经颈内动脉骨髓干细胞移植治疗脑梗死后遗症

目的:探讨骨髓干细胞移植治疗脑梗死后遗症的临床疗效与可行性。方法:病人9例,平均60.5岁。脑梗死发生后2wk～22mo。50岁以下取自体骨髓血120～150mL,50岁以上(含50岁),取胎儿脐带血约80mL。实验室即刻分离,分离后的骨髓干细胞(混于10mL生理盐水中)。经股动脉穿刺,以Seldinger氏方法,送入5.0F猎人头导管,导管尖端置于颈内动脉处缓慢注入。结果:移植术后2wk～3mo观察。肢体运动,痛温感觉语言功能。明显改善6例,改善2例,无变化1例。总有效率89%。结论:经颈内动脉骨髓干细胞移植治疗脑梗死后遗症方法近期有效,安全性目前可靠。     

经皮冠状动脉介入治疗术后患者血浆可溶性Fas因子改变及他汀类药物干预

目的探讨经皮冠状动脉介入治疗术后6个月再狭窄患者和术后早期患者血浆可溶性Fas的改变及短期阿托伐他汀治疗对其的影响。方法选择29例经皮冠状动脉介入治疗术后再狭窄患者和无再狭窄患者,以及20例术后早期短期应用阿托伐他汀治疗的患者,均设立正常对照组。采用酶联免疫吸附测定法检测其血浆可溶性Fas水平。结果经皮冠状动脉介入治疗术后再狭窄组血浆可溶性Fas(469±126 ng/L)显著高于正常对照组(43±9ng/L)、冠心病组(123±23 ng/L)和无再狭窄组(132±30 ng/L)(P均<0.01);冠心病组和无再狭窄组血浆可溶性Fas也高于正常对照组(P均<0.01);而冠心病组和无再狭窄组之间血浆可溶性Fas差异无显著性。择期冠状动脉介入治疗术后6 h血浆可溶性Fas水平急剧增高;术后3天对照组血浆可溶性Fas升高达最高峰,阿托伐他汀治疗组则显著降低(分别为2 036±422和1 157±268 ng/L,P<0.01);术后7天对照组仍维持在高水平,治疗组下降至最低水平(分别为1 460±266和798±111 ng/L,P<0.01)。结论经皮冠状动脉介入治疗术后再狭窄患者血浆可溶性Fas高于无再狭窄患者,血浆可溶性Fas持续增高可能成为预测再狭窄的有效指标;阿托伐他汀干预可使血浆可溶性Fas水平显著降低,可能是阿托伐他汀防治再狭窄的机制之一。     

中医药通过肺淋巴管系统干预间质性肺疾病的研究进展

间质性肺疾病(ILD)是一种以弥漫性肺实质的炎症和肺纤维化改变为特征的疾病。淋巴管系统在炎症和纤维化疾病中发挥重要作用。已知在炎症性疾病和纤维化疾病中淋巴管系统具有重要功能。但在间质性肺疾病中淋巴管系统作用的相关研究较少,随着科技的进步,逐渐发现了间质性肺疾病中肺淋巴管系统发挥作用的重要机制。且近年来运用中药疗法干预淋巴管系统来治疗疾病成为研究热点。现将基于肺淋巴管系统与间质性肺疾病中的相关性来探讨中医药对间质性肺疾病的干预作用。     

精神分裂症患者精神残疾的影响因素研究进展

精神分裂症是一种常见而严重的精神疾病之一,其患病率约为1%,无文化、地区差异[1].精神残疾是指各类精神障碍(尤指精神分裂症)患者予抗精神病药物(如氯氮平)持续治疗一年无效,以致对其日常生活和社会功能造成严重影响的状态[2].第二次残疾人抽样调查结果显示,精神残疾率高达45.0%,且近半数(48.4%)的精神残疾由精神分裂症所致[3].精神残疾不仅严重危害个人健康及社会安定,而且加重了社会医疗负担[1,4].故本文对近几年国内外学者对精神分裂症患者精神残疾的影响因素(包括药物治疗、人口社会因素、疾病特征和精神症状等)和干预措施等研究现况进行总结,旨在深入研究精神分裂症患者精神残疾的影响因素,并为干预措施提供依据,以便进一步改善精神分裂症患者的社会功能,提高其生活质量,促进其早日回归社会.     

Use of the burn intervention score to calculate the charges of the care of burns

Background

To our knowledge this is the first published estimate of the charges of the care of burns in Sweden. The Linköping Burn Interventional Score has been used to calculate the charges for each burned patient since 1993. The treatment of burns is versatile, and depends on the depth and extension of the burn. This requires a flexible system to detect the actual differences in the care provided. We aimed to describe the model of burn care that we used to calculate the charges incurred during the acute phase until discharge, so it could be reproduced and applied in other burn centres, which would facilitate a future objective comparison of the expenses in burn care.

Building immunization decision-making capacity within the World Health Organization European Region

A National Immunization Technical Advisory Group (NITAG) is a multi-disciplinary body of national experts that provides evidence-based recommendations to policy-makers, assisting them in making sound immunization policy and programme decisions. The World Health Organization (WHO) Regional Office for Europe is working to strengthen the capacity of newly-established NITAGs and has targeted efforts on low- and middle-income countries. The Regional Office, in collaboration with WHO Headquarters and USA Centers for Disease Control and Prevention (CDC), developed a new training strategy and held training workshops to improve NITAGs’ functioning and ability to make evidence-based recommendations. Feedback from countries that participated in trainings indicated that the updated training materials and interactive approach with follow-up technical support enabled them to align their NITAG charters and processes with WHO recommendations. To ensure continued progress, global and regional partners such as WHO and CDC should continue providing technical support to recently established NITAGs.