Syndecan-1和E-candherin在声门上型喉鳞状细胞癌中的表达及意义

目的：探讨Syndecan—1和E—candherin两种黏附分子在声门上型喉鳞状细胞癌中的表达情况及与喉癌生物学行为之间的关系。方法：应用SP免疫组织化学法检测了38例声门上型喉鳞状细胞癌和7例喉黏膜慢性炎症组织中的Syndecan-1和E—candherin的表达并根据阳性瘤细胞占肿瘤细胞总数的比率进行半定量分析和统计检验。结果：Syndecan-1和E—candherin的阳性染色部位主要集中于细胞膜，E—candherin也可表达于细胞间质。Syndecan-1和E-candherin在恶性程度高的癌细胞上膜表达明显缺失，并与组织学分化、肿瘤大小密切相关。Syndecan-1和E-candherin在喉鳞状细胞癌细胞上的表达结果有相关性，但无敏感性差异。结论：Syndecan-1和E-candherin的表达可能在声门上型喉鳞状细胞癌的发生发展等生物学行为中起着重要的作用。     

Association of low caregiver health literacy with reported use of nonstandardized dosing instruments and lack of knowledge of weight-based dosing.

OBJECTIVE: Caregivers of young children frequently measure doses of liquid medications incorrectly. Use of nonstandardized dosing instruments and lack of knowledge that dosing is weight-based contribute to dosing errors. We sought to assess whether low caregiver health literacy was associated with these outcomes. METHODS: This was a cross-sectional analysis of caregivers presenting to an urban pediatric emergency room. Dependent variables were caregiver reported use of nonstandardized dosing tools and knowledge of weight-based dosing. The independent variable was caregiver health literacy (Test of Functional Health Literacy in Adults [TOFHLA]). RESULTS: Two hundred ninety-two caregivers were assessed: 23.3% reported use of nonstandardized liquid dosing instruments, and 67.8% were unaware of weight-based dosing. Caregivers who were unaware of weight-based dosing were more likely to use nonstandardized dosing tools (28.3% vs 12.8%; P = .003). In unadjusted analyses, overall health literacy, reading comprehension, and numeracy were all associated with both dependent variables. In analyses adjusting for child age, health care experiences, and caregiver acculturation and education, inadequate/marginal overall health literacy was associated with lack of knowledge of weight-based dosing (adjusted odds ratio [AOR] 2.3; P = .03), whereas lower reading comprehension was associated with both lack of knowledge (AOR 2.0; P = .03) and reported use of nonstandardized instrument (AOR 2.4; P = .007). CONCLUSIONS: Low health literacy, in particular reading comprehension, was associated with reported use of nonstandardized dosing instruments and lack of knowledge regarding weight-based dosing. Both caregiver health literacy and sociodemographic factors should be considered in the design of interventions to prevent medication administration errors.     

从民间祭奠到精神分析-关于丧失后哀伤的过程

人的成长过程中伴随着各种丧失。避免这种丧失的重要途径就是要通过哀伤。对于重要的客体丧失，如亲人的去世，不同的民族与文化有着不同的固定的祭奠仪式，文中简介了当今中国城市丧葬祭奠礼仪方式。透过这一仪式可以看到，祭奠仪式有着重要的心理动力学意义，表现为：1）通过固定的仪式，提供了一个特定的时间和空间，完成与丧失的客体的分离；2）众人聚集得以分享和获得支持，也是为了社区的一种对丧失与死亡的修通；3）所致悼词和个人对死者的哭诉，个体的冲突和痛苦用社会和文化可以接受的方式得以表达；4）清明节的祭扫，是一种有规律性的看望，也是和与过去、和失去的亲人的一种连接方式。精神分析与世俗的悼念仪式有着类似的心理功能，而它为丧失者提供了特别的哀伤过程：1）帮助丧失者进行现实检验，面对真实的丧失；2）提供诉说的时空．完成与旧的客体的分离；3）稳定的设置和长程的治疗，使精神分析师成为丧失的分享者和丧失者的陪伴者；4）最重要的是精神分析通过移情使丧失者与新的客体建立了联系，而且是新的联系和新的体验。     

In vitro evaluation of ablation parameters of normal and fibrous aorta using smooth excimer laser coronary angioplasty

A modified exeimer laser energy delivery system was used to irradiate 100 segments of normal and fibrous aorta in vitro. The laser beam was scanned into 8 fiber bundles consisting of 50 fibers each resulting in a reduction of the applied pulse energy. The total repetition rate was increased to 150 Hz in order to keep the repetition rate per fiber bundle close to 20 Hz and to minimize thermal injury. The results demonstrate that effective ablation (etch rate per 8 pulses > 2.0 μm) occurred at an energy fluency of 50 mJ/mm² in both normal and fibrous aorta. Tissue damage (carbonization, tissue separation, fissures, cracks, and vacuolization) was in a range of 100 ± 28 to 152 ± 30 μm for normal aorta and in a range of 57 ± 35 to 110 ± 39 μm for fibrous aorta. We conclude that effective ablation of normal and fibrous human aorta can be achieved by the application of smooth excimer laser coronary angioplasty. This improvement of excimer laser technology may result in a reduction of shock wave- and cavitation-induced damage leading to a reduction of tissue injury. However, this awaits further in vitro and in vivo confirmation. © 1993 Wiley-Liss, Inc.     

