The effect of high-dose salmon calcitonin on bone mineral metabolism in the normal rat

Summary The paucity of information on the effect of long-term high-dose salmon calcitonin administration on normal bone mineral metabolism and histology prompted an investigation of the influence of high-dose synthetic calcitonin in the rat. Serum ionized calcium, osteocalcin or BGP (bone gla protein), and immunoreactive PTH were measured serially during calcitonin administration and bone histomorphometry analyzed at 6 weeks (after sacrifice). Daily injections of salmon calcitonin, 0.4 IU/100 g (group B) and 2 IU/100 g (group C), resulted in significant hypocalcemia at 4 hours for both experimental groups (P<0.004). Serium iPTH was significantly higher over the study period for both groups administered calcitonin. Serum BGP levels were significantly lower than controls during the study in group C (P<0.002) and to a lesser extent in group B (P<0.05). In group C, bone histomorphometry revealed increased resorption (onteoclast count), decreased trabecular bone volume, and decreased double-labeled tetracycline surface (bone formation). In group B an increase in osteoclast count but no alteration in bone formation was observed. To assess the role of PTH in the above findings, high-dose calcitonin was administered to parathyroidectomized rats. All of the above changes in bone histomorphometry were not observed in this group of animals. In conclusion, high doses of calcitonin promote hypocalcemia, secondary hyperparathyroidism, and osteoclastosis in the normal rat in a dose-dependent manner with very high-dose calcitonin impairing bone formation.     

几丁糖预防术后腹腔粘连的实验研究

目的探讨几丁糖对术后腹腔粘连的预防作用.方法将45只大鼠随机分为A、B、C 3组,于腹腔内浆膜损伤部位分别注入1%乳酸液、32%右旋糖酐-70液和2%几丁糖乳酸液各2 ml,术后14 d处死动物,观察各组腹腔粘连状况.结果 3组粘连分级比较有显著性差异(P＜0.01),C组粘连发生率与另2组有显著差异(P＜0.05).光镜下C组炎症反应轻微,纤维增生不明显;电镜下C组纤维细胞分泌胶原能力弱,间皮细胞增生活跃.结论几丁糖可有效降低大鼠术后腹腔粘连的发生和粘连程度,其作用优于右旋糖酐-70,且不影响切口的愈合.     

惠州市结核病控制项目实施效果评价

目的 总结我市结核病控制项目实施效果和经验。方法 根据全市各县(区)上报的结核病报表和有关总结材料进行分析。结果 在项目实施期间发现涂阳病人7522例，治愈了7303例，涂阳病人登记率从1993年的8．2／10万提高到2001年的39．4／10万，初、复治涂阳病人治愈率从1992年的80．0％和81．8％提高到2001年的98．9％和96．2％。结论 我市结核病控制项目实施效果显，项目所取得的成功经验和技术策略对今后结核病控制可持续发展有着重要的指导作用。     

临床输液反应的分析与预防

目的对临床发生的输液反应进行分析,找出发生的原因,探讨预防措施。方法:对30例输液反应资料进行分析。结果:以热原反应最为多见,占76.67%,而过敏反应,占16.67%,局部反应,占6.67%。结论:严格执行消毒制度,遵守无菌操作规程,把好药品和输液器具质量关,合理用药,注意配伍等是减少临床输液反应的关键。     

乳腺癌改良根治术后皮下积液的预防措施

目的 探讨乳腺癌术后皮下积液的防治方法。方法 回顾北京友谊医院普外科2002年1月～2004年12月收治的女性乳腺癌患者312例。比较皮下引流管接持续高负压吸引组（A组）与持续低负压引流组（B组），乳腺癌改良根治术后皮下积液的发生率。结果 A组160例患者拔管前合计引流量220～350ml，平均270ml。35例发生皮下积液，积液发生率为21．8％。同时伴皮瓣坏死5例。B组152例患者拔管前合计引流量160～250ml，平均180ml。17例发生皮下积液，积液发生率为11．2％。皮瓣坏死3例。B组与A组比较皮下积液发生率有显著性差异（P=0．011）。结论 乳腺癌改良根治术后引流管接持续低负压吸引有助于减少皮下积液的发生率。     

The impact of new screening protocol on individuals at increased risk of colorectal cancer

