功能性矫治器在正畸矫治中运用的伦理思考

功能性矫治器是正畸临床中常用的一种矫治器，作者从口腔正畸学理论基础出发，探讨了功能性矫治器在正畸矫治作用中存在的伦理道德问题，主要有（1）不能正确的诊断、制定周密的矫治计划。（2）操作不规范、不细致、缺乏敬业精神。（3）态度简单，粗曝，缺乏与患者良好的交流。并提出解决方法（1）刻苦学习专业知识，不断提高诊疗水平及个人修养。（2）建立高度的道德责任感，以严谨的作风，规范的操作为病人服务。（3）尊重、善待青少年，建立良好的医患关系。     

肺部疾病中痰巨噬细胞对结核菌素试验反应的临床研究

目的:测定肺结核、肺肿瘤及非特异性炎症患者注射结核菌素前后痰巨噬细胞的不同数量变化,由此提供一种新的鉴别诊断方法。方法:皮内注射结核菌素、收集注射前、后痰液,测定痰巨噬细胞在不同时间的数量变化。结果:肺结核病人在结核菌素试验后痰巨噬细胞明显增加,肺部肿瘤及非特异性炎症则无显著性变化。结论:肺部患者测定结核菌素前后痰巨噬细胞变化,可作为菌阴肺结核与肺部肿瘤及非特异性炎症鉴别诊断依据之一。     

Glial cell line-derived neurotrophic factor (GDNF) gene expression in the human brain: A post mortem in situ hybridization study with special reference to Parkinson's disease

Summary Glial cell line-derived neurotrophic factor (GDNF) is a potent neurotrophic factor for dopaminergic neurons. Since dopaminergic neurons degenerate in Parkinson's disease, this factor is a potential therapeutical tool that may save dopaminergic neurons during the pathological process. Moreover, a reduced GDNF expression may be involved in the pathophysiology of the disease. In this study, we tested whether altered GDNF production may participate in the mechanism of cell death in this disease. GDNF gene expression was analyzed by in situ hybridization using riboprobes corresponding to a sequence of the exon 2 human GDNF gene. Experiments were performed on tissue sections of the mesencephalon and the striatum from 8 patients with Parkinson's disease and 6 control subjects matched for age at death and for post mortem delay. No labelling was observed in either group of patients. This absence of detectable expression could not be attributed to methodological problems as a positive staining was observed using the same probes for sections of astroglioma biopsies from human adults and for sections of a newborn infant brain obtained at post-mortem. These data suggest that GDNF is probably expressed at a very low level in the adult human brain and its involvement in the pathophysiology of Parkinson's disease remains to be demonstrated. GDNF may represent a powerful new therapeutic agent for Parkinson's disease, however.     

老年肝外胆管梗阻85例治疗分析

目的：探讨老年性肝外胆管梗阻的治疗。方法：85例老年胆管梗阻中良性疾病引起的梗阻为59例，主要是由于胆管结石嵌顿MIRRIZI‘S综合征；恶性肿瘤引起的梗阻为26例，主要为壶腹部周围癌，肝门区肿瘤等。手术分别采取胆囊切除术、胆总管切开取石＋T管引流术、胰十二指肠切除术、腹部探查＋内外引流术以及ERCP下行置管内支撑术后引流和ENBD等。结果：良性疾病引起的梗阻中仅1例术后死于ARDS，恶性肿瘤 引起的梗阻者中有11例术后死于肝肾综合征、ARDS和DIC等。结论；手术仍是老年肝外胆管梗阻的首选方法。老年患者合并其它脏器病变，病情较重者如先行胆管引流，能有效降低病死率及延长生命。     

Distributive profiles of free and protein-incorporated tryptophan and valine in cerebral cortex slices from adult and 2-day-old rats

The distribution of the specific radioactivity and the incorporation into protein of [³H]-tryptophan and [³H]valine at varying layers from surface to centre were measured in incubated slices of cerebral cortices from infant and adult rats. Specific radioactivity in free amino acids was in both age groups highest in the intact surface layer. Incorporation of tryptophan into protein was even in slices from adult rats but much less than the average in the surface layers in slices from infant rats. Incorporation of valine exhibited similar heterogeneity in both age groups. The results suggest in brain slice preparations a zonal compartmentation of amino acid and protein metabolism which varies for different amino acids.     

