蚌埠医学院在校学生心理卫生调查

目的　了解蚌埠医学院在校学生心理状况 ,为素质教育提供服务。方法　采用症状自评量表 (SCL- 90 )对该校 1～ 4年级学生进行调查分析。结果　该校在校生有 5个因子得分高于全国大学生常模 ,高年级学生得分高于低年级 ,男女生在人际、抑郁、敌对、偏执等方面差异有显著性。结论　应针对大学生的心理特点 ,在大学院校进行心理健康教育。     

阴道毛滴虫与沙眼衣原体共生关系的初步探讨

目的 :为了探讨阴道毛滴虫与沙眼衣原体共生、协同致病的关系 ,对南通市公安局收容教育所非淋菌性阴道炎、尿道炎 (后称非淋患者 )患者以及本市某国营纺织厂同龄纺织女工阴道毛滴虫的寄生情况进行了 6个月以上的连续性观察。方法 :对 2 0 0 1年到 2 0 0 3年期间南通市公安局收容教育所非淋患者 1983例女性和随机抽样国营纺织厂纺织女工 2 84人分别采用生理盐水涂片法镜检阴道毛滴虫滋养体。结果 :非淋患者阴道毛滴虫滋养体的平均阳性检出率为 2 0 .6 8% (41/1983) ,明显高于正常对照组 (1.0 6 % ,3/2 84 ) ,差异显著 (X2 =2 5 .2 9,P <0 .0 0 1) .其中沙眼衣原体感染者 ,阴道毛滴虫滋养体的阳性检出率有增高趋势。结论 :非淋患者中沙眼衣原体感染时 ,其阴道毛滴虫阳性检出率高于其他患者。同时选择部分病例采用单纯抗非淋病治疗和抗非淋病与抗滴虫同时治疗进行比较并跟踪追访 6个月 ,缓解和消除症状后者明显优于前者 ,少数不规范治疗或擅自放弃治疗的人 ,延误病情或使病程迁延而转为慢性 ,给根治来一定的难度。建议注意阴道毛滴虫与沙眼衣原体共同感染协同致病的情况 ,要鉴别病原体 ,联合用药 ,提高疗效。     

48例干扰素治疗慢性乙肝不良反应的观察及护理

重组α-2b干扰素是具有抗病毒和免疫调节作用的生物学调节活性物质。近年来，国外文献报道α-2b干扰素治疗慢性乙型病毒性肝炎(CAH—B)取得较好效果。特别是基因工程问世，使大量的高纯度干扰素应用于临床。现对48例慢性乙肝患者使用干扰素后的不良反应的观察与护理，报道如下。     

富氧对海拔3700m高原人体运动心力储备的影响

目的　探讨富氧对高原人体运动心力储备方面的影响。方法　对海拔 3 70 0m高原的 1 2名健康青年富氧 (氧浓度为 2 4%～ 2 5 %)前后分别进行踏阶运动 ,采用心力监护仪采集和记录心动周期和心力信息 ,把完成规定运动量运动后第一心音 (S1 )幅值对安静时S1 幅值增加的相应倍数评估心肌收缩能力储备指数 (CCRI) ;利用舒张期和收缩期时限数据计算舒张期 /收缩期比值 (D/S比 )。结果　运动后较安静时HR ,D/S ,S1 幅值均增高 ,有非常显著性差异 (P <0 .0 1 ) ;富氧运动较未富氧运动CCRI,D/S ,S1 幅值增高 ,有显著性差异 (P <0 .0 5 ) ,HR无统计学意义 (P >0 .0 5 )。结论　高原低氧环境下心脏储备主要是心肌收缩能力储备而不是心率储备。富氧对增强机体心力储备具有重要作用     

