还原型谷胱甘肽联合甘草酸二铵对腹部开放伤后海水浸泡犬肝功能损伤的治疗作用

Objective To investigate effect of reduced glutathione and diammonium glycyrrhizinate on the treatment of hepatic damage in experimental dogs following open abdominal injuries coupled with seawater immersion. Methods Twenty-four dogs with open abdominal injuries were randomly divided into 3 groups: the control group (given with simple observation after 1.5 h seawater immersion); the routine treatment group (given routine care and fluid transfusion after 1.5 h seawater immersion) ; the hepatic treatment group (given routine are, fluid transfusion and hepatic treatment as well, after 1.5 h seawater immersion). Each group consisted of 8 dogs. Blood samples were taken at different time points to measure total bilirubin (TB), alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), prothromin time (PT), endotoxin, tumor necrosis factor-α(TNF-α), interleukin-6 (IL-6), and pathological examination was also made at the same time. Results For the control group, contents of TB, ALT, AST and LDH increased significantly and survival time was less than 24 hours. Contents of TB, ALT, AST and LDH of the routine treatment group also increased significantly, but survival time of all the experimental animals was mere than 24 hours. Reduced glutathione and diammonium glycyrrhizinate could reduce the extent of lesion quite significantly 12～24 hours following open abdominal injuries. Conclusions Reduced glutathione and diammonium glycyrrhizinate seemed to have good effects on the treatment and prevention against hepatic damage induced by trauma coupled with seawater immersion. It could be used as a primary means for the treatment of such kind of hepatic damage.     

Phase I trial of doxorubicin-containing low temperature sensitive liposomes in spontaneous canine tumors.

PURPOSE: To determine the maximum tolerated dose, dose-limiting toxicities, and pharmacokinetic characteristics of doxorubicin encapsulated in a low temperature sensitive liposome (LTSL) when given concurrently with local hyperthermia to canine solid tumors. EXPERIMENTAL DESIGN: Privately owned dogs with solid tumors (carcinomas or sarcomas) were treated. The tumors did not involve bone and were located at sites amenable to local hyperthermia. LTSL-doxorubicin was given (0.7-1.0 mg/kg i.v.) over 30 minutes during local tumor hyperthermia in a standard phase I dose escalation study. Three treatments, given 3 weeks apart, were scheduled. Toxicity was monitored for an additional month. Pharmacokinetics were evaluated during the first treatment cycle. RESULTS: Twenty-one patients were enrolled: 18 with sarcomas and 3 with carcinomas. Grade 4 neutropenia and acute death secondary to liver failure, possibly drug related, were the dose-limiting toxicities. The maximum tolerated dose was 0.93 mg/kg. Other toxicities, with the possible exception of renal damage, were consistent with those observed following free doxorubicin administration. Of the 20 dogs that received > or = 2 doses of LTSL-doxorubicin, 12 had stable disease, and 6 had a partial response to treatment. Pharmacokinetic variables were more similar to those of free doxorubicin than the marketed liposomal product. Tumor drug concentrations at a dose of 1.0 mg/kg averaged 9.12 +/- 6.17 ng/mg tissue. CONCLUSION: LTSL-doxorubicin offers a novel approach to improving drug delivery to solid tumors. It was well tolerated and resulted in favorable response profiles in these patients. Additional evaluation in human patients is warranted.     

外科学教学中的审美教育

医学审美教育是医学生全面素质教育不可分割的组成部分,笔者结合长期外科教学实践,阐述了在外科学教学中运用医学美学原理对外科学的美进行开发和挖掘,使医学生在熟练掌握外科学基本理论和基本技能的同时,潜移默化地接受美的教育,美的熏陶,更能激发他们对外科学的热爱和兴趣,达到全面提高医学生整体素质的目的。     

高压氧综合治疗持续植物状态30例疗效分析

目的评估高压氧综合治疗持续植物状态的疗效和探讨最佳治疗方案。方法回顾性分析了1999年—2005年应用高压氧治疗的30例持续植物状态病例,主要分析了原发病因、高压氧治疗次数以及高压氧治疗时机与疗效的关系。结果脑外伤组显效率和好转率明显高于非脑外伤组(P<0.05),开始治疗时间≤30d组及31～60d组好转率明显高于≥61d组(P<0.05)。结论高压氧综合治疗对脑外伤所致持续植物状态患者60d以内开始行高压氧治疗的患者疗效较好。     

从天价医药费事件折射出当前我国医疗机构存在的问题

目前，我国许多医院的医疗卫生工作人员在为患者进行医疗卫生服务的过程中，为了医院和个人的经济利益，存在着过度医疗消费现象。最典型的是哈尔滨医科大学第二附属医院发生的天价医药费事件。导致这种现象出现的原因是由于法律的不健全、制度的不完善等而导致的监督力度不够，加之有些医务工作者在经济利益的驱使下使自己的职业道德滑坡，从而导致了老百姓看病贵现象的出现。     

脑卒中后抑郁症相关心理社会因素的对照研究

目的 探讨脑卒中后抑郁症相关的心理社会因素,以指导心理干预,提高生活质量。方法 30例卒中后抑郁患者为研究组,42例卒中后无抑郁患者为对照组。以医学应对问卷、社会支持评定量表(SSRS)和Barthel指数(BI)为评定工具,对两组患者分别进行评定。结果研究组面对量表分显著低于对照组(P<0.05),而屈服量表分显著高于对照组(P<0.01)。研究组SSRS评分显著低于对照组(P<0.01)。两组BI评分差异无显著性(P>0.05)。结论 有针对性的心理教育性干预并加强社会支持可能对防治卒中后抑郁起重要作用。