心理支持疗法对机械通气患者应激反应的影响

目的 观察心理支持疗法(PST)对ICU患者机械通气应激反应的影响。方法 将34例连续机械通气时间在20h的清醒患者，随机分为采用标准的PST方法进行治疗的观察组和对照组，观察焦虑抑郁程度和应激反应改变情况。结果 对照组患者的焦虑抑郁程度明显高于观察组，部分应激反应激素水平升高幅度也明显大于观察组。结论 PST可通过缓解机械通气患者的焦虑抑郁等不良情绪状态减轻机械通气带来的各种心身应激反应，有利于提高机械通气治疗的有效性和安全性。     

学龄前儿童的屈光异常与弱视调查

目的了解屈光检查在学龄前儿童弱视普查中的临床用途。方法应用日本尼康手提全自动检影仪对学龄前儿童进行小瞳孔验光,发现屈光有异常的儿童,再进一步进行散瞳检影验光。结果学龄前儿童屈光异常主要以远视散光和混合散光为主,近视与近视散光较少。学龄前儿童屈光异常的发病率是7.87%,弱视发病率为4.04%,接近全国其他同类报告(3.83%)。结论儿童弱视屈光普查优于视力普查,准确性高、效率高。     

rhBMP-2对不同培养时间骨髓基质干细胞成骨能力的影响

目的：探讨不同培养阶段骨髓基质干细胞成骨能力的变化及BMP-2对其成骨能力的影响。方法：培养兔骨髓基质干细胞，测定第3代和第18代细胞碱性磷酸酶及骨钙素活性；测定BMP-2对不同培养时间骨髓基质干细胞成骨能力的影响；测定rhBMP-2对细胞增殖的影响。结果：细胞传至第18代后，分泌的骨钙素（OC）水平及ALP活力明显降低，与第3代细胞相比，差异显著（P〈0．05）。第3代细胞在rhBMP-2的诱导下，分泌的OC水平及ALP活力在原基础上进一步升高，与对照组相比，差异显著（P〈0.05）。结第18代细胞在rhBMP-2的诱导下，分泌的OC水平及ALP活力在原基础上升高，与对照组相比，差异不显著（P〉0．05）；随培养时间的延长，各组细胞数量均有所增加，rhBMP-2诱导组与对照组细胞无显著性差异（P〉0．05）。细胞的传代次数对细胞增殖无明显影响（P〉0．05）。结论：rhBMP-2对细胞增殖无影响。随着传代次数的增加，骨髓基质干细胞的成骨能力下降，rhBMP-2促进其成骨的能力亦下降。     

Genome-wide scan identified QTLs underlying femoral neck cross-sectional geometry that are novel studied risk factors of osteoporosis.

A genome-wide screen was conducted using a large white sample to identify QTLs for FNCS geometry. We found significant linkage of FNCS parameters to 20q12 and Xq25, plus significant epistatic interactions and sex-specific QTLs influencing FNCS geometry variation. INTRODUCTION: Bone geometry, a highly heritable trait, is a critical component of bone strength that significantly determines osteoporotic fracture risk. Specifically, femoral neck cross-sectional (FNCS) geometry is significantly associated with hip fracture risk as well as genetic factors. However, genetic research in this respect is still in its infancy. MATERIALS AND METHODS: To identify the underlying genomic regions influencing FNCS variables, we performed a remarkably large-scale whole genome linkage scan involving 3998 individuals from 434 pedigrees for four FNCS geometry parameters, namely buckling ratio (BR), cross-sectional area (CSA), cortical thickness (CT), and section modulus (Z). The major statistical approach adopted is the variance component method implemented in SOLAR. RESULTS: Significant linkage evidence (threshold LOD = 3.72 after correction for tests of multiple phenotypes) was found in the regions of 20q12 and Xq25 for CT (LOD = 4.28 and 3.90, respectively). We also identified eight suggestive linkage signals (threshold LOD = 2.31 after correction for multiple tests) for the respective geometry traits. The above findings were supported by principal component linkage analysis. Of them, 20q12 was of particular interest because it was linked to multiple FNCS geometry traits and significantly interacted with five other genomic loci to influence CSA variation. The effects of 20q12 on FNCS geometry were present in both male and female subgroups. Subgroup analysis also revealed the presence of sex-specific quantitative trait loci (QTLs) for FNCS traits in the regions such as 2p14, 3q26, 7q21 and 15q21. CONCLUSIONS: Our findings laid a foundation for further replication and fine-mapping studies as well as for positional and functional candidate gene studies, aiming at eventually finding the causal genetic variants and hidden mechanisms concerning FNCS geometry variation and the associated hip fractures.     

