Abstract:Randomized controlled trial （RCT）, considered as the strongest evidence-based method in clinical trial, can provide first-hand scientific evidence for clinical practice and instruct clinicians to make correct decisions in practice. This article introduces the principles for RCT designing, analyzes the common problems concerning RCT in clinical practice and the common mistakes made in RCT statistical methods. It is concluded that application of RCT method and correct statistical methods are of great importance in clinical medical research.

Abstract:1临床资料患者男，38岁，因“胸闷、气急10d”入院。入院5个月前患者骑摩托车时胸部撞击路旁大树，当时神志清楚，感胸部剧痛，当天于外院行胸部X线检查未发现明显异常，休息后疼痛逐渐缓解，未随访观察。入院10d前，患者疲劳后出现鼻塞、流涕等上呼吸道感染症状，自感发热，未测体温，并逐渐出现胸闷、乏力，入院3d前，患者胸闷、乏力症状明显加重，并出现活动后气急，伴有恶心、呕吐，症状持续不能缓解，于当地卫生所行胸部X线检查提示“心影增大”。入院后体格检查：半卧位，神智清楚，体温37．0℃，脉搏80次／min，呼吸22次／min，血压100／70mmHg（13／9kPa）。[第一段]

Abstract:2006年4月16～17日在成都召开第四届亚太地区循证医学研讨会期间，中国48家医（药）学期刊和中国临床试验注册中心（Chinese Clinical Trial Register，ChiCTR）、卫生部中国循证医学中心、循证医学教育部网上合作研究中心和Chinese Cochrane Centre的代表经过充分讨论达成共识，决定共同发起创建中国临床试验注册和发表机制，并成立“中国临床试验注册和发表协作网（Chinese Clinical Trial Registration and Publishing Collaboration，ChiCTRPC）”。这种临床医学研究管理新模式的创建和应用，将对提高中国临床试验信息透明度和质量、提高医学研究公信度发挥极其重要的作用。本文介绍其结构特点和运作方式。[第一段]

Abstract:Objective：To search for a method for analyzing medical service quality of different disease entities using the first page data of medical records. Methods： Based on documents review and real data analysis, the basic principles, methods and steps of disease entity dividing and selecting, evaluation index selecting, and calculating were introduced. Special attention was paid to certain problems in the discussion. Results： When the inpatients of selected disease entities covered 60%o of total hospitalized patients, the medical quality information included exceeded 80% of the total information. For 97.66% disease entities, their inpatient cost and length of hospital stay were logarithmic-normally distributed. Conclusion. Dividing disease entities by fixed digits of ICD-9 code is easily performable. This method should be used when the disease entities include about 60% of total inpatients, and geometric mean should be used in calculating average length of hospital stay and average cost.

Abstract:Objective： To explore the application of data envelopment analysis in optimal allocation of military health resources. Methods： The relative technical efficiency of 52 military health service units （MHSUs） was assessed by C^2GS^2 model, a variable-return to scale, input oriented data envelopment analysis （DEA） method. MHSUs were classified with hierarchical clustering analysis. The confounding factors （geographic factor and arms of service） were analyzed using Coehran-Mantel-Haenszel X^2 test and the output of health service was analyzed using Kruskal-Wallis H test; then the quantity of health resources of different types of MHSUs was compared using Kruskal-Wallis H test and the structure of the resources was analyzed with ratios of different items. Results： Eighteen of the 52 MHSUs were technical efficient and the median score was 0.84. The relative technical efficiencies of 52 MHSUs were clustered into 4 types： type A, type B, type C and type D, referring to the best performance, average performance, inferior performance and the worst performance, respectively. The quantity of type D MHSUs was higher than those of other types of MHSUs and the structure of type D MHSUs was unreasonable compared with other types of MHSUs. The quantity and structure of type D MHSUs could be adjusted according to those of the type A or type B MHSUs. Conclusion： Combined with other statistical methods, DEA can be used to evaluate, classify the relative technical efficiency and analyze the resource allocation of different types of decision making units （DMUs）. The quantity and structure of health resource with inferior relative technical efficiency DMUs can be adjusted to optimize the allocation of health resources.

Abstract:Objective：To evaluate the resource allocation efficiency in 9 military institutes for drug and instrument control, so as to table an optimized proposal for resource allocation. Methods： Data envelopment analysis （DEA） was used to evaluate the resource allocation efficiency of the sample institutes based on data collection. Results： Of the 9 institutes, 1 was pure technical inefficient, 3 were resource disposability inefficient, and 5 were scale inefficient. An optimized resource allocation proposal was tabled to each of the 9 institutes. Conclusion： With the progress of the army＇s modernization and the deepening of reform on the army＇s establishment and structure, military institutes for drug and instrument control should adjust the resource allocation strategy for more technical and social benefit

Abstract:Statistical analysis is an important step in clinical drug trial and standard statistical analysis can reveal the true characteristics of drugs. This paper reviews the existing problems in statistical analysis of clinical drug trials. Some specific operations concerning different steps of statistical analysis are tabled based on the international principles of statistical analysis for clinical drug trials, which may contribute to the reliability of the trial results.

