老年认知功能障碍与脑结构CT测量的相关性研究

目的探讨脑萎缩与老年认知功能障碍之间的相关性。方法对开滦集团公司1063名离退休职工进行健康查体,用简易精神状态量表(MMSE)评定认知功能,按分界值将本次研究对象分为认知功能障碍组和认知功能正常组,同时用CT线性测量脑的相关部位以诊断脑萎缩情况,并对各型脑萎缩与认知功能的相关系数及提示老年认知功能障碍的敏感度、特异度、准确度进行分析。结果1063名观察对象中符合入选标准并资料完整者共计511名,其中108名有认知功能障碍,髓质脑萎缩55名、皮质萎缩5名、混合型萎缩30名;认知功能正常者403名,髓质脑萎缩214名、皮质萎缩13名、混合型萎缩62名。认知功能障碍组脑萎缩的发病率高于认知功能正常组,差异具有统计学意义(P<0.005);2组间颞叶海马钩回间距(26.86mm±3.73mmvs25.95mm±3.80mm)及海马钩回间距/大脑左右径的比值(0.21±0.02vs0.20±0.02)差异具有统计学意义(P<0.05);海马钩回间距、皮质脑萎缩、混合型脑萎缩与认知功能障碍呈负相关(分别为r=-0.094,P=0.034,r=-0.156,P≈0.000,r=-0.147,P≈0.000),以海马钩回间距20mm提示老年认知功能障碍的敏感度最高(98.14%),混合型脑萎缩的特异度(84.86%)、准确度最高(72.80%)。结论CT测量相关脑结构,判断脑萎缩类型可以为老年认知功能障碍的诊断提供有价值的信息。     

蟾酥注射液对小鼠S180和人结肠癌HT-29裸鼠移植性肿瘤的影响

目的研究蟾酥注射液对小鼠移植性肿瘤 S180和人结肠癌 HT-29裸鼠移植性肿瘤的抑制作用.方法分别用小鼠 S180和人结肠癌 HT-29裸鼠两种荷瘤小鼠模型,观察药物对上述肿瘤的抑瘤作用,并镜下观察后者细胞凋亡情况.结果与荷瘤阴性对照组比较,蟾酥注射液各剂量组对小鼠 S180抑瘤率( IR)为 19.1%～38.2%(P<0.05),呈量效关系;而对人结肠癌 HT-29裸鼠移植性肿瘤的 IR为 9.5%～15.8%(P>0.05),也呈量效关系,但差异均未见统计学意义;环磷酰胺则能显著抑制小鼠 S180和 HT-29细胞裸鼠移植性肿瘤的生长( IR分别为70.7%和 67.1%, P<0.01),镜检可见其有显著促进肿瘤细胞凋亡作用;未发现实验药物出现明显的毒副作用.结论该实验所用的蟾酥注射液,对小鼠 S180有抑制作用,而对人结肠癌 HT-29裸鼠移植性肿瘤,则作用不明显,表明不同类型的肿瘤对其敏感性不同.     

静脉药物配置中心查对工作的管理

静脉药物配置中心的开展是医院药学服务转型的需要，医院药学从过去的“以药品为中心”，转变到现代的“以患者为中心”的服务模式，静脉药物配置中心的实施更好地解决了药物的物理、化学、生物、药理上的配伍及贮藏和使用等问题。静脉药物配置中心的建立，是符合时代发展要求的一项新举措，是医院现代化的一个标志，也使医院护理管理上了一个新的台阶。     

透明质酸钠预防粘连性肠梗阻术后再粘连临床观察

Objective To investigate the prevention of intestines adhesion about sodium hyaluronic acid in postoperative intestines adhesion.Methods Eighteen cases of adhesive intestine obstruction were done intestinal release or bowel resection.2～4mL sodium hyaluronic acid was put to the wound,anastigmatic and rough surface of peritoneal.Gastrointestinal decompression,anti-infective and infusion were taken after oper-ations.Followed up 8～24 months.Results Obstructive symptoms haven't happened,the effective rate is 100%.Only 2 cases have intermittent abdominal pain without obstruction,the incidence was 11%.Conclu-sion Sodium hylauronic acid is effective to prevent the adhesion of postoperative intestines adhesion,simp-ler use,fewer side-effects and great value to appliance.     

