特发性肺纤维化急性加重期证候与血清生物标志物的相关性研究＊

目的 通过分析特发性肺纤维化急性加重期（AE-IPF）患者证候与血清生物标志物的关系，为中医辨证治疗提供参考。方法 采用观察性研究设计，收集2019年3月至2019年11月三个中心的AE-IPF患者76例，其中痰热壅肺证26例、痰浊阻肺证50例，并纳入健康志愿者10例作为对照。采用ELISA测定患者血清CCL18、HMGB1、KL-6、MMP-7、SP-A和SP-D水平，分析与中医证候的相关性。结果 AE-IPF患者血清CCL18、HMGB1、KL-6、MMP-7、SP-A和SP-D水平均显著高于健康对照组。血清CCL18、HMGB1、KL-6、MMP-7和SP-D水平在痰热壅肺证和痰浊阻肺证患者间无显著性差异（P＞0.05），而血清SP-A水平存在显著性差异（P＜0.05）。结论 血清SP-A与AE-IPF证候存在一定的相关性，血清SP-A的浓度升高，与痰热壅肺证关系越密切，反之，血清SP-A浓度降低，则与痰浊阻肺证关系越密切。AE-IPF痰热壅肺证患者的预后可能较痰浊阻肺证患者更差。     

信息管理与信息系统(医学)专业课程体系设置

针对当前国内医学信息学专业的发展现状和社会对医学信息学领域的人才需求,探讨信息管理与信息系统(医学)专业的培养目标和培养方向,并在此基础上对该专业的课程设置和教学方法提出一些构想,以便促进我国目前医学信息学专业教学的发展。     

复杂主动脉病变的腔内血管外科治疗

目的 探讨复杂主动脉病变的腔内血管外科治疗方法。方法 对21例合并有内脏动脉缺血等复杂的主动脉病变,双球管定位下经锁骨上动脉到股动脉交换导丝以确保真腔内植入带膜支架,对真腔完全被假腔压闭的患者采取真腔内加压推进以通过导丝,用超长带膜支架来封堵大破口治疗夹层合并巨大假性动脉瘤形成,对夹层合并腹主动脉瘤患者采取血管腔内技术联合开腹手术等方法。结果 术后内漏3例,其中2例7 d后停止,1例漏血持续存在。3例主动脉创伤术后完全康复,余18例复杂主动脉夹层术后即时造影示瘘口已被完整覆盖,假腔无血漏入,内脏动脉等恢复真腔供血。18例中6例合并肠管缺血,3例合并肾动脉缺血,3例肠管缺血、肾动脉缺血,2例腹主动脉真腔完全被假腔压迫,以及2例合并下肢缺血术后均逐渐恢复,无脏器及肢体缺血坏死发生。2例合并腹主动脉瘤夹层行支架型人工血管封闭夹层破口后行开腹手术切除腹主动脉瘤、人工血管置换。16例随访5～36个月,平均22.3月,1例内漏持续存在,但假腔未继续加大,其余患者存活良好。结论 对复杂的主动脉病变的治疗,通过对腔内血管外科技术进行改进,并适当结合传统手术方法,使某些过去被认为不能够治疗的复杂主动脉病变可得以成功治疗。     

青岛市某高校学生精神药物使用情况调查

本文采用个人自填问卷方式，对青岛市某高校三年级和五年级学生使用包括酒类、香烟在内的精神药物的情况进行调查。结果表明大学生对酒、香烟等精神药物的使用较为普遍。其中烟、酒的使用率随着年级的增长而提高，五年级学生饮酒、抽烟率明显高于三年级学生（Ｐ＜０．０５）。提示大学生中酒、香烟等精神药物的使用问题是值得注意的。     

Expression of CD68 CD45RO CD20 and proliferating cell nuclear antigen in nasal polyps]

