低剂量电离辐射对小鼠免疫器官cAMP和儿茶酚胺含量的影响

本文报道，７５ｍＧｙ／（１２．５ｍＧｙ／ｍｉｎ）单次全身Ｘ射线照射后９小时用ＳＲＢＣ免疫Ｃ５７ＢＬ／６小鼠，在免疫后４天和７天脾脏、胸腺和下丘脑ｃＡＭＰ含量均降低；而在免疫后４天脾脏去甲肾上腺素、肾上腺素和酪氨酸含量均增高，免疫后７天肾上腺素含量仍持续增高；当连接γ射线６５ｍＧｙ（０．０１５ｍＧｙ／ｍｉｎ，６ｈ／ｄ）全身照射小鼠后即刻或２９小时后免疫，脾脏和下丘脑ｃＡＭＰ含量也均降低。提示，低剂量     

脑梗死患者血清高敏C反应蛋白的变化及临床意义

目的探讨脑梗死患者血清高敏C反应蛋白(hsCRP)含量的变化及其临床意义。方法随机选择57例脑梗死患者,检测其高敏C反应蛋白的血清水平。观察脑梗死不同病情含量变化,并分析与患者临床神经功能缺损程度评分的相关性。结果脑梗死患者的血清hsCRP水平明显高于正常对照组(P<0.01)。脑梗死不同临床分型组间血清hsCRP水平比较,重型组明显高于中型、轻型组,差异均有统计学意义(P<0.01)。脑梗死患者血清hsCRP含量与临床神经功能缺损程度评分呈正相关(r=0.255,P<0.05)。结论血清hsCRP水平增高与脑组织受损程度有密切关系。hsCRP升高可能是脑梗死发病的一个危险因素。hsCRP升高对治疗及估计预后有指导意义。     

碱性成纤维细胞生长因子对受照后大鼠血脑屏障的影响

目的评价定量检测放射性血脑屏障（BBB）破坏的不同方法，探讨碱性成纤维细胞生长因子（bFGF）对放射性BBB破坏的保护作用。方法60只急性放射性脑损伤模型大鼠（直线加速器6MeV电子束单次照射25Gy）分为单纯照射组和照射前尾静脉注射bFGF组（250ng／kg），并设未照射对照组；分别于照射后2、7和30d采用脑干-湿重法检测脑含水量，并用单次静脉注射3mg／kg伊文氏蓝（EB）后脑组织的EB含量法评估BBB破坏情况。结果照射后脑组织含水量和EB含量均较对照组明显增高，注射bFGF组脑组织含水量和EB含量均低于单纯照射组（P〈0．05）。受照后不同日期的脑组织EB含量差异有统计学意义（P〈0．05），而脑含水量差异没有统计学意义。结论注射EB后检测脑组织，浓度法较干湿重法测脑含水量能更好地反映BBB的破坏情况；bFGF对受照后BBB破坏有保护作用。     

慢性放射性肠炎并发肠梗阻的治疗

目的探讨放射性肠炎并发肠梗阻的治疗方法及临床效果。方法对2001年8月至2006年12月间收治的51例慢性放射性肠炎并发肠梗阻患者的临床资料进行总结。结果本组患者放射性肠炎并发肠梗阻均为肿瘤切除后盆腔、腹腔接受放射治疗所致,从放疗结束到肠梗阻症状出现的时间为(11.9±22.6)个月。分别采用了保守治疗(方案包括禁食、胃肠减压、抑制消化液分泌、营养支持、灌肠、补液、对症等,对于有感染征象的患者选用敏感的抗生素)、肠切除吻合术、肠造口术及短路手术。2例患者因肿瘤广泛转移未行有效手术治疗,1例患者术后因腹腔出血死亡,48例患者得到治愈,治愈率达94.1%。结论慢性放射性肠炎并发肠梗阻的治疗方案应该根据患者的营养状况及肠管损伤情况进行选择。     

Metabolic Characterization of Nondiabetic Severely Obese Patients Undergoing Roux-en-Y Gastric Bypass: Preoperative Classification Predicts the Effects of Gastric Bypass on Insulin–Glucose Homeostasis