Serum digoxin and beta-methyldigoxin in elderly patients on hospital admission: correlation with home compliance and clinical variables

Summary Serum digoxin and beta-methyldigoxin (BMD) were measured in 165 elderly patients (age >60 years) admitted to hospital, of whom 109 had been treated at home with digoxin and 56 with BMD.The mean BMD level was significantly lower than that of digoxin (1.1 vs. 1.4 ng/ml). Creatinine clearance and daily dose were the variables most strongly associated with digoxin level, and the prescribed dose and serum albumin were the best predictors of the BMD concentration. Compliance was assessed by a compliance index (CI), namely the ratio of the measured glycoside concentration, corrected for creatinine clearance, over the expected steady-state dose, calculated from a hospitalized reference group. Compliant individuals in both treatment groups, i.e. those with a CI > the median value, were characterized by a lower daily dose and dosage frequency.Toxicity, whether clinical or electrocardiographic, was present in 9% of the patients and was associated only with a significantly higher mean serum level of the drug.     

婴幼儿患者手术的护理要点

目的进一步认识婴幼儿患者实施外科手术的危险性及规范手术配合程序的重要性,提高配合质量,提出手术配合要点。方法回顾近几年168例婴幼儿患者外科手术护理配合,同时结合自己的临床实际经验和手术配合中的体会,提炼出婴幼儿患者手术的护理配合要点。结果婴幼儿患者手术的配合要做好术前评估,掌握患者心肺主要脏器的功能情况,做好充分准备,手术室感染控制,术中的各项检测,监测输液量、速度及体温维持情况。结论掌握婴幼儿患者手术的护理配合要点,可提高手术配合质量和手术成功率。     

新生鼠和成年鼠脑7种微量元素含量的比较

利用高频电感耦合等离子体原子发射光谱法（ICP－AES）测定Sprunge－Dawley大鼠新生期大脑皮层、海马、小脑、间脑和脑桥等部位的锌、铁、铜、锰、铬、锶、钼等7种微量元素的含量，并与成年动物做了比较。结果表明：（1）新生期大鼠全脑7种微量元素含量的多寡依次为：锌、铁、铬、锶、锰、铜、钼；成年期时钢跃居第四位，总含量低于新生期。（2）脑内不同部位微量元素的含量不同。新生大鼠海马和小脑内多数元素含量高于其他脑区，钼在间脑和海马中含量较高。成年鼠皮层、海马微量元素含量较高，皮层内铜、锶、钼含量最低。     

Biological characteristics of newly diagnosed poor prognosis acute myelogenous leukemia

A pilot study was conducted of the biological characteristics of the leukemia cells of newly diagnosed patients with poor prognosis acute myelogenous leukemia (AML). This study included measurements of the pretherapy proliferative rate of the leukemia cells in vivo, assessment of differentiation in vivo during remission induction therapy, and the level of expression of the fms, myc, and IL1β genes in pretherapy leukemia cells. Short cell cycle times were characteristic of the best prognostic category and were associated with a rapid reduction in marrow leukemia cells in cytosine arabinoside (araC)-sensitive patients. Expression of c-fms was associated with rapid reduction in marrow leukemia cells during araC therapy and with a successful treatment outcome. Expression of the IL1β gene was associated with short remissions. These studies suggest that when compared to newly diagnosed standard prognosis AML, the leukemia of poor prognosis patients is more likely to exhibit long cell cycle times, low levels of fms expression, and is less likely to be associated with myeloid differentiation during remission induction therapy. © 1993 Wiley-Liss, Inc.