急性吗啡耐受大鼠脑内孤啡肽含量和释放量变化的研究

目的：应用放射免疫分析方法检测急性吗啡耐受过程中大鼠脑室灌流液、中脑导水管周围灰质（ＰＡＧ）及杏仁核中孤啡肽（ＯＦＱ）免疫活性（ｉｒ）的动态变化。结果：（１）每２小时皮下注射盐酸吗啡１次（７ｍｇ／ｋｇ）,连续注射８次,造成急性吗啡耐受。此组大鼠脑室灌流液中ＯＦＱｉｒ较生理盐水对照组升高４０％,差异显著（Ｐ＜０．０５）。（２）皮下注射吗啡１、６、８次的大鼠ＰＡＧ中ＯＦＱｉｒ含量呈逐渐增长趋势,分别较生理盐水组升高９％（Ｐ＞０．０５）、３５％（Ｐ＜０．０５）和６０％（Ｐ＜０．０１）。（３）皮下注射１次吗啡的大鼠杏仁核中ＯＦＱｉｒ与生理盐水组相比,降低１１％,但无统计学意义;至第８次吗啡注射后较对照组升高４１％（Ｐ＜０．０５）。结论：多次注射吗啡能引起大鼠脑内ＯＦＱ含量和释放增多,结合以往关于ＯＦＱ在脑内对抗吗啡镇痛的事实表明内源性ＯＦＱ可能参与急性吗啡耐受的形成。     

吸入一氧化氮治疗兔油酸急性呼吸窘迫综合征

目的：探讨吸入一氧化氮（ＮＯ）对急性呼吸窘迫综合征（ＡＲＤＳ）肺换气功能的影响及其毒副作用。方法：油酸诱发新西兰兔ＡＲＤＳ模型后分组（ｎ＝９）进行机械通气治疗４ｈｒ：（１）对照组；（２）吸入２０ｐｐｍＮＯ（ＮＯ组）。于动物实验的基础状态、治疗前测定ＰａＯ２／ＦｉＯ２、肺内静动脉分流（Ｑ·ｓ／Ｑ·ｔ）、血ＮＯ２－／ＮＯ３－和高铁血红蛋白（ＭｅｔＨｂ），治疗后ＰａＯ２／ＦｉＯ２于１、２、４ｈｒ，其余指标于４ｈｒ复查一次。观察肺病理并测定肺湿干重比（Ｗ／Ｄ）。结果：治疗后，对照组ＰａＯ２／ＦｉＯ２较治疗前呈下降趋势（４ｈｒ，Ｐ＜０．０５），Ｑ·ｓ／Ｑ·ｔ增加（４ｈｒ，Ｐ＜０．０１），ＮＯ组各时点ＰａＯ２／ＦｉＯ２均较治疗前和同时点的对照组明显增加（Ｐ＜０．０１～０．０５），Ｑ·ｓ／Ｑ·ｔ明显低于治疗前和同时点的对照组（４ｈｒ，Ｐ＜０．０５，Ｐ＜０．０１）。实验结束时，ＮＯ组ＮＯ２－／ＮＯ３－和ＭｅｔＨｂ较对照组显著增加（Ｐ＜０．０５，Ｐ＜０．０１），两组的肺病理和Ｗ／Ｄ无明显区别。结论：吸入２０ｐｐｍ能够明显改善兔油酸型ＡＲＤＳ的肺换气功能，无明显近期毒副作用     

急性吗啡耐受大鼠脑内弧啡肽含量和释放量变化的研究

目的：应用放射免疫分析方法检测急性吗啡耐受过程中大鼠脑室灌流液、中脑导水管周围灰质（ＰＡＧ）及杏仁核中孤啡肽（ＯＦＱ）免疫活性（ｉｒ）的动态变化。结果：（１）每２小时皮下注射盐酸吗啡１次（７ｍｇ／ｋｇ）,连续注射８次,造成急性吗啡耐受。此组大鼠脑室灌流液中ＯＦＱ－ｉｒ较生理盐水对照组升高４０％,差异显著（Ｐ〈０．０５）。（２）皮下注射吗啡１、６、８次的大鼠ＰＡＧ中ＯＦＱ－ｉｒ含量呈逐渐增长趋势,分     

