皮肤穿支血管的解剖学研究

目的：对全身皮肤血管区域进行定性和定量分析，确定全身皮肤穿支血管的位置、数量、口径、穿支蒂的长度、类型、来源血管以及穿支所供应皮肤的面积，为穿支皮瓣提供血管解剖基础。方法：选用10具新鲜尸体，采用改良氧化铅一明胶灌注技术进行动脉灌注。将每个口径大于0．5mm的穿支血管进行解剖并记录。拍摄X线片以显示皮肤内血管的形态和分布。定量数据分析包括全身各部位的穿支血管的数量、口径、类型及其供应区域的面积。结果：发现全身128支起源血管发出440支穿支供应皮肤。其中肌皮穿支与肌间隔穿支之比为3：2。穿支平均直径为0．7mm。穿支血管的分布规律如下：①躯干皮肤的血供主要来自肌皮穿支，这些穿支在皮肤内的走行距离和分布范围大于肢体皮肤的穿支。②肢体皮肤的血供主要来自肌间隙穿支血管，主要分布在深筋膜表面，皮神经和浅静脉周围穿支之间形成链式血管吻合。③单位面积的穿支数量与皮肤的移动程度成反比，穿支的口径大小和穿支在皮肤内走行距离与皮肤移动度成正比，与穿支的供应面积成正比。结论：本研究提供详细的皮肤穿支血管解剖数据，为临床设计应用穿支皮瓣提供解剖学依据。     

AMPK调节骨骼肌细胞GLUT4基因表达的机制研究

腺苷酸活化蛋白激酶(AMPK)能调节运动/肌肉收缩所引起的骨骼肌细胞葡萄糖转运蛋白4(GLUT4)基因的表达,但至今它的调节机制不清.研究显示在非运动刺激引起的细胞信号事件中由组蛋白去乙酰化酶(HDACs)以及组蛋白乙酰化酶(HATs)控制的组蛋白乙酰化状态是调节基因表达的重要机制,所以我们假设AMPK信号途径是通过征用HDACs中的HDAC5(在骨骼肌细胞内高表达)来实现对运动/肌肉收缩引起的GLUT4基因表达控制.细胞分为正常浓度葡萄糖对照组(NGLU组)、正常浓度AICAR组(NGLU AICAR组)、高浓度对照组(HGLU组)、高浓度AICAR组(HGLU AICAR组).用5 mmol/L和20 mmol/L葡萄糖浓度培养骨骼肌细胞后,NGLU AICAR组和HGLU AICAR组与肌肉收缩模拟信号刺激5-氨基-4-甲酰胺咪唑核糖核苷酸(AICAR)孵育.AICAR能激活NGLU组骨骼肌细胞AMPKα2、减少骨骼肌细胞核HDAC5蛋白、促使HDAC5与骨骼肌细胞加强因子(MEF2)蛋白分离和上调GLUT4基因的表达;相反,高浓度葡萄糖延迟由AICAR引起的AMPKα2磷酸化、AMPKα2向细胞核转入、HDAC5向细胞核转出和GLUT4基因的表达.实验结果说明在不同葡萄糖浓度下的骨骼肌细胞GLUT4基因表达变化都对应着上游AMPK蛋白和下游HDAC5蛋白的变化,AMPK可能是征用转录抑制子HDAC5来调节MEF2的活性而达到控制肌肉收缩所引起的GLUT4基因表达.     

大、中学生对文化维度的知觉

目的:考察大、中学生对文化维度的知觉的情况和发展趋势。方法:用Trandis编制的个人主义-集体主义量表(Individualism-Collectivism Scale)对1760名大、中学生进行测量。结果:大、中学生对文化维度的知觉存在年龄效应;随着年龄增加,对集体主义维度的知觉从42.05%下降到27.40%,而对个人主义维度的知觉从5.01%上升到18.58%;水平维度的知觉从47.06%下降到40.71%;垂直维度的知觉从4.14%上升到6.19%。结论:大、中学生对文化维度的知觉的差异主要表现在个人主义和集体主义的维度,水平维度和垂直维度有轻微的波动。     

REDUCTION IN PERITONITIS INCIDENCE IN CONTINUOUS AMBULATORY PERITONEAL DIALYSIS WITH A NEW CATHETER AND IMPLANTATION TECHNIQUE

Recurrent episodes of peritonitis with the same organism cultured at thecatheter exit site suggest that early tunnel colonization is associated with a transferof these organisms through the catheter tunnel directly from the skin into the peri-toneal cavity.In this circumstance the catheter has failed in its fundamental designto establish and maintain a bacteriological barrier.A three part study was conductedusing the Moncrief-Popovich Catheter and Implantation Technique.The first part of     

人单核细胞和T细胞在体外对巨核细胞生成的调节作用

已经证明骨髓中的单核一巨噬细胞和T淋巴细胞在体外能调节巨核细胞的生成。本文报告的是外周血单核细胞和T淋巴细胞在体外培养中能影响巨核细胞的集落形成单位(CFU-M)。使用血浆凝块培养技术,抗血小板糖蛋白抗血清作为探针的间接免疫荧光方法以及共培养研究证实粘附单核细胞与自身缺失粘附单核细胞的靶细胞共培养时能抑制CFU-M。与靶细胞单独培养时所形成的CFU-M相比较,其抑制率从26％～46％。而加入T淋巴细胞后,在同样的效靶比例时,对CFU-M没有明显的影响。集落大小检查表明了在外周血中所形成的集落体积大于在骨髓中所形成的集落。     

