摘要:Acute pancreatitis(AP) is characterized by its sudden onset and rapid progression and is often complicated by liver injury. AP-induced liver injury may develop into hepatic failure and even result in death. Thus, it is of importance to protect liver function and block injury-related pathways. In the pathogenesis of liver injury in AP, inflammatory cytokines, nuclear factor-kappa B(NF-κB) and oxygen free radicals play important roles. The complexity of the mechanism underlying the development of liver injury exerts, to some extent, a contribution to the difficulties in the treatment of this disease. Currently, the drugs used to treat the disease include L-arginine (L-Arg), calcium ion antagonists, somatostatin and a variety of inflammatory mediator inhibitors. Additionally, some traditional Chinese medicines such as tripterygium, wilfordii, rhubarb and salvia miltiorrhizae may also have some effects. In this article, the pathogenesis of liver injury in AP and its therapy are reviewed.

摘要:Objective: To construct recombinant adeno-associated virus co-expressing human vascular epithelial growth factor 165(hVEGF165) and bone morphogenetic protein 7(hBMP7), measure the virus titer and verify the recombination. Methods:The AAV helper-free system was used as basis to generate recombinant AAV. The IRES sequence of plasmid pIRES was cut down and subcloned into ITR/MCS containing vector pAAV-MCS to construct recombinant plasmid pAAV-MCSa-IRES-MCSb. The hVEGF165 and hBMP7 gene was amplified by PCR and inserted into upstream MCSa and downstream MCSb respectively. Then, recombinant plasmid pAAV-hVEGF165-IRES-hBMP7, pAAV-RC and pHelper were co-transfected into AAV-293 cells to complete rAAV-hVEGF165-IRES-hBMP7 packaging. The GFP labeled rAAV-IRES-GFP was simultaneously packaged by using the parallel plasmid pAAV-IRES-hrGFP. The efficiency of AAV packaging was monitored under fluorescent microscope and recombinant viral particles were harvested from infected AAV-293 cells. The virus titer was measured by infecting AAV-HT1080 cells, and the recombinant AAV-hVEGF165-IRES-hBMP7 was verified by PCR of the exogenous interest genes. Results:Recombinant pAAV-hVEGF165-IRES-hBMP7 was verified by double digestion. GFP expression in AAV-293 could be observed under fluorescent microscope 72 h after transfection and the system provided a high packing ratio of 95%. The recombinant adeno-associated virus has a high titer of 5.5×1011vp/ml, and AAV-HT 1080 was infected at a ratio of 90%. The recombinant virus was confirmed by PCR of exogenous hBMP7 and hVEGF165 gene. Conclusion:Recombinant rAAV-hVEGF165-IRES-hBMP7 was successfully constructed with a high virus titer, which may offer foundation for in vitro and in vivo experiments of hVEGF165 and hBMP7 co-expression and provide a new method for gene therapy of bone regeneration.

摘要:Objective: To study the role of nuclear factor-kappa B(NF-κB) in cholesterol efflux from THP-1 derived-foam cells treated with AngiotensinⅡ(AngⅡ). Methods:Cultured THP-1 derived-foam cells were treated with AngⅡ or preincubated with tosyl-phenylalanine chloromethyl-ketone(TPCK) NF-κB inhibitor. The levels of activated NF-κB in the cells were examined by sandwich ELISA. Cellular cholesterol content was studied by electron microscopy scanning and zymochemistry via fluorospectrophotometer and cholesterol efflux was detected by scintillation counting technique. ABCA1 mRNA and protein were quantified by RT-PCR and Western blotting. Results:Addition of TPCK to the cells before AngⅡ stimulation attenuated the response of NF-κB p65 nuclear translocation induced by AngⅡ and showed no peak in foam cells group and caused a reduction in cholesterol content and an increase in cholesterol efflux by 24.1%(P < 0.05) and 41.1%(P < 0.05) respectively, when compared with AngⅡgroup. In accordance, the ABCA1 mRNA and protein were increased by 30% and 19%(P < 0.05) respectively, when compared with AngⅡ group. Conclusion:AngⅡ can down-regulate ABCA1 in THP-1 derived-foam cells via NF-κB, which leads to less cholesterol efflux and the increase of cholesterol content with the consequence of the promotion of atherosclerosis.

摘要:Objective:To explore the effect of bile salt and bile acid on cultured eternalized human gastric mucosa epithelium GES-1 cells. Methods:Cultured eternalized human gastric mucosa epithelium GES-1 cells were treated with media containing 6 different kinds of bile salts and 3 different kinds of bile acids and their mixture with different concentrations: GCDC(glycochenodeoxycholate), GDC(glycodeoxycholate), GC(glycocholate), TCDC(taurochenodeoxycholate), TDC(taurodeoxycholate), TC (taurocholate), LCA(lithocholicacid), CA(cholic acid), DCA(deoxycholic acid)(50μmol/L,250μmol/L,500μmol/L,1000μmol/L), DY(mixture of bile salts) and DS(mixture of bile acids)(250μmol/L,500μmol/L,1000μmol/L,1500μmol/L, 2000μmol/L), in comparison with the control group(in normal media without bile salts and bile acids). Cell proliferation was assessed by MTT(3-[4,5-Dimethylthiaolyl]-2,5-diphenyl-tetrazolium bromide) assay for 72 hours with different concentrations and the apoptotic cells were assayed by flow cytometry (FCM) with Annex V-FITC conjugated with propidium iodide(PI) staining for 24 hours with different concentrations(1500,2000μmol/L). Results:There was no significant difference in morphology and cell proliferation in GC group after 24~72 h. Low concentration(50μmol/L) of GCDC, GDC, TCDC, TDC and TC accelerated gastric epithelial cell growth in a dosage-time dependent manner. At middle concentration(250-500μmol/L), it showed positive effect after 24~48 h, while negative effect after 72 h. At high concentration(1000μmol/L), it accelerated gastric epithelial cell growth after 24h and show consistent inhibition even leading to necrosis after 48~72 h. LCA and CA showed a positive effect on the concentration of 50μmol/L after 24~72 h, while 250-1000μmol/L showed a trend towards apoptosis after 24~72 h. At 50-500μmol/L, DCA showed proliferation after 24 h and apoptosis after 48~72 h, but showed necrosis after 24~72 h at 1000 μmol/L. DY and DS could facilitate normal gastric mucosa epithelial cell growth at low concentration (250-500μmol/L), however at 1000-2000μmol/L the trend shifted from apoptosis to necrosis. FCM with Annexin-V conjugated with PI staining revealed that GCDC, GDC, GC, TCDC, TDC, TC, LCA, CA, DCA, DY and DS induced apoptosis of human gastric mucosal epithelial cells. They were all significantly higher than that of the control(P < 0.05), but there was no significant difference in GC group (P > 0.05). The bile salts induced apoptosis in a time-dose-dependent manner. Conclusion:Our results suggested that bile acid and bile salt is the trigger of injury in human gastric mucosal epithelial cells.

摘要:Objective: To evaluate the effectiveness of regenerous tissue and bone substitute in autogenous tooth transplantation in the larger recipient socket. Methods:In 3 Beagle dogs, 18 incisors were transplanted to the recipient sockets, 2 mm wider mesio-distally. The regenerous tissue group, the bone substitute group and the control group contained 7, 7 and 4 teeth respectively. No additional material was used in control group. Clinical and radiographic examinations were done every month and were sacrificed 3 months later. Subsequently, decalcified sections were prepared for routine histological evaluation. Ordinal scores for root surface resorption were analyzed using the Kruskal-Wallis test. Results:All donor teeth survived. A statistically significant difference was found among all three treatment groups(P = 0.0001). The proliferating tissue in space positively affected the periodontal healing without any resorption. Inflammatory resorption of the root surface and formation of new bone were observed in the bone substitute group. Surface resorptions of the roots were found in the control group. Conclusion:Proliferating tissues enhance the regeneration of periodontal tissues in larger recipient sockets and prevent root resorption. Sinbone HT is beneficial for the stabilization of the transplanted teeth in larger sockets.

摘要:Objective:To evaluate Wells, Kahn, St.Andréand Constans scores for the prediction of deep venous thrombosis in Chinese patients. Methods:One hundred and seventy-two patients, prospectively, blinded referred for evaluation with four clinical-score systems for suspected deep venous thrombosis, were examined by ultrasonography. Sensitivity, specificity, positive predictive value, nega-tive predictive value and receiver operation curves were calculated for four clinical scores. The difference between areas of the ROC curve for each of the scores was compared with others and reference line. Results:Forty-six of 172 patients had deep venous throm-bosis proven by sonography. The sensitivity, specificity, positive predictive value and negative predictive value for Wells score was 91.3%, 57.1%, 43.8% and 94.7%, respectively, for Kahn score; 65.2%, 71.4%, 45.5% and 84.9%, respectively, for St.Andréscore; 63%, 38.9%, 27.4% and 74.2% respectively, for Constans score; 95.7%, 34.9%, 34.9% and 95.7% respectively. Area under ROV curve of Constans score was 0.814, which was similar to that of Wells score, then followed by Kahn score and that of St.Andréscore was no difference with the reference line. Conclusion:Based on the results of our study, the sensitivity, negative prediction value and area under ROC curve are larger for Constans score and Wells score in Chinese hospitalized patients than that of Kahn score or St.Andréscore. Considering the aim of the clinical assessment, Constans score and Wells score are more efficient for Chinese hospitalized patients.

摘要:Objective:To analyze the value of CT pulmonary angiography(CTPA) in assessing right ventricular dysfunction(RVD) after acute pulmonary embolism. Methods:Thirty-six patients with CTPA-confirmed PE who underwent ultrasonic cardiography(UCG) within the ensuing 24 hours were retrospectively reviewed. According to the severity of the disease, the patients were divided into the massive PE group(24 cases) and non-massive PE group(12 cases) respectively. CT scans were analyzed for findings suggestive of RVD. Scans were considered positive for RVD if the right ventricle was dilated(RVd/LVd＞1) or if the interventricular septum was straightened or deviated towards the left ventricle. Results were then compared with the results of UCG to estimate the value of CTPA in detecting RVD associated with PE. Results:In all cases, compared with UCG, the diagnostic sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, positive predictive value, and negative predictive value of CTPA was 84.61%, 78.26%, 3.892, 0.197, 68.75% and 90% respectively. Kappa value was 0.60, which suggested moderate agreement between CTPA and UCG in the whole level. In the massive PE group, the diagnostic sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, positive predictive value, negative predictive value of CTPA was 84.61%, 72.73%, 3.103, 0.212, 78.57% and 80% respectively. Kappa value was 0.58, which suggested moderate agreement between CTPA and UCG in the massive PE group. In the non-massive PE group, the diagnostic specificity of CTPA was 83.33%. By statistics, the value of RVd/LVd had significant difference between the massive PE and the non-massive PE group. Conclusion:CTPA can reliably detect RVD through the evaluation of cardiac morphology. However, this result requires confirmation using a larger prospective cohort study.

