城市血吸虫病综合防治措施的研究

目的探索快速控制城市血吸虫病流行的综合措施。方法在城市血吸虫病流行区选择3个试点现场,南津港、太平桥2个点采取以化疗为主的综合防治措施,小柳叶洲点采取以环境改造灭螺为主的综合防治措施。结果南津港点3年居民血吸虫感染率分别为2.80%、2.60%和2.24%,并发生急性血吸虫病2例;感染螺平均密度分别为0.0009、0.0027、0.0020只/0.1m2。小柳叶洲点3年无居民粪检阳性者,无急性血吸虫病例,哨鼠感染率为0,没有查到感染性钉螺。太平桥点3年居民感染率分别为1.18%、0.20%和0.26%,无急性血吸虫病例,家畜感染率分别为6.35%、3.57%和3.85%,2004年发现感染性钉螺,平均密度为0.0001只/0.1m2。结论在城市血吸虫病流行区,采取以环境改造灭螺为主、人群化疗、健康教育、药物灭螺灭蚴的综合防治措施能快速控制疫情。采取以化疗为主的综合防治措施,难以有效控制疫情。     

Irritable bowel syndrome and health-related quality of life: a population-based study in Calgary, Alberta.

BACKGROUND: Little is known about the health-related quality of life (HRQOL) of nonclinical samples of people with irritable bowel syndrome (IBS) in Canada. In a pilot survey, the impact of IBS on HRQOL using a population-based, urban sample was examined. METHODS: A random sample of Calgary residents (18 years of age or older), selected by random digit dialing (n=1521), completed a structured questionnaire including ROME II Criteria and Medical Outcomes Study Short-Form 12-Item Health Survey, version 2 (SF-12v2). The mean scale and summary scores of SF-12v2 for those who did and did not meet ROME II criteria and for those who met ROME II criteria with and without visiting a physician in past three months were determined and compared using multiple regression analyses. RESULTS: Of the 951 households successfully contacted, 590 (62%) were willing to participate, of which 437 (74%) individuals were recruited. One hundred ten IBS cases (81 of which were women) and 327 non-IBS controls (180 of which were women) were identified. All of the eight mean scale scores and the two mean summary scores were significantly lower in people with IBS than in those without, whether or not adjusting for demographics. Forty-four of the 110 IBS cases (40%) sought medical help. Significantly lower mean physical component score and three scale scores (general health, social functioning and role physical) were found in those who sought medical help than in those who did not. CONCLUSIONS: People with IBS experience significant impairment in HRQOL, including both physical and mental well-being. People with IBS who seek medical help report worse physical health than those who do not, but their mental health is no different.     

水通道：从原子结构到临床医学

阿格雷（Peter Agre）博士，美国杜克大学医学院细胞生物学系教授，约翰斯霍普金斯大学医学院生物化学系客座教授。阿格雷教授其研究成果在于分离出了长期以来所搜寻的特定输送水分子的通道。这一发现开启了针对细菌、植物和哺乳动物水通道的系列生化、生理和遗传研究之门，从而使得研究人员可以仔细跟踪水分子通过细胞膜的过程，并了解为何只有水分子而不是其他小分子能够通过细胞膜，阿格雷博士也因此获得了2003年诺贝尔化学奖。     

(加味)柴芍承气汤对重症急性胰腺炎及其并发症的作用

目的探讨(加味)柴芍承气汤对重症急性胰腺炎(SAP)及其并发症的防治作用。方法65例SAP患者分为中药组35例,对照组30例。2组的内科治疗相同,中药组一经确诊即予柴芍承气汤加味银杏叶治疗,每剂煎成100~150m l,自鼻胃管内注入或口服,每日2~3次,直至患者腹痛缓解、腹胀基本消失、肠鸣恢复。分别观察2组患者治疗72 h后的PaO2、SaO2肾功能、脑病、局部并发症情况、腹痛缓解时间、肠鸣恢复时间、病死率,以及血清中血小板活化因子(PAF)、肿瘤坏死因子(TNF-α)、白介素-1(IL-1)水平变化。结果治疗72 h后中药组与对照组低氧血症的发生率分别为45.71%、73.73%,P<0.05;肾损害、脑病、局部并发症发生率以及病死率均低于对照组,但无统计学差异;腹痛缓解时间、肠鸣恢复时间均优于对照组(P<0.05);中药组血清中PAF、TNF-α、IL-1水平显著降低(P<0.01),而对照组则无明显变化。结论该汤剂对SAP及其并发症有较好的防治作用。抑制细胞因子或炎症介质可能是该汤剂治疗SAP的重要机制。     

