综合医院心理咨询门诊儿童咨客分析

目的；了解综合医院心理咨询门诊儿童咨客的特点。方法：总结中山大学附属三院心理咨询门诊近3年儿童咨客的资料。结果：咨客男女比例为1．96：1，咨客人数随着年龄的增长而增加，女童中13－16岁的比例男童大，5－8岁和9－12岁的比例较男童小。广州市内外的咨客比例为1．38：1，不同年龄儿童咨客的居住地构成是有差异的。最常见的病种是精神分裂症，神经症、精神发育迟滞，儿童多动症，单纯咨询和品行障碍，不同年龄，不同性别的儿童咨客的疾病构成是有差异的。结论：综合医院心理咨询门诊与儿童心理咨询门诊的儿童咨客是有差异的。     

大剂量卡铂化疗的药物毒性观察

6例肺癌患者接受了大剂量卡铂并自体骨髓移植治疗 ,卡铂剂量从 5 60～ 1375 mg/ m2 ,5例加用 VP～ 1630 0 mg,1例并用 MMC6mg和 VCR2 mg;主要毒性反应为白细胞、中性粒细胞、血小板减少和脱发 ( WHO毒性反应 ～ 级 )其次是贫血、皮肤粘膜出血、呕吐和可逆性肝功能损害 ,口腔粘膜溃疡及轻度发烧各 2例 ,一过性蛋白尿、室上性心动过速和便秘各 1例 ,尿素氮和肌酐未见升高 ;全部患者骨髓均获解救 ,从自体骨髓回输到骨髓造血功能重建成功平均 2 6.67( 17～ 32 )天     

Caring for the adolescent with HIV infection or AIDS in the critical care setting.

Caring for the adolescent with HIV infection or AIDS in the critical care setting is challenging. This article discusses medical treatments for HIV, aspects of adolescent development that influence their behaviors, certain behaviors that put adolescents at risk for HIV acquisition, ethical and legal concerns for caring for this population, nursing implications for care, and the needs of nurses caring for this population.     

Thyroid-vitamin A interactions in chicks exposed to 3,4,3',4'-tetrachlorobiphenyl: influence of low dietary vitamin A and iodine

Poultry chicks receiving a low vitamin A semipurified diet and exposed to 3,4,3',4'-tetrachlorobiphenyl became hypothyroid in comparison with unexposed controls. Metabolic rate, total serum thyroxine, total serum triiodothyronine, and food intake decreased significantly while thyroid weight increased. Unexpectedly, growth rate was not affected on this diet. In the case of chicks receiving a low vitamin A--low iodine semipurified diet and exposed to the PCB congener, the hypothyroid response was apparently antagonized. Comparing exposed chicks with unexposed controls, metabolic rate and the proportion of free T3 (i.e., %T3 resin uptake) increased while total serum thyroxine and thyroid weight were unchanged. In addition, growth rate, food consumption, and serum retinol decreased on this diet. These results are interpreted to mean that growth rate may have been altered by circulating levels of retinol, and vitamin A insufficiency may predispose birds to the hypothyroid effects of PCBs.     

胸水CYFRA21-1、CEA及NSE联合测定对肺癌的诊断价值

目的　通过胸水CYFRA2 1 1(细胞角蛋白片段 )、CEA(癌胚抗原 )及NSE(神经烯醇化酶 )的检测 ,探讨各指标对肺癌诊断特异性及联合分析对肺癌的诊断价值和临床意义。方法　对 12 3例肺良性疾病组患者和 15 6例肺癌组患者胸水进行上述肿瘤标志物测定。将肺癌患者又根据病理类型分成腺癌组 (81例 )、鳞癌组 (5 0例 )、小细胞癌组 (12例 )和未定性癌组 (13例 )对各指标分别进行对照分析。结果　肺癌组胸水CYFRA2 1 1、CEA及NSE含量 (ng/ml)分别为 5 5 34± 37 44、5 7 11± 5 2 6 5及 16 99± 2 9 2 2 ,而肺良性疾病组的含量则分别为 9 0 8± 7 5 4、9 92± 6 2 8和 7 30±6 2 9,各指标的统计学检验均有极显著差异 (P <0 0 0 1)。CYFRA2 1 1在肺鳞癌组最高 ,与小细胞肺癌组相比有显著差异 (P <0 0 5 ) ,而与腺癌组和未定型癌组相比无显著差异 (P <0 0 5 ) ;CEA主要在腺癌组的含量均比其他肺癌组有极明显增高 (P <0 0 0 1) ;NSE则在小细胞癌组最高 ,其含量与其他肺癌组相比有极明显增加 (P <0 0 0 1)。结论　胸水CYFRA2 1 1,CEA及NSE在不同组织类型肺癌中的含量明显不同 ;三者联合测定对肺癌的诊断有重要的临床参考价值     

糖尿病合并冠心病的概述

从糖尿病合并冠心病的流行病学、病理基础、发病机理及临床、治疗五个方面论述了糖尿病合并冠心病的现代基础研究,并对其中西医结合治疗提出了方法.     