摘要:Objective: To compare clinical outcomes and safety of eptifibatide or tirofiban in patients with acute coronary syndrome(ACS) undergoing percutaneous coronary intervention(PCI). Methods:Thirty-six patients with ACS(unstable angina/non-ST-segment elevation myocardial infarction, UA/NSTEMI) who underwent PCI were randomly divided into two groups to receive eptifibatide or tirofiban treatment. Eptifibatide or tirofiban was predominantly initiated in the catheter laboratory before the intervention. In-hospital and 30-day MACE outcomes; bleeding as well as platelet counting were investigated in those two groups. Results:No in-hospital and 30-day MACE event occurred in the two groups. The number of ischemia leads after treatment reduced compared to that before PCI in the two groups. There was improvement in the number of ischemia leads for 24 h after administration in the tirofiban group than those in eptifibatide group(4.21±2.46 vs. 3.89±3.31, P =0.03). The two groups showed no incidence of massive bleeding. Minor bleeding rates were 16.7% and 22.2% in the two groups respectively. Conclusion:Eptifibatide as an adjunct to PCI may further decrease the incidence of ischemia event in patients with ACS and improve the safety, but its long-term efficacy and side effects need further observation.

摘要:Objective: It was known that neutrophils play an important role in ischemic-reperfusion injury. In this study we tested the effect and its mechanism of dipyridamole on neutrophils. Methods:Hydrogen peroxide(H2O2) production by neutrophils was determined using luminol amplified chemiluminescence and the percentage of activity was calculated by observing the uninhibited peak height. Results: Dipyridamole per se produced a concentration-dependent inhibition of H2O2 by formyl-MetleuPhe(fMLP)-stimulated neutrophils. Dipy-ridamole at a low concentration(0.3μmol·L-1) that per se affected neutrophils only slightly, enhanced markedly the effects of adenosine on neutrophils. On the other hand, dipyridamole did not alter the inhibitory effect of NECA(5’-N-ethylcarboxamidoadenosine) on neutrophils. However, propentofylline, a known inhibitor of adenosine uptake, also gotten the same result. Conclusion:Dipy-ridamole inhibited the production of H2O2 by fMLP-stimulated neutrophils. Dipyridamole at a low concentration enhanced the inhibi-tory effect of adenosine on neutrophils. The mechanism involved is probably due to the effect of dipyridamole on adenosine uptake.

摘要:Objective: To investigate the regulation of High sensitive C-reactive protein(Hs-CRP) and WBC count in patients with coronary heart disease(CHD) by percutaneous transluminal intervention(PCI) and to discuss the mechanism of inflammatory reaction after coronary stenting. Methods:127 patients who received successful percutaneous transluminal coronary stenting, were divided into groups of stable angina(SAP), unstable angina(UAP), and acute myocardial infarction(AMI) according to their clinical types. Another 41 stable angina patients with more than 7o% of coronary artery tenosis who did not receive PCI served as control. Serum Hs-CRP levels and WBC count were determined before intervention, 3 days and 7 days post PCI and the data were analyzed statistically by t-test. Results: There showed no difference in clinical baseline characteristics between groups. The serum Hs-CRP level and WBC count was gradually raised in the UAP and AMI group(how about SAP group, and had no difference in CAG group and SAP group). After PCI serum Hs-CRP levels and WBC counts were significantly higher in the SAP group than in the coronary angiography group(CAG) at 3 days and had no difference at 7 days. In the UAP and AMI group, the serum Hs-CRP level at 3 days and 7 days declined obviously, however serum WBC count did not decrease apparently. Conclusion: The serum Hs-CRP level and WBC count elevate transiently after PCI. There are different inflammatory reactions in different types of coronary heart diseases after coronary stenting procedure.

摘要:Objective:To research on consistency of identifying solitary pulmonary masses with CT. Methods:Three observers with different working backgrounds in imaging diagnosis individually interpreted the same group images of solitary pulmonary mass, by 12 indexes of objective signs. The differences in interpretation resulted in ante- and post-interpretations were assessed by the x2 test. The agreement of two interpretations from the same observer was confirmed with the kappa test. A double-blind method was adopted for analysis. Results:The agreement rates of ante- and post-interpreting from the three observers were respectively 82.65%(486/588) 80.27%(472/588) and 84.86% (499/588) while their interpreting results were generally accordant without significant difference(x2 = 4.975, df = 2, P = 0.083) however there was difference between the observer 2 and observer 3(x2 = 4.875, df = 1, P = 0.027). There were five indexes with k > 0.40 of ante- and post-interpreting results of the three observers, including clarity of nodule borderline, presence of sentus, uniformity of density, existence of cavity and calcification in pathological region, among them, the agreement rate of interpreting borderline and cavity was higher(k > 0.07); the blood vessel convergence poorer(0 < k ≤ 0.40); the other six CT signs of interpretation were slightly different. Conclusion:The ability to identify solitary pulmonary mass was inconsistent, and needs to be improved further.

摘要:Objective:To investigate the expression of Survivin p53 and its relationship with apoptosis、proliferation in hepatocellular carcinoma(HCC). Methods:The expression of Survivin, p53 and the proliferation of tumor cells marked by proliferation cell nuclear antigen (PCNA) in 42 cases of HCC were assessed by immunohistochemical method. TUNEL was used to detect apoptosis. Results:Survivin protein was expressed in 30 of 42 cases of HCC(71.4%) and in 4 of 34 cases of adjacent cirrhosis tissues(11.8%). Expression of Survivin protein was negative in 10 cases of normal tissues. Survivin protein positive expression rate in HCC was significantly higher than adjacent cirrhosis tissues and normal tissues(P < 0.001). The increased Survivin protein expression in cancer was significantly associated with histological grade(P = 0.003), p53 protein(P = 0.013), survival time(P < 0.05) and the ratio of proliferative index to apoptotic index(P < 0.01), but was not significantly correlated with age, sex, clinical stage, tumor size, metastasis, AFP, HBs-Ag(P > 0.05).Conclusion:There is a marked increased expression of Survivin in HCC, which may play an important role in breaking the balance of proliferation and apoptosis of HCC cells. The correlation between Survivin and p53 expression in HCC indicates that cooperation between Survivin and p53 plays a certain role in occurrence and /or development of HCC.

摘要:Objective:To observe the clinical effect of anterior decompression and reconstruction using titanium mesh with locking plates in the treatment of cervical spondylotic myelopathy. Methods:One hundred and twenty patients with cervical spondylotic myelopathy were treated by anterior decompression and reconstruction using titanium mesh with locking plates. There were 66 men and 54 women ranges in age from 37 to 72 Years(mean age, 58.3 years). The mean Japanese orthopedic surgery association(JOA) scale was 9.6 points before operation. Patients were followed up clinically and radiographically. Results:Having stood surgery well, the operation time ranged between 60~100 min and bleeding during operation ranged between 20~200 ml. There were no case of postoperative infection, recurrent laryngeal nerve palsy, or esophageal or tracheal laceration or rupture. The average follow-up period was 14.3 months(range, 12 to 24 months) in 96 who were followed up. At the last follow-up visit the mean JOA scale had improved to 14.4 points, reflecting an improve-ment of 4.8 points. The results were considered to be excellent in 87 patients, good in 25, fair in 6, and poor in 2. No hardware-related complications or adjacent segment degenerative changes were encountered during the follow-up periods. Stable bone union was observed in all cases and the average time required for fusion was 5.7 months. Conclusion:Titanium mesh filled with autologous bone graft can avoid the complications associated with harvesting bone from the iliac crest donor site. When combined with cervical anterior locking plate, it can obtain satisfatory clinical results for the treatment of cervical spondylotic myelopathy.

摘要:2008年10月中旬公布征求意见的《关于深化医药卫生体制改革的意见》有许多亮点,其中最突出的是强调新一轮中国医疗体制改革必须坚持政府主导-这不仅是由政府性质和医改任务所决定,而且直接针对目前客观存在的医疗卫生领域公益公平的缺失-经济和社会失衡的风险-坚持政府主导将促进政府转变职能,在建设服务型政府过程中,从根本上缓解人民群众看病难看病贵-

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摘要:食品安全监管是保障食品安全的重要措施-而目前食品安全的监管力度尚不够,为此应充分注重源头管理,对突发性食品安全事件应能及时回应,同时应加强执法力度-投入适当经费研究防控措施-加大食品安全举报的奖励-加强食品安全国际间的交流和改变目前食品安全监管模式-加大环境污染的治理,以从政策上引导食品的生产与加工等方面来增强对食品生产的安全监管-

摘要:中医药是中华民族优秀的文化遗产,在国民卫生保健中起着不可或缺的重要作用-但是,目前国家对中医药的法律保护还存在缺陷和不足-文章在介绍古代-民国时期以及当前的中医药法制的基础上,剖析中医药立法存在的问题并对中医药立法难点进行分析,为国家出台中医药基本法提供相关建议-

摘要:文章系统地从法律的适用-归责原则-举证责任分配和免责事由等方面阐述了血液制品一般缺陷致人损害侵权中如何适用产品责任的问题-文中重点指出,此类侵权同时属于医疗行为侵权,因此在因果关系上应采用举证责任倒置;同时,根据举证责任的分配原则和《关于民事诉讼证据的若干规定》第7条,也兼具督促医院及时保留血液制品残液之目的,建议对血液制品存在缺陷实行举证责任倒置-

摘要:文章界定了会诊的法律性质,认为会诊是民事合同行为,其兼具有非典型合同-诺成合同-要式合同-有偿合同等特征,并进一步阐述了会诊过程中医方相关民事责任问题,包括合同责任与侵权责任的归责原则-合同责任和侵权责任的类型-会诊医师的民事责任等-

摘要:构建合理的城市土地权利体系,有利于充分利用城市土地,防止土地资源的闲置和浪费-大陆法系国家和地区在城市土地上设定的用益物权主要有地上权-地役权-人役权-典权等-应当借鉴其他国家的经验,并结合具体国情构建中国的城市土地权利体系-

摘要:土地承包经营权物权化会引起许多矛盾和冲突,立法应提供相应的解决方案-要使土地承包经营权制度健康发展,必须进一步完善集体土地所有权制度,必须明确规定土地承包经营权的权能,必须为其提供通畅的救济渠道-另外,针对土地承包经营权不可克服的弊端,法律上应当提供复数的农地经营模式以供农民根据实际情况选择-

