Improvements in retention rates and changes in client group with methadone maintenance streaming

This study evaluated changes in client population and in retention rates following the introduction of a system of methadone maintenance streaming. A low intervention and low supervision stream was combined with two abstinence-orientated streams. Privileges of take-home doses and local pharmacy dose collection were contingent on successful participation in the abstinence-orientated streams. The clinic also modified policy to allow clients greater control over dose levels. The case notes of the first 100 clients entering the programme in the year prior to the changes (1991) and in the year following the changes (1993) were compared. The results showed a significant increase in retention rates. The demographic and heroin using histories did not change, but the newer programme attracted a greater proportion of clients with no previous history of methadone maintenance treatment. Mean clinic dose increased from 45 mg to 63 mg when clients were allowed to exert control over dose. These findings reveal improved outcomes in a public methadone maintenance programme as a result of policy changes designed to give clients greater control of their treatment.     

Is the retractile testis a normal,physiological variant or an anomaly that requires active treatment?

Conventional teaching states that the retractile testis is a normal, physiological variant that descends spontaneously by puberty and requires no active treatment. Critical review of the literature, however, suggests that this complacent view may be inappropriate. Substantial overlap exists between the three seemingly separate entities of the late descending, the ascending and the retractile testes. This overlapping group probably accounts for the recently observed increased incidence of orchidopexies. Retractile testes that spend most of the time in an extrascrotal position are subject to the same adverse effects of higher temperatures as true undescended testes, regardless of whether they can be manipulated into the scrotum; what matters is where they actually reside most of the time. The evidence suggests that such retractile testes suffer similar pathological changes to true undescended testes if left to await spontaneous descent. Evidence is presented to support a radical, novel proposal that the retractile testis is a variant of the spectrum of pathological maldescended testes and requires active treatment. A new strategy is proposed for the management of this common pathology. Correspondence to: D. W. Goh     

金钗石斛光合作用特征的初步研究

利用LiCor-6400光合测定系统测定了不同天气条件下，金钗石斛叶片24hCO2吸收的动态变化，以及CO2吸收对有效光合辐射的响应。结果表明：晴天，白天和夜间金钗石斛都能吸收CO2，中午有光下呼吸现象，CO2的交换方式具景天酸代谢途径（CAM）的特点；阴雨天，中午没有光下呼吸现象，白天都在吸收CO2，夜间21：00仍有CO2吸收，23：00以后至次日凌晨处于暗呼吸状态。金钗石斛叶片CO2吸收对光照强度的效应表现出强光抑制现象，饱和光照强度为1000μmol/m^2s。叶片受到强光照射后，光合饱和点降低，CO2吸收速率下降，说明金钗石现象，饱和光照强度为1000μmol/m^2s。叶片受到强光照射后，光合饱和点降低，CO2吸收速率下降。说明金钗石斛是兼性景天酸代谢植物，随着环境条件变化，光合作用可在CAM途径与C3途径间变化，这一光合特性可能是金钗石斛适应需荫环境和生物缓慢，稀少的主要原因之一。     

荆州市乡村卫生室用药情况调查分析

目的：调查分析荆州市乡村卫生室用药情况，为有关部门制定农村医疗卫生政策提供依据。方法：抽样调查荆州市72个乡村卫生室1999—2000年用药情况，采用Microsoft Access2000及Microsoft Excel2000对调查结果进行数据录入、整理和统计处理。结果：荆州市农村用药处于较低水平，2000-1999年用量有一定增长。用药品种以国家基本药物为主，使用率较高的药物主要为抗感染药、解热镇痛抗炎抗痛风药、维生素、消化系统药、呼吸系统药等。结论：荆州市乡村卫生室药物应用基本合理。农村合作医疗政策是切实可行的。     

反复流产患者的中医护理对策

目的 :探讨结合现代护理观为指导的具有中医特色的整体护理模式。方法 :运用中医基础理论知识 ,针对引起反复流产患者的病因 ,将患者主要分为内分泌异常型、免疫异常型、生殖道异常型、感染型、全身性疾病影响型、染色体异常型施以护理。结果 :依据不同证型 ,有的放矢的实施护理 ,使患者明确了引起反复流产的根本原因、治疗措施、注意事项、预防保健方法 ,消除了紧张、恐惧、焦虑等心理障碍 ,树立了再次妊娠的信心 ,提高了妊娠成功率     

15例甲状腺间变癌临床病理及免疫组化分析

[目的]探讨甲状腺间变癌的临床病理特征和免疫组化结果的意义。[方法]光镜观察和免疫组织化学SP法检测15例甲状腺间变癌。[结果]甲状腺间变癌的病理分型为梭形细胞型、巨细胞型和混合细胞型。15例中免疫组化阳性表达率分别是：Vimentin86．6％(13／15)、CK73．3％(11/15)、CEA60．0％(9／15），CD68 6．6％(1/15)；TG和降钙素均为阴性。2例伴有乳头状癌其中Vimentin和CK均阳性；1例伴破骨样巨细胞CD68阳性。[结论]甲状腺间变癌是上皮源性、恶性度高的肿瘤。熟悉其形态特征．结合免疫组化对诊断甲状腺间变癌具有重要意义。     

中医诊断的特色和优势

通过与西医诊断相比较,对中医诊断的原理与思维特点、辨证的优点与不足、辨证与辨病的结合、中医诊断研究的现状与展望等问题进行了论述,从中阐明了中医诊断的特色与优势。     

川白芷与公白芷的形态组织学对比鉴定

为配合川白芷规范化种植（GAP）的研究，作者采用常规生药学鉴定的方法，对川白芷和公白芷进行了形态组织学的对比鉴定，找出了它们在药材性状和显微特征上的主要区别，为防止商品川白芷中混入公白芷提供鉴别依据。     

卵巢上皮性癌BRCA1和p53基因表达的临床意义及相互关系研究

目的：探讨BRCA1、p53基因蛋白在卵巢上皮性癌中的表达情况及相互关系。方法：应用S-P免疫组织化学法检测50例卵巢上皮性癌组织中BRCA1和p53蛋白的表达。采用Kaplan—Meier法分析两种蛋白表达情况与患者预后的关系。结果：1)BRCA1蛋白在卵巢癌组织中的阳性表达率仅为30％，明显低于正常卵巢组织(100％)和良性肿瘤组织(90％)(P＜0．01)；BRCA1在低分化癌、有淋巴结转移的卵巢癌组织中表达减少甚至缺失。2)p53蛋白在卵巢癌组织中的表达率为64％，而在正常卵巢及良性肿瘤组织中无表达；其表达仅与病理学分级有关。3)两种基因蛋白表达比较呈显著负相关(P＜0．01)。4)患者生存随访表明，有BRCA1表达的患者平均生存期长于无表达者；而p53对生存时间无影响。结论：BRCA1基因在转录后水平的下调对卵巢上皮性癌的发生发展有重要的作用．同时BRCA1基因与p53基因协同促进肿瘤的演进恶化。