PTCD在诊治阻塞性黄疸中的应用及体会

对阻塞性黄疸病人,术前进行经皮肝穿刺胆道引流术(PTCD)能达到胆道减压,减轻全身黄疸的目的,为该类病人术前准备提供一项行之有效的方法。本文报告12例,其定位诊断符合率为100％,定性诊断符合率为75％,结合实践提出了进行PTCD的适应证选择和预防并发症的切实措施。     

Evaluation of the effects of opioid agonists and antagonists under a delayed matching-to-sample procedure in pigeons

The effects of several opioid agonists and antagonists were examined in pigeons performing under a delayed matching-to-sample procedure. The mu agonists morphine and l-methadone, the kappa agonists U 50,488 and ethylketocyclazocine, and the opioid antagonist naloxone had no effect on the accuracy of responding. These drugs were, however, behaviorally active as evidenced by the dose-dependent decreases in rates of responding associated with their administration. In contrast, the sigma agonists (+) N-allylnormetazocine and phencyclidine decreased the accuracy of responding in a dose-dependent fashion. The relative magnitude of these drug-induced decreases in accuracy were similar across the no delay (0-s), short (2-s), and long (8-s) delay intervals. For these drugs, accuracy-decreasing effects were obtained only at doses that reduced rates of responding. The results of the present investigation parallel those reported in pigeons responding under drug discrimination tasks, in which the discriminative stimulus properties produced by the mu and kappa agonists are similar to each other but distinguishable from those produced by the sigma agonists.Recipient of Research Scientist Development Award DA 00033 from the National Institute on Drug Abuse     

鸡矢藤提取物对小白鼠离体子宫的作用

鸡矢藤[Paederia Scandens]提取物0.32mg 加入营养槽内,对小白鼠各期离体子宫的收缩张力、收缩强度、收缩频率以及子宫活动力均有增强作用。与给药前比较,诱导期组分别增加85%、47%、21%和72%;动情期组分别增加70%、77%、41%和41%;非动情组分别增加47%、76%、62%和66%,而且三组间作用无显著性差异。本品还能增强 PGE_2对小白鼠离体子宫的收缩张力、收缩强度、收缩频率以及子宫活动力。与 PGE_2的作用比较,分别增加34%、39%、9%和45%,但收缩频率增加无统计学意义(P>0.05)。上述结果表明,鸡矢藤提取物对小鼠子宫有显著性兴奋作用,而且还能增强PGE_2对小鼠子宫兴奋作用,其机制尚待进一步研究。     

维生素E对小鼠胸腺和脾脏T淋巴细胞转化及MΦ诱导IL－1的影响

ＶＥ缺乏组、１／３需要量组、需要量组、３倍需要量组、２０倍需要量组的初断奶小鼠喂养８周后观察Ｔ淋巴细胞转化及Ｍ中诱导ＩＬ－１反应。结果表明，ＶＥ增强半合适、合适剂量ＣｏｎＡ诱导的胸腺、脾脏Ｔ淋巴细胞转化，且半合适剂量诱导的反应高于合适剂量，ＶＥ增强合适剂量ＰＨＡ诱导的脾Ｔ细胞反应，但不影响其诱导胸腺Ｔ细胞反应。ＶＥ还提高ＭΦ诱导ＩＬ－１生成。上述实验以缺乏组反应最弱，３倍量组反应最强，而２０倍量组反有下降趋势。     

维生素E的抗脂质过氧化作用

本研究观察到:维生素 E 能抑制 H_2O_2引起的大鼠红细胞脂质过氧化和红细胞溶血,也能抑制分别由维生素 C-NADPH 和 Fe~(2+)-半胱氨酸诱发的大鼠肝、脑微粒体的脂质过氧化,可能还有清除过氧化氢、超氧自由基和羟自由基的作用。     

前列腺素E1治疗慢性乙型肝炎黄疸的观察

目的观察前列腺素E1治疗慢性乙型肝炎重度黄疸的疗效。方法在综合治疗基础上，分别使用前列腺素E1（治疗组）和门冬氨酸钾镁（对照组）治疗慢性乙型肝炎重度黄疸患者各35例，并观察其症状、体征及肝、肾功能等，疗程4周。结果治疗组的症状、体征及肝功能指标及总有效率，均显著优于对照组，两组比较差异有显著意义（P〈0．05）。结论前列腺素E1治疗慢性乙型肝炎重度黄疸能显著地促进黄疸消退和改善肝功能。     

