转化生长因子-α促进小鼠胚泡扩展和基质金属蛋白酶分泌

目的研究转化生长因子-α（transforming growth factor-α，TGF-α）在胚胎植入早期阶段的作用。方法小鼠胚泡体外培养于含或不含各种浓度的TGF-α培养液中。用粘附、扩展胚胎的百分数来评价胚泡的着床能力。用明胶酶谱法来检测胚泡分泌基质金属蛋白酶情况。结果实验组与对照组的胚泡粘附率无明显差异，但是培养24h后，实验组胚泡扩展率显著高于对照组。明胶酶谱结果显示实验组胚泡分泌基质金属蛋白酶（matrix metalloproteinase, MMPs）早于对照组。结论 TGF-α通过促进胚泡扩展和基质金属蛋白酶分泌参与到胚泡植入进程的调节当中。

应用不同实验室检测方法早期诊断和监测SLE患儿活动性HCMV感染的研究

目的了解系统性红斑狼疮(systemic lupus erythematosus, SLE)患儿活动性人类巨细胞病毒(human cytomegalovirus, HCMV)感染的状况，并比较不同实验室检测方法的诊断价值。方法实验组观察了21例初诊为SLE并接受免疫抑制治疗的患儿，对照组观察了21例免疫力正常的骨科患儿。治疗前后应用间接免疫荧光法检测外周血多形核白细胞(polymorphonuclear leukocytes, PMNLs)中的HCMV pp65抗原和p72抗原，PCR方法检测血清中的HCMV DNA，ELISA方法检测血清中的HCMV IgM和IgG抗体。应用美国标准统计软件Systat中的卡方检验(Chi-square test)或精确概率法(Fisher's exact test)对实验数据进行统计分析，P值小于0.05表示有显著性差异。结果实验组活动性HCMV感染发生率为28.6%(6/21)，4例发生于免疫抑制治疗后，另外2例发生于免疫抑制治疗前，对照组无一例发生活动性感染，两组相比有显著性差异(P=0.027)。实验组各项实验室检测的阳性率分别为：pp65 23.8%(5/21)、p72 14.3%(3/21)、PCR 42.9%(9/21)、IgM 9.5%(2/21)、IgG 90.5%(19/21)。实验组各项实验室检测方法诊断活动性HCMV感染的敏感性分别为：pp65 83.3%(5/6)、p72 50%(3/6)、PCR 100%(6/6)、IgM 33.3%(2/6)、IgG(双份血清抗体滴度呈≥4倍增高)50%(3/6)。特异性除PCR方法为80%(12/15)外，其余均为100%(15/15)。结论 SLE患儿活动性HCMV感染发生率较免疫力正常的儿童显著增高，免疫抑制治疗前后均可发生。HCMV pp65抗原血症检测是早期诊断和监测SLE患儿活动性HCMV感染的较好指标。

超声手术刀在妇科腹腔镜手术中的应用价值

目的探讨超声手术刀在妇科腹腔镜手术中的应用价值。方法在腹腔镜下应用超声手术刀进行各种妇科手术，观察术中失血量、手术时间、围手术期体温和血象变化以及组织的损伤程度。结果在腹腔镜下使用超声手术刀进行各种手术42例。其中子宫切除术4例，卵巢囊肿剥出或切除术9例，输卵管切除术18例，输卵管切开取胚术4例，子宫肌瘤挖出术3例，单纯粘连分离术3例，附件切除术1例。术中失血量、手术时间以及对组织的损伤程度与手术类型有关，少失血量、手术时间、组织的损伤深度、损伤平分以及纤维蛋白沉积平分平均分别为24.77±4.71 毫升、23.39 ±3.01分钟、0.22±0.10毫米、0.98±0.21和0.38±0.26，大失血量、手术时间、组织的损伤深度、损伤平分以及纤维蛋白沉积平分平均分别为166.7±47.18 毫升、127.2±16.99分钟、0.35±0.20毫米、1.25±0.20和0.81±0.29。除子宫切除术以外，其它各种手术在手术前后体温、血红蛋白以及白细胞总数之比较差异无显著性。结论超声手术刀在妇科腹腔镜下进行各种妇科手术，由于操作简单，安全可靠的，因而值得推广。

