Estrogen replacement therapy among elderly women: results from the 1995 medicare current beneficiary survey

Research Objectives: To develop population-based estimates of estrogen replacement therapy use rates in 1995 among women over age 65 living in the community; to estimate the impact of socioeconomic and health characteristics on estrogen use. Method: Estimates are based on a large, nationally representative sample of Medicare beneficiaries; detailed self-report data were merged with Medicare claims. Results: Overall, 13.1% of women reported use of estrogen replacement therapy in 1995. Estrogen users were more likely to be white, age 65–74, with private insurance, high income, history of osteoporosis and heart problems, no history of breast cancer, and a patient of gynecologists. Conclusions: Estrogen use was substantially lower among the socioeconomically disadvantaged, controlling for medical history variables, suggesting considerable inequity in access to estrogen replacement therapy treatment.     

轻、中度缺氧对事件相关电位的影响及不同刺激模式的比较

目的 观察轻、中度缺氧对脑事件相关电位（ＥＲＰ）的影响,比较不同刺激模式发的ＥＲＰ对缺氧的敏感性,方法１２名受试者在地面、２５００ｍ和４３００ｍ匠心同度（吸放低氧混合气）分别进行视觉Ｏｃｄｄｂａｌｌ、Ｓｔｅｒｎｂｅｒｇ记忆量（ＭＳＥＴ）为１ 和ＭＳＥＴ为３的任务测试,记录ＥＲＰ的Ｐ３潜伏期、波幅和反应时（ＲＴ）及反应错误率（ＥＲ）。结果 ４３００ｍ高度缺氧时Ｐ３潜伏期显著延长,任务难度较大时ＥＲ增     

Back to the future for wound care?

The European Renaissance was a time of enormous change and rapid progress in the arts, sciences, and medicine. A glimpse of wound care in the last phase of the European Renaissance is provided by the analysis of work by Wilhelm Fabry, the "father of German surgery," as provided in his book De Combustionibus ("Burns") which details his range of treatments for the burn wound, as well as his approach to the later problems of scarring and contracture. We describe some of the historic events which may have stimulated Fabry's writings, in particular, the influences passed down from the medical school of Padua which thereby advanced the cause of wound care and surgery. Finally, we briefly explore the potential of such an approach to the works of our medical forefathers.     

Reading, Demographic, Social and Psychological Factors Related to Pre-adolescent Smoking and Non-smoking Behaviors and Attitudes

The purpose of this study was to examine reading, demographic, social and psychological factors related to pre-adolescent smoking and non-smoking behaviors and attitudes. The school-home humanistic education program was implemented in a large, urban public school system. It stressed responsible decision-making, increased self-esteem and the inter-relationships among the acquisition of knowledge of the consequences of smoking, personal feelings, family relationships and behavior. The results showed that family involvement was necessary to affect smoking attitudes and behaviors. Of all the variables studied, reading had a most pervasive relationship. Peer influence and self-esteem also were related to smoking knowledge, smoking attitude, future smoking intentions and the "purchase" of cigarettes. Two of several conclusions drawn from the results are: 1. Family involvement is necessary to affect attitudes and behaviors. 2. Health education research that does not investigate the relationship between program outcomes and reading achievement may be misleading.     

疏肝起萎汤配合夫妻性感集中训练疗法治疗心因性勃起功能障碍147例疗效观察

目的:观察疏肝起萎汤配合夫妻性感集中训练疗法治疗心因性勃起功能障碍的临床疗效。方法:将406例患者随机分为3组,治疗组147例采用疏肝起萎汤(由柴胡、枳壳、白芍、淫羊藿、蜈蚣、川芎、陈皮、炙甘草组成)配合夫妻性感集中训练疗法治疗;对照Ⅰ组132例采用疏肝起萎汤治疗;对照Ⅱ组127例采用家庭性感集中训练疗法治疗。观察3组综合疗效和症状改善情况。结果:治疗组痊愈99例,好转37例,痊愈率67.35％,总有效率92.52％;对照Ⅰ组痊愈49例,好转34例,痊愈率37.12％,总有效率62.88％;对照Ⅱ组痊愈53例,好转36例,痊愈率41.70％,总有效率70.08％。治疗组与对照Ⅰ组、对照Ⅱ组痊愈率、总有效率比较,差异均有显著性意义(P<0.05)。结论:疏肝起萎汤配合夫妻性感集中训练疗法治疗心因性勃起功能障碍,疗效确切。     

