肝豆状核变性的治疗进展

阐述肝豆状核变性（HLD）在药物、饮食、外科和分子生物学方面的治疗进展，介绍了HLD的药物治疗、外科治疗和分子生物学治疗中的新方法或新技术：以DMPS等为主的药物治疗仍是治疗HLD的主体方法，肝移植等是治疗HLD中的暴发性肝功能衰竭的首选方法，基因等治疗为HLD的彻底治疗提供了可能。     

用于HIV新发感染检测的亲和力方法的研究进展

艾滋病病毒(HIV)新发感染率的估算方法主要有三种:队列研究、数学模型法和实验室方法。其中利用实验室方法检测横断面样本,从而估算新发感染率,已经成为HIV新发感染率重要的估算方法之一,越来越受到重视。在所有实验室检测方法中亲和力方法出现较早,发展历史较长,从20世纪90年代前后至今,已有20多年的研究历史,最近几年更是有了较大的发展。文章通过对亲和力方法的原理、亲和力指数方法用于HIV新发感染检测的现场应用研究,以及亲和力方法的最新研究进展,限制性抗原亲和力方法的研发和初步评价三部分内容的介绍,综述亲和力方法用于HIV新发感染检测的最新进展。     

Assessment of patient's pain-related behavior at physical examination may allow diagnosis of recent osteoporotic vertebral fracture

Background contextAlthough innumerable studies have analyzed the multiple aspects of osteoporotic vertebral fractures, no study has focused on the clinical features related to spine pain in patients with recent osteoporotic vertebral compression fractures (VCFs).PurposeTo determine whether the assessment of pain-related behavior (P-RB) of patients with osteoporotic VCFs of recent onset may allow the fracture to be strongly suspected, or even diagnosed, at physical examination.Study designPain-related behavior of elderly patients attending an outpatient spine clinic was evaluated on the basis of six consecutive movements made on the examining table.Patient sampleFifty-six patients complaining only of lumbar or thoracic pain. The fractured patients (FPs), representing the fracture group (FG), were the 19 who had a recent VCF, whereas the control group (CG) consisted of the remaining 37 patients.MethodsAssessment of P-RB was based on six parameters: grimacing, sighing, clenching or blocking eyelids, gaping or strongly tightening the lips, need for help to take positions, and extreme difficulty to turn in the prone position. A score of 1 or a decimal was assigned to each parameter, the final score to each patient being 0 to 6. Three types of injury, acute (I), subacute (II), or chronic (III), were identified on the basis of the time elapsed from the probable occurrence of the fracture. The diagnosis of recent fracture was based on magnetic resonance images. Patients were videotaped during their movements. An examiner, unaware of the clinical history and diagnosis, gave a P-RB score to all patients and indicated whether they had to be placed in FG or CG, and also their presumable type of fracture. Subsequently, a DVD with the videotapes of all patients was given to three independent examiners, not specifically expert of spine conditions, who were asked to make the same evaluations as the first examiner.ResultsThe mean scores for P-RB given by the first examiner were 4.6 to FG and 0.7 to CG (p<.01). He identified as FPs 89% of those who were in FG. The type of fracture was indicated correctly in 88% of patients identified as FPs. The mean scores for the three types of fracture ranged from 5.4 (Type I) to 3.3 (Type III) (p<.001). The mean scores for P-RB given by the independent examiners to FG and CG were similar to those of the first examiner. The rates of correctness in identifying the type of fracture in patients indicated as FPs varied from 87% to 80%. The mean scores assigned to the patients included in the three types of fracture ranged from 5.4 to 2.8.ConclusionsPain-related behavior evaluation of patients with osteoporotic VCF during their movements on the examining table may allow to suspect, or even diagnose, the presence of a fracture, particularly in the initial 4 to 6 weeks after the occurrence. Even orthopedic surgeons not particularly familiar with spine care may be able to suspect the injury during physical examination.     

