防晒制剂皮肤安全性的实验研究

目的 :探讨同一系列不同SPF(sunprotectionfactor)防晒制剂对皮肤的安全性 ,筛选安全有效的防晒制剂配方。方法 :选用白化豚鼠背部去毛 ,分别涂抹SPF值为 15、2 8、30 +三种防晒制剂 ,以UV光源照射 ,波长为 32 0～4 0 0nm ,强度为 ( 16 8± 2 )mW/cm2 。结果 :三种不同SPF防晒制品对实验动物皮肤各时相点反应积分为 ,SPF15组为0 ;SPF2 8组为 1;SPF30 +组为 3。结论 :三种不同SPF值产品对皮肤的光毒性有一定差异 ,提示SPF值在 2 8以内的防晒制剂皮肤安全性较好 ,SPF30 +的防晒制剂对皮肤有一定光毒刺激反应。     

A risk index for prostate cancer

BACKGROUND: The aim of the present study was to create a simple numerical index predicting the presence of prostate cancer in a group of high risk patients, for the purpose of selecting those most likely to need prostate biopsy. METHODS: 100 consecutive patients at high risk of having prostate cancer seen at Ramathibodi Hospital, Thailand between November 2000 and February 2002 were prospectively studied. All patients underwent transrectal prostate biopsies. The following predictor variables were obtained: age, digital rectal examination (DRE) findings, prostate specific antigen level, transrectal ultrasonography (TRUS) findings, and prostate volume determined by TRUS. The outcome was the presence of prostate cancer on histological examination of the biopsy specimens. A risk index for prostate cancer based on the linear predictor of a multiple logistic regression model was created. RESULTS: Almost all predictor variables were significantly related to the presence of prostate cancer. The final multiple logistic regression model with four categorized predictors (excluding DRE) was shown to have good discrimination, calibration, and cross-validity. For a cutoff risk index of 10, corresponding to a 10% probability of having prostate cancer, the sensitivity for detecting prostate cancer was 96.2%, with a specificity of 73.0%. Based on this cutoff, 55% of patients in this series might not require prostate biopsy. CONCLUSION: A risk index for prostate cancer was developed. If this index can be externally validated, the potential savings from avoiding unnecessary prostate biopsies, on the basis of selection using the index, could be significant.     

体重对腰椎后路开窗减压手术疗效的影响

目的对不同体重老年腰椎管狭窄患者行单纯腰椎后路开窗减压手术,并评价其治疗效果。方法回顾性分析1996年12月～2002年12月间145例因老年腰椎管狭窄而采用单纯腰椎后路开窗减压手术治疗患者的病例资料,结合问卷调查患者对手术的满意程度,比较不同体重患者住院期间及术后症状改善情况,评估手术疗效。结果不同体重患者术后腰腿疼痛明显缓解、日常生活质量改善,患者对手术的满意率达67.59%。而且患者的各种统计数据表明,不同体重组之间差异无显著性意义(P>0.05)。结论体重在一定程度上影响老年腰椎管狭窄患者的手术治疗结果。单纯腰椎后路开窗减压手术,可以达到较为理想的治疗效果。     

Effective pulmonary blood flow in children with acute asthma attack requiring hospitalization

In children with acute obstructive lung disease gas exchange is affected by ventilation-perfusion mismatch and the degree of bronchoconstriction. Standard lung function measurements do not reflect the impairment in gas exchange. Alternatively, the effective pulmonary blood flow (EPBF), that is, the proportion of the cardiac output that is supplying well-ventilated lung units, can give accurate and noninvasive estimates of ventilation-perfusion mismatch. We measured EPBF with the argon freon ?22 rebreathing technique in children with acute severe asthma to assess their response to nebulized salbutamol and to determine whether induced changes in the EPBF could be predicted from baseline measurements. Twenty-four children admitted with an acute asthma attack had spirometry and triplicate EPBF measurements before and after nebulized salbutamol. Eighteen patients had repeated tests 50 days later when fully recovered; 4 patients were taking methylxanthines on at least one occasion. The mean forced expiratory volume in 1 sec (FEV₁) rose from 55% of predicted to 66% after salbutamol and to 83% with recovery. The mean coefficients of variation for EPBF measurements on the three test occasions were 11.3%, 8.2%, and 9%. Except in children on methylxanthines, the EPBF values were reduced during the acute asthma attack (median, 2.53 L/min/m²; range, 1.99–3.60 L/min/m²) compared with paired values obtained after recovery (median, 2.89 L/min/m²; range, 2.2Eb4.04 L/min/m²) (P = 0.009). Salbutamol caused a highly significant increase in EPBF from 2.88 L/min/m² (range, 1.86–3.80) before treatment to 3.34 L/min/m² (range, 2.264.65) immediately afterwards (P = 0.0003). The spirometric indices did not relate to the changes in the EPBF values. However, when the effective stroke volume index was calculated in 11 patients, the changes induced by nebulized salbutamol had a significant inverse relation with the pretreatment FEV, (P = 0.61; P = 0.02). In conclusion, the argon freon-22 rebreathing technique can be used successfully and reproducibly to measure EPBF in children with an acute asthma attack. Except in children taking methylxanthines, EPBF during the acute attack is reduced and rises significantly after salbutamol. EPBF values after recovery were significantly higher than the presalbutamol values during the attack. Spirometric indices do not relate to the EPBF changes but are inversely related to the effective stroke volume changes. Pediatr Pulmonol. 1994; 17:370–377. © 1994 Wiley-Liss, Inc.     

