核酸及核苷酸用于营养及免疫调节治疗的早期卫生技术评估

目的 评价核酸或核苷酸用于临床营养支持和免疫调节治疗的安全性、有效性和经济学价值。方法 检索中国生物医学文献数据库、Cochrane图书馆、MEDLINE光盘数据库、EMBASE光盘数据库,并联机检索SCI数据库,鉴定有关随机对照试验(RCTs),采用RevMan4.l进行Meta-分析。结果 纳入46个随机对照试验,涉及核酸/核苷酸用于肠内营养支持、婴儿营养、免疫调节治疗。18个研究报告了含核苷酸组分的免疫增强型肠内营养对外科术后和危重症患者预后的影响,合并分析发现免疫营养对患者感染率、住院时间和费用有肯定意义。发现1个报告在母乳代用品中加入核苷酸对婴儿免疫功能影响的研究,但报告对临床结局无明显影响。27个对“免疫核酸”用于免疫调节治疗的随机对照试验均为低质量研究,合并分析无法肯定iRNA的临床价值。结论 在外科术后患者应用免疫肠内营养制剂可降低感染率、缩短住院时间并可能减少住院费用,但不能确定作为组分之一的核苷酸的作用。尚无证据支持在母乳代用品中添加核苷酸具有临床意义。不能肯定免疫核酸是否具有免疫调节作用,亦未发现核酸在延缓衰老、改善老年人健康状况方面的可用证据。建议对核酸、核苷酸用于营养支持治疗和免疫调节治疗进行进一步研究,严格规范“核酸营养品”的宣传和应用。     

中医外科学的起源及形成

对中医外科学的起源和形成历史，进行了概略而系统的讨论。认为：处理外科疾病是人类最早的医事活动之一，中医外科学起源于商周时期，初步形成了春秋，战国和秦汉六朝时期，经验不断积累于隋唐时期，不断完善和发展于宋金元形时期。     

二巯基丙磺酸钠解救毒鼠强中毒的疗效分析

目的：探求急性毒鼠强中毒（ＡＴＩ）的临床解毒方法。方法：应用二巯基丙磺酸钠解救ＡＴＩ３４例，进行疗效观察，并与既往常规治疗的２３例进行对照比较。结果：治疗组获得满意疗效，３例死亡，有效率９１．２％；对照组预后欠佳，死亡１３例，有效率４３．５％。结论：二巯基丙磺酸钠（Ｎａ—ＤＭＰＳ）对ＡＴＩ具有良好的止痉作用，可明显提高治疗效果。     

Treatment of ulcerative colitis by traditional Chinese medicine and dynamic study of immune functions

The effect of the traditional Chinese medicinal herbs enema and enteric-coated capsules in the treatment of ulcerative colitis (UC) were compared in 260 cases. The immune complexes and the dynamic change of autoantibodies were monitored in 28 out of the 260 cases before and after treatment. The following results were observed. (1) There was no significant difference in the total effective rate between the enema group and the oral capsule group (93.3% and 87.5% respectively), but the recovery rates of purulent hemafecia, mucusfecia and erosion accompanying colitis, etc. in the former group were higher than those in the latter (P less than 0.01). (2) The circulating immune complexes were found 43 times above the normal range in 17 cases with positive rate 60.7%, and tended to decrease as the condition became better after treatment. Antinuclear antibodies were determined by the indirect fluorescent immune method and the indirect enzyme labelling method and the positive rates were 53.6% and 64.7% respectively, both being much higher than those in the controls (P less than 0.01).     

~(99)Tc-MDP对类风湿性关节炎患者外周血单核细胞产生细胞因子的影响

目的 :探讨“云克”(99Tc MDP)治疗类风湿性关节炎 (RA)的免疫机制。方法 :采用ELISA双抗体夹心法 ,观察“云克”体外对RA患者外周血单核细胞 (PBMC)产生白介素 1(IL 1)和可溶性白介素 2受体 (sIL 2R)的影响。结果 :“云克”有抑制RA患者IL 1的分泌及细菌脂多糖 (LPS)的促分泌作用 ,并对可溶性白介素 2受体的自发分泌及植物血素 (PHA)诱导分泌均有抑制作用。结论 :“云克”对RA的治疗机制可能与其降低IL 1和sIL 2R的作用有关     

牛磺酸对大鼠缺血心肌Bcl-2和Bax蛋白表达的影响

目的：探讨大鼠心肌缺血损伤与凋亡相关基因bcl-2和bax表达的关系及牛磺酸的影响。方法：结扎大鼠冠状动脉左前降支建立心肌缺血模型。检测心肌线粒体中超氧化物歧化酶（SOD）、Ca^2 -ATPase活性及MDA（丙二醛）含量，用免疫组化法检测Bcl-2和Bax蛋白在心肌中的表达量。结果：结扎冠脉左前降支可致心肌线粒体MDA含量升高，SOD和Ca^2 －ATPase活性下降；缺血心肌Bax蛋白表达呈显著升高；牛磺酸能明显减少缺血心肌线粒体MDA的生成，降低心肌Bax蛋白的表达，增加Bcl-2蛋白的表达。结论：结扎大鼠冠状动脉左前降支导致的心肌缺血损伤与Bcl-2和Bax蛋白的表达有关。     