FA贫血病人造血细胞hHR21sp基因表达的研究

目的检测UV和γ辐射对正常人外周血单核细胞的hHR21sp基因转录表达水平及hHR21sp在范可尼贫血（Fanconis Anemia FA）骨髓造血细胞和激活后的外周血单核细胞的转录表达情况,并分析hHR21sp基因在FA贫血发病机制中的作用。方法对范可尼贫血骨髓造血细胞和激活后的外周血单核细胞和正常人外周血单核细胞在UV或γ辐射后不同时间提取细胞总RNA，通过RT-PCR、Southern杂交、以β-actin为内参照放射影像对hHR21sp基因的转录表达水平进行检测,比较FA骨髓造血细胞与对照组差异和激活前后FA外周血单核细胞hHR21sp基因的表达水平。结果正常人外周血单核细胞与对照组比较在80j/m2 UV辐射hHR21sp表达于3h开始增加；在6h表达水平高，与正常对照有2倍差异（P<0.05）；而γ-辐射5 Gy辐射6 h增加明显，在9h后有所降低与正常对照有2倍多差异（P<0.01）。可见FA病人骨髓造血细胞和对照组的hHR21sp基因表达水平有明显差异（P<0.05）。实验发现在激活后对FA病人外周血单核细胞检测，hHR21sp基因表达较对照组PB-MNC降低达2倍之多（P<0.05）。结论 hHR21sp表达水平在一定剂量电离辐射范围内随辐射剂量增加而增高，且对γ-辐射较UV辐射敏感，FA病人骨髓造血细胞和对照组的hHR21sp基因表达有明显差异，激活后的FA病人外周血单核细胞 hHR21sp基因表达降低显著，提示FA病人造血细胞hHR21sp基因表达缺陷，本研究结果为下一步深入研究FA发病机制提供实验基础。

IgA肾病和紫癜性肾炎患者单核细胞白细胞介素－1受体拮抗剂的产生能力受其基因多态性的影响

目的阐明IL－1受体拮抗剂（IL－1ra）基因多态性对其功能的影响，论证IL－1ra基因型与IgA肾病（IgAN）及紫癜性肾炎（HSPN）临床表型之间联系的机理。方法用PCR方法对IgAN和HSPN病人IL－1ra基因型进行分析，从IL－1ra不同基因型患者获取外周血单核细胞，观察单核细胞经GM－CSF刺激后IL－1ra、IL－1α和IL－1β的产生能力。结果无论是IgAN，还是HSPN患者，不携带IL－1ra基因IL1RN＊2等位基因者其单核细胞IL－1ra的产生能力明显高于携带该等位基因的个体 (IgAN 21.55±3.08ng/ml vs 13.85±2.24ng/ml, P<0.001; HSPN 23.72±6.68ng/ml vs 12.67±2.24ng/ml, P<0.01)，而IL－1α和IL－1β的产生能力与是否携带IL1RN＊2等位基因无关。结论 IL－1ra基因多态性能对其功能产生影响。携带IL1RN＊2等位基因者其体内单核细胞IL－1ra的产生能力存在缺陷。该结果为临床上根据IL－1ra基因型有针对地采取干预治疗奠定了基础。

环孢素A治疗特发性膜性肾病

目的采用前瞻对照性研究，探讨环孢素A （CYA）治疗成年人特发性膜性肾病(IMN)的疗效。方法本研究纳入30例IMN患者，15例采用CSA治疗，另15例采用开博通(CAP)治疗。全部患者在诊断上排除了继发性膜性肾病，且在正式进入研究治疗前未用或已停用类固醇激素和细胞毒药物达半年以上。CSA组应用CSA的起始剂量为5mg/kg/day，一月后逐月减量，三月后按2mg/kg/day维持一年。CAP组长期按37.5mg/day剂量服用CAP。结果在前三个月的诱导期末，CSA组中6(6/15)例患者发生完全缓解，2(2/15)例患者发生部分缓解，而在CAP组仅2(2/15)例患者发生部分缓解。观察15月后，CSA组有8例患者发生过完全缓解(其中1例于减药过程中复发)，4例患者部分缓解，而CAP组无更多病例发生完全或部分缓解。在平均随访44月后，CSA组已完全缓解的病例中2例复发，1例转成部分缓解，而在长期应用CAP治疗的患者中，3例患者在随访15月以后出现自然缓解。两组患者治疗前的血清肌酐水平无显著性差异，临床观察中未发现CSA相关的严重副反应。3例CSA治疗患者的重复肾活检资料表现肾小球基膜病变在CSA治疗后(包括持续缓解中的病例)未发生显著改变，1例患者在复发且出现血清肌酐升高后，肾小管间质出现纤维化改变，而另两例缓解患者的肾小管间质未出现明显变化。结论剂量为5 mg/kg/day的 CSA治疗方案对IMN具有诱导缓解作用，有效率可达78%，但停用CSA 6-9月(或减量过程)后，肾病综合征的复发率较高(50%)。