广西武鸣华侨农场心血管病危险因素的调查研究

对广西武鸣华侨农场4158人进行基线普查,410人进行膳食调查和作8小时夜尿电解质测定,并将高血压低发区广西的资料与高发区的北京作对比.结果显示,体重指数高是高血压一个重要的危险因素,而体重过重又与膳食中摄入碳水化合物和总热量大有关.另一主要的危险因素是钠,膳食中摄入钠高,尿Na和Na/K比值高者,血压水平和高血压的患病率亦高.     

华支睾吸虫对自然感染动物模型猫肝脏/胆管及生理生化指标的影响

目的 了解自然状态下猫感染华支睾吸虫的现状及该病对肝脏／胆管及生理生化指标的影响。方法 观察活猫的精神状态，处死后肝脏形态及切开后的眼观形态；通过病理切片观察肝脏、胆管及胆囊的病理变化；测定血常规及肝脏功能指标。结果 7.3％的肝脏（8／218，218为阳性猫）表面有明显的黄豆粒大小的肿瘤；94％（205／218）的肝脏质地变硬，结缔组织增生；29．8％（25／218）肝脓肿，肝色较黄，小叶结构模糊：54．1％（118／218）胆管内上皮细胞增生，淋巴细胞浸润；感染猫血红细胞显著降低（P〈0．01），血清丙氨酸氨基转移酶显著升高（P〈0．05）。结论 华支睾吸虫对肝脏、胆管及胆囊造成了严重伤害，很可能是肝癌、胆管癌的诱因之一。     

Absence of a relationship between umbilical cord thickness and coiling patterns.

OBJECTIVE: The purpose of this study was to evaluate a relationship between the umbilical cord thickness and cord coiling patterns during the fetal sonographic anatomic survey in the second trimester of pregnancy. METHODS: This was a prospective study of 470 patients with singleton pregnancies who had a fetal anatomic survey with recorded umbilical coiling patterns between 18 and 23 weeks' gestation. The umbilical cord thickness was assessed as an umbilical diameter at the level of the fetal abdominal cord insertion and compared with the antenatal umbilical coiling index (aUCI), calculated as a reciprocal value of the distance between a pair of umbilical cord coils. RESULTS: Three hundred twenty-one patients had adequate sonographic umbilical cord images and maternal demographic, antenatal, and labor data to meet inclusion criteria. The mean aUCI was 0.41 with 10th and 90th percentiles of 0.21 and 0.60, respectively. A total of 10.6% (34/321) and 9.3% (30/321) of patients were categorized as having hypocoiled and hypercoiled umbilical cords, respectively. The mean cord diameter +/- SD was 9.48 +/- 0.97 mm (range 7.0-12.5 mm). There was no statistically significant correlation between aUCI and umbilical cord thickness (P = .1164). CONCLUSIONS: An aUCI, or umbilical coiling pattern, does not correlate with umbilical cord thickness. It appears that a lesser amount of the umbilical supportive tissue, mainly Wharton jelly, is not related to an increased umbilical cord coiling pattern.     

胰腺癌细胞的增殖同膜脂质饱和度,膜胰岛素受体的关系

外源性表皮生长因子(或生长抑素)能促进(或抑制)胰腺癌细胞的增殖。胰腺癌细胞增殖速率的高低与细胞膜脂质饱和度的降、升;与膜胰岛素受体数量的增减密切相关。测定细胞膜脂质饱和度和胰岛素受体数量,是判断胰腺癌增殖状态的灵敏指标,有一定临床价值。     

Pulsatility and resistance indices in intrarenal arteries of normal adults

In order to establish the normal range of values of Pulsatility (PI) and Resistance (RI) Indices in the intrarenal vasculature, a study of 50 healthy volunteers (23 males, 27 females), divided into five groups of 10 according to age, was performed with Duplex Doppler ultrasound. Both kidneys were examined in all individuals and, in 12, indices were also compared between upper and lower poles of both kidneys. In addition, repeat examinations were performed in nine subjects on three different days, in order to assess the reproducibility of the method. No differences were found in the mean values of both indices between males and females, upper and lower poles, right and left kidneys. A statistically significant increase (p < 0.01, unpaired t-test) was demonstrated when the oldest age group (7th decade) was compared to the youngest age group (3rd decade). The method appeared remarkably reproducible for RI (4.2–7%), with wider variation in the PI (9.5–22.7%).     

How can we predict ureteral obstruction after gynecological surgery? The changes in Doppler resistive index and plasma creatinine and magnesium concentrations after surgical, unilateral ureteral obstruction in a rabbit model

The aim of this study is to evaluate the changes in Doppler resistive index (RI) and plasma creatinine and magnesium concentrations after unilateral ureteral obstruction in a rabbit model. Fourteen adult female rabbits were used in this study. In seven rabbits, the left ureter was ligated with silk suture, and the control group was sham operated. Before surgery and on the second and seventh days after surgery, blood samples were obtained to measure plasma creatinine and magnesium concentrations. Doppler RIs of both kidneys were also measured before surgery and on the second and seventh days after the surgical procedure. With regard to magnesium levels, there was a significant within-subjects sessions difference [F(2, 20) = 15.21, P= 0.001] indicating a decrease through sessions. Magnesium concentrations decreased significantly at the postoperative second and seventh days compared to preoperative baseline levels (P= 0.003 and P= 0.001, respectively). Multifactorial analysis of variance was applied for each session separately with laterality, and groups as factors. The Doppler RI and the creatinine level did not show any significant differences or interactions for all sessions (P > 0.05). The decreasing plasma magnesium concentration after surgery may indicate ureteral injury; however, Doppler studies and creatinine levels may not be useful as well.