1例蕈样霉菌病患者的护理

蕈样霉菌病又名蕈样内芽肿，是原发于皮肤的T细胞淋巴瘤，是一种罕见的疾病，国内统计仅占恶生淋巴瘤的1％，根据受侵皮肤表现分为红斑期、斑块期、肿瘤期。由于病因不明确，早期临床表现为蕈样前期，无症状，非暴露体表部位皮肤出现红斑样隆起，持续时间由数月到数年不等，确诊较困难，在治疗和护理上有其特殊性。我院于2004年11月23日收治首例蕈样霉菌病患者，现将护理体会介绍如下：     

Both A chain and B chain of beta-bungarotoxin are functionally involved in the facilitation of spontaneous transmitter release in Xenopus nerve-muscle cultures.

In the present study, Xenopus nerve-muscle cultures were used to explore the functional roles of A chain (a phospholipase A(2) subunit) and B chain (a non-phospholipase A(2) subunit) of Bungarus multicinctus beta-bungarotoxin. It was found that beta-bungarotoxin induced an increment of the frequency of spontaneous synaptic currents (SSCs) in the nerve-muscle cultures. Modification of beta-bungarotoxin with pyridoxal-5'-phosphate or substitution of Ca(2+) with Ba(2+) in buffer abolished the phospholipase A(2) activity of beta-bungarotoxin and the facilitatory phase of SSC as well. Antibodies that were directed specifically against A chain or B chain effectively inhibited phospholipase A(2) activity, and as a consequence the SSC frequency was not greatly different from the control rate. These results suggest that both A and B chains are indispensable parts of beta-bungarotoxin for inducing the facilitation of SSC frequency with Xenopus nerve-muscle cultures.     

黄芩苷对局灶性脑缺血大鼠脑组织基因表达谱的影响

目的 :研究黄芩苷对局灶性脑缺血大鼠脑组织基因表达谱的影响 ,探索黄芩苷治疗脑缺血的药理作用机制。方法 :分别从假手术组、局灶性脑缺血组、黄芩苷治疗组SD大鼠的脑组织中抽提总RNA ,Cy3 ,Cy5荧光标记 ,反转录分别合成cDNA探针后 ,与含有 4096条大鼠基因的BioStar基因表达谱芯片杂交 ,AxonGenepix 40 0 0B扫描仪扫描 ,GenePixPro 3 .0软件分析表达信号。结果 :大鼠局灶性脑缺血组差异表达的基因有 211条 ,其中 12条基因上调 ,199条基因下调。黄芩苷治疗后差异表达的基因有 177条 ,其中有 89条基因上调 ,而 88条基因下调。进一步分析发现 ,1个在模型组下调的基因经黄芩苷治疗后上调 ,3个在模型组上调的基因经黄芩苷治疗后下调 ,3个在模型组上调的基因经黄芩苷治疗后表达进一步增强。结论 :在基因组水平上黄芩苷可能通过多基因 ,多途径调节大鼠脑缺血基因表达谱而发挥药理作用。     

Changes in the gene expression associated with carbon tetrachloride-induced liver fibrosis persist after cessation of dosing in mice.

Recent studies have shown that gene expression profiles change in the livers of animals treated acutely with toxic chemicals such as carbon tetrachloride (CCl(4)). This study was undertaken to evaluate the changes in gene expression in mouse liver immediately after a long-term treatment with CCl(4) and possible effects of treatment cessation on these changes. Adult 129/Sv(pc)J mice were treated twice a week with CCl(4) at 1 ml/kg in olive oil for 4 weeks. Hepatic pathological changes observed in the CCl(4)-treated mice included necrosis, inflammation, and fibrosis, along with increased serum alanine aminotransferase activities. Consistent with these changes, expression of genes involved in cell death, cell proliferation, metabolism, DNA damage, and fibrogenesis were upregulated as detected by microarray analysis and confirmed by real-time RT-PCR. Four weeks after CCl(4) treatment cessation, the pathological changes were recovered, with the exception of fibrosis, which was not completely reversed. Most of the gene expression profiles also returned to the control level; however, the fibrogenetic genes remained at a high level of expression. These results demonstrate that changes in gene expression profile correlate with pathological alterations in the liver in response to CCl(4) intoxication. Most of these changes are recoverable upon withdrawal of the toxic insult. However, liver fibrosis is a prolonged change both in gene expression and histopathological alterations.     

患者对预检分诊服务满意度理论框架的扎根理论研究

目的 通过扎根理论研究构建患者视角的预检分诊服务满意度理论框架,为评估和量化患者对预检分诊服务的满意度提供参考。方法 采用目的抽样和理论抽样的方法,选择27例接受过预检分诊服务的患者进行半结构式深度访谈;运用程序化扎根理论的研究方法,采用NVIVO12.0软件辅助对原始数据进行开放式编码、主轴编码及选择性编码,并进行理论饱和度检验。结果 析出患者期望、服务质量、信息供给、人本关怀、持续改进5个主范畴。结论 5个主范畴分别构成预检分诊服务满意度的主体因素、核心因素、关键因素、基本因素和保障因素。该理论框架可为改善预检分诊服务、评估患者满意度提供参考。     

阿米洛利的神经保护作用

阿米洛利是一种上皮细胞钠离子通道(ENaC)阻滞药,作为一种保钾利尿药已在临床应用了数十年.研究表明,中枢神经系统的多种离子通道对阿米洛利敏感,如酸敏感离子通道(ASIC)、Na+/H+交换泵等.这些通道具有重要的生理功能,而且还可能参与了脑缺血、组织酸中毒等病理学过程.阿米洛利通过阻滞这些通道,呈现出减轻缺血和酸化介导的神经元损伤等效应,很有可能成为治疗脑缺血等的新型神经保护剂.     

实时荧光定量RT-PCR检测舌癌E-cadherin mRNA的表达

目的:了解E-cadherin在舌癌中的表达及其临床意义.方法:采用实时定量PCR检测29例舌鳞癌患者的癌组织和正常组织中E-cadherin mRNA,分析E-cadherin基因表达与临床病理参数的相关性.结果:舌癌组织中E-cadherin mRNA表达水平2.23±1.16(E-cadherin/β-actin),低于正常组织组8.59±2.71,两组间差异有统计学意义(P＜0.01),E-cadherin mRNA水平与临床病理参数之间无相关性(P＞0.05).结论:E-cadherin的表达下降是舌癌发生过程中的重要事件,实时定量PCR检测E-cadherinmRNA的表达对舌癌早期诊断有重要参考价值.     

中医药治疗功能性消化不良现状述评

文章从古代著作探讨功能性消化不良（Functional Dyspepsia,FD）的中医病名。FD 的发病与饮食、外邪内居及精神因素有关,病位主要在肝脾胃三脏,肝郁、脾虚及胃气不降为 FD 主要的病机关键,但目前对 FD 的病机演变规律研究深入不足。FD 的治疗有辨证分型、专法专药,以及辨病辨证相结合等,但缺乏严谨有效的评价体系,对患者生活质量也不够重视。