血清抗脑抗体在小儿颅内感染性疾病中诊断价值的研究

目的　观察小儿颅内感染时血清抗脑抗体 (ABAb)的变化 ,探讨其在诊断中的价值。方法　选取 2 0 0 2年 2月至 2 0 0 3年 9月济南市儿童医院收治的 98例颅内感染患儿 ,分为病毒性脑炎 (病脑 )组 5 0例 ,化脓性脑膜炎 (化脑 )组 37例 ,结核性脑膜炎 (结脑 )组 11例。并选取 2 0例对照组患儿 ,进行血清ABAb检测 ,并与血清降钙素原(PCT)、肿瘤坏死因子 α(TNF α)、白介素 6 (IL 6 )进行对比分析。结果　血清ABAb在病脑组、化脑组、结脑组阳性率分别为 78 0 0 %、5 1 35 %、4 5 4 5 % ,与对照组比较 ,差异均有显著性 (P <0 0 5 ) ;病脑组与化脑组、结脑组比较差异亦有显著性 ( P <0 0 5 )。血清ABAb与血清PCT、TNF α、IL 6呈中度正相关 ;血清PCT、TNF α、IL 6之间呈高度正相关 ,均在化脑时升高明显 ,与其他组比较差异有显著性 (P <0 0 5 )。经多元判别分析 ,诊断病脑或化脑 ,误判率 8 0 4 % ,判别符合率 91 96 %。结论　在小儿颅内感染时 ,血清ABAb可呈阳性 ,病脑阳性率最高 ,结合血清PCT、TNF α、IL 6检查 ,可协助小儿颅内感染的诊断与鉴别诊断     

恒河猴细菌感染性子宫出血模型内膜组织NF-kB活性及TNF-α、IL-1mRNA表达的实验研究

目的:探讨核因子κB(NF-κB)及肿瘤坏死因子-α(TNF-α)、白细胞介素-1(IL-1)在恒河猴细菌感染性子宫出血模型中的变化。方法:选择月经正常的雌性育龄恒河猴7只,随机分为模型组4只和正常对照组3只,通过官腔细菌接种制作细菌感染性子宫出血模型。用电泳迁移率改变分析法(EMSA)检测模型组及正常对照组恒河猴子宫内膜组织NF-κB与靶基因DNA的结合活性,用反转录-多聚酶链式反应(RT-PCR)法检测两组恒河猴子宫内膜组织TNF-α、IL-1mRNA的表达。结果:模型组NF-κB活性及TNF-α、IL-1mRNA的表达量均明显高于正常对照组,差异有显著性意义(P<0.01)。结论:NF-κB活化及TNF-α、IL-1mRNA的高度表达可能参与了恒河猴细菌感染性子宫出血发病机制。     

Recombinant human complement C5a receptor antagonist reduces infarct size after surgical revascularization

OBJECTIVES: This study tested the hypothesis that a recombinant human C5a antagonist, CGS 32359, attenuates neutrophil activation and reduces infarct size in a porcine model of surgical revascularization. METHODS: CGS 32359 (0.16-16 micromol/L) dose-dependently inhibited superoxide production by human C5a-activated porcine neutrophils (18 +/- 3.7 vs 1.6 +/- 0.5 nmol/5 min/5 x 10(6) neutrophils; P <.05) and reduced neutrophil adherence to coronary endothelium from 194 +/- 9 to 43 +/- 6 neutrophils/mm(2) (P <.05). The left anterior descending coronary artery was occluded for 50 minutes, after which saline solution (n = 8), mannitol-buffer vehicle (n = 9, 102 mg/kg bolus, 102 mg. kg(-1). h(-1)), or CGS 32359 (CGS, n = 7, 60 mg/kg bolus, 60 mg. kg(-1). h(-1)) was infused. After ischemia, 1-hour arrest was achieved by means of multidose hypothermic (4 degrees C) blood cardioplegia, followed by 2.5 hours of off-bypass reperfusion. The ligature on the left anterior descending artery was released before the second infusion of cardioplegic solution. RESULTS: Area at risk was similar in all groups (saline solution, 27% +/- 2%; mannitol-buffer vehicle, 26% +/- 2%; CGS, 26% +/- 2% left ventricular mass). Infarct size (area necrosis/area at risk) was significantly reduced by CGS (18% +/- 6%, P <.05) versus saline solution (52% +/- 3%) and mannitol-buffer vehicle (60% +/- 4%). Postischemic systolic shortening (sonomicrometry) in the area at risk was significantly improved with CGS (0.8% +/- 0.9%) compared with saline solution (-3.7% +/- 1.1%) and mannitol-buffer vehicle (-6.4% +/- 1.0%). Myeloperoxidase activity from accumulated neutrophils was less in the ischemic zone of CGS (0.014 +/- 0.002 U/100 mg tissue; P <.05) than mannitol-buffer vehicle (0.133 +/- 0.012 U/100 mg tissue). CONCLUSIONS: We conclude that the recombinant human C5a receptor antagonist CGS 32359 inhibits surgical ischemia-reperfusion injury after coronary occlusion.     