Abstract:1临床资料患者男性，38岁，骶尾部外伤后发现局部肿块形成9个月余，破溃不愈4个月余入院。患者于2004年12月跌倒后发现骶尾部肿块，经理疗，热敷、局部肿块切开引流等多种治疗后效果不佳。2005年7月外院行右侧髂内动脉及臀上臀下动脉栓塞后，后行骶尾部肿块切除术。术后病理示：小细胞性恶性肿瘤，间叶肉瘤，高度恶性。术后创面迁延不愈，肉芽组织增生，遂于2005年8月8日转入我科。查体：骶尾部可见大小10cm×8cm创面，基底部肉芽增生，表覆大量液态分泌物，黄白色，肉芽组织呈暗红色。创面斜向下方有一长约4cm的窦道。内有少量黄白色分泌物，创缘红肿。心电图、腹部B超、胸片及全身骨扫描均未见明显异常，术前骶尾部MRI：骶尾部皮下软组织内可见不规则异常信号影，范围大直径约10cm。以右侧为主。肿瘤界限不清，增强后肿瘤周围强化，而内部强化不明显，骶尾骨未见明显骨质破坏。[第一段]

Abstract:Clinical data management, a critical part of clinical trials, plays a decisive role in assuring the accuracy and reliability of the trail results. This article discusses the quality standards of clinical data, introduces the important rules and principles for standardized clinical data management, and reviews the development and current status of clinical data management home and abroad. It is proposed that we should learn the advanced clinical data management modes from international partners and introduce standardized clinical management software from abroad, so as to improve the clinical data management in China.

Abstract:1临床资料死者女性，50岁，因左下肢红斑伴左下肢肥大，皮下蚯蚓状团块50年，加重2年；左下肢疼痛，高热6d，以左下肢Klippel—Trenaunay综合征（K—T综合征）、左下肢皮内淋巴管炎入院。查体见左下肢较健侧明显增粗增长，左下肢足背、踝部至腹股沟、腹部皮肤有大片暗红色无痛性红斑，左下肢大隐静脉行程区可见蚯蚓状团块，以小腿内侧为多，左侧小腿皮肤触痛。左侧股动脉、足背动脉搏动减弱。左下肢静脉彩超示瞩静脉受压，大隐静脉扩张。MRI血管造影检查：左下肢明显较右侧粗大。左侧大腿中下段至小腿可见多支动脉与静脉间有异常交通，大量的静脉曲张，走行扭曲，可见少数静脉呈瘤样扩张。入院后在全麻下行左小腿皮下组织切除术＋左小腿原位自体全厚皮肤整张植皮术。术后病情平稳，术后17d起时有胸闷心慌，术后22d症状加重，突然心跳呼吸停止，抢救无效死亡。[第一段]

Abstract:Objective：To elucidate and compare the parametric method and non-parametric method in estimation of the area under ROC curve, so as to provide a basis for their application in diagnosis assessment. Methods： The areas under ROC curves were estimated by parametric method of fitting binomial model and by non-parametric method of Mann-Witney statistics. The method was employed in the diagnostic tests of lung cancer. Results： By non-parametric methods, the areas under ROC curves of Cyfra21-1 and CEA were respectively 0.77 and 0.87 in the lung cancer diagnostic tests; by parametric methods, they were 0.78 and 0.87, respectively. It was indicated that when the sample size was large, the values of areas under ROC Curves were similar between parametric method and non-parametric method. Conclusion： Non-parametric method should be used to evaluate the area under ROC curve if the sample size is small, and for large sample size, the parametric method or nonparametric method should be chosen according to the actual situation.

Abstract:Objective：To explore the forecasting method of disease index time series of cucumber downy mildew disease. Methods： Using the time series of cucumber downy mildew disease, we established an autoregressive integrated moving average model,ARIMA（2,2,0） based on model identification, comparison of residual variance, estimation and verification of parameter, observation of the correlation of the estimates matrix, autocorrelation check of the residuals, analysis of the fitting of model and so on. Results： An ARIMA model （2,2,0） was established： （1＋0. 487 1B＋0. 554 7B^2）（1-B）^2y, =α1, with the Sum of Squared Error （SSE） being 0. 001 822 and the Root of Mean Squared Error （RMSE） being 0. 008 537. The predicted values of validating date fitted well with the primary values. The established model showed satisfactory forecasting ability and was suitable for forecasting the middle stage and late stage cucumber downy mildew disease. Conclusion： Limiting the alternatives of model by residual variance, together with parameters estimation, the correlation of the estimates matrix, the autocorrelation check of the residuals and the fitting test, can help to search for suitable model quickly and accurately

Abstract:Gastroesophageal reflux disease （GERD）, a common disorder in the West, is less seen in Asian countries. No nationwide epidemiological study of GERD has been conducted in China up to now and the population distribution of GERD remains unknown. Many factors are believed to be responsible for GERD. In addition to some recognized factors, the influences of factors like obesity, smoking and so on are till unclear. Furthermore, GERD is believed to be associated with many diseases. This article reviews the disease distribution, risk factors and associated diseases of GERD.

