宝鸡市城市饮用水与人群健康效应的调查研究

本文通过对宝鸡市居民饮自来水和自备井水的人群进行了回顾性和前瞻性调查分析，结果发现，饮自来水与饮未经处理自备井水明显的差异。即调查组（饮自来水）肠道传染病发病率为４．２２％和６．８２％，对照组（饮自备井水）发病率为７．７１％和１１．５６％经卡方检验Ｐ＜０．０５，差异有显著性。从发病病种来看，调查组和对照组均以腹泻为主，其次为痢疾和肝炎，发病率分别是：腹泻，调查组为３５．５９‰和６３．００‰，对照组     

Lumbar Puncture Ordering and Results in the Pediatric Population: A Promising Data Source for Surveillance Systems

Background: The Centers for Disease Control and Prevention is incorporating laboratory data into real-time surveillance systems. When normal patterns of laboratory test orders and results are modeled, aberrations can be detected. Because many test orders are available electronically well before results, atypical patterns of test ordering may signal outbreaks.
Objectives: The authors sought to characterize baseline patterns in the ordering and early results of lumbar punctures, motivated by the possibility of using these data for real-time surveillance for early detection of meningitis or encephalitis outbreaks.
Methods: Retrospective cohorts of pediatric emergency department patients at a single hospital (1993–2003) and from the National Hospital and Ambulatory Medical Care Survey (1992–2000) were used for analysis.
Results: Test ordering exhibits seasonal patterns, with monthly peaks in January and August (p < 0.0001). For the hospital cohort, the rate of cerebrospinal fluid pleocytosis exhibits seasonal patterns (p < 0.0001), with a peak from August to October. This is strongly associated with the rate and pattern of clinical neurologic disease (p < 0.0001). A long-term secular decline in daily test ordering is evident, dropping from 5.3 to 2.9 in the hospital sample, and from 371.8 to 185.3 in the national sample (p < 0.001). The long-term rate of pleocytosis has declined (p < 0.0001), though the yield of testing for pleocytosis has improved (p = 0.0104).
Conclusions: Laboratory test patterns correspond with those of clinical disease and are a promising source of surveillance data. Using such data for real-time monitoring requires specific adjustments for patient age, periodicities, and secular trends.     

Acute effects of high-dose thyrotropin releasing hormone infusions in Alzheimer's disease

Thyrotropin releasing hormone (TRH) was administered intravenously to ten patients with Alzheimer's Disease (AD) in a high-dose paradigm, thought to maximize central nervous system effects and potentially produce facilitation of cholinergic function, a known property of the neuropeptide. Acute effects of TRH on behavioral, cognitive and physiologic measures were assessed after patients received 0.1 mg/kg TRH, 0.3 mg/kg TRH and placebo, the higher TRH dose and placebo being given in a randomized, double-blind fashion. Patients showed statistically significant increases in arousal and improvement in affect, as well as a modest improvement in semantic memory, all after receiving the higher TRH dose. Both TRH doses produced transient rises in systolic blood pressure, with no effect on diastolic blood pressure, heart rate or temperature. This study suggests that high-dose TRH can be safely administered to AD patients and is neurobehaviorally active; further studies are needed to determine the extent and mechanism of the cognitive and psychobiological properties of this peptide in AD and other neuropsychiatric disorders.     

新胆碱酯酶抑制剂对实验性重症肌无力的治疗作用

本文应用实验性重症肌无力模型研究了7种新的胆碱酯酶抑制剂对实验性重症肌无力的治疗作用,其中包括6种二甲氨基甲酸烷氧(烷硫)基苯酯及1种中草药提取物,大多数化合物对乙酰胆碱酯酶有较强的抑制作用,并见到有不同程度的治疗效果。二甲氨基甲酸-3-叔丁基-4〔2-(1-哌啶基)乙氧基〕苯酯不仅明显改善肌无力症状,而且毒性小、副作用较新斯的明轻,值得进一步研究。     

建立白介素-1β诱导小型猪冠状动脉狭窄动物模型

目的探讨建立快速、稳定冠状动脉狭窄程度符合临床干预治疗的动物模型方法。方法将小型猪40头随机分为5组,每组8头分别开胸手术,游离搔刮冠状动脉前降支和回旋支外膜并按组包裹含不同剂量白介素-1β(IL-1β)纸巾,IL-1β含量依次为0、3.0、4.5、6.0、7.5μg。术后2周行冠状动脉造影,观察局部冠状动脉狭窄病变情况,处死动物,对包裹纸巾的冠状动脉血管段行病理分析。结果冠状动脉造影见各组冠状动脉管腔平均狭窄程度依IL-1β剂量分别为0、20.61%、39.58%、77.34%、93.79%。IL-1β剂量7.5μg组中2头猪前降支100%狭窄,1头于术后11d死亡未作造影。组织病理学检查见含IL-1β纸巾包裹的冠状动脉血管内膜均有不同程度的增生、炎性细胞浸润、管腔缩小,增生的血管内膜内可见少量血管平滑肌细胞;不含IL-1β纸巾包裹的冠状动脉血管内膜和中膜无增生,管腔无变化。结论采用游离搔刮小型猪冠状动脉前降支和回旋支外膜并包裹含IL-1β6.0μg的纸巾,2周内可建立起稳定、可靠、狭窄程度符合临床冠心病干预治疗的实验研究动物模型。     

