哮喘模型豚鼠变态反应机制的实验研究

目的 :观察哮喘豚鼠的变态反应机制是否与人体一致。方法 :健康豚鼠 2 4只 ,随机分为空白组、模型组、药物内服组。以血清总IgE、IgG、IL - 4为效应指标 ,观察 3组动物效应指标的变化。 结果 :各组动物血清总IgE水平没有发生显著性变化 ,模型组与空白组比较 ,IgG含量较空白组显著降低(P <0 .0 5 ) ,IL - 4含量显著升高 (P <0 .0 5 ) ,经药物治疗后 ,IgG含量明显增高 (P <0 .0 5 ) ,IL - 4含量则明显下降 (P <0 .0 5 )。结论 :豚鼠的哮喘是由IgG介导的变态反应 ,与人体哮喘由IgE介导的病理机制有所不同 ,建议实验应用豚鼠哮喘模型应当受到限制。     

双标记原位杂交法检测间期细胞BCR/ABL融合基因

目的 :应用双标记原位杂交方法检测 BCR/ ABL融合基因。方法 :BCR基因探针用地高辛标记 ,碱性磷酸酶显色 ;ABL基因用3 H- d ATP标记 ,核子乳胶放射自显影。结果 :检测 9例初治的慢性粒细胞白血病 ( CML)病人均为阳性 ,阳性细胞比例为 93% ;检测 CML来源的 K5 62细胞株阳性细胞占 98.8% ;正常人假阳性率为 0 .75 %。结论 :该方法简便、快速 ,适用于 CML微小残留病的检测     

Wortmannin抑制PI3-K途径对K562及NB4细胞增殖的影响

目的 :为探讨Wortmannin抑制磷酰肌醇 - 3激酶 (PI- 3K)途径对K5 62 ,NB4细胞增殖的影响 ,探寻慢性髓细胞性白血病 (CML)的治疗新途径 .方法 :用磷酰肌醇 - 3激酶 (PI - 3K)特异抑制剂Wort mannin抑制PI - 3K活性 ,观察慢性髓细胞性白血病细胞系K5 62细胞和急性早幼粒细胞性白血病细胞系NB4细胞在 2 4,48,72h增殖能力的变化 .t检验统计分析 .结果 :K5 62和NB4细胞在 2 4,48,72h的增殖抑制率分别为 3 4 67% ,5 7 46% ,65 85 %和 2 6 2 9% ,5 5 1% ,2 10 % .集落形成实验以GM -CSF为主要生长刺激物的培养体系在 3 7℃ ,5 %CO2 孵箱培养 14d后细胞系的集落数和集落形成率分别为K5 62 :80 75±10 2 4和 16 15 % ,K5 62 +WT :3 8 0 0± 12 75和 7 60 % ,NB4:2 9 5 0± 5 97和 5 90 % ,NB4+WT :3 0 5 0± 5 74和 6 10 % .集落形成抑制率为 :5 2 94%和 3 3 9% .结论 :Wortmannin可显著抑制K5 62细胞的增殖和集落形成 ,而对NB4细胞无明显影响 (P均 <0 0 5 ) .Wortmannin可以通过抑制PI - 3K通路抑制K5 62细胞的增殖 ,而对NB4细胞增殖无明显影响     

The effects of oral 4-hydroxyandrostenedione on peripheral aromatisation in post-menopausal breast cancer patients

This study investigated the influence of the aromatase inhibitor 4-hydroxyandrostenedione (4OHA, formestane), given orally, on peripheral aromatase activity and plasma oestradiol (E ₂) levels in post-menopausal women with advanced breast cancer. The aim was to establish whether an optimal dose could be identified that had a pharmacological effectiveness comparable with that of parenteral 4OHA. A total of 13 post-menopausal women were studied before treatment and after a minimum of 4 weeks on treatment with one or more of the following doses: 125 mg once daily (od), 125 mg b.i.d. (bd) and 250 mg od. In all, seven aromatase studied were performed at 125 mg od; four, at 125 mg bd; and ten, at 250 mg od. Three patients were studied at all doses. E₂ was measured concurrently and was available at all dose increments for seven patients. Given at doses of 125 mg od, 125 mg bd and 250 mg od, treatment with formestane inhibited in vivo aromatisation by 62.3%±9.5%, 70.0%±5.1% and 57.3%±5.3%, respectively (mean±SEM). Corresponding values for plasma E₂ suppression were 30.7%±6.5%, 43.4%±4.5% and 42.9%±6.7%, respectively. Thus, apart from a somewhat better suppression of plasma E₂ levels by the two higher doses as compared with 125 mg od, no significant difference in the degree of aromatase inhibition or plasma E₂ suppression was observed. The suppression of E₂ by oral 4OHA at 125 mg bd or 250 mg od approaches that achieved by the recommended parenteral schedule of 250 mg fortnightly, but inhibition of aromatase at this dose was substantially inferior. The findings are consistent with a hypothesis that 4OHA given orally may cause substantial plasma oestrogen suppression during part of the day, but neither the od nor the bd regimens investigated in the present study were capable of producing optimal aromatase inhibition.     

