城市综合医院适应社会主义市场经济的探讨

城市综合医院适应社会主义市场经济的探讨黄光英我国正处在计划经济向社会主义市场经济体制的转轨中，医疗保障制度、医院运行机制、医院内部管理及分配机制均要进行相应改革。彭佩云在今年的全国卫生厅局长会议上指出：“在改革中要坚持为人民服务的宗旨，坚持社会效益第...     

ERK—CREB通路在针刺缓解内脏痛中的作用及Cx43基因敲除对其的影响

目的探讨细胞外信号调节激酶（extracellular signal-regulated kinase, ERK）-cAMP反应元件结合蛋白（cyclic AMP response element binding protein,CREB）通路在针刺缓解内脏痛中的作用及缝隙连接蛋白43（connexin43,Cx43）基因敲除对其的影响。方法选用野生型（wide type,WT）和Cx43基因敲除杂合子（heterozygous,HT）小鼠,随机分为6组：HT空白对照组、HT模型组、HT针刺组、WT空白对照组、WT模型组、WT针刺组,建立醋酸致炎性内脏痛模型,采用免疫印迹法（Western blot）观察脊髓背角磷酸化ERK（pERK）和磷酸化CREB（pCREB）的表达。结果HT和wT空白对照组小鼠脊髓背角pERK和pCREB很少表达,两组间差异无统计学意义（P〉0．05）。腹腔注射醋酸能诱导脊髓背角ERK和CREB的磷酸化,与对照组比较差异有统计学意义（P〈0．01）;HT和WT两组间比较差异无统计学意义（P〉0．05）。与模型组比较,WT针刺组小鼠脊髓背角pERK和pCREB表达水平明显降低,差异有统计学意义（P〈0．01）;HT针刺组小鼠pERK和pCREB表达水平虽然亦有下降趋势,但与模型组比较差异无统计学意义（P〉0．05）。HT和WT针刺组两组间差异有统计学意义（P〈0．05）。结论①外周伤害性刺激可以诱导ERK—CREB通路的激活;②针刺缓解炎性内脏痛的作用可能与抑制脊髓神经元ERK—CREB通路的激活有关;③敲除Cx43基因影响针刺镇痛作用的机制可能与ERK—CREB通路有关。提示Cx43及以Cx为结构基础的细胞缝隙连接通讯（gap junctional intercellular communication, GJIC）与针刺镇痛效应密切相关。     

MAPK级联通路与病理性疼痛的中枢敏感化

疼痛是一种与组织损伤或潜在损伤相关的不愉快的主观感觉和情绪体验。病理性疼痛包括炎症性疼痛和神经病理性疼痛,是神经元可塑性变化的表现形式之一。     

Psychological Factors Are Closely Associated with the Bell’s Palsy: A Case-control Study

To observe the differences in psychological status between Bell’s palsy (BP) patients and healthy subjects, and to examine the relationship between psychological factors and the severity of BP, we conducted a case-control, multi-center clinical investigation. A total of 695 subjects were as-signed to the case group (n=355) and the control group (n=340). House-Brackmann grading system and Facial Disability Index (FDI) were adopted to assess the BP patients; Kessler Psychological Dis-tress Scale (K10) and 16 Personality Factor (16PF) scale were employed to evaluate the psychologi-cal distress and personality profiles of all subjects. Two independent samples t test was used to com-pare the differences between cases and controls, and to compare the differences among different BP patients. Pearson correlation analysis was used to examine the relationship between psychological factors and severity of facial paralysis. The results showed that psychological distress (K10) in case group (27.09±5.80) was significantly higher than that in control group (13.43±3.02) (t=-37.219, P=0.000). The scores of personality factor Warmth (A), Openness to Change (Q1), Self-Reliance (Q2) were lower in cases than in the controls (P<0.01, P<0.05, P<0.05, respectively), whereas the scores of Sensitivity (I), Vigilance (L), Apprehension (O), and Tension (Q4) were significantly higher in cases than in the controls (P<0.05, P<0.01, P<0.01, P<0.01, respectively). In addition, the psy-chological distress was significantly higher in female patients, severe (HB score Ⅳ-Ⅵ) patients, and subacute (onset time 72-168 h) patients compared with that in male patients, mild (HB score Ⅰ-Ⅲ)patients, and acute (onset time≤72 h) patients (P<0.05). The scores of personality factor in fe-male patients, severe patients, and subacute patients were also significantly different from male pa-tients, mild patients, and acute patients (P<0.05). The result of Pearson correlation analysis showed that psychological factors (K10, personality A, F, L, N, O, Q4) were closely related to HB scores. We are led to conclude that the psychological status between BP patients and healthy people are different; psychological distress and personality factors are closely associated with severity of facial paralysis.     

