铁制剂治疗缺铁性贫血的随机对照临床研究

目的 了解硫酸铁控释片、琥珀酸亚铁、多糖铁复合物治疗缺铁性贫血的疗效及不良反应。方法 将105例不诊于血液科门诊的缺铁性贫血患者，按照入选标准，以随机区组的方法随机分入3个治疗组，分别予以硫酸业铁控释片（福乃得，500mg，每日1次）、琥珀酸业铁（速力菲,，0．1g，每日3次）、多糖铁复合物（力蜚能，0．15g，每日2次）治疗8周，每1－2周随访1次，随访血常规、网织红细胞计数及药物的不良反尖。治疗前及治疗结束检查血清铁、总铁结合力、血清铁蛋白等有关铁参数。结果与结论 以血红蛋白和血清铁蛋白恢复正常作为完全缓解的标准，硫酸亚铁控释片、琥珀酸亚铁、多糖铁复合物3种药治疗8周，缺铁性贫血的完全缓解率分别为74％、76％、40％（P＝0．004），总的有效率分别为81％、89％、76％（P＞0．05）。主要的不良反应为胃肠道反应，3种药中以多糖铁复合物的不良反应最少，其次为琥珀酸亚铁，硫酸铁控释片的不良反应最常见，但大多数能够耐受。     

吉西他滨联合顺铂治疗晚期非小细胞肺癌的临床研究

目的 观察吉西他滨（gemcitabine，GEM）联合顺铂方案治疗晚期非小细胞肺癌的疗效及不良反应。方法 对经病理组织学或细胞学诊断证实的56例晚期非小细胞肺癌患者采用GP方案行静脉化疗：GEM1000mg／m^2，静脉滴注，d1，d8；DDP30mg／m^2，静脉滴注，d1～d3；21天重复，至少治疗2个周期。结果 可评价疗效56例，完全缓解（CR）5．3％（3／56），部分缓解（PR）42．9％（24／56），稳定（SD）33．9％（19／56），进展（PD）17．9％（10／56），总有效率（RR）48．2％（27／56）；肿瘤控制率（CR＋PR＋SD）为82．1％（46／56）；中位缓解期7．4个月，中位生存期11．3个月；不良反应以白细胞及血小板减少，消化道反应，乏力为常见，患者均可耐受，无化疗相关死亡。结论 吉西他滨联合顺铂对晚期非小细胞肺癌有较好疗效，不良反应可为患者所耐受，值得临床应用。     

可手术的Ⅲ期贲门癌术前选择性动脉灌注化疗

目的探讨可手术的Ⅲ期贲门癌术前选择性动脉灌注化疗的疗效。方法可手术的Ⅲ期贲门癌选择性胃左动脉灌注化疗一次。结果76例经胃肠双重造影、腹部CT和B超检查均有不同程度的改善,临床症状明显好转,参照全国胃癌协作组第二次会议制定的进展期胃癌全身化疗判定标准,完全缓解(CR)4%(3/76),部分缓解(PR)86%(65/76),稳定(S)11%(8/76)。结论可手术的Ⅲ期贲门癌术前接受选择性动脉介入化疗近期疗效明显。     

Multivariate comparison of elemental concentrations in human teeth

R-mode factor analysis was applied to characterize the chemical composition of human teeth investigated by particle induced X-ray emission (PIXE), Rutherford backscattering spectrometry (RBS) and X-ray fluorescence (XRF) techniques. The approach developed in this study enabled the separation between essential mineral teeth components and the pollutants deposited in teeth tissues during the human life. The three independent sources of metals incorporated in human teeth were found. The first source, representing about 43% of the variance of the concentration data, was characterized by pollutant elements of power industry emissions. The second factor was loaded with toxic elements of general urban pollution. The third factor represented the tooth source as it contained mainly large fractions of the mineral components of the tooth tissue as Ca and K.     

