椎管内转移癌病人氨甲喋呤配伍高渗盐水硬膜外灌注治疗顽固性疼痛的临床探讨

１０例椎管内转移癌病人曾长期使用大剂量镇痛药难以奏效，而少数病例便采用硬膜外腔注射吗啡２～４ｍｇ疼痛缓解仅１ｈ。采用硬膜外腔灌注氨甲喋呤配伍高渗盐水，使抗癌药直接与肿瘤接触，几分钟内杀死癌细胞，加之高渗盐水能促使肿瘤和神经干脱水，肿瘤体积缩小和破坏，改善局部动脉缺血和组织水肿，从而减轻或消除肿瘤对神经根的压迫，缓解和消除神经痛。     

护理人员的职业损伤因素及健康维护

作者指出临床一线的护理人员是发生职业损伤的高危群体。产生职业损伤的危险因素包括基础教育和继续教育缺乏职业损伤及其防范知识；影响护理人员身体健康的诸因素，如化疗专用的溶药设备、洁净操作台或相对密闭的溶药环境不健全；乙型肝炎等医院内易感性等疾病增加，被血液、体液等污染的医疗锐器刺伤是护理人员职业感染的主要途径；护理人员工作职业特点对健康不利的影响，护理人员心理压力大。为维护护理人员身心健康，应加入医院感染、职业损伤和健康维护的在校理论教育内容，加强护理人员职业安全教育，采取防范职业损伤的措施，如化疗药物中心配药、使用一次性手套等措施。     

Hypertrophic smooth muscle in the partially obstructed opossum esophagus. Excitability and electrophysiological properties

Partial obstruction of the opossum esophagus leads to thickening of the circular muscle, hypertrophy of smooth muscle cells, and diminution of the extracellular space. The pharmacological and electrophysiological properties of this hypertrophied muscle were studied. Carbachol produced phasic and tonic contractions of the circular muscle. The EC50 for tonic contractions was greater for hypertrophied than for normal muscle (21.1 +/- 3.9 mumol/L vs. 4.8 +/- 2.2 mumol/L; P less than 0.05). The resting membrane potential difference of hypertrophied muscle (-50.8 +/- 0.2 mV) was similar to that of normal muscle (-50.0 +/- 0.2 mV). Electrical stimulation of intrinsic nerves in the normal muscle produced a hyperpolarization followed by a depolarization of smooth muscle membrane potential. Hypertrophied muscle responded either with an attenuated hyperpolarization or no hyperpolarization, both of which were followed by a depolarization. The space constant in the long axes of the hypertrophied circular muscle cells was greater than normal (4.4 +/- 0.2 mm vs. 3.4 +/- 0.1 mm; P less than 0.001). The threshold potential for initiation of action potentials was more negative for hypertrophied (-43.2 +/- 0.4 mV) than for normal circular muscle (-41.6 +/- 0.2 mV; P less than 0.005). These data indicate that alterations in neuromuscular function accompany the hypertrophy of esophageal smooth muscle.     

Entrapment of platelets in the penis during and after erection

Because of the development of hypercoagulability and the deposition of fibrin in the penis during erection a study of the possible role of platelets in this process was undertaken. Platelet response was studied in 9 adult chacma baboons (Papio ursinus) using autologous in vitro indium-111-labelled platelets and sequential scintigraphy of the penis during erection. The blood pooling pattern was obtained using in vivo technetium-99m-labelled red cells in a similar investigation. A statistically significant retention of platelets occurred during and after erection, which could not be attributed to blood pooling (P less than 0,05). Entrapment of platelets could lead to enhanced activity and activation, and might play a significant role in hypercoagulability and fibrin deposition during erection. Therefore platelets could be an important factor in the pathogenesis of ageing impotence.     

多源耐药基因表达水平的检测在儿童白血病中的临床意义

应用逆转录ＰＣＲ结合同位素定量分析，对３２例儿童白血病患者的多源耐药基因表达水平进行了研究。结果显示，初发病人的表达均较低，复发病人表达较高，缓解期病人表达程度介于两者之间，为探讨多源耐药基因表达水平与临床化疗之间的相关性及逆转克服多源耐药性药物的应用，提供了一定的理论依据。     

米非司酮配伍米索前列醇终止早孕用药方法的探讨

作者对１２０例妊娠４９ｄ以内的孕妇采用４种不同的服药方法进行药物流产，其中使用第３、４种用药方法的孕妇均于加用米索前列醇后８ｈ内排出孕囊，且２ｈ内排出率明显增加，与常规用药方法比较有显著性差异（Ｐ＜０．０１），同时对用药机理作了讨论。     

胃粘膜肠上皮化生与胃癌关系的粘液组织化学和免疫组织化学研究

应用ＡＢ（ｐＨ１．０）ＫＯＨ／ＰＡＳ粘液组织化学和ＡＢＣ法凝集素标记免疫组织化学方法对１９０例胃粘膜标本进行观察。结果表明，结肠不完全型肠上皮化生多见于肠型癌及其癌旁组织。在形态学和功能上，显示出一定程度的分化不成熟。两型肠化在弥漫型癌中无显著差异。５种凝集素受体含量和分布的差异与胃癌的组织学类型和分化程度有关，凝集素肠化分型和组织学类型的关系与粘液组化染色基本相符。我们认为不完全型肠化与肠型胃癌的发生关系密切，而完全型肠化可能与弥漫型胃癌有关。应用ＡＢ／ＫＯＨ／ＰＡＳ染色进行肠化分型和凝集素标记，对于癌前病变的检测和癌的早期诊断都具有一定价值。     

不同气功的心血管效应

用XG-2型血液循环功能测试仪,对健康中老年人,一次锻炼放松功(24人)和禅密功(28人)前后进行测试,结果表明不同气功的短时效应差别甚大,为辨证施功提供了实验根据。     

溶血磷脂胆硷对缺血性心室肌电生理的影响

用台氏液加溶血磷脂胆硷（ＬＰＣ）３ｘｌ０－４灌流离体绵羊心室小梁肌，其０期去极化最大速率（Ｖｍａｘ）、静息电位（ＲＰ）、动作电位幅值（ＡＰＡ）、动作电位复极达ＡＰＡ５０％和９０％的时程ＡＰＤ５０、ＡＰＤ９０分别下降３９．８％、１０．４％、１４．５％、２１．３％和１４．８％；用“模拟缺血溶液”加ＬＰＣ３×ＩＯ－４灌流，其Ｖｍａｘ、ＲＰ、ＡＰＡ、ＡＰＤｓ０和ＡＰＤ９０分别下降７８％、２２．７％、２６％、３５．４％和２１％；实验中对“模拟缺血溶液”中各种成分对ＬＰＣ效应的影响进行分析，发现主要的因素是酸中毒。结果表明：ＬＰＣ是心肌缺血中心律失常的重要因素之一，缺血诱导的酸中毒更加重了ＬＰＣ对心肌细胞的毒性作用。