接诊成批特重烧伤病人的护理管理

[目的]探讨接诊成批特重烧伤病人的护理管理方法。[方法]回顾总结2000年1月—2006年2月收治的8批42例特重烧伤病人的护理管理方法。[结果]8批42例病人中,38例病人通过治疗痊愈出院,4例病人因多器官功能衰竭抢救无效死亡。[结论]充分做好病人入院前的准备,合理组织分工,严密观察和处理病人是成功接诊成批特重烧伤病人的关键。     

氧疗加鱼肝油治疗新生儿中、重度尿布皮炎的效果观察

目的 观察氧疗加鱼肝油治疗新生儿中重度尿布皮炎的效果。方法 对60例中度和40例重度尿布皮炎的新生儿采用在传统护理的基础上，加用直接吹氧和涂抹鱼肝油，并观察其疗效。结果 中度有效55例（91．7％），无效5例（8．3％）；重度有效33例（82．5％），无效7例（17．5％）。结论 氧疗加鱼肝油可保持新生儿臀部皮肤干燥清洁，加促皮炎消退，促进创面愈合，增加患儿的舒适感，对促进患儿的生长发育有重要意义。     

腹腔镜在妇科的应用及其护理进展

随着科学技术的发展 ,新的医疗器械不断开发和应用 ,腹腔镜在妇科各种疾病的诊断和治疗中广泛使用 ,微创手术逐渐被人们认识和接受 ,但同时也向临床护理提出了新的要求。     

Neuropathic pain: early spontaneous afferent activity is the trigger

Intractable neuropathic pain often results from nerve injury. One immediate event in damaged nerve is a sustained increase in spontaneous afferent activity, which has a well-established role in ongoing pain. Using two rat models of neuropathic pain, the CCI and SNI models, we show that local, temporary nerve blockade of this afferent activity permanently inhibits the subsequent development of both thermal hyperalgesia and mechanical allodynia. Timing is critical-the nerve blockade must last at least 3-5 days and is effective if started immediately after nerve injury, but not if started at 10 days after injury when neuropathic pain is already established. Effective nerve blockade also prevents subsequent development of spontaneous afferent activity measured electrophysiologically. Similar results were obtained in both pain models, and with two blockade methods (200mg of a depot form bupivacaine at the injury site, or perfusion of the injured nerve just proximal to the injury site with TTX). These results indicate that early spontaneous afferent fiber activity is the key trigger for the development of pain behaviors, and suggest that spontaneous activity may be required for many of the later changes in the sensory neurons, spinal cord, and brain observed in neuropathic pain models. Many pre-clinical and clinical studies of pre-emptive analgesia have used much shorter duration of blockade, or have not started immediately after the injury. Our results suggest that effective pre-emptive analgesia can be achieved only when nerve block is administered early after injury and lasts several days.     

新塔花胶囊治疗稳定型心绞痛临床疗效观察

目的：探讨新塔花胶囊对稳定型心绞痛的疗效及作用机制。方法：４７例经临床症状及心电图检查证实的稳定型心绞痛患者随机分为２组。治疗组３７例口服新塔花胶囊，对照组１０例口服川芎嗪胶囊，均为每日３次，每次４粒，１个月为１个疗程。分别观察治疗前后２组患者心绞痛缓解及心电图、动态心电图改善情况。结果：心绞痛缓解情况治疗组显效７例，有效２３例，无效７例，总有效率８１．１％；对照组有效７例，无效３例，总有效率７０．０％。２组比较有显著性差异（Ｐ＜０．０１）。心电图显示２组的ＳＴ段改善有显著性差异（Ｐ＜０．０５）。动态心电图ＳＴ段降低持续时间，治疗组服药后时间明显缩短（Ｐ＜０．０５）。结论：新塔花胶囊治疗稳定型心绞痛是安全有效的药物。     

细胞角蛋白-7癌胚抗原在胃癌中表达的意义

目的 探讨细胞角蛋白 -7(CK7)、癌胚抗原(CEA)在胃癌中表达的意义。方法 通过免疫组织化学方法分别研究CK7、CEA在30例胃癌和2例正常人胃中的表达情况。 结果 1、正常成人胃粘膜中无CK7和CEA的表达 ;2、30例胃癌中有11例表达CK7(36.7%)、28例表达CEA(93.33 %) ,而且CK7在分化相对较低的印戒细胞癌中的表达率(66.7%)远高于高分化管状腺癌(16.7%)(p<0.05) ;CEA表达在胃癌组织浸润前缘的病例共有19例 ,其中发生淋巴结转移的13例(68.4 %) ,CEA表达的位置与淋巴结转移有明显相关性 ( p<0.05)。结论 CK7阳性细胞在胃癌组织中所代表的可能是一种分化程度相对较低的细胞 ,CEA阳性表达的细胞与具有恶性生物学行为的胃癌细胞有密切关系。胃癌中CK7、CEA表达的特点可能对进一步研究胃癌形成的机制提供一定的帮助     

