单倍相合骨髓移植术后中枢神经系统并发症

为了探讨单倍体骨髓移植术后神经系统并发症的发生情况,对10例单倍相合骨髓移植术后神经系统并发症的发生时间、病因、治疗措施及预后等临床资料进行了总结分析.结果表明：74例接受单倍体相合骨髓移植病人中10例发生并发症,其中3例病人出现脑出血,感染3例（真菌感染,CMV脑炎,单纯疱疹病毒性脑炎各1例）,癫痫、格林-巴利综合征、脑病和精神分裂症各1例,因神经系统并发症直接导致死亡的患者4例.结论：神经系统并发症是单倍相合骨髓移植术后常见的严重并发症之一,并导致较高的死亡率,尤其是脑出血对病人的威胁较大;单倍相合骨髓移植术后免疫重建缓慢,对相关感染并发症和周围神经的病变应引起重视.     

正常组与直肠癌组直肠系膜及筋膜的CT研究

目的探讨正常组与直肠癌组直肠系膜及其筋膜的CT表现. 方法资料分为2组,正常组54例,无盆腔疾病病史,直肠癌组51例分为外膜受侵组和外膜正常组.由两位放射科医生共同观察分析CT图像,详细记录:①直肠系膜筋膜显示情况;②直肠系膜与盆壁脂肪的密度,并测量CT值;③对直肠外膜模糊者,分别测量病变侧、病变对侧系膜CT值.采用SPSS 10.0软件对数据进行统计. 结果正常组前、后、左、右侧直肠系膜筋膜显示率分别为6.8%、15.9%、81.8%、84.1%,直肠癌组前、后、左、右侧直肠系膜筋膜显示率分别为1.8%、28.3%、81.1%、83.0%,两组间无统计学差异.无论正常组或直肠癌组,直肠系膜CT值高于盆壁脂肪CT值,多数情况下这种差异肉眼可辨,直肠癌组直肠系膜CT值高于正常组,外膜受侵组病变侧系膜CT值高于外膜正常组,统计学有显著差异.外膜受侵组病变对侧系膜CT值与外膜正常组无统计学差异. 结论螺旋CT图像能够显示直肠系膜及筋膜,侧方筋膜显示率高于前、后方筋膜.直肠系膜CT值高于盆壁脂肪,其差异肉眼可辨.直肠癌组直肠系膜的密度高于正常组,直肠外膜受侵,病变侧直肠系膜密度显著增高.     

疼痛教育项目提高癌症患者疼痛治疗效果的有效性评价

目的：确定疼痛教育项目对减轻患者对疼痛治疗的顾虑、提高遵医行为，从而提高疼痛缓解程度及对疼痛治疗的满意程度的有效性。方法：对112例癌症疼痛患者开展疼痛教育，对比干预前后患者对疼痛治疗的顾虑和遵医行为的变化，对比干预前后患者的疼痛缓解程度及对疼痛治疗的满意度的变化。结果：与疼痛教育前比较，教育后患者对疼痛治疗的总体顾虑水平明显减低（P〈0．01）；能够完全遵医嘱用止痛药的患者比例明显增加（P〈0．01）；疼痛中度及明显缓解的患者比例增加（P〈0．01）；患者对疼痛治疗的满意度明显提高（P〈0．01）。结论：在规范化治疗的前提下，开展疼痛教育项目，可明显减轻患者对疼痛治疗的顾虑，提高其治疗依从性，从而保证疼痛治疗的顺利进行，对临床癌症疼痛控制起积极的促进作用。     

Literature review of peripheral vascular trauma:Is the era of intervention coming?

Traumatic peripheral vascular injury is a significant cause of disability and death either in civilian environments or on the battlefield.Penetrating trauma and blunt trauma are the most common forms of vascular injuries.Besides,iatrogenic arterial injury(IAI)is another pattern of vascular trauma.The management of peripheral vascular injuries has been improved in different environments and wars.There are different types of vascular injuries,such as vasospasm,contusion,intimal flaps,intimal disruption or hematoma,external compression,laceration,transection and focal wall defects,etc.The main clinical manifestations of vascular injuries are shock following massive hemorrhage and limb necrosis due to tissue and organ ischemia.Ultrasound,computed tomography angiography(CTA)and magnetic resonance angiography(MRA)are most valuable for assessment of peripheral vascular injuries.Angiography remains the gold standard for diagnosing vascular trauma.Immediate hemorrhage control and rapid restoration of blood flow are the primary goals of vascular trauma treatment.There are many operative treatment methods for vascular injuries,such as vascular suture or ligation,vascular wall repair and vascular reconstruction with blood vessel prostheses or vascular grafts.Embolization,balloon dilation and covered stent implantation are the main endovascular techniques.Surgical operation is still the primary treatment for vascular injuries.Endovascular treatment is a promising alternative,proved to be safe and effective,and preferred selection for patients.In summary,rapid diagnosis and timely surgical intervention remain the mainstays of the treatment.However,many issues need to be resolved by further studies.     

Insight into Mechanisms of Cellular Uptake of Lipid Nanoparticles and Intracellular Release of Small RNAs

Purpose

Understanding mechanisms of cellular uptake and intracellular release would enable better design of nanocarriers for delivery of nucleic acids such as siRNA and microRNA (miRNA).

