No impact of repeated endoscopic screens on gastric cancer mortality in a prospectively followed Chinese population at high risk.

BACKGROUND: Gastric cancer (GC) is the leading cause of cancer deaths in China. Our study prospectively evaluated the impact of repeated endoscopic screens on GC mortality in a high-risk population in China. METHODS: Between 1989 and 1999, a population-based gastroscopic screening was conducted in 4,394 residents of Linqu County, China, a region with the highest rates of GC worldwide. Residents ages 35 to 64 years received initial gastroscopies with biopsies in 1989. Repeated endoscopies were performed in 1994 and 1999. Cancer occurrences and deaths were actively monitored throughout the entire period until July 2000. Mortality from GC was compared with expected values based on mortality rates obtained for Linqu in the 1990-1992 Chinese Cancer Mortality Survey. RESULTS: Between March 1989 and July 2000, 39,303 person-years were accumulated; 85 new GCs occurred, 29 (34.5%) were in early stage. Fifty-eight cases (68%) were identified at one of the screens. The number of observed deaths from GC (37) was close to the expected (36.8). The standardized mortality ratio was 1.01 (95% CI 0.72-1.37) for the entire cohort, 1.13 (95% CI 0.77-1.57) for males, and 0.65 (95% CI 0.26-1.32) for females. CONCLUSIONS: Despite high population coverage with repeated screens, no reduction in GC mortality was observed in this high-risk population in China.     

自制32P敷贴器治疗瘢痕疙瘩

目的：观察自制32P敷贴器局部敷贴治疗不同类型瘢痕疙瘩的临床疗效。 方法：105例瘢痕疙瘩患者中，39例病变厚度≤ 0.3 cm的行单纯敷贴治疗，病变厚度> 0.3 cm的66例随机分为2组，单纯敷贴组36例，手术+敷贴组30例。单纯敷贴根据病变表面积大小及形状剪取敷贴片，根据剂量率和衰变校正计算每天敷贴时间，直接贴于病变表面，每天4.0~5.0 Gy/(部位•次)，连续4 d为一疗程，每疗程间隔4周，总治疗4~6个疗程。幼儿单次剂量控制在每天4 Gy/(部位•次)以下。手术+敷贴组患者手术切除瘢痕疙瘩，待手术伤口无渗出后根据伤口形状剪取敷贴片对准伤口敷贴，剂量及疗程同单纯敷贴组。 结果：单纯敷贴治疗对病变厚度≤0.3 cm的39例瘢痕疙瘩治愈32例(82%)，总有效率98%；对病变厚度> 0.3 cm的瘢痕疙瘩单纯敷贴和手术+敷贴两组治疗总有效率分别为56%和93% ，两组差异有显著性意义(P < 0.01)，其中病程< 9个月的患者治疗有效率分别为25%和75%，病程较长患者治疗有效率分别为13%和77%。治疗过程中有26例在敷帖过程中出现局部皮肤烧灼和刺痛感，均以炉甘石洗剂局部外用处理后缓解；5例出现Ⅰ度放射性皮炎，2例出现Ⅱ度放射性皮炎，以百多邦软膏局部外用后缓解，无出现Ⅲ度以上放射性皮炎病例。治愈患者局部皮肤均有不同程度的色素沉着或皮肤颜色改变。 结论：32P敷贴治疗瘢痕疙瘩治疗安全有效，对病程较短或病变厚度小于0.3 cm的患者可单纯敷贴治疗，病程较长或病变厚度大于0.3 cm患者建议先手术后再敷贴治疗。     

Working‐correlation‐structure identification in generalized estimating equations

Selecting an appropriate working correlation structure is pertinent to clustered data analysis using generalized estimating equations (GEE) because an inappropriate choice will lead to inefficient parameter estimation. We investigate the well‐known criterion of QIC for selecting a working correlation structure, and have found that performance of the QIC is deteriorated by a term that is theoretically independent of the correlation structures but has to be estimated with an error. This leads us to propose a correlation information criterion (CIC) that substantially improves the QIC performance. Extensive simulation studies indicate that the CIC has remarkable improvement in selecting the correct correlation structures. We also illustrate our findings using a data set from the Madras Longitudinal Schizophrenia Study. Copyright © 2008 John Wiley & Sons, Ltd.     

中药肾区渗透并常规治疗高血压性肾损害40例疗效观察

目的：观察中药肾区皮肤外敷渗透加西药常规治疗高血压肾损害结果。方法：将部分中药粉碎微细化处理，将另部分中药液化处理．粉液混合装袋醋浸后外敷在肾区皮肤上，用药物导入仪肾区靶点式导人人体。并用一般西医常规治疗。结果：平均治疗3周血肌酐下降23％，BUN下降26％，24h蛋白尿下降23％，尿量增加16％，收缩压下降9％，舒张压下降7％。结论：中药的肾区皮肤外敷渗透加西医常规治疗效果明显高于一般常规治疗。     

