Randomised controlled trial of zinc supplementation in malnourished Bangladeshi children with acute diarrhoea

OBJECTIVE: To evaluate the impact of zinc supplementation on the clinical course, stool weight, duration of diarrhoea, changes in serum zinc, and body weight gain of children with acute diarrhoea. DESIGN: Randomised double blind controlled trial. Children were assigned to receive zinc (20 mg elemental zinc per day) containing multivitamins or control group (zinc-free multivitamins) daily in three divided doses for two weeks. SETTING: A diarrhoeal disease hospital in Dhaka, Bangladesh. PATIENTS: 111 children, 3 to 24 months old, below 76% median weight for age of the National Center for Health Statistics standard with acute diarrhoea. Children with severe infection and/or oedema were excluded. MAIN OUTCOME MEASURES: Total diarrhoeal stool output, duration of diarrhoea, rate of weight gain, and changes in serum zinc levels after supplementation. RESULTS: Stool output was 28% less and duration 14% shorter in the zinc supplemented group than placebo (p = 0.06). There were reductions in median total diarrhoeal stool output among zinc supplemented subjects who were shorter (less than 95% height for age), 239 v 326 g/kg (p < 0.04), and who had a lower initial serum zinc (< 14 mmol/l), 279 v 329 g/kg (p < 0.05); a shortening of mean time to recovery occurred (4.7 v 6.2 days, p < 0.04) in those with lower serum zinc. There was an increase in mean serum zinc in the zinc supplemented group (+2.4 v -0.3 mumol/l, p < 0.001) during two weeks of supplementation, and better mean weight gain (120 v 30 g, p < 0.03) at the time of discharge from hospital. CONCLUSIONS: Zinc supplementation is a simple, acceptable, and affordable strategy which should be considered in the management of acute diarrhoea and in prevention of growth faltering in children specially those who are malnourished.     

李祥国治疗冠状动脉痉挛心绞痛的经验

李祥国教授对冠心病冠状动脉痉挛所致之心绞痛的治疗经验独到，强调从肝论治，辨其寒热、虚实，应用疏肝解郁、温阳舒脉及养阴清热、柔肝解痉之法，疗效显著。     

The relationship between dietary fat intake and risk of colorectal cancer: evidence from the combined analysis of 13 case-control studies

The objective of this study was to examine the effects of the intakeof dietary fat upon colorectal cancer risk in a combined analysis of datafrom 13 case-control studies previously conducted in populations withdiffering colorectal cancer rates and dietary practices. Original datarecords for 5,287 cases of colorectal cancer and 10,470 controls werecombined. Logistic regression analysis was used to estimate odds ratios (OR)for intakes of total energy, total fat and its components, and cholesterol.Positive associations with energy intake were observed for 11 of the 13studies. However, there was little, if any, evidence of anyenergy-independent effect of either total fat with ORs of 1.00, 0.95, 1.01,1.02, and 0.92 for quintiles of residuals of total fat intake (P trend =0.67) or for saturated fat with ORs of 1.00, 1.08, 1.06, 1.21, and 1.06 (Ptrend = 0.39). The analysis suggests that, among these case-control studies,there is no energy-independent association between dietary fat intake andrisk of colorectal cancer. It also suggests that simple substitution of fatby other sources of calories is unlikely to reduce meaningfully the risk ofcolorectal cancer.     

电视胸腔镜在胸部肿瘤中的应用

电视胸腔镜外科（ＶＡＴＳ）在胸部肿瘤的临床应用尚存争议。自１９９６年１０月～１９９７年８月，我科共行胸腔镜手术１６例：肺癌切除２例，纵隔肿瘤切除３例，恶性胸水行胸膜固定术２例，恶性心包积液行心包开窗术４例，常规开胸术前诊断性探查５例，初期结果较为满意。结论：ＶＡＴＳ创伤较小，安全有效。可选择性地用于胸部良恶性肿瘤的诊断和治疗。     

Sequential T Cell Response Involved in Tumor Rejection of Sarcoma, Meth A, in Syngeneic Mice

We investigated the type of T cell response involved in Meth A tumor rejection in primary immune and hyperimmune syngeneic mice. It was found that a CD4⁺ T cell-mediated delayed-type hypersensitivity (DTH) response activating non-specific killer cells such as macrophages, NK and LAK cells, without a specific CD8⁺ cytotoxic T lymphocyte (CTL) response, was the major immune response leading to Meth A tumor rejection in primary immune mice. In contrast, the specific CD8⁺ CTL response was the major response leading to the tumor rejection, in addition to CD4⁺ T cell-mediated DTH response, in hyperimmune mice. Analysis of CD4⁺ T cell clones established from primary immune and hyperimmune spleen cells indicated that a CD4⁺ T cell clone (C9) of primary immune mice (although only one clone was established) was of Th1 type, and induced cytotoxicity in accessory cells by classic DTH in vitro. Eight CD4⁺ T cell clones were established from hyperimmune spleen cells. Six out of the eight clones were of the Th2 type and two were Th0-like. However, no Th1-type CD4⁺ T cell clone was established from hyperimmune spleen cells. All of these CD4⁺ T cell clones, even the Th2-type clones, were capable of inducing cytotoxicity in vitro in T cell-depleted accessory cells, as in an in vitro DTH response. We postulate on the basis of these results that the T cell response leading to Meth A tumor rejection in vivo sequentially changed from a CD4⁺ T cell-mediated classic DTH response to a CD8⁺ CTL response, in addition to a cellular response mediated probably by Th2-type cells, during the process of repeated immunization.     