Method

In this study, we investigated cellular pharmacokinetics of siRNA by co-encapsulating fluorescently labeled siRNA and molecular beacon (MB) in four different formulations of cationic lipid nanoparticles (LNPs). A miRNA mimic was also used as a probe for investigating cellular pharmacokinetics, which correlated well with RNAi activities.

Results

We tried to find the best LNP formulation based on the combination of DOTMA and DODMA. When the DOTMA/DODMA ratio was at 5/40, the LNP containing a luciferase siRNA produced the highest gene silencing activity. The superior potency of DOTMA/DODMA could be attributed to higher uptake and improved ability to facilitate siRNA release from endosomes subsequent to uptake.

Conclusions

Our findings may provide new insights into RNAi transfection pathways and have implications on cationic LNP design.     

Clinical analysis of surgical treatment of portal hypertension

AIM: To review the experience in surgery for 508 patients with portal hypertension and to explore the selection of reasonable operation under different conditions. METHODS: The data of 508 patients with portal hypertension treated surgically in 1991-2001 in our centers were analyzed. Of the 508 patients, 256 were treated with portaazygous devascularization (PAD), 167 with portasystemic shunt (PSS), 62 with selective shunt (SS), 11 with combined portasystemic shunt and portaazygous devascularization (PSS+PAD), 9 with liver transplantation (LT), 3 with union operation for hepatic carcinoma and portal hypertension (HCC+PH). RESULTS: In the 167 patents treated with PSS, free portal pressure (FPP) was significantly higher in the patients with a longer diameter of the anastomotic stoma than in those with a shorter diameter before the operation (P<0.01). After the operation, FPP in the former patients markedly decreased compared to the latter ones (P<0.01). The incidence rate of hemorrhage in patients treated with PAD, PSS, SS, PSS+PAD, and HCC+PH was 21.09% (54/256), 13.77 (23/167), 11.29 (7/62), 36.36% (4/11), and 100% (3/3), respectively. The incidence rate of hepatic encephalopathy was 3.91% (10/256), 9.58% (16/167), 4.84% (3/62), 9.09% (1/11), and 100% (3/3), respectively while the operative mortality was 5.49% (15/256), 4.22% (7/167), 4.84% (3/62), 9.09% (1/11), and 66.67% (2/3) respectively. The operative mortality of liver transplantation was 22.22% (2/9). CONCLUSION: Five kinds of operation in surgical treatment of portal hypertension have their advantages and disadvantages. Therefore, the selection of operation should be based on the actual needs of the patients.     

离退休干部心理健康状况及幸福感分析

目的：调查分析某干休所离退休干部心理健康及幸福感状况,以便于提供科学的心理指导,提高整体健康水平。方法通过问卷调查124名离退休干部,包括一般资料、症状自评量表（SCL-90）和幸福度量表（MUNSH）,与120名在职干部进行对照分析。结果离退休干部SCL-90表中的强迫症状、人际关系敏感、焦虑、偏执及总分均显著低于对照组（ P＜0．05）,躯体化症状高于对照组（P＜0．05）;MUNSH表中离退休干部的负性情感明显低于对照组（P＜0．05）;离退休干部心理健康状况与幸福感总分具有显著相关性。结论良好的心理健康状况有利于提高幸福感,对离退休干部的心理健康问题应采取适当的干预措施。     

老年带状疱疹后神经痛的多种因素分析

目的探讨老年带状疱疹后神经痛的多种因素情况。方法分析我院收治的60例带状疱疹患者临床资料,依据是否发生神经痛分为非神经痛带状疱疹组即A组50例,带状疱疹并神经痛组即B组10例。结果两组带状疱疹患者前驱痛、皮损类型、疼痛程度、初治时间的比例情况具有明显差异（P〈0．05）。两组带状疱疹患者性别、发热、受累神经比例无明显差异（P〉0．05）。结论有无前驱痛、皮损类型、疼痛程度、初治时间与带状疱疹后神经痛的发生有关,为指导临床治疗提供可靠的理论依据。     

初中生“基本认知能力测验”信效度分析

目的初中生"基本认知能力测验"信效度分析。方法以中国社会科学院心理研究所基本认知能力测验系统(2.0版)为工具,对分层随机抽取的300名初中生进行认知能力测试。结果①各分量表重测信度比较高,其相关系数分别是:数字拷贝0.90,汉字比较0.73,心算0.75,汉字旋转0.62,数字工作0.91,双字词再认0.59,无意义图形再认0.56,均达到显著水平(P0.05);②因素分析发现基本认知能力测验有6个纬度,分别是:数字拷贝、双字词再认、数字加工、数字工作、汉字比较、心算。结论基本认知能力测验信效度较好,能很好的反映初中生的认知状况。     

2008年奥运会驾驶员志愿者人格特征分析

目的研究2008年奥运会驾驶员志愿者人格特征。方法采用缩减版明尼苏达多相人格调查表(MMPI-2)及自制问卷,分析1000名驾驶员志愿者的人格特征。结果驾驶员志愿者在MMPI-2所有8个临床量表上的T分均未超过60分;与军校学员相比,各临床量表得分均有显著差异;MMPI剖析图表现为明显的单峰(高D)和单谷(低Ma)特征。结论驾驶员志愿者总体健康状况良好;具有比较独特的人格特征。