GraVes眼病炎性活动期与静止期血清sICAM-1水平的研究

目的:研究可溶性细胞间粘附因子-1(sICAM-1)在Graves眼病(GO)炎性活动期与静止期的水平差异及其与各项甲状腺功能指标的关系。方法:将GO炎性活动期与静止期患者,Graves病(GD)无眼病患者及正常对照,分为A、B、C、D四组,抽取空腹静脉全血,测血清sICAM-1,各组间进行比较。并分析各组sICAM-1与FT3、FT4、TG、TM的相关关系。结果:①A、B、C组患者血清sICAM-1均明显高于正常对照组(P<0.05)。A组患者sICAM-1水平最高,与B组及C组患者相比有统计学差异(P<0.01);②前三组各组内sICAM-1与FT3、FT4成直线相关关系,与TG、TM成直线相关关系;③GO炎性活动期患者sICAM-1与GO评分成正相关。结论:血清sICAM-1水平可作为反映GO活动性评判的免疫指标,长期监测sICAM-1可预示GD进展为临床活动性眼病的可能性。     

原发性强直性脊柱炎的早期临床特点

目的 探讨原发性强直性脊柱炎（ＡＳ）的早期临床特点。方法 １２０例ＡＳ的早期临床特点。结果 该组病人的发病出现１６－２０岁和３０－３５岁两上发作年龄高山峰，初发年龄较低；外周关节受累的频率较脊柱高；下肢大和骶骼关节常易受累，其中髋关节，膝关节、踝关节和胸锁关节受累的频率分别为７９％，８５％，５７％和６３％，小关节受累少见，虹膜为和主动脉关闭不全的发生率１２．５％和４．５％，未发现有前更炎和类风湿结     

The Stockholm breast cancer screening trial — 5-year results and stage at discovery

In screening programmes it is important to assess a preliminary effectiveness of the screening method as soon as possible in order to forecast survival figures. In March 1981 a controlled single-view mammographic screening trial for breast cancer was started in the south of Stockholm. The population invited for screening mammography consisted of 40,000 women aged 40–64 years, and 20,000 women served as a well-defined control group. The main aim of the trial was to determine whether repeated mammographic screening could reduce the mortality in the study population (SP) compared to the control population (CP).The cumulative number of advanced mammary carcinomas in the screening and the control populations from the first five years of screening have shown a tendency towards more favourable stages in the screened population aged 40–64 years. A breakdown by age suggests an effect in age group 50–59 years, but not yet in age groups 40–49 and 60–64 years.When comparing the rates of stage II+ cancer, an increased number is found in the study group. As the total rate of breast cancer is higher in SP than in CP, there ought to be a concealed group of stage II+ cancers in the CP which makes the comparison biased. A new approach has been designed, where an estimation of the hidden number of stage II+ cancers in CP is added to the clinically detected cases, and in this respect a comparison has shown a decrease in the cumulative number of advanced cancers in the SP in relation to the CP (p<0.05). According to this it could be important to add the estimated number of undetected, hidden cases in the control group in order to utilize the difference in detection rate in the screening- and control group respectively.     

休克期大面积切痂对严重烧伤大鼠细胞免疫功能影响的研究

目的 观察休克期大面积切痂对严重烧伤大鼠细胞免疫功能的影响，探索改善烧伤后机体免疫功能紊乱的有效方法。方法 将大鼠分成休克期切痂组（A组）、常规切痂组（B组）和正常对照组（C组）。A、B组造成30％TBSAⅢ度烫伤，C组不烫伤。A组伤后第6h、B组伤后第4d切痂，并于伤后第1、5、9d各活杀10只，取材送检，观察其免疫指标的变化。结果 （1）A、B组与C组比较：A、B组烫伤大鼠各时相点CD3^＋T细胞变化不大（P〉0．05），但CD4^＋T细胞、CD4^＋／CD8^＋比值明显下降、CD8^＋T细胞增高（P〈0．05或P〈0．01）。NK细胞活性明显下降（P〈0．05或P〈0.01），外周血CD25^＋T淋巴细胞表达及经活化后脾脏CD25^＋T淋巴细胞表达明显下降（P〈0．05或P〈0．01）。（2）A组与B组比较：A组CD4^＋T细胞、CD4^＋／CD8^＋比值明显升高、CD8^＋T细胞降低（P〈0．05或P〈0．01），NK细胞活性明显升高（P〈0．05或P〈0．01），外周血CD25^＋T淋巴细胞表达及经活化后脾脏CD25^＋T淋巴细胞表达均明显升高（P〈0．05或P〈0．01）。结论 （1）大鼠烫伤后细胞免疫状况发生了明显变化。（2）休克期切痂可以改善烫伤大鼠T淋巴细胞亚群分布，提高NK细胞活性，增加外周血CD25^＋T淋巴细胞的表达。提高经活化后脾脏CD25^＋T淋巴细胞数。从而改善烫伤大鼠伤后机体的细胞免疫功能。     

A multicentre randomized controlled trial of oral misoprostol and i.m. syntometrine in the management of the third stage of labour