病毒性肝炎病人血浆VitE水平及其临床意义

观测了急性肝炎和重症肝炎病人血浆ＶｉｔＥ及Ｌｐｏ水平及其动态变化。急性肝炎和重症肝炎病人血浆ＶｉｔＥ低于对照组，Ｌｐｏ高于对照组，均以重症肝炎更明显，且死亡病例血浆ＶｉｔＥ低于存活者。部份病人口服ＶｉｔＥ不能提高其血浆水平，并随病情加重而逐渐降低。讨论了病毒性肝炎病人血浆ＶｉｔＥ降低与Ｌｐｏ升高的关系及其临床意义，认为动态观测血浆ＶｉｔＥ可作为判断重症肝炎病情进展及预后的参考。     

Requiring Consent vs. Waiving Consent for Medical Records Research: A Minnesota Law vs. the U.S. (HIPAA) Privacy Rule

The use of medical records in research can yield information that is difficult to obtain by other means. When such records are released to investigators in identifiable form, however, substantial privacy and confidentiality risks may be created. These risks become more common and more serious as medical records move to an electronic format. In 1996, the state of Minnesota enacted legislation with respect to consent requirements for the use of medical records in research. This legislation has been widely criticized because--it is claimed--it creates an unnecessary impediment to research. In this article, we show that these arguments rest upon misinterpretation and/or misrepresentation of the 1996 legislation. A consent requirement had actually been present in Minnesota since 1976 (though codified in a patient rights statute rather than a privacy statute). The 1996 law does not require specific consent, as often claimed, but rather only a general authorization. The campaign against the Minnesota legislation appears to have been motivated by concern with respect to the then impending federal privacy rule. The HIPAA rule, as enacted, is in fact less stringent with respect to consent than the Minnesota consent law. On the other hand, the Minnesota consent law has not been effectively applied or enforced. As we change the way we manage sensitive medical information, new efforts are needed to provide protection against the confidentiality risks in research. Patient consent is an important tool in this regard. New instrumentalities are needed to solicit and document consent.     

维生素E琥珀酸酯诱导人胃腺癌细胞凋亡途径

目的　探讨维生素E琥珀酸酯 (VES)诱导人胃腺癌SGC -790 1细胞凋亡的死亡受体 (Fas)信号转导途径。方法　人胃腺癌SGC -790 1细胞经不同剂量VES(5,10 ,2 0 μg/ml)处理 ,同时做琥珀酸、维生素E和空白对照 ,采用DAPI(4,6-贰脒基 -2 -苯基吲哚 )荧光染色法观察细胞凋亡情况 ,用WesternBlot法检测Fas、带有死亡结构域的Fas相关蛋白 (FADD)和天冬氨酸特异性半胱氨酸蛋白酶 (caspase -8)蛋白表达情况 ,Fas和FADD反义寡聚核苷分别转染SGC -790 1细胞后 ,用荧光法检测caspase -8活性。 结果　经VES处理后的细胞DAPI染色可见凋亡的形态学改变 ,2 0 μg/mlVES处理 48h后的细胞凋亡率为 89.6% ;VES处理 48h后Fas、FADD和caspase -8蛋白表达明显增加 ,且呈剂量 -效应关系 ;阻断Fas可明显抑制FADD蛋白表达 ,Fas和FADD反义寡聚核苷转染细胞后caspase -8活性明显降低 (P <0 .0 1) ,其中阻断Fas的效果高于阻断FADD。结论　维生素E琥珀酸酯诱导人胃腺癌SGC -790 1细胞凋亡过程中启动了Fas信号转导途径 ,VES启动Fas后 ,FADD将Fas和caspase -8联接起来 ,活化caspases级联反应 ,从而构成Fas/FADD/caspase -8的凋亡信号途径     

老年轻度认知功能损害患者血清维生素E、超氧化物歧化酶和丙二醛的测定及临床意义

目的　了解轻度认知功能损害 (MCI)患者血清维生素E(VitE)、超氧化物歧化酶 (SOD)和丙二醛(MDA)的水平 ,探讨其变化的临床意义。方法　采用 1∶1配对病例对照设计 ,受试者均于晨 7时空腹抽静脉血 ,应用紫外分光光度法测定了 4 5例老年MCI患者和 4 5例健康老年人血清VitE ,SOD和MDA的含量。结果　老年MCI患者血清VitE含量及SOD活性显著低于健康老年人 (P <0 .0 1) ,血清MDA含量显著高于健康老年人 (P <0 .0 1)。结论　以MDA为代表的自由基代谢产物参与了MCI的病理生理过程 ;临床上应给予外源性VitE以进行早期干预治疗。