异环磷酰胺治疗晚期恶性肿瘤病人42例的护理体会

目的　总结采用联合异环磷酰胺化疗的晚期恶性肿瘤人护理对策。方法　对 4 2例晚期恶性肿瘤病人采用联合异环磷酰胺方案化疗 ,全程观察治疗过程所出现的护理问题 ,记录并总结其要点。结果　4 2例病人顺利度过化疗期 ,心理表现也正常。结论　护士熟悉药物的特性和毒性反应 ,及早预防、及时处理和加强毒性反应护理 ,才能保证化疗的顺利进行。     

光学相干断层扫描技术诊断RPE脱离

目的:观察黄斑区视网膜色素上皮(RPE)脱离的光学相干断层扫描(OCT)图像特征。方法:并发黄斑区RPE脱离的眼底病病例共48例(52眼),进行黄斑区OCT检测,观察其图像特征,并结合FFA结果进行分析。结果:根据形态特征,RPE脱离可分为两种,浆液性RPE脱离和出血性RPE脱离。前者见于部分中心性浆液性脉络膜病例(16例)、特发性浆液性RPE脱离(7例)、部分视网膜下新生血管病变的病例(10例),后者仅见于部分视网膜下新生血管病变的病例(16例)。结论:OCT能够直观形象地显示RPE脱离的形态特征,准确地测量RPE脱离的范围大小。     

盐酸洛美沙星眼凝胶临床生物等效性试验

目的:观察3g/L盐酸洛美沙星眼凝胶的临床疗效及安全性。方法:对128例(203眼)细菌性结膜炎和细菌性角膜炎患者采用多中心、随机分组、平行对照试验,观察其主要症状体征消失情况、角膜炎症面积缩小情况、病原菌清除效果和不良反应。试验组(testgroup,TG)65例(103眼),对照组(controlledgroup,CG)63例100眼,分别应用3g/L盐酸洛美沙星眼凝胶和3g/L盐酸洛美沙星滴眼液。结果:①TG治愈率(80.6%)高于CG治愈率(65.0%);②TG(细菌性结膜炎)眼痛异物感消失率和消失时间(83.7%,5.33±2.00d)优于CG(64.1%,6.36±1.50d);TG(细菌性结膜炎)流泪消失率(91.8%)高于CG(75.0%);③记分统计表明:TG(细菌性结膜炎)结膜充血改善(平均下降1.76分)明显优于CG(平均下降1.25分);TG畏光消失情况(平均下降1.24分)好于CG(平均下降0.87分);TG(细菌性结膜炎)分泌物消失情况(平均下降1.64分)好于CG(平均下降1.33分);④其他情况两组间无明显差异。结论:3g/L盐酸洛美沙星眼凝胶治疗眼前段细菌感染安全、有效,对结膜炎症状体征的改善优于滴眼液。     

膀胱粘膜下层无细胞基质的研制

目的 探讨膀胱粘膜下层无细胞基质的制作与评价。方法 自膀胱解剖出膀胱粘膜下层，置于PBS、0．5％SDS、双蒸水中反复洗涤去除细胞，必要时加用胰蛋白酶消化。获得的细胞外基质采用HE、免疫组化、扫描电镜评价去细胞效果，细胞植入无细胞基质观察细胞能否粘附于该材料。结果 HE、免疫组化、扫描电镜均未见制备的材料中存在细胞及细胞碎片，体外细胞植入试验见细胞可粘附于材料并增殖。结论 采用本制备方法可以得到膀胱粘膜下层无细胞基质，有望为临床提供尿道下裂生物替代材料。     

Prenatal X-irradiation increases GFAP- and calbindin D28k-immunoreactivity in the medial subdivision of the nucleus of solitary tract in the rat

Glial fibrillary acidic protein- (GFAP) and calbindin D28k-immunoreactivity (IR) were investigated in the medial subdivision of the nucleus of the solitary tract (mNST) of prenatally X-irradiated rats. Pregnant rats were exposed to a single whole-body X-irradiation on day 11 or 16 of gestation at a dose of 1. 3 Gy. The offspring were killed at 7-14 days of age for the immunohistochemical observations. Rat pups showed strong GFAP-IR at the level rostral to the obex when receiving X-rays on day 11 of gestation, with hypertrophy of astrocyte cell bodies and cytoplasmic processes, but weak GFAP-IR when receiving X-rays on day 16 of gestation. Calbindin D28k-IR was stronger in the animals receiving X-rays on day 11 or 16 of gestation compared to that in the control animals. In the present study, the increase of GFAP- and calbindin D28k-IR cells in the mNST might indicate that adaptative mechanisms are taking place to preserve integrated nervous system function and possibly, to provide neuroprotection.     