摘要:文章通过问卷调查研究了患者满意度的影响因素-患者满意度与治疗效果正相关关系最大,同时也与医患间的沟通-医护人员的服务态度有很高的正相关关系,而与治疗费用没有显著负相关关系,患者倾向于支付较高的价格以获得高质的医疗服务,这说明医疗服务市场是需求弱弹性和价格刚性的-医患间的沟通-医护人员的服务态度与治疗效果间也存在显著正相关关系-因此要提高患者的满意度医院必须首先提高医疗水平,其次强化医护人员的沟通技巧,加强医护人员的服务意识培养-医疗收费方面需要通过第三方即政府监管部门的监管,才能使其合理化-

摘要:目前,无论从法规上或理论上认为,民办医疗机构分为非营利组织与营利组织两类,其中,民办非营利医院为非营利组织-文章认为,在非营利组织与营利组织中间,还存在第三类组织,即“准非营利组织”,其理论意义是提出了民办非营利医院的性质应是“准非营利” ,其实践意义是民办非营利医院不受非营利组织标准的束缚,大部分收入是来自医疗服务的销售,盈余合理回报,可以分配给组织成员,能促进民办非营利医院的发展-

摘要:目的:研究影响南通市县级及以下医疗机构主要系统疾病住院患者医疗费用构成的主要因素及内在联系,探讨控制住院费用不合理增长的重点并提出建议-方法:对2005年4月南通市海门-海安县二级-一级农村医疗机构的全部出院患者病案首页中关于费用的数据,采用因子分析方法,分析支配医疗费用的公因子-结果:诊察-化验因子,治疗-手术-护理因子,床位-检查因子,其他因子是支配住院患者主要系统疾病费用的公因子-结论:应明确因子内部的相关性联系和因子间的特征,综合措施控制住院费用的不合理增长-

摘要:目的:评价南京地区大学生预防艾滋病同伴教育的近期效果,为今后高校大学生预防艾滋病的健康教育提供依据-方法:2007年10月~2008年4月随机抽取南京地区15所高校4 500名大学生进行艾滋病相关知识-态度-行为的基线调查,然后从中随机分层整群抽取1 400名一年级至三年级在校学生进行同伴教育培训,作为同伴教育干预组,按同样的方法另选取2 000名学生作为同期对照组,半年后再进行相关认知调查,根据认知情况评价干预效果-结果:在对艾滋病相关知识的知晓率-安全性行为-艾滋病患者等问题持正向/积极态度或行为意向

摘要:文章对南京市新型农村合作医疗的运行情况进行分析,发现参合人数不断增加,筹资水平逐年提高;实现了以大病统筹为主的政策要求,但资金结余率偏高;不同级别医院的住院人次分布不均衡-建议规范定点医疗机构的服务行为;实行逐级转诊制度;加强乡镇卫生院的建设;积极探索补偿方法和费用支付方式;建立健全新型农村合作医疗管理信息系统-

摘要:在建设和谐社会的今天,医患关系的好坏,直接影响到医院的形象,医患矛盾是当前一个十分突出的问题,是社会矛盾的一个焦点-如何处理好医患关系,解决好医患矛盾,是卫生事业管理者必须探讨的课题-多年实践表明,医患沟通是建立和谐医患关系最有效的途径,而医患沟通技巧则尤为关键-

摘要:学术权力和行政权力是存在于高校学术管理中的两种基本权力形式-如何协调两种权力的运行-保障学术权力的行使一直是学界探讨的热点-文章认为,基于我国历史文化背景和目前的现实,诸多问题的突破点在于保证行政权力的规范运行上-故拟通过分析行政权力在学术管理中的地位-作用,针对目前权力运行中存在的主要问题,提出行政权力规范运行的对策-

摘要:文章分析了大学行政人员目前在高等教育活动中的现状,并论述了行政人员融入高等教育活动的必要性,在此基础上思考如何利用高等教育本身优越的资源,使大学行政人员多方位融入高等教育活动,以求高等教育与大学行政人员本身得到更好-更和谐的发展-

摘要:文章运用皮尔逊相关系数对高校图书馆读者群进行相关性分析和显著性检验,根据分析结果对高校图书馆的建设提出建议,主要有构建合理的馆藏结构,加强高校图书馆员队伍的建设以及高校图书馆应开展多元化的信息服务-

摘要:研究生导师队伍的可持续发展是落实科学发展观的需要与保障条件,也是研究生教育自身发展的必然选择-实现研究生导师队伍的可持续发展,就必须积极探索建立健全适应研究生导师队伍可持续发展的管理模式和管理创新体系,以保证研究生导师队伍的整体发展水平-

摘要:全科医生是在现代“社会—心理—生物”医学模式催生下产生的,主要从事基层社区卫生保健服务-社区卫生服务正在我国飞速发展,而其主力军——全科医生的培养模式还存在不足-文章分析比较了国外全科医学教育的模式,针对我国全科医学教育存在问题进行深入的思考-

摘要:作为世界上高等教育最为发达的国家之一,美国高校学生事务管理研究与实践,走在了世界的前列,有着较强的规范性-制度性-专业性-相对而言我国高校学生事务管理起步较晚,相关规章制度尚不健全-专业化步伐较为缓慢-文章通过对中美高校学生事务管理的产生发展-行业管理组织-录用与培养机制和规章制度等进行比较,借鉴美国高校学生事务管理的经验,提出对我国高校学生事务管理方面的几点启示-

摘要:近年来,医学院校本科招生一直“高温不退”,然而就业市场却出现了变化,医学生遭遇到了极大的就业尴尬-文章从社会-学校和学生个人三个方面,对医学生就业情况进行了系统分析,并提出相关对策,认为应该在社会大政策的正确指导,学校教育的准确引导下,提高的医学生自身综合素质,树立正确的就业观,从而解决医学生就业难的问题-

摘要:文章调查大学生对现有教学方式-授课学时等的看法,并开展课堂师生互动的教学实践,改变单向授课方式,培养学生自主学习能力和创造能力-结果显示,在教学手段上,大学生更希望板书与多媒体相结合的教学方法,80%~90%的大学生对授课时仅用板书,或仅用多媒体作为辅助教学手段持不满意态度;100%的大学生认为实行课堂教学师生互动教学方式有必要;90%的大学生希望压缩现有授课学时,增加师生互动的时间-通过本次课堂师生互动的教学实践,大学生们给予了较高的评价,认为开展师生互动可增强自身综合素质,提高学习能力和表达能力,扩展

摘要:在七年制口腔临床实习中,把学生分为ABC三层,分层训练-一对一分层辅导能使不同类别的学生充分发挥其学习主动性-激发学生的学习热情,有利于学生实践能力和临床思维能力的培养-分层教学在实习中是值得坚持和推广的教学方法-

摘要:目的：构建针对ＰＩ３-Ｋ／Ａｋｔ基因的特异性短发卡ＲＮＡ（ｓｈＲＮＡ）真核表达载体。方法：用ＤＮＡ重组技术将针对大鼠ＰＩ３-Ｋ／Ａｋｔ基因不同位点所设计的８个ｓｈＲＮＡ序列克隆到真核表达质粒ｐＧｅｎｅｓｉｌ-１中。在酶切分析及序列测定后，用脂质体转染至大鼠肾小球系膜细胞（ＧＭＣｓ），Ｗｅｓｔｅｒｎ ｂｌｏｔ检测蛋白的相对表达量来筛选最佳沉默效率的ｓｈＲＮＡ。结果：限制性酶切及核酸序列分析证明重组质粒正确。Ｗｅｓｔｅｒｎ ｂｌｏｔ证实在重组质粒中ｓｈＰｉｋ３ｃ３-２、ｓｈＡｋｔ１-４具有最佳沉默效率。结论：成功构建了ＰＩ３-Ｋ／Ａｋｔ ｓｈＲＮＡ的真核表达质粒。该实验结果为进一步研究ＰＩ３-Ｋ／Ａｋｔ信号通路的生物学功能奠定了基础。

摘要:目的：构建含３个结核杆菌ＥＳＡＴ-６抗原Ｔ细胞表位及Ｆｌｔ３配体基因的重组质粒，并使其在大鼠肾小球系膜细胞（ＧＭＣｓ）中表达。方法：用计算机软件预测结核杆菌ＥＳＡＴ-６抗原的Ｔ细胞表位谱，选取３个Ｔ细胞表位，并以Ａｌａ-Ａｌａ-Ｔｙｒ（ＡＡＹ）序列作为接头，合成全基因序列，定向克隆入真核双表达载体ｐＩＲＥＳ及质粒ｐＩＲＥＳ-ＦＬ。在酶切分析与序列测定后，用ＰＥＩ转染至ＧＭＣｓ细胞，并行Ｗｅｓｔｅｒｎ ｂｌｏｔ 鉴定其体外表达。结果：核酸序列测定证实重组质粒构建正确，Ｗｅｓｔｅｒｎ ｂｌｏｔ 证实该重组质粒能在体外ＧＭＣｓ细胞中表达融合蛋白。结论：成功构建了结核杆菌ＥＳＡＴ-６抗原多表位基因重组质粒。

摘要:目的：制备并鉴定人疱疹病毒６型（ＨＨＶ-６）单克隆抗体。方法：用纯化的ＨＨＶ-６南京分离株Ｅ５免疫ＢＡＬＢ／ｃ小鼠，取其脾细胞与骨髓瘤细胞ＳＰ２／０融合，经间接ＥＬＩＳＡ法筛选，间接免疫荧光法、免疫印迹实验等方法鉴定单抗。并采用套式ＰＣＲ法和ＥＬＩＳＡ法，在口腔癌中进行了初步的应用。结果：获得了一株分泌抗ＨＨＶ-６单克隆抗体的杂交瘤细胞系，命名为ＪＡ９。单克隆抗体亚类鉴定表明：其为ＩｇＧ１亚类，轻链为κ。用间接ＥＬＩＳＡ法检测细胞上清单抗效价为１ ∶ ５００；单抗腹水滴度为１ ∶ ８．０ × １０４。免疫印迹实验结果表明：ＪＡ９单抗腹水与约７５ ｋｕ ＨＨＶ-６ Ｅ５病毒蛋白结合。口腔癌患者唾液的ＨＨＶ-６阳性检测率结果分别是：套式ＰＣＲ法６０％，ＥＬＩＳＡ法４０％。结论：成功制备并鉴定一株抗ＨＨＶ-６南京分离株Ｅ５单克隆抗体，为ＨＨＶ-６进一步的基础研究及临床快速诊断提供可能。

