抗抑郁剂在脑卒中患者中的预防性应用

目的观察预防性应用抗抑郁剂对脑卒中后抑郁(PSD)发生率及神经功能康复的影响。方法64例脑卒中患者随机分成两组,分别接受帕罗西汀与安慰剂治疗,采用改良爱丁堡斯堪的那维亚评分量表(MESS)和日常生活能力量表(ADL)评定脑卒中患者治疗前及治疗后神经功能缺损程度及日常生活能力;治疗结束时评定患者的PSD发生率。结果与安慰剂对照组相比,在治疗结束时,帕罗西汀组患者的MESS、ADL得分分别为11.1±4.3,27.6±4.8,低于安慰剂组的13.6±3.2及32.8±4.1;帕罗西汀组患者的PSD发生率为10.7%,亦低于对照组的41.4%,差异均具有统计学意义。结论预防性应用抗抑郁剂可以降低PSD发生率,并有利于脑卒中患者的神经功能康复。     

Treatment Integrity and Therapeutic Change: Commentary on Perepletchikova and Kazdin

Perepletchikova and Kazdin's (this issue) analysis of the treatment integrity literature should guide future research and practice on this vital issue facing clinical research and practice. This commentary considers the construct of treatment integrity and those factors that moderate the relationship between treatment integrity and treatment outcome. Specifically, this paper examines the three components of treatment integrity specified by Perepletchikova and Kazdin (treatment adherence, therapist competence, treatment differentiation), the relationship between treatment integrity and treatment outcome, and measurement and validation issues involving treatment integrity.     

Egr-1基因剔除减少炎性相关因子在实验性胰腺炎中的表达

目的：探讨Egr-1基因剔除对实验性胰腺炎小鼠胰腺组织中炎性相关因子表达的影响。 〖HTH〗方法：利用Egr-1基因剔除小鼠，采用大剂量雨蛙素诱导的实验性胰腺炎模型，观察Egr-1基因剔除后，胰腺组织水肿、MPO水平、血清淀粉酶水平、肺组织MPO水平的改变。并利用定量PCR的方法，检测胰腺组织中炎症相关因子组织因子（TF）、纤维蛋白溶酶原激活因子抑制因子（PAI-1）、单核细胞趋化吸引蛋白1（MCP-1）、Gro-1、IL-6和细胞间黏附分子-1（ICAM-1） mRNA的表达。 〖HTH〗结果：Egr-1基因剔除小鼠胰腺组织水肿明显轻于野生型，但组织MPO水平与血清淀粉酶与野生型组间相比无明显差异；肺组织MPO水平明显低于野生型。定量PCR检测结果表明， Egr-1基因剔除组，胰腺组织中TF、PAI-1，以及MCP-1、ICAM-1和IL-6　mRNA的表达，明显少于野生型组。 〖HTH〗结论：Egr-1基因剔除可明显减轻急性胰腺炎的严重程度，其作用可能通过减少胰腺组织中TF、PAI-1，以及MCP-1、ICAM-1和IL-6的表达而实现。     

New therapies for rheumatoid arthritis

Rheumatoid arthritis (RA) is a chronic, systemic inflammatory disease, which continues to cause significant morbidity in affected persons. In the past few years, a number of new exciting therapeutic options have become available. These reflect the application of knowledge obtained from advancements in understanding of disease pathogenesis and underlying molecular mechanisms. A number of these therapies are outlined in the following review, including the various biological modifiers, in particular, anti-tumour necrosis factor-alpha agents and interleukin-1 (IL-1) receptor antagonists, which have been developed in recognition of the role of pro-inflammatory cytokines in RA. Also notable, is the current interest centring on the development and trials with B cell depletion therapies, specifically rituximab, in patients with RA. This demonstrates acknowledgment for a more significant role for B cells in the aetiology of RA, in contrast to the long held view that RA was a predominantly T cell mediated disease. To evaluate this therapeutic option for RA, salient features from recent rituximab trials have been collated. Finally, a selection of other therapeutic alternatives, including anti-IL-6 receptor monoclonal antibody and tacrolimus, and newer anti-rheumatic therapies presently in development are summarized.     

秦巴山区初中学生心理健康状况调查研究

目的　了解秦巴山区初中学生心理健康状况及其影响的主要因素。方法　采用 SCL-90临床症状自评量表随机对陕西省安康地区双溪乡初中学生进行心理健康测查。结果　秦巴山区双溪乡初中学生心理健康状况与全国初中学生心理健康常模比较 ,并未出现显著性差异 ;影响初中男生心理健康因素从大到小的顺序为 :抑郁 >躯体化 >焦虑 >强迫 >精神病性 >恐怖 >人际关系 >偏执 >其它 >敌对 ;影响女生心理健康因素从大到小的顺序为 :抑郁 >躯体化 >焦虑 >人际关系>强迫 >精神病性 >恐怖 >敌对 >其它 >偏执。结论　秦巴山区初中学生心理健康状况良好。影响秦巴山区初中学生心理健康的最主要因素为 :抑郁、躯体化和焦虑。     

Altered production of tumour necrosis factors alpha and beta and interferon gamma by HIV-infected individuals.

