不同输血方式对肺鳞癌患者围术期TNF—α和IL—lO的影响

[目的]探讨同种输血和自体输血对肺鳞癌患者围术期肿瘤坏死因子-α(TNF-α)和白细胞介素—10(IL—10)的影响和相互关系。[方法]2001年1月至2003年1月对31例肺鳞癌患者行肺癌根治术，将其分为两组，同种输血组(A组)17例，自体输血组14例(B组)。测定两组围术期血清中TNF-α和IL—10的浓度。[结果]A组输血后d1与输血前相比血清中TNF-α、IL-10浓度增高，以IL—10变化尤为明显，输血后d5TNF-α降低并接近输血前的水平，明显低于B组，IL—10仍明显高于输血前的水平。B组中不同时问IL—10无显著变化，TNF-α于ds明显高于输血前。[结论]肺鳞癌患者围术期同种输血后血清中TNF-α降低与IL—10升高有关，IL—10升高可能是同种输血后免疫抑制的重要原因。自体输血可减轻或去除这一作用。     

Easier node dissection after chemoradiotherapy for lung cancer with collagen insertion at mediastinoscopy

Objective: Induction chemoradiotherapy followed by anatomical resection is a current therapeutic strategy for non-small-cell lung cancer with mediastinal node involvement. Dense peritracheal fibrosis and sclerosis after chemoradiotherapy cause difficult mediastinal node dissection. We evaluated a novel technique to make the mediastinal node dissection easier after induction therapy. Methods: At the end of mediastinoscopic node biopsy for staging of lung cancer, cotton-type collagen was inserted anterior and lateral to the trachea in patients with pathologically confirmed mediastinal node involve-ment (n=45). The induction therapy consisted of concurrent use of platinum-based chemotherapy and hyperfractionated radiotherapy. After the chemoradiotherapy all patients underwent a pulmonary resection with complete mediastinal node dissection 7–12 weeks after the collagen insertion. Surgical findings of the mediastinum and the time for node dissection were compared with those without collagen insertion at mediastinoscopy after chemoradiotherapy (n=5). Results: All five patients without collagen insertion showed sclerotic and fibrotic change of mediastinal nodes with severe adhesion to the trachea. In 42 of 45 patients with collagen insertion (93.3%) the collagen remained unabsorbed and separated the mediastinal nodes from the trachea. Mediastinal node dissection was easily accomplished by removing mediastinal tissues lateral and anterior to the collagen. The rate of mediastinal node separation was significantly higher with collagen insertion than without (p< 0.0001). The times for node dissection in patients with and without collagen insertion showed no significant difference. Conclusion: Cotton-type collagen insertion at staging mediastinoscopy for lung cancer separates the mediastinal nodes from the trachea and makes the node dissection easier after induction chemoradiotherapy.     

小儿内伤头痛辨治

74例小儿慢性头痛经辨证治疗,显效80.95%,好转16.67%,无效2.38%。痰浊头痛二陈汤或半夏白术天麻汤加减;肾虚头痛,杞菊地黄汤加减;淤血头痛,补阳还五汤;气血虚头痛八珍汤加减。指出了小儿内伤头痛的病因病机,并指出脑电图,脑阻抗血流图、CT、甲皱微循环可做为此病的诊断及疗效指标。     

Screening Mouse Genes Related to Blastocyst Implantation by Using PCR Subtraction

Objective To identify genes that may be related to embryo implantation Materials & Methods The PCR subtraction technique was applied at implantation and inter-plantation sites on day 4. 5 of pregnancy in mice. Two novel Expressed Sequence Tags (ESTs ), EST8 and EST81 were identified; their expression in tissues was analyzed by Northern blotting, and their full-length cDNAs were synthesized by PCR.Results We found that these two novel ESTs (EST8and EST81) were noticeably expressed in implantation site in the mouse on day 4. 5 of pregnancy. EST8 was expressed at high level in livers and implantation sites of the mice, while at low level in ovaries and inter-plantation sites. EST81 was predominantly expressed in implantation site and ovary, and at low level in all other tissues. Their complete cDNAs, 1 665bp and 1 264 bp respectively, were synthesized by using PCR.Conclusion The two full-length cDNAs were responsible for embryo implantation,and their functions need to be further studied.     