OBJECTIVE: Screening colonoscopy has been shown to reduce mortality and cancer stage in hereditary nonpolyposis colorectal cancer (HNPCC) individuals. However, the benefit of screening in intermediate risk groups is unknown. The most recent national guidelines have recommended a reduction of screening frequency for the intermediate risk group. Therefore, this study aims to compare the results of colonoscopic screening in HNPCC and intermediate risk groups and assess the effect of the most recent screening protocol recommendations. METHOD: A total of 244 individuals; 108 from HNPCC families (28 mismatch repair gene carriers) and 136 from intermediate risk families were referred for regular colonoscopic screening by the Regional Genetics Service. Findings from 417 colonoscopies performed between 1992 and 2003 were evaluated. RESULTS: A total of three cancers, 39 adenomas and 41 hyperplastic polyps were found in the HNPCC group compared with one cancer, 22 adenomas and 19 hyperplasic polyps in the intermediate risk group. If the recent screening guidelines for the intermediate group were applied, then 89 (44%) fewer colonoscopies would have been performed. Although no cancers would have been missed, six adenomas (mean size = 5.7 mm, range 2-10 mm) with two graded as severely dysplasic and six hyperplastic polyps would not have been detected. CONCLUSION: The detection rate and distribution of adenomas were similar in both groups. If the new colonoscopic screening recommendations for the intermediate risk group had been applied, a small number of significant lesions would have been missed.     

Using stories to battle unintentional injuries: Narratives in safety and health communication

After 14 years of rising death rates due to unintentional injuries in the U.S., it is time to ask how safety messages can be redesigned to have a greater impact on risky behavior. To this end, many researchers have called for a new, narrative approach to prevention messages—based on persuasive stories about people who have suffered injuries and illnesses in the past. Still, there is scant evidence that story-based communications are more effective than equivalent non-narrative messages at changing actual (rather than self-reported) safety and health behavior. Our research examined the impact of injury stories on actual safety behavior in a controlled experimental setting at a US university. Teams of participants assembled a product (a child's swing) using written instructions. The instructions contained safety messages targeting assembly mistakes that have been linked to serious injuries in children who play on swings. Participant teams were randomly assigned to three conditions: assembly instructions containing story-based safety messages, instructions with concrete (but non-anecdotal) safety messages, and instructions with traditional abstract safety messages. After adjustment for covariates, story-based messages resulted in a 19 percent improvement in safety behavior, compared with non-narrative communications. Importantly, injury stories did not create undue fear of the message object, demonstrating that brief anecdotes about accident victims can convince people to take reasonable precautions without creating unwarranted alarm about risks.     

利多卡因治疗外伤性蛛网膜下腔出血疗效分析

目的探讨早期静脉注射利多卡因对外伤性蛛网膜下腔出血（tsAH）继发性脑损伤的治疗作用。方法重度颅脑损伤后SAH患者60例（GCS评分≤8分）。随机分为治疗组（早期静脉注射利多卡因组）和对照组。在治疗前后对患者均进行GCS评分、颅内压（ICP）测定以及头部CT、发射计算机体层摄影（ECT）、经颅多普勒（TCD）检查。结果利多卡因治疗7d后即出现颅内压降低、挫伤脑组织血流供应改善、脑水肿减轻，与对照组比较，有明显差异（P〈0．01）；GCS评分在利多卡因治疗7d、14d后较对照组明显增加（P〈0．01）。结论早期静脉注射利多卡因能明显减轻颅脑损伤后SAH继发性脑组织损伤的程度，有利于神经功能的早期恢复。     

异位妊娠259例临床总结分析

目的探讨异位妊娠的发病相关因素,提出防治措施。方法对我院10年间收治的259例异位妊娠病例的发病趋势,既往病史及节育状况、误诊情况作一回顾分析。结果近10年异位妊娠发生率为2.19%并呈上升趋势。人工流产、节育手术、下腹部手术等与异位妊娠的发生关系密切。结论降低人工流产率,减少性病传播是预防异位妊娠发生的重要手段,随着高科技手段的应用使异位妊娠早期准确的诊断成为可能,为保守治疗赢得机会。     

产褥期并发深静脉栓塞的预防和护理

探讨引发产褥期深静脉栓塞的危险因素,加强早期观察,实施有效的预防措施,以及产褥期深静脉栓塞病人的护理对策。