In vitro studies shows that recombinant tumour necrosis factor (TNF) alpha and beta, and interferon-gamma (IFN-gamma) can enhance HIV replication, and peripheral blood mononuclear cells (PBMC) infected with HIV in vitro secrete high levels of the same cytokines. As T cells secrete all three mediators, the capacity of T cell activation signals to trigger cytokine production in PBMC from HIV-infected individuals was investigated as such patients may be immunocompromised. We demonstrate that asymptomatic seropositives in CDC group II/III as well as patients who have progressed to CDC group IV of the disease proliferate efficiently to anti-CD3 antibody, recombinant interleukin-2 (rIL-2), phytohaemagglutinin (PHA), PHA plus phorbol 12,13 dibutyrate (PMA) but secrete significantly (P less than 0.05) higher amounts of TNF-alpha, TNF-beta and IFN-gamma compared with controls in response to the same stimulants. We also show a difference between group II/III and group IV patients with the latter secreting more TNF-alpha and IFN-gamma. The kinetics of TNF-alpha and -beta, and IFN-gamma production was stimulus dependent with overall levels varying in time for each stimulus. Furthermore, the kinetics of the response to all three stimulants were altered in seropositives; CDC group II/III and group IV patients secreted higher levels of cytokines over several time points compared to controls. The altered production of these mediators by HIV-infected patients may contribute to disease progression and to the pathogenesis of AIDS.     

Effect of ultrasound on the myocardium and cardiac conduction (A morphological study)

Focused ultrasound is used to create local foci of lesions in the myocardium. It is shown that this method can be used for the treatment of monofocal tachycardias. The effect of focused ultrasound on the myocardium, coronary artery, and atrioventricular node is studied in experiments on dogs, and the ultrasound-destroyed zones of the myocardium are investigated morphologically. Translated fromByulleten' Eksperimental'noi Biologii i Meditsiny, Vol. 118, N ^o 7, pp. 104–107, July, 1994 Presented by F. G. Uglov, Member of the Russian Academy of Medical Sciences     

Human polyspecific immunoglobulin attenuates group A streptococcal virulence factor activity and reduces disease severity in a murine necrotizing fasciitis model

Objectives

Streptococcus pyogenes causes life-threatening invasive infections including necrotizing fasciitis (NF). Current treatment guidelines recommend the use of a cell-wall–active antibiotic combined with a protein synthesis inhibitor and surgical debridement in NF patients. Adjunctive therapy with intravenous immunoglobulin (IVIG) has been proposed for superantigen-associated streptococcal toxic shock syndrome. So far, benefits of IVIG treatment remain unclear and prospective clinical studies are scarce. Thus, we aimed to assess the effects of IVIG on virulence factor activity in vitro, ex vivo in patients and in vivo in a NF mouse model.

徐州地区334例早产儿临床分析

目的探讨我院2006年334例早产儿,分析发生的危险因素,以总结提高产科早产预防、医疗水平,并提供研究参考。方法早产组334例与同期分娩的足月对照组334例分析比较,早产的临床相关因素及对围产儿的影响。结果胎膜早破,妊娠高血压综合征,前置胎盘,臀位,多胎妊娠是早产的重要因素。早产使新生儿窒息,围生儿死亡,低体重儿增加。结论早产使围产儿窒息和死亡率增加。加强早产预测可望降低早产的发生,提高围生医学质量。     

去甲肾上腺素诱导严重烧伤大鼠脑组织VEGF表达的实验研究

目的：观察去甲肾上腺素（NE）诱导严重烧 伤后24h大鼠脑组织血管内皮细胞生长因子(VEGF)的表达变化。方法:(1 )采用40%全身总体表面积（TBSA）Ⅲ°烧伤大鼠模型，用干、湿重法检测NE刺激烧伤24h大 鼠脑组织含水量；(2)用高效液相色谱法，检测烧伤大鼠脑组织去甲肾上腺素活性水平的变 化;(3) 用免疫蛋白印迹法（Western blotting）检测NE诱导脑组织VEGF蛋白表达变化。 结果：(1) 烧伤大鼠和NE刺激后的烧伤大鼠脑组织水肿明显；(2)烧伤后2 4 h大鼠脑组织NE活性增加，而NE刺激后的烧伤大鼠，脑组织NE的活性增加显著;(3) NE刺 激剂量增大时，脑组织VEGF的蛋白表达逐渐增加，烧伤后VEGF的蛋白表达增加明显，随NE刺 激剂量增大，烧伤后VEGF的蛋白表达明显增强。结论:NE可诱导严重烧 伤大鼠脑组织VEGF的蛋白表达，提示烧伤后NE水平增高是脑水肿形成的一个重要因素。