卵巢上皮癌的雌激素产生与预后

本文用免疫组织化学方法（ＡＢＣ法）对随访的４８例绝经后卵巢上皮癌患者的癌组织进行雌二醇（Ｅ２）的免疫组化检测。结果显示：４８例卵巢上皮癌中，有３３例Ｅ２染色阳性。Ｅ２阳性组术后５年生存率为５８％（１９／３３），Ｅ２阴性组术后５年生存率为２７％（４／１５），有显著性差异。提示Ｅ２阳性的卵巢上皮癌预后较好，５年生存率高，Ｅ２检测可作为卵巢上皮癌预后估计的指标之一。     

Disruption of selective attention by apomorphine,but not amphetamine,in the mongolian gerbil

To test the hypothesis that apomorphine, but not amphetamine, disrupts selective attention to a novel stimulus, gerbils were exposed to a novel object for one 60-s trial following an injection of 0, 1, 3, or 6 mg/kg d-amphetamine base, or 0, 0.1, 0.3, 1, 3, or 10 mg/kg apomorphine HClSC. They were tested the next day for habituation to the stimulus. As a control, half of each group of gerbils were injected but not exposed to the object on day 1. All non-exposed gerbils and all exposed gerbils that received amphetamine showed a decrement in investigation, indicative of habituation, on day 2. Furthermore, a gradient of responding during dishabituation was obtained from gerbils given d-amphetamine (1 mg/kg) which was dependent on the distance a novel object was moved, indicating a perception of location as occurs in normal gerbils. In contrast, those exposed gerbils that received 1 mg/kg or more of apomorphine did not show habituation on day 2. That the disruption of habituation by apomorphine was due to a failure of input rather than of retrieving the information was demonstrated in an experiment in which two groups of gerbils were habituated to a novel object prior to injection with apomorphine (1 mg/kg) or saline. Both groups continued to show habituation on subsequent trials and increased responding when the object was moved. Thus, the motor capabilities necessary for investigation were functional. When gerbils that received apomorphine were pretreated with the dopamine receptor blocker pimozide, habituation occurred on day 2, suggesting that the disruption of habituation was mediated by dopamine. On the other hand, the depressant effect of large doses of apomorphine on initial investigation was not blocked completely by pimozide.     

人孕中期胎儿结膜上皮干细胞定位特征的免疫组化研究

目的研究孕中期不同胎龄胎儿结膜上皮细胞中,角蛋白7、14、19p63和增殖细胞核抗原(PCNA)的表达及分布情况,探讨人胎儿结膜上皮干细胞的定位特征。方法取正常引产6h内的孕中期不同胎龄胎儿眼球前部组织,采用HE、免疫组化染色法,观察角蛋白p63和PCNA的表达及分布情况。结果PCNA及p63表达情况一致,主要表达在睑缘皮肤黏膜交界处及角膜缘上皮深层细胞。角蛋白19主要表达在穹窿部及球结膜上皮细胞。角蛋白14表达在睑缘皮肤黏膜交界处及睑结膜上皮细胞。角蛋白7表达在穹隆部至角膜缘上皮细胞。结论细胞角蛋白7、14、19和p63及PCNA在人孕中期不同胎龄的胎儿结膜上皮细胞的特征性表达表明,人孕中期胎儿结膜上皮细胞普遍具有增殖的活性,干细胞位于睑缘皮肤黏膜交界处和角膜缘上皮细胞的深层。     

食道癌精确放疗的临床应用及影像学表现

目的分析T2000-ROT食道癌精确定位系统的临床应用及放疗后的影像学改变。方法采用带有N形标记柱的体部框架，内加真空负压垫。对病人身体进行固定和重复固定，服稀钡或泛影葡胺造影后，以3mm或5mm层厚进行CT断层扫描，将病人图像数据传输到3DTPS，通过CT图像信息以及标记点，计算出肿瘤的三维坐标。根据现有的长方形旋转照射野剂量模型，计算某一照射方案下体模中任意一点的剂量值及横断面上的等剂量分布。利用直线加速器对病人实施治疗。结果利用该系统治疗160例经DR或CT确诊并经病理证实为食道癌病人，有效研究病例114例，治疗后1年和3年局部控制率为96．5％和86．8％；经CT或DR检查病变消失，食道恢复正常者分别为75％和75．4％，管壁显示僵硬、蠕动减弱者为22．5％和11．4％；局部复发为2．5％和13．2％。结论T2000-ROT食道癌精确放疗系统，定位精确，能够使高剂量区均匀准确分布于病灶及亚临床灶区，杀灭肿瘤病灶，使食道恢复正常形态和功能，有效提高局部控制率。     