FAME全自动酶标分析系统的应用

血液检测的核心是质量保证（ＱＡ）与质量控制（ＱＣ）。高品质的诊断试剂和一个全面标准化、规范化的操作过程（ＳＯＰ）是保证血液检测质量的关键。笔者采用ＭｉｃｒｏｌａｂＡＴ＆ＦＡＭＥ全自动酶免疫分析系统（简称ＦＡＭＥ系统）对献血者进行血液筛查试验，意在通过...     

生存质量系统模型

本综述了一些经典性的生存质量（Ｑｕａｌｉｔｙ ｏｆ ｌｉｆｅ，ＱＯＬ）研究献，有关ＱＯＬ概念的理论和数据研究，ＱＯＬ定义、ＱＯＬ结构和范围、ＱＯＬ与卫生有关的ＱＯＬ（ＨＲＱＯＬ），ＱＯＬ与健康状况概念的比较、ＱＯＬ的认知过程及相关的心理机制、ＱＯＬ缺口理论、幸福（Ｈａｐｐｉｎｅｓｓ）的序列模型，ＱＯＬ的决定因素及ＱＯＬ应变机制理论、世界卫生组织生存质量量表的结构及理念。作综述了各主要ＱＯＬ理     

成人呼吸窘迫综合征时肺换气功能的研究

连续动态监测４２例重症感染合并成人呼吸窘迫综合征（ＡＲＤＳ）高危状态患者的肺换气功能５项指标（ＰａＯ＿２／ＦｉＯ＿２、ａ／ＡＰＯ＿２、Ｑｓ／Ｑｔ、ＲＩ及Ａ－ａＤＯ＿２），探讨各项换气功能指标在ＡＲＤＳ早期诊断中的意义。临床上将ＡＲＤＳ高危患者分为肺功能受损（Ⅰ组）、肺早期衰竭（Ⅱ组）及肺衰竭（Ⅲ组），结果：肺早期衰竭患者临床表现虽不明显，但肺内分流已＞１０％，ａ／ＡＰＯ＿２０．５～０．６，表明患者ＡＲＤＳ病理过程已经启动，且已进入肺衰竭。本研究资料经Ｂａｙｅｓ判别分析结果，Ⅱ与Ⅰ组的Ｆ值３６．２３，Ⅲ与Ⅰ组Ｆ值５１．２６，Ⅲ与Ⅱ组Ｆ值１５．７６。提示：３组间确有区别。被选中的自变量为不同病期时的呼吸次数、ＰａＯ＿２／ＦｉＯ＿２、ａ／ＡＰＯ＿２、ＲＩ和Ｑｓ／Ｑｔ。说明这些指标对ＡＲＤＳ的诊断具有参考价值。作者认为ＰａＯ＿２／ＦｉＯ＿２用以判别肺衰较单独使用ＰａＯ＿２更合理，并提出将ａ／ＡＰＯ＿２应用于临床则较Ａ－ａＤＯ＿２有其优点。     

多脏器功能失常综合征与肠道内细菌及内毒素易位

多脏器功能失常综合征与肠道内细菌及内毒素易位王今达过去被称为多脏器衰竭（ＭｕｌｔｉｐｌｅＯｒｇａｎＦａｉｌｕｒｅ简称ＭＯＦ）的诊断名词，近年来已被多脏器功能失常综合征（ＭｕｌｔｉｐｌｅＯｒｇａｎＤｙｓｆｕｎｃ－ｔｉｏｎＳｙｎｄｒｏｍ简称ＭＯＤＳ）所代...     

