植物雌激素两种单体对子宫内膜腺上皮细胞作用的比较

目的 探讨植物雌激素两种单体在浓度5～80μmol／L对人子宫内膜腺上皮细胞增殖的影响。方法 2003年8～12月应用胶原酶阶梯消化法，原代培养人子宫内膜腺上皮细胞，用MTT方法观察植物雌激素的主要成分金雀黄素和大豆甙元对细胞体外增殖的影响。结果 低浓度的大豆甙元能促进子宫内膜腺上皮细胞轻度生长．随浓度的增加其作用明显，但当浓度达到40μmol／L，抑制细胞生长；不同浓度的金雀黄素均抑制子宫内膜腺上皮细胞的增殖。结论 植物雌激素两种单体对人子宫内膜腺上皮细胞的作用是明显不同的，提示在应用植物雌激素时要考虑不同成分的差别?     

铬、鱼油对肥胖模型大鼠瘦素和胰岛素的影响

目的铬、鱼油参与并调节糖、脂肪代谢,选择铬、鱼油作为影响因素,观察其对饮食诱导肥胖大鼠的影响。方法将肥胖模型大鼠按体重随机分为4组,每组8只。分别为肥胖组、鱼油组、鱼油+铬组和铬组,另设基础对照组。在实验的第0周和第6周空腹采尾血,测定血清瘦素和胰岛素水平。结果3个实验组的胰岛素和瘦素水平在第0周时,与肥胖组差异无显著性(P>0.05),第6周时,显著低于肥胖组(P<0.05)。结论结果提示铬、鱼油有缓解肥胖大鼠高胰岛素和高瘦素水平的作用。     

农村卫生人员继续教育的实践与思考

结合甘肃省农村卫生队伍的实际状况，坚持学历教育与岗位培训并举，分层次、分阶段培训的原则，建立农村卫生人员继续教育网络，构建“自学-培训-评价”三位一体的农村卫生人员继续教育体系。从中认识到：建立继续教育网络是农村卫生人员继续教育的基础工程；提高服务能力是农村卫生人员继续教育的主旋律；构建“自学-培训-评价”三位一体的继续教育体系是农村卫生人员继续教育的质量保证。     

Upper gastrointestinal burns by peroxyacetic acid in children- a review of seven cases

Objective： To study the clinical features of upper gastrointestinal burns by peroxyacetic acid （PA） in children and improve its treatment and outcome. Methods： The clinical materials of 7 cases with upper gastrointestinal burns by PA including clinical presentation, treatment and outcomes were reviewed. Results： There were six boys and one girl. The concentration of the swallowed PA was from 10% to 20% and the amount was 3-10 ml. The mainly bums were located in esophagus in one case, stomach in three cases, both esophagus and stomach in three cases. The gastrostomy and operation of dilating esophagus were performed in the cases with esophageal stricture. The pyloroplasty or gastroduodenostomy was performed in the cases with pyloric obstruction. All the cases were followed up for 12-18 months, dysfunction of esophagus or（and） cardia as well as stiffness and hypodynamia of the stomach was showed in most of the patients. Conclusion： The degree of upper gastrointestinal burns by PA varied according to different concentrations of PA which was swallowed. Correct emergent measures in the acute stage of the burns was very important, gastric tube should be inserted and go through esophagus and pylorus and must be retained for 5-8 weeks to prevent the stricture of esophagus and pylortts, otherwise the tube could act as a passage of nutriment. Prophylaxis of upper gastrointestinal bums by PA is very important because the treatment of the burns is difficulty and the outcomes are not always satisfactory.     

妊娠合并血小板减少112例临床分析

目的:探讨妊娠合并血小板减少的发病机制及围生期的处理方法。方法:回顾分析天津医科大学总医院1992年至2002年间112例妊娠合并血小板减少患者的病因及临床处理经验。结果:112例孕妇中特发性血小板减少性紫癜27例,占24.1%;子痫前期44例,占39.3%;妊娠期特发性血小板减少40例,占34.8%;血栓性血小板减少性紫癜1例,占0.89%。阴道分娩27例,剖宫产85例。产后出血13例,产褥感染1例。结论:多种原因可以导致妊娠妇女血小板减少。如无产科指征,以阴道分娩为宜;血小板<50×109/L时,在血源充足时行剖宫产。不主张采用侵入性检查方法确定胎儿血小板水平。     

