东莞市结核病控制项目实施10年社会与经济效益评价

目的分析东莞市实施世界银行贷款结核病控制项目10年的成本-效益。方法对1992—2001年东莞市世界银行贷款额度，地方配套经费使用与病人发现、治疗情况进行分析。结果10年利用世界银行贷款79．22万元，地方配套资金316．37万元，共计395．59万元，治愈涂阳肺结核病人3776例。减少结核菌感染3．77—5．66万人。减少肺结核传染源发生0．19-0．28万人。节约治疗资金340．08万元。减少治疗误工费336．10万元。因减少活动性肺结核的发生而避免经济损失522．54—770．06万元。结论东莞市10年世界银行贷款结核病控制项目成效显著，使3．77—5．66万人免受结核菌感染，减少或避免了各种费用1198．72—1446．24万元。     

Infusion versus bolus of an ultrasound contrast agent: in vivo dose-response measurements of BR1

RATIONALE AND OBJECTIVES: To determine the efficacy of an ultrasound contrast agent infusion using Doppler intensitometry estimation of backscatter enhancement in blood. METHODS: Multiple intravenous injections of BR1 (SonoVue) were performed in chronic dog studies, using bolus (0.05-2 mL) and infusion (3-40 mL/h during 6 minutes) administration. The pulsed Doppler signal from the femoral artery was recorded and analyzed for mean Doppler power and integrated fractional enhancement. RESULTS: For bolus injection, time-intensity curves exhibited a rapid first pass (peak 30 dB for 0.45 mL) followed by a slower washout. Integrated fractional enhancement exhibited a linear relation with the dose (R2 = 0.99). For infusion administration, peak enhancement increased with the infusion rate from 8 to 22 dB. At rates exceeding 30 mL/h, the enhancement was stable with a plateau-like pattern. CONCLUSIONS: Infusion of BR1 is easily achieved and allows the duration of enhancement to be increased as long as desired. Stable enhancement is obtained for rates greater than 30 mL/h.     

Effects of Triptolide on the Expression and Activity of NF-κB in Synovium of Collagen-induced Arthritis Rats

Summary： The expression and activity of NF-kB in the synovium of collagen-induced arthritis （CIA） rats was detected in order to investigate the possible therapeutic effects of triptolide on rheumatoid arthritis （RA）. The experimental Wistar rat model of CIA was set up by intradermal injection of emulsion of bovine collagen 11 and the successful rate of setting-up models was evaluated by arthritis index （AI）. Rats were grouped randomly into three groups： normal, model and treatment group. The expression of TNF-α and IL-6 in synovial fluid was detected by ELISA, and the expression and activity of NF kB in synovium by immunohistochemistry method and by electrophoretic mobility shift assay （EMSA） respectively. As compared with normal group, the expression of TNF a and IL-6 in synovia （P〈0. 05）, and the expression and activity of NF-kB （P〈0.05） in synovium were increased in model group. There was statistical difference in above-mentioned indexes between model group and treatment group. Triptolide may play a protective role in IRA via downregulating the expression and activity of NF-kB in synovium.     

针刺足三裹、指按中脘穴对胃及十二指肠变形改变的影像学研究

目的 探讨研究刺激足三裹、中脘穴封胃及十二指肠变形改变的作用及诊断价值。方法 选取一组共30例上消化道钡餐造影检查表现为胃及十二指肠变形的病例。十二指肠球部变形26例，其中15例有球部变形，但无壁宠；11例有球部变形，有壁宠；胃窦部痉挛4例。当发现变形改变後随即采用针刺足三裹、指按中脘穴得气後观察变形器官的变化。结果 经刺激足三裹、中脘穴後，28例在短时间内（3．6分钟）即见效，十二指肠变形之球部舒展、充盈如常，壁瓮显示清楚，粘膜亦显示清晰，胃窦部变形缓解．窦腔变宽，蠕动波出现；2例有所改善。结论刺激穴位後封胃及十二指肠变形改变有明显作用，有利于胃、十二指肠良、恶性变形病变的诊断与鉴别，封定性诊断意义较大，又无副作用。在上消化道造影影像学检查中，发现胃及十二指肠变形改变後，刺激足三裹、中脘穴具有良好效果，是提高龛影显示率、缓解痉挛的一种见效快、行之有效的方法。     

脑钠肽对血液透析患者心功能不全的诊断价值

OBJECTIVE: To detect plasma brain natriuretic peptide (BNP) changes in hemodialysis patients with chronic renal failure (CRF) and assess the diagnostic value of BNP for cardiac function. METHODS: Plasma BNP concentration was measured in 93 hemodialysis patients with CRF and 52 healthy control subjects. In the 93 patients, echocardiographic examinations were performed to determine the relationship between BNP and cardiac function. RESULTS: The median plasma BNP levels in 52 normal controls were 3.35 pg/ml (1.00-9.73 pg/ml), and 146.5 pg/ml (56.2-546.9 pg/ml) and 90.0 pg/ml (18.3-310.5 pg/ml) in 93 patients before and after hemodialysis, respectively, showing significant difference among those 3 groups (P<0.001). The plasma BNP levels in patients with CRF complicated by heart failure (LVEF<50%) before and after hemodialysis were 686.0 pg/ml (334.5-1319.3 pg/ml) and 248.0 pg/ml (80.3-814.5 pg/ml) respectively, significantly higher than 62.8 pg/ml (22.0-321.6 pg/ml) and 20.7 pg/ml (1.0-200.9 pg/ml) in patients with normal cardiac function (LVEF > or = 50%) (P=0.002). The plasma BNP levels in patients with dilated left ventricle before and after hemodialysis were 609.0 pg/ml (254-1152.0 pg/ml) and 310.0 pg/ml (28.3-839.6 pg/ml) respectively, significantly higher than 62.8 pg/ml (23.2-192.5 pg/ml) and 22.4 pg/ml (1.0-80.7 pg/ml) in patients with normal left ventricle. Multiple linear regression analysis for left ventricular diastolic dimension, LVEF and plasma BNP level before hemodialysis showed that high BNP level was significantly correlated with dilated left ventricle and poor cardiac function (P<0.01). CONCLUSIONS: Plasma BNP levels in hemodialysis patients with CRF are significantly higher than those in healthy controls, and are significantly lowered after hemodialysis but still remain higher than the normal level. Plasma BNP levels in hemodialysis patients with dilated left ventricle or heart failure are significantly higher than those in patients with normal left ventricle or cardiac function, and high plasma BNP level is significantly correlated with dilated left ventricle and poor cardiac function.     

