JX-1对雄性小鼠生殖细胞致突变作用的研究

本文采用小鼠精子试验和小鼠睾丸DNA合成抑制试验,检测了JX-1对雄性生殖细胞的致突变作用。实验结果表明JX-1对小鼠精子总数、精子活动率及精子畸形率均无统计学意义的增加,与小鼠睾丸DNA合成抑制试验阴性反应一致。作者认为JX-1对雄性生殖细胞为一种非诱变剂。     

Psychological morbidity after myocardial infarction in an area of deprivation in the UK: evaluation of a self-help package.

BACKGROUND: Psychological morbidity after an acute myocardial infarction (AMI) is known to be common, but can be addressed by appropriate rehabilitation. The area in which this research was conducted experiences high rates of deprivation and of coronary heart disease and limited access to hospital-based rehabilitation. Responding to concern about psychological needs of AMI patients, a self-help package was introduced and evaluated alongside standard hospital-based cardiac rehabilitation. AIMS: To evaluate the impact of a home-based self-help package (the Heart Manual), alongside existing cardiac rehabilitation provision, on psychological morbidity and health status after AMI. A secondary aim was to assess the suitability of the Heart Manual for older patients aged over 80 years. METHODS: A controlled observational study, comparing two cohorts of patients discharged from hospital after AMI. The intervention group was given the self-help package in addition to standard care. The control group received standard care alone. Outcome measures used were the Hospital Anxiety and Depression Scale and the EuroQol. RESULTS: The intervention group showed significant improvement in anxiety and depression scores after 3 months and nonsignificant improvement in general health status. Patients who attended hospital-based rehabilitation classes, and those aged over 80 years, also benefited from the intervention. CONCLUSION: A home-based self-help rehabilitation package is an effective tool alongside hospital-based rehabilitation classes and can be given to all age groups.     

PFT-α对结肠上皮细胞凋亡和周期的影响及机制探讨

目的探讨p53抑制剂（p-fifty three inhibitor—alpha，PFT-α）对结肠上皮细胞凋亡、周期的影响及机制。研究PFT-α对热化疗损伤结肠上皮细胞的影响。方法顺铂联合温热处理原代培养结肠七皮细胞30min，对比加入不同浓度PFT-α后，Annexin V—FITC／PI染色，流式细胞仪检测细胞凋亡。PI染色检测细胞周期。Western blot检测结肠上皮细胞Cyclin B1和Cdc2（Tyr15）表达。结果不同浓度PFT-α作用于热化疗处理的结肠上皮细胞后，细胞凋亡率下降且呈剂量依赖性。流式细胞仪细胞周期分析显示在运用PFT-α后，结肠上皮细胞的G2／M延长，CyclinB1和Cde2（Tyr15）蛋白表达随PFT—α的剂量升高而逐渐增强。结论PFT-α可能通过促进CyclinB1蛋白表达，Cde2（Tyr15）磷酸化水平升高，降低CyclinB1／Cde2活性，细胞停滞于G2／M期，减轻热化疗对结肠上皮细胞的损伤。     

110例胃癌外科治疗分析

目的　探讨胃癌外科治疗的现状。方法　对我院 2002 年 5 月~2004 年 7 月收治并手术治疗的胃癌 110 例的临床资料进行回顾性分析。结果　110 例胃癌中,手术切除 101 例(91 .82%),其中根治性切除91例,姑息性切除10 例;远侧胃切除 78 例(77 .23%),近侧胃切除 7 例(6 .93%),全胃切除16例(15 .84%);行消化道重建的 104 例中,手法吻合 13 例(12 5%),单吻合器67例(66. 42%),双吻合器 24 例(23. 08%)。术后病理早期癌 9 例(8. 18%),进展期胃癌共 101 例(91 .82%)。术前肠外营养支持5~7天14例(12. 73%),术后行肠道营养86 例(85 15%),肠外营养90例(89 .11%)。手术死亡1例(0 .9%),12例发生术后近期并发症(9. 09%)。结论　胃癌患者早期诊断仍困难,但手术切除率及根治性切除率较以前明显升高,吻合器使用明显增加,有助于降低近期并发症发生率并提高肿瘤治疗的效果。需长时间营养支持时肠内营养较肠外营养更容易维持内环境稳定。     

Evaluating the effectiveness of interventions: exploration of two statistical methods.

