西藏地区农牧民生活习俗与包囊虫病的关系调查

目的　探讨西藏地区农、牧民生活习俗与包囊虫病的关系。方法　自制问卷对 7个县 2 40个家庭 163 1名成员与包囊虫感染有关的生活习俗进行调查分析。结果　饭前便后洗手的人仅有 16 1%,餐具一般都用天然水洗 ,大部家庭用天然绵羊绒擦洗茶具。大多数人都喝过河溪水 ,池塘水 ,人人都吃半生不熟的肉 ,半数以上的吃生肉和生血肠 ,绝大多数人喝未经消毒的鲜牛、羊奶。 10 0 %家庭养狗 ,所有人员与狗、羊、牛、马接触密切。包囊虫病人占调查人数 0 43 %( 7/ 163 1) ,有典型症状者占 0 67%( 11/ 163 1)。结论　当地居民感染包囊虫与不良生活习俗有关     

Mechanisms of opioid-induced tolerance and hyperalgesia.

Opioid tolerance and opioid-induced hyperalgesia are conditions that negatively affect pain management. Tolerance is defined as a state of adaptation in which exposure to a drug induces changes that result in a decrease of the drug's effects over time. Opioid-induced hyperalgesia occurs when prolonged administration of opioids results in a paradoxic increase in atypical pain that appears to be unrelated to the original nociceptive stimulus. Complex intracellular neural mechanisms, including opioid receptor desensitization and down-regulation, are believed to be major mechanisms underlying opioid tolerance. Pain facilitatory mechanisms in the central nervous system are known to contribute to opioid-induced hyperalgesia. Recent research indicates that there may be overlap in the two conditions. This article reviews known and hypothesized pathophysiologic mechanisms surrounding these phenomena and the clinical implications for pain management nurses.     

应激反应介质在糖尿病心血管并发症中的作用

近30年来糖尿病患病率在多数欧美和亚洲国家中迅速增高。糖尿病心血管并发症是糖尿病患者的主要死亡原因,其发生机制不甚明了。糖尿病有关的代谢因素增加循环和组织中氧化和糖化蛋白或脂蛋白的水平和氧化应激性。这些改变可引起动脉粥样硬化,凝血因子和血小板活性增高,纤溶活性     

肠道T细胞淋巴瘤临床分析

本文总结报告了3例肠道T细胞淋巴瘤(intestinal T-cell lymphoma，ITCL)的诊治资料，并结合文献复习，发现IT—CL多见于中年男性，以腹痛、血便、发热、体质量下降为主要症状，治疗效果差，预后不良。病理改变以肠道溃疡形成为特点，溃疡形态呈多形性、多灶性、不规则，镜下瘤细胞明显异型、弥漫性浸润，中至大细胞多见。肿瘤细胞呈T细胞表型。ITCL临床少见，缺乏特异性临床表现，极易误诊。故临床医师应重视对ITCL临床病理特征、免疫表型和基因型的研究，注意识别，促其早期诊治。     

浅谈健康教育中的护理风险管理

健康教育作为临床护理中的重要内容，对病人的疾病转归有重要作用。而任何医疗护理行为都是具有超过各种服务之上的高科技行为的组合活动，具有高风险性，健康教育同样存在一定的风险性。所以，我们应提高风险意识，加强风险管理，将风险降低至最低限度。     

Reconstruction of the cervical part of the esophagus using a free revascularized segment of the jejunum and microsurgical technic

The article analyses the experience in 11 reconstructions of the pharynx and cervical esophagus with a free vascularized jejunal segment employing microsurgical technique for squamous cell carcinoma of the upper digestive tract. The operative technique is described. It is noted that this operative procedure is a difficult method of surgical management of defects in the pharynx and cervical esophagus and is attended in some cases with complications. From personal experience and review of the literature, the authors conclude that autotransplantation of a free vascularized jejunal segment with the use of microsurgical technique is the best method for reconstruction of defects in the pharynx and cervical esophagus.     

根据桂枝汤的效应消除半衰期和表观消除半衰期制订给药方案的探讨

为探讨药效法估测的效应消除半衰期和效量法估测的表观半衰期对合理制订给药方案的意义和作用,以桂枝汤解热和抗炎的药物动力学实验中所得的相应参数值设计了给药方案,观察了它们在提高药效上的作用。结果表明在给药总剂量相等、首次给药同时开始的情况下,以半衰期设计的给药方案组的药效均明显高于习惯的一次给药组;而以效应消除半衰期设计给药方案组药效增强率又高于以表观半衰期设计的方案组。提示效应消除半衰期比表观半衰期似更有实践意义。     

Microbiological analyses and inflammatory effects of settled dusts from rice and hay

Fourteen samples of settled dust from two factories processing rice and wheat straw near Shanghai, China, were examined by dilution plating for total bacteria, gram-negative bacteria, thermophilic actinomycetes, and fungi. They were also examined for aflatoxin, endotoxin, and potential to stimulate production of human interleukin 1 beta (IL-1 beta) and to consume complement. The concentrations of total microorganisms were consistently greater than 10(7) CFU/g and ranged from 10(7) to 10(9) CFU/g. In general, the level of microbial contamination was greater in the hay dust samples than in the rice dust samples, with bacteria being the most numerous microorganisms observed followed by molds, thermophilic actinomycetes, and yeasts. The predominant fungi were species of Aspergillus, Cladosporium, Penicillium, Trichosporon, and Cryptococcus. No significant levels of aflatoxin were observed and the isolates of A. flavus examined lack significant aflatoxigenic potential. The levels of microorganisms in these samples, the types of organisms found, and the inflammatory mediators such as endotoxin suggest that workers exposed to these dusts may be at risk for respiratory illness.     

A case-control study of Alzheimer's disease in China.

We conducted a case-control study to assess possible factors associated with Alzheimer's disease (AD) with 70 clinically diagnosed AD patients and 140 age- and sex-matched nondemented neighborhood controls in China. Factors significantly associated with AD cases were family history of dementia in first-degree relatives, family history of psychotic disorders in first-degree relatives, and left-handedness/ambidexterity. A history of arthritis showed a significantly negative association with AD. Neither a family history for Down's syndrome, history of head trauma, nor other conditions that might support immune or viral hypotheses in AD were significantly associated with AD cases. These data support the role of familial/genetic factors in AD.     

Relationship between height, collagen metabolism, hair zinc and excessive fluoride intake]

After eliminating confounding factors, the study was made on the relationship between height, collagen metabolism, hair zinc and excessive fluoride intake. 140 schoolchildren aged 12-13 years born and reared in endemic fluorosis areas were surveyed. The results were as follows: 1. The average height of children with dental fluorosis III degree (DF III degree) was appreciably smaller than that of children without dental fluorosis. Among children with excessive fluoride intake, a negative correlation between the height and fluoride level in staple foods was seen. 2. The more the fluoride ingested, the higher the urinary THP excreted, showing that fluoride intoxication interfered with the collagen metabolism. 3. Among children with excessive fluoride intake, the height showed negative correlation with urinary THP/Cr, suggesting that the effect of fluoride on collagen metabolism indicated the mechanism of height retardation. 4. As compared to control group with the excessive fluoride intake but without dental fluorosis group, there was a significant reduction in hair zinc in group with DF III degree, suggesting that the zinc in the body decreased because of zinc metabolism disturbance by excessive fluoride intake. But among cases with excessive fluoride intake, no appreciable correlation between hair zinc and height was found. Therefore, it could not be confirmed that the effect of fluoride on zinc metabolism affected the height development.