Evaluation of corticospinal tract injury with three-dimensional diffusion tensor tract in patients with acute cerebral infarction

Three-dimensional diffusion tensor tract (DTT) is the newest imaging to describe the structure of white matter fiber in three-dimensions, it has great significance in dividing the concrete anatomic site of gray and white matter lesions, displaying the correlation with fibrous band and judging clinical prognosis, which is incomparable by other imagings.OBJECTTVE: To observe the conditions of corticospinal tract (CST) in acute cerebral ischemic stroke patients,and analyze the relationship between motor function and the severity of CST injury.DESIGN: A case-control observation.SETTTNG: Department of Medical Imaging, Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA.PARTTCTPANTS: Fifteen patients with acute cerebral infarction were selected from Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA from February to December in 2005. They all suffered from acute attack and motor disorder of hemiplegic limbs to different extent, and were conformed by CT or MRI.There were 9 males and 6 females, aging 16-87 years old, the median age was 51.7 years, and all were right handed. Fifteen right-handed normal subjects, who were matched by age and sex with the patients in the cerebral infarction group, were selected from the relatives of patients and physicians of the Imaging Department as the control group. All the subjects were informed and agreed with the study.METHODS: The patients with acute cerebral infarction and subjects in the control group received MR diffusion tensor imaging (DTI) with GE 1.5 T nuclear magnetic resonance system, fiber tracking with the software of dTV- Ⅱ. Fractional anisotropy (FA) maps and three-dimensional tractography of bilateral CST of all patients were created. Displacement, continuity and destroy of fibrous bands were observed. At the same time, muscle strength of ipsilateral hand of patients with cerebral infarction was measured with Brunnstrom standard. The correlation between the severity of CST injury and the muscle strength of ipsilateral hand was analyzed with spearman correlation analysis.MAIN OUTCOME MEASURES: ① FA values in the infarcted sites and those in the contralateral corresponding sites of patients with cerebral infarction; ② CST manifestations in the patients with cerebral infarction and the control group.RESULTS: All the 30 testees were involved in the analysis of results. ① The FA values in infarcted sites of white matter were significantly lower than those in the contralateral ones (t =4.570, P ＜ 0.001 ). ② In the control group, bilateral CST were reconstructed, they originated from precentral gyrus, went downwards to internal capsule, and extended to pontine and medulla oblongata, each fiber had good uniformity in continuous form. In the patients with cerebral infarction, the forms of contralateral CST were consistent with those in the control group with good continuity. Due to the involvement by the infarcted site to different extents, the ipsilateral CST manifested as continuous interruption and loss of uniformity in anatomic structure and form. The CST involvements were divided into three grades: integrated CST for grade I (n =2); integrated CST but compressed or displaced for grade 2 (n =5); interrupted CST for grade 3 (n =8). ③ The severity of CST injury was obviously correlated with the muscle strength of the ipsilateral hand (r=0.888, P＜ 0.05＝.CONCLUSION: ① CST is injured to different extents in patients with acute cerebral infarction, and the severity of injury is associated with muscle strength. It is indicated that it can be used to judge the prognosis of rehabilitative treatment. ②DTT can directly display the status of pyramidal tract more three-dimensionally.     