二维多普勒定量评价架桥前后乳内动脉血流特性变化

目的：用二维多普勒测定冠状动脉架桥（ＣＡＢＧ）患者术前、术后乳内动脉（ＩＭＡ）血流特性的变化。为判断ＩＭＡ桥的通畅性提供依据。方法：对３１例ＩＭＡ架桥患者在术前测定原位的左、右乳内动脉（ＬＩＭＡ与ＲＩＭＡ）的直径（Ｄ）、流量（Ｆ）及时间流速积分（ＴＶＩ），和心输出量（ＣＯ），并将术后不同时间测定的各指标与术前对比。结果：术后６ｈ到１０周两者的Ｄ与Ｆ，Ｆ／ＣＯ与术前相比均明显上升（Ｐ〈０。．０５），     

恶性肿瘤病人生质量调查分析

目的：探讨恶性肿瘤病人生存质量（ＱＯＬ）状况。方法：制定恶性肿瘤病人ＱＯＬ调查表，对１００例恶性肿瘤患进行调查，结果：本调查表比较客观的反映了肿瘤病检ＱＯＬ，其评分与病人活动状况评分（ＫＰＳ评分）相关性良好（γ＝０．３０４，Ｐ〈０．００１）。结论：恶性肿瘤病人ＱＯＬ是反映患健康程度的主观指标，ＱＯＬ与生存率同样重要。     

吸入一氧化氮改善烟雾吸入性损伤犬肺通气功能的意义

目的评价吸入一氧化氮（ＮＯ）对犬烟雾吸入性损伤肺通气功能改善的效果。方法烟雾吸入伤后，将１７只犬随机分为２组，对照组（ｎ＝８）单纯吸氧（ＦｉＯ２，０．４５），治疗组（ｎ＝９）吸氧（ＦｉＯ２，０．４５）＋０．００４５％（４５ｐｐｍ）ＮＯ，连续监测１２小时血气变化；并按时相点抽血检测有关指标。数据行多个样本均数间方差分析。结果吸入ＮＯ治疗组ＰａＣＯ２、呼吸指数（ＲＩ）、肺泡死腔率（ＶＤ／ＶＴ）、肺动脉分流率（ＱＳ／ＱＴ）和碳氧血红蛋白（ＨｂＣＯ）含量比对照组均有不同程度的下降（Ｐ＜０．０５～０．０１），而动脉血浆亚硝酸盐（ＮＯ－２）水平则明显高于对照组（Ｐ＜０．０１）。结论吸入ＮＯ能明显改善肺通气功能，作为吸入性损伤的综合治疗，吸入ＮＯ疗法值得进一步研究。     

The effect of x-rays on the rickettsiostatic activity of streptomycin,aureomycin, and penicillin

The effect of x-rays on the rickettsiostatic activity of streptomycin, penicillin and aureomycin in the embryonate egg was investigated. Only a slight reversal of the rickettsiostatic action of 5 mg. of streptomycin occurred in embryonate eggs given 100 r of x-rays at 4 days of incubation, whereas complete reversal occurred in those given 1000 r. Groups of eggs irradiated with intermediate doses of x-rays showed a graded response. The rickettsiostatic activity of 5 mg. (1660 Oxford units/mg.) of penicillin or of 5 mg. of aureomycin was not reversed by doses of x-rays ranging from 100 to 1000 r. 500 r of x-rays reversed the rickettsiostatic activity of 2 mg., 4 mg., 8 mg., or 16 mg. of streptomycin per egg in proportion to the amount of streptomycin injected. The rickettsiostatic activity of 2 mg. of streptomycin was completely reversed and the activity of 16 mg. only partially reversed. Reversal of the rickettsiostatic activity of streptomycin by x-rays was observed when radiation was given up to 6 days after the injection of the antibiotic into 7-day-old embryos. Reversal of the rickettsiostatic activity of 4 mg. of streptomycin could be detected when the antibiotic was injected 3 days after 500 r of x-radiation. Explanations of the observed phenomena are discussed in terms of biochemical and biophysical alterations of the cells of the host.     

