先天性眼球畸形的CT、MRI表现

目的 提高对先天性眼球畸形的CT、MRI表现认识,并探讨其临床诊断价值. 资料与方法 回顾性分析24例(31眼) 先天性眼球畸形患者的CT、MRI资料,其中行眼眶CT检查13例,眼眶MRI 9例,颅脑MRI 2例. 结果 牵牛花综合征16眼,特征性表现为眼球后部视神经乳头局限性缺损致玻璃体腔膨出,合并视网膜脱离2眼,合并眼眶囊肿9眼,合并胼胝体发育不全1眼.永存原始玻璃体增殖症(persistent hyperplastic primary vitreous,PHPV)7眼,表现为小眼球,晶状体后方软组织肿块和永存玻璃体动脉.巩膜葡萄肿1眼.Coats 病2眼,主要表现为视网膜下积液,球内密度或信号增高.单纯小眼球3眼.先天性无眼球2眼. 结论 CT、MRI有助于先天性眼球畸形的诊断及鉴别诊断.     

中药病毒宁滴剂的抑菌、抗炎作用

病毒宁滴剂为广州中医药大学热带医学研究所和北京市宇维生科贸技术有限公司为寻求治疗感冒的有效手段而联合研制的 ,主要用于外感风热初起型感冒的中药滴鼻制剂 ,该药主要由清热解毒的柴胡、鱼腥草等中药提炼研制而成。为进一步探讨该药的药理机制 ,对其在体内体外的抑菌、抗炎作用进行了研究。结果发现病毒宁滴剂体外试验对 6种细菌菌株有不同程度的抑制作用 ,但作用不强 ;体内抗菌试验表明 ,病毒宁滴剂 2 5 0 0mg kg剂量组可降低金黄色葡萄球菌攻击小鼠的死亡率 (P <0 .0 0 5 ) ;病毒宁滴剂5 0 0mg kg剂量组具有抑制二甲苯致小鼠毛细血管通透性增加的作用 (P <0 .0 0 5 ) ;其 2 5mg kg、 5 0mg kg、10 0mg kg剂量组还具有抑制大鼠足跖肿胀形成的作用。表明病毒宁有一定的抑菌作用 ,尤其对金黄色葡萄球菌有较强体内保护作用 ,并有较明显的抗炎消除肿胀作用     

白藜芦醇对大鼠脊髓损伤后受损局部Ca~(2 ),Mg~(2 )-ATP酶活性的影响

目的:探讨白藜芦醇(resveratrol,Res)对脊髓损伤(SCI)后受损部位局部Ca2 ,Mg2 -ATP酶活性的影响,分析SCI后局部微环境改变及Res的作用。方法:采用重物下落撞击法制备成年大鼠的脊髓损伤模型,于损伤后即刻腹腔注射给予Res 50 mg/kg,100 mg/kg或甲基强的松龙(MISS)100 mg/kg,并于给药后1 h,24 h,48 h时分别取受损脊髓组织,利用测磷法检测Ca2 ,Mg2 -ATP酶活性。结果:Res 100 mg/kg对Ca2 -ATP、Mg2 -ATP及Ca2 ,Mg2 -ATP酶活性在SCI后的活性抑制有明显的改善作用(P<0.05或0.003),最大改善率分别在71％、180％和120％以上,基本以1 h时影响较大,但对Mg2 -ATP酶活性的最大影响在48 h处,MPSS对SCI后1h Ca2 、Mg2 -ATP酶活性影响最大。Res的作用与MPSS相当或更强。结论:Res通过调节Ca2 ,Mg2 -ATP酶活性改善SCI后局部微环境,可能有效缓解SCI后继发性反应而产生保护作用。     

桂枝汤对体温双向调节作用的机理探讨──对下丘脑乙酰胆碱和去甲肾上腺素作用的影响

大鼠脑室注射去甲肾上腺素２０ｎｇ／只，仍快速引起体温下降，口饲给予１０ｇ／ｋｇ桂枝汤，能部分拮抗去甲肾上腺素的降温作用，大鼠脑室注射乙酰胆碱１ｍｇ／只，能使体温升高；口饲给予桂枝汤，能阻断其发热反应。结果提示，桂枝汤可能通过促进下丘脑中过量去甲肾上腺素或乙酰胆碱的灭活，拮抗或部分拮抗它们的降体温或发热作用。     

Promising clinical outcome of stereotactic body radiation therapy for patients with inoperable Stage I/II non-small-cell lung cancer

PURPOSE: To evaluate the efficacy and toxicity of hypofractionated stereotactic body radiotherapy in patients with Stage I/II non-small-cell lung cancer. METHODS AND MATERIALS: Forty-three patients with inoperable Stage I/II non-small-cell lung cancer underwent treatment prospectively using the stereotactic gamma-ray whole-body therapeutic system (body gamma-knife radiosurgery) with 30 rotary conical-surface Co(60) sources focused on the target volume. Low-speed computed tomography simulation was conducted, which was followed by three-dimensional conformal radiotherapy planning. A total dose of 50 Gy was delivered at 5 Gy/fraction to the 50% isodose line covering the planning target volume, whereas a total dose of 70 Gy was delivered at 7 Gy/fraction to the gross target volume. The median follow-up duration was 27 months. RESULTS: Three to 6 months after treatment, the complete response rate for body-gamma knife radiosurgery was 63%, and the overall response rate was 95%. The 1-year, 2-year, and 3-year local control rates were all 95% in all patients. The 1-year, 2-year, and 3-year overall survival rates were 100%, 91%, and 91%, respectively, in patients with Stage I disease and 73%, 64%, and 64%, respectively, in those with Stage II disease. Only 2.3% (1/43) of the patients had Grade 3 pneumonitis. CONCLUSION: Our highly focused stereotactic body radiotherapy method resulted in promising local control and survival with minimal toxicity.     

