癌症是否以扼杀个体的方式保全物种？

通过对胚系突变内源性的分析，探讨了癌症对于维持胚系突变基线比率的负选择调节作用。认为早发性癌症因避免高胚系突变的长期积累而保护了人类。     

妊娠合并阑尾炎误诊2例

病例1 女，26岁，孕2产0，因停经14周下腹痛伴恶心、呕吐1d。1d前无明显诱因出现脐周痛，后固定于右下腹，并伴有恶心及呕吐，但无尿频、尿急及尿痛，无里急后重，无其它不适。就诊于社区服务站，B超显示：胎儿发育良好，诊断为“妊娠呕吐，先兆流产”，给予静脉滴注生理盐水1000ml，葡萄糖盐液1000ml，     

癌症是否以扼杀个体的方式保全物种？

通过对胚系突变内源性的分析。探讨了癌症对于维持胚系突变基线比率的负选择调节作用。认为早发性癌症因避免高胚系突变的长期积累而保护了人类。     

药物不良反应(二)

9.胃复安引起锥体外系反应5例(浙医一院神经科张佩利)胃复安又名“灭吐灵”,一般认为该药毒性低,对其所致的锥体外系反应常认识不足,造成误诊的屡见不鲜。侧1:姚××,女,19岁。因上腹饱胀,服胃复安2次(20mg)后,觉右下肢僵硬,步履困难。某医院诊断“伤筋”治疗无好转。继之出现不自主的头向后仰,颈部强直,两眼阵阵上翻,意识清楚。检查:面容呆板,头向后仰,两眼上视,斜方肌及颈后肌肉紧张,四肢张力稍增高。给肌     

高职护生课堂教学中教师情绪调控的意义及策略初探

分析高职护生的特点,阐述高职护生课堂教学中教师情绪调控的意义,探讨调控教师情绪的相应策略。     

常德市社区工作人员院外救护能力现状调查报告

目的:通过了解社区工作人员院外救护能力现状,探讨普及院外救护培训的有效方法。方法:采用问卷调查法对常德市4个社区的社区工作人员进行随机问卷调查。结果:社区工作人员院外救护能力欠佳;被试者均认为掌握院外救护知识和技能非常重要;进行院外救护培训会影响社区工作人员在发生紧急情况时所做的判断和行为选择。结论:社区工作人员院外救护能力需进一步提高,可通过普及公众急救知识和技能、配备院外救护员、建立完善培训体系和复训制度来实现。     

多潘立酮对大鼠胃黏膜保护机制的探讨及其剂量依赖关系研究

目的:探讨多潘立酮对大鼠胃黏膜保护中的作用及其是否存在剂量依赖关系。方法:24只健康大鼠随机分为空白对照组、多潘立酮低剂量实验组、多潘立酮高剂量实验组,每组各8只。空白对照组予生理盐水1.5 ml灌胃,多潘立酮低剂量实验组、多潘立酮高剂量实验组分别给予0.5 mg/kg、1 mg/kg多潘立酮溶于生理盐水1.5 ml灌胃,每日3次,连续3 d。使用放射免疫法测定3组胃黏膜前列腺素E2(PGE2)水平,免疫组织化学染色检测环氧酶-1和环氧酶-2蛋白表达水平,逆转录PCR法检测环氧酶-1和环氧酶-2 mRNA表达水平,并进行组间比较。结果:空白对照组、低剂量多潘立酮实验组、高剂量多潘立酮实验组大鼠胃黏膜组织的PGE2含量分别为(61±36)μg/L、(158±39)μg/L、(237±80)μg/L;环氧酶-1蛋白表达水平分别为0.209±0.034、0.226±0.041、0.242±0.036;环氧酶-1 mRNA表达水平分别为0.56±0.03、0.98±0.08、1.54±0.08。两实验组大鼠胃黏膜组织PGE2含量、环氧酶-1蛋白及mRNA表达水平均明显高于对照组(P均<0.01),其中高剂量多潘立酮实验组大鼠胃黏膜PGE2含量、环氧酶-1蛋白及mRNA表达水平均明显高于低剂量多潘立酮实验组(P均<0.01)。3组的胃黏膜组织均无环氧酶-2蛋白及mRNA表达。结论:多潘立酮对胃黏膜组织具有保护作用,可能与其增加胃黏膜环氧酶-1基因和蛋白表达水平及促进胃黏膜PGE2分泌有关,而且该保护作用可能存在一定剂量依赖关系。     

肾混合性上皮间质肿瘤和成人囊性肾瘤的临床病理学观察

Objective To study the clinicopathologie features,immunophenotype and differential diagnosis of mixed epithelial and stromal tumor of kidney ( MEST) and adult cystic nephroma ( CN).Methods Five cases of MEST and 4 cases of CN were retrospectively analyzed.Immunohistochemical study was carried out and the literature was reviewed.Results All of the five patients with MEST were females.Their median age was 45 years.For CN,there were 3 males and 1 female and their median age was 41 years.All patients presented with loin pain and hematuria.On gross examination,MEST was well-circumscribed but non-encapsulated.There was no evidence of haemorrhage or necrosis.Three of the cases were solid in nature.One was composed of a mixture of solid and cystic elements,while the remaining case showed a multicystic cut surface bridged by thick fibrous septa.On the other hand,CN were well-circumscribed and encapsulated.They were multiloculated cystic in nature.The cystic spaces were separated by thin septa and there was no significant solid or necrotic component.Histologically,MEST consisted of proliferation of cystically dilated glands admixed with spindly stromal cells with various cellularity and growth patterns.Both the glandular and stromal elements were well-differentiated with no cytologic atypia identified.The glandular structures in 2 of the cases were partially lined by endometrial or tubal epithelium.In contrast,the thin-walled cystic spaces in CN were lined by a single layer of epithelium.Immunohistochemical　study showed that the epithelial cells were positive for pan-cytokeratin and epithelial membrane antigen.The spindle cells in MEST expressed vimentin (5/5 ) ,smooth muscle actin (3/5 ),desmin (4/5 ),CD10 (5/5),estrogen receptor (4/5) and progesterone receptor (4/5).They were negative for HMB45,CD34,CD117 and S-100 protein.On the other hand,the spindle cells in CN were variably positive for vimentin (4/4),smooth muscle actin (4/4),desmin (1/4),estrogen receptor (3/4) and progesterone receptor (1/4).They were negative for CD10,HMB45,CD34,CD117 and S-100 protein.Conclusions Both MEST and CN are uncommon renal neoplasm.Most of them run a benign clinical course.The stromal cells in MEST show smooth muscle or myofibroblastic differentiation.Areas demonstrating Miillerian features also existed in some cases.MEST and CN share overlapping histological and immunohistochemical features,and may represent spectrum of the same group of lesions.     

美洛西林/舒巴坦致白细胞减少伴低血钾1例分析与药学监护

摘 要 目的：对1例患者静滴美洛西林/舒巴坦致白细胞减少伴低血钾的病例进行分析,为临床安全用药提供参考。方法: 临床药师追查用药史,分析该不良反应发生的原因,并给出处理意见。结果: 该患者发生白细胞减少伴低血钾是由美洛西林/舒巴坦引起,对症处理后白细胞和血钾均恢复正常。结论:临床药师需关注患者用药后的异常检查结果,保证患者用药安全。