多序岩黄芪化学成分研究（Ⅳ）

目的研究多序岩黄芪(Hedysarum polybotrysHand.-M azz.)的化学成分。方法用柱色谱分离,用理化性质及波谱方法鉴定结构。结果从多序岩黄芪中分离鉴定了3个化合物:(1)白桦脂酸,(2)二十六碳酸,(3)蔗糖。结论化合物1和2为首次从该植物中分离得到。     

不同微生物诱导家蝇幼虫表达抗菌肽的特性

研究不同微生物诱导家蝇幼虫表达的抗菌肽特性.用3种不同的病源菌通过针刺感染的方法诱导家蝇幼虫表达抗菌肽,通过Sephadex G25分离,用Hult mark改进法和抑菌圈测定法作抑菌试验,用毛细管电泳（CE）分析不同微生物诱导得到的抗菌肽样品差异,检测抗菌肽的热稳定性和酸碱耐受性.发现不同微生物诱导产生的家蝇抗菌肽具有广谱抑菌性,但不同样品对不同病源菌抑菌活性有差异,不同测定抑菌效果的方法对抑菌结果有影响,各种抗菌肽样品CE蛋白谱具有明显不同.抗菌肽样品都具有热稳定性和酸碱耐受性.说明不同微生物诱导产生的家蝇抗菌肽类型以及抗菌肽含量与诱导源有关,抗菌肽为家蝇幼虫体内固有成分,诱导增加了抗菌肽的表达量同时刺激新抗菌肽的产生.用志贺氏菌、金黄色葡萄球菌、鼠伤寒沙门氏菌诱导家蝇幼虫可产生较多含量高活性好的抗菌肽.     

颅内后循环远端动脉瘤的介入治疗

目的回顾性分析20例以电熔断解脱弹簧圈栓塞的后循环远端动脉瘤的治疗结果,探讨颅内动脉后循环远端动脉瘤的介入治疗方法与安全性。方法20例患者(其中18例以自发性蛛网膜下腔出血起病,2例以头痛起病)经造影证实大脑后动脉、小脑上动脉、小脑前下动脉、小脑后下动脉之远端动脉瘤分别为2例、4例、4例、10例。其中小脑上动脉供血之动静脉畸形1例,伴有血流相关破裂动脉瘤。小脑后下动脉远端多发动脉瘤1例。所有动脉瘤均采用GDC、EDC或Matrix弹簧圈栓塞。其中单纯栓塞动脉瘤2例;栓塞动脉瘤同时栓塞载瘤动脉18例。结果所有病例栓塞操作均顺利完成,无手术相关的死亡,术后出现一过性功能障碍2例;载瘤动脉栓塞后多数可见侧支供血,未见叫显的小脑供血减少。结论后循环远端动脉瘤由于动脉瘤特性、载瘤动脉细小、动脉瘤与载瘤动脉比例等因素,多需要闭塞载瘤动脉。为避免可能造成的侧支血管的闭塞,建议用弹簧圈栓塞。     

超声刀在骨巨细胞瘤中的应用

[目的]探讨超声刀在四肢骨巨细胞瘤手术中的临床应用价值。[方法]观察2004年2月~2006年8月应用超声刀肿瘤刮除、局部化疗和骨移植治疗四肢骨巨细胞瘤患者6例,所有的患者均完整随访。[结果]术后随访6个月~2年6个月,平均1.5年,未见肿瘤局部复发和肺转移。6例超声刀肿瘤刮除自体骨或异体骨移植后骨修复完善,肢体无畸形、无塌陷及骨折,无明显功能障碍,植骨生长良好未见排斥反应。[结论]应用超声刀肿瘤刮除、局部化疗和自体骨或异体骨移植治疗四肢骨巨细胞瘤效果良好,安全有效。     

Effects of α1-adrenergic receptor on the proliferation of cholangiocarcinoma cells

Objective To investigate the correlation between α1-adrenergic receptor and the pathological behavior of cholangiocarcinoma, and the effects of norepinephrine (NE) on the proliferation of cholangiocarcinoma cell line QBC939. Methods Thirty-six samples of cholangiocarcinoma were resected in Southwest Hospital from August 2002 to March 2008. The expression of α1-adrenergic receptor in the 36 samples of cholangiocarcinoma tissue and 4 samples of normal bile duct tissue were detected by SABC technique. The proliferation of cholangio-carcinoma cell line QBC939 was detected after processing the cells with NE, phentolamine and prazosin. All the data were analyzed by chi-square test. Results The high positive expression rate of α1-adrenergic receptor was 68% (17/25) in patients with lymph node metastasis, which was significantly higher than 9% (1/11) in patients without lymph node metastasis (χ2=10.604, P<0.05). The high positive expression rate of α1-adrenergic receptor was 85% (11/13) in patients with middle and low positioned cholangiocarcinoma, which was significantly higher than 30% (7/23) in patients with hilar cholangiocarcinoma (χ2=9.753, P<0.05). NE promoted the proliferation of cholangiocarcinoma cell line QBC939 by stimulating the expression of α1-adrenergic receptor, and in a concentration-dependent manner. The proliferative effect was weakened as time passed by, and it was eliminated by phentolamine and prazosin. Conclusions The expression of α1-adrenergic receptor is diverse due to lymph node metastasis and the location of the tumor, α1-adrenergic receptor with high expression may play an important role in the proliferation and metastasis of cholangiocarcinoma.     

