腹腔镜卵巢穿刺内凝治疗多囊卵巢不孕症的临床研究

目的探讨腹腔镜卵巢穿刺内凝对多囊卵巢不孕症的治疗价值。方法１５１例腹腔镜卵巢穿刺内凝术（实验组）和１５１例开腹卵巢楔切术（对照组）治疗多囊卵巢不孕症配对对比研究。结果实验组的手术时间３３．１±７．２ｍｉｎ，术中失血１５．６±４．７ｍｌ，总排卵率９２．０５％，总妊娠率４９．６７％，均优于对照组（Ｐ＜０．０１）；术后雄激素、ＬＨ／ＦＳＨ下降幅度小于对照组（Ｐ＜０．０１）。随时间推移，两组术后排卵巢、妊娠率均有下降倾向，而术后雄激素、ＬＨ／ＦＳＨ则有逐渐回升的倾向。结论腹腔镜卵巢穿刺内凝术对多囊卵巢不孕症有较好的治疗效果     

前列腺带性结构及其雄激素、雌激素、表皮生长因子受体分布特征的研究

为了探讨雄激素受体（ＡＲ）、雌激素受体（ＥＲ）、孕激素受体（ＰＲ）和表皮生长因子受体（ＥＧＦＲ）在前列腺带性结构中的分布，应用单饱和剂量测定法，分别测定了前列腺移行带、外周带组织中ＡＲ、ＥＲ、ＰＲ和ＥＧＦＲ的含量。结果表明，在１１例前列腺增生症（ＢＰＨ）患者２２份标本中，移行带和周围带ＡＲ全部阳性；尽管ＡＲ浓度个体差异很大，但是两带之间仍有密切相关性（Ｐ＜０００１）；周围带ＡＲ浓度高于移行带，两带ＡＲ浓度均高于ＰＲ、ＥＲ；ＰＲ和ＥＲ在前列腺带性结构上没有明显差异。ＥＧＦＲ在移行带明显高于周围带。研究证实了ＡＲ、ＥＲ、ＰＲ，ＥＧＦＲ在前列腺移行带和周围带上的分布特征。     

一个RET原癌基因Met918Thr突变的多发性内分泌腺瘤病Ⅱb家系报道

目的 检测一个多发性内分泌腺瘤病(MEN)Ⅱb家系的RET原癌基因突变。方法 提取患者及其父母的外周血基因组DNA，对RET原癌基因第16外显子进行聚合酶链反应(PCR)，将PCR扩增产物进行直接基因测序和限制性内切酶分析。结果 检测到患者RET原癌基因第16外显子918密码子存在ATG(Met)／ACG(Thr)点突变，而在患者父母中未检测到该突变。结论 通过对MENⅡb患者及其父母的基因筛查发现，该患者点突变是杂合子错义突变。该疾病的诊断达到了基因水平。     

尿毒症患者的性激素变化及其临床意义探讨

目的 :探讨女性尿毒症患者卵巢功能障碍的发病情况及其临床意义。方法 :应用酶免疫法 (EIA)测定了2 3例更年期前女性尿毒症非透析患者、15例透析患者及 2 9例健康献血者中促卵泡素 (FSH)、泌乳素 (PRL)、促黄体素 (LH)、雌二醇 (E2 )及孕酮 (P)的水平。结果 :尿毒症女患者PRL、FSH及LH均较健康对照组升高 ,而孕酮值显著降低 ,对此均有显著差异 ;且尿毒症女患者PRL升高、孕酮值降低与肾小球滤过率 (GFR)呈明显相关。透析患者较非透析患者PRL升高更为明显 ,孕酮值亦较非透析患者有所升高 ,但无显著意义。结论 :尿毒症女患者的排卵障碍及月经紊乱等都与尿毒症的严重程度相平行。透析并不能改善尿毒症女患者的卵巢功能障碍 ,只有纠正与改善肾功能 ,才能使尿毒症女患者的卵巢功能得以改善     

