建立公正的医疗服务机制

更章指出当前医疗服务存在的不公正现象及其原因。说明了建立公正医疗服务机制的必要性，分析了公正医疗服务机制的特点；论述了建立此机制的主要措施是：制定卫生法及医疗服务法、加强对医疗机构的监督管理、适当增加政府经济投入、进行广泛的社会监督、建立透明的信息系统及健全的社会医疗救助制度。     

负压对缺血肢体血流动力学影响的实验研究

目的：观察负压对肢体动脉闭塞犬患肢血流动力学的影响。方法：犬15只，随机分治疗组10只和对照组5只。两组均采用切断犬后肢股动脉分支、动脉腔内置入螺旋状金属丝的方法，制作肢体缺血模型。在模型制作后2wk，治疗组行患肢负压治疗10d，对照组不做负压治疗。两组均于模型前、模型后2wk及治疗结束后，用彩色多普勒观察患肢股动脉血流动力学指标：收缩期最大流速(Vmax)、平均流速(Vmean)、阻力指数(R1)、搏动指数(P1)的变化。结果：治疗组在治疗后患肢股动脉Vmax、Vmean显著增加(P＜0．001)，RI、PI显著降低(P＜0.01)；对照组各指标无明显变化(P＞0．05)。结论：负压对缺血肢体血流动力学表现为流速增加，阻力下降。     

先天性一侧肺动脉缺如的电子束CT诊断

目的 评价电子束CT(EBCT)诊断先天性一侧肺动脉缺如的价值。方法 对经平片、超声心动图检查后拟诊为肺血管疾病或原发性肺动脉高压的患者行EBCT检查，EBCT诊断先天性一侧肺动脉缺如的11例患者入选，并与超声心动图、核素通气灌注扫描、心血管造影的检查结果作进一步的比较及评估。结果 单发一侧肺动脉缺如4例，均为女性成年人。合并多发心血管畸形7例，其中合并复杂畸形3例，均为男性儿童和左肺动脉缺如；合并单发心血管畸形4例，其中3例为右肺动脉缺如。结论 (1)儿童时期明确诊断的一侧肺动脉缺如多合并有心血管畸形，且左肺动脉缺如多见，成年人明确诊断的单发一侧肺动脉缺如多为右肺动脉缺如。(2)EBCT对先天性一侧肺动脉缺如的诊断有较高的实用价值，较之多普勒超声更为准确，与心血管造影各具独特优势，但EBCT为无创检查是其特点。     

Differential sensitivity of mouse oocytes to colchicine-induced aneuploidy

Unpublished results from our laboratory showed that colchicine increased the incidence of hyperploid mouse metaphase II (MII) oocytes when injected at the same time as human chorionic gonadotrophin (HCG). The objective of the present study was to determine whether the time of administering colchicine influenced the incidence of aneuploidy in MII oocytes. CD-1 mice were given pregnant mare's serum (PMS) and 48 hr later, HCG. An intraperitoneal injection of 0.2 mg/kg colchicine was given at +4, +2, 0, -2, or -4 hr relative to HCG. Oocytes were collected 17 hr post-HCG and processed, and chromosomes were subsequently C-banded. The percentage of hyperploid oocytes was 0.77, 2.56, 5.71, 7.79, 3.54, and 2.70 for control, +4, +2, 0, -2, or -4 hr pre/post-HCG, respectively. Chi-square analyses of these data demonstrated that colchicine significantly increases the proportion of aneuploid oocytes, and that the relative sensitivity of colchicine-induced aneuploidy depends upon the time that this drug is administered relative to HCG.     

IL-12表达障碍与支气管哮喘关系研究进展

支气管哮喘是由Th2介导的Ⅰ型变态反应,与内源性IL-12生成不足有关,该文综述了IL-12的生物学效应、IL-12表达障碍与支气管哮喘的关系以及IL-12、重组IL-12（rIL-12）在支气管哮喘治疗方面的应用前景。IL-12与Ⅰ型变态反应关系密切,内源性IL-12表达不足使支气管哮喘患者免疫系统向Th2方向偏移,在过敏原或病毒等外因的刺激下发生支气管哮喘。用IL-12对支气管哮喘进行免疫治疗已在动物实验中取得了显著效果,将IL-12、rIL-12或IL-12的内源性诱生物应用于人体的方法也在不断探索中并取得了一定效果,基于IL-12的治疗方法可能为支气管哮喘等变应性疾病的免疫治疗开辟新的途径。     

肌钙蛋白I、肌酸激酶同工酶对肺炎所致心力衰竭的诊断价值

目的 探讨血清心肌肌钙蛋白-Ⅰ（CTnⅠ）诊断肺炎心力衰竭（心衰）时心肌损害的临床价值。方法 检测肺炎心衰30例，轻症肺炎25例，健康儿童20例血清CTnI，肌酸激酶同功酶（CK-MB），对其临床诊断意义进行比较。结果 肺炎心衰组与健康儿童组、轻症肺炎组CTnⅠ与CK-MB阳性率、敏感性、特异性比较，均有显著性差异，P值均〈0．01。在诊断肺炎心衰患儿心肌损害上CTnⅠ优于CK-MB。结论 CTnⅠ与CK-MB对肺炎心衰患儿心肌损害有诊断价值，与CK-MB比较，CTnⅠ有较高特异性、灵敏度。     