摘要:目的：在大肠杆菌中表达ＥＢ病毒潜伏膜蛋白１（ＬＭＰ１）胞外肽段与谷胱甘肽Ｓ-转移酶（ＧＳＴ）融合蛋白，并用该融合表达蛋白检测ＥＢ 病毒相关鼻咽癌（ＮＰＣ） 患者血清中的特异性抗体。方法：用ＢａｍＨⅠ和ＥｃｏＲⅠ将含ＬＭＰ１ 胞外区重组基因的质粒ｐＭＤ１８-ＬＭＰ１双酶切后，克隆到ｐＧＥＸ-４Ｔ-２中。重组质粒经酶切鉴定、核酸序列分析后转化大肠杆菌ＢＬ２１（ＤＥ３），以异丙基硫代-β-Ｄ-半乳糖苷（ＩＰＴＧ） 诱导表达融合蛋白，表达的蛋白经谷胱甘肽Ｓ-转移酶柱亲和层析纯化，纯化的蛋白经Ｗｅｓｔｅｒｎ ｂｌｏｔ 法检测鉴定。结果：重组表达质粒经酶切鉴定为阳性，核酸序列分析正确。ＳＤＳ-ＰＡＧＥ 和Ｗｅｓｔｅｒｎ ｂｌｏｔ 结果显示表达的重组蛋白分子质量约为３２．２ ｋｕ，此抗原能够与鼻咽癌患者血清中抗体特异性结合。结论：成功获得了ＬＭＰ１ 胞外区重组基因表达的蛋白，并证明原核表达的ＬＭＰ１胞外肽段保持了原有的抗原性，能够与ＥＢＶ相关鼻咽癌患者血清中的抗体特异性结合。

摘要:目的：研究表皮生长因子受体（ｅｐｉｄｅｒｍａｌ ｇｒｏｗｔｈ ｆａｃｔｏｒ ｒｅｃｅｐｔｏｒ，ＥＧＦＲ）抑制剂ＡＧ１４７８对人肝细胞癌细胞ＨｕＨ７黏附、迁移及侵袭的影响及其相关细胞内信号转导通路，探讨ＥＧＦＲ在肿瘤转移中的作用。方法：用ＡＧ１４７８处理人肝细胞癌细胞ＨｕＨ７；用ＭＴＴ法检测细胞的黏附能力变化；用Ｔｒａｎｓｗｅｌｌ小室观察体外细胞迁移能力变化；Ｔｒａｎｓｗｅｌｌ小室结合Ｍａｔｒｉｘ胶检测肿瘤细胞侵袭能力的变化；用Ｗｅｓｔｅｒｎ ｂｌｏｔ法检测Ｅｒｋ２及Ｐａｘｉｌｌｉｎ蛋白表达。结果：ＡＧ１４７８（２０ μｍｏｌ／Ｌ）处理后，细胞的黏附、迁移和侵袭能力分别下降了５２％、４９％和７０％（Ｐ ＜ ０．０１），Ｅｒｋ２及Ｐａｘｉｌｌｉｎ的表达水平也明显降低（Ｐ ＜ ０．０１）。结论：ＥＧＦＲ与人肝细胞癌细胞ＨｕＨ７的黏附、迁移和侵袭性密切相关，并可能通过Ｅｒｋ２及Ｐａｘｉｌｌｉｎ信号转导通路调控人肝细胞癌的发展。

摘要:目的：构建以Ｌｉｖｉｎ基因为靶基因的ｓｉＲＮＡ表达载体ｐＧＰＵ６／ＧＦＰ／Ｎｅｏ／Ｌｉｖｉｎ，获得稳定沉默Ｌｉｖｉｎ基因的胃癌细胞ＳＧＣ-７９０１／ｓｉＲＮＡ-Ｌｉｖｉｎ。方法：化学合成ｓｉＲＮＡ-Ｌｉｖｉｎ寡核苷酸，将其分别克隆进载体ｐＧＰＵ６／ＧＦＰ／Ｎｅｏ，进行核酸序列测定。脂质体法转染ＳＧＣ-７９０１细胞，半定量ＲＴ-ＰＣＲ和Ｗｅｓｔｅｒｎ ｂｌｏｔ检测Ｌｉｖｉｎ基因在ＳＧＣ-７９０１细胞中的沉默效率，Ｇ４１８筛选获得稳定转染的细胞克隆。结果：酶切分析显示，所有质粒均为阳性重组载体，核酸测序表明合成的序列准确插入ｐＧＰＵ６／ＧＦＰ／Ｎｅｏ载体，Ｇ４１８筛选基因转染ＳＧＣ-７９０１细胞后形成稳定克隆。其中ｐＧＰＵ６／ＧＦＰ／Ｎｅｏ／Ｌｉｖｉｎ-４转染后Ｌｉｖｉｎ ｍＲＮＡ沉默效率大于７０％。结论：成功获得Ｌｉｖｉｎ 特异性ｓｉＲＮＡ表达载体，ＳＧＣ-７９０１细胞Ｌｉｖｉｎ基因的表达受到抑制，转染胃癌细胞后获得ＳＧＣ-７９０１／ｓｉＲＮＡ-Ｌｉｖｉｎ细胞克隆。

摘要:目的：分离克隆人类免疫缺陷病毒１型（ＨＩＶ-１）编码的病毒复制负调控因子（Ｎｅｇａｔｉｖｅ ｆａｃｔｏｒ，Ｎｅｆ）基因，并将其导入ＢＣＢＬ-１细胞和ＮＩＨ／３Ｔ３细胞中进行表达。方法：根据ＧｅｎＢａｎｋ登记的Ｎｅｆ基因核苷酸序列设计ＰＣＲ引物，在其５′端分别引入ＥｃｏＲⅠ和ＳａｌⅠ酶切位点；以含有Ｎｅｆ基因的ｐＣＩＮＬ质粒为模板，扩增Ｎｅｆ基因，经双酶切后克隆进真核表达载体ｐＣＩ-ｎｅｏ中。为了便于蛋白检测，在下游引物５′端引入Ｆｌａｇ序列，构建重组真核表达质粒。重组质粒经酶切鉴定、核酸序列测定和分析后分别瞬时转染ＢＣＢＬ-１细胞和ＮＩＨ／３Ｔ３细胞，用ＲＴ-ＰＣＲ、Ｗｅｓｔｅｒｎ ｂｌｏｔ分别从核酸和蛋白水平检测Ｎｅｆ基因的表达情况。结果：成功构建了含Ｎｅｆ基因的重组真核表达质粒，核酸序列分析显示，克隆的Ｎｅｆ基因序列全长６５１ ｂｐ，与ＧｅｎＢａｎｋ中登记的Ｎｅｆ基因序列１００％同源，引入的Ｆｌａｇ序列完全正确；ＲＴ-ＰＣＲ和Ｗｅｓｔｅｒｎ ｂｌｏｔ都在Ｎｅｆ预期位置检测到特异性条带。结论：ＨＩＶ-１ Ｎｅｆ基因在ＢＣＢＬ-１细胞和ＮＩＨ／３Ｔ３细胞中获得了正确表达。

摘要:目的：针对前期应用基因芯片（Ａｆｆｙｍａｔｉｘ Ｒａｔ ２３０．２．０）筛选出的大鼠早期肝癌中高表达的人同源基因ＧＤＦ１５（Ｇｒｏｗｔｈ Ｄｉｆｆｅｒｅｎｔｉａｔｉｏｎ Ｆａｃｔｏｒ １５），进一步在人小肝癌组织中检测其表达水平以探讨其作为人小肝癌候选诊断标志物的价值。方法：应用ＲＴ-ＰＣＲ检测ＧＤＦ１５在大鼠早期肝癌结节中的表达以对芯片结果进行初步验证；进一步采用ＲＴ-ＰＣＲ、实时荧光定量ＰＣＲ对ＧＤＦ１５在随机配对的正常肝脏组织（ｎ ＝ １０）与小肝癌（ｎ ＝ １０）中基因转录水平半定量和定量检测，同时用免疫组化鉴定其在正常肝脏组织（ｎ ＝ １０），癌旁组织（ｎ ＝ ２６），小肝癌（ｎ ＝ １２）及大肝癌（ｎ ＝ １４）中蛋白水平的表达。结果：ＧＤＦ１５在大鼠早期肝癌结节中较正常组织表达显著上调（Ｐ ＜ ０．０５），与芯片结果一致。在人小肝癌，其转录及蛋白水平的表达均明显高于正常肝脏组织（Ｐ ＜ ０．０５）。免疫组化结果显示１２例小肝癌中１０例表达强阳性，其在细胞中的表达定位于细胞浆与细胞外基质。结论：分泌性蛋白ＧＤＦ１５在人小肝癌组织中高表达，提示其具有潜在的小肝癌筛选价值。

摘要:目的：观察水通道蛋白１（ＡＱＰ１）在肺腺癌组织中的表达并分析其临床意义。方法：取肺腺癌组织３０例及正常肺组织３０例，应用免疫组织化学，Ｗｅｓｔｅｒｎ ｂｌｏｔ技术检测ＡＱＰ１蛋白在肺腺癌和正常对照组织中的表达及分布，并收集临床资料，分析其与临床病理资料关系。结果：ＡＱＰ１散在表达于正常肺组织的毛细血管内皮细胞，在肺腺癌组织中ＡＱＰ１大量表达于肿瘤的血管内皮细胞以及肿瘤细胞膜、细胞浆；肺腺癌中ＡＱＰ１蛋白表达水平较正常组织明显增多，二者之间差异有统计学意义；ＡＱＰ１在肺腺癌组织中表达与肿瘤病理分级、淋巴结转移相关（Ｐ ＜ ０．０５），而与肺腺癌的ＴＮＭ分期无明显相关性（Ｐ ＞ ０．０５）。结论：ＡＱＰ１ 在肺腺癌组织中表达增高，在正常组织中较低。提示ＡＱＰ１可能与肺腺癌的发生和发展密切相关，具体机制有待深入研究。

摘要:目的：探讨表皮生长因子受体（ＥＧＦＲ）、环氧化酶－２（ＣＯＸ-２）在胃癌组织中的表达及其相关性，并探究它们与幽门螺杆菌（Ｈ．ｐｙｌｏｒｉ）感染的关系。方法：采用免疫组化ＥｎＶｉｓｉｏｎ两步法检测４７例胃癌组织及相应的２０例癌旁组织ＥＧＦＲ、ＣＯＸ-２的表达；用快速尿素酶诊断法和１３Ｃ呼气试验两种方法检测胃癌患者Ｈ．ｐｙｌｏｒｉ感染状况。结果：胃癌组织中ＥＧＦＲ、ＣＯＸ-２的阳性表达率均明显高于癌旁组织（Ｐ ＜ ０．０１）；ＥＧＦＲ、ＣＯＸ-２在胃癌中表达呈正相关（Ｐ ＜ ０．０５）。有Ｈ．ｐｙｌｏｒｉ感染的胃癌组织中ＥＧＦＲ、ＣＯＸ-２的阳性表达率较未感染的胃癌组织中高（Ｐ ＜ ０．０１）。结论：ＥＧＦＲ、ＣＯＸ-２在胃癌组织中高表达且有相关性，Ｈ．ｐｙｌｏｒｉ感染可能上调胃癌组织中ＥＧＦＲ、ＣＯＸ-２的表达。

