脊柱复合性损伤的救治风险与早期治疗

目的评估脊柱复合性损伤的特点和救治风险,探讨风险控制与最佳治疗的方法。方法采用AIS、ISS、TRISS及APACHEⅡ等评分方法对273例脊柱复合性损伤患者进行定量评价与救治分类,并依据伤后的损伤分级、参数评定及计量评分等指标进行量化分析和统计处理。结果颈椎合并伤115例,胸椎合并伤141例,胸腰椎合并伤294例,腰骶椎合并伤181例;患者的救治风险和脊椎伤的治疗选择或手术时机与其合并伤的解剖伤势及由此所构成的整体伤情密切相关(P<0.01或<0.05);高风险性伤员往往综合伤势严重,生存概率(Ps)趋低,并发症和死亡率高(P<0.01或<0.05)。结论脊柱脊髓损伤常合并有严重的多发伤,高危伤情不仅可增加其救治风险和脊柱伤的处理难度,且还易于丧失手术最佳时机。分类救治对伤员的风险控制和脊柱伤的专科治疗是有益的。     

1994～2002年广西甲型副伤寒和伤寒流行情况分析

目的 了解1994～2002年接种伤寒Vi疫苗后的7年间伤寒和副伤寒流行变化，评价Vi疫苗对控制伤寒流行的效果并分析甲型副伤寒的特征及影响其爆发流行的因素。方法对自治区疾病控制中心实验室记录、伤寒副伤寒爆发调查报告、监测系统资料、全区伤寒流行地区伤寒Vi疫苗供应情况进行统计分析。结果 经过血培养证实甲型副伤寒病例为1200例、伤寒为285例；甲型副伤寒与伤寒的流行病学、临床特征十分相似；饮用污染水是引起甲型副伤寒爆发的主要原因；从1999年起，甲型副伤寒杆菌开始超过伤寒菌为优势流行菌株。结论 在广泛使用伤寒Vi疫苗后，伤寒基本得到控制，但因为引起副伤寒发病的危险因素依然存在，甲型副伤寒已取代寒，成为广西农村地区的最重要的传染病之一。为控制甲型副伤寒的流行，在安全饮用水供应状况得到全面改善之前，应尽快研制出副伤寒疫苗。     

Exploring cancer register data to find risk factors for recurrence of breast cancer – application of Canonical Correlation Analysis

Background  

A common approach in exploring register data is to find relationships between outcomes and predictors by using multiple regression analysis (MRA). If there is more than one outcome variable, the analysis must then be repeated, and the results combined in some arbitrary fashion. In contrast, Canonical Correlation Analysis (CCA) has the ability to analyze multiple outcomes at the same time.     

Genetic Conservation of Hemagglutinin Gene of H9 Influenza Virus in Chicken Population in Mainland China

The hemagglutinin (HA) genes of 12 H9N2 influenza virus strains isolated from chickens in Mainland China during the period 1995–2002 were genetically analyzed. All the isolates possessed the same amino acid motif -R-S-S-R/G-L- at the cleavage site of HA. Except for the conserved amino acids, as is the case in the other avian influenza viruses, located in the receptor binding site, all of the 12 isolates possessed N at amino acid position 183; A, T, or V at position 190; K at position 137, whereas the representative strains of the other lineage (except Dk/HK/Y280/97-like lineage) virus of H9N2 viruses had H, E, and R at these positions respectively. These could be considered as the partial molecular markers of the H9 viruses isolated from chickens in Mainland China. Phylogenetic analyses showed HA genes of these isolates belonged to that of A/duck/Hong Kong/Y280/97-like virus lineage. No A/quail/Hong Kong/Gl/97-like virus was found in chicken, population since the outbreak of H9N2 influenza in Mainland China in 1992. The available evidence indicates that HA genes of H9 influenza virus circulating in Mainland China during the past years were well conserved.     

Altered impedance during pigment aggregation in<Emphasis Type="Italic">Xenopus laevis</Emphasis> melanophores

Melanophores are dark-brown pigment cells located in the skin of amphibia, fish and many invertebrates. The skin colour of these organisms is regulated by the translocation of pigment organelles, and the pigment distribution can be altered by external stimuli. The ability to change colour in response to stimuli makes these cells of interest for biosensing applications. It was investigated whether pigment aggregation in Xenopus laevis melanophores can be detected by impedance measurements performed in transparent microvials. The results show that cell attachment, cell spreading and pigment aggregation all resulted in impedance changes, seen particularly at the highest frequency tested (10 kHz). The mechanisms behind the impedance changes were investigated by the addition of latrunculin or melatonin, both of which cause pigment aggregation. The latrunculin-induced aggregation was associated with cell area decrease and filamentous actin (F-actin) breakdown, processes that can influence the impedance. Lack of F-actin breakdown and an increase in cell area during melatonin-induced aggregation suggest that some other intracellular process also contributes to the impedance decrease seen for melatonin. It was shown that impedance measurements reflect not only cell attachment and cell spreading, but also intracellular events.     