Abstract:Gene regulatory networks （GRN）, which focuses on the complex interactions of genes in life, is an important part in the study of the functional genomics and is the frontier of bioinformatics research. Application of gene-chip technique in bioinformatics provides a great number of basic data for the research of GRN. This paper reviews the origin and recent development of GRN, explicates the preconditions and rationales for construction of GRN, and analyzes several classic GRN models： Boolean networks, linear models, non-linear models and Bayesian networks. The rationales, basic algorithms, advantages, disadvantages and applicability of the models are reviewed based on the characteristics of gene-chip data.

Abstract:Objective： To isolate and identify Sertoli cells from mouse testis. Methods： Testis were isolated from male mouse aged 18-20 days old and were cultured by enzymatic digestion. The Sertoli cell gene with a zinc finger domain （SERZ） was obtained by RT-PCR and was inserted into pcDNA3.0 to construct recombinant plasimid pcDNA3.0-SERZ, pcDNA3.0- SERZ was then cleaved by restriction endonuclease Kpn I and Xba I to obtain the linear templets for preparation of the probes. The expression of SERZ mRNA in the cultured cells was analyzed by in situ hybridization with the prepared probes. The expression of androgen binding protein （ABP） mRNA in the cultured cells was detected by RT-PCR. Results： Under light microscope, most Sertoli cells were polygonal and were completely extended,mimicking a membrane. The nuclei were triangular or irregular, weakly stained and with obvious nucleoli. The neighbouring cells were interlaced with one another and the cell purity was （85.1± 2.5） %. SERZ mRNA was highly expressed in the cytoplasm of the cultured cells. RT-PCR showed that ABP mRNA was expressed in the cultured cells. Conclusion： We have successfully isolated and identified Sertoli cells from mouse testis, with the cell purity being （85.1±2. 5）%.

Abstract:Objective：To observe the anti-tumor effect of T lymphocytes harboring anti-CD20 scFv-CD8-TCRζ fusion gene on human B lymphomas in vitro and in vivo, so as to explore the feasibility of CD20-mediated autogenous T lymphocytes in killing B-cell lymphomas. Methods, A fusion gene containing anti-CD20 scFv, CD8 molecule and CD3ζ chain was constructed and was cloned into pcDNA3. After confirmed by restriction endonuclease analysis, the fusion gene was used to transfect the human peripheral T lymphocytes through electroporation and expression of anti-CD20 scFv-CD8-TCRζ fusion protein was induced. The CD20 antigen-recognition ability of transfected T cells was determined by flow cytometry. The killing effect of transfected T cells on B cell lymphomas-Raji cells was tested in a cytotoxicity assay. The anti-tumor efficacy of this gene-modified T cell against the Raji tumor cell line was also evaluated in BALB/c nude mice. Results： We successfully constructed the anti-CD20 scFv-CD8-TCRζ fusion gene and expressed its protein on T cells. Flow cytometry and cytotoxicity assay demonstrated that the gene engineered T cells specifically recognized CD20 antigen and specifically inhibited B-cell lymphomas Raji cells. Furthermore, the T cells significantly inhibited the transplanted Raji cells in irradiated BALB/c nude mice. Conclusion： T lymphocytes transfected with anti-CD20 scFv-CD8-TCRζ fusion gene have antigen-specific anti-tumor effect in vitro and in vivo, which lays a foundation for utilizing human T lymphocytes to treat human B-cell lymphomas.

Abstract:Objective：To study the inhibitory effect of tumor-selective replication-competent adenovirus-mediated human endostatin（CX-hE）on transplanted ovarian cancer （OV-90） in nude mice. Methods： BALB/c nude mice were inoculated subcutaneously with OV-90 cells to establish the animal model bearing human ovarian cancer. Eighteen nude mice bearing cancer were divided into 3 groups to receive intratumoral injection of PBS, CX-hE or Ad-hE, 1/2 d, 5 times. Then their livers were harvested for pathologic examination. Another 15 nude mice were divided into 3 groups to receive single intratumoral injection of CX-hE, Ad-hE or ONYX-015. Venous blood was collected on day 1,3 and 7 after injection for hEndo measurement by ELISA. The tumors were harvested for pathologic examination and immunohistochemical staining. Results： The tumors grew more slowly in CX-hE group and their sizes were markedly smaller than those of Ad-hE group（P〈0.05） and PBS group（P〈0.01）. Endostatin levels were detected in the sera of nude mice in all single injection groups, and the endostatin expression in CX-hE group increased as time passing by. The endostatin level in CX-hE treated group was much higher（P〈0.01） and increased faster than that in Ad-hE treated group. Immunohistochemical staining for Hexon of adenovirus capsid showed more positive tumor cells in the tumor tissues treated with CX-hE. Immunohistochemical staining for vWF revealed a decreased microvessel density in the tumor tissues treated with CX-hE. Conclusion： CX-hE and Ad-hE can inhibit tumor growth and the effect of CX-hE is superior to that of Ad-hE. There is no growth halt or disappearance of tumors in all groups.