腺伴随病毒载体介导多巴胺合成酶的三重基因转移

目的探讨使用腺伴随病毒（AAV）载体介导编码多巴胺合成相关的三种生物酶基因的共转移。方法使用AAV载体将多巴胺生物合成相关的三种生物酶--酪氨酸氢化酶（TH）、芳香族氨基酸脱酶（AADC）、以及三磷酸鸟苷环水解酶Ⅰ（GGH）基因共转导入293细胞，以Western印迹分析检测TH、AADC、GCH的表达，以高效液相色谱法检测细胞内多巴胺水平。结果 TH、AADC、GCH的可在使用三种AAV载体（AAV-TH、AAV-AADC、AAV-GCH）转导的细胞中有效共表达，进一步分析发现，这种共表达可使该细胞有效地自发生成多巴胺。结论使用AAV载体进行TH、AADC、GCH三重基因共转导是有效的，这对帕金森病基因治疗的研究可能具有重要意义。

肾组织浸润细胞在新月体肾炎患者中的分布特点及意义

目的研究肾组织各种浸润细胞在各类新月体肾炎发生发展中的发病机制。方法分析56例各类新月体肾炎患者肾组织中单核细胞(CD68+)及增殖细胞核抗原阳性细胞(PCNA+)的分布特点，并就它们与肾组织中淋巴细胞亚群CD4+及CD8+细胞浸润的关系进行分析探讨。结果本组新月体患者肾组织中CD68+、PCNA+、CD4+及CD8+细胞均明显高于正常供肾组织。在Ⅰ型新月体肾炎患者肾组织中CD68+及PCNA+细胞数高于Ⅱ及Ⅲ型新月体肾炎患者。肾间质CD4+与肾小球CD68+及PCNA+细胞数呈线性相关者主要表现在Ⅲ及Ⅰ型新月体肾炎患者。结论本文资料进一步证实肾组织各类浸润细胞在新月体肾炎发生发展中的重要作用。肾间质CD4+与单核细胞及PCNA+细胞呈直线正相关可能为新月体肾炎患者活动与否的一种标志。在狼疮性新月体肾炎患者肾组织中CD4+及CD68+细胞浸润与血管炎及Ⅲ型新月体肾炎患者相似，提示这些患者在新月体的形成中主要由细胞免疫异常所参与。

LMP7基因多态性与1型糖尿病易感性及DR3基因的关系

目的研究华南地区汉人大多功能蛋白酶(LMP)7基因与1型糖尿病(DM-1)易感性及DR3基因的关系。方法以聚合酶链反应-限制性片段长度多态性技术对71例DM-1患者及86例正常对照进行LMP7基因分型。根据DR3基因将DM-1患者及对照组分别分为DR3阳性组与DR3阴性组。分别于随机人群及DR3配对的人群比较LMP7各基因型及等位基因频率在DM-1患者与对照组之间的差异。根据发病年龄将DM-1分为3组，A组≤14岁，B组15-30岁，C组≥31岁。结果在随机人群：DM-1组LMP7-B/B频率显著降低(39% vs 58%，P<0.05)，LMP7-B/A频率显著升高(54% vs 31%，P<0.01)。在DR3阳性人群：LMP7各基因型及等位基因频率在DM-1组与对照组间无显著性差异。在DR3阴性人群：DM-1组LMP7-B/B频率显著降低(40% vs 61%，P<0.05)，LMP7-B/A频率显著升高(55% vs 28%，P<0.01)。 LMP各基因型及等位基因频率在糖尿病各发病年龄组间无显著性差异。结论 LMP7-B/B可能是DM-1的保护基因型， LMP7-B/A可能是DM-1的易感基因型，它们与DM-1的关系可能不受DR3基因的影响。LMP7-B/B基因型阳性者患DM-1危险性降低。LMP7-B/A基因阳性者患DM-1危险性增加。LMP7基因与DM-1发病年龄可能无关。

