应用膀胱三角区壁瓣成形尿道治疗女性外伤性尿道缺损(附5例报告)

目的：探讨膀胱三角区壁瓣成形尿道治疗女性外伤性尿道损伤的疗效。方法：自膀胱颈后唇向上，取梯字形壁瓣，形成锥状管，经膀胱颈口，自阴道前壁外拉至外阴部，在原尿道外口处固定，替代尿道。结果：3例随访8年，1例6年，1例5年，平均随访7年，均排尿通畅，无尿失禁和尿道狭窄。结论：女性外伤性尿道缺损，应用膀胱三角区壁瓣形成锥状管替代尿道法治疗，手术简单，对患者打击小，成功率高，远期效果好。     

自拟威秦麻细蠲痹汤治疗风寒湿性关节痛临床报告

目的：用威秦麻细蠲痹汤内服，合药渣煮水加50度白酒泡足局部热敷治疗风寒湿性关节痛45例病人，具有祛风除湿、温经通络、调节机体促进康复。方法：以威秦麻细蠲痹汤为基本方一日一剂，根据临床发病部位及风、寒、湿的偏胜而辩证加减，配合荮渣煮水加50度白酒泡足和疼痛部位热敷，七天为一疗程．结果：45例病人中治愈71．1％：有效24．4％；显效4．5％；无效为0；总有效率100％，疗程最短的二周；最长为5周；平均21天。结论：威秦麻细蠲痹汤内服配合药渣外敷及泡足和热敷疗法共奏祛风除湿、散寒止痛，益气活血之功效，使机体气充血旺，营卫复常；血行风灭，温经散寒，脾健湿去而形成通则不痛，荣则不麻不酸的良性循环，疗效满意．     

Serum transforming growth factor-β1 level reflects disease status in patients with esophageal carcinoma after radiotherapy

AIM: To evaluate the relationship between changes in serum transforming growth factor β1 (TGFβ1) level and curative effect of radiotherapy (RT) in patients with esophageal carcinoma.METHODS: Ninety patients with histologically confirmed esophageal carcinoma were enrolled. Serum samples for TGFβ1 analysis were obtained before and at the end of RT. An enzyme-linked immunosorbent assay was used to measure serum TGFβ1 level. Multivariate analysis was performed to investigate the relationship between disease status and changes in serum TGFβ1 level.RESULTS: Serum TGFβ1 level in patients with esophageal carcinoma before RT was significantly higher than that in healthy controls (P ＜ 0.001). At the end of RT, serum TGFβ1 level was decreased in 67.82% (59/87) of the patients. The overall survival rate at 1,3 and 5 years was 48.28% (42/87), 19.54% (17/87)and 12.64% (11/87), respectively. Main causes of death were local failure and regional lymph node metastasis.In patients whose serum TGFβ1 level decreased after RT,the survival rate at 1, 3 and 5 years was 61.02% (36/59),28.81% (17/59) and 18.64% (11/59), respectively. The survival rate at 1 year was 17.86% (5/28) in patients whose serum TGFβ1 level increased after RT, and all died within 18 mo (P ＜ 0.01).CONCLUSION: Serum TGFβ1 level may be a useful marker for monitoring disease status after RT in patients with esophageal carcinoma.     

初诊T2DM短期胰岛素强化治疗40例分析

目的观察初诊T2DM短期胰岛素强化治疗的疗效。方法对40例初诊T2DM患者采用三餐前皮下注射短效胰岛素和睡前注射中效胰岛素2wk，并检测治疗2wk前后FPG、PPG、GHbA1C及血脂等值进行比较。结果两组治疗后FPG、PPG、GHbA1C及血脂各值均显著低于治疗前p〈0．05（x^2=4．940—11．544）。结论胰岛13细胞功能异常和（或）胰岛素抵抗是T2DM发病的基本环节，早期强化胰岛素治疗能获得血糖的有效控制，减少或延缓并发症的发生。     

Inhibition of the expression of lysyl oxidase and its substrates in cadmium-resistant rat fetal lung fibroblasts.

Copper (Cu)-dependent lysyl oxidase (LO) catalyzes crosslinking of collagen and elastin stabilizing the extracellular matrix (ECM). Chronic inhalation of cadmium (Cd), a toxic metal, induces emphysema. To probe mechanisms of Cd injury to the lung, we developed Cd-resistant (CdR) cells from rat fetal lung fibroblasts (RFL6) by chronic exposure to CdCl(2) from 1 to 40 microM and further examined their expressions of LO, LO substrates, and Cu-scavenging thiols. Levels of cellular thiols, metallothionein, and glutathione in CdR cells were elevated to 13.0- and 3.2-fold of parental controls, respectively, whereas LO mRNA and protein levels were markedly reduced in these cells, with catalytic activity declining to only 16% of the parental control. A conspicuous 52 kDa species rather then the normal 50 kDa proenzyme appeared in the CdR cell extract but not in the conditioned medium, which was codistributed with the endoplasmic reticulum marker [DiOC5(3)] within the cell, implying the Cd-induced 52 kDa species as a product of an abnormal LO-processing defect in secretion. Addition of Cu into CdR cell cultures enhanced the expression of LO mRNA, protein and catalytic activities reflecting limitation of Cu bioavailability for LO in these cells. With inhibition of LO, CdR cells also displayed downregulation of collagen and elastin, substrates of LO. Restoration of collagen synthesis by exposure of CdR cells to purified LO or Cu suggests that inhibition of LO and limitation of Cu cofactor by Cd, as key phenotype changes, accelerated collagen and elastin damage, a critical event pertinent to emphysema pathogenesis.     