ON HYPERTROPHY AND REGENERATION OF THE ISLANDS OF LANGERHANS

1. Hypertrophy of the islands of Langerhans occurs in two forms: (1) the simple type which is nothing more than an increase in size of preexisting islands; and (2) the columnar type, in which the islands are composed of anastomosing columns of cylindrical cells. 2. Regeneration of the islands of Langerhans takes place by means of a budding off of columnar cells from the ducts. The process is analogous to the development of the islands in the fetal pancreas. 3. Newly formed islands of Langerhans are composed of cylindrical cells similar in all respects to those constituting hypertrophied islands of the columnar type. The two structures are identical, the latter being a later phase of the former. 4. Newly formed islands of Langerhans are capable of a greater hypertrophy than preëxisting islands. Both types of insular hypertrophy are usually of a compensatory character, the columnar, or regenerative type, being the more important. 5. Hypertrophy and regeneration of the islands of Langerhans occur most frequently in diabetes mellitus (34 per cent. of 100 cases studied). These changes are usually associated with sclerosis or hyaline degeneration of other islands. 6. Hypertrophy and regeneration of the islands of Langerhans are occasionally observed in cirrhosis and carcinoma of the pancreas. In some of the most advanced cases, however, the islands have been spared and neither hypertrophy nor regeneration are present. 7. Regeneration of the islands of Langerhans has been noted in five cases in which there was no evidence of diabetes and where the pancreas was for the most part normal. In four of these cases, columnar hypertrophy of the islands was also observed. All five cases were associated with abnormalities of the larger ducts—obstruction, chronic inflammation, and adenomatous proliferation of the lining epithelium. 8. The occurrence of hypertrophy and regeneration of the islands of Langerhans affords considerable evidence in favor of their anatomic and functional independence.     

重症监护病房鲍曼不动杆菌医院感染暴发调查与对策分析

目的：对发生于重症监护病房（ICU）的鲍曼不动杆菌（ABA）医院感染暴发进行调查,为控制医院感染提供依据和对策。方法按《医院消毒技术规范》要求进行采样和细菌培养,对患者、环境来源菌株进行细菌鉴定和药敏试验。结果环境中ABA检出率从高到低依次为吸痰小瓶（88．9％）、护工手（60．0％）、呼吸机回路（37．5％）、医务人员手（28．0％）、床头桌面（25．0％）、鼻拭子（13．3％）、设备按钮（12．5％）、医务人员工作服（12．0％）、工作人员拖鞋底（6．7％）。患者痰标本和医院环境中分离到的ABA具有相同的耐药菌谱。此次感染暴发的感染源为1例ABA感染患者,暴发原因为呼吸机回路非一次性使用和医护人员手卫生依从性差。结论规范医务人员操作行为、严格无菌技术、加强病房环境管理、提高医护人员手卫生依从性,能有效预防和控制医院感染。     

缓慢牵伸深筋膜的超微结构观察

目的:观察缓慢牵伸深筋膜前后超微结构的变化。方法:建立新西兰大白兔双侧胫骨延长模型,延长速度为1mm/d和2mm/d,每12h一个增量,延长率为胫骨长度的10％和20％。以透射电镜观察深筋膜超微结构的变化,随机选取视野测量各牵伸组胶原原纤维的直径,并进行统计学处理。结果:正常对照深筋膜由纤维细胞和胶原原纤维构成,缓慢牵伸后的深筋膜代谢活跃,2mm/d的延长速度下胶原原纤维破坏,直径增粗,成纤维细胞溶酶体和粗面内质网增多;1mm/d的延长速度下,胶原原纤维无破坏,直径变细,成纤维细胞粗面内质网增多,延长率为20％下,成纤维细胞有核分裂相,毛细血管内皮细胞呈活化状态。结论:缓慢牵伸深筋膜后,其超微结构发生代谢活跃的显著变化,2mm/d的延长速度下为损伤与修复,1mm/d的延长速度,20％延长率下发生再生性变化。     

Characterization of alpha-L-fucosidase from two different families with fucosidosis.