Abstract:Objective：To prepare and evaluate the effectiveness of chitosan-carboxymethylcellulose membrane in preventing postoperative intestinal adhesion. Methods： Chitosan-carboxymethylcellulose membrane was prepared with 1 ： 1 ratio of chitosan and carboxymethylcellulose. Glutaraldehyde and ammonium aluminium sulfate were used for cross-linkage, glycerin for enhancing plasticity; and then the product was dried. The membrane was observed with scanning electron microscopy （SEM） and its tensile strength and breaking elongation were measured. Forty-eight SD rats with ileum injury were randomly divided into A, B and C groups （n= 16）. During operation, the injury in group A was treated with chitosan-carboxymethylcellulose membrane, in group B with chitosan membrane, and in group C without treatment （control group）. The adhesion was observed on the 14th postoperative day. Results： The tensile strength of chitosan-carboxymethylcellulose membrane was 20 MPa and the breaking elongation was 65%. SEM showed that the morphology of the membrane had crossed fibroid structures and irregular pores. The severity of adhesion in group A and B was significantly lower than that in group C （P〈0.01）. Milder inflammatory changes and less fibrous proliferation were found in group A and B compared with those in group Co Epithelia rehabilitated better in group A than in group B, and the proliferation of fibroblast was not significant under electron microscope. In group C, epithelia rehabilitated slowly and fibroblasts excreted collagen actively. Conclusion： Chitosan-carboxymethylcellulose membrane is feasible for suturing during operation and is effective in reducing intestinal adhesion and it is superior to chitosan membrane.

Abstract:Objective： To investigate the inhibitory effect of Epibueropyridinium A on aldose reductase. Methods： Aldose reductase was extracted from cattle crystalline lens. Besides Epibueropyridinium A, the reactive system also contained DL-glyceraldehyde, aldose reductase, and NADPH. The activity changes of aldose reductase were detected at 340 nm. Epalrestat was taken as the positive control. The inhibitory type, Ki and IC50 were determined by double reciprocal plot, quadratic drawing, and drawing of inhibitor＇s concentration to inhibitory ratio, respectively. Results： Epibueropyridinium A significantly inhibited the activity of aldose reductase in a competitive manner, with IC50 being 4.2 μg/ml and Ki being 4.88μg/ml. Conclusion.. Epibueropyridinium A is competitive inhibitor of aldose reductase.

Abstract:1病例资料患者女性，27岁，江苏人。因“便血12d，加重3d”急诊收入院。患者于12d前无明显诱因出现大便呈暗红色血样，2～3次／d，总量约为500-800g，排便时伴下腹部不适，到当地医院给予对症治疗（具体不详），无明显好转，3d前上述情况加重，大便中含有暗红色血凝块，伴头晕、乏力，无呕吐，无发热、腹痛，黄疸。急诊行胃镜示浅表性胃炎，未见出血灶。肠镜未见明显异常。急诊行肠系膜上、下动脉造影检查仍未见明显异常。为进一步治疗转入我科。入院查体：重度贫血貌，皮肤巩膜未见黄染，全身未触及肿大的淋巴结，双肺未见异常，心率100次／min，未闻及病理性杂音，腹软，无明显压痛及反跳痛，无腹块，腹水征阴性，肠鸣音活跃。查血色素79g／L，予禁食、补液、输血、止血、抗感染等积极治疗，但患者病情仍不断加重，每天便血总量仍在1000ml以上，7月20日到外院行小肠镜检查，发现回肠内多个节段性浅表溃疡形成，大小不规则，部分呈纵行，溃疡周边有较明显的充血水肿和肉芽组织增生改变，诊断为回肠克罗恩病。取活检病理提示符合克罗恩病。经给予输液、输血，激素加5-氨基水杨酸治疗后，大便出血停止，病情稳定出院。既往有“痔疮”病史，2个月前有“肛瘘切除术”病史。[第一段]

Abstract:Objective： To investigate whether there is pharmacokinetic interaction between amlodipine and irbesarta when they are administered together into beagle dogs. Methods： Six healthy adult beagle dogs were evenly divided into 3 groups according to a self-controlled randomized 2-way crossover design. Animals in 3 groups were given a single oral dose of 5 mg amlodipine powder, 250 mg irbesartan powder and compound powder of amlodipine and irbesartan （containing 5 mg amlodipine and 250 mg irbesartan）, respectively. The concentrations of amlodipine and irbesartan in beagle dog plasma were determined at specified time points by HPLC-ESI-MS/MS and HPLC-Fluorescence method, respectively; the pharmacokinetic parameters were calculated subsequently. Results： Cm,xand AUC0-∞ of amlodipine were （267.63±38.49） ng/ml and （5 648.71±871.68） ng · h/ml when administered alone and were （267.43±37.97） ng/ml and （5 751.60±924.49） ng · h/ml when combined with irbesartan,respectively. Cmaxand AUC0-∞ of irbesartan were （2 623.56±198.65） ng/ml and （10 327.53±1 522.58） ng · h/ml when administered alone and were （2 345.61±42.32） ng/ml and （10 217.12±1 239.13） ng · h/ml when combined with amlodipine,respectively. There was no significant difference in cmax and AUC of the 2 drugs when they were used alone or jointly. Conclusion： There is no obvious pharmacokinetic interaction between amlodipine and irbesarta when they are administered jointly into beagle dogs.

