TRAIL联合化疗药物对人宫颈癌Hela细胞增殖与凋亡的影响

目的探讨肿瘤坏死因子相关诱导凋亡配体 (TRAIL)对人宫颈癌Hela细胞的作用 ,以及与化疗药物的协同作用。方法将Hela细胞接种至 96孔培养板后分别加入浓度为l.0、10 .0、10 0 .0 μl/L的TRAIL、0 .1、1.0、10 .0mg/L的阿霉素 (ADM )和丝裂霉素 (MMC) ,及不同匹配的TRAIL MMC和TRAIL ADM ,采用四甲基偶氮唑盐 (MTT)比色法分别检测肿瘤细胞的生存率 ;将Hela细胞接种至 12孔板 ,培育 2 4h后加入不同浓度的TRAIL、ADM、MMC、TRAIL ADM、TRAL MMC ,用流式细胞术检测不同处理组肿瘤细胞的凋亡率和死亡率。结果 10 0 μg/LTRAIL引起细胞的凋亡率为 2 0 .1% ,与无药物组 1.1%的凋亡率有非常显著性差异 (P <0 .0 1) ;单独采用 10mg/LMMC、ADM对细胞的抑制率为 3 6.0 %和 44 .1% ,而 10 0 μg/LTRAIL与 10mg/LMMC、ADM联合后对细胞的抑制率分别达到 5 8.4%和 73 .7% ,两者有协同作用 (P <0 .0 5 )。结论在体外实验中 ,TRAIL可通过诱导宫颈癌Hela细胞的凋亡而产生抗肿瘤作用 ;TRAIL与化疗药物ADM、MMC有协同抗肿瘤作用。     

单耳堵塞对沙土鼠中脑下丘神经元谷氨酸受体密度的影响

目的考察单耳堵塞对沙土鼠中脑下丘(IC)背侧核(ICd)、外侧核(ICx)和中央核(ICc)部位谷氨酸(Glu)受体密度的影响。方法实验在30只沙土鼠上进行,雌雄不拘。分别在沙土鼠出生后3周龄(21dpn)、6周龄(42dpn)和成年(70dpn)实施单耳堵塞,4周后以体外受体标记放射自显影方法,考察比较IC左右侧各部位的银粒密度变化,并以此为相对指标,分析动物IC的神经元Glu受体密度的变化。结果成年组两侧IC神经元Glu受体密度没有显著性差异;3周龄和6周龄组呈现堵耳对侧的Glu受体密度明显少于堵耳同侧的不均衡分布(ICd部位:t=2.53,P=0.0186,t=1.77,P=0.0443;ICx部位:t=1.90,P=0.0359,t=2.03,P=0.0367;ICc部位:t=1.07,P=0.0332;t=2.35,P=0.0208)。并且3周龄组ICc部位的两侧Glu受体密度比值最小(0.61±0.03)。结论出生后6周前单耳堵塞对沙土鼠IC的神经元Glu受体发育具有明显影响,与Glu受体相关的下丘听觉功能发育将延续到出生后6周。     

The Epidemiology and Diagnosis of Penetrating Eye Injuries

It is estimated that there are 3.1 penetrating eye injuries per 100,000 person-years in the United States. OBJECTIVES: To evaluate the epidemiology of penetrating eye injuries and to identify physical examination findings that facilitate the diagnosis and ophthalmologic referral of patients with these injuries. METHODS: This was a retrospective chart review of emergency department patients with penetrating eye injuries seen for evaluation from July 1987 to January 1999. The setting was a tertiary referral, university hospital. Three hundred eighty-four patients with 390 penetrating eye injuries were enrolled; 56% were transferred from outlying hospitals. RESULTS: Penetrating eye injuries were seen almost three times per month. Eighty percent of the injuries occurred in males, and the mean age was 29 years. Twenty-five percent of the patients had used alcohol in the period immediately preceding the injury. Final visual outcome was 28% with enucleation, "no light perception" (NLP) in 10%, light perception to 20/200 in 24%, and light perception of 20/200 or better in 38%. Poor visual outcome was associated with poor initial visual acuity, alcohol use, and delayed presentation (p = 0.036, 0.025, 0.036, respectively). Gun-related injuries caused 33% and motor vehicle crashes (MVCs) caused 21% of the worst outcomes (enucleation or NLP). In MVCs where seat belt use was reported, 71% of injured patients were unrestrained. The most common initial physical findings were hyphema (76%), abnormality of the pupil or uvea (94%), and initial visual acuity worse than 20/200 (77%). All patients had at least one of these findings. Complications occurred in 25% of cases, most commonly traumatic cataract or infection. Complications occurred more commonly in those patients transferred than in those presenting directly (p = 0.002). CONCLUSIONS: Penetrating eye injuries are relatively common, occur predominantly in young males, and often result in poor visual outcome in the affected eye. Motor vehicle crashes, alcohol use, and fire-arm use are associated with more severe injuries.     