Pulmonary resection for metastases from colorectal cancer

Aim: The prognosis of patients with disseminated colorectal carcinoma is poor except for those with single organ pulmonary or hepatic metastases. The objective of the present study was to evaluate the result of pulmonary metastasectomy for colorectal secondary and to identify the prognostic factors. Methods: This was a retrospective study of 80 patients who had pulmonary metastasectomy for pulmonary secondary from colorectal carcinoma in Queen Elizabeth Hospital, Hong Kong. Results: The overall 5‐year and 10‐year survival rates of the entire cohort were 42.5% and 35.5%, respectively. High premetastasectomy carcinoembryonic antigen (> 20 μg/dL), short disease‐free interval (< 12 months) and incomplete resection were the independent prognostic factors. Neither the characteristics of the primary colorectal tumour nor the number of metastatic nodules had a significant contribution to the long‐term survival. Six patients underwent second pulmonary metastasectomy and three were still free from tumour recurrence after the second operation. Conclusion: Patients with pulmonary metastases from colorectal carcinoma would benefit from pulmonary metastasectomy. High premetastasectomy carcinoembryonic antigen and short disease‐free interval were negative predictive factors for survival. Long‐term follow‐up study is required, as recurrence can occur more than 5 years after pulmonary metastasectomy. Also, whether the survival benefit is due to surgical treatment effect or lead‐time bias remains undecided.     

Poly-L-Lysine玻片在寡核苷酸芯片制备中的改进

目的 为了制得适合固定未修饰寡核苷酸的芯片，提高检测灵敏性，对Patrick Brown实验室的多聚左旋赖氨酸包被玻片的方法进行改进。方法 玻片经清洗后用缩水甘油-丙氧基三甲氧基硅烷进行硅烷化，然后应用Poly-L-Lysine在玻片表面形成聚合物涂层，经次亚苯基二异硫氰酸盐表面活化后可使寡核苷酸共价连接在芯片表面。设计了各种实验考察方法改进前后芯片表面的性能，并将改进后的玻片初步应用于SARS冠状病毒寡核苷酸芯片检测中。结果 方法改进后芯片表面性能优良：固定效率高、点的同一性好、杂交效率和热稳定性好、寡核苷酸结合牢固、芯片可以重复利用。结论 利用共价连接，方法改进后的芯片表面适合固定未修饰的寡核苷酸，解决了寡核苷酸与玻片之间物理结合不稳定、易剥离的缺陷，提高了芯片检测的灵敏性。     

经尿道前列腺电切术后膀胱颈挛缩多因素分析

目的 :对经尿道前列腺电切术 (TURP)后膀胱颈挛缩 (BNC)发生的各种可能因素进行分析 ,探讨减少该并发症的途径。　方法 :对 10 17例行TURP患者中发生BNC的 2 4例进行统计学分析 ,在手术方法、前列腺电切重量、单位时间前列腺组织电切重量、置管时间、高频发生器类型及有无糖尿病、尿潴留及前列腺炎等方面进行比较 ,了解其可能发生的因素。　结果 :TURP术后BNC发生率明显高于开放手术病例 ,小前列腺、单位电切时间长、高频发生器功率大及术前前列腺炎患者易发生BNC(P <0 .0 5 ) ,而术前尿潴留、糖尿病及术后置管时间对BNC发生无明显影响 (P >0 .0 5 )。　结论 :小前列腺、前列腺炎及电流损伤是发生BNC的重要因素 ,患者的选择及熟练精确的电切技术可减少BNC的发生。     

Particle size and morphology of UHMWPE wear debris in failed total knee arthroplasties--a comparison between mobile bearing and fixed bearing knees.

Osteolysis induced by ultrahigh molecular weight polyethylene wear debris has been recognized as the major cause of long-term failure in total joint arthroplasties. In a previous study, the prevalence of intraoperatively identified osteolysis during primary revision surgery was much higher in mobile bearing knee replacements (47%) than in fixed bearing knee replacements (13%). We postulated that mobile bearing knee implants tend to produce smaller sized particles. In our current study, we compared the particle size and morphology of polyethylene wear debris between failed mobile bearing and fixed bearing knees. Tissue specimens from interfacial and lytic regions were extracted during revision surgery of 10 mobile bearing knees (all of the low contact stress (LCS) design) and 17 fixed bearing knees (10 of the porous-coated anatomic (PCA) and 7 of the Miller/Galante design). Polyethylene particles were isolated from the tissue specimens and examined using both scanning electron microscopy and light-scattering analyses. The LCS mobile bearing knees produced smaller particulate debris (mean equivalent spherical diameter: 0.58 microm in LCS, 1.17 microm in PCA and 5.23 microm in M/G) and more granular debris (mean value: 93% in LCS, 77% in PCA and 15% in M/G).     