OBJECTIVE: To study the cellular expression of CD45RO, CD20, CD68 and proliferating cell nuclear antigen (PCNA) in nasal polyps. METHODS: Nasal polyp tissues from 50 patients were evaluated for cellular expression of CD45RO, CD20, CD68 and PCNA using immunohistochemistry SP by counting the average number in 5 chosen high-power fields, Histopathological observations were combined with HE. Analyses were performed on SPSS10.0. RESULTS: CD68+ cells were expressed more in nasal polyps dominated by eosinophils than by neutrophils(P < 0.05). There was no difference between CD45RO and CD20, but both of them had negative correlation(P = 0.05). Significant correlation was found between CD68+ cells and eosinophils or PCNA positive cells on epithelium. PCNA positive cells on epithelium had significant correlation on fibroblast (P < 0.05). CONCLUSION: Inflammatory cell infiltration (eosinophilia CD45RO, CD20, CD68) and cell proliferating in epithelium cells, glandular cell and fibroblast are strongly correlated with formation of nasal polyps. The nasal polyps are not only characteristic of eosinophilia but also by lymphocytes dominated by CD45RO and CD68 positive cells. CD68 may be stem cell of nasal polyp.     

高原地区人胎儿脊柱的生长发育

本文用X线摄片的方法,对西宁地区胎龄为17—36周的60例胎儿脊柱的骨化及生长动态进行了研究。结果:1、提供了高原地区人胎儿脊柱长轴生长发育的资料。脊柱各段以胸段为最长,其次为腰、颈、骶段。2、计算出胎龄与脊柱各段长度间的回归方程,据此可以胎龄推算脊柱的长度,反之亦可以脊柱的长度估计胎龄。3、报道了颈、骶、尾段亿发骨化点出现顺序的规律。     

Changes in height of choroidal melanomas after plaque therapy.

Serial ultrasonic measurements of 82 uveal melanomas treated with brachytherapy plaques (cobalt-60 and iodine-125) and followed up for up to 141 months revealed that no two patients had identical patterns of change. The mean absolute change in tumour height after treatment was 1.8 mm at six months, 5.6 mm at 48 months for large tumours, and 0.9 and 1.9 mm for medium sized tumours. Eighty of the 82 patients fell into one of three patterns of response: 57 patients had a decrease in height after treatment (type D), 13 patients had the same height after treatment (type S), and 10 patients had a progressive increase in height (type I). Life table comparison showed no correlation between survival and location of tumour, sex of patient, size of tumour when treated, or laterality. There was a slight correlation between age and survival. Patients older than 60 died more frequently from metastatic melanoma than those under 60 (p = 0.06). Life table analysis showed a significant correlation between tumour regression type and survival. At 48 months the best cumulative probability of survival was in patients with type D (88% alive) compared with those of type I (34% alive, p = 0.0004).     

去甲肾上腺素缩血管作用对犬冠状血管舒张的限制

在10只麻醉开胸犬的左前降支冠状动脉(LAD)恒流灌注,持续监测灌注压,并于冠脉内注入2.5mg心得宁以阻断心脏的β_1-肾上腺素能受体,观察去甲肾上腺素(NE,α-肾上腺素能刺激)对LAD内给予腺苷所致冠状血管舒张的限制作用。随着LAD内注入的腺苷量增加,冠状动脉阻力(R)咸剂量依赖性降低,分别为对照值的8.7％(2μg/min),20.6％(10μg/min)和28％(50μg/min)。而于LAD内再给予相同齐0量(6μg)的NE,则使不同剂量扩张的冠脉收缩,R成阶梯状增加,分别为对照值的17.4％(腺苷2μg/ml),23.2％(腺苷10μg/min)和34.1％(腺苷50μg/min),表现为隙苷引起的冠状血管扩张愈大,NE能刺激引起的缩血管作用愈强。这表明α-肾上腺素能缩血管作用可限制腺苷引起的冠状血管舒张,因而有助于保持冠状血管张力及其储备力。     

玻璃体切除术联合睫状体平部切口摘除球内异物

报道玻璃体切除术联合睫状体平部切口摘除球内异物的联合手术，治疗眼球后段异物８例８眼。其中，３眼为非磁性异物，５眼为磁性异物，均一次手术成功取出异物。介绍了此联合手术的方法，并对其意义、适应证以及手术前的准备进行了较为详细的讨论，对其并发症的处理和预防也作了叙述。