基于中医五辨思维辨识火郁证

感染性发热归属于中医学火热证范畴,火热证的病机大多为阳气怫郁、阻遏于内,这种因郁而作的发热,称为火郁证。运用五辨（辨病、辨症、辨证、辨人、辨机）思维辨识火郁证,对火郁证的发病特点及规律进行概括,可把握火郁证的内在发病机制,有助于全面而深刻地理解感染性发热。     

食管粘膜活检取样误差的发生机制及对策

目的：探讨食管粘膜活检取样误差的发生机制及对策。方法：对来自河南食管癌高发区２８例患者行食管内镜检查和中、下段粘膜活检组织病理检查,１０天短期随访后对同一人群作重复检查;并对８８位无症状受检者进行碘染与活检相结合的方法。结果：第二次粘膜活检组织中,食管中段２４％的患者病变减轻,２８％的患者病变加重,４８％的患者病变维持不变。食管下段粘膜活检中,４８％的患者病变减轻,１６％的患者病变加重,３２％的患者病变维持不变;碘染受检者的食管粘膜中染色正常和染色异常的粘膜组织在癌前病变各阶段的构成比无明显差异。组织形态学测量显示：各级癌前组织与正常上皮组织的厚度无明显差异。结论：粘膜活检取样误差可严重影响组织病理学检查随访结果。食管粘膜癌前病变,特别是较轻度病变的厚度与同期正常上皮无明显改变,造成内镜下识别困难,是造成取样误差的重要因素。碘染可明显提高内镜下病变与同期正常组织的识别,但对小范围病变的活检准确度仍需改进。肿瘤抑制基因ｐ５３蛋白聚集的重复性检出率较高,可能是食管癌变过程中的有效指标。     

Raised levels of antistreptokinase antibody and neutralization titres from 4 days to 54 months after administration of streptokinase or anistreplase

Streptokinase and anistreplase are antigenic and their administrationoften leads to antibody formation. These can cause allergicreactions and/or neutralization of streptokinase with resultingsuboptimal treatment. Currently, streptokinase re-administrationis considered appropriate for up to 5 days and from 1 year aftera previous dose. Antistreptokinase antibody and neutralizationtitres (NT) were measured in three groups of patients to determineif this practice is appropriate: 1. (early)—36 patientswhose titres were measured for at least 5 days after thrombolysis;2. (late)—57 patients who received thrombolysis 12–54months previously; 3. (controls)—182 consecutive suspectedmyocardial infarction patients (without previous exposure tothrombolysis). Results were as follows (mean±SEM): 1. (early)—theantibody and/or NT were raised by day 4 in 19.4% of the patients.One patient could have neutralized 1.97 million units (MU) ofstreptokinase by day 4. (Day 4—antibody 1:39±11,NT 0.19±0.05 MU; day 5–1:136±41 and NT 0.7±0.43MU respectively.) 2. (late)—23 patients (40%) had eitherantibody titres 1:160 and/or NT> 1.5 MU. (12–23 months—antibody1:243±43, NT 0.63±0.15 MU; 24–35 months—1:98±31and 0.69±0.22 MU; 36–54 months—1:87±14and 0.54±0.12 MU.) All titres were significantly higherthan the controls (antibody 1:25±3. NT 0.14±0.01MU, P<0.01). After streptokinase or antistreplase, antibodies are raisedfrom 4 days to at least 54 months. It would seem prudent toavoid their re-administration during this time interval.     

小鼠光气染毒对肺脏细胞的凋亡作用

背景与目的:小鼠原代肺Ⅱ型细胞的分离、培养方法的建立,探讨光气对肺水肿小鼠的肺脏细胞凋亡的诱导作用.材料与方法:12只二级BALB/c小鼠,雄性,随机分为2组:正常对照组(6只)和染毒组(6只).正常对照组小鼠以空气为对照,染毒组小鼠给予11.9 mg/L剂量的光气,时间为5 min.染毒后4 h,分离、培养肺Ⅱ型细胞,电镜观察两组小鼠肺Ⅱ型细胞、肺Ⅰ型细胞、嗜酸性粒细胞、巨噬细胞、淋巴细胞和纤毛细胞凋亡情况.结果:单宁酸染色和电镜鉴定培养细胞为小鼠原代肺Ⅱ型细胞;小鼠给予11.9 mg/L的光气染毒5 min,电镜显示光气染毒肺水肿小鼠原代肺Ⅱ型细胞出现凋亡小体,肺Ⅱ型细胞核染色质呈现月牙型,嗜酸性粒细胞、巨噬细胞、淋巴细胞和纤毛细胞均出现凋亡征象.结论:建立了小鼠原代肺Ⅱ型细胞的分离、培养方法,证明光气染毒可造成肺水肿小鼠肺脏细胞发生凋亡.     

芦荟对大鼠肝微粒体脂质过氧化损伤体外模型的影响

目的: 探讨芦荟的抗氧化作用及其剂量效应关系。方法: 通过大鼠微粒体的提取,制备了VC/Fe2+和过氧基异丙苯(CHP)脂质过氧化损伤模型,检测不同剂量芦荟轧汁干预对丙二醛(MDA)含量变化的影响,观察芦荟清除活性氧的抗氧化作用。结果: 在CHP微粒体脂质过氧化激发模型中,各芦荟干预组的MDA含量均较对照组显著降低(P﹤0.01),在VC/Fe2+模型中,低剂量芦荟轧汁干预组与高剂量干预组MDA含量较阳性对照组显著下降(P﹤0.05),并且高剂量组降低更加明显(P﹤0.01)。但中剂量芦荟轧汁组MDA含量反而较阳性对照组有一定的升高。结论: 芦荟轧汁在抗氧化方面存在着双向效应,在一定剂量范围内有着较好的抗氧化作用,可能是芦荟的医疗保健功效的机制之一;但特定的剂量又可激发活性氧的生成。