72例短暂性脑缺血发作患者长期随访研究

目的连续收集了本院1959年10月至1977年12月的72例首次短暂性脑缺血发作(transient ischemic attack，TIA)患者，并于1982年、1988年、1993年、1998年分别进行了四次连续随访，其中随访时间长者达35年。同时观察了首次TIA后的复发情况，TIA患者完全性卒中与心肌梗死的发生情况，及其病死率和死亡原因，各年限的生存率及其95％可信区间，TIA患者神经血管外科的手术指征范围。方法对72例TIA患者进行了长达35年的随访，采用队列研究，寿命表法等医学流行病学研究方法对上述各观察项目进行分析。结果随访结果显示，总的TIA复发率为27.9％，完全性卒中的发生率65.7％，心肌梗死的发生率8.4％，病死率72.7％；主要死亡原因为完全性卒中，占所有死亡患者的59.6％。其中非老龄患者的首位死亡原因为脑出血，老龄患者的首位死亡原因为脑梗死。致死性心肌梗死患者2例，占死亡患者的2.8％。满29年的生存率为27.3％，其95％可信区间为16.8-37.8％。本研究随访结果显示，有神经血管外科手术指征的患者19人，占所有患者的26.6％。结论本组患者首次TIA后约有近1/3患者出现TIA复发，完全性卒中的发生率较心肌梗死的发生率明显升高。主要死亡原因为完全性卒中而非心肌梗死。估计用神经血管外科手术来预防TIA患者发生完全性卒中的作用有限。

受低强度微波辐射后兔晶体上皮细胞的早期改变

目的通过流式细胞技术定量检测受低强度微波辐射后兔晶体上皮细胞的早期损伤改变来验证微波安全接触标准的可靠性并探讨其发生机理。方法用强度分别为5mW/cm2和10mW/cm2的微波连续照射兔眼3h，流式细胞AnnexinⅤPI（碘化丙啶）双染色法定量检测兔晶体上皮细胞受辐射损伤的早期变化，以自身防护眼作对照比较。结果 5mW/cm2实验组兔晶体上皮细胞多数发生了早期凋亡。10mW/cm2实验组兔晶体上皮细胞受辐射后多数经早期凋亡发展到了细胞继发性坏死阶段。两组比较，10mW/cm2的微波对细胞的损伤明显大于5mW/cm2的微波。结论 5mW/cm2及10mW/cm2的低强度微波均导致兔晶体上皮细胞发生了不可逆的损伤，这种损伤是细胞水平上微波"非热"效应的结果。

产后出血的干预性治疗

目的讨论产后出血干预治疗的合理方案。方法回顾性分析15例行干预性治疗的严重产后出血的病人的临床特点及方法。结果 15例患者中子宫切除者9例，行动脉栓塞治疗7例（2例切除子宫后又行栓塞治疗），行病灶挖除术1例。需行干预性治疗的产后出血的原因依次为：DIC,子宫动－静脉瘘及血管畸形，胎盘异常，子宫肌瘤及子宫裂伤。结论应针对产后出血的不同原因、部位及性质选择合理有效的干预治疗。合理的治疗方案是抢救病人生命，保留生育功能，尽可能减少创伤的关键。

线粒体脑肌病患者骨骼肌mtDNA点突变与临床类型的研究

目的探讨线粒体脑肌病患者骨骼肌mtDNA在3243及8344位点点突变与发病类型的关系。方法提取患者骨骼肌中的DNA，以两对寡核苷酸为引物行PCR扩增，分别应用BglⅠ和ApaⅠ酶切后，琼脂糖电泳判定。结果 2例患者nt3243位点出现A→G点突变，其中为MELAS和MERRF各一例；2例MERRF患者nt8344位点出现A→G点突变，其中1例同时存在着3243位点突变。结论 nt3243及nt8344位点突变分别与MELAS 和MERRF的发病有关。1例MERRF患者同时存在上述2个位点的突变,这可能与线粒体脑肌病临床表现多样化有关。