Multivesicular liposome formulation for the sustained delivery of breviscapine

Breviscapine, a well-known bioactive flavonoid ingredient extracted from the traditional Chinese medicine, has been extensively used in clinic to treat ischemic cerebrovascular and cardiovascular diseases in China. In order to prolong the duration of the drug in the circulation, reduce the frequency of injection administration and subsequently afford patient compliance, multivesicular liposome (MVL, namely DepoFoam) was utilized as a sustained-delivery system for breviscapine. In vitro release and in vivo pharmacokinetics of MVLs containing breviscapine (bre-MVLs) following intramuscular injection to rats were investigated compared with those of traditional liposomes containing breviscapine (bre-TLs). The drug durations both in vitro and in vivo were significantly prolonged for the bre-MVL, and that the drug release in vitro and the absorption in vivo showed a good linear correlation (R=0.9834), which provided an evidence for the suitability to select human plasma as the medium of drug release from MVLs in vitro. Drug release from bre-MVLs (triolein/tricaprylin, 10/0) in vitro extended a long period of 5-6 days, while the bre-TLs released 80% within only 4h. The mean residence time (MRT) obtained from the pharmacokinetics study of bre-MVL was about 16.6- and 5.04-fold longer than those of breviscapine solution (BS) and bre-TL, respectively. A duration in vivo for a period of 4-5 days was fulfilled for bre-MVL. In conclusion, MVL can be successfully used as a sustained delivery system of breviscapine.     

Targeting of antigens to activated dendritic cells in vivo cures metastatic melanoma in mice

Anti (alpha)-DEC-205 antibodies target to the DEC-205 receptor that mediates antigen presentation to T cells by dendritic cells. To exploit these properties for immunization purposes, we conjugated the melanoma antigen tyrosinase-related protein (TRP)-2 to alphaDEC-205 antibodies and immunized mice with these conjugates together with dendritic cell-activating oligonucleotides (CpG). Upon injection of the melanoma cell line B16, alphaDEC-TRP immunized mice were protected against tumor growth. Even more important for clinical applications, we were able to substantially slow the growth of implanted B16 cells by injection of alphaDEC-TRP2 conjugates into tumor bearing hosts. Approximately 70% of the animals were cured from existing tumors by treatment with alphaDEC conjugates carrying two different melanoma antigens (TRP-2 and gp100). This protection was due to induction of melanoma-specific CD4 and CD8 responses. Thus, these data show that targeting of dendritic cells in situ by the means of antibody-antigen conjugates may be a novel way to induce long-lasting antitumor immunity.     

高等医学院校内部教学质量管理与保障系统的构建与实践

高等医学教育管理体制改革是高校管理体制改革的重要组成部分.当前,高校医学教育管理体制改革面临诸多挑战缺乏统一规划;对发展新体制的重要性和紧迫性认识不够;新体制缺乏合适的主体模式;管理体系不健全;多级管理导致教育成本扩大化;理论研究滞后等等.正确认识上述挑战并提出有效对策,必将有利于推进高校管理体制改革的进程.首先,在对策选择中制定统一的发展规划极其重要,有了规划就可以避免盲目改革;其次,要充分认识发展新体制的重要性和紧迫性,从战略上高度重视新体制的发展;第三,要根据自身实际选择适合的主体模式;第四,在确定新体制的管理模式后,必须完善管理体系;第五,新体制要形成从管理机构到管理内容的"科学分散"与"相对分权";最后,要大力开展医学教学管理研究,形成具有医学教育特点的,灵活、高效的管理理论和实践机制.     

干扰素- γ与干扰素- α治疗慢性乙型肝炎中抗肝纤维化作用的对比研究

目的观察干扰素IFN-γ和IFN-α治疗慢性乙型肝炎(CHB)肝纤维化的组织学变化和评价其临床疗效.方法40例CHB患者分为IFN-γ治疗组、IFN-α治疗组和对照组,IFN-γ组应用1MUIFN-γ治疗9个月;IFN-α组应用干扰素α-2b,3 MU,疗程为6个月;对照组用护肝片等常规治疗.观察治疗前后肝纤维化总计分和血清透明质酸(HA)等指标变化.结果治疗后肝纤维化计分在IFN-γ组和IFN-α组分别下降至(10.2±5.3)和(11.8±6.4),较治疗前(13.4±5.4)和(13.5±7.2)降低,有统计学意义(P＜0.01和P＜0.05);血清HA水平分别下降到(165.2±98.4)ng/mL和(215.3±132.6)ng/mL,与治疗前及对照组比较,差异有显著性(均P＜0.001);治疗后两组比较,IFN-γ治疗组的纤维化计分和HA水平显著低于IFN-α治疗组(P＜0.05和P＜0.01).两组治疗后炎症总计分较治疗前及对照组均显著下降(P＜0.01).结论IFN-γ是治疗CHB肝纤维化的较好的药物.     

婴幼儿心脏直视手术并发症的分析

目的探讨婴幼儿体外循环心内直视术后并发症特点及其死亡原因。方法回顾分析416例先天性心脏病婴幼儿的临床资料。结果416例婴幼儿体外循环心内直视术后肺部并发症75例，低心排28例，急性肾功能衰竭5例，消化道出血8例，脑部并发症：昏迷1例、蛛网膜下腔出血2例。死亡21例，死亡率5．0％；以死于低心排综合征的婴幼儿比例最高（57．1％），其次是呼吸功能衰竭、肾功能衰竭。结论婴幼儿体外循环心内直视术后的并发症及死亡率与体外循环有着密切关系，因此在提高婴幼儿各种先，心病矫治技术的同时应加强体外循环心脏手术中的心肺保护效果。