羟苄磺唑头孢菌素和氨甲苯唑头孢菌素

头孢菌素类发展很快,目前在美国上市品种已达十六种(见表一),而且不久还将续有增加.现在把头孢菌素列作首选药物治疗的疾病种类虽还不多,但使用已很广泛.从临床上得到的满意结果来看,确证了它们抗菌活性谱广与严重不良反应产生率低的性质.胃肠外给药的头孢菌素经常用"代"的名称分类,分类依据主要看它对革蓝氏阴性菌     

Statement on breast feeding,fertility and contraception

An important part of the human reproductive process, breastfeeding also plays a key role in infant nutrition while protecting the infant from exposure to infection. Breastfeeding also plays a major role in the natural regulation of fertility, but breastfeeding patterns are changing along with urbanization and lifestyle changes. These changes are tending towards a shortening of the duration of breastfeeding, a reduction in the daily frequency of breastfeeding episodes, and an earlier introduction of food supplements. Consequently, the risk of pregnancy during lactation has increased. The literature suggests considerable variability in the length of breastfeeding and postpartum amenorrhea and in the duration of lactational infertility among different populations. Both the return of ovarian activity and fertility depends on the time elapsed since delivery. Variables that play a primary role in the length of amenorrhea and infertility include: the duration of breastfeeding the frequency and duration of suckling; the administration of supplements to the infant; the mother's nutritional status; and geographic, social, and cultural factors. Knowledge of local breastfeeding practices and the associated risks of pregnancy should be a prerequisite for those counseling nursing women. All women should be advised and encouraged to breastfeed fully, as far as is practicable. Women also need to be informed that it is difficult to predict exactly the duration of lactational infertility for each woman. The timing of the introduction of contraception depends on the risk factors and some programmatic aspects, such as the possibility that the woman may not return after delivery or after the 1st postpartum visit as well as the type of contraceptive chosen. Current information on the influence of contraceptive methods -- IUDs, oral contraceptives, injectable contraceptives, norplant, barrier methods, periodic abstinence, and sterilization -- upon breastfeeding are summarized.     

Involvement of doctors in torture: conclusions and recommendations

In 1984 the Council of the British Medical Association set up a working party, chaired by J.P. Quillam, to investigate claims that doctors in some countries were cooperating with the use of torture as a routine instrument of repression. The conclusions and recommendations of the working party's recently published report are reproduced here, along with a list of the members of the working party. Among the report's conclusions [which are reproduced also in the British Medical Journal 1986 Mar 15; 292(6522): 781-782] are that doctors have a responsibility to support any practitioner who refuses to keep silent about abuses of human rights, to check for signs of physical abuse of prisoners, and to publicize any violations of the Declaration of Tokyo. Physicians are also encouraged to offer their services to organizations such as the Medical Foundation for the Care of Victims of Torture.     

电针及吗啡对大鼠脊髓内P物质(SP)脑啡肽(ENK)及乙酰胆碱酯酶(AChE)的影响——免疫细胞化学及组织化学研究

大白鼠56只,共分四组,即①对照组;②电针组;③吗啡组;④吗啡+电针组。应用Sternbergel氏PAP免疫组织化学技术显示各组动物脊髓内P物质(SP),脑啡肽(ENK),及以Karnovsky-Roots氏组织化学方法显示乙酰胆碱酯酶(AChE),此外,还取已染SP及AChE的切片制作电子显微镜标本,作SP及AChE超微分布的观察,各种活性物质,并作了半定量测定及分析。电针后,在痛阈升高的同时,脊髓第Ⅱ层内SP的免疫反应性(LI)升高(P<0.001,与对照组相比),然而,与此相反在同一个部位内的ENK-LI降低(P<0.001)。注射吗啡后,SP-LI与电针组者相似;在第Ⅱ层内坛加(P<0.001),但注射吗啡动物若再进行电针,SP-LI不仅不继续升高反而降低(P<0.001,与吗啡组相比)。至于脊髓后角内AChE活性的组织化学改变,各组动物间互相差异,如:3.855±0.550(对照组),4.225±0.477(电针组),3.252±0.405(吗啡组)以及3.775±0.401(吗啡+电针组)。脊髓第Ⅱ层,不仅富于SP-LI,而且AChE也丰富、电镜观察表明“细”纤维轴终末内SP-LI见于清亮突触囊泡的周围,而由“粗”纤维(有薄层髓鞘者)AChE多分布于轴内。以上结果表明:在SP-LI改变方面,电针镇痛与吗啡镇痛的作用相似,但是在AChE活性的改变方面,二者作用相反,并认为:电针及吗啡分别对SP-LI及ENK-LI的影响可用Jessell-Iversen氏一级传入信息在脊髓内加工的模式来解释,同时,SP与乙酰胆碱之间的功能联系也不能排除。含AChE神经元可能影响SP的释放。