Pleural dosimetry and pathobiological responses in rats and hamsters exposed subchronically to MMVF 10a fiberglass.

Interspecies differences in pulmonary and pleural responses to the inhalation of natural mineral and synthetic vitreous fibers have been observed in chronic and subchronic studies. However, the reasons for these differences are not clearly understood. There are also fiber-specific differences in the outcome of chronic inhalation exposure to natural mineral and synthetic vitreous fibers. Whether these differences are dependent upon the ability of these fibers to translocate to the pleural space is unknown. The present study was conducted to compare retained fiber burdens and selected pathological responses in the pleural compartments of rats and hamsters following subchronic inhalation of MMVF 10a fiberglass, a fiber negative for tumorigenesis or fibrosis in chronic studies. Fischer 344 rats and Syrian golden hamsters were exposed for 4 or 12 weeks by nose-only inhalation at nominal aerosol mass concentrations of 45 mg/m3 (610 WHO fibers/cc). Pulmonary fiber burdens and pulmonary inflammatory responses were greater in rats than in hamsters. The total number of fibers in the lung was approximately three orders of magnitude greater than in the pleural compartment. Pleural burdens in the hamster (160 fibers/cm2 surface area) were significantly greater than burdens in similarly exposed rats (60 fibers/cm2 surface area) following 12 weeks of exposure. With time postexposure, pleural burdens decreased in hamsters but were essentially unchanged in rats. Pleural inflammatory responses in both species were minimal. In rats, pleural inflammation was characterized by increased numbers of macrophages and increases in mesothelial cell replication during the period of fiber exposure. In contrast, hamsters had increased numbers of macrophages and lymphocytes, and mesothelial-cell replication indices were elevated on the parietal pleura of the costal wall and diaphragm, with some of these responses persisting through 12 weeks of postexposure recovery. Taken together, the results suggest that differences among rodent species in pleural responses to inhaled fibers are due to a delivered dose of fibers and to the biological responses to the presence of the fibers.     

慢性肾功能衰竭中医证候研究现状

中医证候规范化研究已成为当前中医界的重大课题之一，近年来，诸多医家从不同角度对慢性肾功能衰竭（CRF）的病因病机，辨证分,下候规范化进行了较深层次的探讨。由于CRF的中医证候复杂，并且呈动态变化，故应加强对其辨证分型和证候规范化的进一步研究。     

辨证治疗中风病248例临床分析

本文通过对２４８例中风病临床分型分析，以气虚血瘀证最多，占３８．３１％，其次为阴虚风动证，肝阳暴亢，风火上扰证。本组病人不论是出血性中风，还是缺血性中风，均采用中药辨证治疗基础上，口服中成药及静脉滴注活血化瘀针剂以加强活血化瘀、涤痰通络这一治疗法则，总有效率为８４．２７％，其中出血性中风和缺血性中风的总有效率分别为８６．９５％和８３．２４％，对血液流变学、脑出血患者治疗前后脑ＣＴ对照观察，认为 一     

Initial transforming event in myelodysplastic syndromes may be viral: case for cytomegalovirus

Myelodysplastic syndromes (MDS) are clonal hematopoietic disorders which begin in a pluripotential bone marrow (BM) stem cell. This early stem cell is believed to acquire a growth advantage over its neighbors as a result of an initial transforming event, the nature of which has remained obscure. In this paper, we propose that pathogens such as those belonging to the herpesvirus family of DNA viruses may play a role in the initial transformation of the stem cell. The case for cytomegalovirus (CMV) as a representative of this family of viruses is discussed at length and a molecular mechanism which may be involved in the oncogenic activity of CMV is proposed. No proof has been presented to implicate CMV directly in MDS, but circumstantial evidence which supports such a possibility is provided.     

用噬菌体肽库筛选SARS病原体的模拟抗原表位

目的筛选SARS病原体的模拟抗原表位。方法以混合SARS患者恢复期血清Ig作为筛选分子，从噬菌体肽库中筛选出能与患者血清Ig结合的模拟抗原表位，并研究其抗原特性。结果得到2个能与SARS患者恢复期血清Ig特异性结合的阳性克隆；DNA测序结果显示这2个模拟抗原表位与SARS抗原无同源性。结论用噬菌体肽库成功筛选得到SARS的模拟表位，为开展用SARS模拟抗原表位探索SARS的防治研究创造了条件。     

高分辨心电图鉴别室速与预激综合征逆向折返性心动过速

目的 :应用高分辨心电图鉴别室性心动过速 (室速 )与预激综合征逆向折返性心动过速。方法 :对17例室律整齐的室速和12例预激综合征逆向折返性心动过速患者进行心电信号叠加高频滤波分析 ,观测QRS波与P波的关系。结果 :在心电信号叠加高频滤波图上 ,17例室速中16例未见P波 ,12例预激综合征逆向折返性心动过速者全部见到P波 ,两组差异有统计学意义 (P<0.001)。结论 :应用心电信号叠加高频滤波分析显示P波的方法有助于室律整齐的室速与预激综合征逆向折返性心动过速的鉴别诊断     

