Efficacy of oral L-ornithine L-aspartate in cirrhotic patients with hyperammonemic hepatic encephalopathy

Hyperammonemia and associated cerebral edema cause neurological abnormalities in liver disease patients. Although only 15% of ammonia production originates in the colon, management strategies for hepatic encephalopathy (HE) have focused on reducing ammonia generation from the bowel rather than on manipulating systemic mechanisms involved in ammonia metabolism. Administration of L-ornithine L-aspartate (LOLA) improves mental status and decreases serum and spinal fluid ammonia levels by stimulating both the urea cycle and glutamine (Gln) synthesis, which are key metabolic pathways in ammonia detoxification. LOLA was shown to be superior to a placebo for management of HE, and the results of several clinical trials suggest that its effectiveness could be higher with the more severe grades of this syndrome. Compared with the standard treatment, LOLA is effective not only in reducing hyperammonemia and the severity of this disease, but also in improving the patient's perceived quality of life. Therefore, LOLA is a promising alternative for the management of HE.     

从汶川地震救援看医学生专业素质培养

本文通过总结汶川地震救援的经验教训,指出汶川地震救援对医学生专业素质培养提出了新的要求:必须对医学生进行灾害救援意识教育,强化灾害救援技能训练,实施灾害救援管理教育,加强灾害卫生防疫和心理疏导技能训练,使医学生成为既能适应平时医疗卫生防治、又能适应各种应急救援的专业化人才.     

Spike timing-dependent plasticity: from synapse to perception

Information in the nervous system may be carried by both the rate and timing of neuronal spikes. Recent findings of spike timing-dependent plasticity (STDP) have fueled the interest in the potential roles of spike timing in processing and storage of information in neural circuits. Induction of long-term potentiation (LTP) and long-term depression (LTD) in a variety of in vitro and in vivo systems has been shown to depend on the temporal order of pre- and postsynaptic spiking. Spike timing-dependent modification of neuronal excitability and dendritic integration was also observed. Such STDP at the synaptic and cellular level is likely to play important roles in activity-induced functional changes in neuronal receptive fields and human perception.     

BDNF-dependent synaptic sensitization in midbrain dopamine neurons after cocaine withdrawal

The neural mechanism underlying the relapse to drug use after drug withdrawal is largely unknown. We found that after withdrawal from repeated cocaine exposure, excitatory synapses onto dopamine neurons in the ventral tegmental area (VTA) of the rat midbrain became highly susceptible to potentiation by weak presynaptic stimuli, an effect requiring endogenous brain-derived neurotrophic factor-tyrosine kinase B (BDNF-TrkB) signaling. The elevated BDNF expression in the VTA after cocaine withdrawal may prime these synapses for potentiation by cue-associated activity, triggering drug craving and relapse.     

医疗缺陷成因中的人文因素及对策研究

医疗缺陷是引起医疗纠纷的主要原因,是影响医疗秩序和医疗服务质量,导致医患关系紧张的重要因素.医疗缺陷的发生凸显人文缺失：必须在医疗服务和医学教育中加强人文教育,从根本上防范医疗缺陷的发生,全面提高医疗服务质量。     

结直肠癌合并肠梗阻的临床病理学研究

目的探讨结直肠癌合并肠梗阻的相关影响因素。方法收集466例结直肠癌患者的临床病理资料,分析肠梗阻与患者临床病理因素的关系。结果全组病例肠梗阻发生率为8.2%(38/466)。单因素分析显示,肠梗阻与性别、肿瘤大小、大体类型、淋巴结转移、远处转移、TNM分期、术前血清癌胚抗原水平以及手术方式相关;Logistic回归分析显示,影响肠梗阻发生的因素为大体类型、年龄、TNM分期和肿瘤大小;其危险程度大小为大体类型年龄TNM分期肿瘤大小。结论结直肠癌合并肠梗阻的特征是好发于中老年人,病程晚,生物行为恶及根治率低。     

上海市宝山区2009年手足口病流行特征分析

手足口病是由多种肠道病毒引起的常见传染病,以婴幼儿发病为主。2005年开始,本市对手足口病开展常规疫情监测。2008年4月我国部分地区发生手足口病爆发疫情,5月2日,卫生部正式将手足口病纳入丙类传染病管理。为了解本区手足口病的流行病学特征,我们对2009年本区手足口病发病情况进行了流行病学分析,并对爆发疫情、聚集性病例、重症病例情况及病原监测情况进行了分析,结果报告如下。