Management of asthma in patients supervised by primary care physicians or by specialists.

French asthma patients may be supervised by general practitioners (GPs) and/or specialists. Therefore, this study examined asthma management in patients exclusively supervised by specialists (SPE), GPs, (GP) and both (GP+SPE group), and compared the findings. Asthma patients were consecutively recruited in 348 pharmacies. Each patient completed a questionnaire providing data on personal characteristics, asthma management, perception of disease and asthma supervision. Asthma control was measured using the Asthma Control Test. Questionnaires were linked to computerised records of medications which had been dispensed before inclusion in the study. From the 1,256 patients (mean age = 36.1 yrs, 54.3% females), 11.4, 36.6, and 52.0% were placed in the SPE, GP, and GP+SPE groups, respectively. During the previous 4 weeks, most patients in the SPE group were properly controlled (52.2 versus 26.4 and 21.5% in GP and GP+SPE groups, respectively). The SPE group made more use of fixed combinations of long-acting beta agonist and inhaled corticosteroid, while receiving less short-acting beta agonists, antitussives and antibiotics. Striking differences in symptoms and asthma management were observed according to the type of asthma supervision. The current results strongly support the need to improve the management of asthma in primary care, and the coordination of care between general practitioners and specialists.     

人肿瘤特异抗原MAGE-3基因疫苗的构建和表达

目的：克隆肿瘤特异性共享抗原mage-3基因，制备基于α－病毒复制酶的高效黑色素瘤特异性基因疫苗。方法：用RT-PCR方法从黑色素瘤细胞系LB373中制备mage-3基因，以含α－病毒复制酶的哺乳细胞高效表达质粒pSMART2a为载体，构建重组DNA疫苗。重组子用载体中的T7和T3启动子序列为测序引物进行自动测序。再将鉴定过的重组质粒用脂质体法转化293细胞，用免疫印迹法和免疫组化法鉴定转化细胞中mage-3蛋白的表达。结果：正确构建了mage-3/pSMART2a重组质粒，并且在转化此质粒的293细胞中检测出了mage-3蛋白的表达。结论：此重组mage-3/pSMART2a质粒可以作为肿瘤特异的DNA疫苗，可进行下一步的肿瘤动物模型的疫苗接种及相关免疫学效应研究。     

常压及控制性降压下脊髓急性牵拉损伤比较研究

目的 评价控制性降压是否增加脊髓对牵拉损伤的易感性。材料与方法健康成年杂种犬6只，随机分为常压和控制性降压脊髓牵拉损伤组。观察常压及控制性降压水平下相同程度牵拉损伤后脊髓血流(SCBF)、体感诱发电位(SEP)、神经源性运动诱发电位(NMEP)改变的差异。结果 外周血有创动脉压(MABP)平均下降幅度为40．5％。经SSPS统计软件独立样本t检验，不同牵拉水平下，常压组及低压组的SCBF(％)、SEP波幅(Asep)(％)及NMEP波幅(％)无显著差异。结论 尼卡地平控制性降压不增加脊髓对牵拉损伤的易感性。     

慢性肾脏病非透析患者脑钠素与动脉粥样硬化及心功能的关系

目的 研究脑钠素（BNP）与慢性肾脏病（CKD）非透析患者动脉粥样硬化及心功能不全的关系。 方法 采用双抗夹心免疫荧光法检测203例CKD非透析患者与16例高血压患者对照组全血BNP水平，分析其与颈动脉超声结果、心脏彩超结果及既往心血管疾病史的关系。 结果 CKD非透析患者BNP水平与对照组相比显著升高[M（范围）：54.40(15.10～ 173.00) ng/L比9.35(7.35～15.00) ng/L，P < 0.01]。Spearman相关分析显示CKD患者BNP与颈动脉内膜中层厚度（IMT）、左室心肌重量指数（LVMI）等呈正相关。存在颈动脉斑块、左室肥厚或既往发生过心血管事件的患者血BNP水平显著增高。多元回归分析显示LVMI、既往心血管事件均是影响BNP水平的独立因素。 结论 CKD非透析患者BNP水平和动脉粥样硬化性疾病、左室肥厚及心功能不全相关，提示BNP水平可作为一项评价CKD非透析患者心功能及动脉粥样硬化的敏感生物学指标。     

OXYGEN FREE RADICAL IN HUMAN OSTEOARTHRITIS

The xanthine oxidase catalysed release of superoxide free radicals (O2-) from endogenous hypoxanthine was determined in homogenates of synovium obtained from three groups of patients, those undergoing primary or revision total hip replacement (THR) for osteoarthritis and those undergoing arthroscopy of the knee for semilunar disc injuries. The concentrations of hypoxanthine in homogenates obtained during THR were found to be significantly higher than those in the group with semilunar disc injuries. The results suggest that there is a greater predisposition to free radical release and tissue damage in osteoarthritis.     