Abstract:Objective：To analyze the cause of HBeAg （one of HBV markers） false-negative reaction during ELISA examination and to discuss its countermeasures. Methods： The patients who were HBsAg （＋） , HBcAb （＋） and HBeAg （-） by ELISA examination were further detected with the reagents of 4 different manufacturers in 2 steps： （1） The serum samples positive of HBsAg and HBcAb by ELISA using reagent A were further detected by qualitative analysis and Double-antibody sandwich ELISA using reagent A , B and C. （2） Reagent D （chemiluminescence method） was used to confirm the diagnosis if the results were positive or weakly positive of HBeAg, or the D values were within a specific range by ELISA using reagent A, B or C. The result of reagent D was taken as the final result. Results： The 274 sera negative of HBeAg were still negative when using reagent A, with the false-negative rate being 2.18%; 5 sera were positive when using reagent B, with false-negative rate being 0.36% ; and 6 sera （including the 5 positive ones using reagent B and 1 negative case using reagent A and B） were positive when using reagent C, without false-negative case. All the 6 positive samples were confirmed by chemiluminescence using reagent D. Conclusion： It is suggested that ELISA examination using reagent A or B can lead to false-negative results of HBeAg. HBsAg （＋）, HBcAb （＋） and HBeAg （-） sera in ELISA examination should be examined with combinations of reagents of different manufacturers.

Abstract:Objeetive：To discuss the clinical outcomes of portal vein stenting combined with transeatheter hepatic arterial ehemoembolization （TACE） in treating portal vein tumor thrombus in the patients with primary hepatic carcinoma （PHC）. Methods： Eleven PHC patients with tumor thrombus in the main branch or trunk of the portal vein were treated with stenting and TACE simultaneously （or TACE were performed 1 week later）. The successful rate of the procedure, the pateney of the obstruction, the complications, the mortality and the survival periods were all recorded. Results： Portal vein puncture was sueeessfully performed in all 11 eases and successful stenting was achieved in 10 eases. Hepatic eneephalopathy combined with hepatic failure was noticed in 1 patient. The median pateney period after stenting was 5.7 （1-18） months. The survival rates of patients at 3, 6 and 12 months after treatment were 5/ 11,4/ 11 and 2/ 11, respectively. Conelusion： Metallic stent implantation combined with TACE has satisfactory outcome in treating tumor thrombus in the main branch and trunk of the portal vein in PHC patients without distant metastases.

Abstract:More than 100 countries have added hepatitis B vaccination to their routine immunization programmes. Hepatitis B vaccines progressed from blood vaccines to recombinant vaccines, then to peptide vaccines and DNA vaccines, to their functions extended from prophylactic to therapeutic. This article analyzes the relationship between hepatitis B vaccine R＆D and the immunization programmes in different countries, to summarizes the R＆D of both prophylactic and therapeutic vaccines,and points out the direction for futare vaccine development.

Abstract:Oxidative stress is a major contributor to the pathogenesis of diabetes and diabetic complications. Heme oxygenase （HO）, an important part of the human defense system, has been recognized to have significant physiological function against oxidative stress. HO can be stimulated by oxidative stress and decompose into carbon monoxide, biliverdin and iron,all with important anti-inflammatory, anti-oxidative stress and anti-apoptosis effects. Overexpression of HO induced by hyperglycemia can protect cells （including islet cells, endothelial cells and monocytes） and tissues from oxidative damage. Increased HO metabolic products not only maintain the physiological function of islet cells, delay diabetes progression, but also regulate vascular, nerve and muscle function,so as to prevent diabetic complications.

Abstract:Objective：To prepare a monoclonal antibody against human angiopoietin-related protein 2（ARP2）. Methods： Human spleen ARP2 gene was obtained by RT-PCR. A pET32a-ARP2 plasmid was constructed and was incorporated into E. coli. The products were purified and were used to immunize 6-week-old BALB/c female mice. Hybridoma secreting antiARP2 monoclonal antibody was obtained by standard procedure. Mass production was carried out after specificity identification with Western blotting. Results： The fusion protein obtained by pET32a system had a relative molecular weight of about 570 000, which was in accordance with the theoretical value. The purity of the protein was more than 90% after purification. The antibody titer was 1 ： 104 in the hybridoma culture supernatant and 1 ： 107-10s in the ascites. The IgG2a type antibody had a relative molecular weight of about 570 000 by Western blot analysis. Immunohistochemistry method showed that the antibody bond with human ARP2. Conclusion： The prepared anti-human ARP2 monoclonal antibody in this study can be used for identification of ARP2 protein.