对卵巢早衰的中西医认识

卵巢早衰（premature ovarian failure,POF）,是指妇女在40岁以前因某种原因出现持续性闭经,伴有卵泡刺激素（follicle stimulating hormone,FSH）升高,而雌激素（estrogen,E。）降低的综合征。POF患者多因闭经、不孕和低雌激素引起的症状就诊。POF的人群发生率约1％～3％,近年来发病率呈上升趋势。引起POF的病因很复杂,治疗上相当棘手,严重影响了POF患者的身心健康。为给广大临床工作者提供较为全面的信息,本文就有关POF的病因、诊断及治疗方面的中、西医认识综述如下。     

中药生力膏对小鼠免疫功能的影响

为探讨中药生力膏对小鼠免疫功能的影响,采用碳粒廓清实验、绵羊红细胞血素及血清免疫球蛋白含量测定等实验,观察不同剂量生力膏对小鼠细胞和体液免疫功能的影响。结果表明,与正常对照组比较,大、中剂量生力膏用药组可显著性提高吞噬指数、吞噬活性、ＨＣ５０及血清免疫球蛋白含量（Ｐ＜０．０１）;小剂量用药组则对以上指标无明显促进作用（Ｐ＞０．０５）。本研究提示中药生力膏可显著提高小鼠细胞和体液免疫功能,并且可能是其增强体力、修复运动性疲劳的作用机制之一。     

生力膏对小鼠运动能力的影响

观察了生力膏对小鼠运动能力的影响。实验结果表明,生力膏具有显著增强小鼠游泳耐力、肌肉静态用力和耐缺氧能力的作用,提高小鼠血红蛋白含量,减少运动小鼠血乳酸的积累,提高实验小鼠血浆睾酮水平。提示生力膏具有增强运动能力和抗疲劳的功效。     

白细胞介素8和一氧化氮在家兔内毒素性急性肺损伤中的作用

目的和方法：采用间隔２４ｈ两次注射大肠杆菌内毒素（ＥＴ）的方法，复制家兔内毒素性急性肺损伤模型，探讨肺损伤的机理。结果：ＥＴ组血浆、肺组织匀浆及支气肺泡灌洗液（ＢＡＬＦ）中白细胞介素８（ＩＬ－８）、亚硝酸／硝酸根离子（ＮＯ２－／ＮＯ３－）水平显著增高（Ｐ＜００１），血浆补体Ｃ５ａ活性明显增高（Ｐ＜００１），ＢＡＬＦ内中性粒细胞明显增多，肺系数、肺水含量及通透指数升高。ＩＬ－８、ＮＯ２－／ＮＯ３－水平以及血清和ＢＡＬＦ中酸性磷酸酶活性变化高度相关。结论：ＩＬ－８、一氧化氮（ＮＯ）参与内毒素性急性肺损伤，而ＩＬ－８是造成肺损伤的重要中间环节。     

对特需医疗服务的再认识

对特需医疗服务的再认识同济医科大学附属同济医院，武汉４３００３０黄光英，杜书伟卫生改革的根本目的是满足人民群众对医疗保健的需求。医院应把社会效益放在首位。这是社会主义卫生事业的性质所决定的，这也是检验医疗卫生改革合理与否的基本标准。经过十几年的医院改...     

糖康治疗四氧嘧啶化学性糖尿病的的实验研究

为探讨纯中药制剂糖康治疗糖尿病的疗效及其机制,采用静脉注四氧嘧啶诱导家兔及大鼠大学性糖尿病观察糖康对动物血糖、血脂和氧自由基代谢的影响。