膀胱移行细胞癌微卫星不稳定性及其机制的研究

目的　探讨膀胱移行细胞癌 (BTCC)染色体微卫星不稳定性的表现及与基因突变的关系。方法　采用聚合酶链反应 (PCR)方法检测 4 0例 BTCC患者 5个微卫星位点的改变 ,同时用同样的方法检测癌组织中BAX基因和转化生长因子 (TGF) - β 型受体基因移码突变的情况。结果　至少发生一个微卫星位点改变的阳性率为 82 % (33/ 4 0 ) ,D9S16 2、D16 S4 76、D9S5 4、FGA和干扰素 (IFN) - A1位点改变各自的阳性率分别为 5 8%(2 3/ 4 0 )、 4 2 % (17/ 4 0 )、 38% (15 / 4 0 )、 4 8% (19/ 4 0 )和 5 5 % (2 2 / 4 0 ) ,阳性检出率与良性病变差异有显著性 ,与肿瘤的分期分级无显著相关性。发生微卫星改变的 33例中 ,33% (11/ 33)和 4 2 % (14 / 33)分别可见 TGF- β 型受体基因和 BAX基因的移码突变。结论　检测染色体微卫星的改变是 BTCC早期诊断、监测复发的有效手段 ,染色体微卫星改变可能是 BTCC发生过程中多基因突变的一种表现形式     

RP-HPLC测定犬血浆中卡托普利

目的　采用反相高效液相色谱法测定犬血浆中卡托普利浓度。方法　以对溴苯乙酰基溴为衍生剂 ,血浆样品经衍生反应后 ,用乙酸乙酯 -苯 (1∶1)提取 ,以ODSC18为固定相 ,乙腈∶水∶冰醋酸 (4 5∶5 5∶0 2 )为流动相 ,UV2 5 8nm紫外检测。结果　在 2 5～ 6 0 0 μg·L-1浓度范围线性良好 ,最小检测浓度为 12 5 μg·L-1。其日内差及日间差RSD分别小于 4 95 %和 2 88% ,相对回收率大于 94 8%。结论　方法简便灵敏 ,为卡托普利样品分析及临床药物监测提供了检测方法。     

喉鳞状细胞癌组织体外原代培养的初步研究

目的 应用体外培养技术,对喉鳞状细胞癌组织进行体外培养,探讨喉鳞癌组织原代培养中的各种影响因素,为建立人喉鳞癌组织的细胞系提供实验基础。方法采用体外组织培养技术,对24例人喉鳞状细胞癌组织进行原代培养,观察原代培养中肿瘤细胞的生长与供体的年龄、肿瘤组织的分化程度及不同培养方法的关系,分析在人喉鳞癌细胞的培养中成纤维细胞、微生物污染的影响。结果 24例人喉鳞状细胞癌组织标本,年龄小于60岁组的细胞生长率为31.25％(5/16例),年龄大于60岁组为37.5％(3/8例);高分化组为100％(2/2例),中分化组为30.8％(4/13例),低分化组25％(2/8例);组织块培养法为43.75％(7/16例),酶消化法培养为10％(1/10例);倒置显微镜下观察,在培养的第5～7天,在贴壁组织块周围可见到有上皮样细胞爬出。全部标本中,成纤维细胞的过度生长和微生物的污染是阻碍人喉鳞癌细胞生长的重要因素。结论培养组织的细胞生长率与供体的年龄关系不大;肿瘤组织的分化程度较高者,细胞的生长率较高;与酶消化分离培养法相比,贴壁组织块培养法的细胞生长率较高;成纤维细胞及微生物的污染是阻碍人喉鳞癌细胞系建立的重要因素。     

迷路纤维化的诊断及人工耳蜗植入3例分析

目的：探讨迷路纤维化的影像学诊断及对人工耳蜗植入术的效果。方法：结合文献复习，报告3例迷路纤维化患者行人工耳蜗植入术的临床资料。结果：术前CT扫描3例均未发现异常。1例术前MRI提示耳蜗基底间纤维状，1例术后提示对侧耳蜗纤维化。2例病变较轻者成功地进行了人工耳蜗植入术，术后恢复良好；1例因病变严重电极未能植入。结论：MRI在迷路纤维化的诊断中有重要价值。慢性化脓性中耳炎为迷路纤维化的病因之一。慢性化脓性中耳炎一期手术清理中耳病变后，具有进行人工耳蜗植入的可行性。