献血感染人类免疫缺陷病毒／获得性免疫缺陷综合征患者201例：应对策略及生活质量调查

目的:调查通过献血途径感染人类免疫缺陷病毒患者的应对方式及生活质量。方法:本调查于2006-01/07完成。共选取201例通过献血途径感染人类免疫缺陷病毒者入病例组,其中113例诊断为获得性免疫缺陷综合征。另取200例年龄、性别和受教育年限匹配的人类免疫缺陷病毒阴性献血者作为对照组。调查对象均签署知情同意书。采用Carver应付策略问卷简版和SF-36生存质量问卷进行调查:①Carver应付策略问卷简版:包括14个分量表,每个分量表包括两个条目,采用4级评分,1代表从来没这么做,4代表常常这样做,每个分量表粗分总分为8。②SF-36生存质量问卷:包括8个维度,各维度采用转换分数记分,最高分100分,最低分0分。生理健康总分和心理健康总分按标准分计算。分析Carver应对策略问卷的验证性因素及信度,比较两组调查对象的应对策略及生活质量,对人类免疫缺陷病毒感染者的应对方式与生活质量进行相关性分析。结果:发出问卷430份,选出内容详实问卷401份,有效率为93.3%。①Carver应付策略问卷中文版各因子的Cronbach’sα系数在0.55～0.84之间,14个因子模型验证性因素分析各拟合指标分别为χ2/df=0.49,IFI=1.05,AGFI=0.93,CFI=1.00,NNFI=1.07,MI=0.44～0.96,RMSEA=0.00,RMR=0.04。符合Carver量表的理论构想,具有很好的结构效度。②人类免疫缺陷病毒感染者前5位的应对方式是接受、积极应对、计划、使用工具支持和使用情感支持。③与对照组相比,人类免疫缺陷病毒感染者更多的采用否认、行为解脱和自责的应对方式(P<0.05～0.01);且在生理健康和心理健康各个方面均较对照组差(P<0.01)。④人类免疫缺陷病毒感染者的自责和行为解脱与总的生理健康和心理健康成负相关(r=-0.22～-0.44,P<0.01)。积极应对、计划和正性重构等应对方式也和反映个体生理健康的活力呈正相关(r=0.26,0.21和0.27,P<0.05)。总体健康知觉与计划、使用情感支持、使用工具支持、自我分散、宣泄和自责等应对方式均呈负相关(r=-0.14～-0.28,P<0.05～0.01)。结论:①Carver应对策略问卷中文版具有较好的信效度。②国内通过献血途径感染人类免疫缺陷病毒者主要的应对方式较积极,但相对正常对照而言,仍表现出更多的消极应对方式,且生活质量全面下降。③人类免疫缺陷病毒感染者的自责和行为解脱对生活质量存在负性影响;个体的躯体功能状况越好,越能采用问题集中应对的方式;自我健康知觉越差的被试,越有应对的动机。     

Percutaneous transluminal angioplasty of infrapopliteal vessels: preliminary results and technical considerations

Infrapopliteal balloon angioplasty was performed in 11 patients facing reconstructive surgery for limb salvage. Twelve separate sessions of angioplasty were performed, during which 15 of 16 diseased tibial runoff vessels were successfully dilated. Three complications occurred during percutaneous transluminal angioplasty (PTA). One was related to the concomitant use of a thrombolytic agent to open a femoropopliteal bypass graft and not related to the angioplasty itself. No limbs were lost as a result of complications. The procedure was a technical success in nine of 12 cases (75%) and an initial clinical success in eight of the nine that were technically successful (89%). Follow-up ranged from 1 to 22 months. Six of the nine cases (67%) remained clinically successful during this period. Preliminary results suggest that infrapopliteal PTA is a safe and effective alternative to surgical reconstruction in selected patients.     

抗心律失常新药关附甲素血浆浓度测定的方法

抗心律失常新药关附甲素(Guan—fu base A)与三氟醋酐反应,迅速定量地生成双-三氟乙酸酯衍生物,其结构经GC-MSD的分析得到证实。关附甲素衍生物经气相色谱分离后,在电子捕获检测器上有较高的响应,线性范围宽(10～2.0×10⁴ng/ml,r=0.9984)。血中平均回收率为97.52%。本法以烯丙洛尔(alprenolol)为内标,定量准确,日内及日间差的变异系数分别小于7%和9%,并已成功地用于关附甲素临床前的药代动力学研究。     

天然有机化合物质谱研究——Ⅺ.苯丙型苷快原子轰击质谱MNa~+的MIKES谱

研究了六种苯丙型苷与Na~+加合离子的快原子轰击质谱(FAB—MS)和质量分离离子动能谱(MIKES)。结果表明:在FAB谱中[M+Na]~+加合离子的丰度要比[M+H]~+离子高得多。由此可给出糖苷的分子量信息,[M+Na]~+离子的MIKES谱可给出糖基序列信息。     

