动态检测子宫内膜异位症患者血清TNF-α的临床意义

目的研究子宫内膜异位症（EM）患者血清TNF-α的水平动态变化及其在EM疗效和预后评价中的意义。方法EM组患者80例,手术前、术后7d、术后3个月、6个月、12个月、18个月、24个月用ELISA法检测外周血清肿瘤坏死因子-α（TNF-α）的水平,并与40例正常健康妇女（对照组）比较。结果EM组术前血清中TNF-α水平均明显高于对照组（P〈0.01）,且Ⅲ～Ⅳ期患者高于Ⅰ～Ⅱ期（P〈0.05）。术后1周血清中TNF-α水平下降,明显低于术前水平（P〈0.01）。EM组随访58例,未复发的52例治疗结束后血清TNF-α水平呈下降趋势,复发的6例治疗结束后血清TNF-α水平呈增高趋势。结论EM患者血清TNF-α水平与EM复发有关,EM患者血清TNF-α水平的动态检测有作为EM疗效评价、复发及预后的重要指标。     

Long-term changes in cerebellar activation during functional recovery from transient peripheral motor paralysis

Localized altered cerebellar cortical activity can be associated with short-term changes in motor learning that take place in the course of hours, but it is unknown whether it can be correlated to long-term recovery from transient peripheral motor diseases, and if so, whether it occurs concomitantly in related brain regions. Here we show in a longitudinal fMRI study of patients with unilateral Bell's palsy that increases in ipsilateral cerebellar activity follow the recovery course of facial motor functions over at least one and a half years. These findings hold true for changes in brain activity related to both oral and peri-orbital activation, even though these processes are differentially mediated by unilateral and bilateral brain connectivities, respectively. Activation of non-facial musculature, which was studied for control, does not show any change in cerebellar activity over time. The localized changes in cerebellar activities following activation of facial functions occur concomitantly with increases in activity of the facial region in the contralateral primary motor cortex suggesting that the cerebellum acts together with the cerebral cortex in long-term adaptation to transient pathological sensorimotor processing.     

乳腺导管内视镜检查对乳头溢液的诊断价值

目的 探讨乳管内视镜对乳头溢液的诊断价值.方法 应用FV-2000E日本超细光导纤维乳管内视镜系统对3267例乳头溢液患者进行乳管内视镜检查,并将检查结果进行病理学分析.结果 本组3267例患者,正常管腔499例(15.27%);导管扩张伴慢性炎症1750例(53.57%);发现乳管内占位病变1018例(31.16%)(溢液性质血性813例,浆液性165例,水样40例),在813例血性溢液中发现浸润性导管癌42例,导管内癌8例.结论 乳管内视镜检查对乳头溢液患者是一种安全有效的检查方法,应作为病因诊断的首选方法.     

医院教学管理中的"五个转变"

本文对医院教学管理实施的＂五个转变＂,即由静态管理转变为动态管理,由被动管理转变为主动管理,由单向管理转变为互动式管理,由强制性管理转变为疏导式管理,由小质量观转变为现代的大质量观的具体做法进行了介绍,认为＂五个转变＂对提升医院教学管理能力,促进医院教学管理的发展具有积极意义。     

Exposure to CSF from sporadic amyotrophic lateral sclerosis patients induces morphological transformation of astroglia and enhances GFAP and S100β expression

We have earlier shown that cerebrospinal fluid (CSF) of amyotrophic lateral sclerosis (ALS) patients’ produces selective degeneration of motor neurons, both in vitro as well as in vivo. The present study further evaluates the effect of ALS–CSF on the astrocytes in embryonic rat spinal cord cultures. We quantified the number of flat and process-bearing astrocytes in spinal cord cultures exposed to ALS–CSF and compared them against controls. In addition, GFAP and S100β expression were quantified by Western blot and measurement of immunofluorescence intensity respectively. We found higher number of process-bearing astrocytes in the cultures exposed to ALS–CSF. Both these proteins increased significantly in cultures exposed to ALS–CSF. Our results provide evidence that astroglia respond to toxic factor(s) present in ALS–CSF by undergoing morphological transformation from flat to process bearing which is further confirmed by elevated expression of GFAP and S100β. The above changes could possibly alter the microenvironment hastening the motor neuron degeneration.     

