Recent Research on Impulsivity in Individuals With Drug Use and Mental Health Disorders: Implications for Alcoholism

Alcohol misuse and dependence, and many of its accompanying psychological problems, are associated with heightened levels of impulsivity that both accelerate the development of clinically significant illness and complicate clinical outcome. This article reviews recent developments in our understanding of impulsivity as they relate to brain circuitry that might underlie these comorbid factors, focusing upon the clinical features of substance use (and dependence), bipolar disorder, and pathological gambling. Individuals who are affected by these disorders exhibit problems in several domains of impulsive behavior including deficient response or “motor” control, and the tolerance of prolonged delays prior to larger rewards at the expense of smaller rewards (“delay‐discounting”). These populations, like alcoholic dependents, also exhibit impairments in risky decision‐making that may reflect dysfunction of monoamine and catecholamine pathways. However, several areas of uncertainty exist including the specificity of impairments across disorders and the relationship between impulse control problems and altered evaluation of reward outcomes underlying observed impairments in action selection.     

Genetic markers differentiating follicular thyroid carcinoma from benign lesions

Thyroid nodules are commonly encountered during routine medical care. The main problem established by a discovery of a thyroid nodule is to discriminate between a benign and malignant lesion. Fine-needle aspiration (FNA) is the most widely used and cost-effective preoperative test for initial evaluation of a thyroid nodule. While the overall accuracy of FNA for classical papillary thyroid carcinoma (PTC) approaches 100%, it has limited accuracy with follicular lesions. Patients with a cytological report of indeterminate or follicular lesions are referred to surgery for a more accurate diagnosis. A more acute molecular-based test for thyroid nodules is needed not only to improve treatment decisions, but also to potentially reduce the long-term health costs. Several studies have looked into biologic markers that could be used as an adjuvant to distinguish the benign from malignant nodules. This review will focus on those biomarkers that are potentially useful in the diagnosis of thyroid lesions commonly classified as indeterminate.     

细胞角蛋白在乳腺疾病中的诊断价值

目的：探讨细胞角蛋白在不同乳腺疾病中的表达及其对乳腺疾病诊断和鉴别诊断的意义。方法：107例乳腺疾病患者中包括普通性导管增生（UDH）33例、不典型性导管增生（ADH）20例、导管原位癌（DCIS）34例,不同病变与浸润性导管癌（IDC）20例,采用免疫组化检测CK5/6、CK34βE12、CK19、CK8/18、SMA、ER、c-erbB-2的表达。结果：CK5/6和CK34βE12在ADH、DCIS、IDC中的表达率显著低于UDH（P〈0.01）;CK19、CK8/18在各组间的表达无明显差异;SMA在良性的肌上皮中表达,部分高级别DCIS中灶状缺如,在IDC中缺如。ER、c-erbB-2在不同疾病中表达模式不同。结论：CK5/6和CK34βE12的表达率有助于UDH与ADH和DCIS的鉴别;细胞角蛋白结合SMA、ER、c-erbB-2的表达可辅助乳腺良恶性疾病的鉴别诊断。细胞角蛋白对于乳腺导管内增生性病变的病理诊断及鉴别诊断有实用意义。     

CEANSECYFRA21-1三项血清标志物在肺癌诊断中的应用

目的:探讨联合检测血清肿瘤标志物癌胚抗原(carcinoembryonic antigen,CEA)、神经元特异性烯醇化酶(neurons specific enolase,NSE)、细胞角蛋白19片段(CYFRA21-1)在肺癌诊断中的应用价值.方法:对74例肺癌组,46例健康对照组,33例肺部良性疾病组,采用电化学发光法进行CEA、NSE、CYFRA21-1检测并对比分析.结果:肺癌组的三项肿瘤标志物水平均高于肺良性疾病和健康对照组.CEA、NSE、CYFRA21-1分别在腺癌、小细胞癌、鳞癌中表达水平最高,其阳性率分别为82.6％、81.3％、68.6％,与其他单项肿瘤标志物比较差异有统计学意义(P＜0.05),且三项联合检测对肺癌诊断敏感性明显高于单项标志物.结论:血清CEA、NSE和CYFRA21-1的联合检测有助于临床对肺癌的诊断,并对组织分型有较高的参考价值.     

