糖尿病患者便秘的原因分析及护理干预

目的探讨糖尿病患者发生便秘的原因，预防便秘的发生。方法将本院287例糖尿病便秘患者随机分成干预组（151例）和对照组（136例），2组在年龄、体重、糖尿病发病史等方面差异比较均无统计学意义（P〉0.05）。给予干预组在健康教育、饮食指导、体育锻炼、腹部按摩及精神心理等方面实施护理干预措施，对照组则采用常规护理，1周后2组进行效果评定。结果干预组接受护理干预后排便情况等方面与对照组比较，差异有显著性意义（χ^2=63.14，P〈0.01）。结论护理干预能够提高糖尿病患者对疾病相关知识的认知和自我管理能力，改变不良的行为和生活习惯，有效地降低糖尿病便秘发生率，提高生活质量。     

Adenocarcinoma arising in mature cystic teratoma: a case report

Benign cystic teratoma is recognized as one of the most common tumors in women during the reproductive age and frequently is treated by pelviscopic operation. Malignant transformation of a benign cystic teratoma is a rare event, and adenocarcinoma is extremely rare, and distinguishing this malignant change from benign disease preoperatively is nearly impossible even by the use of radiological imaging or various tumor markers. Therefore, patients should be informed that if a laparoscopic cystectomy is undertaken, a prompt second staging operation should be performed if the definitive pathology reveals an unexpected malignancy. We present a case with thyroid papillary carcinoma of follicular variant arising from mature cystic teratoma removed by laparoscopic salpingo-oophorectomy followed by staging laparotomy. We briefly reviewed literatures with regard to malignant transformation of a benign cystic teratoma.     

超级γ刀治疗胰腺癌46例临床结果分析

目的：观察超级γ刀治疗胰腺癌的疗效和放射反应。方法：46例胰腺癌采用超级γ刀治疗,治疗时采用仰卧位,体架和真空负压袋体位固定,CT扫描和三维计划,PTV在GTV外扩1cm,50%剂量线为处方剂量线,处方剂量3Gy-5Gy/次,4-5次/周,肿瘤边缘总剂量40Gy-50Gy,肿瘤中心区域80Gy-100Gy。结果：原发灶的完全缓解率（CR）13.0%,部分缓解率（PR）60.1%,总有效率（CR＋PR）73.9%。Ⅰ、Ⅱ期1、2年生存率分别为80.0%和50.0%,Ⅲ、Ⅳ期1、2年总生存率分别为44.4%和22.2%;Ⅰ、Ⅱ期和Ⅲ、Ⅳ期的2年生存率比较有显著差异（P〈0.05）。治疗期间胃肠反应Ⅰ-Ⅱ级为60.3%,Ⅲ级13.0%,经对症处理病人均能按计划完成治疗。结论：超级γ刀治疗胰腺癌,对不能手术的患者可提高局控率和生存率。     

Sonographic and pathologic findings in typical and atypical medullary carcinomas of the breast

PURPOSE: We investigated whether there was a relationship between the sonographic and histologic appearances of medullary carcinomas of the breast to determine whether sonography is helpful in the differentiation of typical and atypical medullary carcinomas. METHODS: We retrospectively reviewed the histologic slides and sonograms of 20 patients who had been diagnosed with medullary carcinoma of the breast. We then classified the carcinomas as typical or atypical based on strict histologic criteria. We also evaluated the relationship between sonographic findings and the histologic reclassification. RESULTS: Eight (40%) of the 20 medullary carcinomas were classified as typical, and 12 (60%) were classified as atypical. On sonography, a smooth outline was visualized in 6 (75%) of the 8 typical medullary carcinomas but in none of the 12 atypical carcinomas. A jagged margin was sonographically visualized in 10 (83%) of the 12 atypical carcinomas, and a focal irregularity in the margin was visualized in 2 (17%) of the 12 atypical carcinomas. Four of the typical medullary carcinomas had posterior enhancement, and 9 of the atypical medullary carcinomas showed retrotumoral shadowing. The difference in tumor-margin regularity between typical and atypical medullary carcinomas was found to be statistically significant (p < 0.001) using the 2-tailed Fisher's exact test. CONCLUSIONS: To prevent overdiagnosis of medullary carcinoma, a thorough pathologic review of the entire tumor is recommended if sonography shows a jagged margin or a margin with focal irregularity.     