间接免疫荧光法检测特异性IgG抗体对流行性出血热诊断意义

本文报告用间接免疫荧光法检测特异性IgG抗体对流行性出血热的诊断意义。53例不同病期的出血热患者的血清,其间接荧光抗体的阳性率为49/53(占92.45％)。有77.36％的患者血清,检出IgG抗体的时间是在发病后的1～2周。血清中IgG的滴度与疾病的严重性无密切相关。另25例非EHF患者,其血清特异性IgG抗体均为阴性。可见检测特异性IgG抗体对EHF的诊断颇为有用。     

早年父亲去世的心理创伤研究——1例男大学生的深入访谈分析

目的 探讨男孩8岁时父亲去世对其带来的创伤影响。方法 运用质的研究方法，对一名在8岁时经历父亲去世的男大学生进行深入访谈，采用主要概念或主题突出分类的方法进行编码分析。结果 父亲去世使个体产生了强烈的不安全感，严重的自卑感和神经症性的防御机制。结论 父亲去世后，家庭氛围是影响孩子心理健康的重要因素。     

多媒体辅助于中药学教学存在的问题及对策

中药学理论源远流长,知识要点繁杂,涉及学科面广。中药学教学对植物药、动物药、矿物药的形象展示、真伪鉴别,地道药材确定以及加工、炮制、煎煮方法的情景呈现有特殊要求,而多媒体课件丰富的色彩、直观的形象,尤其是妙趣横生的音频、视频及动画效果可弥补传统教学的缺憾,为中药学教学提供了新的手段和方法。回顾中药学教学历程,辩证地分析多媒体辅助中药学教学存在的问题,探索解决问题的方法和措施,以期寻求更好的教学策略。     

Parental education and children's online health information seeking: Beyond the digital divide debate

Research has shown that increasing numbers of teenagers are going online to find health information, but it is unclear whether there are disparities in the prevalence of online health seeking among young Internet users associated with social and economic conditions. Existing literature on Internet uses by adults indicates that low income, less educated, and minority individuals are less likely to be online health seekers. Based on the analysis of data from the Pew Internet and American Life Project for the US, this study finds that teens of low education parents are either as likely as or even more likely than teens of high education parents to seek online health information. Multiple regression analysis shows that the higher engagement in health seeking by teens of low education parents is related to a lower prevalence of parental Internet use, suggesting that some of these teens may be seeking online health information on behalf of their low education parents. Implications of these findings are discussed in relation to the issues of the digital divide and digital empowerment.     

Changes in T .lymphocyte subsets after severe traumatic brain inJury

BACKGROUND： Besides local changes of cranial parenchymal cells, hemorrhage, etc., severe traumatic brain injuries also cause the changes of total body fluid and various functions, and the changes of lymphocytes and T lymphocyte subsets should be paid more attention to. OBJECTIVE： To reveal the changing laws of T lymphocyte subsets after severe traumatic brain injury, and compare with mild to moderate brain injury. DESIGN： A comparative observation. SETTINGS： Department of Neurosurgery, Longgang District Buji People＇s Hospital of Shenzhen City; Central Laboratory of Shenzhen Hospital of Prevention and Cure for Chronic Disease. PARTICIPANTS： All the subjects were selected from the Department of Neurosurgery, Longgang District Buji People＇s Hospital of Shenzhen City from August 2002 to August 2005. Thirty patients with severe brain injury, whose Glasgow coma score （GCS） was ≤ 8 points, were taken as the experimental group, including 21 males and 9 females, aging 16 - 62 years. Meanwhile, 30 patients with mild traumatic brain injury were taken as the control group （GCS ranged 14- 15 points）, including 18 males and 12 females, aging 15 -58 years. All the subjects were in admission at 6 hours after injury, without disease of major organs before injury Informed consents were obtained from all the patients or their relatives. METHODS： （1） The T lymphocytes and the subsets in peripheral blood were detected with immunofluorescent tricolor flow cytometry at l, 3, 7 and 14 days after injury in both groups. （2） The conditions of pulmonary infections were observed at 4 days after injury. The differences of measurement data were compared with the t test. MAIN OUTCOME MEASURES： Changes of T lymphocytes subsets at 1 - 14 days after severe and mild or moderate traumatic injury. RESULTS： Finally, 28 and 25 patients with mild to moderate traumatic brain injury, whereas 25 and 21 patients with severe traumatic brain injury were analyzed at 7 and 14 days respectively, and the missed ones died due to the development of disease. （1） Changes of T lymphocyte subsets： At 1 and 3 days after injury, CD3, CD4, CD8, CD4/CD8 began to decrease, whereas CD8 increased in the experimental group, which were very significantly different from those in the control group （t =2.77 - 3.26, P 〈 0.01）, and began to recover at 7 days, which were significantly different from those in the control group （t = 2.06 - 2.24, P 〈 0.05）, and generally recovered to the normal levels at 14 days （P 〉 0.05）. （2） Conditions of pulmonary infections： At 4 days after injury, the rate of pulmonary infection was significantly different between the experimental group and control group [73% （22/30）, 0, x2=37.29, P 〈 0.01]. CONCLUSION： Patients with severe traumatic brain injury suffer from damages of cellular immune function at early period （within 7 days）, and they are easily to be accompanied by pulmonary infections.