Abstract:Objective：To establish a rat hyperparathyroidism model secondary to chronic renal failure, so as to lay a foundation for studying the mechanism and treatment of secondary hyperparathyroidism. Methods： Thiry-six male Sprague-Dawley rats, weighing 200-250 g, were randomly divided into 6 groups： 5/6 nephrectomy plus high phosphorus food group （STNx ＋ HP）, 5/6 nephrectomy plus low phosphorus food group （STNx ＋ LP）, 5/6 nephrectomy plus normal phosphorus food group （STNx ＋ NP）, sham operation plus high phosphorus food group（Sham ＋ HP）, sham operation plus low phosphorus food group（Sham ＋ LP）, and sham operation plus normal phosphorus food group（Sham ＋ NP）. Nephrectomy was performed in 2 steps. Serum phosphorus levels （P） and iPTH levels were detected at day 7 pre-operation and day 7, 14, and 21 after the second operation. The kidneys, thyroid glands and parathyroid glands complex underwent pathological analysis 4 weeks after operation. Results： Five patients survived in STNx＋NP group, 4 in STNx＋LP group and 4 in STNx＋HP group postoperatively. No death occurred in sham operated groups. Serum phosphorus levels of nephrectomy groups at different time points after operation were higher than those before operation and those of sham operation groups （P〈 0. 05）. Serum phosphorus level of STNx＋HP group was obviously higher than those before operation and Sham ＋ HP group（P〈0.05）; those of STNx＋NP and STNx＋LP were similar to those of Sham ＋ NP and Sham ＋ LP group, respectively; but were both lower than that of STNx＋HP group（P〈0.05）. Pathological analysis demonstrated renal glomerulus putty denaturalization and sclerosis. Histological examination of parathyroid glands revealed gland hypertrophy, mostly adelomorphous cells and acidophilia cells, in STNx＋ NP group 28 d after operation. Conclusion： Nephrectomy plus high phosphorus foods can be used to establish hyperparathyroidism model secondary to chronic renal failure in rats, with low cost, simple operation, short experiment cycle and low animal mortality.

Abstract:Objective：To establish a method for determining the contents of Stellettin B and Stellettin D in total isomalabaricanes in different batches of Stelletta tenuis Lindgren. Methods： A high pressure liquid chromatography （HPLC） method was applied. The column YMC Pack-SIL （250 mm×4.6 mm, 5 μm） was used at room temperature, and the mobile phase was nhexane ： ethyl acetate （75 ： 25） with a flow rate at 1.0 ml · min^-1 for 30 min. UV detector wave length was at 360 nm. Resuits： The regression equation were：Y=52 181 633 X＋957 495（r=0. 996 9）for Stellettin B and Y=62 636 828 X-451 022 （r=0. 998 0） for Stellettin D,with the linear range being 2.4-30μg and 2.0-32μg, correspondingly. The RSD values for accuracy test, stability test and repeatability test were 3.07%-4.76%. The average contents of Stellettin B and Stellettin D in total isomalabaricanes in different batches of Stelletta tenuis Lindgren were 59. 93% and 30. 98%, respectively. Conclusion： This HPLC method provides a fast, accurate and effective way to determine the active contents in total isomalabaricanes from Stelletta tenuis Lindgren.

Abstract:1临床资料患者，男，32岁。因上腹及左腰部疼痛3个月余于2005年3月22日入我院，入院时患者上腹及左腰部疼痛，夜间加甚，平卧加重，坐起缓解。体检；T：36．6℃，P84次／min，R20次／min，血压120／85mmHg（1mmHg=0．133kPa），浅表淋巴结未及肿大，两肺呼吸音清，P84次／min，律齐，未闻及病理性杂音，腹隆起，右上腹可见一斜行的长约15cm手术瘢痕，中上腹可触及-约5cm大小的包块，质地硬，边界不清，肝脾肋下未及，无压痛及反跳痛，双下肢不肿。超声胃镜示胰头囊腺瘤（恶性可能性大），浅表性胃炎。CT示胰头区偏右上方不均匀囊性病灶，胰头囊腺癌可能，伴腹膜后淋巴结转移。曾剖腹探查示：于后腹膜淋巴结转移性腺癌（1／1），消化道造影未见下消化道病变。经肿瘤科会诊后诊为胰头囊腺癌，予以放疗。放疗开始后出现恶心呕吐等反应。为减轻化放疗的不良反应，于放疗第5天在放疗前静滴阿米福汀（大连美罗大药厂生产，批号：20050201）400mg匀速静滴；约数分钟后患者自觉上腹部不适，P75次／min，[第一段]

Abstract:Objective：To improve the pretreatment method described in ChP （2005 Edition, Vol I ） for the determination of sarsasapogenin in Rhizoma Anemarrhenae. Methods： According to orthogonal design L9 （33）, the extraction time, alcohol concentration, extraction frequency,etc, were modified to achieve the best extraction outcome with ultrasonic wave extraction. Results： The optimal extraction condition included 70%0 alcohol and twice ultrasonic wave extraction,20 min each time. Finally hydrolization was applied to obtain sarsasapogenin for determination. Conclusion： Compared with the pretreatment method in ChP, this improved extraction method shows a higher sarsasapogenin content in determination and is more accurate in reflecting the true content of sarsasapogenin in Rhizoma Anemarrhene