抗癌药紫杉醇的神经毒性和耳毒性

紫杉醇(Paclitaxel,商品名Taxol)是从红豆杉科红豆杉属植物中提取得到的二萜类化合物,分子式为C47H51NO14。1963年,美国化学家瓦尼和沃尔从一种生长在美国西部大森林中的太平洋杉的树皮和木材中分离到紫杉醇粗提物,在筛选实验中发现其具有很强的抗肿瘤活性。1971年分离出紫杉醇单体成分、确定其化学结构,并正式     

The role of the L-arginine/nitric oxide pathway for relaxation of the human lower oesophageal sphincter

Smooth muscle specimens were taken from the oesophagogastric junction (OGJ) in patients operated on for gastrointestinal malignancies not involving the OGJ. The smooth muscle bundles of the inner, circular layer of the OGJ were richly innervated by fine nerve fibres staining positively for NADPH diaphorase. The outer longitudinal layer had a markedly lower number of NADPH-diaphorase positive nerve fibres. When the preparations were suspended in organ baths for recording of isometric tension, they developed active tension. Transmural field stimulation (TMS) induced frequency-dependent relaxations, which were abolished by N^G-nitro-L-arginine (L-NNA; 10^-4 M), and were often converted to atropine-sensitive contractions. The effect of L-NNA was concentration-dependent, and the concentration-response curve for L-NNA was shifted to the right by L-arginine pre-incubation. The enantiomer N^G-nitro-D-arginine (10^-4 M) also showed inhibitory actions on the responses to TMS, but significantly less than L-NNA. Relaxant responses to vasoactive intestinal polypeptide (VIP), forskolin, and sodium nitroprusside were unaffected by L-NNA pre-incubation. Exposure to a 124 mM K⁺ solution resulted in a biphasic relaxation of the preparations. This relaxation was not seen in preparations treated with scorpion venom (20/µg mr^-1) or L-NNA (10^-4M). Instead, a contractile response to 124 mM K⁺ solution was found. The results suggest that NANC responses to electrical stimulation of nerves in the human OGJ are mediated by a product generated from L-arginine. Moreover, the inhibitory biphasic response to 124 mM K⁺ is dependent on the release of this mediator, which seems capable of relaxing the muscle independently of changes in K⁺ conductance.     

The Anti-Leu4 (CD3) Monoclonal Antibody Reacts with Proximal Tubular Cells of the Human Kidney

A recent observation that certain kidney tubular cells, especially those in the normal kidney, were positively stained with the anti-Leu4 monoclonal antibody (MoAb) led us to investigate systematically the reactivity of three different anti-CD3 MoAb with a panel of normal human kidneys. Using immunohistochemical and immunofluorescence staining techniques, the anti-Leu4 MoAb was found to react with proximal tubular cells in all eight examined kidneys, while no tubular-cell reactivity was observed with the OKT3 or DAKO-T3 MoAb. In each kidney, however, all three antibodies reacted with a similar number of occasionally encountered T cells. The G11 MoAb, which has been reported to react with a calcium receptor-associated molecule, and the anti-Leu4 MoAb showed almost identical patterns of tubular-cell reactivity. The observed co-distribution of Leu4-expressing structures with a putative Ca2+ sensor in the kidney and the fact that binding of anti-Leu4 to T cells induces Ca2+-mediated signal transduction, warrant further studies on a potential role of Leu4-expressing structures in Ca2+ regulation of proximal tubular cells.     

来曲唑显著改善了一名生长激素缺乏的青春期男童的生长状况

为改善身材矮小青少年的生长状况采用芳香酶抑制剂来抑制雌激素生成的临床经验有限,本文记录了对这样1例患者联合应用生长激素和来曲唑治疗。来曲唑为第三代芳香酶抑制剂,该病例表明短期效果良好。来曲唑显著改善了一名生长激素缺乏的青春期男童的生长状况@Shah B. @Prasad K     

Cyclophosphamide in the male rat: cerebral biochemical changes in progeny

Adult male Wistar rats were treated with cyclophosphamide either alone or with both cyclophosphamide and vinblastine. They were then mated with virgin non-treated females. Examination of their offspring showed an increased post-natal mortality rate; and diminished learning capacity and spontaneous activity in the adults. These disorders were also found in the second generation, resulting from mating between animals of the first generation. Biochemical analyses of the brains of the offspring of treated males in the first and second generations showed a diminished activity of hippocampal choline acetyl-transferase. Moreover, the second generation showed a diminution of fronto-parietal cortex norepinephrine. These biochemical results may correspond to the observed behavioral deficits. Furthermore, by studying experimental mutation, they add to our knowledge of the consequences of certain cytostatic treatments.