Enhancing Nurse Assessment of Alcohol and Drug Dependency: A Preliminary Study

The purpose of this project was to prepare nurses to provide brief interventions for clients with alcohol or other drug (AOD) dependency in order to reduce hospitalization, morbidity, and mortality. The project was a collaborative process between a major medical center and a school of nursing. Nurses were surveyed for understanding of alcohol and other drug assessment, and a day long training was provided to teach techniques of brief interventions. The short-term results included increased knowledge of nurses about AOD assessment. Long-term results indicated that 95% of patients referred to the AOD team were confirmed to have AOD problems (Dunn & Ries, 1997). This project documents the need for nurses to have more knowledge about AOD problems and brief intervention techniques.     

Chronic obstructive pulmonary disease and asthma General and medical management with special attention to exacerbations

The general management of patients with chronic obstructive pulmonary disease and asthma is discussed. Pathophysiological mechanisms of bronchial obstruction and inflammation are briefly described. The importance of preventive measures is emphasized. Medicine prescribed in chronic obstructive pulmonary disease and asthma, their relative place in treatment schedules and route of administration are reviewed. Finally, the importance of maximal bronchodilatation in exacerbations is stressed and the few indications for antibiotic treatment are discussed.     

2003-2005年新生儿感染常见致病菌及耐药性的变迁

目的了解本地区新生儿2003至2005年感染常见致病菌的种类及耐药的现状，以指导临床合理应用抗生素。方法收集我院新生儿科2003年1月至2005年12月收治的613份体液培养阳性（痰液、血液、分泌物、胃液等标本）的患儿资料，对常见检出菌及其耐药性的变迁情况进行分析。结果共检出40种613株病原菌，以革兰阴性杆菌为主约占57．6％，而肺炎克雷伯菌和大肠埃希菌分别位于前二位，其产ESBLs菌株检出率分别为78．1％和82．6％。药敏结果显示，常见致病菌对青霉素、第一、二代头胞类抗生素、红霉素类耐药性显著增加，但对第三代头胞类抗生素如头孢曲松、头孢噻肟（凯福隆）、头孢他啶（复达欣）及B内酰胺酶抑制剂复方制剂、碳青霉烯类、万古霉素等较敏感。产ESBLs菌仅对亚胺培南及B内酰胺酶抑制剂复方制剂敏感。结论革兰阴性杆菌特别是肺炎克雷伯菌和大肠埃希菌是新生儿感染主要病原菌，产ESBLs菌比例增加应引起高度重视。碳青霉烯类、哌拉西林／三唑巴坦和头孢哌酮／舒巴坦，可作为新生儿严重医院感染经验用药，应尽量根据药敏试验调整抗生素。     

某铜矿山巷道内气溶胶浓度与粒径分布的测量和分析

目的 定性了解矿山巷道内气溶胶的浓度和粒径分布特性。方法 在巷道内的不同区间,分别用凝结核颗粒计数器和个人气溶胶测量仪巡测气溶胶的粒子数和质量浓度,并通过质量浓度的分级测量定性评价微米级气溶胶的粒径分布;在调度室内外,用金属丝网筛扩散法测量亚微米级气溶胶的粒径分布。结果 巷道内可吸入颗粒物(PM10)的平均质量浓度为0.42 mg/m³,其量值大小因工作断面而异,且受人工活动影响变化较大;巷道内粒径大于1.0 μm的颗粒物广泛存在,而粒子直径小于5 nm的气溶胶基本上未被检出。结论 矿山巷道内气溶胶特性因工作断面、人工活动和通风条件的不同而变化明显,在开展内照射剂量评价时应考虑粒径大于1.0 μm放射性气溶胶粒子的剂量贡献。     

脑膜转移癌诊疗现状

脑膜转移癌(CM)近年来发病率有所提升.其诊断为腰穿脑脊液及以核磁共振成像为主的影像学检查.治疗方法包括鞘内化疗、放射治疗、手术及对症支持,但具体治疗方案存在争议.目前推荐个体化治疗及综合治疗,靶向药物在本病中的应用有望取得较好的治疗效果.