Effects of beta 1- and beta 1 + beta 2-antagonists on training-induced myocardial hypertrophy and enzyme adaptation

The effects of beta 1- and beta 1 + beta 2-antagonists on the myocardial adaptation to exercise training were investigated in male Sprague-Dawley rats randomly divided into trained (treadmill, 1 hr/day, 5 days/week for 10 weeks at 27 m/min, 15% grade) without drug (TC), sedentary without drug (SC), trained treated with atenolol (TA) (10 mg/kg body wt, i.p.), trained treated with propranolol (TP, 30 mg/kg body wt, i.p.), and sedentary propranolol. Doses of both beta-antagonists were titrated to decrease the exercise heart rate by 25% compared to the controls. The heart weight and heart/body weight ratio were significantly greater in TC (1.28 +/- 0.07 g (P less than 0.01); 296 +/- 12 mg/100 g body wt (P less than 0.05) respectively) than in SC (1.09 +/- 0.04 g and 268 +/- 11 mg/100 g body wt), or in TP and TA. Myocardial mitochondrial protein was unchanged by training or beta-blockade. Citrate synthase and beta-hydroxyacyl CoA dehydrogenase activities were not altered. Carnitine palmitoyltransferase activity was increased in SP compared to SC. Training increased hexokinase activity only in TC (5.22 +/- 0.12 vs 4.26 +/- 0.23 mumol/min/g wet wt, P less than 0.01). Lactate dehydrogenase activity increased significantly (P less than 0.01) in both TC (383 +/- 14 mumol/min/g wet wt) and TA (372 +/- 14 mumol/min/g wet wt) compared to SC (276 +/- 14 mumol/min/g wet wt), but not in TP versus SP. These data indicate that (1) beta-adrenergic blockade prevents training-induced cardiac hypertrophy; (2) beta-antagonists have little effect on the myocardial oxidative capacity; and (3) while the training induction of myocardial hexokinase is inhibited by both beta 1- and beta 1 + beta 2-antagonists, myocardium may increase its ability to utilize lactate during exercise with training despite beta 1-blockade.     

Poly(L-lysine)-g-poly(D,L-lactic-co-glycolic acid) micelles for low cytotoxic biodegradable gene delivery carriers.

Poly(lactic-co-glycolic acid) (PLGA)-grafted poly(L-lysine) (PLL) (PLL-g-PLGA) was synthesized to demonstrate its micelle-forming property in an aqueous solution. The micelles were used as a gene delivery carrier. The hydrodynamic diameter of PLL-g-PLGA micelles in an aqueous solution was ca. 149 nm with a narrow size distribution. Critical micelle concentration (cmc) was 9.6 mg/l. The PLL-g-PLGA micelles could be used to produce compact nanoparticulate complexes with plasmid DNA, which could efficiently protect the complexed DNA from enzymatic degradation by DNase I. The micelle/DNA complexes had highly compacted structure sized between 200-300 nm with a positive surface charge value. The PLL-g-PLGA micelles exhibited much higher transfection efficiency with lower cytotoxicity than PLL. Here, we demonstrated that biodegradable and cationic PLL-g-PLGA micelles could be used as an effective DNA condensation carrier for gene delivery system.     

在"医学教育国际标准研讨会"开幕式上的讲话

本次会议对经济全球化时代尤其是加入世界贸易组织之后,全面提升中国医学教育水平和质量,提高中国医学教育国际合作与竞争能力,具有十分重要的意义.要在国际竞争中立于不败之地,中国的高等医学教育必须增强紧迫感和危机感,加强国际交流与合作,加速高等医学教育国际化进程,积极研究并学习和借鉴医学教育国际标准,加快改革与发展,全面提高中国高等医学教育的综合实力.医学教育国际标准的引入,为我们重新审视和制定我国医学教育质量标准提供了十分有价值的参考.     

Paraffinoma in the urinary bladder: CT findings.

A case of a paraffinoma in the urinary bladder is presented. Plain radiography and intravenous urography showed a low attenuation filling defect in the urinary bladder, and CT demonstrated a lobulated fat-attenuation mass floating in the urinary bladder.