investigation parallel those reported in pigeons responding under drug discrimination tasks, in which the discriminative stimulus properties produced by the mu and kappa agonists are similar to each other but distinguishable from those produced by the sigma agonists.Recipient of Research Scientist Development Award DA 00033 from the National Institute on Drug Abuse     

子宫内膜活检在不孕症诊治中的评价(附1278例临床与病理分析)

本文报道了子宫内膜活检在诊治不孕症中的作用,并分析了1278例原发性不孕症患者子宫内膜活检后的临床诊断与病理学阳性的关系。其中无排卵性内膜85例占6.2％,黄体功能欠缺50例占3.9％,子宫内膜增生症21例占1.6％,子宫内膜炎8例占0.6％和内膜结核24例占1.8％。文中还对不孕的原因作了进一步的分析与讨论,提出了不孕症的诊治意见。     

母血中胎儿有核红细胞的荧光原位杂交法在产前诊断中的可行性探讨

探讨荧光原位杂交法（FISH）对母血中胎儿有核红细胞（NRBC）进行无创性产前诊断的可行性。20例孕龄15-20周的孕妇外周血经不连续密度梯度离心、制片、显微镜下识别并共计数NRBC及定位，然后行Y染色体的FISH检测。结果发现10例孕男性胎儿的孕妇外周血细胞涂片中每例均有阳性杂交信号出现；阳性率为60％（24/40）。10例孕女性胎儿的孕妇外周血细胞涂片中1例出现阳性杂交信号；阴性率为95％（38/40），假阳性率仅为5％（2/40）。结果提示FISH法对于用母血中分离到的胎儿细胞进行染色体异常的无创性产前遗传学检查具有重要意义。     

新生儿胃穿孔18例诊治报告

目的 :探讨新生儿胃穿孔的诊断、治疗效果及预后因素。方法 :对 1 8例新生儿胃穿孔病例诊断、治疗及预后因素进行分析。结果 :1 8例患儿均有拒奶、腹胀、呕吐、呼吸困难等症状。腹部立位 X线片示膈下有大量游离气体。其中单纯穿孔 6例 ,多发穿孔 4例 ,胃壁缺损 7例 ,全胃壁缺如 1例。单纯及多发胃穿孔行胃修补术 ,3例同时行胃造痿术。胃壁肌层缺损行病变组织切除、胃壁修补及胃造痿术。 1例全胃壁肌层缺如仅行腹腔引流术。本组存活 8例 ;死亡 1 0例 ,病死率 5 5 .5 6%。死亡原因为多脏器功能衰竭、DIC。结论 :新生儿胃穿孔预后差 ,且受发病时间、就诊时间、病变严重程度等综合因素影响     

原发性十二指肠肿瘤43例诊治分析

目的　探讨原发性十二指肠肿瘤 (PTD)的诊断和治疗。方法　回顾性分析我院 1995 2 0 0 3年间 4 3例PTD的临床资料。结果　十二指肠镜确诊率为 85 .7% ,B超检查的阳性率为 5 5 .6 % ,CT检查阳性率为 80 % ,肿瘤位于十二指肠降段 (乳头部或其对侧 ) 35例 ,占 81.4 % ,2例平滑肌瘤切除术后存活 5年以上 ,1例乳头部腺瘤行肿瘤局部切除术后半年出现黄疸 ,病因不详。 4例间质瘤均健在且生存 16 2 1个月 ,36例原发性十二指肠恶性肿瘤中胰头十二指肠切除 18例 ,节段切除 1例 ,手术切除率为 5 1.2 %。结论　B超、CT、纤维十二指肠镜检查是诊断PTD的主要手段。手术切除是最基本有效的治疗方法。对于良性肿瘤可行局部肿瘤切除、十二指肠节段切除或经内镜切除。对于恶性肿瘤 ,胰十二指肠切除术是首选术式。     

Multiple primary malignancies in Japanese patients with renal cell carcinoma

AIM: To evaluate the incidence, nature and prognosis of multiple primary malignancies involving renal cell carcinoma (RCC) in Japan. METHODS: Between 1975 and 1998, 319 patients underwent an operation for RCC at Hokkaido University, Sapporo, Japan. The incidence of other primary malignancies was determined and classified as antecedent, synchronous or subsequent. Follow-up was obtained by thorough chart review or telephone interview, and ranged from 0 to 276 months (median 49.0 months). To analyze the influence of other primary malignancies on prognosis, overall and cause-specific survival rates of the patients with an antecedent or synchronous malignancy were compared to the remaining patients. RESULTS: Of the 319 patients there was at least one other malignancy in 38 patients (12%). Four patients had two other malignancies. The other malignancies were antecedent in 13, synchronous in 19 and subsequent in 10 patients. Twenty-two patients had gastrointestinal cancer. In cases of antecedent or synchronous diagnosis of other primary malignancies, RCC was commonly incidental, small or low-stage. Multivariate analysis using Cox's proportional hazards model showed that, for overall survival, the presence of other antecedent or synchronous malignancies was the second most significant prognostic factor, following the pathological stage of RCC. CONCLUSIONS: In Japanese patients with RCC, the incidence of other primary malignancies was not uncommon and these malignancies contributed to the prognosis of these patients. Therefore, the malignant potential of individual tumors should be paid careful attention in the management of these patients.     