扩大经额硬膜外入路切除巨大侵袭性垂体瘤

目的:探讨采用扩大的经额硬膜外入路切除巨大侵袭性垂体瘤的临床应用.方法:1997年6月至2002年3月采用该入路显微外科切除巨大侵袭性垂体瘤10例,肿瘤主要累及于鞍上、蝶筛窦及上斜坡区.结果:本组10例中,肿瘤全切6例,次全切除3例,大部分切除1例.术后发生颅神经麻痹4例,其中动眼神经障碍3例,外展神经障碍1例.全组无手术死亡.术后影像学随访6～24个月,全切除肿瘤病例未见肿瘤复发,次全切除者无明显增大.结论:该入路可充分显露鞍区肿瘤,术野开阔,对脑组织损伤小,适用于已侵犯蝶筛窦区及上斜坡的侵袭性垂体瘤.     

99Tcm-HMPAO labelled leucocytes: comparison with 111In-tropolonate labelled granulocytes

The lipophilic complex, 99Tcm-hexamethylpropyleneamine oxime (HMPAO) is an efficient leucocyte label, and labels granulocytes with more stability than mononuclear leucocytes. The recovery of 99Tcm-HMPAO granulocytes, expressed as the percentage of injected granulocyte-associated activity circulating as granulocyte-associated activity 40-45 min after injection, was 37% (S.E. 3%), similar to the recovery of 111In-labelled granulocytes isolated and labelled in plasma using tropolone. The T1/2 of 99Tcm-HMPAO labelled granulocytes in blood was 4.4 h (S.E. 0.4 h), less than that of 111In-labelled granulocytes, although when a correction was made for 99Tcm elution, it was 6.4 h. The initial biodistribution of 99Tcm-labelled leucocytes was similar to 111In-labelled granulocytes, with a rapid initial lung transit, prominent splenic activity, bone marrow activity and minimal hepatic activity, although, unlike 111In, 99Tcm activity was also seen in urine, occasionally in the gallbladder, and, from about 4 h, consistently in the colon. Bone marrow activity was particularly prominent with 99Tcm. About 6% of 99Tcm was excreted in the faeces up to 48 h after injection, and about 17% in urine up to 24 h. The time-activity curves of reticuloendothelial activity up to 24 h were broadly similar for the two labelled cell preparations, and the differences that were observed can be explained on the basis of a higher rate of 99Tcm elution. Clinical information given by the two agents was similar in 27 of 30 patients who received both. Of the three who gave different information, one received 111In-labelled granulocytes which were considered to be functionally suboptimal and two, with inflammatory bowel disease, showed different distributions of abnormal bowel activity. We conclude that with respect to granulocyte kinetics and clinical data, 99Tcm-HMPAO labelled leucocytes are comparable with 111In-tropolonate labelled granulocytes.     

探索灰色文献

在概述了灰色文献的起源、内涵、外延及其他特征的基础上,对各国学者对灰色文献的研究进行了比较分析,对灰色文献的自身价值和社会作用进行了分析评价.     

Delay of cranial bone regeneration by CO2 and Nd-YAG laser application: an experimental study related to craniosynostosis

In this study we have investigated the negative influence of CO₂ and Nd-YAG laser irradiation on rapid cranial regeneration and whether it has any use in certain types of craniosynostosis. Twenty-two newborn rats were used in the study. Both CO₂ and Nd-YAG laser irradiation, which was applied to free bony edges after, suturectomies, resulted in a significant decrease in skull regeneration. Histopathological examinations revealed severe degeneration caused by both types of laser energies.     

阿昔洛韦片剂和胶囊在人体的生物利用度

10名男性受试者按交叉实验设计口服阿昔洛韦片剂和胶囊各400 mg 后,用改良的 HPLC 测定血药浓度,计算表明阿昔洛韦胶囊口服后吸收快于片剂,峰浓度也较高,但吸收程度(AUC_(0-12h))相似。