Repeated measures designs are often used to evaluate the effectiveness of interventions. In these designs, the outcomes are measured on several occasions before and after implementation of the intervention. Two statistical methods, the repeated measures analysis of variance (RM-ANOVA) and hierarchical linear models (HLM), can be used to analyze the data. The authors provide an overview of the statistical models underlying RM-ANOVA and HLM and discuss the strengths and limitations of each. They propose that the 2 methods are complementary in determining the effectiveness of interventions.     

骨髓输液在PICU的应用探讨

目的　探讨骨髓输液在PICU的适应证、方法及临床效果。方法　选择PICU危重症建立静脉通道困难患儿 30例 ,采用 7号骨穿针或 7～ 9号头皮针于胫骨粗隆下 1～ 2cm穿刺、固定 ,接入医嘱液体 ,记录穿刺所需时间、入液速度及生命体征变化、并发症等。结果　 2 8例 1次成功 ,2例用头皮针者有堵塞 ,换针后重新穿刺成功 ,穿刺、固定到接入液体平均时间 (30± 10 )s。速率 :一般压力 (8± 3)ml (kg体重·h) ,加压下 (17± 6 )ml (kg体重·h) ,所有病例均达到了医嘱要求。骨髓输液持续时间 3～ 2 2h ,无 1例出现并发症。结论　骨髓输液在PICU危重症抢救中可迅速建立液体通道 ,争取抢救时间。头皮针比骨髓穿刺针易于固定 ,使用更方便     

局域网在医院感染管理中应用的初步设想

[目的]利用医院局域网对医院感染进行实时监控，提高工作效率。[方法]采用Windows98平台，应用Access建立数据库，进行感染监控。[结果]局域网使用方便、操作简单，使医院感染监控及时、准确。[结论]利用医院局域网对医院感染可进行实时性监控，减轻了医护人员和专职人员的工作量，提高了工作效率。     

Telmisartan and irbesartan therapy in type 2 diabetic patients treated with rosiglitazone: effects on insulin-resistance, leptin and tumor necrosis factor-alpha.

The aim of our study was to investigate the metabolic effect of telmisartan and irbesartan in subjects treated with rosiglitazone, a well-known insulin-sensitizing drug, in order to clarify the direct metabolic effects of the two former drugs. Patients were enrolled, evaluated, and followed at 3 Italian centers. We evaluated 188 type 2 diabetic patients with metabolic syndrome (94 males and 94 females in total; 49 males and 46 females, aged 56+/-5, treated with telmisartan; and 45 males and 48 females, aged 55+/-4, treated with irbesartan). All had been diabetic for at least 6 months, and glycemic control by the maximum tolerated dietary changes and maximum tolerated dose of oral hypoglycemic agents had been attempted and failed in all cases. All patients took a fixed dose of rosiglitazone, 4 mg/day. We administered telmisartan (40 mg/day) or irbesartan (150 mg/day) in a randomized, controlled, double-blind clinical manner. We evaluated body mass index (BMI), glycemic control (HbA1c fasting plasma glucose and insulin levels [FPG, and FPI, respectively], and homeostasis model assessment [HOMA] index), lipid profile (total cholesterol [TC], low density lipoprotein-cholesterol [LDL-C], high density lipoprotein-cholesterol [HDL-C], and triglycerides [TG]), systolic and diastolic blood pressure (SBP and DBP), tumor necrosis factor-alpha (TNF-alpha), and leptin during the 12 months of this treatment. No BMI change was observed after 6 or 12 months in either group. Significant decreases in HbAlc and FPG were observed after 6 months in the telmisartan group, and after 12 months in both groups. The decrease in HbA1c and FPG at 12 months was statistically significant only in the telmisartan group. A significant decrease in FPI was observed at 12 months in both groups, and this decrease was significantly greater in the telmisartan group. Significant decreases in the HOMA index were observed at 6 and 12 months in both groups, and the decrease in the HOMA index after 12 months was significantly greater in the telmisartan group than in the irbesartan group. Significant changes in SBP, DBP, TC, and LDL-C were observed after 6 and 12 months in both groups. Significant decreases in TNF-alpha and leptin levels were observed after 6 months in the telmisartan group, and after 12 months in both groups. In conclusion, in this study of patients with type 2 diabetes mellitus and metabolic syndrome, telmisartan seemed to result in a greater improvement in glycemic and lipid control and metabolic parameters related to metabolic syndrome compared to irbesartan. These observed metabolic effects of different angiotensin type 1 receptor blockers could be relevant when choosing a therapy to correct metabolic derangement of patients affected by metabolic syndrome and diabetes.