原发性小肠恶性肿瘤的诊治

目的探讨原发性小肠恶性肿瘤临床表现的共同规律和有效的诊断方法及治疗措施,以利早期诊断与提高疗效。方法对７５例原发性小肠恶性肿瘤进行分析,生存率计算用寿命表法,生存分析用ＣＯＸ模型。结果１３例做Ｘ线胃肠钡餐检查,诊断准确率达８４．６％。根治性切除术后１,３,５年生存率分别为８７．５％、６８．７％和４８．１％,姑息性切除术后１,３,５年生存率分别为５７．９％、３３．８％和２４．１％。用ＣＯＸ模型对各临床因素进行预后分析,选入模型的因素有年龄、组织学类型、肿瘤部位和手术方式。结论Ｘ线胃肠钡餐检查是最有价值的诊断方法。根治性手术切除是最有效的治疗手段。影响原发性小肠恶性肿瘤预后的因素有年龄、组织学类型、肿瘤部位和手术方式,而化学治疗意义不大。     

Development of a school-based nutrition intervention for high school students: Gimme 5

PURPOSE: To describe a 4-year intervention targeting fruit/vegetable consumption by high school students. DESIGN: This is a cohort study involving six pairs of schools (n = 12) matched on gender, race, enrollment, and location with schools randomly assigned within pairs to intervention or control conditions. SETTING: Twelve Archdiocese of New Orleans high schools. SUBJECTS: Cohort was defined as students (n = 2339) who were ninth-graders in the 1993-94 school year who provided baseline data. INTERVENTION: Four components of the intervention are: (1) school-wide media-marketing campaign, (2) school-wide meal and snack modification, (3) classroom workshops and supplementary subject matter activities, and (4) parental involvement. MEASURES: Focus groups were conducted for target population input and program development. Process evaluation included student feedback on media-marketing intervention materials and activities reported here. Process measures also included school meal participation, student characteristics, and verification of intervention activities. RESULTS: Focus groups identified barriers to increased consumption of fruit and vegetables as lack of availability, variety, and inconsistency in taste. Student attitudes were favorable regarding a school program to improve diet and parental involvement. Low consumption of fruits/vegetables was reported. After a 2-month school-wide program introduction utilizing various media-marketing materials and activities, 93% of students were aware of the program and 96% could identify the healthy eating message. CONCLUSIONS: Program development can be guided and enriched by student input via focus groups. Media-marketing activities effectively delivered health messages and attracted students' attention. Materials and activities used were acceptable channels for increasing awareness, positive attitudes, and knowledge about fruits/vegetables.     

A comparison of perinatal mortality between ethnic Chinese and ethnic whites: Why the Chinese rate was lower

Objectives. To confirm the observation that has been occasionally reported in the literature that perinatal mortality rate is lower in ethnic Chinese than in ethnic whites, and to assess the reasons for this lower perinatal mortality rate.

Methods. Secondary‐analysis based on published data.

Results. This exercise demonstrates that the perinatal mortality rate was lower in ethnic Chinese than in ethnic whites. The birth weight distribution in ethnic Chinese was more favourable with reduced births at two extremes of the distribution, and the exposure to risk factors for perinatal death by their mothers was also lower.

Conclusion: Perinatal mortality rate is lower in ethnic Chinese than in ethnic whites, and the lower perinatal mortality rate in ethnic Chinese is probably caused by their favourable birth weight distribution and lower exposure to risk factors of perinatal death by their mothers.     

The blocking effects of glycyrrhize uralensis and chelidonium majus on mutagenesis induced by Aflatoxin Bl

Glycyrrhiza Uralensis (GU) and Chelidonium Majus (CM) (25, 50, 100, 200 mg/plate) have obvious blocking effects onSalmonella Typhimurium strains (TA97, TA98, TA100, TA102) mutagenesis induced by aflatoxin Bl (AFB1). The blocking rates of GU and CM are more dependent on the doses. A compound of GU and CM, called Wei Lingsu (WLS), could impede chromosomol aberrations and sister chromatid exchanges (SCE) of human peripheral lymphocyte induced by AFB1, at the concentrations of 1–50 mg/ml, the blocking rates are 52.94%–88.24% and 15. 50%–38.23% saperatly. WLS could also impede the inhibition of AFB1 to lymphocyte mitosis.     

K-ras mutation in colorectal carcinomas from singapore

54 sporadic colorectal cancers were analyzed for aberrations in the K-ras oncogene. DNA was extracted from frozen tissues obtained from surgical resection and analyzed for mutations in codons 12, 13 and 61 of the K-ras oncogene using single strand conformation polymorphism analysis (SSCP) and direct sequencing. Point mutations in the K-ras oncogene were found in 26/54 (48%) cases, all of which resulted in amino acid substitutions. No other types of mutations (e.g. insertions or deletions) were found. 4 of the mutations were at codon 12, 22 in codon 13 and only 1 was a codon 61 mutant. G-->A transitions were found to be predominant. A remarkable finding was the high preponderance of (13)Gly-(13)Ser mutations (54%). No correlation was observed between K-ras mutations and tumor location, Dukes' stage, differentiation levels, age or sex of the patient.     

保定医学堂的初创

保定医学堂是在我国医学教育中较早的一所中西医结合院校,该校的建立为中西医结合的发展起到了积极的作用。本文介绍了该学堂建立时的历史背景,教学计划及学生管理等方面的规章制度,这对当前的教育、教学改革无疑有所裨益。     

龚定国考

经考证,著《内府秘传经验女科》的龚定国是明末名医龚廷贤之子。     

生脉散对小鼠多能造血干细胞（CFU－S）影响的实验研究

生脉散系著名古方,广泛用于多种疾病所致“气阴两虚”证。采用符合该证的实验性骨髓抑制及贫血小鼠,以脾集落法等项技术观察生脉散对小鼠血发生的影响。将对照组与实验组进行比较,结果显示：生脉散可刺激多能造血干细胞增殖（Ｐ＜０．０５）,骨髓有核细胞增生（Ｐ＜０．０５）,白细胞增生（Ｐ＜０．０１）,对Ｈｂ及红细胞作用不明显（Ｐ＞０．０５）．结合其他学者的工作,推测生脉散的“益气养阴”作用与影响血发生功能有关。     

金石散胶囊溶解胆石的临床研究

自１９８７年迄今,用金石散（４－６胶囊／次,２－３次／天）治疗胆结石患者１７７例,３月为一疗程,共２－４疗程。治疗前后均经Ｂ超检查以判断疗效。结果显示：１．服药一月,９０％病人的发热、腹胀、疼痛等临床症状消失。２、６２例胆囊结石经服药平均８．１８＋７．１４月后,３例结石完全消失（４．８４％）,３７例结石减少变小,总有效率６４．５２％;而临床类型型相似的另外２３例,用ＵＤＣＡ治疗作为对照组,总有效率