功能性消化不良的突出症状与临床特征及病理生理学机制的关系

背景与目的：功能性消化不良（FD）被认为是一类由不同病理生理原因导致的多种机能紊乱而促发的症状。Rome Ⅱ委员会建议将具有同种病理生理学及临床特征的FD患划分为感觉明显疼痛组和感觉不适组两个亚组。该研究旨在分析显疼痛或感觉不适与病理生理学机制间的关系，评价是否考虑到个体的显性症状将会产生更好的结果。方法：持续性FD患（n=720；489例女性；年龄41．3±0．6岁）填写消化不良调查问卷并确定出最令人烦恼的症状。分析此显症状在人口统计学、临床、病理生理学特点上的相互联系（研究592例患幽门螺杆菌感染、胃排空情况，对332例患行胃敏感性、顺应性试验）。结果：根据Rome Ⅱ标准，22％疼痛明显，78％不适感明显。疼痛明显的患超敏性的发生率较高（44％ vs 25％），且在这些病例中观察到的胃排空迟缓较少出现（16％ vs 26％），但是有较多的重叠。详细分析表明可能有8种消化不良症状其中之一较为突出。     

腹腔镜治疗肾盂旁囊肿10例

目的探讨腹腔镜治疗肾盂旁囊肿的可行性。方法回顾分析2003年10月-2005年3月，10例肾盂旁囊肿行后腹腔镜肾囊肿开窗术。结果10例手术均成功。手术时间40-60min，平均55min。10例随访3～24个月，平均12．8月。无复发。结论腹腔镜治疗肾盂旁囊肿安全、可行。     

Dynamic observation on thyroid function in severe head injury.

The dynamic changes of thyroid hormone levels in patients with severe head injury were observed. The results showed that the serum thyroid hormone levels changed rapidly within several hours after the injury and the mean levels of serum total T3 and T4 (TT3, TT4) decreased while high reverse triiodothyronine (rT3) increased significantly. Serum TT3, TT4 and rT3 levels returned to normal gradually in 2 to 3 weeks after the injury in the surviving group, whereas serum total T4 gradually declined and rT3 steadily increased in the fatal group. The mean levels of serum TSH remained unchanged in both groups. Therefore, the use of the levels of serum thyroid hormones as adjuvant indices can be helpful in making pertinent judgements of the severity and prognosis of severe head injuries.

     

不同婴儿食品铝含量的测定

本文应用原子吸收光谱法测定母乳、牛奶、奶粉及不同喂养方式婴儿血清中锌、铜、铁及铝含量。母乳中锌、铜、铁含量均较牛奶丰富，铝含量低于牛奶；奶粉中锌、铜、铁含量高于牛奶，与母乳无显著差异，铝含量高于牛奶。母乳、牛奶及奶粉喂养的贫血患儿血清铝含量无显著差异，均明显低于铝中毒的血清铝水平。     

自制与进口氯化十六烷基吡啶抑菌作用的比较研究

以液体稀释法比较了自制与进口十六烷基吡啶作用于4种口腔常见微生物的最低抑菌浓度和最低杀菌浓度的实验结果,经t检验证明两者间无显著差异,提示自制氯化十六烷基吡啶的药效质量可靠。并就控制接种菌量及杀菌机理等问题作了初步探讨。