正常子宫内膜、子宫内膜增殖症及子宫内膜癌ras、HER-2/neu癌基因表达的研究

为研究ｒａｓ、ＨＥＲ－２／ｎｅｕ癌基因的表达与子宫内膜癌发生、发展的关系，本文用免疫组化ＡＢＣ法检测了２３例正常子宫内膜、４４例子宫内膜增殖症及１０３例子宫内膜癌组织中ｒａｓ、ＨＥＲ－２／ｎｅｕ癌基因的表达情况。结果表明：在子宫内膜非典型增生中即存在ｒａｓ基因的过度表达，过度表达率为２０％，子宫内膜癌ｒａｓ的过度表达率为１８．４％，且ｒａｓ的过度表达与子宫内膜癌的病理分级、分期及患者的生存率无关，说明ｒａｓ癌基因的异常表达可能与癌形成的早期有关。子宫内膜癌中ＨＥＲ－２／ｎｅｕ的过度表达率为２７．２％，ＨＥＲ－２／ｎｅｕ的过度表达与子宫内膜癌的分期无关，与分级及患者的预后有关，存在ＨＥＲ－２／ｎｅｕ过度表达者的生存率低于无过度表达者，前者的５年生存率为５４．８％，后者为７９．６％，结果提示ＨＥＲ－２／ｎｅｕ的过度表达是判断子宫内膜癌预后的生物学指标。     

卵巢上皮性癌BRCA1和p53基因表达的临床意义及相互关系研究

目的：探讨BRCA1、p53基因蛋白在卵巢上皮性癌中的表达情况及相互关系。方法：应用S-P免疫组织化学法检测50例卵巢上皮性癌组织中BRCA1和p53蛋白的表达。采用Kaplan—Meier法分析两种蛋白表达情况与患者预后的关系。结果：1)BRCA1蛋白在卵巢癌组织中的阳性表达率仅为30％，明显低于正常卵巢组织(100％)和良性肿瘤组织(90％)(P＜0．01)；BRCA1在低分化癌、有淋巴结转移的卵巢癌组织中表达减少甚至缺失。2)p53蛋白在卵巢癌组织中的表达率为64％，而在正常卵巢及良性肿瘤组织中无表达；其表达仅与病理学分级有关。3)两种基因蛋白表达比较呈显著负相关(P＜0．01)。4)患者生存随访表明，有BRCA1表达的患者平均生存期长于无表达者；而p53对生存时间无影响。结论：BRCA1基因在转录后水平的下调对卵巢上皮性癌的发生发展有重要的作用．同时BRCA1基因与p53基因协同促进肿瘤的演进恶化。     

受区带蒂筋膜包绕耳大神经移植治疗面神经缺失性损伤

目的 评价带蒂筋膜包绕耳大神经移植治疗面神经缺失性损伤的临床疗效。方法 耳源性与外伤性面神经缺失损伤7例，取带蒂的颞肌筋膜或腮腺咬肌筋膜，在移植的耳大神经下方包绕移植神经和两端吻合口形成管筒，将移植神经首尾颠倒行束膜缝合。结果 4例耳源性面瘫，神经移植术后随访2．0～2．5年，面神经功能由Ⅳ级3例，Ⅴ级1例，恢复至Ⅲ级3例，Ⅵ级1例；3例外伤性面瘫神经移植术后随访2年，面神经功能由Ⅵ级恢复均达Ⅲ级。结论 受区带蒂筋膜包绕耳大神经移植，提供血运良好的神经修复与再生的生物学环境，促进术后面神经功能的恢复。     

富硒钝顶螺旋藻生物保健功能研究

目的对富硒钝顶螺旋藻的抗氧化、抗衰老、抗疲劳与增强免疫功能进行研究。方法通过对照服用富硒钝顶螺旋藻(每天每只小鼠摄入1．072μg Se)、普通钝顶螺旋藻小鼠和空白对照组小鼠血液中CAT(过氧化氢酶)、GSH-Px(谷胱甘肽过氧化物酶)和SOD(超氧化物歧化酶)活性的不同对富硒钝顶螺旋藻在抗氧化与抗衰老功能方面的强化作用进行评价。通过比较小鼠血液中的乳酸脱氢酶活性的变化以及游泳、爬杆能力的不同，并进行碳粒廓清和迟发型超敏反应实验，以此对富硒钝顶螺旋藻抗疲劳、增强免疫的效果进行研究。结果与普通钝顶螺旋藻相比，富硒钝顶螺旋藻具有更强的抗氧化、抗衰老、抗疲劳与增强免疫力的功能。     

试谈在化学教育中培养学生的人文精神

以化学史、辩证唯物主义教育、环境教育、道德行为习惯教育4方面为突破口，探索化学教育中如何培养学生的人文精神。