食管癌三维适形后程加速超分割放射治疗的疗效分析

目的评价三维适形后程加速超分割放射治疗食管癌的疗效及放疗反应、并发症。方法2002年2月至2004年5月,71例食管鳞癌随机分成两组,三维适形后程加速超分割组36例,食管病变上下外约4cm,前后、左右外约0.5~1cm作为PTV1,每次2GY,每周5次,DT40GY后,病变上下外约2cm,前后、左右外约0.5~1cm作为PTV2,每日2次,每次1.5GY,间隔4~6小时,总疗程6周,总剂量67GY/38次。非三维适形后程加速超分割组35例,时间、剂量、分割方式同适形组。所有病例均采用8MV-X外照射。结果1、2、3年的生存率和原发肿瘤的局控率,与非适形后程加速超分割比较,适形组明显提高,分别为88.9%、75%、63.9%比68.6%、51.4%、40%和86.1%、72.2%、58.3%比65.7%、48.5%、34.3%。适形组的急性放射反应明显低于非适形后程加速超分割组,两组有显著差别。结论本研究的初步结果表明食管癌适形后程加速超分割放射治疗的疗效优于非适形后程加速超分割组。     

早期应用无创性通气治疗老年Ⅱ型呼吸衰竭的护理

目的　探讨应用无创性通气治疗老年Ⅱ型呼吸衰竭的护理。方法　在常规治疗的同时 ,实验组与对照组分别应用无创通气和呼吸兴奋剂治疗 ,观察 2组患者治疗前、后、治疗间歇期动脉血气变化及康复例数。结果　实验组患者治疗后血气明显改善 (P <0 .0 1) ,康复例数明显多于对照组 (P <0 .0 1)。结论　应用无创通气可促进呼吸衰竭患者的康复 ,护士要加强对患者的心理支持 ,严密监测生命体征 ,保持呼吸道通畅 ,熟练掌握无创通气呼吸机的性能、使用方法 ,防止并发症     

移情对建立新型医患关系伦理模式的利与弊

在现代社会这样一个转轨时期，医患矛盾越来越突出，如何缓和医患关系、建立新型医患关系伦理模式成为大家共同关心的课题。作者从移情的角度入手，阐述了新型医患关系伦理模式的内涵，分析了移情对于缓和医患关系有哪些有利之处与不利之处，并提出了如何适度利用移情的方法，使其发挥最大作用。     

A comparative study of using comet assay and gammaH2AX foci formation in the detection of N-methyl-N'-nitro-N-nitrosoguanidine-induced DNA damage.

Comet assay is a useful technique in the detection of DNA damages, particularly DNA strand breaks; and it has been utilized to show that a potent carcinogen N-methyl-N'-nitro-N-nitrosoguanidine (MNNG), can induce such damages. Recently, gammaH2AX foci formation has been suggested as another sensitive way to detect DNA double strand breaks (DSBs). However, there is no systematic comparison being conducted to evaluate the consistency of these two methods. Using MNNG as a model chemical, the sensitivity of neutral comet assay and gammaH2AX foci formation in detecting MNNG-induced damage was studied. It was found that at concentrations of 0.1 and 1 microg/ml, both methods can detect MNNG-induced damage in human amnion FL cells. However, at 0.1 microg/ml, comet assay revealed more percentage of cells with DNA damage than gammaH2AX fluorescence revealed. On the other hand, while gammaH2AX foci were readily formed at very early times by 10 microg/ml MNNG treatment, neutral comet assay did not detect any significant DNA damage at the same time points. In addition, 10 microg/ml MNNG induced a distinct whole nuclei staining pattern of gammaH2AX, a type of DNA damage which was not detected by neutral comet assay but could be detected by alkaline comet assay. Therefore, gammaH2AX may be used as a sensitive indicator for DNA damage.     

交锁髓内钉治疗下肢长管状骨骨折的效果

①目的 探讨交锁髓内钉治疗下肢长管状骨骨折的效果。②方法 应用交锁髓内钉治疗下肢长管状骨骨折56例，随访8～26个月，观察治疗结果。③结果 56例病人术后对位、对线均满意，股骨骨折平均愈合时间为19．9周，胫骨骨折平均愈合时间为17．7周，2例延迟愈合。无主钉或锁钉断裂．无肢体短缩、功能障碍发生。④结论 交锁髓内钉是治疗下肢长管状骨骨折的一种理想、可靠的内固定方法，其疗效满意，值得临床推广应用。     

Expression of CⅡTA Gene in Five Human Malignant Hematological Cell Lines and Its Significance