多环芳烃不同程度污染城市人群尿中多环芳烃代谢产物水平的检测及其意义

目的：研究多环芳烃不同程度污染城市人群尿中多环芳烃代谢产物1-羟芘葡糖苷酸（1-OHPG）和2-萘酚（2-naphthol）的水平,阐明1-OHPG和2-萘酚作为评价多环芳烃污染及对人群健康危害指标的可行性。方法：采用随机整群抽样方法,在多环芳烃（PAHs）严重污染（大同）、中等污染（长春）和较轻污染（昆明）的城市,分别对60名儿童及其家长进行问卷调查,并测定尿中多环芳烃代谢产物1-OHPG和2-萘酚的水平。结果：大同市学生尿中1-OHPG水平［（10.94±6.58） μmol·mol^-1肌酐］和家长尿中1-OHPG水平［（5.87±6.87） μmol·mol^-1肌酐］高于长春学生［(6.33±8.54） μmol·mol^-1肌酐］和家长［（4.60±4.08） μmol·mol^-1肌酐］,也高于昆明学生［（1.90±3.57） μmol·mol^-1肌酐］和家长［（1.62±2.44） μmol·mol^-1肌酐］ （P<0.01）,长春市学生和家长尿中1-OHPG水平高于昆明市学生和家长尿中1-OHPG水平（P<0.01）。大同、长春、昆明三城市学生之间和家长之间尿中2-萘酚水平比较差异均无显著性(P>0.05)。结论：尿中1-OHPG水平能较好地反映人群接触PAHs污染的状况,可作为评价PAHs污染对人群健康损害的生物指标。     

肺癌患者血清肿瘤标志物联合检测的临床意义

目的探讨肿瘤标志物癌胚抗原(CEA)、糖类抗原153(CA153)、糖类抗原199(CA199)及铁蛋白(SF)单项及联合检测对肺癌诊断的价值。方法对70例肺癌患者、68例良性肺疾病患者及62例健康对照组进行CEA、CA153、CA199及SF的检测,并计算上述指标单项及联合检测在肺癌诊断中的敏感度和特异度。结果肺癌组CEA、CA153及CA199水平明显高于良性肺病组及健康对照组(P<0.05)。4项标记物在不同病理类型肺癌中CEA、CA153及CA199总体比较均有差异,其中肺腺癌CEA及CA153水平高于其他类型(P<0.05),小细胞肺癌CA199水平高于其他类型(P<0.05)。4项肿瘤标记物联合检测的敏感度(87.7%)明显高于单项敏感度(分别为62.3%、56.1%、57.3%和62.4%)。结论CEA、CA153、CA199及SF联合检测可明显提高肺癌的检出率,联合检测对于鉴别肺癌与肺部良性疾病、肺癌不同病理分型有一定的参考价值。     

呼吸康复对慢性阻塞性肺疾病患者血清炎症因子的影响

目的 观察呼吸康复对稳定期慢性阻塞性肺疾病(COPD)患者低度系统炎症相关炎症因子的下调作用.方法 将本院呼吸科47例稳定期慢性阻塞性肺疾病患者随机分为COPD对照组(23例)和COPD呼吸康复组(24例),同时选取本院内科体检的20名健康对照者.COPD对照组和COPD呼吸康复组分别用常规治疗和常规治疗辅以24周的呼吸康复后,比较两组的肺功能指标、健康相关生存质量(HRQoF)以及血气分析.免疫比浊法检测COPD两组治疗前后以及健康对照组的血清C-反应蛋白(CRP),酶联免疫吸附试验(ELISA)检测血清白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α),并比较健康对照组和COPD两组的炎症因子.结果 治疗后COPD呼吸康复组的肺功能、HRQoF以及血气分析均较COPD对照组好转(P<0.05). COPD两组患者在治疗前后血清CRP、IL-6、TNF-α水平均比健康对照组高(P<0.05),治疗后COPD呼吸康复组的CRP[(16.4±3.1)mg/L]比治疗前[(14.6±2.9)mg/L]下降(P=0.048),其他均无明显变化(P>0.05).结论 呼吸康复有助于稳定期COPD患者呼吸功能的恢复,但对低度系统炎症相关因子的影响还不完全明确. Abstract： Objective To explore the value of pulmonary rehabilitation contributed to down-regulate the serum C-reactive protein (CRP),interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α) in chronic obstructive pulmonary(COPD). Methods Forty-seven patients with stable COPD and 20 age-and sex-matched health subjects with normal pulmonary function were admitted to the study.Forty-seven patients were randomly divided into the COPD control group(n=23) treated on regular therapy and the COPD intervention group (n=24) treated on both regular one and pulmonary rehabilitation, for 24 weeks. pulmonary function, Health-related quality of life(HRQoF) and blood gas analysis were compared between the COPD control group and the COPD intervention group then. Whilst Serum CRP level was measured with the immune-turbidimetric method, while IL-6 and TNF-α concentrations were measured with ELISA among the health and the two COPD patients.Results The COPD intervention group showed better therapy in pulmonary function, HRQoF and blood gas analysis than the COPD control group(P<0.05). Serum CRP, IL-6 and TNF-α were significantly higher before and after treatment in two COPD groups than in control subjects(P<0.05). Serum CRP was down- regulated [(16.4±3.1)mg/L vs (14.6±2.9)mg/L, P=0.048]in the COPD intervention group after therapy than that in COPD control group, but there was no significant different change for IL-6 and TNF-α(P>0.05). Conclusions Pulmonary rehabilitation may have beneficial effects on pulmonary function in stable COPD patients,but still indefinite effect on inflammatory markers in low-grade systemic inflammation.     