RANK signaling is not required for TNFalpha-mediated increase in CD11(hi) osteoclast precursors but is essential for mature osteoclast formation in TNFalpha-mediated inflammatory arthritis.

To address the controversy of whether TNFalpha can compensate for RANKL in osteoclastogenesis in vivo, we used a TNFalpha-induced animal model of inflammatory arthritis and blocked RANKL/RANK signaling. TNFalpha increased osteoclast precursors available for RANK-dependent osteoclastogenesis. RANK signaling is not required for the TNFalpha-stimulated increase in CD11b(hi) osteoclast precursors but is essential for mature osteoclast formation. INTRODUCTION: Although critical roles of TNFalpha in inflammatory arthritis and RANKL in bone resorption have been firmly established, a central controversy remains about the extent to which TNFalpha can compensate for RANKL during osteoclastogenesis and the stage at which RANK signaling is required for osteoclastogenesis. Here, we used the human TNFalpha transgenic mouse model (TNF-Tg) of erosive arthritis to determine if there are both RANK-dependent and -independent stages of osteoclastogenesis in TNFalpha-induced erosive arthritis. MATERIALS AND METHODS: Osteoclastogenesis and osteoclast precursor (OCP) frequency were analyzed using histology, fluorescence-activated cell sorting (FACS), and cell culture from (1) TNF-Tg mice treated with the RANKL antagonist, RANK:Fc, or (2) TNF-Tg X RANK -/- mice generated by crossing TNF-Tg mice with RANK-/- mice. RESULTS: Treatment of TNF-Tg mice, which have increased OCPs in their spleens, with RANK:Fc dramatically reduced osteoclast numbers on the surface of their arthritic joints and within their bones, but did not decrease CD11b(hi) OCP numbers in their spleens. Long-term RANK:Fc administration alleviated joint erosion. Furthermore, TNF-Tg x RANK -/- mice had severe osteopetrosis, no osteoclasts, and no joint erosion, but increased CD11b(hi) precursor numbers that failed to form mature osteoclasts in vitro. CONCLUSION: RANK signaling is essential for mature osteoclast formation in TNFalpha-mediated inflammatory arthritis but not for the TNFalpha-induced increase in CD11b(hi) OCP that subsequently can differentiate into osteoclasts in inflamed joints.     

骨髓细胞移植上调血管内皮生长因子及其受体的表达并改善缺血心脏功能

目的：通过骨髓细胞移植对心肌梗死大鼠模型血管内皮生长因子及其受体表达的影响，探讨骨髓细胞移植改善缺血心脏功能的可能机制。方法：利用左前降支冠状动脉结扎术制备大鼠心肌梗死模型，然后行异体骨髓细胞移植；分别于术后1d，3d，7d，14d和28d取材；利用免疫荧光和RT—PCR技术分析细胞移植对血管内皮生长因子(VEGF)及其受体(Flk一1)表达的影响和移植细胞的分化情况；通过免疫组化计算血管数量；应用血流动力学检测大鼠心脏功能在术后各时间点的变化。结果：VEGF和Flk-1在移植组动物的心肌梗死区残存细胞、梗死周边区细胞以及部分移植细胞内表达。移植组VEGF和Flk-1的mRNA表达明显高于对照组。分别于术后3d和14d达到高峰，以后逐渐减弱。术后7d，14d和28d移植组血管数量较同期对照组明显增加，移植组心脏功能较对照组明显改善。术后14d可在部分移植细胞中检测到心肌细胞或血管内皮细胞特异性蛋白的表达。结论：骨髓细胞移植通过上调移植细胞及受者内源性VEGF和Flk—1的表达，促进血管新生，进而改善缺血心脏功能。