Syndecan-1和E-candherin在声门上型喉鳞状细胞癌中的表达及意义

目的：探讨Syndecan—1和E—candherin两种黏附分子在声门上型喉鳞状细胞癌中的表达情况及与喉癌生物学行为之间的关系。方法：应用SP免疫组织化学法检测了38例声门上型喉鳞状细胞癌和7例喉黏膜慢性炎症组织中的Syndecan-1和E—candherin的表达并根据阳性瘤细胞占肿瘤细胞总数的比率进行半定量分析和统计检验。结果：Syndecan-1和E—candherin的阳性染色部位主要集中于细胞膜，E—candherin也可表达于细胞间质。Syndecan-1和E-candherin在恶性程度高的癌细胞上膜表达明显缺失，并与组织学分化、肿瘤大小密切相关。Syndecan-1和E-candherin在喉鳞状细胞癌细胞上的表达结果有相关性，但无敏感性差异。结论：Syndecan-1和E-candherin的表达可能在声门上型喉鳞状细胞癌的发生发展等生物学行为中起着重要的作用。     

构筑健康教育工程实现社会医院双赢

介绍了四川大学华西医院10年来构筑普及医疗卫生保健知识系统工程的认识体会、经验和取得的成效,指出医院在普及卫生保健知识中的职责和优势。     

大肠癌182例分析

目的研究大肠癌的发病情况、病理类型及临床表现并探讨其临床意义。方法回顾该院1987～2006年经大肠镜及病理检查确珍的大肠癌病例,对比性分析老年组（≥60岁）和非老年组（〈60岁）前10年（1987～1996年）及后10年（1997～2006年）大肠癌发病特点。结果后10年大肠癌发病率显著上升,主要以老年组增高为主,非老年组增加不明显。老年组与非老年组大肠癌的发病部位相同,依次为直肠、左半结肠、右半结肠,最好发的部位为直肠、乙状结肠。病理类型仍然为肿块型、溃疡型和浸润型。血便、黏液脓血便仍然是大肠癌最常见的临床表现。结论20年间大肠癌发病率迅速上升,前10年仅占26.2%,后10年占73.8%,老年组发病率明显增高。老年组与非老年组其发病部位、病理类型、临床表现差异均无显著性。     

复发性胶质瘤再手术治疗的探讨

目的 探讨复发性胶质瘤患者再手术的效果。方法 对22例复发性胶质瘤患者再手术前的功能状态、两次手术间隔时间及手术切除的程度与术后存活期等资料进行临床和统计学分析。结果 第二次手术前生活能自理或半自理的病人（Kamofsky计分≥60）平均生存期约16月，生活不能自理的病人（Kamofsky计分〈60）平均生存期约6月（P〈0．01）。两次手术间隔时间大于1年者平均生存期约17月，间隔时间小于半年者平均生存期约6月（P〈0．01）。手术肿瘤全切除者平均生存期约15月，次全切除者平均生存期约10月（P〈0．05）。结论 术前功能情况好，手术间隔时间大于1年及术中全切肿瘤者再手术治疗可获得较好效果。     

Neuroprotective effect of estrogen after chronic spinal cord injury in ovariectomized rats

BACKGROUND: At present, there is still lack of effective drugs for chronic spinal cord injury, whereas it is found recently that estrogen has a neuroprotective effect on brain and spinal cord injuries. OBJECTIVE: To observe the effect of estrogen on the apoptosis of nerve cells after gradual chronic spinal cord injury in ovariectomized rats. DESIGN: A randomized controlled animal trial. SETTING: Institute of Orthopaedics, the Second Hospital of Lanzhou University. MATERIALS: Sixty-five female Wistar rats of common degree, weighing 220–250 g, were provided by the experimental animal center of Lanzhou University. The rats were randomly divided into sham-operated group (n =5), estrogen-treated group (n =30) and saline control group (n =30), and the latter two groups were observed at 1, 3, 7, 14, 28 and 60 days respectively, and 5 rats for each time point. METHODS: All the rats were treated with bilateral oophorectomy 2 weeks before the experiment. T10 vertebral lamina was revolved into using plastic screw. The spinal canal impingement was not induced initially. After that, the original incision was opened to expose the screw every 7–10 days. MAIN OUTCOME MEASURES: The apoptosis and Caspase-3 positive cells in the damaged spinal cord were detected using terminal deoxynucleotidal transferase-mediated dUTP-biotin nick end labeling (TUNEL) method and Caspase-3 immunohistochemical staining at 1, 3, 7, 14, 28 and 60 days after chronic spinal cord injury respectively. RESULTS: Totally 65 rats were used, and the deleted ones during the experiment were supplemented by others. Changes of Caspase-3 expression after spinal cord injury: In the sham-operated group, only a small amount of Caspase-3 proteins were observed in the rat spinal cord, mainly located in motor neurons of spinal cord anterior horn. In the estrogen-treated group and saline control group, positive cells expressed occasionally at 1 day postoperatively, began to increase obviously at 7 days after injury, strongly expressed at 14 and 28 days, but decreased at 60 days, mainly located in the neurons of spinal cord gray matter anterior horn, and they expressed fewer in the motor neurons and white matter of ventral horn, and there were obvious differences between the estrogen-treated group and saline control group at 7, 14, 28 and 60 days (P < 0.05). CONCLUSION: Estrogen can reduce the apoptosis of nerve cells and promote the recovery of neurological function following gradual chronic spinal cord injury.