弹性开放襻前房型与巩膜缝线固定襻后房型人工晶体植入术的疗效比较

目的评价、比较弹性开放襻前房型与巩膜缝线固定襻后房型人工晶体的疗效及安全性。方法回顾性研究68例（68只眼）后囊缺失无晶体眼的人工晶体植入术的手术结果。根据植入人工晶体的类型分为两组。第一组（30只眼）为施行弹性开放襻前房型人工晶体植入术者。第二组（38只眼）为施行巩膜缝线固定襻后房型人工晶体植入术者。使用超声生物显微镜，结合前房角镜，观察术后人工晶体襻的准确位置，襻与周围组织的关系，以评价这两种人工晶体对眼前段结构的影响。随访6个月至20个月。结果术后矫正视力达0.5以上者，第一组有27只眼（占90.0%），第二组有35只眼（占92.1%）。两组比较无统计学意义（P>0.05）。在第一组有23只眼（76.7%）出现手术并发症，总并发症数为40次/眼；而在第二组分别为13只眼（34.2%）和19次/眼。两组比较有统计学意义（P<0.05）。超声生物显微镜和前房角镜检查显示：在第一组，所有的人工晶体襻均与虹膜完全接触，且不同程度压迫虹膜，甚至引起房角后退。虹膜前粘连12只眼。在60个人工晶体襻中，39个襻的固定脚板固定于睫状体带，其余21个襻（12只眼）穿过虹膜侵入到睫状体实质内，伴有反复发作的葡萄膜炎。在第二组的76个人工晶体襻中，52个襻固定于睫状体沟，8个襻（8只眼）固定在虹膜下，引起房角粘连。另外16个襻固定于睫状体冠部。结论巩膜缝线固定襻后房型人工晶体现有的缝襻方式，不能确保将襻固定在睫状体沟的位置。弹性开放襻前房型人工晶体的晶体襻可压迫虹膜组织，甚至通过虹膜，侵入到睫状体组织内，刺激睫状体组织。植入巩膜缝线固定襻人工晶体较植入弹性开放襻前房型人工晶体更安全、疗效更佳。

PPP1R3基因多态性与2型糖尿病相关性研究

目的应用病例对照分析法对骨骼肌糖原相关蛋白磷酸酶1的糖原靶调节亚单位基因多态性与2型糖尿病相关性进行研究。方法应用寡核苷酸连接测定技术和直接电泳的方法，对该基因的Asp905Tyr和3'非翻译区ARE多态性位点基因型进行了测定。结果 BMI25携带Asp905等位基因组能增加2型糖尿病的危险（OR=3.66; 95% CI: 1.48-9.06）；ARE多态性与2型糖尿病未见相关(OR=1.15; 95% CI: 0.62-2.14)。结论 Asp905协同肥胖增加2型糖尿病的危险。在中国人群中，该基因的Asp905Tyr和ARE多态性不是致糖尿病基因主要的变异。

Objective To investigate the role of suppressor gene p16 in the process of differential regulation of retinoic acid (RA) on the A549 lung cancer cells.Methods Tumor suppressor gene p16 was transferred into A549 cells and the cells were treated with all-trans retinoic acid (ATR) at the dosage of 5×10-6 mol/L for 4 d. After that, the proliferation and differentiation of A549 cells were examined by growth curve and cytometry analysis, the change of lung lineage-specific marker MUC1 was tested by immunohistochemical staining. Meanwhile, Western blot was used to observe the change of p16 protein expression in A549 cells treated with ATRA.Results ATRA could obviously inhibit the growth and induce the differentiation of A549 Cells that were transferred with p16 gene. There were more cells arrested in G1/G0 phase and the expression of MUG1 was markedly down-regulated than in control cells. The expression of p16 protein was up-regulated in A549 cells treated with ATRA.Conclusion Suppressor gene p16 could enhance the effects of RA and proliferated suppression and differential induction of A549 cells.

Objective To explore whether Pvu Ⅱ restriction fragment length polymorphisms (RFLP) in the lipoprotein lipase (LPL) gene are associated with hypertriglyceridemics (HTG).Methods Pvu Ⅱ restriction fragment length polymorphisms in the lipoprotein lipase gene on a sample of 135 HTG patients and 193 age-matched healthy individuals in Chengdu area were detected with the method of PCR-RFLP.Results The P+P+ genotype frequency and P+ allelic frequency of LPL gene for HTG cases are higher than those for control groups (0.460 vs 0.337, P<0.05; 0.689 vs 0.565, P<0.01). The serum levels of TG, apoC Ⅱ, apoC Ⅲ, apoE and TG/HDL-C in P+P+ genotype are higher than those in P-P- genotype (P<0.05).Conclusion The results suggest that P+P+ genotype in the lipoprotein lipase gene is associated with susceptibility to hypertriglyceridemics in Chinese population.