宫颈癌细胞增殖和DNA倍体与放射敏感性的关系

为研究宫颈癌细胞增殖参数 S期比例 (SPF)、增殖指数 (PI)和 DNA倍体与宫颈癌放射敏感性的关系 ,探讨它们在预测宫颈癌放射敏感性中的价值。对 4 7例宫颈癌患者放疗前行宫颈癌组织取材 ,进行流式细胞术分析 ,在放疗过程中每周测量 1次宫颈局部瘤床的大小 ,计算肿瘤消退 1/ 2所需照射剂量 (D0 .5 ) ,研究 SPF、PI和 DNA倍体与D0 .5之间的关系。结果显示 :SPF与 D0 .5呈正相关 (r=0 .6 0 4 ,P<0 .0 1) ,PI与 D0 .5无明显关系 ,DNA倍体对 D0 .5的影响有显著性意义 (P<0 .0 5 )。提示 :宫颈癌细胞放疗前 SPF和 DNA倍体与放射敏感性有关 ,该两项指标有可能成为宫颈癌放射敏感性的预测指标     

Sympathoadrenal excitation and inhibition by lower brainstem stimulation in cats

Effects of stimulation of brainstem sites on hemodynamics and plasma catecholamine levels were assessed in cats under chloralose-urethane anesthesia. Pressor areas of the dorsal medulla (DM) and ventrolateral medulla (VLM) and the depressor area of the paramedian reticular nucleus (PRN) were stimulated electrically using a monopolar electrode, or chemically using sodium glutamate microinjection. Plasma levels of norepinephrine (NE) and epinephrine (EPI) were measured in caval blood above the adrenal veins. Electrical stimulation of the DM and VLM produced increases in blood pressure and in plasma NE and EPI levels that were enhanced after acute vagotomies. The NE and EPI responses were attenuated after acute, bilateral adrenalectomies, confirming augmented adrenomedullary secretion, whereas the pressor responses were intact. Injection of sodium glutamate into the same pressor regions of the DM or VLM also produced pressor responses and elevated plasma catecholamine levels, indicating that the responses resulted from activation of neuronal perikarya. Stimulation of the PRN attenuated pressor and catecholamine responses during stimulation of the DM and VLM. The results indicate that pressor responses during stimulation of the DM and VLM are due at least partly to activation of perikarya in these regions, are associated with but not dependent on adrenomedullary activation, and are enhanced after vagotomy; and that neurons of the PRN exert inhibitory modulation of the pressor and adrenomedullary responses during stimulation of VLM and DM.     

端粒酶突变体对肝癌细胞端粒酶活性的作用

目的　观察端粒酶突变体对肝癌细胞端粒酶活性和生长抑制的作用。方法　利用质脂体转染法在培养的肝癌细胞中导入端粒酶突变体，并与维甲酸和人参皂甙对照，利用TRAP－银染方法对不同时期肝癌细胞进行了端粒酶活性的测定，并观察各期细胞生长情况。结果　在加入端粒酶突变体后肝癌细胞端粒酶活性明显降低，细胞出现明显凋亡现象，其作用效果与维甲酸基本相同。结论　端粒酶突变体对肝癌细胞的抑制作用可能是通过抑制端粒酶活性途径实现的。     

Point mutation in the parkin gene on patients with Parkinson’s disease

Summary To investigate the distribution of possible novel mutations from parkin gene in variant subset of patients with Parkinson’s disease (PD) in China and explore whether parkin gene plays an important role in the pathogenesis of PD, 70 patients were divided into early-onset group and late-onset group; 70 healthy subjects were included as controls. Genomic DNA from 70 normal controls and from those of PD patients were extracted from peripheral blood leukocytes by using standard procedures. Mutations of parkin gene (exon 1–12) in all the subjects were screened by PCR-single strand conformation polymorphism (SSCP), and further sequencing was performed in the samples with abnormal SSCP results, in order to confirm the mutation and its location. A new missense mutation Gly284Arg in a patient and 3 abnormal bands in SSCP electrophoresis from samples of another 3 patients were found. All the DNA variants were sourced from the samples of the patients with early-onset PD. It was concluded that Parkin point mutation also partially contributes to the development of early-onset Parkinson’s disease in Chinese. WANG Tao, male, born in 1961, Associate Professor This work was supported by grants from the key program of the special scientific project of Scientific & Technologic Agency of Hubei Province (Serial No. 2001AA308B01) and the Hygienic Research Project of Hygienic Agency of Hubei province (Serial No. WJ 01529).