高迁移率族蛋白B1对大鼠脾脏树突状细胞表面共刺激分子表达的影响

目的观察高迁移率族蛋白B1(HMGB1)对树突状细胞(dendritic cells,DC)表面共刺激分子表达的影响,并对其机制进行初步探讨。方法分离正常Wistar大鼠脾脏DC后置于96孔培养板(1×10~5/孔),采用HMGB1刺激,观察HMGB1刺激与DC表面共刺激分子CD80、CD86和主要组织相容性复合物(MHC)Ⅱ表达的时间-效应关系及剂量-效应关系。结果HMGB1刺激后,DC表面共刺激分子CD80、CD86和MHCⅡ表达分别于24～72 h明显上调(P＜0．05,0．01),其中以作用48 h后DC表面共刺激分子表达上调尤为显著(P＜0．01)；0．1μg/ml、1μg/ml、10μg/ml的HMGB1刺激均可诱导DC表面共刺激分子CD80、CD86和MHCⅡ表达增强(P＜0．05,0．01),其中HMGB1的浓度在1μg/ml时,大鼠DC表面共刺激分子CD80、CD86和MHCⅡ的表达增强最明显(P＜0．01)。结论HMGB1能诱导DC表面共刺激分子表达增强,HMGB1可能是诱导DC成熟的免疫刺激信号。     

Patterns of asbestosis in New Jersey.

Hospital discharge data from New Jersey were used to identify cases of asbestosis for the 8 years 1979-1986. Multiple admissions were deleted so that each individual was counted once at the time of his/her first hospitalization with an asbestosis diagnosis. White males had the highest age-adjusted average annual discharge rate of 19.3 cases/100,000 population, followed by black males (12.3 cases/100,000) and white females (1.2 cases/100,000). The discharge rate was positively associated with age in each race/sex category. The relationship between rates for black males and white males depended on age: under 65 years, the rates were almost equal, and at 65 years and older, the white rates were nearly twice the black rates. There were two areas of the state where the rates were highest: the north-central and southwest regions. These two areas represent manufacturing and shipbuilding applications of asbestos, respectively. During the years 1979-1986, the annual percentage increase in asbestosis rates was 20% for white males, 17% for black males, and 8% for white females. Continued surveillance will reveal when the rates for asbestosis stop increasing.     

Psychiatric morbidity in policemen and the effect of brief psychotherapeutic intervention — a pilot study

The level of psychiatric morbidity and perceived sources of stress among police officers were investigated using the General Health Questionnaire (GHQ) and a stress situation questionnaire, which were sent to 171 officers. Half of the responders were invited to attend group counselling sessions weekly for 12 weeks. Outcome measures studied were a second GHQ completed at the end of the treatment period and the amounts of sick leave taken in the 12-week period before, during and after the treatment period. The results were that 61 people returned the first GHQ of whom 59 were male and of whom 14 were classed as ‘cases’. Of the 31 assigned to the treatment group, 22 attended at least one session. Responses to the stress situation questionnaire and the content of counselling sessions tended to confirm the impression that internal aspects of the organization were viewed as prime sources of stress and dissatisfaction. There were no significant changes in GHQ score within or between groups, nor were there significant differences in the amount of sick leave taken. Nevertheless the sessions appeared to be valued and we conclude that this sort of intervention is at least feasible. We recommend that similar studies measure psychiatric morbidity during treatment and at follow-up, rather than immediately after finishing, when reactions to this termination are prominent.     

Experiences and learning during a graduate nurse program: an examination using a focus group approach

The graduate nurse year requires individuals to make a huge transition from university student to registered nurse as part of the health care workforce. New graduates experience steep learning curves throughout the first year of professional practice. This study sought to explore experiences and learning occurring throughout the graduate nurse program for a group of seven new nurse graduates. Focus group interviews were conducted at six months and 12 months into the program using the same set of guiding questions. The first interview highlighted that graduates early in the graduate year were internalised, concentrating on their own survival in managing workloads, facing practice realities and coming to terms with themselves as nurses. Learning was primarily about survival strategies and performing tasks. By the second interview, graduates were much less focussed on themselves. They understood their place in the health care team, had gained confidence in their relationships, and were showing concern for the next graduates arriving. Learning at this stage involved more higher order skills, including critical thinking.     

