肝硬化病人门静脉和肝动脉多谱勒血流参数变化的意义

目的 :探讨肝硬化门脉高压病人门静脉和肝动脉彩色多谱勒血流参数变化的意义。方法 :肝硬化伴食道静脉曲张的病人 6 6例 ,正常人对照组 5 8例。测量门静脉血流速度 (PVV)和肝动脉阻力参数 (HA- PI) ,计算肝血管指数。结果 :在肝硬化门脉高压病人比对照组 PVV明显降低 (12± 2 .2 ) cm/ s;(15 .8± 2 .6 ) cm/ s,P<0 .0 0 1)和 HA- PI明显增高(1.3± 0 .15 ;0 .94± 0 .16 ,P<0 .0 0 1) ,肝血管指数明显减低 [(8.6± 2 .1) cm/ s;(16 .7± 4 .2 ) cm / s,P<0 .0 0 1) ]。彩色多谱勒血流参数 PVV、HA- PI、肝血管指数对肝硬化门脉高压的诊断的敏感性和特异性分别为 89%、84 %、83%、81%、95%、91%。结论 :肝血管指数对肝硬化门脉高压的诊断的敏感性和特异性更高。     

肺肿瘤99Tcm-N(NOEt)2SPECT显像与P-糖蛋白和增殖细胞核抗原表达的关系

目的探讨肺肿瘤99Tcm-氮-二(N-乙基-N-乙氧基二硫代氨基甲酸盐)[N(NOEt)2]SPECT显像病变部位与对侧对应正常肺组织放射性比值(T/N)与术后病理组织中P-糖蛋白(P-gp)和肿瘤增殖细胞核抗原(PCNA)表达间的关系.方法对22例(20例为术前未经药物治疗的肺癌,2例为肺良性病变)患者进行手术,取肿瘤标本,经常规石蜡切片,用免疫组织化学技术检测病变组织P-gp和PCNA表达,并与术前99Tcm-N(NOEt)2 SPECT显像T/N比值对比.结果22例患者中,20例肺恶性肿瘤99Tcm-N(NOEt)2 SPECT显像均表现为异常放射性浓聚,T/N比值为1.29±0.04;2例肺良性病变99Tcm-N(NOEt)2显像T/N比值为1.08±0.13,其中1例为假阳性.22例患者除1例肺腺癌仅P-gp表达阴性外,其余患者P-gp、PCNA均呈阳性表达.22例患者99Tcm-N(NOEt)2SPECT延迟显像T/N比值与术后病理组织中P-gp和PCNA表达程度均无关(r值分别为0.123和-0.145,P均＞0.05,双侧),且病理组织中P-gp与PCNA表达程度也无关(r=0.062,P＞0.05,双侧).结论肿瘤细胞摄取99Tcm-N(NOEt)2与其P-gp和PCNA表达程度无关.     

Acute Cellular Rejection Predominated by Monocytes Is a Severe Form of Rejection in Human Renal Recipients With or Without Campath-1H (Alemtuzumab) Induction Therapy

Campath-1H has been used successfully for induction and has resulted in a low rate of acute cellular rejection (ACR) in renal transplantation in combination with various postoperative immunosuppression regimens. This study was undertaken to investigate the extent of monocyte involvement in ACR, with or without Campath-1H induction. We found that monocytes represented the majority of inflammatory cells in grades Ib or higher ACR, but not with Ia type of ACR, regardless of the status of Campath-1H induction. Cases of ACR, following Campath-1H induction, appear to demonstrate a 'pure form' of monocytic ACR, whereas monocytes were mixed with many other types of inflammatory cells in the cases of ACR in the absence of Campath-1H induction. In addition with Campath-1H induction, the cases of monocyte-predominant ACR were found to uniformly exhibit a good response to corticosteroid treatment. We conclude that monocyte-predominate ACR may represent a severe form of rejection, with or without Campath-1H treatment.     