Objective To summarize microskin grafting in recent 15 years.Methods Microskin grafting was performed in 162 patients with extensive burn. The indications and forms of the grafting, mechanization in making microskin and outcome of wound recovered by micrografts were discussed.Results Extremely extensive third degree burns, common extensive third degree burns and extensive granulation wound were healed by different ways of microskin grafting. A new machine was used to mince micrografts with good clinical results. The homografts as covertures were exfoliated in either necrosis or desquamation. Scar formation was related to wound repair. Conclusions Microskin grafting has made progress in recent years. The orientation and even spread of micrografts are very important for good wound repair. The technique should be further improved.

Objective To evaluate the effectiveness of a community-based acquired immunologic deficiency syndrome (AIDS) educational intervention in young adults.Methods A quasi-experimental design was used. Two townships in Kunshan county, matched by socioeconomic characteristics, were randomly assigned to intervention or control group. Eight hundred young adults aged 18-30 were recruited from the two townships as study subjects. A 12-month comprehensive educational intervention on AIDS prevention was conducted in the intervention group through local family planning services.Results After intervention, subjects in intervention significantly improved their knowledge on AIDS and attitudes related to AIDS prevention. Reported rate of condom use during the last episode of sexual intercourse increased from 8.5% at baseline to 14.4% after intervention (χ2=4.66, P=0.0308). No obvious change was observed among subjects in control group.Conclusion This study demonstrated the feasibility of integration of AIDS educational intervention into the existing family planning services. Integration of AIDS programs into family planning program should be considered as a realistic approach for AIDS control in China.

Objectives To assess weight loss efficacy ,safety and tolerability of sibutramine in simple obese subjects.Methods Randomized, double-blind, placebo-controlled clinical trial. Four hospital outpatient clinics in Shanghai, Chongqing, Shandong and Tianjin, respectively. Participants: 233 men and women, 18-65 years old, with body mass index (BMI) ranging from 27 to 40*!kg/m2 were randomly divided into an intervened group and a placebo control group. Sibutramine 10 mg or placebo once a day. Main outcome measures: Body weight, routine laboratory and clinical safety monitoring.Results Of 233 eligible patients, 120 received sibutramine and 113 received placebo. Weight reduction was significantly greater in the intervened group (6.8±3.1) kg than the placebo control group (0.48±2.6) kg from week 4 onwards to week 24 (P<0.001). Some minor side effects were noticed in the subjects who took sibutramine. But the symptoms were light and short term. Sibutramine was will tolerated.Conclusions Sibutramine 10*!mg once a day is an effective an safe therapy for weight reduction in simple over-weighted and obese subjects.

Objective To study the inhibitory effect of oxymatrine on hepatitis B virus (HBV) in vitro.Methods Microparticle enzyme immunoassay, bDNA signal amplification assay was used for determining secreted HBsAg/HBeAg in the culture medium, HBV DNA from core particles in the cytoplasm and MTT colorimetric assay was used to assay the oxymatrine cytotoxity.Results The inhibitory rates of HBsAg and HBeAg were 40.57% and 48.27% by oxymatrine at the concentration of 2000*!μg/ml. At 100-2000*!μg/ml, it can remarkably decrease the level of viral core associated-HBV DNA in the cytoplasm. No significant toxicity was shown in such concentrations.Conclusion Oxymatrine has a potential anti-HBV activity in vitro.

Objective To summarize the experience in microsurgical treatment of multiple intracranial aneurysms.Method Eight patients with 17 aneurysms were analyzed retrospectively.Results Seven patients were followed uq from 0.5 month to 10 years. According to Student's standard, the results in 5 patients were excellent and 2 good. One patients with bilateral PCom aneurysm died 1 week after operation.Conclusions Multiple intracranial aneurysms should be removed as soon as possible, especially bilateral ones. The best way is first to clip the bled aneurysm and then the contra lateral one by using coronal incision and bilateral pterional approach. The approach has the advantage of minimal invasion, good exposure, and less time-consuming.