儿童输液中心患儿家属心理需求调查分析

目的 探讨儿童输液中心患儿家属的心理需求，方法 采用问卷调查的方法。结果 家属对患儿所患疾病知识的了解需求十分强烈，占100%，技术服务需求占93%，65%的家属担心输液时出现不良反应，75%的要求发放保健知识手册，根据上述需求，采取相应的护理措施，家属的满意度达到了99%。结论 通过对家属心理需求调查分析及采取相应措施，能提高服务质量。     

Facilitation of discrimination transfers under amphetamine: the relative control by S+ and S− and general transfer effects

Rats were trained in a Y-maze on a two-choice simultaneous black-white discrimination with either black or white as S⁺. Animals were then transferred to one of three discrimination tasks. In task 1 (New S^–), a new stimulus, either vertical or horizontal stripes, was substituted for the original S^–. In task 2 (New S⁺), a new stimulus, either vertical or horizontal stripes as in task 1, was substituted for the original S⁺. In task 3 (New S⁺/S^–) animals were trained on horizontal-vertical discrimination. The pre-trial administration of 1 mg/kg d-amphetamine facilitated the acquisition of the original black-white discrimination with both black as S⁺ and white as S⁺. Likewise, the drug improved performance in all three transfer conditions. However, the course of learning in the three transfer tasks was different in the placebo- and amphetamine-treated animals. Amphetamine-treated animals were disrupted more by a change in S⁺ than by a change in S^–, whereas the opposite pattern was evident in the placebo controls. When both discriminative stimuli were changed, placebo animals exhibited pronounced decrement in performance, whereas amphetamine animals exhibited excellent learning. The implications of these findings for the effects of amphetamine on discrimination learning are discussed.     

转化人关节软骨细胞的Ⅱ型胶原表型诱导

目的 用离心管聚集体培养（Aggregate culture)诱导转化人关节细胞的Ⅱ型胶原。方法 将体外长期培养的第30，40，50代转化软骨细胞消化后进行离心管培养，比较细胞在单层培养，离心管聚集体培养，以及在普通培养基，RAI诱导培养基下[2型骨形态发生蛋白（BMP－2）＋抗坏血酸盐（Ascorbate) 胰岛素（insulin)]，Ⅰ，Ⅱ，Ⅲ型胶原的表达和胞外基质发生情况。结果 在单层培养条件下，转化软骨细胞只表达Ⅰ型胶原，而在BAI诱导培养基及离心管聚集体培养下转化软有细胞表达的Ⅱ型胶原和大量胞外基质。结论 离心管聚集体培养是诱导转化软骨细胞Ⅱ型胶原的有效方式。     

Preparation of leukocyte-poor platelets by filtration

There is evidence that leukocyte contaminating red blood cells and platelet concentrates are responsible for refractoriness to platelet transfusions. The efficacy of a cotton-wool filter to remove leukocytes from red blood cells has been documented previously. The present study was designed to evaluate whether the cotton-wool filters can effectively remove leukocytes from platelet concentrates. Sixty pools of random-donor platelets and single-donor plateletpheresis products were filtered through a cotton-wool filter. The efficacy of filtration was determined by measuring the absolute numbers of leukocytes and platelets and subpopulations of mononuclear cells. The average platelet loss was 8% per pool of random platelets and 10% per plateletpheresis product. The average leukocyte removal was 99% from a pool of random platelets and plateletpheresis concentrates collected by CS-3000 and 90% from plateletpheresis concentrates harvested by single-stage COBE/IBM-2997. The filtration removed 100% of granulocytes, 95% of monocytes, 90% of B-lymphocytes, and 85% of T-lymphocytes. We conclude that filtration through a cotton-wool filter is an efficient and cost-effective method for preparation of leukocyte-poor platelets.