吸入麻醉药对人血浆和血小板血栓素B2生成与血小板聚集的影响

目的：探讨吸入麻醉剂氟烷、安氟醚和异氟醚对人血浆血栓素Ｂ２（ＴＸＢ２），血小板ＴＸＢ２生成与血小板聚集的影响。方法：血浆ＴＸＢ２和血小板ＴＸＢ２的生成量用放免分析法测量，血小板聚集率用比浊法测量。结果：吸入１ＭＡＣ氟烷３０分钟后，血浆ＴＸＢ２浓度、二磷酸腺苷（ＡＤＰ）和肾上腺素（Ｅ）诱导的血小板ＴＸＢ２生成量与血小板聚集率显著下降，吸入１ＭＡＣ安氟醚３０分钟后，血浆ＴＸＢ２浓度和血小板ＴＸＢ２生成量与血小板聚集率亦显著下降，其降低的程度比氟烷轻。吸入１ＭＡＣ异氟醚对上述指标无明显影响。血小板ＴＸＢ２生成的减少与血小板聚集率的下降呈显著正相关。结论：氟烷显著抑制血小板聚集，安氟醚次之，异氟醚对血小板聚集无明显影响。其机制可能与氟烷和安氟醚通过抑制血小板上血栓素Ａ２受体的亲和力，降低ＡＤＰ和Ｅ诱导的血小板ＴＸＢ２的生成有关。     

支气管肺泡灌洗液、血清、尿液中CEA测定对肺癌诊断价值的研究

应用放射免疫方法联合检测支气管肺泡灌洗液(BALF)、血清、尿液中癌胚抗原(CEA)含量,结果显示:肺癌患者BALF、血清、尿液中CEA均有不同程度的升高,与结核及肺良性疾病组间有显著差异(P<0.01)。其阳性率分别为63.64％,57.38％,27.58％,以BALF阳性率为最高,这对肺癌的诊断及判断预后提供了方便可行的检测手段。     

Prof. Shan Zhaowei＇s Experience in Treating Atrophic Gastritis

Prof. Shan Zhaowei （ 单兆伟 ）, the author＇s teacher, has been engaged in TCM for more than 30 years, with profound knowledge in the treatment of diseases of the spleen and stomach, which are introduced in the following.     

The prevalence of LRRK2 Gly2385Arg variant in Chinese Han population with Parkinson's disease.

We conducted a case-control study to determine the prevalence of the LRRK2 Gly2385Arg variant in patients with Parkinson's disease in Han population in mainland China. Heterozygous LRRK2 Gly2385Arg variant was identified in 14 of 235 patients with Parkinson's disease (5.69%), but not in 214 unrelated healthy controls. Multivariate analysis indicated the frequency of Gly2385Arg variant in the female patients with early age at onset is higher than their male counterparts. The founder haplotype analysis showed the variant carriers shared the same founder. Clinically, the LRRK2 Gly2385Arg carriers presented with classical Parkinson's disease symptoms. Our study indicates that the LRRK2 Gly2385Arg variant is a potential ethnic-specific genetic risk factor of Parkinson's disease within Chinese Han ethnicity.     

Role of mast cells and monoamines in the thrombocytopaenia and mortality elicited by tumour necrosis factor in mice.

We explored the thrombocytopaenia elicited by the i.v. injection of mouse recombinant tumour necrosis factor (TNF) in mice. Injection of 10 micrograms of TNF led to a thrombocytopaenia (evident after 0.5 hr) which was caused by decreased platelet survival, as seen by the injection of labelled platelets. TNF-induced thrombocytopaenia was not prevented by heparin, nor by depletion of either fibrinogen or C'. TNF-induced thrombocytopaenia was markedly attenuated in mice treated with reserpine, an agent that depletes monoamines from mast cells and other cells, and in the mast-cell-deficient WWv mice. In vitro, TNF elicited a modest release of monoamine from peritoneal mast cells and from a mast cell line. When mice are injected with 3H-serotonin (3H-5HT) before TNF, TNF injection increased the plasma 3H-5HT content 1 hr later, modifications absent in reserpine pretreated or mast-cell-deficient mice. 3H-5HT content of the small intestine was markedly depleted in TNF-injected mice, suggesting that this organ is the source of the plasma 3H-5HT. Drop in body temperature and mortality induced by TNF were also attenuated in mast-cell-deficient, and in reserpine pretreated mice. These results indicate that TNF can induce a release of monoamines from mast cells, mainly from those of the small intestine, a process that contributes to TNF-induced thrombocytopaenia and mortality.     