Objective To evaluate the effect and feasibility of using estrogen cream for the prevention and treatment of recurrent urinary tract infection (UTI) in postmenopausal women.Methods Forty-five postmenopausal women with a history of recurrent UTI were divided into two groups (group premarin and group antibiotic). Participants were assigned to apply intravaginal premarin cream (group premarin, n=30) or oral antibiotic (group antibiotic, n=15) for 3 months respectively. Urine routine test, midstream urine and vaginal cultures, vaginal health score (VHS), vaginal cell maturation value (MV), endometrial thickness and blood estrogen level were obtained before and after the study.Results The incidence of UTI in the group premarin was significantly reduced as compared with that in the group antibiotic (2/27 vs 12/15, P<0.001). In the group premarin Lactobacilli reappeared (from 0 to 59.3%) and MV (from 9.2±6.8 to 74.6±14.1) and VHS (from 5.2±0.4 to 13.4±2.5) were improved after 3 months. There was no significant change in the group antibiotic.Conclusion It seems that intravaginal use of estrogen cream would effectively prevent and reduce the UTI in postmenopausal women.

Objective To construct a recombinant live attenuated Salmonella typhimurium vaccine strain expressing Helicobacter pylori urease subunit B (ureB).Methods ureB gene was amplified by PCR and cloned into a prokaryotic expression plasmid pTrc99a, and the identified recombinant plasmid was then used to transform an attenuated Salmonella typhimurium vaccine strain SL3261. The ureB expressed in the recombinant vaccine strain was analyzed by SDS-PAGE and optical density scanning. Two and 10 days after recombinant strain intragastric immunization, the C57BL/6 mice were sacrificed, and the spleens and terminal ileums were cultured.Results The ureB gene could be amplified from the recombinant prokaryotic expression plasmid pTrc99A-ureB and the plasmids extracted from transformed SL3261 strain. SDS-PAGE and optical density scanning indicated that ureB was expressed in the recombinant vaccine strain SL3261 (pTrc99A-ureB) as a protein with 66*!kD of molecular weight. Recombinant strain was found in both spleen an terminal ileum of each mouse two and ten days after intragastric immunization.Conclusions A recombinant liver attenuated Salmonella typhimurium vaccine strain expressing Helicobacter pylori ureB was constructed and identified, and this study will help to develop an oral recombinant live vaccine against Helicobacter pylori infection.

Objective To study the endovascular treatment of artery rupture caused by injury on which surgery was impossibly performed. Methods All 76 patients underwent selective angiography to make accurate diagnosis. Endovascular occlusion of the target artery with a balloon catheter was accomplished and surgical vessel repair followed in 13 cases. Under the condition that the blood supply of the remote limb on which the artery rupture was detected remained normal, the injured artery was obstructed completely with either detachable balloon or coil in 63 cases.Results No complication, disability, or death was found in any case.Conclusions Occlusion of the blood flow of the target vessel with balloon catheter is an easy, effective and safe preoperational approach for patients who fail to be treated perfectly with direct surgery.

Objective To explore the association between underweight and mortality from all cause Method We examined the relationship of underweight and mortality among subjects who participated in the survey of cardiovascular risk factors (in 1984-1986 and in 1992). Relative Risks (RRs) were estimate from the COX proportional hazard model by using a BMI between 18.5-24.9kg/m2 as reference category Results During an average 12.40 years followup, we documented 307 deaths of which 158 were from cancer, 93 from cardiovascular diseases, and 56 from other causes We observed a Lshaped relation between BMI and overall mortality.(P for trend<0.01); In multivariated analyses, we found that the RR of mortality for a BMI of <18.5kg/m2 was 1.58 (95% CI 1.16-2.14) as compared with the risk among subjects with BMI of 18.5-24.9kg/m2 The RR of overall mortality among subjects with BMI of <18.5kg/m2 was still significant after the exclusion of subjects who died from cancers during the first five years follow-up Conclusion Total mortality was increased among underweight people, and this association can not been completely explained by smoking and early deaths from caner.

Objective To detect the patients with IgA nephropathy by glycobilolgy and immunological technique.Methods An helia aspera lectin-ELISA immunoassay was developed to discriminate the aberrantly glycosylated IgA in serum from normal IgA molecules by using HAA lectin, which reacts preferentially with the GalNAc of the terminal sugar chain, and AKP conjugated specific IgA antibody.Results The results given by A405 nm values from 156 controls, 22 patients with IgAN and 19 patients with uncertain IgAN were 0.22±0.10, 0.68±0.17 and 0.38±0.15, respectively. The significance between the controls and the patients with IgAN was observed (P<0.001).Conclusion This assay is sensitive, specific and valuable for the diagnosis of patients with IgA nephropathy.

