明天的医学向何处去——平衡医学方法论略谈

《明天的医学向何处去》一文是王佑三同志应中国中医研究院、中西医结合研究会1990～2010年中医药研究的重大进展与突破预测研究课题组和中国人体科学学会之约所撰。本报征得作者同意稍加删节后发表,期望引起对“明天的医学”的关注。     

Differential expression of two forms of GABAA receptor gamma 2-subunit in mice.

The gamma-aminobutyric acid type A (GABAA) receptor gamma 2-subunit is important for benzodiazepine action. In previous studies, two forms of gamma 2-subunit have been found which are generated by RNA alternative splicing (gamma 2L and gamma 2S) and differ by the presence or absence of an 8-amino acid insertion in the major intracellular loop between proposed transmembrane domains M3 and M4. We have used the RNase protection assay to study regulation of expression of the two forms of gamma 2-subunit in mouse brain, as judged from mRNA levels. We find that gamma 2L and gamma 2S are differentially expressed in brain regions and that gamma 2S is expressed at a fairly constant level during brain development while gamma 2L increases dramatically with maturation. Their differentially regulated expression suggests further that gamma 2L and gamma 2S form receptors with important functional differences.     

Effects of Vagal and Sympathetic Nerves on Transmembrane Potential of Cardiac Ventricular Cells of Toad

The effects of vagal and sympathetic nerves on the transmembranepotentials of cardiac cells of toad were observed by means of microelectrodetechnique.The vagal nerve was stimulated there would be an increase in restingpotential and acceleration in repolarization of action potential(AP).However,ifatropine was used before stimulation the above-mentioned phenomena woulddisappear.When the sympathetic nerve was stimulated the AP amplitudeincreased,but resting potential(RP)remained the same.The increase of APresulted from the increases of overshoot.When the sympathetic nerve wasstimulated although the heart rate increased and the duration of AP wasshortened,the plateau phase of AP was prolonged.These results suggest that theeffects of vagal and sympathetic nerves on the transmembrane potential of cardiacventricular cells are coordinated and the normal characteritics of transmembranepotential are maintained by both the vagal and sympathetic nerves.     

耳廓复合组织瓣连续法修复鼻翼缺损

目的观察耳廓复合游离组织瓣连续法修复鼻翼缺损的疗效，以探讨鼻翼缺损的有效修复手段。方法耳廓复合游离组织瓣2次连续法修复鼻翼缺损7例，移植物面积0．5cm×0．7cm～0．8cm×1．2cm。结果7例耳廓复合游离组织瓣移植后全部成活。术后随访6～18个月，移植物无明显回缩，鼻外形满意。结论耳廓复合游离组织瓣连续移植修复鼻翼缺损，适合较严重鼻翼缺损，手术成功率高，术后鼻外形满意，双侧分次取材，耳廓外形双侧对称无畸形。     

Acupuncture Treatment for 34 Cases of Epiphora with Dysfunction of Lacrimal Duct

We have treated 34 cases of epiphora due to dysfunction of the lacrimal duct with a warm needle puncturing at the Jingming (UB 1) point. The effect was significantly better than that of the control group treated with lacrimal duct irrigation and norflaxacin eye drops (a total effective rate of 91.07% vs. 54.29%).     

非体外循环冠状动脉搭桥术临床分析（附11例报告）

（1）目的 总结探讨11例非体外循环冠状动脉搭桥术（OPCAB）的经验。（2）方法 2001年6－12月对11例冠心患采用非体外循环心脏不停跳方法完成冠状动脉搭桥术。（3）结果 共搭桥35支，平均3．17支／例，其中左乳内动脉桥8支，大隐静脉桥27支。6例患（54．5％）未血，无手术死亡及并发症。（4）结论 非体外循环搭桥术克服了体外循环搭桥术（CABG）的诸多缺点和弊端，手术简化，时间缩短，适应证扩大，并发症明显减少，效果满意。     

脾动脉栓塞治疗外伤性脾破裂28例临床疗效观察

目的：探讨脾动脉栓塞术对外伤性脾破裂的疗效及并发症的处理。方法：采用Seldinger法行脾动脉栓塞术治疗外伤性脾破裂28例。结果：所有患者出血立即停止，其中4例行2次栓塞。28例均有脾区疼痛，22例发热。脾动脉栓塞5天后血小板、白细胞上升近1倍，7天后恢复至正常范围。28例随访6－36月，查免疫球蛋白、CT等结果满意，未有再出血及发生暴发性感染。结论：脾动脉栓塞不但有良好的止血作用，而且能保留脾脏的免疫功能，可在非手术治疗失败时选用，是外伤性脾破裂的一种有效治疗方法。     

干扰素病毒唑联合治疗慢性丙型肝炎疗效及干扰素抗体的影响

目的 :研究干扰素与病毒唑联合治疗慢性丙型肝炎疗效及干扰素抗体的影响。方法 :观察组 2 0例采用干扰素 α2b 3MvTiwIH +病毒唑 10 0 0mgQdpo连用 2 4周 ;对照组 3 2例采用干扰素 α2b 3MvTiwiH连用 2 4周。停药后观察 2 4周比较疗效并检测干扰抗体。结果 :观察组完全应答率为 5 0 % ,明显高于对照组 18.7% ;复发率为 2 5 .0 %低于对照组 5 6.3 % (P <0 .0 1)。无反应率均为 2 5 .0 %。且复发与干扰素抗体尤其是中和抗体有关。结论 :观察组疗效优于对照组 ,复发与干扰素抗体尤其是中和抗体有关。     

Altered swelling behavior of femoral cartilage following joint immobilization in a canine model.

Periods of reduced joint loading have been shown to induce changes in the biochemical composition. metabolism and mechanics of articular cartilage. In this study, changes in cartilage swelling behavior were studied following a 4-week period of joint immobilization, using a recently developed osmotic loading technique [J. Biomech, 32 (1999) 401-408]. The magnitude and distribution of swelling strains were measured in cartilage-bone samples equilibrated in physiological and hypotonic saline, relative to a hypertonic reference NaCl solution. Physicochemical parameters (glycosaminoglycan fixed charge density and water volume fraction) were determined in site-matched cartilage samples. The experimental data for swelling strains, fixed charge density and water volume fraction were used with a triphasic mechano-chemical theory [J. Biomech. Eng. 113 (1991) 245-258] to determine the effect of joint immobilization on the tensile modulus of the cartilage solid matrix. Four weeks of immobilization resulted in a significant increase in the magnitude of swelling-induced strains, and a significant decrease in fixed charge density in cartilage, as compared with the contralateral controls. Joint immobilization also resulted in decreases in values for the modulus of cartilage, as compared with the contralateral controls. Our results suggest that 4 weeks of joint immobilization had a significant effect on cartilage mechanical function that may be linked to collagen changes in the cartilage extracellular matrix.