哮喘患者团体辅导实践与体会

结合临床实践,重点介绍作为心理干预形式之一的团体辅导在哮喘患者中的应用情况,包括实施方案、过程、所遇问题及处理等方面。笔者旨在验证、推广团体辅导这一有效改善哮喘患者情绪的心理干预方法,为提高哮喘患者生活质量的临床实践活动提供参考。     

社区高血压病患者的群体干预效果

目的根据"以病人为中心、以家庭为单位、以社区为范围"的全科理念对高血压病患者进行群体干预,以达到更为理想的治疗效果。方法将社区中303名高血压病患者作为一个群体统一管理。结果群体干预效果明显优于针对某一患者治疗的专科模式,有显著性差异(P0.01)。结论高血压病患者群体干预效果显著,在慢性病管理中,全科模式有明显优越性,值得提倡。     

母婴ABO血型不合与新生儿溶血病的关系

目的　探讨O型孕妇血清IgG抗体效价与新生儿溶血病的关系。 方法　对丈夫血型为A型 ,B型或AB型的 75 4例O型孕妇进行血清IgG抗A(B)抗体水平检测 ,同时对IgG抗A(B)≥ 6 4的孕妇所生的新生儿做HDN免疫血清学检查。 结果　 75 4例O型孕妇中产前IgG抗A(B)≥ 6 4的有 2 87例 ,其所生新生儿发生新生儿溶血病的例数为 31例。结论　新生儿溶血病发病率与孕妇血清IgG抗A(B)效价的高低成正相关。     

高危新生儿脑干听觉诱发电位的近期观察

目的 为了解高危新生儿脑干及听觉功能障碍情况.方法 于1995年8月～1996年1月对128例高危新生儿进行脑干听觉诱发电位(Anditory Brainstem Responses—ABR)测定.结果 急性期高危新生儿ABR异常率为51.4%,其中高胆红素血症,低体重儿,窒息和丁胺卡那霉素应用组ABR异常率分别为61.1%、66.7%、53.8%和 2.8%.血清胆红素(Sb)值>290.7μmol/L和重度窒息儿ABR异常率明显高于Sb<290.7μmol/L和轻度窒息儿.早产儿和足月小样儿ABR异常率无明显差异.丁卡组对听阀的近期影响不大.结论 高危新生儿是脑干和听觉功能障碍的高危人群,应当密切随防和早期干预.     

Groups for poorly socialized children in the elementary school

Many inner-city children, living in resource-poor violent communities, have low self esteem, deficient social skills and do not know how to prevent and cope with provocation and conflict. A group therapy model is described for assisting elementary school children deal with these problems. Groups were led by volunteer mental health professionals in two inner-city elementary schools.     

Rh phenotype prediction by DNA typing and its application to practice

The complexity of the RHD and RHCE genes, which is the greatest of all blood group systems, confounds analysis at the molecular level. RH DNA typing was introduced in 1993 and has been applied to prenatal testing. PCR-SSP analysis covering multiple polymorphisms was recently introduced for the screening and initial characterization of partial D. Our objective is to summarize the accrued knowledge relevant to the approaches to Rh phenotype prediction by DNA typing, their possible applications beyond research laboratories and their limitations. The procedures, results and problems encountered are highly detailed. It is recommended that DNA typing comprises an analysis of more than one polymorphism. We discuss future directions and propose a piecemeal approach to improve reliability and cost-efficiency of blood group genotyping that may eventually replace the prevalent serology-based techniques even for many routine tasks. Transfusion medicine is in the unique position of being able to utilize the most extensive phenotype databases available to check and develop genotyping strategies.