对比剂增强磁共振血管造影诊断肺隔离症

目的评价对比剂动态增强三维（3D）磁共振血管成像（MRA）技术识别异常体循环动脉，诊断肺隔离症的方法与价值。方法三位经胸部X线平片和CT检查怀疑患有肺隔离症的患者，接受了对比剂动态增强3D MRA检查。我们描述了MRA影像显示并与手术所见作了对比。结果对比剂动态增强 3D MRA 清楚地显示了发自于降主动脉的异常血管，供应下肺叶基底段的病灶部位。其中两例于静脉相还显示了病灶的引流肺静脉，并见其汇入左心房。MRA影像显示与外科手术所见相符。结论对比剂动态增强3D MRA 可以正确诊断肺隔离症，并可替代传统的创伤性的血管造影检查。

胃癌患者外周血淋巴细胞白介素2受体检测的临床意义

目的了解胃癌患者外周血淋巴细胞(PBL)膜白细胞介素2受体(CD25）水平的临床意义。方法用流式细胞仪检测100例正常人和110例胃癌患者术前PBL中CD25%,并进行临床病理分析。结果正常人PBL中CD25%平均为17.24±5.33，110例胃癌病人PBL中CD25%平均为22.47±6.82, 差异有非常显著性(P<0.01)。胃癌患者PBL中CD25%升高与肿瘤发生部位、大体类型、肿瘤大小、分化程度和临床分期均有相关性。结论检测胃癌患者术前PBL中CD25%,可为临床提供病人诊断、免疫治疗及预后评估的参考依据。

β肾上腺素能受体在支气管哮喘发病中的作用

目的观察支气管哮喘不同状态时外周淋巴细胞肾上腺素能受体（βAR）及β2ARmRNA水平的变化。方法用放射配基结合受体分析法，放射免疫法，逆转录聚合酶链反应（PT-PCR）及原位杂交等方法测定哮喘患者不同状态下β2AR密度，β2ARmRNA水平，血浆cAMP和cGMP水平。结果缓解期哮喘患者外周淋巴细胞βAR的密度较正常人明显升高，血浆cAMP水平无显著差异，而发作期哮喘患者βAR及血浆cAMP水平均较正常人明显降低；缓解期哮喘患者外周淋巴细胞β2ARmRNA水平与正常人无显著差异。结论βAR数量、功能及其信使核糖核酸水平与哮喘不同发病状态有关，其改变仅为哮喘病程中伴随出现的变化，不是其发病的原发因素。

鼠慢性萎缩性胃炎模型的建立及致萎缩因素探讨

目的建立鼠慢性萎缩性胃炎(CAG)动物模型并探讨致萎缩因素。方法应用60%酒精和20mmol/L去氧胆酸钠(A因素)，0.05%-0.1%氨水(B因素)，0.05%吲哚美辛(C因素)按有重复的L8(27)正交设计对SD大鼠分三批进行制模刺激，三批刺激时间分别为3个月，6个月，9个月。实验到期后取出全胃，观察大鼠胃黏膜大体观及各项萎缩指标。结果应用A、B、C三因素(单因素或多因素)刺激6个月或9个月均可出现典型的胃窦萎缩性胃炎征象，且制模成功率达100%，该两批建成的CAG模型其胃黏膜基本病理变化无明显差异，而制模刺激3个月则无明显的胃黏膜萎缩出现。结论应用60%酒精，20mmol/L去氧胆酸钠，0.05%-0.1%氨水，0.05%吲哚美辛对SD大鼠刺激6个月可成功的建立CAG模型，延长刺激时间并不能进一步加重鼠胃黏膜萎缩程度。

Femoral fractures in the presence of other intramedullary implants are uncommon. These fractures are difficult to manage and the presence of other intramedullary implants creates a complex problem. The rate of these fractures has increased due to an increase in the number of patients having total hip arthroplasty (THA) and the use of various new techniques for femoral fractures.1-5 Literature on the treatment of femoral fractures with other intramedullary implants is rare.2,3 From 1995 to 1998, we reduced these fractures openly and fixed them with a shape memory alloy sawtooth-arm embracing fixator (EF), and the outcomes were satisfactory.