Abstract:目的:定量检测大鼠肝细胞癌发生发展过程中转化生长因子(TGF)-β1/2及其受体TβRⅠ/ⅡmRNA的表达水平.方法:成年SD雄性大鼠随机分为实验组和对照组,实验组利用二乙基亚硝胺诱导建立大鼠肝细胞癌模型,分别于第1～18周分批处死动物(肝癌组3只,对照组1只).取肝组织标本作组织切片和病理检查;抽提肝组织RNA并逆转录,实时荧光定量PCR技术分析TGF-β1/2、TβRⅠ/Ⅱ mRNA表达水平,以β-actin为内参照.结果:相对于β-actin,正常大鼠肝脏TGF-β1和TGF-β2的mRNA含量分别为0.007 6±0.002 8和0.001 6±0.001 1;TβRⅠ和TβRⅡ分别为0.003 4±0.001 4和0.061 2±0.043 3.在大鼠肝癌发生发展过程中TGF-β1和TGF-β2的表达逐渐升高,TβRⅠ和TβRⅡ基因的表达则逐渐下降.结论:肝癌细胞中TGF-β1和TGF-β2及TβRⅠ和TβRⅡ基因表达水平的变化可能使TGF-β对肝癌细胞的抑制作用减弱,TGF-β及其受体介导的信号转导通路在肝癌发生发展过程具有重要作用.

Abstract:目的:对白念珠菌菌相转换基因HYR1上游N乙酰葡萄糖胺激活序列进行初步定位,探讨菌相转换可能的调控机制.方法:DNAssist 2.0软件分析HYR1基因上游1 800 bp内可能的N-乙酰葡萄糖胺激活序列片段,选择-1 800～+43bp、-1 400～+43 bp、-1 000～+43 bp、-600～+43 bp、-400～+43 bp、-200～+43 bp这些区域作为分析目标,PCR扩增这些片段,将其分别克隆至含β-半乳糖苷酶(LacZ)报告基因的载体PNG17中构建质粒重组体,分别命名pHYR1.8、pHYR1.4、pHYR1.0、pHYR 0.6、pHYR0.4、pHYR0.2,测序确认后转化酵母菌EGY48,培养含有不同重组体的酵母转化子,将不同的酵母转化子接种于含有N乙酰葡萄糖胺和β-半乳糖苷(X-gal)的培养基上,在不同条件下观察培养基的颜色变化.结果:成功构建6种重组体pHYR1.8、pHYR1.4、pHYR1.0、pHYR 0.6、pHYR0.4、pHYR0.2,经测序,插入片段与预期序列完全一致.酵母菌转化子生长良好,在N-乙酰葡萄糖胺作用下,含pHYR1.8和pHYR1.4的转化子使培养基成蓝色,含其他重组体pHYR1.0、pHYR 0.6、pHYR0.4、pHYR0.2的转化子不使培养基显色.结论:N-乙酰葡萄糖胺可能通过HYR1上游-1 400～-1 000 bp区域内的启动元件激活HYR1基因诱导白念珠菌菌相转换.

Abstract:目的:研究酮康唑微囊在兔体内的药动学特征.方法:以复凝聚法制备酮康唑微囊,采用紫外分光光度法直接测定微囊中酮康唑含量.采用HPLC法测定兔血浆中酮康唑浓度,其条件为:以乙腈直接沉淀血浆蛋白,色谱柱为配有Waters保护柱的sunfire C18(150 mm×4.6 mm,5 μm)色谱柱;流动相为甲醇:磷酸盐缓冲液(80:20),流速1.0 ml·min-1;检测波长235 nm;进样20μl;柱温(35±1)℃;外标法峰面积定量.结果:血浆中酮康唑浓度分别在20～400 ng·ml-1和400～4 000ng·ml-1范围内,浓度与峰面积之间有良好的线性关系,线性相关系数r2分别为0.998 4和0.999 7;口服酮康唑微囊后,24 h内血浆中酮康唑浓度平稳,酮康唑微囊的药动学特征符合一室模型,主要药动学参数分别为:t1/2(4.62±0.05)h;tmax(2.0±1.03)h;cmax(2 154.52±43.07)ng·ml-1;Ke(0.15±0)h-1;AUC0～∞(16 075.38±98.50)ng·h·ml-1.结论:酮康唑微囊化后,较之普通片及其原料药血药浓度更高,作用时间更长,生物利用度有显著提高.

Abstract:目的:分析长海医院14年全院住院糖尿病患者的死因及特点.方法:根据1991～2004年长海医院住院死亡糖尿病患者的资料进行纵向分析、死亡构成特点分析.结果:1991～2004年长海医院糖尿病患者死亡220例,占总死亡例数的4.73﹪;主要死因依次为肿瘤27.27﹪、心血管疾病17.3﹪和脑血管疾病9.1﹪.其中代谢综合征(MS)患者和非MS患者年龄无统计学差异,但前者病程显著长于后者(P＜0.01).结论:长海医院14年住院死亡患者糖尿病患病率显著低于上海市平均水平,糖尿病患者应早期、定时筛查防治肿瘤及MS.

Abstract:目的:总结4例中枢神经系统血管炎(CNSV)的临床诊断经验,提高CNSV的诊断率.方法:分析4例CNSV患者的临床表现、血清学以及影像学改变.结果:4例患者起病形式无1例相同;影像学显示多发病灶和复发病灶;血清学显示红细胞沉降率增快3例,抗核抗体阳性2例,cANCA阳性1例.结论:CNSV临床表现多样,诊断主要依据血清学、影像学和活组织检查,结合其他脏器病变可以提高CNSV诊断的阳性率.

