早期干预对早产儿免疫功能的影响

目的:探讨早期干预对早产儿免疫功能的影响。方法:胎龄（30～35）周早产儿77例被随机分为两组,早期干预组40例及对照组37例,早期干预方法为新生儿期的早期抚触及出院后的抚触加婴儿操,干预时间为2年。医护人员每3个月随访1次直到2年。检测两组患儿出生时、1月龄和24月龄时外周血T淋巴细胞亚群CD₃⁺、CD₄⁺、CD₈⁺阳性率及血清免疫球蛋白IgG、IgA、IgM水平。结果:出生时及1月龄时两组早产儿外周血T淋巴细胞亚群CD₃⁺、CD₄⁺、CD₈⁺阳性率及血清免疫球蛋白IgG、IgA、IgM水平无显著性差异（P>0.05）,24月时早期干预组外周血T淋巴细胞亚群CD₃⁺、CD₄⁺、CD₈⁺阳性率及血清免疫球蛋白IgG、IgA、IgM水平明显高于对照组（P<0.05）。结论:早期干预能够促进早产儿免疫功能的发育,提高早产儿的生活质量。     

Clinical and experimental study on therapeutic effect of Weixibaonizhuanwan on gastric precancerous lesions

AIM: To study the therapeutic effect of Weixibaonizhuanwan on gastric precancerous lesions.METHODS: Thirty-six patients with gastric precancerous lesions were treated with Weixibaonizhuanwan for 3 mo. Thirteen (36.1%) patients presented with mild atrophic gastritis, 14 (38.9%) with moderate atrophic gastritis, and nine (25.0%) with severe atrophic gastritis. Twenty-two (61.1%) and 27 (75.0%) of the cases were accompanied by intestinal metaplasia (IM) and dysplasia (DYS), respectively. Twenty of the 36 patients were men and 16 were women, ranging from 30 to 67 years in age, with 61.1% of the patients being 40-59 years old. The duration of the disease in these patients ranged from 3 mo to 21 years, with 20 (55.6%) patients experiencing durations of the disease between 5 and 10 years. The clinical manifestations of the disease in these patients included fullness of the abdomen (31 cases), abdominalgia (27 cases), anorexia (30 cases), eructation (26 cases), pantothenic acid (6 cases), and loose stool (9 cases). Patients were treated with Weixibaonizhuanwan and symptom improvement, level of atrophy of the gastric mucosa, and IM and DYS progression were analyzed.RESULTS: After a 3-mo treatment with Weixibaonizhuanwan, seven patients experienced recovery. The treatment was effective in 11 cases, improved symptoms in 13 cases, and was ineffective in five cases. The overall efficacy rate was 86.1%. In patients with mild atrophic gastritis (n = 13), 11 improved into superficial gastritis and two experienced no improvement. In 14 cases of moderate gastritis, four cases improved into superficial gastritis and seven turned into mild atrophic gastritis, with three patients experiencing no improvement. Among severe atrophic gastritis patients (n = 9), five improved into moderate atrophic gastritis after treatment and four experienced no improvement. The overall efficacy rate in chronic atrophic gastritis patients was 77.8%. Among 9 patients with IM, IM disappeared in six cases, whereas three cases showed no improvement after treatment. In cases with moderate IM (n = 10), IM disappeared in two, turned into mild IM in five, and showed no change in three. Out of four cases with IM, one case turned into moderate IM and three showed no change. The overall efficacy rate in IM patients was 63.6%. Out of 16 cases of mild DYS, DYS disappeared in 11, whereas five cases showed no change. Out of nine cases of moderate DYS, DYS disappeared in two and turned into mild DYS in five cases, with two patients experiencing no change after treatment. No improvement was observed in the two cases of severe DYS after treatment. The overall efficacy rate in DYS patients was 66.7%. After treatment, expression of carcinoembryonic antigen (CEA) and proliferating cell nuclear antigen (PCNA) in gastric mucosa significantly decreased (P < 0.01). Before treatment, cancer staging of these patients by positive CEA expression was I, II, III, and IV in 13, 12, 9, and 2 cases, respectively. After treatment, the number of cases per stage changed to 25, 7, 3, and 1, respectively. Similarly, before treatment, staging by positivity of PCNA expression was I, II, III, and IV in 16, 11, 10, and 4 cases, respectively, and changed to 21, 9, 5, and 1, respectively, after treatment.CONCLUSION: The use of Weixibaonizhuanwan in the treatment of gastric precancerous lesions showed promising therapeutic effects in patients after 3-mo treatments.     