Postpartum haemorrhage accounts for nearly 28% of maternal mortality in developing countries. Syntometrine is an effective and commonly used oxytocic in preventing postpartum haemorrhage, but it requires a controlled storage environment and i.m. administration. Misoprostol is an orally active uterotonic agent. A total of 2058 patients having a singleton pregnancy, low risk for postpartum haemorrhage and vaginal delivery were randomized to receive either 1 ml syntometrine or 600 microgram misoprostol for the management of the third stage of labour. There were no significant differences between the two groups in the mean blood loss, the incidence of postpartum haemorrhage and the fall in haemoglobin concentration. The need for additional oxytocic injection was significantly higher in the misoprostol group [relative risk (RR) 1.62, 95% confidence interval (CI) 1.34-1.96], but that of manual removal of placenta was reduced (RR 0.29, 95% CI 0.09-0.87). Shivering and transient pyrexia were more common in the misoprostol group. Oral misoprostol might be used in the management of the third stage, especially in situations where the use of syntometrine is contraindicated and facilities for storage and parenteral administration of oxytocics are limited.     

终末糖基化产物对培养的人脐静脉内皮细胞粘附分子表达的影响

目的：探讨终末糖基化产物在糖尿病动脉粥样硬化（AS）形成中的作用机理。 方法： 分离正常人脐静脉内皮细胞（HUVECs），将终末糖基化终产物（AGE）修饰的人血清白蛋白（AGE-HSA）、人血清白蛋白（HSA）与HUVECs在体外共同培养，并用荧光单克隆抗体染色，流式细胞仪定量检测细胞间粘附分子-1（ICAM-1）、血管细胞粘附分子-1（VCAM-1）的表达。 结果： 正常人HUVEC表达ICAM-1和VCAM-1。AGE-HSA能以时间和剂量依赖的方式上调ICAM-1、VCAM-1的表达（P<0.05），而HSA对HUVECs上述粘附分子的表达均无影响。 结论： AGE能上调HUVECs粘附分子的表达，从而促进AS时单核/巨噬细胞的浸润。     

紫杉醇联合草酸铂、卡培他滨三药方案治疗晚期转移性鼻咽癌的临床研究

目的探讨紫杉醇联合草酸铂、卡培他滨三药方案治疗晚期转移性鼻咽癌的疗效及不良反应。方法2002年1月至2005年1月，110例晚期转移性鼻咽癌病人入组：试验组55例患者．第1天应用紫杉醇135mg／m^2、草酸铂130mg／m。静脉滴注，口服卡培他滨1650mg／m^2／d，连服l-14d，每3周为一个周期，连用2-4个周期；对照组55例患者，第1-5天应用DDP 20mg／m^2、5-Fu 0．5g／m^2静脉注射，3周为一个周期，连用2-4个周期；治疗结束2-4周后评价疗效。结果试验组疗效可评价55例，对照组疗效可评价53例。试验组与对照组有效率分别为（CR＋PR）50．9％（28例）和32．1％（17例），两者差异有统计学意义（P〈0．05）。试验组和对照组中位生存时间为10．6个月和8．6个月，两者差异有统计学意义（t〈0．05）。安全性方面：试验组Ⅳ反应主要为手足综合征8例（14．5％）、骨髓抑制2例（3．6％）和消化道毒性4例（7.3％）；对照组Ⅳ反应主要为消化道毒性8例（15.1％）、骨髓抑制2例（3.8％）。结论紫杉醇联合草酸铂、卡培他滨三药方案对晚期转移性鼻咽癌的疗效较DDP＋5-Fu有优势，且不良反应可以耐受。     

Fertilization and early embryology: The effect of equilibration temperature and time on the outcome of ultrarapid freezing of 1-cell mouse embryos

Mouse 1-cell embryos were frozen ultrarapidly at a rate of 2500°C/minin solutions containing 0.25 M sucrose, 0.5% (w/v) bovine serumalbumin (BSA) and 3 or 4.5 M dimethyl sulphoxide (DMSO) or 3or 4.5 M 1, 2-propanediol (PROH) in HEPES-buffered modifiedEarle's medium. We investigated the effect of pre-freeze equilibrationfor 1, 3, 5 or 10 min at 22°C and for 1, 3, 5, 10, 15 or20 min at 4°C. After thawing in a 22°C water bath ata rate of 2500°C/min and dilution in 1 M sucrose in HEPES-bufferedmodified Earle's medium, embryos were cultured in vitro in bicarbonate-bufferedmodified Earle‘s medium with 0.5% (w/v) crystalline BSA.Embryo viability was expressed as the percentage of hatchingor hatched blastocysts resulting from the initial number offrozen-thawed 1-cell embryos. To determine the toxicity of thefreezing solutions, embryo viability was evaluated after equilibrationwithout freezing. Our results demonstrated that the concentration,the equilibration temperature and time are very important factorsin ultrarapid freezing of mouse 1-cell embryos. Optimal viabilitywas found when equilibration was done in 4.5 M DMSO for 3–5min at 22°C and in 4.5 M PROH for 3–5 min at 4°C.The results with regard to exposure to the freezing solutionsindicated that the loss of viability beyond an optimum is notdue solely to cryoprotectant toxicity, in particular not at4°C and not for DMSO. It is suggested that the temperatureand time of equilibration influence the degree of cryoprotectantpermeation and subsequent rehydration, which play a role indetermining freezing susceptibility in terms of ice formation.We conclude that both DMSO and, in contradiction to previousreports, PROH can be used perfectly adequately for ultrarapidfreezing on condition that concentration, and the temperatureand time of equilibration are controlled.