Carcinoma of the gallbladder: CT findings in 50 cases

Fifty patients with histologically proven carcinoma of the gallbladder were examined by computed tomography (CT). The gallbladder masses were categorized into two broad groups: group 1 (74%) included patients in whom the gallbladder was identified along with a mass lesion; and group 2 (26%), where a large mass was present in the gallbladder fossa with no identifiable gallbladder. Group 1 was further divided into three types according to the nature of the tumor: Type 1, mass almost filling the entire gallbladder lumen; Type 2, a polypoidal mass projecting into the lumen; type 3, an infiltrating tumor seen as focal or diffuse wall thickening. Liver involvement, in the form of localized invasion in the vicinity of the primary gallbladder malignancy, was the most common associated finding (80%). Other ancillary features included presence of calculi, lymphadenopathy, and biliary obstruction. CT was found useful for characterizing and defining the extent of carcinoma of the gallbladder. However, it may not consistently demonstrate involvement of the gastrointestinal tract, omentum, and abdominal wall. CT can also be used for aspiration/biopsy guidance of the gallbladder mass in selected cases.     

Health visitors' assessments of parent-child relationships: a focus group study

BACKGROUND: Health visitors (HVs), also known as public health nurses, in the UK provide a universal community-based service to preschool children and their parents. Since they have ongoing supportive contact with almost all mothers and young children they have opportunities to identify problems in the parent-infant relationship: for example during developmental screening, home visits and immunisation clinics. Research into the role of screening for problems in the parent-child relationship in early childhood is sparse and little is known about how such problems are currently identified in the community. OBJECTIVE: To explore the approaches taken by health visitors (HVs) to identifying problems in the parent-child relationship. DESIGN: Focus group study. SETTING: Glasgow, Scotland. Participants: 24 health visitors sampled purposively. RESULTS: Multiple sources of information were used by health visitors in assessing parent-child relationships. These include use of known risk factors, knowledge of local norms, direct observations of behaviour, reflection on the relationship between the parent and health visitor, as well as more intuitive reactions. In many cases understanding difficulties in parent-child relationships involved piecing together a jigsaw over a considerable time span. Continuity of relationships appeared to be crucial in this task. Home visits were described as the most informative setting in which to develop an understanding of the parent-child relationship. Participants reported a lack of formal training in the assessment of parent-child relationships and were keen to obtain more training. CONCLUSIONS: Health visitors use complex strategies to integrate information about parent-child relationships. These strategies are acquired in a variety of ways, but receive little emphasis during basic professional training.     

D-dimer testing is useful to exclude deep vein thrombosis in elderly outpatients

Summary.  Background:  Deep vein thrombosis (DVT) can be safely and reliably excluded in patients with a low clinical probability and a negative D-dimer result but the accuracy and utility of such a strategy is unclear in elderly patients. Objectives:  We sough to compare the performance of the Wells pretest probability (PTP) model and D-dimer testing between patients of different age groups and to examine the utility of the two PTP model classification schemes (low/moderate/high vs. unlikely/likely) in excluding DVT in elderly outpatients. Patients/Methods:  Pooled analysis of databases from three prospective diagnostic studies evaluating consecutive outpatients with suspected DVT. Results:  A total of 2696 patients were evaluated. DVT was diagnosed in 400 (15%) patients overall and in 50 out of 325 (15.5%) patients ≥ 60 years old. The PTP distribution and the prevalence of DVT in each PTP category were similar among the different age groups. The negative predictive values of a low or unlikely PTP score in combination with a negative D-dimer result were 99% for all groups. A negative D-dimer in combination with a low or unlikely PTP excluded 21.7% and 31% of patients ≥ 80 years old, respectively. Conclusions:  The combination of a low or unlikely PTP with a negative D-dimer result can effectively and safely exclude DVT in a significant proportion of elderly outpatients. However, this clinical prediction rule needs to be prospectively validated with different D-dimer assays in this specific population.     