肿瘤患者医院感染的分析与预防措施

目的了解肿瘤科医院感染特点,为临床减少肿瘤患者感染提供参考信息。方法以主动监测与系统回顾相结合的方法,对2005年全年入住肿瘤科2 679例患者的临床资料进行统计、分析、评定。结果2 679例肿瘤患者发生医院感染120例次,医院例次感染率为4.47%,其中感染1次者179例、2次者31例、≥3次者10例;以呼吸道感染占首位,其中上呼吸道38例、下呼吸道36例,其次为消化道10例、血液9例、手术切口感染8例、泌尿道6例和其他部位感染13例。结论提高机体免疫力、控制内源性感染,是预防与控制肿瘤患者感染的主要措施。     

Anatomic and spiral computed tomographic study of the genial tubercles for genioglossus advancement.

OBJECTIVE: To measure and compare Chinese mandibular genial tubercles measured anatomically and with computed tomography (CT). STUDY DESIGN AND SETTING: Spiral CT scans were taken of 40 adult human skulls; the superior genial spines were measured using anatomic and CT methods. RESULTS: The height and width of the superior genial spines, mandible thickness, and distance from the menton to the inferior and superior margins of the superior genial spines were 5.82 +/- 0.71, 6.98 +/- 1.35, 11.95 +/- 1.59, 11.08 +/- 2.05, and 16.91 +/- 2.30 mm from anatomic measurements and 6.17 +/- 0.71, 7.01 +/- 1.13, 12.19 +/- 1.64, 10.41 +/- 1.55, and 15.73 +/- 2.12 mm using spiral CT, respectively. The anatomic and CT measurements were correlated. CONCLUSION: Spiral CT of the genial tubercles can help locate the osteotomy in genioglossus advancement. SIGNIFICANCE: This study acquired reference data on Chinese genial tubercles demonstrating that CT measurements of the genial tubercles reflect their anatomy, which should allow accurately locate the osteotomy.     

Excretion of 1,2,4-benzenetriol in the urine of workers exposed to benzene

Urine samples were collected from 152 workers (64 men, 88 women) who had been exposed to benzene, 53 workers (men only) exposed to a mixture of benzene and toluene, and 213 non-exposed controls (113 men, 100 women). The samples were analysed for 1,2,4-benzentriol (a minor metabolite of benzene) by high performance liquid chromatography. The time weighted average solvent exposure of each worker was monitored by diffusive sampling technique. The urinary concentration of 1,2,4-benzentriol related linearly to the intensity of exposure to benzene both in men and women among workers exposed to benzene, and was suppressed by toluene co-exposure among male workers exposed to a mixture of benzene and toluene. A cross sectional balance study in men at the end of the shift of a workday showed that only 0.47% of benzene absorbed will be excreted into urine as 1,2,4-benzenetriol, in close agreement with previous results in rabbits fed benzene. The concentration of 1,2,4-benzenetriol in urine was more closely related to the concentration of quinol than that of catechol. The fact that phenol and quinol, but not catechol, are precursors of 1,2,4-benzentriol in urine was further confirmed by the intraperitoneal injection of the three phenolic compounds to rats followed by urine analysis for 1,2,4-benzenetriol.     

α_2受体阻滞后肾上腺素诱导的心衰病人血小板的聚集功能

先前的研究表明血小板α_2受体变化表征交感神经突触前α_2受体的变化。为了解心衰病人血小板α_2受体功能状况,我们观察了10例Ⅲ、Ⅳ级心功能的心衰病人及10例配对正常人由肾上腺素诱导的血小板聚集率在α_2受体阻滞前后的变化。结果表明肾上腺素诱导的血小板聚集率在两组无显著性差异,但应用α_2阻滞剂Rauwolscine(0.25mg/L)后,0.25,0.5,1.0mg/L E诱导的心衰病人血小板聚集率显著低于对照组,提示血小板α_2受体在心衰时有数量的减少或(和)功能的降低,表征交感神经突触前NE释放的负反馈机制被抑制。