严重急性呼吸道综合征24例死亡危险因素分析

目的　回顾性分析严重急性呼吸道综合征 (SARS)病人的死亡危险因素 ,为降低 SARS病死率提供可借鉴经验。方法　对来自本省太原市及各地区收治 SARS7家医院所提供的死亡 SARS病历资料进行回顾性分析。包括 :年龄、基础疾病、实验室数据、影像学检查及治疗措施等。结果　 2 4例死亡 SARS病人中 ,男性 14例和女性 10例。平均年龄 5 7.4岁。其中≥ 5 0岁 2 1例 (88% )。有基础疾病者 2 0例 (83% )。其中心血管疾病 12例占居首位 ,糖尿病 9例居次席 ,脑血管疾病 8例位居第三 ,慢性阻塞性肺疾患 (COPD) 5例占第四位和消化道疾病占末位。有并发症者 13例 (5 4 % ) ,依次为急性呼吸窘迫综合征 (ARDS)、休克、多器官功能障碍综合征 (MODS)和继发感染等。部分资料齐全的病人在入院时的生命体征都平稳。血液学和动脉血气检测与分析均显示在疾病晚期与入院时相比 :白细胞计数增多 ,血糖升高和乳酸脱氢酶 (L DH)值升高 (P均 <0 .0 0 1) ,而淋巴细胞计数显著减少 (P<0 .0 0 5 ) ,动脉血氧分压 (Pa O2 )和氧合指数 (Pa O2 / Fi O2 )均呈进行性降低 (P<0 .0 0 5 ,P<0 .0 0 1)。近半数SARS病人血液生化指标异常。结论　年龄、基础疾病、低氧血症和 L DH值升高 ,皮质类固醇和抗生素的滥用所致的继发感染等都是 SARS病人死?     

基质金属蛋白酶-9、颈动脉内中膜厚度与冠心病关系的研究

目的研究血清基质金属蛋白-9水平(MMP-9)、颈动脉内中膜厚度(IMT)与冠心病的关系,及二者在冠心病预测中的意义。方法79例住院患者,根据临床表现和冠状动脉造影结果分为正常组30例、稳定心绞痛20例和急性冠脉综合征组29例(不稳定心绞痛15例和急性心肌梗死14例)。观察冠状动脉粥样硬化斑块的特征,进行冠脉积分统计。采用ELISA法检测基质金属蛋白酶-9。所有患者均行双侧颈动脉超声检查,测定双侧颈总动脉内中膜厚度。结果1.急性冠脉综合征组MMP-9水平显著高于稳定型心绞痛组和正常对照组(P<0.05),而稳定型心绞痛组与对照组间差异无显著性(P>0.05);2.左侧IMT水平三组间相互比较皆有显著性差异(P<0.05),右侧IMT在急性冠脉综合征组显著高于正常对照组(P<0.05),但急性冠脉综合征组与稳定型心绞痛组,稳定性心绞痛组与对照组间差异无显著性(P>0.05);3.急性冠脉综合征组MMP-9、左侧IMT水平与冠状动脉积分有明显相关性,右侧IMT与冠状动脉积分之间无明显相关性。结论MMP-9、IMT显著升高可能提示斑块不稳定性可对冠心病患者进行危险分层,能更有效地预测急性冠脉事件的发生。     

暴发性急性胰腺炎38例治疗分析

目的：探讨暴发性急性胰腺炎的治疗方法.方法：回顾性分析从1991年1月至2005年12月收治的38例暴发性急性胰腺炎病例,分为急诊手术治疗、非手术治疗和非手术治疗结合早期手术治疗3细观察疗效.结果：38例中存活24例,总体生存率为63.16%,其中急诊手术治疗10例,存活4例（40%）;单纯非手术治疗组16例,存活9例（56.25%）;非手术治疗结合早期手术治疗治疗组12例,存活11例（91.67%）.3组存活率两两比较其差异具有显著性（P＜0.05）;3组的急性生理学和慢性健康评分标准APCHEⅡ（acute physiology and chronic health evaluationⅡ）评分两两比较均不具有显著性差异（P＞0.05）.结论：对于暴发性急性胰腺炎应在强化的非手术监护治疗下行早期手术治疗,腹腔间隔室综合征的发展程度是决定手术时机的关键;手术目的是进行充分有效的腹腔减压和引流而不是以清除胰腺的坏死组织为目的;术后血液透析对于阻止胰腺局部病变和全身病情加重,保护脏器功能具有显著功能.     

老年性骨质疏松症的证候特征及相关危险因素的分析

目的 探讨老年性骨质疏松症的证候特征及其相关危险因素.方法 对98名老年性骨质疏松症患者进行中医证候评定,以39例骨密度正常老年人作对照,Logistic回归分析等统计学方法用于相关危险因素的分析.结果 老年性骨质疏松症最常出现的中医证候是气虚证、肾精亏虚证;较常出现的证候是瘀血证和痰浊证.气虚证是老年性骨质疏松症的独立危险因素;如果考虑两种病理因素合而为病,则肾精亏虚与阴虚是老年性骨质疏松症的危险因素,脾气虚与瘀血阻络两两交互作用,发生骨质疏松症的危险性更高.结论 骨密度与气虚证、脾虚血瘀证、肾虚阴亏证具有密切关系,气虚、肾虚阴亏、脾虚血瘀是老年性骨质疏松症的基本病理因素.