韩国医疗服务支付方式改革对我国的启示

随着我国城镇职工基本医疗保险制度改革的深入，支付方式的改革越来越显得重要。我国与韩国一样，在社会医疗保险初期，支付方式都是按服务项目付费、这种支付方式导致服务数量的增加、治疗方案的扭曲，医生更愿意提供收益好的服务。为了寻求解决办法，韩国在1997年尝试实施按诊断相关分组(DRG)的支付方式。通过对韩国支付方式改革的回顾，为我国城镇职工基本医疗保险支付方式的改革提供借鉴。     

Contemporary trends in surgery of adrenal glands

There have been analysed the records of suprarenectomy in 459 patients with Conn' syndrome, syndrome of Icenko-Cushing as well as with androsteroma, pheochromocytoma and other tumors, who were operated in the clinic of abdominal surgery of S.P. Fedorov Russian Military Medical Academy. On the base of retrospective analysis the most actual aspects in surgery of the adrenal glands and the ways of the development of this branch of medicine have been determined. High effectiveness and perspectiveness of endovideosurgical removal of the adrenal glands is shown. Original and tested methods of choice of surgical approach, prophylaxis and treatment for some complications of suprarenectomy (adrenal insufficiency, Nelson' syndrome, etc.) are proposed. Substantiated policy in so-called hormono-inactive tumors of the adrenal glands is proposed.     

生物技术在军事领域的应用前景分析

生物技术是指人们以现代生命科学为基础,结合其他基础学科的科学原理,采用先进的工程技术手段,按照预先设计来改造生物体或加工生物原料,为人类生产出所需产品或达到某种目的。主要包括基因工程、细胞工程、酶工程、发酵工程和蛋白质工程以及克隆技术、纳米技术、基因芯片技术等新技术。这门技术具有鲜明的军、民两用性,随着生物技术在军事领域的深入发展和广泛应用,必将使得武器装备、军队指挥、作战方法、军事后勤等方面发生质的变化。     

铬、鱼油对肥胖模型大鼠瘦素和胰岛素的影响

目的铬、鱼油参与并调节糖、脂肪代谢,选择铬、鱼油作为影响因素,观察其对饮食诱导肥胖大鼠的影响。方法将肥胖模型大鼠按体重随机分为4组,每组8只。分别为肥胖组、鱼油组、鱼油+铬组和铬组,另设基础对照组。在实验的第0周和第6周空腹采尾血,测定血清瘦素和胰岛素水平。结果3个实验组的胰岛素和瘦素水平在第0周时,与肥胖组差异无显著性(P>0.05),第6周时,显著低于肥胖组(P<0.05)。结论结果提示铬、鱼油有缓解肥胖大鼠高胰岛素和高瘦素水平的作用。     

浅议医学重点学科的建设与管理

重点学科的建设管理是一项科学细致的工作，需要结合实际认真加以研究，才能取得好的效果，我们就医学重点学科的建设管理提出以下思路。     

藏药波棱瓜栽培技术的研究

目的：介绍波棱瓜的栽培采收加工方法。方法：通过生物学观察和田间试验，总结了波棱瓜种植技术和主要病虫害防治方法。结果：此种植方法、田间管理、病虫害防治、采收与加工方法等在青藏高原东部地区是可行的。结论：波棱瓜的种植技术和主要病虫害防治方法、采收方法可以在青藏高原东部地区推广，满足藏药生产对波棱瓜的原料需求，具有较明显的经济效益。     

中药治疗失眠概述

失眠，中医学称为不寐，轻者表现为入睡困难，睡则易醒，重者彻夜不得眠，足临床上的常见病、多发病，病程长，缠绵难愈，严重影响患者的：亡作和生活质量。中医药治疗失眠有其独到的见解，文献报道小少，现仅将近一年的文献摘其重点综述如下。