摘要:目的：探讨切除修复交叉互补基因（ＥＲＣＣ１） ｍＲＮＡ表达及１１８ Ｃ／Ｔ基因多态性与胃癌对奥沙利铂辅助化疗预后的关系。方法：根治术后胃癌患者６２例，采用奥沙利铂为主的方案进行辅助化疗。采用半定量ＲＴ-ＰＣＲ方法检测胃癌组织中ＥＲＣＣ１ ｍＲＮＡ水平。采用ＰＣＲ-ＬＤＲ（连接酶检测反应）检测ＥＲＣＣ１ １１８Ｃ／Ｔ基因多态。结果：６２例胃癌组织ＥＲＣＣ１ ｍＲＮＡ表达水平的中位值为０．６７２；ＥＲＣＣ１ １１８ Ｃ／Ｃ、Ｃ／Ｔ和Ｔ／Ｔ基因型分别占５１．６％（３２／６６）、４３．５％（２７／６２）和４．８％（３／６２）。ＥＲＣＣ１ ｍＲＮＡ高表达组（＞０．６７２）无复发生存率和总生存率均显著低于低表达组（Ｐ ＜ ０．０５）；携带Ｃ／Ｔ和Ｔ／Ｔ基因型患者与Ｃ／Ｃ基因型患者的无复发生存率和总生存率差异无显著性（Ｐ ＞ ０．０５）。多因素分析结果显示ＥＲＣＣ１ ｍＲＮＡ水平是影响患者预后的独立危险因素（Ｐ ＜ ０．０５），而ＥＲＣＣ１ １１８Ｃ／Ｔ多态与预后无关（Ｐ ＞ ０．０５）。结论：ＥＲＣＣ１ ｍＲＮＡ表达水平与接受奥沙利铂为主辅助化疗胃癌患者的预后有关，可用于其预后预测。

摘要:目的：研究ＤＮＡ修复基因ＸＰＤ７５１基因多态性与晚期非小细胞肺癌（ＮＳＣＬＣ）对吉西他滨／顺铂（ＧＰ）方案化疗敏感性的关系。方法：收集经病理学确诊的晚期ＮＳＣＬＣ １１６例，所有病例化疗前抽静脉血，提取白细胞ＤＮＡ，用多聚酶链反应—限制性片段长度多态性（ＰＣＲ-ＲＦＬＰ）分析技术检测ＸＰＤ７５１基因型，所有患者均为ＧＰ方案化疗。结果：① 在肺癌患者中，ＸＰＤ７５１ Ｌｙｓ／Ｌｙｓ、Ｌｙｓ／Ｇｌｎ和Ｇｌｎ／Ｇｌｎ基因型分别为９４例（８１．０％）、２０例（１７．２％）和２例（１．８％）。经化疗后，４４例患者有效，总有效率３７．９％。②ＸＰＤ７５１ Ｌｙｓ／Ｌｙｓ、Ｌｙｓ／Ｇｌｎ和Ｇｌｎ／Ｇｌｎ基因型有效率分别为３９．４％、２５．０％、１００．０％，三者相比差异无统计学意义（χ２ ＝ ４．７７５，Ｐ ＝ ０．０９３） 。与携带Ｌｙｓ／Ｇｌｎ基因型患者相比，Ｌｙｓ／Ｌｙｓ基因型者对ＧＰ方案化疗效果无显著增加，调整性别、年龄、临床分期和细胞学类型后的ＯＲ＝１．０９，９５％ＣＩ：０．９５～１．５１。③携带Ｌｙｓ／Ｌｙｓ基因型患者的恶心呕吐反应和脱发程度均高于Ｌｙｓ／Ｇｌｎ和Ｇｌｎ／Ｇｌｎ基因型患者（χ２ ＝ ４．０３２，Ｐ ＝ ０．０４５；χ２ ＝ ４．３４４，Ｐ ＝ ０．０３７）。结论：ＸＰＤ７５１基因多态性与晚期ＮＳＣＬＣ对ＧＰ方案化疗的敏感性无显著相关，但可作为预测ＧＰ方案化疗毒副反应的指标。

摘要:目的：探讨ＪＷＡ基因多态性与江苏人群宫颈癌易感性之间的关系。方法：采用聚合酶链反应限制性片段长度多态性（ＰＣＲ-ＲＦＬＰ）方法，检测２２７例宫颈癌患者和３３３例年龄、性别相匹配的非肿瘤者ＪＷＡ-７６Ｇ＞Ｃ、４５４Ｃ＞Ａ和７２３Ｔ＞Ｇ多态性的频率和分布，比较不同基因型携带者患宫颈癌的危险性，通过分层分析探讨初潮年龄、初次生育年龄和产次对患宫颈癌的影响。结果：ＪＷＡ-７６ＧＣ和４５４ＡＡ基因型均可增加罹患宫颈癌的危险性。携带３～５个危险等位基因者比携带０～２个等位基因者患宫颈癌的危险性更大（ＯＲ＝１．７０，９５％ＣＩ＝１．２０～２．４２）。分层分析结果显示，初潮年龄早、生育年龄晚和产次多且携带３～５危险等位基因者能增加患宫颈癌的危险性。本研究未发现ＪＷＡ基因７２３Ｔ＞Ｇ多态性与宫颈癌之间存在显著相关。结论：ＪＷＡ基因-７６Ｇ＞Ｃ和４５４Ｃ＞Ａ多态性显著增加江苏地区汉族人群患宫颈癌的危险性。

摘要:目的：探讨雌激素受体拮抗剂三苯氧胺联合表皮生长因子受体抑制剂吉非替尼对人小细胞肺癌（ＮＳＣＬＣ）细胞株增殖和凋亡的影响及相关的分子机制，为联合分子靶向和激素治疗ＮＳＣＬＣ提供理论依据。方法：以吉非替尼及三苯氧胺单独或联合处理ＮＳＣＬＣ细胞株，ＭＴＴ法比较细胞增殖，流式细胞仪检测细胞凋亡。应用荧光定量ＰＣＲ及Ｗｅｓｔｅｒｎ ｂｌｏｔ检测三种肺癌细胞株中表皮生长因子受体（ＥＧＦＲ）及雌激素受体β（ＥＲβ）的表达情况，并分别检测雌二醇，三苯氧胺（ＴＡＭ）对细胞中ＥＧＦＲ，以及表皮生长因子（ＥＧＦ）和吉非替尼对ＥＲβ表达的影响，同时还检测了雌二醇对ＥＧＦＲ的磷酸化作用。结果：联合吉非替尼和三苯氧胺增强对ＥＧＦＲ，ＥＲβ阳性的Ａ５４９，Ｈ１６５０细胞的抑制作用，促进凋亡，但对ＥＧＦＲ，ＥＲβ阴性的Ｈ５２０细胞无明显改变。雌二醇可促进细胞ＥＧＦＲ磷酸化，却也抑制其表达，而三苯氧胺则上调ＥＧＦＲ的表达。同时，ＥＧＦ及吉非替尼对ＥＲβ的表达也有类似的相反的调控作用。结论：联合吉非替尼和三苯氧胺能够增强对ＥＧＦＲ，ＥＲβ均阳性的肺癌细胞的抗增殖作用，这可能与细胞内ＥＧＦＲ信号转导途径和雌激素信号通路的交叉有关。因此，结合针对ＥＧＦＲ的分子靶向治疗与激素治疗可能为肺癌的治疗提供新的途径。

摘要:目的：探讨汉防己甲素联合顺铂对小鼠移植性肝癌的抑制效果。方法：建立小鼠移植性肝癌模型，观察汉防己甲素和顺铂处理后各组小鼠移植瘤大小和体重变化。结果：汉防己甲素治疗组具有抑制小鼠移植性肝癌的生长作用，５ ｍｇ／ｋｇ和１０ ｍｇ／ｋｇ的汉防己甲素治疗组的抑瘤率分别为４０．１％和４７．２％，与对照组比较有显著性差异（Ｐ ＜ ０．０５）；２．５ ｍｇ／ｋｇ和５ ｍｇ／ｋｇ的顺铂治疗组的抑瘤率分别为５５．８％和５９．９％，而分别联合５ ｍｇ／ｋｇ的汉防己甲素后抑瘤率为７３．６％和８１．９％（Ｐ ＜ ０．０５），分别联合１０ ｍｇ／ｋｇ的汉防己甲素后抑瘤率为８２．３％ 和９１．４％（Ｐ ＜ ０．０１）；同时发现汉防己甲素与顺铂联合应用能增加顺铂的抑瘤率且无明显的毒性反应。结论：汉防己甲素、顺铂对小鼠移植性肝癌生长都有明显的抑制作用；汉防己甲素能增强顺铂的抑瘤作用，与顺铂具有协同抗肿瘤作用。

摘要:目的：利用基因芯片技术研究大肠癌肝转移基因表达的改变及其相关基因。方法：收集手术切除５例大肠癌合并肝脏转移患者的原发和转移病灶的新鲜组织标本，提取总ＲＮＡ，合成荧光标记的ｃＲＮＡ与Ａｇｉｌｅｎｔ ｈｕｍａｎ １Ａ ｏｌｉｇｏ 芯片杂交。挑选１０个差异表达基因，分别设计引物，用实时ＲＴ-ＰＣＲ法定量测定２１例术中收集的新鲜原发和转移标本中各基因的表达水平，并比较和分析其表达差异。结果：以表达差异≥２．０或≤０．５倍为限，在 ５对标本中，共同上调１１０个基因，共同下调９６个基因。挑选１０个差异表达基因的实时ＲＴ-ＰＣＲ结果与芯片结果完全相符。结论：大肠癌肝转移涉及众多基因表达的改变，应用基因微矩阵有助于发现基因变化的规律及其分子机理的深入研究。

摘要:目的：研究东亚钳蝎毒素多肽对ＰＣ１２细胞膜电位的影响及其与钠通道的关系。方法：分别用终浓度为１０、２０、４０ μｇ／ｍｌ的毒素多肽作用于荧光染料ＤｉＢＡＣ４（３）标记的ＰＣ１２细胞，在激光共聚焦显微镜上监测细胞膜电位的实时动态变化，并观察钠通道阻断剂ＴＴＸ（ｔｅｔｒｏｄｏｔｏｘｉｎ）预处理对毒素多肽膜电位效应的影响。结果：加入毒素多肽后ＰＣ１２细胞膜电位呈去极化改变，３ ｍｉｎ后达到最大水平，５ ｍｉｎ内趋于稳定。各浓度组毒素多肽作用细胞３ ｍｉｎ后，所测得的标准化荧光强度值分别为１．３７５ ± ０．０４８、１．５０４ ± ０．０３４、１．８３９ ± ０．０２２，和对照组相比差异均有显著性（Ｐ ＜ ０．０１）。而１ μｍｏｌ／Ｌ ＴＴＸ与ＰＣ１２细胞共孵育２０ ｍｉｎ后再加入４０ μｇ／ｍｌ毒素多肽所测值为１．０３５ ± ０．０２８，与对照组相比无显著差异（Ｐ ＞ ０．０５），提示毒素多肽的膜电位效应可被ＴＴＸ完全抑制。结论：东亚钳蝎毒素多肽可引起ＰＣ１２细胞膜电位去极化，且其效应在一定范围内随浓度增加而增大，钠通道可能参与了这一过程。