Evidence for nonacetylcholinesterase targets of organophosphorus nerve agent: supersensitivity of acetylcholinesterase knockout mouse to VX lethality

The possibility that organophosphate toxicity is due to inhibition of targets other than acetylcholinesterase (AChE, EC 3.1.1.7) was examined in AChE knockout mice. Mice (34-55 days old) were grouped for this study, after it was determined that AChE, butyrylcholinesterase (BChE), and carboxylesterase activities had reached stable values by this age. Mice with 0, 50, or 100% AChE activity were treated subcutaneously with the nerve agent VX. The LD50 for VX was 10 to 12 microg/kg in AChE-/-, 17 microg/kg in AChE+/-, and 24 microg/kg in AChE+/+ mice. The same cholinergic signs of toxicity were present in AChE-/- mice as in wild-type mice, even though AChE-/- mice have no AChE whose inhibition could lead to cholinergic signs. Wild-type mice, but not AChE-/- mice, were protected by pretreatment with atropine. Tissues were extracted from VX-treated and untreated animals and tested for AChE, BChE, and acylpeptide hydrolase activity. VX treatment inhibited 50% of the AChE activity in brain and muscle of AChE+/+ and +/- mice, 50% of the BChE activity in all three AChE genotypes, but did not significantly inhibit acylpeptide hydrolase activity. It was concluded that the toxicity of VX must be attributed to inhibition of nonacetylcholinesterase targets in the AChE-/- mouse. Organophosphorus ester toxicity in wild-type mice is probably due to inhibition or binding to several proteins, only one of which is AChE.     

小鼠胚胎干细胞植入大鼠脑内分化的研究(英文)

目的观察小鼠胚胎干(ES)细胞植人大鼠隔区和海马内后的分化情况,并对其作研究和分析。方法成年SD大鼠35只,体质量200～250g,雌雄不限。以SD大鼠为宿主,将ES细胞移植入宿主隔区和海马内,移植后l,2,3,4和8周后取脑,冷冻切片,进行Nissl,M6,NSE,GFAP免疫组织化学染色。结果ES细胞移植入大鼠隔区和海马内后,从第2周开始表达M6、GFAP、NSE等抗原,持续至第4周,主要位于移植区内,较少迁移。结论小鼠ES细胞移植入大鼠隔区和海马内后,分化为神经元,神经胶质细胞。     

人表皮干细胞体外分选和培养对构建组织工程皮肤种子细胞的可能性

目的:探讨人表皮干细胞在体外分选和培养的可能性,为构建组织工程皮肤寻找理想的种子细胞。方法:实验于2002-01/12在中山大学基础医学院动物中心完成。根据表皮干细胞与Ⅳ型胶原蛋白的高黏附的特性,运用黏附实验将干细胞从培养在鼠Ⅳ型胶原包被的培养瓶的表皮细胞中分选出来,并从形态学、超微结构及免疫组化等方面进行了鉴定。结果:分选出来培养的细胞符合表皮干细胞的特征,说明分选培养的细胞是表皮干细胞。结论:预先在体外对表皮干细胞进行分选和培养是可行的,该细胞群有望成为构建组织工程皮肤的种子细胞,为下一步应用表皮干细胞构建组织工程皮肤奠定了牢固的基础。     

Changes in biologic characteristics of breast cancer treated with high-intensity focused ultrasound

Proliferation, invasion, immortalization and metastasis are the main malignant characteristics of cancer. Previous studies have shown that high-intensity focused ultrasound (US), or HIFU, can induce irreversible damage both to breast cancer cells and to tumor blood vessels. However, light microscopy alone may not always show this clearly. In this study, molecular biologic techniques were used to examine any changes in molecular markers associated with malignant behavior after exposure to HIFU. A total of 48 women with breast cancer were randomized to a control group (mastectomy) and a HIFU group (HIFU followed by mastectomy). Immunohistochemical staining, messenger RNA (mRNA) in situ hybridization and telomere-repeat amplification protocol-enzyme-linked immunosorbent assay (TRAP-ELISA) techniques were used to detect tumor expression of proliferating cell nuclear antigen (PCNA), cell adhesion molecule CD44v6, matrix metalloproteinase-9 (MMP-9), erbB2 mRNA, and to measure telomerase activity in both groups. The results demonstrated that there were significant alterations in expression of PCNA, CD44v6, MMP-9, erbB2 mRNA, and a dramatic decrease in telomerase activity in the HIFU group. It is concluded that malignant tumor characteristics are arrested by HIFU, and that biologic factors are potential markers for assessing HIFU efficacy.