抑肽酶预处理防护大鼠肝脏缺血再灌注损伤的实验研究

目的 探讨抑肽酶预处理对肝脏缺血再灌注损伤的防护作用。方法 SD大鼠80只，随机分为抑肽酶预处理和生理盐水预处理两组，观察肝脏缺血再灌注损伤引起及抑肽酶预处理的影响。结果 拟肽酶预处理组大鼠缺血再灌注损伤引起的血清谷丙转氨酶（ALT），谷草转氨酶（AST）活性及肝组织丙二醛（MDA）含量变化均显著低于生理盐水预处理组（P＜0．01）；肝细胞形态学异常改变也明显较生理盐水预处理组轻。结论 抑肽酶预处理对大鼠肝脏缺血再灌注损伤有明显的防治作用。     

红细胞调控白细胞免疫功能新的自然实验研究体系

目的用血液免疫反应路线图实验体系评估红细胞在白细胞免疫活性中的作用。方法将0·3ml血浆加入0·2ml全血细胞悬液(全血细胞组)或0·2ml白细胞悬液(白细胞组)中,37℃温育1h,用免疫酶联法测定IL-8和IL-12水平,流式细胞仪测定白细胞膜CD4、CD8、CD35和CXCR4表达量。结果全血细胞组IL-8和IL-12水平(分别为5·96±4·26、9·84±2·23ρB·pg-1·ml-1)明显低于白细胞组(分别为15·09±9·86、13·59±3·69ρB·pg-1·ml-1,P<0·05),淋巴细胞CD4、CD35、CXCR4表达量(分别为37·79±12·00、154·66±70·00、34·40±20·45)明显高于白细胞组(分别为18·54±11·32、83·26±35·99、16·69±11·09,P<0.01),粒细胞CD35表达量(603·63±257·64)明显高于白细胞组(384·86±174·16,P<0.01)。成人全血细胞组淋巴细胞和粒细胞CD35和CXCR4表达量明显高于脐血全血细胞组(P<0·05或P<0·01)。结论红细胞是白细胞(包括T淋巴细胞、B淋巴细胞、NK细胞、树突状细胞、粒细胞等)免疫功能的调控者和指导者,脐血红细胞免疫调节功能明显下降;本研究为红细胞免疫调控活性测定提供了新的近似自然的方法。     

中药对大鼠辐射损伤防护作用的实验研究

目的探讨中药当归、川芎、黄芪、丹参提取液对大鼠放射性骨髓损伤的防护作用.方法雄性SD大鼠60只,随机分为正常对照组、模型组、中药组,每组6只,在相同条件下饲养2周,模型组和中药组大鼠给予6.0 Gy 60Co γ射线一次性全身照射,继续饲养1周处死全部动物并取材.用骨髓细胞计数法计数骨髓有核细胞数,用Western blot法测定血管内皮生长因子（vascularendothelialgrowth factor,VEGF）、血小板衍生生长因子（ptatelet derived growth factor,PDGF）的蛋白含量.结果与正常对照组比较,模型组大鼠的骨髓有核细胞数、VEGF、PDGF蛋白含量明显减少（P＜0.01）,与模型组比较,中药组大鼠的骨髓有核细胞数、VEGF、PDGF蛋白含量明显增加（P＜0.01或P＜0.05）.结论中药当归、黄芪、川芎、丹参对大鼠放射性骨髓损伤有一定防护作用.     

Laparoscopic Local Resection Based on Sentinel Node Evaluation for Early Gastric Cancer: A Preliminary Report

We previously reported that lymphatic mapping using isosulfan blue can be used to identify sentinel nodes (SNs). This study was undertaken to evaluate the feasibility of using the SN technique in treating early gastric cancer and to explore its usefulness for minimal invasive surgery. Twenty-three patients with early gastric cancer who underwent SN biopsy were retrospectively evaluated. Based on SN evaluation, individualized surgery was performed in five patients with T1N0M0 gastric cancer. When pathological examination of frozen sections revealed metastasis in SNs, we performed a standard D2 gastrectomy. Laparoscopic local resection was applied when the SN biopsy was negative. Our results showed that the success rate with SN biopsy in early gastric cancer was 100%, as were the accuracy, sensitivity, and specificity. All five patients with early gastric cancer had SNs negative for metastases both by frozen section and by postoperative pathology. Thus, all these patients underwent laparoscopic local resection without extended lymphadenectomy. We conclude that SN biopsy is a useful tool to individualize the operative procedure, and laparoscopic local resection can be safely performed using SN guidance in selected patients with early gastric cancer.