后颅凹成血管细胞瘤的影像学特点及其诊断

目的：探讨成血管细胞瘤的影像学特点。材料与方法：报道１４例成血管细胞瘤的ＣＴ和ＭＲＩ所见，分析肿瘤的特点。结果：囊性肿瘤，在ＭＲＩ上表现为囊性病灶和附壁肿瘤结节；在ＣＴ上表现为该典型征象占８１．８％。混合性肿瘤３例，在ＣＴ和ＭＲＩ上表现实质性肿块、偏心性囊变和均一显著强化；后者还可见肿瘤旁和肿瘤内血管流空。结论：ＣＴ和ＭＲＩ均是诊断成血管细胞瘤的有效检查方法。成血管细胞瘤的特征性影像学表现是囊肿和突入囊内的壁结节，以及肿瘤的异常显著增强     

城市社区医疗预防保健人员知识与技能的需求调查

通过对405名城市基层医疗预防保健人员的知识和技能的需求调查看出,面对医学模式的转变,社区居民医疗预防保健需求的不断增长,他们现有的知识和技能已极不适应。2/3以上的人员认为以往所学的知识不够用,较普遍地要求增加预防医学、临床医学等课程的学习,提高疾病诊断、群众工作、组织交往、科研的能力。调查为基层在职医学教育提供了参考依据。     

更新护理观念 促进护理学科发展

随着新的医学模式的确立，护理学科的核心思想已从以疾病为中心的功能护理逐步发展为以病人为中心的整体护理阶段。其内涵：把病与病人，反生物学的病人与社会和心理学的人，把病人与其所处的环境，把病人从入院－出院－康复都作为一个整体，目前，我国护理工作主体仍处于以疾病为中心的护理思考指导下的功能制护理，局限了护理学科的发展，近年来，我国护理界引进了整体护理，并将其思想应用于临床护理工作中，进行了多方位探讨，旨     

吉林省38所医院护理工作抽查情况分析

吉林省第一周期的医院评审工作基本结束,为了巩固成果,防止滑坡,吉林省医院评审委员会多次组织专家对38所二三级甲乙等医院护理工作进行现场抽查。对吉林省护理工作的概况及抽查中发现的共性问题进行了分析。同时建议:加强护理人员的职业道德教育;解决护理人员编制不足问题;提高护理人员技术劳务价值;运用激励手段提高护理工作质量。     

江汉平原鼠间流行性出血热感染研究

为了解湖北省江汉平原流行性出血热（ＥＨＦ）疫区鼠间感染状况，采用挖洞法捕鼠，鉴定鼠种、性别和年龄，检查有无皮肤破伤，检测ＥＨＦＶ抗原抗体。结果，黑线姬鼠和褐家鼠占所捕鼠的６９．７％和２３．６％，其ＥＨＦＶ感染率分别为２１．８％和３０．９％。鼠间ＥＨＦＶ感染，成年鼠显著高于亚成年鼠和幼年鼠，感染率分别为４０．８％、１７．０％和１２．４％；皮肤破伤鼠感染率４５．９％，显著高于非皮肤破伤鼠的１３．９％。感染鼠以窝为单位具有明显的窝聚集性，而感染鼠窝在地理空间上则随机分布。感染鼠血清分型，黑线姬鼠以野鼠型为主，少数为未定型；褐家鼠以家鼠型为主，亦有少数未定型。这表明，江汉平原ＥＨＦ疫区是以黑线姬鼠和褐家鼠为主要宿主动物的家野混合型疫区；年龄、皮肤破伤和密切接触是该疫区鼠间ＥＨＦＶ传播的重要因素。