急性中毒患者血液毒鼠强的GC/MS检测及临床应用

目的利用气相色谱-质谱（GC/MS）建立一种快速检测中毒患者血液毒鼠强的方法.方法考察5种有机溶剂液-液法提取血液毒鼠强的回收率,研究毒鼠强的线性方程、最低检测限及精密度.结果乙酸乙酯提取毒鼠强的回收率为90.40%,RSD=2.8%,n=5;毒鼠强线性方程为y=156.5x＋236.1,R=0.9988;最低检测限为4ng/ml;日内精密度为RSD为4.3%,日间精密度为RSD为6.7%.解析了毒鼠强质谱图的主要碎片归属.结论所建方法简单快速,灵敏度高,选择性好,可用于临床中毒患者血液毒鼠强的检测.     

硝苯地平制剂的溶出度测定方法

目的测定硝苯地平制剂的溶出度。方法在溶出介质中加入非离子表面活性剂吐温-80,使硝苯地平的溶解度增加至86μg·ml-1。结果及结论此方法完全符合溶出度测定的漏槽条件。     

益气除痰法延长非小细胞肺癌中位生存期的作用

目的:观察益气化痰法延长Ⅲ、Ⅳ期非小细胞肺癌(NSCLC)生存期的作用.方法:采用前瞻性、多中心、随机、对照的临床流行病学方法,将符合标准的病例按肺郁痰瘀型、脾虚痰湿型、阴虚痰热型及气阴两虚型四型辨证施治,辨病治疗以益气化痰法为主,辨证治疗分别以宣肺除痰、益气除痰、滋阴化痰、益气养阴法为主.用乘积极限(K-M)法分析不同证型的中位生存期及中位疾病进展时间.结果:肺郁痰瘀型、脾虚痰湿型、阴虚痰热型及气阴两虚型肿瘤总缓解率分别为9.1%、23.6%、11.5%、13.2%(P<0.05);瘤体总稳定率分别为69.7%、77.8%、69.2%、78.9%(P>0.05);中位生存期分别为308天、401天、300天和326天(P>0.05);1年累积生存率分别为45.63%、51.53%、41.95%、46.01%(P>0.05).结论:益气化痰法可使Ⅲ、Ⅳ期NSCLC的中位生存期达到9个月,与化疗配合应用可达到12个月,是晚期非小细胞肺癌的一种有效治法.其中,脾虚痰湿型患者中位生存期达到13个月,有可能进一步提高疗效.     

The association of XRCC1 haplotypes and chromosomal damage levels in peripheral blood lymphocyte among coke-oven workers.

Theoretically, a haplotype has a higher level of heterozygosity than individual single nucleotide polymorphism (SNP) and the association study based on the haplotype may have an increased power for detecting disease associations compared with SNP-based analysis. In this study, we investigated the effects of four haplotype-tagging SNPs (htSNP) and the inferred haplotype pairs of the X-ray cross-complementing group 1 (XRCC1) gene on chromosome damage detected by the cytokinesis-block micronucleus assay. The study included 141 coke-oven workers with exposure to a high level of polycyclic aromatic hydrocarbons and 66 nonexposed controls. The frequencies of total MN and MNed cells were borderline associated with the Arg(194)Trp polymorphism (P = 0.053 and P = 0.050, respectively) but not associated with the Arg(280)His, Arg(399)Gln and Gln(632)Gln polymorphisms among coke-oven workers. Five haplotypes, including CGGG, TGGG, CAGG, CGAG, and CGGA, were inferred based on the four htSNPs of XRCC1 gene. The haplotype CGGG was associated with the decreased frequencies of total MN and MNed cells, and the haplotypes TGGG and CGAG were associated with the increased frequencies of total MN and MNed cells with adjustment for covariates among coke-oven workers. This study showed that the haplotypes derived from htSNPs in the XRCC1 gene were more likely than single SNPs to correlate with the polycyclic aromatic hydrocarbon-induced chromosome damage among coke-oven workers.     

中西医结合治疗输卵管阻塞性不孕症

陈益昀主任中医师是全国第二、三批中医药专家学术经验继承指导老师，临床悬壶五十余载，治学严谨，注重实际。几十年的临床实践加之深厚扎实的理论功底，尤其能够结合现代医学知识，使其在治疗疾病，立法用药上独树一帜。笔者有幸随师学习，获益匪浅，兹将陈老师运用中西医结合治疗输卵管阻塞性不孕症的经验总结介绍如下：