Therapeutic strategies for psoriasis

Psoriasis is a chronic, inflammatory, hyperproliferative skin disease that affects approximately 1-2% of the general population in the U.K. and U.S.A. It is rarely life-threatening, but causes considerable patient morbidity. The disease waxes and wanes, with substantial variability both between and within individual patients. There is no cure for psoriasis; therefore, the aim of treatment is to minimize the extent and severity of the disease to the point at which it no longer disrupts substantially the patient's quality of life. We review the current treatment options, which include topical therapies, phototherapy and systemic agents. Lack of efficacy, adverse effects and aesthetic problems limit the use of many topical therapies. Likewise, the risk of toxicity is a major problem with currently available phototherapies and systemic treatments. Advances in understanding the aetiology and pathogenesis of psoriasis allude to the possibility of innovative, targeted therapies in the future.     

Dexamethasone enhances mallory body formation in drug-primed mouse liver

In a clinical study in which patients with alcoholic hepatitis were treated with prednisone for 1 month, posttreatment liver biopsies showed diminished inflammation, but Mallory bodies were not diminished. This suggested that steroid treatment may reduce inflammation by inhibiting NFkappaB activation. Sparing of Mallory bodies suggests that NFkappaB activation may not be involved mechanistically in Mallory body formation. To test this idea, we induced Mallory body formation in drug-primed mice with or without dexamethasone treatment. As predicted, dexamethasone decreased NFkappaB activation; however, Mallory body formation was increased. Surprisingly, TNFalpha and iNOS, which normally increase as a result of NFkappaB activation, were upregulated by the dexamethasone treatment. It was concluded that NFkappaB activation is not involved in Mallory body formation. Despite this, induced increases in TNFalpha, iNOS, c-jun/API and c-myc expression indicate that oxidative stress is likely involved in Mallory body formation.     

TSGF、CEA在治疗非小细胞肺癌中的临床意义

目的:本研究旨在观察TSGF(肿瘤特异性生长因子)、CEA(癌胚抗原)在非小细胞肺癌(NSCLC)后程放疗同步化疗中的变化,评价以上肿瘤标志物的临床价值。方法:40例NSCLC患者均进行后程照射同步两周期化疗,分别于治疗前以及治疗完成后4周进行TSGF以及多肿瘤标志物蛋白芯片检测。结果:TSGF、CEA在治疗开始时的阳性率分别为62%、57%,治疗后各观测指标均显著性下降(P<0.05),尤其对于达CR的患者。对于治疗有效的患者,CEA阴性患者的近期生存期显著长于阳性患者。结论:NSCLC患者后程放疗同步TP方案化疗中,对于治疗有效患者TSGF、CEA的下降与影像学资料具有一致性;并且CEA可以作为预后指标。     

香港传染病防制的工作模式和经验

本文介绍了香港特别行政区传染病防制的组织框架和相关工作，在人员培训、固定薪酬制、轮岗制、媒体监督、规范化管理等方面总结了香港的经验，对于目前内地公共卫生改革和传染病防治工作的开展可起到借鉴作用。     

氯唑沙腙对抗HepG2肿瘤细胞的作用研究

目的研究氯唑沙腙(chlorzoxazone)对HepG2细胞存活和凋亡的影响。方法采用MTT法检测氯唑沙腙对体外培养的HepG2细胞存活率的影响,通过检测LDH释放观察氯唑沙腙对HepG2细胞的致坏死作用,通过TUNEL法评价细胞凋亡率,透射镜评价细胞的超微结构。结果氯唑沙腙在50～500μmol.L-1浓度范围内对HepG2细胞的存活率均有抑制作用,呈明显的剂量依赖效应关系。荧光显微镜和透射电镜下可见典型的肿瘤细胞凋亡改变。氯唑沙腙在100、200、300及500μmol.L-1浓度下作用48h均可诱导HepG2细胞凋亡,具有明显的剂量效应关系。氯唑沙腙100、200、300及500μmol.L-14种浓度分别作用于HepG2细胞24、48及72h,发现以上各种浓度在48h即可诱导细胞凋亡,作用时间越长,凋亡率越高,有明显的时间效应关系。结论氯唑沙腙能够抑制HepG2细胞存活和诱导细胞凋亡。     

宣散方针灸治疗慢性阻塞性肺疾病36例临床研究

目的:观察宣散方针灸治疗急性发作期慢性阻塞性肺疾病(COPD)的临床疗效.方法:对36例慢性阻塞性肺疾病急性发作期的患者采用宣散方针灸治疗.结果:临床控制7例,占19.44%;显效21例,占58.33%;好转5例,占13.89%;无效3例,占8.33%.总有效率为91.67%,显控率为77.78%.结论:提示宣散方治疗急性发作期慢性阻塞性肺疾病具有良好的疗效.