快速老化小鼠海马突触体内NMDA受体的表达变化

目的:观察NMDA受体在SAMP8小鼠海马突触体内的表达变化。方法:首先应用生物化学的方法分离海马突触蛋白,并对其进行鉴定。其次,Western Blot检测NMDA受体的主要亚基NR1、NR2A和NR2B在SAMP8小鼠海马突触体内的表达变化。结果:PSD-95和synaptophysin特异性抗体检测显示突触蛋白的分离是成功的。SAMP8小鼠海马内NR1、NR2A和NR2B在突触的表达均显著低于SAMR1小鼠。进一步分析NR1、NR2A和NR2B蛋白在突触的表达量占总表达量的比值,SAMP8小鼠同样显著低于SAMR1小鼠,而SAMR1和CD-1小鼠间没有显著性差异。结论:SAMP8小鼠海马突触体内NR1、NR2A和NR2B的蛋白表达水平均显著性降低,推测NMDA受体在突触表达水平的降低可能是导致受体功能失调,激发突触功能损伤信号途径的原因之一,进而导致SAMP8小鼠学习记忆功能的下降。     

藿香正气袋泡剂工艺实验研究

根据藿香正气水处方制备藿香正气袋泡剂。制备工艺中将苍术、陈皮等含较多挥发性成分的药材制成粗粉，厚朴采用有效成分双提取法，并将厚朴油与处方中的藿香油、紫苏叶油一起采用β－ＣＤ包结工艺进行包结，其余药材采用水提取，制成袋泡剂。实验结果表明：本工艺制成的袋泡剂能有效地保存药材中的按性成分，药物溶出快，且口感好，服用剂量小。稳定性实验证明：袋泡剂热稳定性良好，紫外及薄层层析证明：袋泡剂与藿香正气水所含成分     

白血病患者心理状况及医学应对方式的研究

目的研究白血病患者的心理状况及医学应对方式，以指导心理干预从而提高白血病患者的生存质量和治疗效果。方法将86名白血病患者作为病例组，68名营养性贫血患者作为对照组，两组均用症状自评量表（SCL-90）和医学应对方式问卷（MCMQ）进行调查。结果白血病患者的SCL-90得分与对照组比较有显著差异，MCMQ量表中，面对应对得分低于对照组，回避和屈服应对得分高于对照组。结论白血病患者的心理状况及其医学应对方式对疾病的发展及预后有很大影响，医护人员应通过心理干预改变白血病患者的不良应对方式，改善他们的心理状况，以提高其生存质量和治疗效果。     

团体咨询对社交焦虑大学生心理健康影响的meta分析

目的 系统评价团体咨询对社交焦虑大学生的干预效果.方法 采用电子数据库检索方法,系统客观地收集有关社交焦虑大学生的团体干预研究报告,并采用meta分析的方法对1990年1月至2013年12月间的15项研究进行统计分析.结果 干预结束时及半年后追踪评价,干预组在SCL-90各因子上的得分均与干预前存在显著性差异,合并效应量分别在0.27～0.66和0.24～0.67之间.结论 团体咨询可以有效提高社交焦虑大学生的心理健康水平.     