内皮素受体拮抗剂治疗充血性心衰一项meta分析

目的初步评价内皮素拮抗剂治疗心衰的效果和安全性。方法借助循证医学检索途径和方法筛选出临床随机对照试验(RCTs),数据用Revman4.2软件进行分析。结果共入选13个临床随机对照试验(RCT)4137名患者,其中3个试验评价了心脏指数改善情况,5个试验评价死亡和心衰恶化,4个试验评价其它副作用。心脏指数改善的总效应为:WMD(加权均数差)0.47,95%可信区间(CI)[0.36,0.57](P<0.00001)。Tezosentan<50mg/h、50mg/h和100mg/h三组比较具有相似的效果及副作用,而副作用有随剂量增加的趋势。作为主要终点指标死亡率和心衰恶化两组相似(RR=1.00,95%CI[0.89,1.13](P=0.89),而其它副作用事件发生率则存在明显差异(RR=1.28,95%CI[1.13,1.44](P<0.0001)。结论内皮素拮抗剂可改善心衰患者的心脏指数,但长期效应尚未得到证实。治疗组患者副作用发生常见,并呈剂量依赖性。内皮素拮抗剂的长期效果还需要设计更完善、纳入例数更多的临床随机对照试验加以阐明。     

Protein kinase C iota protects neural cells against apoptosis induced by amyloid beta-peptide

Protein kinase C (PKC) isoforms are increasingly recognized as playing important roles in the regulation of neuronal plasticity and survival. Recent findings from studies of non-neuronal cells suggest that atypical isoforms of PKC can modulate apoptosis in various paradigms. Because increasing data support a role for neuronal apoptosis in the pathogenesis of Alzheimer's disease (AD), we tested the hypothesis that PKCiota (PKCiota) can modify vulnerability of neural cells to apoptosis induced by amyloid beta-peptide (ABP), a cytotoxic peptide linked to neuronal degeneration in AD. Overexpression of PKCiota increased the resistance of PC12 cells to apoptosis induced by ABP. Associated with the increased resistance to apoptosis were improved mitochondrial function and reduced activity of caspases. In addition, ABP-induced increases in levels of oxidative stress and intracellular calcium levels were attenuated in cells overexpressing PKCiota. These findings suggest that PKCiota prevents apoptosis induced by ABP by interrupting the cell death process at a very early step, thereby allowing the cells to maintain ion homeostasis and mitochondrial function.     

Why the prevention strategies are in low priority？

It is a puzzle to many researchers that with so extensive resources, so advanced technology, and so urgent need the world over, so little has been done to alleviate the suffering of the people. Why is it so difficult to develop the prevention and health promotion strategies？ This paper tries to discuss the issue.     

The expression of TRPA1 mRNA in the rat brain

Objective： To investigate the distribution of TRPA1 （one kind of the TRP-like ion channel family） channel in the hippocampus and cerebral cortex of rat. Methods： RT-PCR was used to amplify the fragment of TRPA1 in the DRG （dorsal root ganglion）, hippocampus and cerebral cortex of adult SD rat. In situ hybridization staining was used to show the distribution of TRPA1 mRNA in the hippocampus and cerebral cortex of adult rat brain. Results： Both RT-PCR and in situ hybridization staining showed that TRPA1 mRNA was expressed in hippocampus and cerebral cortex of the adult rat brain. Conclusion： Our results suggest that there is expression of TRPA1 mRNA both in the hippocampus and cerebral cortex of the adult rat brain.     

重型颅脑损伤救治的临床伦理学问题探析

重型颅脑损伤病人病情危急，致残率、死亡率高，而医护人员的医德修养直接影响危重病人的治疗效果．也关系着医疗卫生行业的社会声誉，因而对临床伦理学有着更高、更严的要求，作者对在救治重型颅脑损伤病人过程中的伦理学问题进行了探讨。