Abstract:目的:评价磁性可切削生物活性徽晶玻璃(magnetic machinable bioactive glass-ceramic,MMBC)人工骨的细胞相容性.方法:将骨髓基质干细胞(bone marrow stromal cell,BMSC)分别和生物玻璃(BG)、MMBC在体外进行培养,在电镜下观察细胞的生长情况,从而评价MMBC的细胞相容性.结果:细胞培养10 d后,在MMBC的孔隙内或表面,有大量的胶原纤维丝相连,部分胶原纤维丝跨越孔隙.孔隙内可见多量细胞生长,而BG内并未见有明显的胶原纤维.结论:MMBC人工骨具有良好的细胞相容性.

Abstract:目的:评价钬激光碎石术(LL)治疗输尿管上段嵌顿结石的疗效.方法:输尿管上段结石患者58例,结石最小0.7cm×1.0 cm,最大1.8 cm× 2.5 cm.应用多尼尔钬激光机经输尿管镜治疗.结果:49例输尿管上段结石原位单次碎石成功,5例结石部分被冲入肾盂(有3例继续在肾盂内行钬激光碎石获成功);单次LL成功率为87.9﹪(51/58).2例发生输尿管穿孔改行开放手术,3例合并明显的输尿管狭窄经改行开放手术后治疗成功.术后结石排净时间平均3.2周,术后无明显血尿、梗阻性脓肾等并发症发生.结论:LL可作为处理输尿管上段嵌顿结石的首选方法.

Abstract:目的:比较舒芬太尼或芬太尼联合左旋布比卡因用于孕妇分娩硬膜外麻醉的镇痛效果.方法:选择100例初产妇,均为单胎头位,随机分为舒芬太尼与芬太尼组,分别与左旋布比卡因联合应用于孕妇分娩硬膜外麻醉进行镇痛.观察两药的镇痛效果、运动阻滞程度,以及胎窘、皮肤瘙痒、恶心呕吐等不良反应的发生率.结果:舒芬太尼组与芬太尼组VAS评分、剖宫产率、产钳助产率、胎窘发生率两组间均无显著差异(P＞0.05).舒芬太尼组产后和产后2 h的运动阻滞程度明显低于芬太尼组(P＜0.05),产后24 h两组无明显差异(P＞0.05).舒芬太尼组瘙痒发生率显著低于芬太尼组(P＜0.05),而恶心呕吐、头晕、尿潴留、低血压发生率两组间均无显著差异(P＞0.05).结论:舒芬太尼与芬太尼均能提供良好的镇痛效果,与芬太尼相比,舒芬太尼更适用于分娩镇痛.

Abstract:目的:观察瑞芬太尼复合丙泊酚持续泵注用于颅内动脉瘤GDC栓塞术的安全性和可行性.方法:75例择期行颅内动脉瘤GDC栓塞术的患者,随机分为3组,每组各25例,分别行单纯丙泊酚、芬太尼复合丙泊酚、瑞芬太尼复合丙泊酚持续泵注维持麻醉.监测麻醉过程中的BP、HR、ECG、SPO2和PETCO2变化、苏醒参数及术后并发症.结果:3组在置入喉罩和拔出喉罩时血压、心率的变化,单纯丙泊酚组＞芬太尼复合丙泊酚组＞瑞芬太尼复合丙泊酚组(P＜0.05);3组的各项苏醒参数包括睁眼时间、自主呼吸恢复时间、拔管时间及定向力恢复时间,单纯丙泊酚组＞芬太尼复合丙泊酚组＞瑞芬太尼复合丙泊酚组(P＜0.05).结论:与芬太尼相比,瑞芬太尼复合丙泊酚持续泵注用于颅内动脉瘤GDC栓塞术的麻醉,血流动力学更稳定,术后苏醒更快、更平稳.

Abstract:中央型肝癌是指紧邻第一、二、三肝门的肿瘤（不包括尾状叶），亦即靠近主要的门静脉、胆管、肝静脉和肝后段下腔静脉。由于此处的肿瘤位置特殊，手术切除难度大、风险高。我科于1999年1月至2004年6月对46例中央型肝癌实施了手术切除，获得了满意的疗效。[第一段]

Abstract:系统性红斑狼疮（systemic lupus erythematosus，SLE）是以T淋巴细胞免疫调节紊乱，B淋巴细胞功能亢进，机体产生大量自身抗体而导致组织器官损伤为特征的自身免疫病。其中，T淋巴细胞免疫调节紊乱是致病的始动环节和关键。导致T淋巴细胞数量及其功能变化的因素非常复杂，本研究检测不同病期SLE以及狼疮性肾炎（lupus nephritis，LN）患者外周血T淋巴细胞亚群的数量，旨在探讨其与疾病活动性的关系。[第一段]

Abstract:1998年1月至2004年12月本院住院检查发现61例前列腺癌（PCa）骨转移患者。其中2例总前列腺特异性抗原（tPSA）均在正常参考值（O～4ng／ml）以内。术前被误诊为良性前列腺增生症（BPH）。术后ECT骨扫描证实有骨转移发生。现将这2例患者的诊治经过报告如下。[第一段]