The role of MHC class Ⅱ transactivator (CⅡTA) in constitutive or IFN-γ inducib|e expression of HLA molecules in human malignant hematological cell lines was investigated. The expression of HLA molecules and CⅡTA protein was detected by Western blot, immunohistochemistry and flow cytometry. The expression of CⅡTA gene was determined by RT-PCR. The capability of peripheral blood T cell reaction stimulated by tumor cells was monitored by mixed lymphocyte reaction. It was found that the HLA Ⅱ-positive tumor cells expressed the CⅡTA quite well, andthe expression of HLA Ⅰ＋Ⅱ was increased in the tumor cells with constitutive or inducible expression of CⅡTA after induced by IFN-γ. The tumor cells which did not express CⅡTA after in-duced by IFN-γ were not response to the expression of HLA Ⅱ promoted by IFN-γ. It suggests a correlation between the inability of some malignant hematological cell lines in response to IFN-γ for HLA expression and the deficiency in the inducible expression of CⅡTA, indicating CⅡTA might take part in the regu|ation of HLA Ⅰ＋Ⅱ expression in the tumor cells, which might p|ay an important role in tumor immunologic escape.     

Disseminating tumor cells and their interactions with leukocytes visualized in the brain.

Brain tumors are increasingly prevalent. Recent advances focus attention on individual, disseminated tumor cells that cannot be imaged or eliminated. Cells of the immune system may be ideally suited to attack individual tumor cells, but more basic understanding is needed. We describe a rat model, using the lacZ reporter gene, that allows identification of individual tumor cells, and tumor-leukocyte interactions in vivo. The model demonstrates how widely tumor can disseminate, without secondary tumorigenesis or recruitment of nonneoplastic cells. It demonstrates that leukocytes have access to disseminating tumor. Among its many applications, this work lays a foundation for developing cell-mediated immunotherapy against individual brain tumor cells.     

甲壳素涂层PGLA神经导管修复兔面神经缺损的实验研究

目的:探讨甲壳素涂层PGLA神经导管修复兔面神经缺损的效果。方法:成年雄性新西兰兔24只,无菌条件下切断双侧面神经下颊支,制成15mm的兔面神经下颊支缺损模型。左侧用甲壳素涂层聚丙交脂-乙交脂共聚物[poly(L-lactide-co-glycolide),PGLA]神经导管修复;右侧用翻转自体神经修复作为对照。术后5周、10周和14周行大体观察、电生理检查、组织学、电镜观察评价修复效果。结果:术后5周观察到神经导管中有新生轴索通过,再生神经发育不成熟;右侧自体神经修复近段有髓神经纤维均匀疏散分布,远段未见明显再生神经束形成。术后14周左侧再生神经已通过神经导管长入远端,电生理检查结果表明自体神经修复侧再生神经质量优于神经导管修复侧,差异有统计学意义(P<0.01)。自体神经修复再生纤维密度优于神经导管修复侧,差异有统计学意义(P<0.01),但自体神经修复侧近段神经髓鞘部分空泡样变性及脱髓鞘改变,远段再生神经纤维束形成少,面肌联带运动程度较导管修复侧严重。结论:甲壳素涂层PGLA神经导管能有效修复周围神经缺损,有望替代自体神经移植。     

基于实验均方误差F值的基因表达数据最佳聚类评判方法研究

目的 近年来产生了一些用于分析基因表达数据的聚类算法，却很少有关于评价聚类算法方法的研究。本研究的目的是尝试建立一个定量的评价基因表达数据聚类结果的方法。方法 本研究提供了一个系统的评价聚类结果的方法，利用我们提出的实验均方误差F值对几个常见的聚类算法进行比较。结果 利用F值对类质量的评价和利用已有的生物学知识对类进行分析的结果一致。结论 实验均方误差F值可以定量地评判用于基因表达数据的聚类算法。     

苯胺衍生物掺杂的PMMA薄膜的二次非线性光学性能的稳定性研究

具有A-π-D电子结构的苯胺衍生物掺杂的玻璃态高聚物PMMA的有机薄膜经极化取向后显示很强的二次非线性光学性能,其取向弛豫是实用化的一个有待解决的重要问题。木文通过几种苯胺衍生物以不同百分比与PMMA掺杂,用紫外-可见吸收光谱、二次谐波强度测量、动态力学粘弹谱等方法进行了取向弛豫的机理研究,结果表明分子尺寸和形状以及偶极矩的大小对取向弛豫有显著影响。