Introduction Obese individuals may have normal insulin–glucose homeostasis, insulin resistance, or diabetes mellitus. Whereas gastric bypass cures insulin resistance and diabetes mellitus, its effects on normal physiology have not been described. We studied insulin resistance and β-cell function for patients undergoing gastric bypass. Methods One hundred thirty-eight patients undergoing gastric bypass had fasting insulin and glucose levels drawn on days 0, 12, 40, 180, and 365. Thirty-one (22%) patients with diabetes mellitus were excluded from this analysis. Homeostatic model of assessment was used to estimate insulin resistance, insulin sensitivity, and β-cell function. Based on this model, patients were categorized as high insulin resistance if their insulin resistance was >2.3. Results Body mass index did not correlate with insulin resistance. Forty-seven (34%) patients were categorized as high insulin resistance. Correction of insulin resistance for this group occurred by 12 days postoperatively. Sixty (43%) patients were categorized as low insulin resistance. They demonstrated an increase of β-cell function by 12 days postoperatively, which returned to baseline by 6 months. At 1 year postoperatively, the low insulin resistance group had significantly higher β-cell function per degree of insulin sensitivity. Conclusions Adipose mass alone cannot explain insulin resistance. Severely obese individuals can be categorized by degree of insulin resistance, and the effect of gastric bypass depends upon this preoperative physiology.     

甲基强的松龙和地塞米松治疗放射性脑水肿的差异

目的研究甲基强的松龙及地塞米松治疗放射性脑水肿的差异。方法建立大鼠脑胶质瘤模型。实验分组：A组（大剂量甲基强的松龙组）、B组（小剂量甲基强的松龙组）、C组（地塞米松组）、D组（对照组）、E组（空白组）。各组均颅内种植肿瘤，于种植15天后A、B、C、D各组给予C060照射，A、B、C组大鼠照射前后分别给予甲基强的松龙和地塞米松治疗。测量大鼠脑水肿情况。结果治疗后，与其他各组比较，D组大鼠脑组织含水率最高，E组最低（P〈0．05）；C组大鼠脑组织含水率明显高于A、B两组（P〈0．05）；但A、B两组间无显著性差异（P〉O．05）。结论甲基强的松龙和地塞米松都可以有效防治放射性脑水肿，且甲基强的松龙比地塞米松疗效更好。     

Supporting insensitive mothers: the Vilnius randomized control trial of video-feedback intervention to promote maternal sensitivity and infant attachment security

Objective   This randomized control trial examined the effects of a short-term, interaction-focused and attachment-based video-feedback intervention (VIPP: video-feedback intervention to promote positive parenting).
Design   VIPP effect on mothers' sensitive responsiveness and infant–mother attachment security was evaluated in a sample ( n  = 54) of low sensitive, non-clinical, middle class Lithuanian mothers.
Methods   Maternal sensitivity was assessed in a free play session with the Ainsworth's sensitivity scale, and attachment security was observed using the Attachment Q sort for home observations.
Results   We found that the intervention mothers indeed significantly improved their sensitive responsiveness through participation in our VIPP. The effect size was large according to Cohen's criteria, d  = 0.78. VIPP enhanced maternal sensitive responsiveness even when maternal age, educational level, depression, daily hassles, efficacy, infant gender, and infant negative and positive affect were controlled for. However, attachment security in the VIPP infants was not enhanced after the intervention, compared with the control infants, and the infants did not seem to be differentially susceptible to the increase in maternal sensitivity dependent on their temperamental reactivity.
Conclusion   We suggest that a relatively brief and low-cost programme can provide effective support for mothers who lack sensitivity in the interactions with their infants.     

CMSS-VEPs: Contrast modulated steady state visual evoked potentials: Its neuronal origin and clinical use

CMSS-VEPs are presented as a sensitive, non-invasive functional investigation technique of the visual function, applicable in clinical practice. New improvements of the technique are presented. The underlying neuronal mechanisms are discussed. The clinical use is illustrated in a case of optic neuritis.