Quintuplet pregnancy and third degree ovarian hyperstimulation despite withholding human chorionic gonadotrophin.

A patient who suffered from polycystic ovarian disease and anovulation, was treated with pure follicle stimulating hormone for induction of ovulation. The treatment was stopped and human chorionic gonadotrophin was not administered because of high serum oestradiol levels and multiple follicular development. Ovulation occurred 11 days after pure follicle stimulating hormone was discontinued, the patient developed third-degree ovarian hyperstimulation syndrome and conceived with a quintuplet pregnancy.     

Integrating human factors into the medical curriculum

Background  The study of human factors is a scientific discipline that deals with the interactions between human beings and the elements of a system. This is important because shortcomings in these areas, if unchecked, can result in adverse outcomes. Research into human factors in industries where safety is paramount has provided the basis of countermeasures against human error. Adverse outcomes in medicine resulting from human error exact a high cost in both patient suffering and financial outlay.
CRM training  One of the approaches used to minimise the effect of human error is to train people in a set of knowledge, skills and attitudes that underpin the domain-specific competencies for that profession. These are referred to as non-technical skills (NTS). In aviation, such an approach has been shown to be both translatable from the training environment to the workplace and effective in reducing adverse outcomes.
Discussion  Medicine has incorporated this style of training, usually centred around simulator-based courses, but as yet in a piecemeal, episodic fashion which relies on participants volunteering to attend courses. Unlike other industries there is no systematic approach to linking the content of this teaching with the more conventional range of topics. As a consequence it is difficult to assess the impact of human factors training in medicine. This is partly because very little work has been done to date in identifying the key non-technical skills required in medicine, and the overall experience of workplace based assessment is limited. Lessons from other high reliability organisations may help to address the main challenges of developing the content, integrating it into the curriculum, reinforcing the concepts in the workplace through staff development and establishing its role in summative assessment.     

^60Co消毒与高温高压消毒胚胎骨的实验研究

在12只健康家兔下颌骨体部的两侧各造成0.7cm×0.5cm×0.3cm的骨缺损区，分别置入^60Co消毒的胚胎骨和高温高压消毒的胚胎骨，发现高温高压消毒可以替代^60Co消毒胚胎骨进行移植，为临床提供了一种新的用作同种异体移植胚胎骨的消毒方法。     

穿琥宁联合病毒唑治疗小儿喘息性肺炎

目的 :观察穿琥宁联合病毒唑治疗小儿喘息性肺炎的疗效。方法 :65例喘息性肺炎患者随机分治疗组和对照组 ,治疗组 3 0例用穿琥宁、病毒唑静脉点滴 7天 ,对照组 3 5例用病毒唑、青霉素静脉点滴 7天。结果 :穿琥宁组的临床治愈率为 83 .3 % ,总有效率 96.7%。对照组临床治愈率为 5 7.1% ,总有效率 71.4%。经统计分析 ,两组疗效有显著性差异 ,χ2 =7.90 ,P <0 .0 1。结论 :穿琥宁联合病毒唑治疗喘息性肺炎治愈率高 ,疗效满意。     

活体胃血供的特点及其临床意义

目的 了解活体胃血供的特点，旨在探索中晚期胃癌的局部灌注化疗方法。方法 对36例胃溃疡患者在行胃大部切除治疗时，进行亚甲蓝染色，观察活体胃各分支动脉自然血供区域和血流阻断后血供范围的变化。结果 术中见左、右胃网膜动脉和左、右胃动脉分别为胃大、小弯近、远段相应区域提供血液，胃壁组织染色时间很短；阻断动脉血流后，染色范围扩展，染色时间延长；阻断伴行静脉后，染色范围进一步扩展，染色时间再度延长。结论 胃左动脉和胃网膜右动脉为胃血供的主要动脉，其他动脉分支为辅助性动脉；一般情况下，经动脉灌注的亚甲蓝在胃组织停留时间极短；阻断伴行静脉后，可使该染料在组织停留时间延长。推测此法可使化疗药物在胃组织中存留时间延长，从而有利于胃癌的局部化疗。