构建"证素辨证"新体系的意义

阐述了中医辨证论治的优势及存在的问题,提出了“证素”的概念,包括病位证素和病性证素,以及证素辨证新体系的内容,指出该体系对发展中医学的重要意义。     

Trends in private dental service provision in major city and other Australian locations

OBJECTIVE: To investigate time trends in dental service provision by location. DESIGN: Five cross-sectional surveys across a 20-year period. SETTING: Australian private general dental practice. PARTICIPANTS: A random sample of dentists. METHODS: Mailed questionnaires were collected in 1983, 1988, 1993, 1998 and 2003 (response rates 71-76%). MAIN OUTCOME MEASURES: Annual services per dentist. RESULTS: Decreases in the provision of restorative services, and increases in diagnostic and preventive services, occurred in major city locations but not in other locations. While decreases over time were observed in extraction rates in both major city and other locations, higher extraction rates persisted outside of major city locations. Denture and endodontic services fluctuated over time in both major city and other locations, with no difference by location observed in 2003-2004. No changes over time were observed for crown and bridge services, but crown and bridge services remained higher in major city compared with other locations in 2003-2004. CONCLUSIONS: While the overall content of dentist workloads has changed to include less emphasis on removal and replacement of teeth and more effort on diagnosis and prevention aimed at retention of natural dentitions, a gap by location remains, with dentist workloads outside of major city locations marked by higher rates of tooth extraction and lower rates of preventive services.     

Association of dry eye disease and sun exposure in geographically diverse adult (≥40 years) populations of India: The SEED (sun exposure,environment and dry eye disease) study - Second report of the ICMR-EYE SEE study group

PurposeTo estimate the prevalence and determine risk factors for dry eye disease (DED) in geographically diverse regions of India.MethodA population based cross-sectional study was conducted on people aged ≥40 years in plain, hilly and coastal areas. Dry eye assessment by objective [tear film break-up time (TBUT), Schirmer I, corneal staining] and subjective [Ocular Surface Disease Index (OSDI)] parameters was performed with questionnaire-based assessment of exposure to sunlight, cigarette smoke, indoor smoke. The prevalence of DED with age, sex, occupation, location, smoking, exposure to sunlight, indoor smoke, diabetes, hypertension, was subjected to logistic regression analysis.Results9,735 people (age 54.5 ± 0.1 years; range 40–99, males 45.5%) were included. The prevalence of DED was 26.2%, was higher in plains (41.3%) compared to hilly (24.0%) and coastal area (9.9%) (p < 0.001) and increased with age (p < 0.001), female gender (p < 0.001), smoking (p < 0.001), indoor smoke (p < 0.001), diabetes (p-0.02), hypertension (0.001), occupations with predominant outdoor activity (p-0.013) and increasing exposure to sunlight (trend). Multi-logistic regression showed a positive association with female sex (OR-1.2, CI-1.01, 1.4), exposure to indoor smoke (OR-1.3, CI-1.1, 1.5), smoking (OR-1.2; CI-1.03, 1.3), prolonged exposure to sunlight (OR-1.8, CI-1.5, 2.2), hypertension (OR 1.3, CI-1.2, 1.4), diabetes (OR-1.2, CI-1, 1.5) and negative association with region - hilly (OR-0.5, CI-0.4, 0.6) and coastal (OR-0.2; CI-0.1, 0.2), and BMI (OR-0.8, CI-0.7, 0.9).ConclusionDED is common in population ≥40 years of age. Its prevalence is affected by extrinsic (geographic location, exposure to sunlight, smoking, indoor smoke) and intrinsic (age, sex, hypertension, diabetes, BMI) factors.     

小儿体温测量部位的研究进展

综述了小儿体温测量常见部位、方法、适用范围,便于儿科护理工作者结合惠儿具体病情和实际情况做出正确、安全、便捷选择.     

经筋辨证探析

经筋是经络系统中相对独立的组成部分,有其自身的循行分布规律、生理功能和病理特点。在概括经筋疾病临床特征的前提下,认为经筋辨证体现出以望筋伤部位颜色、形态功能异常以及触结筋病灶点分布规律以辨病筋为基础,筋性肢节病辨筋伤与筋性骨伤之标本且局部与整体多维互参辨病位,筋性脏腑病辅以脏腑辨证辨阻滞气血之病筋,八纲辨证贯穿始终的辨证思路。通过探讨经筋辨证,以期丰富经络辨证体系的科学内涵,更好地指导筋伤病的针灸临床实践。