两种分离方法培养成体大鼠骨髓间充质干细胞的比较分析

目的比较分析目前较简单易行的贴壁培养法和密度梯度离心法培养大鼠骨髓间充质干细胞（MSCs）的效果.方法用贴壁培养法和密度梯度离心法分别培养大鼠MSCs,流式细胞仪检测MSCs的表面标记物.结果贴壁培养法培养的原代细胞较密度梯度离心法培养的原代细胞生长快,但传代细胞这一差异不明显;而密度梯度离心法培养的原代细胞较贴壁培养法培养的原代细胞形态一致,随着传代的增加,贴壁培养法培养的细胞形态逐步趋于一致.流式细胞仪检测示：贴壁培养法培养的细胞：CD29（99.8%）、CD90（99.6%）、CD34（3.01%）;密度梯度离心法培养的细胞：CD29（100%）、CD90（97.1%）、CD34（0.89%）.结论用贴壁培养法和密度梯度离心法都可以得到纯度较高的MSCs,两种培养方法的效果无明显差异.     

高频超声诊断小儿急性阑尾炎及分型的体会

目的探讨小儿阑尾炎的声像图特征及其分型的价值。方法对90例临床拟诊急性阑尾炎的患儿行高频超声检查,分析其声像图特征并进行分型,与手术及病理结果对照。结果 90例拟诊急性阑尾炎的患儿,超声诊断总体符合率为98.9%。声像图显示阑尾增粗,壁增厚,黏膜毛糙、回声中断或缺失。病理类型符合率分别为：急性单纯性阑尾炎91.3%,化脓性阑尾炎97.8%,坏疽性阑尾炎76.2%,阑尾脓肿100%。结论高频超声检查对小儿阑尾炎的诊断及分型具有重要价值,能够较准确的估测炎症改变的程度,有利于临床医生选择合理的治疗方法。     

干扰素与阿德福韦酯序贯治疗慢性乙型肝炎的临床研究

目的 探讨干扰索与阿德福韦酯序贯治疗慢性乙型肝炎的临床疗效。方法将90例慢性乙型肝炎病人随机分成3组;干扰素组30例：单纯应用干扰素治疗,疗程至少1年;干扰素与阿德福韦酯组30例：先用干扰素治疗,疗程至少1年,再用阿德福韦酯治疗,疗程2年;阿德福韦酯组30例：单纯应用阿德福韦酯治疗,疗程3年。3组停药后均随访6个月,观察3组患者用药前、后的主要症状及体征变化,并检测用药前、后及随访6个月的血常规、肝功能、乙肝病毒标志物（HBeAg、HBeAb、HBV—DNA）等的变化。结果干扰素组显效13例、有效7例、无效10例;干扰素与阿德福韦酯组显效19例、有效6例、兀效5例;阿德福韦酯组显效14例、有效5例、无效11例;3组总有效率方面比较,差异有极显著性（P〈0．01）。讨论干扰素与阿德福韦酯的序贯治疗可持续抑制乙肝病毒,达到减轻或防止肝细胞损伤和疾病进展,从而改善患者的生活质量和延长存活时间。