1. Two different families with a different type of fucosidase deficiency are described. 2. In the first family the activity of alpha-L-fucosidase in leucocytes of two patients with fucosidosis type I was about 4 to 8% of the normal value. The activity of alpha-L-fucosidase in the leucocytes of the father and the mother are in the heterozygote range, while a sister of the propositus showed normal values. 3. The activity of alpha-L-fucosidase of the propositus from urine, serum and liver were also severely decreased. The activity of alpha-L-fucosidase in the urine of the parents and the healthy sister of thr propositus were about 5% of the mean normal value. However in the serum these values were above 50%. 4. The KM value for alpha-L-fucosidase from leucocytes of the patient was increased about 10 times and in serum this value was even higher. The KM values from the enzyme of the parents were in the normal range. 5. The abnormal enzyme from the propositus is unique in its thermal behaviour since after heating its activity increased. 6. In the second fanily the activity of alpha-L-fucosidase in the leucocytes of the patient is about 30% of the mean normal value, while the arylsulphatase A activity is also decreased (25% of the mean normal value). 7. The activity of alpha-L-fucosidase from the leucocytes of the father and the healthy brother are about 50% of the mean normal level, while the enzyme of the mother showed a normal activity. 8. The alpha-L-fucosidase activity in the urine and the liver of the propositus is also decreased. The serum enzyme activity however was in the normal range. 9. The KM value of alpha-L-fucosidase and heat stability of the enzyme of the patient were normal. In the leectrophoretic pattern of the whole family one bond was missing.     

Production of CTX-M-3 extended-spectrum beta-lactamase and IMP-1 metallo beta-lactamase by five Gram-negative bacilli: survey of clinical isolates from seven laboratories collected in 1998 and 2000, in the Kinki region of Japan

The aim of this study was to research the distribution in the Kinki region of Japan of Enterobacteriaceae and Pseudomonas aeruginosa that produce extended-spectrum beta-lactamase (ESBL) and metallo beta-lactamase (MBL). One thousand isolates, 200 of each of four enterobacterial species (i.e. Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae and Serratia marcescens) and 200 of P. aeruginosa, were collected from seven different laboratories during two 2 month periods, one in 1998 and one in 2000. A double-disc synergy test (DDST) and 2-mercaptopropionic acid inhibition test (2-MPAT) were used to confirm beta-lactamase-producing isolates. The DDST was positive for one isolate of E. coli, five of K. pneumoniae, two of E. cloacae and 14 of S. marcescens. The 2-MPAT was positive for five isolates of S. marcescens and two of P. aeruginosa. We identified the beta-lactamase type of each isolate by molecular confirmatory tests (isoelectric focusing, PCR and DNA sequencing): CTX-M-3 ESBLs (three isolates of K. pneumoniae, two of E. cloacae and 13 of S. marcescens), CTX-M-2 ESBL (one isolate of K. pneumoniae), SHV-12 ESBLs (one isolate of E. coli and one of S. marcescens), CTX-M-3 and SHV-12 combination ESBL (one isolate of K. pneumoniae) and IMP-1 MBLs (five isolates of S. marcescens and two of P. aeruginosa). In conclusion, many species of Gram-negative bacilli that produce CTX-M-3 ESBLs and IMP-1 MBLs were disseminated widely in different hospitals of the Kinki region of Japan. Therefore, monitoring of laboratory bacterial ecology seems important to stop the spread of these strains through nosocomial outbreaks.     

