杂多阴离子对SiO_2细胞毒性的拮抗作用

本文采用离体细胞培养法,以细胞存活率、乳酸脱氢酶活性和酸性磷酸酶活性为指标,研究了几种α-Keggin结构的杂多阴离子对石英粉尘细胞毒性的影响。结果表明,与对照组比较,所用杂多阴离子无细胞毒性(P>0.05),石英尘经杂多阴离子作用后,细胞毒性显著降低,与石英尘组比较,上述三项指标差异均有显著意义(P<0.01),由此表明杂多阴离子对石英的细胞毒性有明显的拮抗作用。     

一种LDL吸附剂载体-聚丙烯酰胺微球的合成及应用

研究用于低密度脂蛋白 (L DL)吸附的聚丙烯酰胺微球载体的合成工艺、结构特性及吸附 L DL 的性能 ,为进一步研发 L DL 吸附剂载体提供实验依据。采用反相悬浮聚合法按一定的配方合成聚丙烯酰胺微球载体 ,通过扫描电镜、图像分析仪、X光小角散射等手段对其结构特性 (粒径、孔径等 )进行表征 ;同时在微球上固定丝氨酰 -天冬氨酰 -谷氨酸 (SDE)三肽配体制成 L DL 吸附剂 ,通过体外静态吸附对其吸附性能进行了初步研究。结果表明微球粒径为 14 2 .1μm,孔径为 119.8nm,符合作为 L DL 吸附载体的需要 ;在交联剂与单体总量一定的条件下 ,微球孔径随着交联剂用量的增加而减小 ;合成的聚丙烯酰胺微球对 L DL 的非特异性吸附很小 ,而在其上偶联配体制成吸附剂后 ,又表现出对 L DL 的特异性吸附。本实验合成的聚丙烯酰胺微球是一种有效的 L DL 吸附剂载体。     

肝癌切除术后辅助肝动脉栓塞化疗的价值

关于原发性肝癌的现有各种治疗手段如外科治疗、微创治疗（肝动脉栓塞化疗、微波射频消融治疗、无水酒精瘤内注射）、放射治疗、化学治疗、免疫治疗和中医中药治疗，都有一定的疗效，但至今仍以手术切除为最有效的治疗方法。近20年来，通过亚临床期肝癌的发现、早期切除、肝癌术后复发的再切除和不能切除肝癌的缩小后再切除、多学科的有序的综合治疗等方法，在一定程度上提高了术后生存率。由于肝癌有早期就容易出现肝内转移的特性，大部分肝癌在手术时已存在有肝内转移灶，所以术后余肝残留肿瘤的机会很大，术后复发率高。     

胫骨平台骨折合并软组织损伤的临床分析与治疗

目的:总结分析各种胫骨平台骨折合并不同类型软组织损伤中的相互关系,探索其诊断与治疗策略。方法:自1995年10月至2004年1月共治疗胫骨平台骨折合并软组织损伤143例。所有病例均行开放复位内固定,对不同类型软组织损伤同时采取相应的处理方法。结果:术后随访129例,随访时间6到27个月,平均16个月;骨折均于12周内愈合,所有患者均恢复了患肢的正常力线,患肢稳定。结论:胫骨平台骨折合并软组织损伤的诊断必须早期、全面、详细、明确,坚强的内固定基础上,对不同类型的软组织损伤必须正确处理,术后应注意被动伸膝及CPM功能锻炼,这样才能最大程度挽救膝关节功能,减少晚期并发症。     

巢蛋白(nestin)在瘢痕疙瘩和增生性瘢痕中的表达

目的探讨巢蛋白（nestin）在瘢痕疙瘩和增生性瘢痕中的表达。方法采用免疫组织化学技术方法检测8例正常皮肤、7例扁平瘢痕、8例瘢痕疙瘩、8例增生性瘢痕中nestin^＋细胞，计数分析nestin^＋细胞在瘢痕疙瘩和增生性瘢痕中的表达。结果①nestin在8例正常皮肤组织中表皮基底细胞和棘细胞、汗腺、毛囊、皮脂腺、血管内皮细胞和7例成纤维细胞的胞浆中表达。nestin在扁平瘢痕、瘢痕疙瘩、增生性瘢痕组织中表皮基底细胞和棘细胞、血管内皮细胞和成纤维细胞的胞浆及残留的汗腺、毛囊、皮脂腺中表达。②瘢痕疙瘩和增生性瘢痕组织中nestin^＋表皮细胞、nestin^＋成纤维细胞和nestin^＋血管内皮细胞的数量明显高于正常皮肤和扁平瘢痕（P〈0．05），而正常皮肤与扁平瘢痕组织中nestin^＋细胞的表达差异无显著性（P〉0．05）。结论巢蛋白在瘢痕疙瘩和增生性瘢痕表皮、成纤维细胞和血管内皮细胞中表达增高提示瘢痕疙瘩和增生性瘢痕的过度增生可能与巢蛋白相关。     