退变性腰椎滑脱CT下小关节面角的测量与意义

目的 经ＣＴ观测退变性腰椎滑脱病人及正常人的腰椎小关节面角,推测矢状方向小关节与退变性腰椎滑脱之间的关系。方法 包括２４例Ｌ４～５节段的退变性滑脱病人和３７例正常人作为研究对象,均为女性。应用ＣＴ对Ｌ３～Ｓ１腰椎小关节进行扫描和小关节面角测量。结果 除观察到明显的退行性变化外,滑脱病人的Ｌ４～５节段小并节面角明显小正常人群。结论 过度朝向矢状面的退变小关节是导致腰椎退变性滑脱的重要原因之一。     

HFJV联合药物治疗兔海水淹溺肺水肿

目的：观察高频喷射通气（HFJV）联合4种药物治疗海水淹溺肺水肿（PE-SWD）的效果并探讨其作用机制。方法：用海水灌注的方法诱导PE-SWD模型,采用HFJV联合地塞米松、东莨菪碱、尼莫地平和果糖二磷酸钠4种药物进行治疗,观察记录相关的生理、生化指标。结果：HFJV联合4种药物治疗能明显改善PE-SWD相关指标。结论：HFJV联合4种药物治疗能有效治疗PE-SWD,可作为其基础治疗。     

安非他酮与西酞普兰治疗老年期抑郁症对照研究

目的观察安非他酮缓释片治疗老年期抑郁症的临床疗效和安全性。方法进行6周的开放式前瞻性随机对照研究,将56名老年期障碍的患者随机分为两组,安非他酮组(26例)和西酞普兰组(30例),疗程6周,采用汉密尔顿抑郁量表(HAMD)和汉密尔顿焦虑量表(HAMA)及副反应量表(TESS)在治疗前和治疗后1、2、4、6周末评定药物疗效和副反应。结果采用t检验,两组HAMD和HAMA总分及各因子分从疗后2~6周均较治疗前显著降低(t=20.45,13.50,6.7,6.06;P均0.01),两组间无显著性差异;治疗结束时TESS评分安非他酮组与西酞普兰组无显著性差异(t=0.23,P0.05)。结论安非他酮缓释片治疗老年期抑郁症的疗效及药物不良反应均与西酞普兰相当,可作为治疗老年期抑郁症的一线药物使用。     

一普二专三开放：灾害救援医学教学体系的构建与实施

21世纪灾难频发，造成大量的人员伤亡和财产损失，救援医学人才匮乏，相关的教育是关键。为培养具备较强综合能力和素养的救援医学人才，我校通过探索，构建了“一普二专三开放”三位一体的教学体系：对全校新生开设急救常识课程；对高年级临床医学生开设《基础灾害救援医学》专业课程；三支学生志愿者服务队对社会开放式急救培训。以“构建灾害救援知识、能力和职业素养结合的教学体系”，“开展多形式的灾害救援仿真情景实践教学”，“灾害救援医学校内教学与服务社会相结合”为特色，经过五年的实践，医学生灾害救援的能力和素质明显提升。     

Consumption and Sources of Dietary Salt in Family Members in Beijing

In China, few people are aware of the amount and source of their salt intake. We conducted a survey to investigate the consumption and sources of dietary salt using the “one-week salt estimation method” by weighing cooking salt and major salt-containing food, and estimating salt intake during dining out based on established evidence. Nine hundred and three families (1981 adults and 971 children) with students in eight primary or junior high schools in urban and suburban Beijing were recruited. On average, the daily dietary salt intake of family members in Beijing was 11.0 (standard deviation: 6.2) g for children and adolescents (under 18 years old), 15.2 (9.1) g for adults (18 to 59 years old), and 10.2 (4.8) g for senior citizens (60 years old and over), respectively. Overall, 60.5% of dietary salt was consumed at home, and 39.5% consumed outside the home. Approximately 90% of the salt intake came from cooking (household cooking and cafeteria or restaurant cooking), while less than 10% came from processed food. In conclusion, the dietary salt intake in Beijing families far surpassed the recommended amounts by World Health Organization, with both household cooking and dining-out as main sources of salt consumption. More targeted interventions, especially education about major sources of salt and corresponding methods for salt reduction should be taken to reduce the risks associated with a high salt diet.