自体与同种异体肌腱重建膝关节前交叉韧带的比较

背景:关节镜辅助下重建前交叉韧带的移植物主要有自体移植物、同种异体移植物和人工韧带3种,关于移植物的选择,存在较多争议。目的:评估自体健侧腘绳肌腱和同种异体肌腱两种移植物在膝关节前交叉韧带重建中的效果。方法:纳入2007-01/2009-01在承德医学院附属医院骨科就诊的经关节镜检查证实为前交叉韧带损伤的患者70例(70膝),分别采用自体健侧腘绳肌腱和同种异体肌腱重建前交叉韧带,记录膝关节Lysholm功能评分、KT-1000测量值及不良反应。结果与结论:患者随访18~24个月,均未发生血管神经损伤,无感染、植入物断裂等并发症;同种异体肌腱移植患者有2例膝关节引流管口持续渗出,经换药半月后愈合,其余切口均一期愈合。末次随访时,自体健侧腘绳肌腱和同种异体肌腱重建患者的Lysholm评分均显著提高,双侧膝关节前向松弛度差值显著减少,且两种方法比较差异无显著性意义(P>0.05)。说明应用自体健侧腘绳肌腱与同种异体肌腱重建膝关节前交叉韧带疗效相当,效果满意。     

盆炎平方口服配合中药保留灌肠治疗湿热瘀结型慢性子宫附件炎的临床疗效及作用机理探讨

目的:探讨盆炎平方口服配合中药保留灌肠治疗湿热瘀结型慢性子宫附件炎的临床疗效及作用机理。方法:将120例湿热瘀结型慢性子宫附件炎患者按就诊先后顺序随机分为2组,每组各60例,其中对照组给予黄藤素分散片配合苦参素栓纳肛治疗,治疗组口服盆炎平方配合中药保留灌肠治疗,比较2组临床疗效及治疗前后血液流变学指标变化。结果:治疗组有效率为91.67%,显著高于对照组的76.67%(P0.05);治疗组治疗后高切全血黏度、低切全血黏度和血浆黏度分别为(2.12±0.21)mPa·s、(7.20±1.72)mPa·s和(1.12±0.13)mPa·s,均显著低于治疗前和对照组,且差异均具有统计学意义(P0.05)。结论:盆炎平方口服配合中药保留灌肠治疗湿热瘀结型慢性子宫附件炎疗效显著,可有效改善患者临床症状,具有较好的临床应用价值。     

心理干预对白血病化疗患者心理状况影响的研究

目的了解心理干预对白血病化疗患者心理状况影响的效果。方法选取在我院血液科住院化疗的白血病患者100例,随机选取50例为观察组,50例为对照组。两组化疗患者在化疗的前一天均测评SCL-90及MCMQ。化疗期间对两组患者进行常规护理的同时对观察组进行心理干预,两周后两组患者再次测评SCL-90及MCMQ。将收集到的资料统计处理后进行t检验。结果两组化疗患者化疗前两个量表共13个因子（躯体化、强迫、人际关系敏感、抑郁、焦虑、恐惧、敌对、偏执、精神病性、其它、面对、屈服、回避）均分比较t检验结果（P〉0.05）差异无显著性。两组患者化疗两周后两表评分比较结果显示,除偏执、精神病性外其它因子均分比较t检验结果（P〈0.05）差异有统计学意义。观察组心理干预前和心理干预后的13个因子,除偏执、精神病性外其它因子均分比较t检验结果（P〈0.05）差异有统计学意义。结论心理干预使化疗期间的白血病患者更多地采用积极面对的行为和应对方式,减少负性情绪反应,主动地配合治疗和护理,对疾病的缓解和预后起到积极的作用。     

心脏手术病人心肌组织心钠素含量的测定

为探讨心脏手术病人心肌组织心钠素含量变化与心脏病的关系。应用放射免疫分析方法对３７例心脏手术病人心肌组织心钠素的含量进行测定。结果风湿性心脏病病人心肌组织心钠素含量明显高于先天性房、室间隔缺损者。证实心功能不同，心肌组织心钠素含量不同，在病理状态下，心室亦分泌心钠素。