Synaptic plasticity in the substantia gelatinosa in a model of chronic neuropathic pain

Chronic neuropathic pain (CNP) is common after peripheral nerve injuries (PNI), but is rather refractory to available anti-pain medication. Advances in neuropathic pain research have identified cellular and molecular cues triggering the onset of neuropathic pain, but the mechanisms responsible for maintenance of chronic pain states are largely unknown. Structural changes such as sprouting of injured A-fibres into the substantia gelatinosa of the dorsal horn in the spinal cord have been proposed to relate to neuropathic pain in partial PNI models. Structural changes in central pain networks may also underlie the more persistent CNP following complete sectioning of a peripheral nerve, because this type of injury results in continuous and spontaneous afferent input to the spinal cord, which can trigger central sensitization. In the present study, the left sciatic nerve was completely sectioned and a 1-cm segment was removed to maintain a chronic pathology, whereas the right sciatic nerve was left intact. Mechanical allodynia was measured up to 84 days after injury, after which synaptic changes were studied in the lumbar substantia gelatinosa. The numbers of larger sized synaptophysin-immunoreactive presynaptic boutons were found to be increased in the substantia gelatinosa ipsilateral to the nerve injury. From these data we conclude that structural synaptic changes within the substantia gelatinosa are present months after complete nerve injury and that this plasticity may be involved in maintaining neuropathic pain states.     

Heterochronic changes in parameters of cardiac pumping function in rat pups

Cardiac pumping function was studied in rat pups by thoracic tetrapolar rheography. The mean daily increment in blood stroke volume increased with age, while the mean daily changes in HR decreased starting from day 30 of life. Changes in the parameters of minute volume of circulation to a greater extent depended on stroke volume than on HR. __________ Translated from Byulleten’ Eksperimental’noi Biologii i Meditsiny, Vol. 142, No. 7, pp. 19–20, July, 2006     

Antinecrotic and antioxidant effects of superoxide dismutase during skin ischemia

Antinecrotic activity of SOD was studied in rats with experimental skin ischemia. Treatment with SOD increased activity of endogenous SOD in skin homogenates (by 70 and 26% compared to the ischemic and intact skin, respectively). However, the rate of superoxide anion generation remained unchanged after SOD treatment. Creatine phosphate content and NAD/NADH redox potential increased by 16 and 21%, respectively, on day 3 after SOD administration. The increase in functional activity of the energy supply system and rise in the reserve capacity of the antioxidant protection system contribute to inhibition of lactate dehydrogenase and creatine phosphokinase and decrease in the cytolysis index under the influence of SOD. Our results indicate that SOD produces the antinecrotic effect and holds much promise for the therapy of skin ischemia. __________ Translated from Byulleten’ Eksperimental’noi Biologii i Meditsiny, Vol. 142, No. 10, pp. 430–432, October, 2006     

Does mucosal remodeling in chronic rhinosinusitis result in irreversible mucosal disease?

Mucosal remodeling in the sinuses is a recently described phenomenon in which the mucosa undergoes potentially irreversible changes as a result of ongoing underlying inflammatory processes. Research into remodeling that occurs in the bronchial airways in asthmatic patients has led to modification of asthma treatment guidelines. However, remodeling in the sinuses has still not led to changes in current medical or surgical management of chronic rhinosinusitis. Upper airway remodeling constitutes a new area of research that poses many unanswered clinical questions and may potentially alter the management of patients with severe chronic rhinosinusitis.     

不同针灸方法治疗带状疱疹(急性期)疗效的比较

目的:比较不同针灸方法治疗带状疱疹(急性期)的疗效。方法:通过多中心临床随机对照试验,将189例急性期带状疱疹患者随机分为5组:基础针刺组、铺棉灸组、火针组、叩刺拔罐组、西药组。基础针刺组取阿是穴(围刺)、夹脊(电针)、支沟(电针)、后溪(电针),铺棉灸组、火针组、叩刺拔罐组在基础针刺组的基础上分别施以铺棉灸、火针、叩刺拔罐,西药组口服盐酸伐昔洛韦胶囊(300mg/次,2次/d)、维生素B1(10mg/次,3次/d),均每日治疗1次,共治疗10d。比较不同方法治疗前后疱疹评价指标(包括止疱时间、结痂时间、脱痂时间)、疼痛强度的变化和综合疗效。结果:在疱疹止疱时间、结痂时间、脱痂时间和综合疗效方面,5组之间的差异均无统计学意义(P>0.05);5组患者疼痛强度比较,治疗第1-6天差异无统计学意义(均P>0.05),治疗第7-10天4个针灸组均明显低于西药组(P<0.05),而4个针灸组间比较差异仍无统计学意义(P>0.05);各组治疗结束时的疼痛强度与本组治疗前比较,差异均有统计学意义(P<0.05)。结论:4种针灸疗法治疗带状疱疹(急性期)疗效基本相当,在疱疹止疱、结痂、脱痂时间及综合疗效等方面与西药疗法无明显差异,但在治疗第7天以后镇痛效果优于西药。