超脉冲CO2点阵激光联合PRP治疗面部痤疮凹陷性瘢痕疗效分析

目的:探究超脉冲CO2点阵激光联合富血小板血浆(PRP)治疗面部痤疮凹陷性瘢痕的疗效。方法:72例面部痤疮凹陷性瘢痕患者,随机分为观察组(36例)和对照组(36例)。对照组采用超脉冲CO2点阵激光治疗,观察组采用超脉冲CO2点阵激光联合PRP治疗。比较两组患者的灰度差异、时间指标、瘢痕程度、疼痛、不良反应及视觉评估。结果:观察组的并发症发生率为11.11%,低于对照组的36.11%,差异具有统计学意义(P<0.05)。治疗后,两组患者的灰度差异率均减小,且观察组患者的灰度差异率显著低于对照组,差异具有统计学意义(P<0.05)。治疗后,观察组的炎性渗出时间、红肿时间、愈合时间、停工时间及瘢痕程度评分均低于对照组,差异均具有统计学意义(P<0.05);但疼痛度评分组间比较,差异无统计学意义(P>0.05)。结论:超脉冲CO2点阵激光联合PRP治疗面部痤疮凹陷性瘢痕效果较好,可有效降低瘢痕程度,减少治疗时间及并发症的发生,帮助患者迅速回归正常工作与生活,值得临床推广使用。     

187例精神疾病患者劳动能力鉴定分析

目的：探讨精神疾病患者劳动能力鉴定状况及与其相关问题。方法：分析1998至2002年共187例精神疾病患者的劳动能力鉴定资料，并进行不同年代、不同诊断、不同级别的组问比较。结果：除1998年外，其余各年度基本资料相似；诊断以精神分裂症为主，精神发育迟滞为次；前者的平均年龄最大、病期最短、累计病休时间最长、残疾级别最低，后者反之。结论：劳动能力鉴定应按有关标准执行，但目前仍存在一些有待进一步完善的问题。     

TPA诱导的血小板聚集的研究

应用不同浓度ＴＰＡ诱发血小板聚集，观察２０名正常人血小板的聚集率。结果显示：ＴＰＡ从５ｎｇ／ｍｌ到１０ｎｇ／ｍｌ之间，随着浓度的增加，血小板聚集率逐渐增加，最佳浓度为１０ｎｇ／ｍｌ。当ＴＰＡ浓度〉１０ｍｇ／ｍｌ时，继续增加ＴＰＡ浓度，血小板聚集率将不再升高，且于２０ｍｇ／ｍｌ时出现明显的解聚现象。     

蛇毒溶栓素对实验动物血小板功能和环腺苷酸含量的影响

本文报道蛇毒溶栓素对实验动物血小板功能和血浆环腺苷酸含量的影响.(1)对血小板数的影响:给家犬以4 u/kg量静注1小时后,循环血的血小板数由药前130.44×10~9/L±50.02×10~9/L下降至60.20×10~9/L±20.50×10~9/L(P<0.05).(2)对血小板聚集功能的影响:猕猴和家兔分别按4 u/kg、8 u/kg量静注1小时后,对ADP诱导的血小板聚集率分别山药前的62.32±22.05%和43.66±10.60%下降至1.32±0.49%和4.95±1.96%;抑制率分别为97.50±1.75%和88.34±4.31%,与药前组相比均有非常显著的差异(P<0.001).(3)对血小板cAMP含量的影响:猕猴和家兔以蛋白竞争结合法测定血小板内cAMP的含量,药后1小时的含量65.43±31.35pmole/mg,32.25±15.43pmo1e/mg蛋白质,与药前12.02±0.95pmole/mg,4.25±3.13pmole/mg蛋白质相比有明显升高(P<0.001).     