Significance of -191G/C single nucleotide polymorphisms in the promoter region of ATP-binding cassette transporter gene in coronary artery disease]

OBJECTIVE: To investigate the effect of -191G/C single nucleotide polymorphisms (SNP) in the promoter region of ATP-binding cassette transporter A1(ABCA1) gene on plasma lipids and its significance in coronary artery disease (CAD). METHODS: By polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), -191G/C SNP in the promoter region of ABCA1 gene was analyzed in 204 patients with CAD and 114 control subjects and the distribution of the -191G/C genotypes compared between the two groups and also between different clinical phenotypes of CAD. The clinical indexes associated with CAD were also compared between the patients with the three genotypes of CAD. RESULTS: The frequency distribution of GG, GC, and CC genotypes significantly differed between CAD group and the control group, and the former group had obvious higher CC genotype frequency and the C allele frequency (P<0.05 and P<0.01, respectively). In CAD patients, the frequency distribution of GG, GC, and CC genotypes varied significantly between those with acute coronary syndrome (ACS) and those with stable angina pectoris (SAP). The CC genotype showed obviously higher frequency in ACS group than in SAP group and the C allele was more frequent in the former group (P<0.05 and P<0.01, respectively). However, no significant difference was noted in the body mass index, total cholesterol, triglyceride, high-density lipoprotein, low-density lipoprotein, or very low-density lipoprotein cholesterols between the three genotypes. CONCLUSIONS: The -191G/C SNP in the promoter region of ABCA1 is associated with increased CAD and the C allele may relate to the stability of CAD without detectable changes in plasma lipids.     

重组人生长激素对肝细胞癌合并肝硬化患者术后蛋白质代谢的影响

目的探讨重组人生长激素（rhGH）对肝细胞癌合并肝硬化患者术后蛋白质代谢的影响。方法24例行根治性切除的肝癌患者随机分为肠外营养（PN）组（n=12）和rhGH＋PN组（n=12）。术前、术后第1天和术后第6天测肝功能、血糖、甲胎蛋白（AFP）、血清前白蛋白、转铁蛋白，用RT-PCR法检测术后第6天肝穿刺组织白蛋白（ALB）mRNA的表达，肝组织行Ki67免疫组织化染色。结果术后第6天，血糖、血清前白蛋白、转铁蛋白、肝组织ALBmRNA表达水平、肝组织Ki67指数，rhGH＋PN组均高于PN组（P〈0．05）。结论rhGH有利于肝细胞癌合并肝硬化患者术后蛋白质合成和肝再生。     

洛赛克预防急性脑出血并发应激性溃疡出血疗效观察

目的观察洛赛克预防急性脑出血并发应激性溃疡出血的疗效。方法将127例经头颅CT检查确诊、浅昏迷至中度昏迷的急性脑出血病人随机分为洛赛克组(Ⅰ组)43例、西咪替丁组(Ⅱ组)43例和对照组(Ⅲ组)41例。在常规脱水利尿、对症支持治疗的基础上,Ⅰ组给予胃管注入洛赛克40mg,每天1次,连续使用10天;Ⅱ组用西咪替丁0.4g加液静滴,每12小时1次,连续使用10天;Ⅲ组仅予常规治疗。结果Ⅰ、Ⅱ、Ⅲ组急性脑出血病人并发应激性溃疡出血的发生率分别为2.32%、13.95%和39.02%,Ⅰ组和Ⅱ组显著低于Ⅲ组(P<0.01),而且Ⅰ组优于Ⅱ组(P<0.05)。结论洛赛克、西咪替丁预防急性脑出血并发应激性溃疡出血疗效显著,且洛赛克优于西咪替丁,无明显不良反应。     

6～24月龄婴幼儿喂养指数分布以及与生长发育的相关性研究

目的利用2002年全国营养和健康状况调查数据建立我国婴幼儿喂养指数,评价喂养情况与生长发育的关系。方法依据世界卫生组织推荐喂养方式,选择母乳喂养、是否用奶瓶喂养、膳食多样性、食物频率等变量,建立喂养指数评分体系,评价喂养指数评分与年龄别体重(WAZ)、年龄别身长(HAZ)和身长别体重(WHZ)关系。结果城乡婴幼儿喂养指数评分存在显著差异(P<0.001),随着婴幼儿月龄的增加,喂养指数评分显著增加(P<0.05),喂养指数得分与WAZ、HAZ和WHZ显著相关(P<0.05)。结论喂养指数可以作为一项综合判断婴幼儿喂养的方法。     

全髋关节置换术的护理

目的探讨全髋关节置换术的护理。方法对27例患者行全髋关节置换术。做好心理护理,术前术后护理,及早指导功能锻炼,合理调节饮食等措施,出院后随访半年以上。结果27例患者,切口均甲级愈合,无护理并发症,髋关节功能恢复好。结论通过精心护理,减少了患者卧床时间,利于早日康复。