重组人肿瘤坏死因子诱导HL－60白血病细胞分化及调控原癌基因表达的作用

采用２０～２００Ｕ／ｍｌ的重组人肿瘤坏死因子（ｒｈＴＮＦ－α）处理体外液相培养的人早幼粒白血病细胞珠ＨＬ－６０，观察到５０～２００Ｕ／ｍｌ的小剂量ＴＮＦ具有诱导其向单核－巨噬细胞途径分化及抑制其增殖的效应。采用细胞总ＲＮＡ打点杂交技术检测１～１００Ｕ／ｍｌＴＮＦ诱导ＨＬ－６０细胞早期（１２小时内）对其ｃ－ｍｙｃ，ｃ－ｆｏｓ原癌基因表达的影响，发现ＴＮＦ可抑制ｃ－ｍｙｃｍＲＮＡ水平及ｃ－ｆｏｓ短暂性表达增高。结果表明此小剂量ｒｈＴＮＦ－α具有诱导白血病细胞分化的效应及调控多癌基因表达的作用。     

大鼠肺微血管和肺泡铸型的扫描电镜观察

用扫描电镜观察以甲基丙烯酸甲酯灌注鼠的肺微血管和肺泡。胸膜下毛细血管较稀疏,网孔粗大。毛细血管部分成锐角折返,亦可见毛细血管盲端。肺泡隔毛细血管均成扁平状膨大,且相互吻合成单层密集网。肺泡铸型为大小不等、不规则的多面体,表面可见肺泡Ⅱ型细胞核之压迹。两肺泡之间可见呈桥式连接的肺泡孔,亦可见部分呈三通管样相连。     

脆性X综合征中不稳定的DNA序列和异常甲基化研究

采用ＰＣＲ结合序列胶分析的方法，对８２条正常中国人Ｘ染色体ＦＲＡＸＡ位点（ＣＧＧ）ｎ重复序列拷贝数的多态性进行了测定，其范围为２１～３１，高峰为２７。并通过Ｓｏｕｔｈｅｒｎ杂交分析了来自６个Ｆｒａ（Ｘ）家系的１５名成员（ＣＧＧ）ｎ的拷贝数与该重复序列上游ＣｐＧ岛的甲基化状态。Ｆｒａ（Ｘ）患者（ＣＧＧ）ｎ大量扩增并伴随ＣｐＧ岛异常甲基化。Ｆｒａ（Ｘ）携带者女性（ＣＧＧ）ｎ扩增较少，有嵌合现象。其子代或产生更大扩增，或保持原来状态，呈动态突变遗传特征。     

Surgical Management of PICA Aneurysm and Incidental Facial Nerve Schwannoma: Case Report.

We report a patient with a posterior inferior cerebellar artery (PICA) aneurysm and an incidental facial nerve schwannoma at the cerebellopontine angle (CPA). A 46-year-old woman presented with the sudden onset of a severe headache, nausea, and vomiting. She had no other abnormal neurological symptoms and signs. Computed tomography (CT) showed hemorrhage in the fourth ventricle. Cerebral angiography demonstrated an aneurysm arising from the tonsillomedullary segment of the left PICA. A facial nerve schwannoma was incidentally found as the aneurysm was being clipped. The aneurysm was clipped via a left transcondylar approach. Subsequently, the schwannoma (2 x 3 x 2 mm) was resected from the facial nerve fascicles, and the facial nerve was preserved. Postoperatively, the patient developed mild to moderate dysfunction of the facial nerve (House-Brackmann grade III [H-B III]) but her hearing was intact. Both a facial nerve schwannoma involving the CPA and an aneurysm involving the PICA can be managed through the transcondylar approach. An asymptomatic facial nerve schwannoma can be resected safely with minimal facial nerve dysfunction.     

西藏地区农牧民生活习俗与包囊虫病的关系调查

目的　探讨西藏地区农、牧民生活习俗与包囊虫病的关系。方法　自制问卷对 7个县 2 40个家庭 163 1名成员与包囊虫感染有关的生活习俗进行调查分析。结果　饭前便后洗手的人仅有 16 1%,餐具一般都用天然水洗 ,大部家庭用天然绵羊绒擦洗茶具。大多数人都喝过河溪水 ,池塘水 ,人人都吃半生不熟的肉 ,半数以上的吃生肉和生血肠 ,绝大多数人喝未经消毒的鲜牛、羊奶。 10 0 %家庭养狗 ,所有人员与狗、羊、牛、马接触密切。包囊虫病人占调查人数 0 43 %( 7/ 163 1) ,有典型症状者占 0 67%( 11/ 163 1)。结论　当地居民感染包囊虫与不良生活习俗有关     

Mechanisms of opioid-induced tolerance and hyperalgesia.

Opioid tolerance and opioid-induced hyperalgesia are conditions that negatively affect pain management. Tolerance is defined as a state of adaptation in which exposure to a drug induces changes that result in a decrease of the drug's effects over time. Opioid-induced hyperalgesia occurs when prolonged administration of opioids results in a paradoxic increase in atypical pain that appears to be unrelated to the original nociceptive stimulus. Complex intracellular neural mechanisms, including opioid receptor desensitization and down-regulation, are believed to be major mechanisms underlying opioid tolerance. Pain facilitatory mechanisms in the central nervous system are known to contribute to opioid-induced hyperalgesia. Recent research indicates that there may be overlap in the two conditions. This article reviews known and hypothesized pathophysiologic mechanisms surrounding these phenomena and the clinical implications for pain management nurses.     

应激反应介质在糖尿病心血管并发症中的作用

近30年来糖尿病患病率在多数欧美和亚洲国家中迅速增高。糖尿病心血管并发症是糖尿病患者的主要死亡原因,其发生机制不甚明了。糖尿病有关的代谢因素增加循环和组织中氧化和糖化蛋白或脂蛋白的水平和氧化应激性。这些改变可引起动脉粥样硬化,凝血因子和血小板活性增高,纤溶活性     

肠道T细胞淋巴瘤临床分析

本文总结报告了3例肠道T细胞淋巴瘤(intestinal T-cell lymphoma，ITCL)的诊治资料，并结合文献复习，发现IT—CL多见于中年男性，以腹痛、血便、发热、体质量下降为主要症状，治疗效果差，预后不良。病理改变以肠道溃疡形成为特点，溃疡形态呈多形性、多灶性、不规则，镜下瘤细胞明显异型、弥漫性浸润，中至大细胞多见。肿瘤细胞呈T细胞表型。ITCL临床少见，缺乏特异性临床表现，极易误诊。故临床医师应重视对ITCL临床病理特征、免疫表型和基因型的研究，注意识别，促其早期诊治。     

浅谈健康教育中的护理风险管理

健康教育作为临床护理中的重要内容，对病人的疾病转归有重要作用。而任何医疗护理行为都是具有超过各种服务之上的高科技行为的组合活动，具有高风险性，健康教育同样存在一定的风险性。所以，我们应提高风险意识，加强风险管理，将风险降低至最低限度。     

根据桂枝汤的效应消除半衰期和表观消除半衰期制订给药方案的探讨

为探讨药效法估测的效应消除半衰期和效量法估测的表观半衰期对合理制订给药方案的意义和作用,以桂枝汤解热和抗炎的药物动力学实验中所得的相应参数值设计了给药方案,观察了它们在提高药效上的作用。结果表明在给药总剂量相等、首次给药同时开始的情况下,以半衰期设计的给药方案组的药效均明显高于习惯的一次给药组;而以效应消除半衰期设计给药方案组药效增强率又高于以表观半衰期设计的方案组。提示效应消除半衰期比表观半衰期似更有实践意义。