摘要:目的：观察中枢性血管加压素（ｖａｓｏｐｒｅｓｓｉｎ，ＡＶＰ）对应激所致大鼠胃排空变化的影响，探讨应激对胃排空的影响以及ＡＶＰ在此过程中的作用。方法：大鼠置入盛有少量冷水的鼠笼中４℃放置４ ｈ，制备大鼠急性心理性应激模型。造模前１０ ｍｉｎ，除对照大鼠外，其余大鼠随机分为４组，分别为假手术组、侧脑室注射ＡＶＰ受体阻断剂组、静脉注射ＡＶＰ受体阻断剂组和侧脑室注射生理盐水组。放射性免疫测定法分别测定大鼠血浆中促肾上腺皮质激素（ＡＣＴＨ）和皮质醇水平；酚红排泄法测定大鼠胃排空率。结果：大鼠４℃放置４ ｈ后，血浆中的ＡＣＴＨ和皮质醇水平显著增高，同时胃排空率显著加快。中枢注射ＡＶＰ 受体拮抗剂后，血液中ＡＣＴＨ和皮质醇含量显著下降，伴随胃排空速度减慢。结论：寒冷刺激引起的下丘脑—腺垂体—肾上腺皮质轴的功能增强是胃排空速度增快的重要原因之一。ＡＶＰ参与了上述过程。

摘要:目的：研究Ｍａｓｐｉｎ基因在乳腺癌患者骨髓和外周血微小转移检测中的应用价值以及骨髓和外周血Ｍａｓｐｉｎ ｍＲＮＡ表达与乳腺癌临床病理因素之间的相关性。方法：采用巢式逆转录-聚合酶链反应检测１０例良性乳腺疾病患者和４１例乳腺癌患者骨髓及外周血中Ｍａｓｐｉｎ ｍＲＮＡ的表达。结果：在１０例对照组骨髓和外周血中均未检测出Ｍａｓｐｉｎ ｍＲＮＡ，而在乳腺癌患者骨髓和外周血中分别有１５例（３６．６％）和１６例（３９％）检测到Ｍａｓｐｉｎ ｍＲＮＡ。骨髓和外周血中Ｍａｓｐｉｎ ｍＲＮＡ检测结果的符合率为８７．８％，检测结果有相关性（χ２＝２２．５６３，Ｐ ＝ ０．０００，Ｒ ＝ ０．７４２）。乳腺癌患者骨髓和外周血中Ｍａｓｐｉｎ ｍＲＮＡ表达率随病理分期升高、淋巴结转移、临床分期进展而升高，但均无显著性差异。如将患者按复发风险分组，高危组患者骨髓和外周血中Ｍａｓｐｉｎ ｍＲＮＡ表达率明显升高，但仅在骨髓中显示有显著性差异（χ２＝６．６２１，Ｐ ＝ ０．０３７），而在外周血中无显著性差异（χ２＝５．９０４，Ｐ ＝ ０．０５２）。结论：Ｍａｓｐｉｎ基因用于乳腺癌患者骨髓和外周血微小转移的检测具有很高的特异性，乳腺癌患者骨髓和外周血中Ｍａｓｐｉｎ ｍＲＮＡ表达可能与高危复发风险相关。

摘要:目的：研究ＮＥＴ-１基因蛋白在胃癌中表达及与胃癌临床病理因素和预后的关系。方法：通过自行设计制备的ＮＥＴ-１抗体，用免疫组化ＳＰ法检测８６例胃癌组织中ＮＥＴ-１基因蛋白表达，结合临床病理因素和随访资料进行统计学分析ＮＥＴ-１表达对胃癌预后的影响。结果：ＮＥＴ-１在胃癌组织中均有表达，其强阳性表达率为５６．９８％，在癌中表达显著高于正常黏膜。ＮＥＴ-１强阳性表达与癌分化（Ｐ ＜ ０．０１）以及患者生存率呈显著负相关（Ｐ ＜ ０．０５），其中３年、５年生存率与中位生存期均显著低于其弱阳性组（Ｐ ＜ ０．０５）。结论：ＮＥＴ-１基因表达能较好地反映胃癌细胞群体增殖活性，是一个重要的生物学标记，能显著上调和促进癌进展。实验设计制备的ＮＥＴ-１抗体将能较好的用于临床肿瘤的研究。

摘要:目的：研究ＳＴＺ诱导的糖尿病肾病大鼠血清超敏Ｃ反应蛋白（ｈｓ-ＣＲＰ）水平变化，并观察噻唑烷二酮类药物罗格列酮对其的干预作用。方法：４０只雄性ＳＤ大鼠随机分三组：即正常对照组（Ｃ组，ｎ ＝ １０）；糖尿病对照组（ＤＣ组，ｎ ＝ １５）：链脲佐菌素６０ ｍｇ／ｋｇ腹腔注射；罗格列酮治疗组（ＤＲ组，ｎ ＝ １５）：４ ｍｇ／（ｋｇ·ｄ）罗格列酮无菌水混悬液灌胃。１０周后观察各组大鼠的血清ｈｓ-ＣＲＰ、尿微量白蛋白（ＭＡＵ）水平及ＢＧ、ＨｂＡ１ｃ、ＢＵＮ等生化指标变化，同时观察光镜、电镜下肾组织病理形态学改变。结果：ＤＣ组及ＤＲ组大鼠血清ｈｓ-ＣＲＰ、ＭＡＵ、ＢＵＮ明显高于Ｃ组，ＤＲ 组低于ＤＣ 组，差异均有统计学意义（Ｐ ＜ ０．０１）。ＤＲ组大鼠肾组织病理学损害较ＤＣ明显改善。结论：糖尿病肾病大鼠血清ｈｓ-ＣＲＰ水平变化与肾脏损害程度相一致，罗格列酮能降低血清ｈｓ-ＣＲＰ的水平，对糖尿病肾病具有一定的保护作用。

摘要:目的：探讨血红素氧化酶-１（ｈｅｍｅｏｘｙｇｅｎａｓｅ-１，ＨＯ-１）在ＤＡ到Ｌｅｗｉｓ大鼠肝移植中对急性排斥反应的影响及其机制。方法：建立ＤＡ到Ｌｅｗｉｓ大鼠肝移植急性排斥模型，实验分３组，各１２对。Ａ组供体术前２４ ｈ阴茎背静脉注射５ ｍｌ／ｋｇ生理盐水作为对照；Ｂ组供体术前２４ ｈ阴茎背经脉注射ＨＯ-１诱导剂钴原卟啉（ＣｏＰＰ），Ｃ组供体给予ＨＯ-１抑制剂锌原卟啉（ＺｎＰＰ），移植后持续予相同处理直至受体死亡。术后７天，各组处死６只，取外周血及肝脏标本，测定血清ＡＬＴ，ＤＢＩＬ水平，组织病理观察排斥反应程度，ＲＴ-ＰＣＲ及Ｗｅｓｔｅｒｎ ｂｌｏｔ法测定移植物内ＨＯ-１ ｍＲＮＡ，Ｆｏｘｐ３ ｍＲＮＡ及其蛋白表达情况，余观察生存期。结果：术后７天，Ｂ组血ＡＬＴ，ＴＢＩＬ水平与Ａ组，Ｃ组相比，差异有统计学意义（Ｐ ＜ ０．０１）；病理示Ｂ组移植肝排斥反应程度轻于Ａ，Ｃ组；Ｂ组ＨＯ-１和Ｆｏｘｐ３ ｍＲＮＡ及其蛋白的表达均强于Ａ，Ｃ组；Ｂ组受体存活时间（２９．８３ ± １．４０）天较Ａ组（１３．００ ± ０．５２）天与Ｃ组（１１．６７ ± ０．４２）天显著延长（Ｐ ＜ ０．０１），而Ａ，Ｃ组之间差异无统计学意义（Ｐ ＞ ０．０５）。结论：诱导移植肝ＨＯ-１持续高表达，可通过促进移植物内Ｆｏｘｐ３表达增强，发挥免疫抑制作用，减轻移植肝急性排斥反应。

摘要:目的：探讨缺血预适应（ＩＰＣ）对大鼠同种异体移植肾早期组织学及ＩＫＫβ、ＮＦ-kＢ、ＴＮＦ-αｍＲＮＡ表达的影响。方法：３６只成年ＳＤ大鼠为供受体，并随机分为以下三组：假手术组（Ａ），剖腹探查后关腹；普通移植组（Ｂ），同种原位肾移植；缺血预适应组（Ｃ），供肾１５ ｍｉｎ缺血１０ ｍｉｎ灌注预处理肾移植。移植术后２４ ｈ，检测各组Ｓｃｒ、ＢＵＮ水平及移植肾组织损伤程度，ＲＴ-ＰＣＲ技术分别检测ＴＮＦ-α、ⅠkＢ 激酶β（ＩＫＫβ）及ＮＦ-kＢ Ｐ６５亚基的转录水平。结果：肾移植后２４ ｈ，与Ｂ组相比，Ｃ组肾小管损伤程度明显减轻（肾小管损伤指数Ｐ ＜ ０．０５），ＴＮＦ-αｍＲＮＡ 表达亦明显减弱（Ｐ ＜ ０．０５）；但Ｂ、Ｃ两组ＩＫＫβ及Ｐ６５ ｍＲＮＡ表达无明显差异（Ｐ ＞ ０．０５）。Ｂ、Ｃ两组Ｓｃｒ、ＢＵＮ水平较Ａ组明显升高，但两组间未有明显差异（Ｐ ＞ ０．０５）。结论：１５ ｍｉｎ／１０ ｍｉｎ缺血预适应能够明显减轻大鼠移植肾早期缺血再灌注损伤，其保护作用可能与ＴＮＦ-α表达抑制，ＴＮＦ-α／ＩＫＫβ／ＮＦ-kＢ Ｐ６５正反馈信号阻断有关。

