【目的】总结原发性甲状腺机能亢进症外科治疗的经验。【方法】对100例原发性甲亢病人的外科治疗进行回顾性临床分析。【结果】全部病例均接受双甲状腺次全切除术，术后1例出现呼吸困难需行气管切开，手术治愈率98%。随访4-54个月，平均24.6个月，2例出现甲亢复发，无1例发生甲低。【结论】外科手术是目前治疗原发性甲亢的较佳选择，而正确和充分的术前准备是手术成功的关键。

目的 利用基因芯片技术分析原发性下肢深静脉瓣膜功能不全（PDVI）所致大隐静脉曲张的基因表达谱和差异基因。方法 对10例PDvI所致的曲张大隐静脉和10例正常对照组织进行mRNA抽提，分别给予荧光素Cy5和Cy3标记以制备cDNA探针，并与含有1220个人类全长互补DNA的基因芯片进行杂交和分析。结果 在PVDI所致的曲张大隐静脉组织中共检测到21个差异基因，其中9个为上调基因，12个为下调基因。差异表达基因包括参与信号传导、细胞周期以及细胞生长、分化、代谢、增殖和凋亡的相关基因。结论 运用基因芯片技术筛选出的差异基因与PvDI所致大隐静脉曲张发病相关。

Tumor progression largely depends on blood supply and neovessel formation, and angiogenesis is emerging as a promising target for cancer therapy. Vascular endothelial growth factor (VEGF), a major proangiogenic molecule, stimulates angiogenesis via promoting endothelial proliferation, urvival and migration. VEGF has been found to be up-regulated in various types of tumors and to be associated with tumor progression and poor prognosis. Inhibition of VEGF or its signaling pathway has been shown to suppress tumor angiogenesis and tumor growth. In the present study, we tested the antiangiogenic and antitumor effects of soluble VEGF receptor-1 [soluble Flt (sFlt)-1] on the growth of follicular thyroid carcinoma (FTC). We constructed a 293 embryonic kidney cell line (293-Flt1-3d) that expresses sFlt-1, which is composed of the first three extracellular domains of Flt-1. The 293-Flt1-3d cells inhibited the in vitro growth of human umbilical vein endothelial cells in a paracrine manner. The in vivo antitumor and antiangiogenic activities of the 293-Flt1-3d cells were tested. When 293-Flt1-3d cells were inoculated at a site remote to the FTC-133 tumor transplant, the growth of FTC-133 tumors were inhibited by 70.37%, as compared with the control treatment with 293 cells expressing control gene LacZ. Immunohistochemical analysis of microvessel densities in treated tumors demonstrated that 293-Flt1-3d cells robustly suppressed intratumoral angiogenesis. Our data suggest that a mammalian cell-mediated approach could effectively deliver sFlt-1 gene therapy and inhibit tumor angiogenesis and tumor growth.

目的 探讨静止压力对血管平滑肌细胞增殖与凋亡的影响。方法 将胚胎鼠血管平滑肌细胞系A10细胞分别在正常大气压下、80、100、200mmHg等静止压力下培养；利用MTT法测定细胞成活率，流式细胞仪测试样品的细胞周期与凋亡率。结果 在较低压力下（100mmHg）A10细胞成活率增加，细胞增殖，处于G0/G1期的A10细胞百分比显著降低，增殖指数（PI）显著升高，凋亡率与正常无差异；在200mmHg的压力下成活率降低，G0/G1期A10细胞百分比显著升高，细胞增殖受抑制，凋亡率亦显著增加。结论 较低的压力可促进血管平滑肌细胞增殖，而过高的压力则可诱导细胞凋亡。

目的 总结一期或分期血管腔内治疗多撕裂口主动脉夹层的临床经验。方法 在DSA监控下，通过一侧或双侧股动脉入路将多枚带膜支架植入主髂动脉，一期或分期封闭这些部位的多个撕裂口。结果 从2001年1月至2004年6月，共有8例患者接受了一期或分期血管腔内治疗，其中5个撕裂口者1例，4个撕裂口者2例，3个撕裂口者2例，2个撕裂口者3例。降主动脉撕裂口11个，腹主动脉撕裂口11个，髂动脉撕裂口4个。一期血管腔内治疗6例，分期腔内治疗2例。共植入带膜支架23枚，其中直管型20枚，分叉型3枚。手术均获成功。术后3、6、12及24个月CT或MRA复查显示夹层均消失，假腔内血栓形成，无内漏发生，患者均健康生存。结论 血管腔内多枚带膜支架一期或分期植入治疗多撕裂口主动脉夹层是一种可行，安全和有效的方法。