大鼠脑缺血时脑细胞膜磷脂含量变化

采用SD大鼠一侧大脑中动脉阻断致局限性脑缺血模型。脑缺血后迅速断头置于液氮中,HPLC外标定量法测定各磷脂组分。观察脑缺血1、5、15、60、360min时脑细胞膜磷脂含量变化。结果显示,PI在缺血早期显著低于对照组(P<0.01～0.05);PE、PC早期仅呈下降趋势,PE在缺血60min组、PC缺血360min组显著低于对照组(P<0.01～0.05)。PS在缺血全过程中变化轻微(P>0.05)。提示磷脂降解与脑缺血存在一定关系,缺血早期首先出现脑细胞膜功能磷脂降解,膜结构磷脂则在缺血后期出现显著变化,且PE较PC优先降解。     

高血压脑出血微创外科治疗的预后因素分析

目的探讨影响高血压脑出血（HICH）微创外科治疗预后的相关因素。方法回顾性分析经微创手术治疗的HICH病人106例,总结其临床特点和疗效,并采用单因素和Logistic多因素回归分析,总结影响预后的有关因素。结果单因素分析显示：平均动脉压（MAP）、术前意识状态、血肿形态、出血部位、血肿量、血肿与脑室关系、血肿再发及术后并发症等因素与HICH微创外科治疗临床预后有关（P〈0.05）。多因素回归分析显示：术前意识状态、术后并发症及出血部位与HICH微创外科治疗预后密切相关（P〈0.01）。结论微创外科手术治疗HICH具有简单、安全、疗效好等优点;术前意识状态、术后并发症、出血部位是影响其预后的重要因素。     

刺激视上核对大鼠痛阈及电针镇痛的影响

以钾离子透引起的大鼠甩尾反应为痛指标，观察了电和化学刺激视上核（ＳＯＮ）对大鼠痛阈（ＰＴ）和电针（ＥＡ）镇痛的影响。电刺激ＳＯＮ后，ＰＴ明显高于假刺激组（Ｐ＜０．０５～０．００１），电刺激ＳＯＮ后电针足三里，镇痛效应明显提高，并有明显的量效关系。电刺激ＳＯＮ的近旁部位（０．５—１ｍｍ）对ＰＴ及电针镇痛无明显影响。ＳＯＮ内注射Ｌ－谷氨酸（Ｌ－Ｇｌｕ）后痛阈和电针镇痛效应都明显对照组，也有明显的量效关     

Alterations of G-protein Coupling Function in Phosphoinositide Signalling Pathways of Rat Hippocampus by Ischaemic Brain Injury

The activation of membrane-associated phospholipase C is rapidly and transiently induced in the central nervous system by a variety of stimuli. Ischaemic brain injury is one of the situations that leads to a dramatic increase in polyphosphoinositide (PPI) turnover. In this study, stimulation of PPI hydrolysis by glutamate (500 μM) was measured in hippocampal slices from rats up to 21 days after an ischaemic insult of 30 min. Ischaemia was induced using the four-vessel occlusion method. PPI hydrolysis elicited by glutamate was significantly increased in the slices prepared from ischaemic rats 24 h after reperfusion, the accumulation of inositol phosphates (InsP_s) and inositol 1,4,5-trisphosphate (InsP₃) was 614±74% ( n = 8) and 182±11% ( n = 9) of the basal level respectively. This potentiation was also observed 21 days after ischaemia. Hyper-responsiveness to glutamate was also accompanied by an increase in AIF⁻₄-stimulated formation of [³H]inositol phosphates. In addition, global ischaemia did not change either high-affinity [³H]glutamate binding in hippocampal membranes or the stimulation of PPI hydrolysis by carbachol or noradrenaline in hippocampal slices. The present results suggest that the increased responsiveness to glutamate is the result, at least in part, of functional changes at the G-protein level, and may contribute to the pathophysiology of ischaemic brain injury or to the regenerative phenomena that accompany ischaemic damage.     

白细胞介素—2新的功能位点及其中枢镇痛作用

白细胞介素－２（ＩＬ－２）不仅是重要的免疫调节因子，而且还具有重要的中枢调节作用。本实验以钾离子透入引起大鼠甩尾反应为指标，发现侧脑室注射ＩＬ—２能显著提高动物痛阈，并能被纳洛酮所阻断，表示ＩＬ－２的中枢镇痛作用可能与阿片受体有关。利用基因定位突变技术获得的无免疫活性ＩＬ－２实查体仍具有中枢镇痛作用，表明ＩＬ—２分子上发挥镇痛和免疫调节作用的功能位点是相互独立的。纳洛酮能够阻断ＩＬ—２的中枢镇痛作用，而不能影响ＩＬ—２增殖ＣＴＬＬ－２细胞的作用，提示ＩＬ－２发挥镇痛和免疫调节作用可能通过不同的受体途径。ＩＬ－２分子中第４５位Ｔｙｒ残基突变为Ｖａｌ后，虽仍保留了免疫活性，但丧失了镇痛功能，表示４５位Ｔｙｒ残基是ＩＬ—２发挥中枢镇痛功能的关键残基之一。我们推测ＩＬ—２的镇痛功能位点可能在ＩＬ—２分子中第４５位Ｔｙｒ残基附近区域。