2型糖尿病血栓前状态的检测及临床意义

目的：探讨2型糖尿病患血栓前状态变化与血栓形成的关系及机理。方法：对96例2型糖尿病患测定6项能反映血栓前状态的分子标志物。结果：与正常对照组比较，各组糖尿病患血栓前状态指标均发生不同程度的变化。血浆vWF：Ag、血浆GMP—140、D—二聚体水平较正常明显升高，t—PA活性下降。结论：糖尿病患存在着血栓前状态及不同程度的血栓形成，血栓前状态指标的检测有助于判断糖尿病的病情及血管病变的程度。     

Role of K ATP channels in cephalic vasodilatation induced by calcitonin gene-related peptide, nitric oxide, and transcranial electrical stimulation in the rat

Objective.— The objective of this study was to explore the role of K_ATP channels in vasodilatation induced by calcitonin gene‐related peptide (CGRP), nitric oxide (NO), and transcranial electrical stimulation (TES) in intracranial arteries of rat. Background.— Dilatation of cerebral and dural arteries causes a throbbing, migraine‐like pain. Both CGRP and NO are potent vasodilators that can induce migraine. Their antagonists are effective in the treatment of migraine attacks. K_ATP channel openers cause headache in the majority of healthy subjects suggesting a role for K_ATP channels in migraine pathogenesis. We hypothesized that vasodilatation induced by CGRP and the NO donor glyceryltrinitrate (GTN) is mediated via K_ATP channels. Methods.— We examined the effects of the K_ATP channel inhibitor glibenclamide on dural and pial vasodilatation induced by CGRP, NO, and endogenously released CGRP by TES. A rat genuine closed cranial window model was used for in vivo studies and myograph baths for studying the effect in vitro. In the closed cranial window model the diameter of dural vessels was measured directly in anesthetized animals to investigate the vascular effects of infused CGRP, NO, and endogenous CGRP after electrical stimulation. Also diameter changes of pial arteries, mean arterial blood pressure and local cerebral blood flow by Laser Doppler flowmetry (LCBF_Flux) were measured. Results.— CGRP, NO, and TES caused dilatation of the 2 arteries in vivo and in vitro. In anesthetized rats glibenclamide significantly attenuated CGRP induced dural and TES induced dural/pial artery dilatation (P = .001; P = .001; P = .005), but had no effect on dural/pial vasodilatation induced by GTN. In vitro glibenclamide failed to significantly inhibit CGRP‐ and GTN‐induced vasodilatation. Conclusions.— These results show that a K_ATP channel blocker in vivo but not in vitro inhibits CGRP, but not GTN‐induced dilatation of dural and pial arteries, a mechanism thought to be important in migraine.     

中药敷脐配合咽三针治疗脑卒中后吞咽障碍并发肺部感染

目的 :探讨中药敷脐配合咽三针治疗脑卒中后吞咽障碍并发肺部感染的效果。方法 :脑卒中后吞咽障碍并发肺部感染90例入选患者随机分为三组各30例。针刺治疗组采用咽三针为主治疗,中药敷脐组采用中药化痰祛瘀方敷脐治疗,针药结合组采用中药敷脐联合咽三针治疗,治疗结束后统计比较分析肺部感染改善情况。结果:组间比较,针药结合组优于单纯中药敷脐组(P0.05),更优于单纯针刺组(P0.01)。结论:中药敷脐配合咽三针治疗脑卒中后吞咽障碍并发肺部感染,改善吞咽困难的同时,也可以有效改善肺部感染症状和体征。