湿热证出汗异常的论治

病理性的出汗和阴液、阳气的盛衰,以及阳气对阴液的蒸化过程是否有阻碍这3个要素紧密相关。对湿热证中出汗的表现及其汗法的宜忌进行了总结,详细论述了汗法的运用技巧,并对当前临床中常见的误治进行了剖析,指出阴阳平和、气化通畅是汗法的最终目的。     

冠心病患者血栓前状态分子标志物的变化

观察冠心病患者凝血、纤溶指标的变化 ,以探讨凝血系统的变化与冠心病发病的关系。采用酶联免疫吸附双抗体夹心法检测 10 0例冠心病患者血浆D 二聚体、血小板α颗粒膜蛋白 14 0及血管性血友病因子含量 ,并与4 4例健康人比较。结果发现 ,冠心病患者血浆D 二聚体、血小板α颗粒膜蛋白 14 0和血管性血友病因子明显升高 ,与对照组比较差异显著 (P <0 .0 1) ,且急性心肌梗死患者各指标变化明显高于陈旧性心肌梗死、不稳定型心绞痛和稳定型心绞痛患者 (P <0 .0 1) ,其中不稳定型心绞痛患者血浆血小板α颗粒膜蛋白 14 0明显高于稳定型心绞痛患者 (P <0 .0 5 )。冠心病患者血小板α颗粒膜蛋白 14 0、血管性血友病因子及D 二聚体水平之间呈明显的正相关性(P <0 .0 5 )。结果提示 ,冠心病患者存在明显的高凝状态 ,表现为继发性纤溶亢进 ,血小板活性增加及血管内皮细胞损伤 ,且与冠心病患者的病情变化有一定关系。     

冠心病患者血清对氧磷酶活性的测定

目的探讨冠心病患者血清对氧磷酶1活性及其与冠心病之间的关系。方法选择冠状动脉造影确诊的冠心病患者106例和非冠心病组62例,用乙酸苯酯法和比色法分别测定两组血脂、血清对氧磷酶1活性、超氧化物歧化酶及丙二醛含量,并进行对比分析。结果冠心病组血清中对氧磷酶1活性和超氧化物歧化酶水平分别为113±64μkat/L和43.8±8.2 kU/L,均较对照组降低(134±72μkat/L和63.4±5.7 kU/L)(P<0.05);而丙二醛含量较对照组升高(9.4±1.8μmol/L比4.1±0.5μmol/L,P<0.01)。对氧磷酶1活性与高密度脂蛋白和超氧化物歧化酶水平呈正相关,与丙二醛水平呈负相关。冠状动脉狭窄者对氧磷酶1活性较无狭窄者明显减低(P<0.001),2、3支血管病变者较1支血管病变者对氧磷酶1活性降低(P<0.05)。结论冠心病患者血清对氧磷酶1活性降低,低对氧磷酶1活性与冠心病严重程度有关。     

人原发性结肠恶性淋巴瘤裸小鼠原位移植肝转移模型的建立

目的 为探讨结肠恶性淋巴瘤的发病机制和实验治疗提供理想的动物模型。方法将结肠恶性淋巴瘤术中原发灶和肝转移灶新鲜瘤组织块植入裸小鼠结肠黏膜层内，观察原位移植的成瘤率，移植瘤的侵袭和转移率。进行形态学（光镜、电镜、免疫组织化学）、染色体核型和流式细胞分析。结果人结肠淋巴瘤原发灶和肝转移灶新鲜瘤组织均获得移植成功。依据WHO新的分类标准，建成1株人结肠原发性（原发灶）非霍奇金B细胞性恶性淋巴瘤裸鼠原位移植高转移模型（HCBL-0303）和1株人结肠原发性（肝转移灶）非霍奇金B细胞性恶性淋巴瘤裸鼠原位移植肝转移模型（HCBL-0304）。移植瘤组织病理学为（非霍奇金B细胞性）高度恶性淋巴瘤；免疫组化显示CDl9、CD20、CD22阳性，CD3、CD7阴性。染色体数目55—59条；流式细胞DI值1．59—1．71，均为异倍体。HCBL-0303肝转移率为63．7％，淋巴结转移率为56．4％；HCBL-0304肝转移率和淋巴结转移率为100％。移植瘤在裸鼠结肠内自主侵袭性生长，发生血液转移、淋巴转移和腹腔内种植性转移。结论HCBL-0303和HCBL-0304是首次成功建立的人结肠恶性淋巴瘤裸鼠原位移植自发性肝转移模型，可用于结肠恶性淋巴瘤的发病机制、侵袭、转移及实验治疗的研究。     

糖尿病是一种心血管疾病和心身疾病的观点探讨

本文就糖尿病患者最早就诊的是心血管内科医师,以及负性情绪可明显影响糖尿病的发展进行了分析,并提出改善心境可明显增加自我控制糖尿病的能力。