Atherothrombosis: state-of-the-art review and approaches to the problem

Acute ischemia resulting from arterial lesions poses a real threat to mankind. The concept of atherothrombosis aims to unite doctors of different specialities to combat this pathology; it suggests active exchange of experience in the management of aherothrombosis between representatives of different medical disciplines. The concept is expected to promote treatment of the patients. The common pathogenetic mechanism of ischemic disorders of the heart, brain, and lower extremities provides a basis for the recommendation of active antithrombotic therapy for their prevention. The current approach to the management of atherothrombosis is prone to further improvement despite certain reports of successful inpatient treatment of acute myocardial infarction. Prevention of blood clot formation, i.e. prophylaxis of atherosclerosis, remains a challenging problem. Statins may prove of great help in this respect. Studies of the effect of infectious factors on the integrity of the fibrous envelope of an atherosclerotic plaque are currently underway.     

THE OCCURRENCE AND VIRULENCE OF PNEUMOCOCCI IN THE CIRCULATING BLOOD DURING LOBAR PNEUMONIA AND THE SUSCEPTIBILITY OF PNEUMOCOCCUS STRAINS TO UNIVALENT ANTIPNEUMOCOCCUS SERUM

Studies of the bacteriology of the blood were made in thirty-seven cases of lobar pneumonia. The pneumococcus was isolated from the blood in approximately 50 per cent. of the cases studied. The course of infection in individuals with pneumococcus in the blood was more severe than in those in which no organism could be cultivated from the blood. 77 per cent. of the patients with positive blood cultures died, and 79 per cent. of patients with negative blood cultures recovered. In fatal instances of pneumonia, where the pneumococcus was found in the blood, the number of organisms per cubic centimeter of blood was very high in the last stage of the disease. In individuals dying of pneumonia without blood infection, the disease was characterized by a rapid spread of the local process in the lungs. It is not unlikely that the symptoms of collapse, developing on the fifth or sixth day of lobar pneumonia, are often the expression of serious invasion of the blood by the pneumococcus. In other instances, they mark an extension of the local process in the lungs. Strains of pneumococcus isolated from the blood of patients with lobar pneumonia were usually of high animal virulence. In a few instances where the organism isolated from the blood was of low virulence for animals, the patients recovered. The protective power of a univalent antipneumococcus serum was tested against nineteen strains of typical pneumococcus and against four strains of closely allied organisms. The serum manifested some degree of protection against twelve out of nineteen strains of typical pneumococci. No protection was observed against the atypical organisms. In eight instances the degree of protection obtained was high, in three low, and in one there occurred only a prolongation of the period of life of the inoculated animal.     

尿毒症性心脏病的异常超声心动图表现

分析５１倒尿毒症性心脏病的超声心动图资料，发现各腔径扩大检出率：ＬＡ为９０．２％，ＬＶ为７４．５％；ＲＶ为４３．１％；ＡＯ为３１，４％；室壁增厚检出率：ＬＶＰＷ为６４．７％，ＩＶＳ为６２．７％。心包积液检出率：５１％，多为少至中等量积１液。二失瓣返流检出率：３７．３％，均为轻至中度返流；主动脉瓣返流检出率：７．８％，均为轻度返流。典型二尖瓣环钙化４例，占７．８％。此外，ＬＡ、ＬＶＤｄ、ＩＶＳ及ＬＶＰＷ总均值超正常高限；ＬＶＥＦ、ＦＳ％值偏低。     

硝苯吡啶所致小鼠牙龈增生的组织病理学和细胞凋亡实验研究

目的:通过动物实验来研究硝苯吡啶造成小鼠牙龈增生的发病机制和预防办法,降低临床应用硝苯吡啶的副作用。方法:采用纯系昆明种雄性小鼠为研究对象,灌喂硝苯吡啶不同时间来观察:1.牙龈增生与牙龈上皮厚度及胶原纤维的变化;2.细胞凋亡指数;3.药物作用时间对上述指标的影响;4.撤药后增生牙龈的恢复情况。结果:小鼠牙龈上皮厚度明显增加,胶原纤维致密性加大,牙龈凋亡细胞数目减少(P<0.05),硝苯吡啶撤退后一段时间,增生的牙龈恢复正常。结论:硝苯吡啶可导致小鼠牙龈增生,服药55天细胞凋亡数减少,此损害是可逆的。