416例甲状腺肿瘤临床病理分析

目的了解本地区甲状腺肿瘤的发病情况，探讨甲状腺肿瘤的诊断与鉴别诊断6方法对416例甲状腺肿瘤病理资料进行回顾性分析。结果甲状腺肿瘤以良性多见，良恶性之比为8．2：1。各类型肿瘤均以女性明显多于男性，男女之比为1：5．4，好发年龄为21～50岁，肿瘤发生于甲状腺右侧多见。结论本组甲状腺肿瘤的发生率、好发年龄、性别差异、良恶之比与文献报道基本一致。乳头状腺瘤与乳头状癌的鉴别有一定难度，对可疑标本要多处取材，连续切片，仔细观察，找出其特征，提高诊断的准确性。     

Prevalence of autoimmune thyroid disorders in a Spanish multiple sclerosis cohort

The aim of the study was to determine the prevalence of thyroid autoimmune disorders in a cohort of untreated multiple sclerosis (MS) patients and compare it with a stratified sample of an adult population. We prospectively studied 93 untreated MS patients. The control group included 401 healthy subjects selected by stratified sampling in a non-iodine-deficient area. Antithyroid antibodies (ATA) (antibodies against peroxidase and thyroglobulin) were considered positive at titres ≥149 IU/ml. Antibodies were positive in 11 MS patients (11.8%; 95% CI 5.3–18.4%). This prevalence was five times higher ( P  = 0.0001) when compared with that in the control population. We found six cases with subclinical hypothyroidism (6.45%; 95% CI 11.4–1.5) in contrast to 2.24% in the control group. Comparing MS with positive and negative ATA, there was a non-significant, slightly higher frequency of low Expanded Disability Status Scale (EDSS) score in the ATA-positive group (81% vs. 73.2%). One year after start of interferon (IFN) treatment, only one patient developed subclinical thyroid dysfunction. MS patients have a higher prevalence of ATA compared with the general population. An initial ATA and thyroid-stimulating hormone (TSH) determination is recommended in all MS patients. A periodic assessment of thyroid function during IFN treatment only seems to be justified in those cases where positive ATA or dysfunction is present before treatment.     

甲状腺微小癌36例临床分析

目的:探讨甲状腺微小癌的诊断和外科治疗经验。方法:36例甲状腺微小癌患者,10例行患侧腺叶切除术,20例行患侧腺叶加峡部切除术,3例行甲状腺次全切除术,加局部淋巴结清扫术1例,加功能性颈淋巴结清扫术2例,术后均服用甲状腺素片80~120mg/d,服药时间维持手术后1~3年,定期复查甲状腺激素水平,以"轻度甲亢"症状为用药标准调整服药用量。2例术后做同位素治疗。结果:术后2例曾出现短暂声音嘶哑,后逐渐恢复,1例出现短期的低钙抽搐。34例术后随访3~10年,平均随访5年,除1例混合型癌伴发肝转移者死亡外,其余无复发和死亡。结论:甲状腺微小癌女性发病较多,以单发癌结节为主,B超、细针穿刺细胞学检查(FNAC)、术中快速冰冻病理检查等方法综合运用能提高甲状腺微小癌的检出率,甲状腺微小癌手术治疗的预后较好。     

儿童甲状腺癌13例临床分析

本文报告１９８５－１９９４年收治的儿童甲状腺癌１３例。年龄７－１６岁。男３岁，女１０例。所有病例无不适，而以颈部肿物就诊。除１例根治术前未做过任何治疗外，其余病例均曾进行过不恰当治疗，颈淋巴结转移１０例，肺转移３例，骨转移１例。病理诊断：乳头状癌１０例，滤泡癌３例。手术以患侧腺叶及峡部切除或加健侧大部分切除为佳。如有颈淋巴结转移应同时行颈部清扫术。本文对儿童甲状腺癌的特征、误诊原因及其治疗进行了计     

Fentanyl and the interleukin-6 response to surgery

It has been suggested that large doses of opioids may suppress the interleukin-6 response to surgery. We examined the effects of the supplementation of inhalational anaesthesia with either 3 or 15 μg.kg⁻¹ fentanyl on the circulating interleukin-6, interleukin-8, C-reactive protein, cortisol and glucose concentrations in 16 patients undergoing pelvic surgery. In both groups, surgery evoked the expected glucose, cortisol and interleukin-6 response but no increase in interleukin-8 was detected. There were no significant differences between the two groups. We conclude that the supplementation of inhalational anaesthesia with conventional doses of opioids does not modify the cytokine response to surgery.