摘要:目的：研究Ｇ蛋白耦联受体激酶相互作用分子１（Ｇ-ｐｒｏｔｅｉｎ-ｃｏｕｐｌｅｄ ｒｅｃｅｐｔｏｒ ｋｉｎａｓｅ ｉｎｔｅｒａｃｔｉｎｇ ｐｒｏｔｅｉｎ １，ＧＩＴ１），细胞外信号调节激酶１／２（Ｅｘｔｒａｃｅｌｌｕｌａｒ ｓｉｇｎａｌ-ｒｅｇｕｌａｔｅｄ ｋｉｎａｓｅｓ １ ａｎｄ ２，ＥＲＫ１／２）在脊髓缺血再灌注损伤过程中的作用。方法：电镜观察缺血３０ ｍｉｎ再灌注不同时间段［Ａ组（对照组）再灌注０ ｍｉｎ、Ｂ组 再灌注３０ ｍｉｎ、Ｃ组 再灌注２ ｈ、Ｄ组 再灌注８ ｈ］脊髓组织标本的形态学改变，Ｗｅｓｔｅｒｎ ｂｌｏｔ 检测各组脊髓标本中ＥＲＫ１／２ 和ＧＩＴ１ 的表达及其磷酸化，免疫共沉淀分析ＧＩＴ１同活化的ＥＲＫ１／２（ｐｈｏｓｐｈｏ-ＥＲＫ１／２，ｐＥＲＫ１／２）相互作用的变化，免疫组织化学分析ｐＥＲＫ１ ／２在神经细胞内的定位表达。结果：电镜结果显示Ｄ组脊髓神经细胞出现早期凋亡的征象；Ｗｅｓｔｅｒｎ ｂｌｏｔ结果显示ｐＥＲＫ１／２的表达、ＧＩＴ１的磷酸化在Ｃ、Ｄ二组较对照组明显增加且均随再灌注时间延长呈明显增加的趋势；免疫共沉淀结果显示ＧＩＴ１-ｐＥＲＫ１／２结合力在Ｃ、 Ｄ两组较对照组明显增加；免疫组织化学结果显示ｐＥＲＫ１／２明显滞留于Ｃ、Ｄ两组的脊髓神经细胞胞浆区内。结论：缺血再灌注损伤过程中ＥＲＫ１／２的活化以及在胞核外区域的滞留可能导致了脊髓神经细胞的凋亡，而ＧＩＴ１作为细胞浆内局部黏附蛋白同ｐＥＲＫ１／２的结合可能导致了其在胞浆区的滞留。

摘要:目的：研究淤血预处理对大鼠小肠淤血再灌注损伤的保护作用。方法：３０只大鼠随机分为３组：淤血再灌注组、淤血预处理组和假手术组。通过阻断门静脉４５ ｍｉｎ、再灌注６０ ｍｉｎ制作小肠淤血再灌注模型。淤血预处理组在门静脉夹闭前先短暂夹闭门静脉５ ｍｉｎ，开放５ ｍｉｎ，并重复１次。假手术组不夹闭门静脉。于夹闭门静脉前、开放后１５、３０、４５和６０ ｍｉｎ分别测定门静脉的血流量，再灌注后６０ ｍｉｎ取末端回肠组织分别作病理学检查、ＭＰＯ和免疫组化ＩＣＡＭ-１测定。结果：淤血预处理组肠黏膜损伤较淤血再灌注组明显减轻，且肠组织ＭＰＯ活性和ＩＣＡＭ-１表达均低于淤血再灌注组，开放血流后门静脉血流量均明显升高。结论：淤血预处理对肠道淤血再灌注损伤具有保护作用。

摘要:目的：分析南京医科大学第一附属医院急诊重症监护病房（ｅｍｅｒｇｅｎｃｙ ｉｎｔｅｎｓｉｖｅ ｃａｒｅ ｕｎｉｔ，ＥＩＣＵ） 医院感染病原菌分布及其耐药现状，为临床合理用药和控制医院感染提供依据。方法：对２００６年１月～２００７年６月该院ＥＩＣＵ 医院感染患者的各类标本中分离出的病原菌，采用Ｋ-Ｂ 纸片扩散法进行敏感试验，对致病菌耐药率进行分析。结果：ＥＩＣＵ医院感染病原菌多为耐药菌，病原菌以革兰阴性杆菌（Ｇ－）为主占６５．３３％、革兰阳性球菌（Ｇ＋）第二占１８．２９％、真菌第三占１６．３８％；革兰阴性杆菌中以铜绿假单胞菌、鲍氏不动杆菌、肺炎克雷伯菌及大肠埃希菌为主；革兰阳性菌主要以葡萄球菌属为主；真菌以白假丝酵母、光滑假丝酵母菌为主。大肠埃希菌和肺炎克雷伯菌的产超广谱耐β-内酰胺酶（ＥＳＢＬｓ）菌检出率分别为５８．０６％和３０．００％；耐甲氧西林葡萄球菌（ＭＲＳ）检出率为７１．８７％。结论：加强对ＥＩＣＵ病原菌分布及耐药率监测，同时依据细菌病原学及抗菌药物敏感性结果，选择抗菌药物，以减少新的耐药株的出现，降低医院感染率。

摘要:目的：探索短串连重复序列（ＳＴＲ）多位点检测孕妇血浆中胎儿游离ＤＮＡ的可行性。方法：改进ＱＩＡａｍｐ离心柱型ＤＮＡ提取方法提取１０例孕中期孕妇血浆中总游离ＤＮＡ，进行Ｄ３Ｓ１３５８、Ｄ１３Ｓ３１７、ＣＳＦ１ＰＯ、Ｄ１２Ｓ３９１、Ｄ６Ｓ４７７、ＶＷＡ ６个ＳＴＲ位点扩增，并以孕妇与胎儿羊水细胞基因组ＤＮＡ为对照，变性聚丙烯酰胺凝胶电泳分析胎儿游离ＤＮＡ提取效果及检测效率。结果：１０例孕中期孕妇血浆样本共检测位点６０个，检出有结果位点４４个，除去母体与胎儿ＤＮＡ基因型完全一致的１４个位点，剩余的３０个位点中，１８个位点成功检出胎儿ＤＮＡ基因型，检出率３０％。检出率最高的位点是Ｄ１３Ｓ３１７和Ｄ１２Ｓ３９１。结论：ＳＴＲ多位点的扩增可以检测得出胎儿特异性ＤＮＡ序列，有望应用于无创伤性产前遗传性疾病的诊断和法医学亲子鉴定中。

摘要:目的：探讨超声造影对肝硬化定量诊断的价值。方法：３０只实验兔以１．２０ ｇ／Ｌ的硫代乙酰胺水溶液作为惟一饮用水的方法建立不同阶段的肝硬化模型，应用Ｂｒａｃｃｏ公司生产的声诺维（Ｓｏｎｏｖｕｅ）作为造影剂，并用自身前后对照的方法，在肝硬化模型建立前后测量肝静脉内造影剂出现的时间（ＨＶＡＴ）及肝动脉内造影剂出现的时间（ＨＡＡＴ），两者相减得到肝动静脉渡越时间（ＨＡ-ＶＴＴ），比较肝硬化前后数值间的差异。结果：口服硫代乙酰胺成功建立了肝硬化模型，ＨＡ-ＶＴＴ在肝硬化前后有明显的差异。结论：以硫代乙酰胺作为唯一饮用水可用于建立家兔的肝硬化模型，ＨＡ-ＶＴＴ有可能发展为定量诊断肝硬化的重要影像学检测方法。

摘要:目的：利用高分辨力彩色多普勒血流成像技术（ＣＤＦＩ）研究股前外侧皮瓣（ａｎｔｅｒｏｌａｔｅｒａｌ ｔｈｉｇｈ ｆｌａｐ，ＡＬＴＦ）穿支血管的分布规律、体表的定位及血流动力学，为ＡＬＴＦ设计提供依据。方法：对１２０例健康志愿者双侧ＡＬＴＦ穿支血管的数目、管径、起点位置、走行位置、穿深筋膜位置、平均流速进行检测，并做统计学分析。结果：单侧ＡＬＴＦ穿支血管平均２．２５支，三种类型：Ⅰ型肌皮穿支（６５．９％）；Ⅱ型肌间隙皮穿支（３０．７％）；Ⅲ型直接皮穿支（３．４％）。最粗大穿支血管（深筋膜穿出点）９７．１％出现在髂前上棘至髌骨外侧缘中点连线的中１／３段。平均血流速度左右侧及各年龄组间差异无统计学意义（Ｐ ＞ ０．０５），男性稍高于女性（Ｐ ＜ ０．０５）。结论：ＣＤＦＩ技术可直观地显示ＡＬＴＦ穿支的走行分布、进行体表定位，并可评价血管质量，从而更好地指导术前ＡＬＴＦ设计，具有较好的临床应用前景。

摘要:目的：探讨６４层螺旋ＣＴ血管造影诊断颈动脉狭窄的准确性及应用价值。 方法：对 ２０例经颈动脉多普勒超声筛选的颈动脉狭窄及闭塞患者进行ＣＴ血管造影检查，所得图像分别进行常规ＣＴ血管造影检查及血管减影颈动脉成像；成像包括原始横断面图像和最大密度投影、多平面重建、容积显示及曲面重建。依据北美症状性颈动脉内膜剥离术临床试验标准：轻度狭窄１０％～２９％，中度狭窄３０％～６９％，重度狭窄７０％～９９％，闭塞１００％；比较常规血管造影和减影血管成像检查结果。结果：２０例共４０支颈动脉，常规血管造影检查显示正常者１２支，轻度狭窄５支，中度狭窄１２支，重度狭窄１０支，闭塞１支；减影血管造影显示正常者４支，轻度狭窄１２支，中度狭窄１０支，重度狭窄１３支，闭塞１支。两者均能很好的显示血管腔内的粥样硬化斑块，但常规血管造影成像在正常与轻度狭窄者及斑块显示方面与血管减影成像有差异，常规ＣＴ血管造影斑块显示率为４２．５％（２５／４０），减影血管成像显示率为９０．０％（３６／４０）。依靠 ＣＴ值可区分钙化斑块、软斑块及混合斑块。结论：ＣＴ血管造影检查不仅对颈动脉狭窄程度的诊断有较高的直观性和准确性。而且减影血管造影在骨性伪影干扰、斑块成像及轻度狭窄方面有一定优势，有望取代ＤＳＡ在颈动脉狭窄诊断中的地位。