活动翼矫治器的研制与初步应用

目的评价活动翼矫治器的设计原理与矫治效能。方法应用活动翼矫治器对588例错畸形病例进行矫治。对2001年～2004年的389例进行研究,分析其疗效、疗程、复诊次数、弓丝使用等情况。结果病例完成时间为4～15个月,平均为8.13个月。复诊次数4～13次,平均7.55次。平均每例上颌使用弓丝1.95根、下颌1.98根。仅11例病例使用口外支抗。结论活动翼矫治器是一种新研发的高效能矫治器,能够明显缩短疗程、减少复诊次数、减少弓丝用量     

培养护生养成阅读药物说明书的习惯

同类药物因原料来源、附加成分和生产厂家不同而商品名称各异,有些名称相似的药物其性能却完全不同。临床实习护生常反映课本讲授的药物知识与临床用药相差甚远,不知如何记住所有的药物。为此,作者在临床教学中培养学生养成阅读药物说明书的习惯,收到良好效果。     

Disability and depression: investigating a complex relation using physical performance measures.

OBJECTIVE: The objective of this study was to examine the relation of physical performance measures with depressive symptoms in older men. METHOD: A cross-sectional, multivariate comparison of several measures of upper- and lower-extremity performance and their relation with depressive symptoms was performed in 2,856 older Japanese American men, aged 71-93 years, who participated in the fourth examination of the Honolulu Heart Program. Depressive symptoms were measured using an 11-item version of Center for Epidemiologic Studies Depression (CES-D) Scale. A score of at least 9 (from a maximum score of 33) is considered clinically significant. Timed functional performance tests, including walking and repeated chair stands, were used to assess lower-extremity performance; handgrip strength was used as an indicator of upper-extremity performance. RESULTS: Two hundred eighty-three participants (9.9%) had a score of 9 or greater on the 11-question CES-D Scale and were considered to be at high risk for depression. Time to walk 10 feet and time to complete five chair stands were significantly longer in those with depressive symptoms, whereas handgrip strength was significantly lower. Only the association of gait speed (time to walk 10 feet) and depressive symptoms remained significant when all physical performance measures were simultaneously included in a multivariate analysis. CONCLUSION: These results demonstrate physical performance measures, particularly gait speed, may be important potential correlates of depression in community-dwelling older men.     

经皮椎体成形术与椎体后凸成形术治疗胸腰椎压缩性骨折的临床疗效比较

目的比较经皮椎体成形术与椎体后凸成形术治疗胸腰椎压缩性骨折的临床疗效。方法对98例胸腰椎压缩性骨折，根据手术方法不同分为椎体成形组和椎体后凸成形组。比较两组术前术后椎体前缘、中线、后缘高度变化，疼痛视觉模糊评分（VAS），手术时间，出血量等方面的差异。结果两组对椎体高度的恢复比较差异有统计学意义（P〈0．01），VAS、手术时间和出血量比较差异无统计学意义（P〉0．05）。结论经皮椎体成形术与椎体后凸成形术具有创伤小、手术时间短、出血量少等微创优点，而椎体后凸成形术具有较好的复位作用。     

Adaptive group sequential design for phase II clinical trials: A Bayesian decision theoretic approach

Bayesian decision theoretic approaches (BDTAs) have been widely studied in the literature as tools for designing and conducting phase II clinical trials. However, full Bayesian approaches that consider multiple endpoints are lacking. Since the monitoring of toxicity is a major goal of phase II trials, we propose an adaptive group sequential design using a BDTA, which characterizes efficacy and toxicity as correlated bivariate binary endpoints. We allow trade‐off between the two endpoints. Interim evaluations are conducted group sequentially, but the number of interim looks and the size of each group are chosen adaptively based on current observations. We utilize a loss function consisting of two components: the loss associated with accruing, treating, and monitoring patients, and the loss associated with making incorrect decisions. The performance of our Bayesian modeling, and the operating characteristics of decision rules under a wide range of loss function parameters are evaluated using seven scenarios in a simulation study. Our method is illustrated in the context of a single‐arm phase II trial of bevacizumab, gemcitabine, and oxaliplatin in patients with metastatic pancreatic adenocarcinoma. Copyright © 2009 John Wiley & Sons, Ltd.