重症肌无力术后延长拔管时间的临床价值

目的　探讨重症肌无力 (MG)胸腺切除术后 ,延长气管拔管时间 ,减少气管切开的价值。方法　回顾分析 1978年至 2 0 0 2年 12月行MG胸腺切除 2 36例 ,按时间分A组 :1996年 12月以前手术者116例 ,对术后可能发生肌无力危象的高危因素病人施行预防性气管切开 ;B组 :1997年后手术 12 0例 ,对具发生危象高危因素者采用延长气管拔管时间 ,并对两组危象发生率及气管切开率进行比较。结果　全组发生危象 4 4例 (18 6 % ) ,气管切开 4 6例 (ARDS 1例除外 )占 19 5 %。其中A组发生危象 2 3例(19 8% ) ,气管切开 34例 (2 9 3% ) ;B组发生危象 2 1例 (17 5 % ) ,气管切开 12例 (10 % )。两组危象发生率无明显差异 ,但A组的气管切开率明显高于B组 (P <0 0 0 1)。结论　对MG胸腺切除术后具发生危象高危因素病人 ,采用延长气管插管时间及辅助通气 ,可显著减少气管切开率。     

基于混合遗传算法的心脏病决策支持系统研究

将遗传算法和 BP算法相结合 ,建立了一个基于混合遗传算法的心脏病决策支持系统来鉴别诊断五种常见心脏病 (冠心病 ,高血压性心脏病 ,风湿性心脏病 ,慢性肺原性心脏病和先天性心脏病 )。一个含有 35 2份心脏病的数据库用来构建和测试了该系统。实验结果表明 ,构建的系统对这五种心脏病均有较好的诊断识别率 ,系统的平均识别准确性达 90 .6 % ,各疾病的用户准确性和程序准确性均大于 85 .0 % ,表现出良好的心脏病的临床诊断决策支持能力     

用荧光原位杂交技术快速诊断孕早期胚胎染色体数目异常

目的探讨荧光原位杂交(FISH)技术在快速产前诊断孕早期胚胎染色体数目异常中的价值.方法采用13,18,21,X和Y染色体特异性DNA探针,对46例孕47～65 d高危孕妇的绒毛间期细胞进行FISH检测,同时行常规染色体核型分析平行诊断.结果与染色体核型分析结果一致的染色体数目正常43例,异常3例(47,XY 21;47,XY 18和45,X).3例异常核型胚胎经治疗性流产后再分别对其绒毛行常规染色体核型分析,结果与产前诊断相符.结论FISH技术用于产前诊断孕早期胚胎染色体数目异常具有快速、准确等优点.     

ENDOSCOPIC ULTRASOUND GUIDED TRUCUT BIOPSY

Endoscopic ultrasound (EUS) is sensitive for staging gastrointestinal malignancies and pancreatic lesions. EUS‐fine‐needle aspiration (EUS‐FNA) offers a diagnostic accuracy of about 60–90% for pancreatic tumors and > 90% for lymph nodes. There are several limitations of EUS‐FNA including the need for on‐site cytopathology review. In addition, accuracy of cytologic review is hampered by the presence of blood, benign epithelial cells, desmoplasia, and well‐differentiated tumors. Furthermore, the small biopsy sample and destruction of tissue architecture limits the diagnostic sensitivity for GISTs and lymphomas. Many of these problems can be overcome with use of EUS trucut biopsy (TCB) needles. These large caliber, cutting needles acquire larger tissue samples allowing preservation of tissue architecture and histologic examination. Our recently described experience with EUS‐TCB initially in swine and later humans demonstrated the safety for acquiring histologic tissue representative of the target organs sampled enabling accurate diagnosis. These studies suggested greater diagnostic accuracy of EUS‐TCB for submucosal mass lesions and lymphoma and potentially the need for fewer needle passes for solid pancreatic neoplasms. In this paper we will review the current TCB literature, device design and technique, help troubleshoot potential problems, and offer opinion as to the utility and role of this new device.