摘要:目的：比较多发性肌炎（ｐｏｌｙｍｙｏｓｉｔｉｓ，ＰＭ），皮肌炎（ｄｅｒｍａｔｏｍｙｏｓｉｔｉｓ，ＤＭ），无肌炎性皮肌炎（ａｍｙｏｐａｔｈｉｃ ｄｅｒｍａｔｏｍｙｏｓｉｔｉｓ，ＡＤＭ）伴肺间质病变（ｉｎｔｅｒｓｔｉｔｉａｌ ｌｕｎｇ ｄｉｓｅａｓｅｓ，ＩＬＤ）的临床特征和预后。方法：回顾３６例炎性肌病伴ＩＬＤ的住院患者（ＰＭ １８例，ＤＭ １１例，ＡＤＭ ７例）。结果：９例ＡＤＭ-ＩＬＤ在临床和病理均无肌炎表现但都有典型的Ｇｏｔｔｒｏｎ征。血清肌酸激酶（ＣＫ）浓度ＰＭ-ＩＬＤ明显高于ＤＭ-ＩＬＤ，ＡＤＭ-ＩＬＤ则基本正常。ＰＭ-ＩＬＤ对激素的治疗效果优于ＤＭ-ＩＬＤ及ＡＤＭ-ＩＬＤ。环磷酰胺（ＣＴＸ）在ＩＬＤ的治疗中有一定效果但对ＡＤＭ-ＩＬＤ的效果不甚明显。 ＰＭ-ＩＬＤ的生存率高于ＤＭ-ＩＬＤ，ＡＤＭ-ＩＬＤ进展快，短期内出现急性呼衰（Ｉ型），死亡率高达８５．７％以上。结论：ＡＤＭ-ＩＬＤ对激素和免疫抑制剂的治疗效果不佳预后差。ＰＭ-ＩＬＤ预后相对较好。同时数据显示，积极的激素治疗并早期联合ＣＴＸ对ＰＭ-ＩＬＤ效果好，对ＤＭ-ＩＬＤ有一定的效果，但对ＡＤＭ-ＩＬＤ则疗效不佳。

摘要:目的：探讨体外循环所引起的肺组织炎性损伤，研究术中应用乌司他丁（ＵＴＩ）对肺的保护作用及可能的机制。方法：２５例患者随机分为两组，实验组将乌司他丁２万Ｕ／ｋｇ于体外循环开始后，直接加入体外循环机中；对照组除用等量生理盐水替代乌司他丁外，其他条件相同。动态检测两组患者左右房中性粒细胞数（ｐｏｌｙｍｏｒｐｈｏｎｕｃｌｅａｒ ｎｅｕｔｒｏｐｈｉｌｓ，ＰＭＮ）、血小板数（Ｐｔ）；血清白细胞介素-６（ＩＬ-６）、白细胞介素-１０（ＩＬ-１０）、肿瘤坏死因子--琢（ＴＮＦ-a）水平；气道压力、肺泡氧合指数（ＯＩ）。结果：①对照组主动脉开放心脏复跳后５ ｍｉｎ左房ＰＭＮ、Ｐｔ明显低于右房（Ｐ ＜ ０．０５）；②体外循环（ｃａｒｄｉｏｐｕｌｍｏｎａｒｙ ｂｙｐａｓｓ，ＣＰＢ）开始后，两组桡动脉血ＩＬ-６、ＴＮＦ--琢进行性升高，于主动脉开放心脏复跳后达最高，后逐渐下降，但仍高于ＣＰＢ前，对照组增高更显著（Ｐ ＜ ０．０５）。③ＣＰＢ开始后，两组桡动脉血ＩＬ-１０进行性增高，于主动脉开放心脏复跳后，达到最高，后逐渐下降，但仍高于ＣＰＢ前，实验组增高更显著（Ｐ ＜ ０．０５）。④两组患者肺泡氧合指数（ＯＩ）ＣＰＢ后比麻醉诱导时增高，对照组升幅明显高于实验组（Ｐ ＜ ０．０５）。⑤两组气道峰压、气道平台压在停ＣＰＢ和手术结束后均有升高，但对照组升高更显著（Ｐ ＜ ０．０５），且对照组与实验组有显著差异（Ｐ ＜ ０．０５）。结论：乌司他丁能通过抑制血小板、中性粒细胞的激活、肺内聚集和扣留，抑制炎症因子ＩＬ-６、ＴＮＦ--琢的产生，并能促进抗炎因子ＩＬ-１０的释放，从而减轻体外循环后肺损伤和通气功能障碍，保护并改善术后肺功能。

摘要:目的：探讨显微椎间盘镜下黄韧带的不同干预方式对临床疗效和随访ＣＴ图象的影响。方法：９２例患者随机分为２组，Ａ组进行常规显微椎间盘镜下髓核摘除术，Ｂ组保留黄韧带行髓核摘除术。分别于术前１天、术后３周、３个月、１年进行资料采集。采用Ｏｓｗｅｓｔｒｙ功能障碍指数（ＯＤＩ）进行疗效评估，计算改善率。术后１年对随访ＣＴ图象进行粘连程度分级，两组间不同粘连级别的人数进行构成比分析，对所有患者的ＣＴ分级与其术后１年改善率进行相关性分析。结果：术前１天ＯＤＩ均数及术后３周改善率比较均未见显著性差异（Ｐ ＞ ０．０５）。术后３个月及术后１年，改善率两组间比较均有极其显著的差异（Ｐ ＜ ０．００１）。Ａ组改善率术后３个月较术后３周略有提高（Ｐ ＞ ０．０５），术后１年出现下降（Ｐ ＜ ０．０５），术后１年与术后３周改善率比较无显著性差异（Ｐ ＞ ０．０５）；Ｂ组改善率总体上呈持续提高趋势，术后３周与术后３个月改善率比较无显著性差异（Ｐ ＞ ０．０５），术后１年与术后３个月、术后１年与术后３周改善率比较可见显著性差异（Ｐ ＜ ０．０５）。术后１年ＣＴ分级，两组间各分级人数构成具有显著性差异（Ｐ ＜ ０．０５）。各患者ＣＴ分级及其改善率的相关性分析，结果显示存在极其显著的差异（Ｐ ＜ ０．０１）。结论：对黄韧带的不同干预方式能够明显影响术后ＣＴ表现出来的椎管内瘢痕粘连的程度差异。椎管内粘连程度与临床疗效呈显著的负相关，即椎管内粘连程度越重，相应的临床疗效越低。

摘要:目的：探讨应用医用臭氧治疗腰椎间盘突出症的临床疗效及适应证范围。方法：腰椎间盘突出症１６２例，按照ＣＴ／ＭＲＩ表现将椎间盘突出分为３种，比较不同类型椎间盘突出的治疗结果；均经皮腰椎间盘内注射浓度为４０ -滋ｇ／ｍｌ医用臭氧６～１５ ｍｌ，退针至椎间孔附近时，向椎旁组织内神经根旁注入臭氧１０ ｍｌ及复方倍它米松１ ｍｌ＋２％利多卡因０．５ ｍｌ＋维生素Ｂ１２注射液０．５ ｍｇ的混合液；按照纤维环是否破裂分组研究纤维环破裂与疗效的关系；另对３例椎间盘突出伴骨性椎管狭窄导致腰腿痛患者行试验性的臭氧注射治疗。结果：１６２例腰椎间盘突出症患者行臭氧注射治疗后６个月复查１４１例有效，总有效率为８７．０３％，其中３４例椎间盘膨出３１例有效（９１．１８％），１１９例椎间盘突出１０６例有效（８９．０８％），９例椎间盘脱垂４例有效（４４．４４％）；７２例纤维环完整者６３例（８７．５％）有效，４７例纤维环破裂者３２（６８．０５％）例有效；统计学差异均有显著性。３例椎间盘突出伴骨性椎管狭窄６个月后随访发现２例有效。均无任何并发症。结论：运用臭氧治疗腰椎间盘突出症方法疗效确切，膨出突出类型疗效较高；纤维环破裂疗效较好，对轻度的椎间盘突出伴骨性椎管狭窄可以试行臭氧消融治疗。

摘要:

摘要:目的：探讨电视宫腔镜在Ｂ超／腹腔镜监护下诊治子宫纵隔中的价值。方法：回顾性分析１８例子宫纵隔的内镜特点、治疗、监护方法及效果。结果：经宫腔镜检查联合Ｂ超诊断子宫纵隔１８例，完全子宫纵隔１０例，不全子宫纵隔８例，２例同时合并有阴道纵隔，其中６例经宫腹腔镜联合手术，１２例在Ｂ超监护下完成手术，平均手术时间３８ ｍｉｎ，平均出血５０ ｍｌ，平均住院时间４天，术后妊娠１６例，足月妊娠分娩活婴１１例。足月妊娠分娩率由术前的５．６６％上升到术后的６８．７５％，自然流产率由术前的８６．７９％下降到术后的６．２５％。结论：电视宫腔镜检查及宫腔镜纵隔电切术诊治子宫纵隔是一种安全、有效、微创的理想方法，可以明显改善子宫纵隔患者的生殖预后。Ｂ超监护是手术的首选。

摘要:目的：评价西班牙ＬＥＮＡ动态血沉分析仪检测血沉结果的可靠性。方法：随机抽取门诊患者１１７人，采用西班牙产ＬＥＮＡ动态血沉分析仪分别以快速法与标准法和魏氏法测定血沉，对三种结果进行统计学比较。结果：快速法与标准法血沉测定值之间差别无统计学意义（ｔ ＝ ０．５８６，Ｐ ＝ ０．５５９），快速法、标准法分别与魏氏法间血沉测定值差别均有统计学意义（ｔ ＝ ３．２４３，Ｐ ＝ ０．００２及ｔ ＝ ４．６３６，Ｐ ＝ ０．０００）；快速法与标准法Ｋａｐｐａ＝０．９０４，Ｙｏｕｄｅｎ指数８４．６７％；快速法与魏氏法Ｋａｐｐａ＝０．８４７，标准法与魏氏法Ｋａｐｐａ＝０．８５６，Ｙｏｕｄｅｎ指数８１．６２％。结论：快速法与标准法假阴性率均较低（３．２６％、１．１４％），而假阳性率均较高（１２．００％、１７．２４％）。当快速法、标准法测定值接近界值时，建议做进一步检测。

摘要:目的:探讨隆乳术后植入假体纤维囊挛缩病例的手术和非手术治疗方法的选择及其治疗效果-方法:4例4只乳房在术后较早期发生纤维囊挛缩(Ⅲ级),采取俯卧位睡姿,2次/天,15 min/次,持续3~6个月-32例35只乳房在手术后期发生纤维囊挛缩(Ⅲ~Ⅳ级),6例患者行纤维囊松解,假体取出后未再植入假体;26例经一次纤维囊松解后行假体重置,术后1.5个月开始采取俯卧位睡姿-结果:非手术治疗组4例纤维囊挛缩症状在术后1年内逐渐消失-手术治疗假体重置组26例乳房形状均自然-手感柔软-1年后复查未再发现硬化-结论:根据隆乳术后植入假体纤维囊挛缩出现的时期和程度,采用相应的处理方法可以取得良好的治疗效果,术后俯卧位睡姿取代乳房按摩可以更有效地预防和治疗纤维囊挛缩-