膝关节运动过程的应力数值模拟

目的观察膝关节关节面在整个运动过程中的应力、应变分布范围、大小及变化规律。方法利用有限元数值模拟方法对行走过程中膝关节关节面应力、应变情况进行分析。结果与结论行走过程中关节面产生应力、应变随时间推移而增加，并且变化规律近似的服从抛物线变化。通过对不同体重的人在行走时膝关节面上产生的应力分析得出，体重对关节面上的应力的大小并不产生重大影响，体重带来的应力差异仅占总应力的10％。     

肩锁钩钢板内固定治疗RockwoodⅢ～V型肩锁关节脱位

目的总结肩锁钩钢板内固定治疗RockwoodⅢ～Ⅴ型肩锁关节脱位的疗效。方法2001年3月-2003年12月,对12例肩锁关节脱位患者采用切开复位肩锁钩钢板内固定治疗,其中RockwoodⅢ型8例,Ⅳ型2例,Ⅴ型2例；脱位距就诊时间为2 h～5 d,平均2．5 d。结果术后10例获得3个月～2年随访,2例失访。术后肩锁关节位置恢复,肩关节外展上举活动范围达160°～170°,2例在举重物时肩锁关节有轻度的疼痛,1例肩关节外展80°时肩锁关节开始疼痛,患侧上肢肌力较健侧稍减弱。肩关节功能按Constant标准评定为86～96分,平均92分。结论肩锁钩钢板内固定可恢复肩锁关节的解剖位置和微动特性,是治疗重度肩锁关节脱位的良好术式。     

蛋白质组学及其在前列腺癌研究中的应用

随着蛋白质组学技术的发展,越来越多的肿瘤标记物被发现,并逐渐应用于临床,这将为肿瘤的早期诊断和预后监测提供可靠的依据。现综述蛋白质组学的研究策略及其在前列腺癌研究中的应用。     

湘中地区50～59岁女性农民400人心血管功能测定

目的:观察体质监测身体功能指标——血压、肺活量/体质量、安静脉搏、台阶指数,了解经济不发达地区女性农民心血管功能现状。方法:于2004-07/08采用随机整群抽样的方法,在湘中地区4个县(市)中随机抽取50～54岁和55～59岁女性农民共400人作为研究对象,用体质测量仪对反映心血管功能的指标进行测定,包括血压、肺活量、安静脉搏、台阶指数。并将所获数据分别与全国同龄女性农民及湖南省城市体力、非体力劳动人群心血管功能指标进行差异性比较。测试同时对测试对象进行询问访谈,内容包括生活环境和经济收入、劳动生活方式、饮食营养习惯、体育锻炼现状、疾病情况等。要求测试者根据自己的实际情况如实回答。结果:400人均完成指标测试,全部进入结果分析。①湘中女性农民50～54岁高血压患病率为31.09%,55～59岁为40.13%,以1级、2级高血压为主。55～59岁年龄组,湘中女性农民收缩压和舒张压均高于全国农民及省内城市人群(P<0.05)。两年龄组比较,55～59岁年龄组高于50～54岁年龄组。②湘中55～59岁女性农民肺活量/体质量低于湖南省城市体力、非体力劳动人群(P<0.01,0.05)。③湘中50～54岁女性农民安静心率高于湖南省城市非体力人群(P<0.01)。④湘中55～59岁女性农民台阶指数低于湖南省城市体力劳动人群(P<0.05)。⑤湘中女性农民的心血管功能受体育锻炼、饮食习惯、经济等因素的影响。结论:湘中地区50～59岁女性农民心血管功能整体低于全国农民和湖南城市体力、非体力人群。影响湘中女性农民身体功能的主要因素有缺乏体育锻炼、饮食习惯、落后经济等因素。     

中药膳食配合运动干预对肥胖性脂肪肝的影响

目的 探讨中药膳食配合运动干预对肥胖性脂肪肝的影响。方法 将68例脂肪肝患者随机分为对照组和观察组各34例。对照组常规给予低脂饮食和易善复、大黄庶虫丸等降酶保肝治疗；观察组按常规方法治疗外，采用中医辨证施食予以活血化淤、健脾利湿的中药膳食疗法配合运动干预．疗程均为1年。结果 治疗后观察组体重、甘油三酯、总胆固醇、谷丙转氨酶等显著低于对照组（均P〈0．01）。结论 中药膳食配合运动干预对肥胖性脂肪肝疗效显著。