SOMATOM CT高压熔断丝炸裂故障分析

简要介绍西门子SOMATOM CT高压发生器的工作原理,并着重分析了高压63A熔断丝炸裂故障原因及其判断与排除方法。文章指出了在检修高压发生器的过程中特别要注意的事项。     

Analgesia produced by intrathecal administration of the kappa opioid agonist, U-50,488H, on formalin-evoked cutaneous pain in the rat

The antinociceptive activity of the selective k opioid agonist U-50,488H, given intrathecally (i.t.) against chemically induced cutaneous pain in rats, was assessed from cumulative dose-response experiments and the formalin test. Three successive i.t. doses of 5, 10 and 35 nmol of U-50,488H produced a gradual reduction of pain scores which was statistically significant at all observation periods. This effect was antagonized significantly by 3 mg/kg i.p. of the opiate antagonists, naloxone and WIN 44,441-3. The analgesia profile showed a clear dose-response relationship. A dose producing 50% ‘maximum posible analgesia’ of 6.20 nmol (95% confidence interval: 3.05–12.59 nmol) was calculated. The results indicated that cutaneous pain of a chemical/inflammatory nature is highly sensitive to activation of k receptors of the spinal cord dorsal horn.     

质疑Frank—Starling心脏定律

心脏收缩释放的能量（作功）是心肌纤维长度（心室舒张末期容积，EDV）的函数，即Frank—Star一1ing（FS）心脏作功定律，被誉为心脏生理学中的“经典”理论。对此，笔者从各种不同角度进行了探讨：首先分析了Frank伸展离体心肌和Starling及其同事使用心肺制备做的实验与动物生理实际的差异，以及人们在实验中观测到的增加心肌前负荷引起收缩力增强的现象（FS现象），认为：①在正常生理条件下的动物体内，来自心脏以外的、如同心肺制备中那样人工控制心室充盈压力升高、引起EDV增加的那种血液的重力动力是不存在的。②另一方面，人为地增加前负荷，那是改变了心肌收缩时的外环境条件。③由此而激发出的FS现象，是心脏适应其外环境条件变化所作出的反应。④此种心肌收缩力增强的反应，需通过心肌细胞内部与收缩过程发生有关的心肌兴奋一收缩和化学一力学偶联等一系列生化机制（不恒定因素）方能得以实现。⑤根据他们实验中观测到的FS现象，在逻辑上不能得出前负荷这一心肌收缩时的外环境条件变化调控其作功的推论。换言之，所有的在实验中被激发出来的FS现象，都不足以成为支持FS心脏定律的证据。然后，引用国内外公认的计算心脏每搏射血作功（w）的生物物理学公式“w=P×（EDV—ESV）”，证明了w和EDV之间没有函数关系。根据心脏作功的医用物理学和生物数学的基本原理，笔者认为Frank—Starling心脏定律表达的不是心脏作功的规律。     

Expression of differential nitric oxide synthase isoforms in human gastric mucosa infected with Helicobacter pylori

Objective: To study the relationship between nitric oxide synthase ( NOS) expression in human gastric mu-cosa and Helicobacter pylori (H. pylori) infection. Methods: Gastric mucosa samples were obtained from antrum of 33 patients received gastroendoscopy. H. pylori infection was confirmed by Giems staining and bacteria culture under mi-croaerophilic conditions. Expression of iNOS, eNOS and nitrotyrosine were detected by immunohistochemistry. Results: (1) The positive rate of H. pylori infection was 66. 7% (22/33) . (2) iNOS positive staining in inflammatory cells was detected in 77. 3% (17/22) of samples with H. pylori and 27. 3% (3/11) without H. pylori infection (P < 0.01). (3) eNOS expression in inflammatory cells was found in 77. 3% (17/22) of samples with H. pylori and 18.2% (2/11) without H. pylori infection ( P < 0. 01) . (4) Nitrotyrosine expression in inflammatory cells was observed in 59. 1% ( 13/22) of samples with H. pylori and 54.5%(6/11) without H. pylori infection (P>0.05). (5) Moderate a     

汉语成语结尾字事件相关电位N400的研究

目的 通过记录汉语成语结尾字匹配与不匹配事件相关电位N400的变化，探讨视觉词语认知模式及汉字认知加工特征。方法发采用南方医院研制的事件相关电位仪，对15例21—36岁健康人右利手受试者中，进行汉语成语正常结尾字(匹配字)与歧义字(不匹配字)N400的研究。结果 受试者对结尾词匹配与不匹配组的N400成分在潜伏期及波幅差异有显著性(P≤0．01)，不匹配组的N400波幅高，潜伏期长。N400广泛分布于各区，左侧比右侧波幅偏高。结论 汉语成语结尾字匹配与不匹配的N400与字词认知中的语义密切相关，有一定的临床价值，可用于临床多种伴有语言障碍疾病的评估。