我省流通领域阿莫西林制剂质量现状

目的:了解流通领域中阿莫西林制剂的质量状况。方法:在全省各市县的部分医药经营企业,抽取阿莫西林胶囊及干糖浆共54批样品,按国家药品标准进行全检后,对其检验结果进行统计分析。结果:不合格的项目有含量、胶囊剂溶出度、干糖浆粒度。该药物制剂的标示百分含量普遍偏低。结论:影响该产品质量的主要项目是含量和溶出度,含量偏低的主要原因是厂家的低限投料,应予以充分重视。     

临床医学专业学位教育的困境与发展走向

自临床医学研究生、临床医学专业学位教育实施以来，社会评价并不高，甚至存在相当数量的负面评价。究其因，一是源于对临床医学专业学位教育的认识误区，二是源于我国目前临床医学专业学位教育制度本身的缺陷。目前，我国高等医学教育体系尚不完善，专业学位教育、研究生教育及毕业后职业技能基本培训之间关系错综复杂，功能定位不清，形成相互干扰和冲突。建议进一步梳理思路，正确认识专业学位教育、研究生教育和住院医师规范化培训的教育特征与功能定位，建立各自恰当的培养目标与培养模式，最终实现在全国建立先进、科学、完善、与国际接轨的完整的医学教育体系。     

Tau immunoreactivity and SDS solubility of two populations of paired helical filaments that differ in morphology

To further understand the processes that lead to the formation of neurofibrillary tangles from paired helical filaments (PHF) in Alzheimer brains, we studied two morphologically distinct fractions of PHF separated on sucrose density gradient. In a fraction with mostly short and non-aggregated PHF, the majority of filaments could be solubilized in SDS. In a fraction containing primarily PHF aggregated into clusters or bundles, sometimes resembling neurofibrillary tangles, filaments were less soluble in SDS. Immunogold labelling with a panel of tau-immunoreactive antibodies demonstrated that N-terminal epitopes of tau were preserved in the short filaments, but were reduced or absent in aggregated filaments. In contrast, C-terminal epitopes were present in both fractions. Furthermore, the accessibility of the microtubule-binding domain to immunolabelling was markedly impaired in short and non-aggregated filaments compared to aggregated filaments. These results are consistent with proteolytic degradation of the N-terminal epitopes and preservation of the C-terminal epitopes and the microtubule-binding domain of tau in the aggregated filaments. Partial proteolysis may be involved in the generation of aggregated PHF in neurofibrillary tangles.     

扩张程度和皮肤血运关系的实验研究

目的研究扩张皮肤血运和扩张程度的关系。方法以扩张容量和扩张皮肤面积作为扩张程度的指标，观察猪皮肤在不同程度超量扩张下的皮肤激光多普勒血流值（LDF）和血管造影。结果超量扩张下LDF呈下降的趋势，而血管密度却是增加的，主要以小静脉和微小静脉的增生扩张为主。结论超量扩张下虽然皮肤血管密度增加，但皮肤血运却逐渐下降。本文浅略解释了这一特殊现象的机制。     

The effect of endothelium-derived nitric oxide on ex vivo whole blood platelet aggregation in man

Summary The effects of changes in endogenous endothelium-derived nitric oxide (NO) on forearm blood flow and ex vivo platelet aggregation have been studied in 7 healthy volunteers.Measurements were made of forearm blood flow and ex vivo collagen-stimulated platelet aggregation during unilateral brachial artery infusions of saline, acetylcholine (ACh), N^G monomethyl-L-arginine (L-NMMA), and prostacyclin (PGI₂). The uninfused arm acted as a control.Forearm blood flow was increased by ACh, an agent which stimulates NO release, and decreased by L-NMMA, an agent which stereospecifically inhibits NO synthesis.Collagen-stimulated platelet aggregation measured ex vivo in whole blood draining the infused arm was unaltered by either ACh or L-NMMA. Conversely, PGI₂, an agent which acts independently of NO, caused an increase in forearm blood flow which was accompanied by significant inhibition of platelet aggregation.The results suggest that release of endothelium-derived NO in quantities sufficient to cause substantial changes in blood vessel tone does not lead to changes in platelet aggregation in the blood flowing through the vessels. It is, however, still possible that endothelium-derived NO modulates platelet activity at the level of the endothelium. Present address: Department of Medicine and Therapeutics, University of Aberdeen Polwarth Building, Forrester Hill, Aberdeen, UK     

体外循环对紫绀型先天性心脏病病人血小板的影响

检测１８例体外循环紫绀型先天性心脏病手术病人术前，术中及术后３，８天外周血血小数量和 附，聚集功能，探讨体外循环对血小板质和量的影响。结果显示，血小板数量和聚集功能在术后显著下降并持续至术后８天，血小板粘附功能显著下降，术后３天恢复。提示体外循环气血界面，人工材料非内皮表面可导致血小板激活，粘附，聚集面在量消耗，数量和功能显著下降。