山海螺本草考证与临床研究进展简

目的：考证山海螺文献记载,综述其临床研究进展。方法：通过查阅古今文献,考证历代本草学对山海螺的记述,汇总其功效报道。结果：山海螺别名有：羊乳（根）、四叶参、奶党、奶树、白河车等,古代本草著作中作为＂羊乳＂的一种,山海螺为肺经药,兼入肝、脾经,是治疗气虚伴有阴津亏乏、痰结肿疡的良药,有扶正之功,无恋邪之弊,补中可清,清中有宣,润而不腻。结论：中医临床应用山海螺有悠久历史,其功效不断被发掘和完善,特别是治疗肿瘤疾患方面具有广阔应用和开发前景。     

百草枯中毒的研究进展

随着百草枯(PQ)的广泛应用,PQ中毒事件数量逐年增加,已成为我国第二位的农药中毒事件。PQ对人有剧毒,中毒后致多脏器严重损害,病死率极高,其中毒机制尚不完全明确,氧自由基产生学说为大多数学者认可。PQ中毒暂无特效解毒药,临床上主要采取综合治疗的办法,如洗胃、导泻、吸附体内毒素、应用激素及免疫抑制剂、清除氧自由基、保护各脏器功能等,同时结合有效的血液净化手段,本文旨在对相关进展做一简要综述。     

奈达铂联合吉西他滨治疗转移性三阴性乳腺癌的近期疗效和不良反应

目的探讨奈达铂联合吉西他滨治疗转移性三阴性乳腺癌(TNBC)的近期疗效和不良反应。方法选择2010-09—2014-12间入住的52例TNBC患者作为研究对象。其中首发组患者21例,术后复发组患者31例。化疗方案为:奈达铂80 mg/m2,d1;吉西他滨1 000 mg/m2,d1,8,静滴。每21 d为一个化疗周期。持续两个周期后对疗效进行评价。比较2组患者近期疗效及不良反应发生情况。结果 (1)首发组总缓解率显著高于术后复发组(P0.05)。首发组患者中位无进展生存时间(PFS)为(21.52±3.22)个月,术后复发组患者PFS为(16.73±1.82)个月,首发组患者PFS显著高于术后复发组(P0.05)。(2)本组患者治疗过程中,主要发生的不良反应包括:贫血、中性粒细胞减少、血小板减少、恶心呕吐、腹泻、便秘、脱发、皮疹等,且不良反应毒性分级以1~2级为主。结论奈达铂联合吉西他滨治疗转移性三阴性乳腺癌(TNBC)的近期疗效显著,不良反应主要以1~2级为主。     

The development of a brief self-report questionnaire to measure ‘recent’ Rash Impulsivity: A preliminary investigation of its validity and association with recent alcohol consumption

Background

Traditionally, impulsivity has been regarded as a stable trait. However, a series of longitudinal and behavioural laboratory studies has found that impulsivity can fluctuate within individuals, suggesting that it has a state as well as a trait manifestation. Whilst existing impulsivity questionnaires tap the former, there is no self-report instrument to assess recent fluctuations in impulsivity.Research aims and designThe present study set out to develop and undertake preliminary validation of a measure of ‘recent’ impulsivity, focusing in particular on Rash Impulsivity. Part of the construct validation of the resulting Recent Rash Impulsivity Scale (RRIS) entailed examining its association with recent alcohol intake, since there are well-documented reciprocal relationships between alcohol consumption and inhibitory control. In developing the RRIS, items from existing trait impulsivity questionnaires were converted into a ‘previous two weeks’ format. The pilot RRIS was then administered, along with a parallel trait version (Trait Rash Impulsivity Scale; TRIS) and a well-established trait impulsivity measure (the BIS-11; Patton, Stanford & Barratt, 1995), to two cohorts of first-year undergraduates aged 17 to 25 (N = 240), on two occasions one month apart. Information about habitual and recent alcohol intake was also gathered.

Results

Factor analyses on both the RRIS and TRIS identified two factors: ‘Cognitive Impulsivity’ (CogImp) and ‘Motor Impulsivity’ (MotImp). Consistent with the RRIS being sensitive to fluctuations in impulsivity, it was found that, as predicted: i) the RRIS was somewhat less strongly correlated than the TRIS with an established trait measure (the BIS-11; Patton et al., 1995); ii) the test–retest stability of ‘Total’ scores (CogImp and MotImp) was weaker for the RRIS than the TRIS; iii) there was evidence that the RRIS MotImp and Total scales were more strongly predicted by recent alcohol intake than were their trait equivalents; and iv) the RRIS CogImp and Total scales correlated more strongly with their trait equivalents in participants whose alcohol consumption had remained stable recently (relative to their habitual intake), compared to those whose consumption had recently changed.

Conclusions

These data suggest that transient changes in impulsivity can be assessed via self-report, and that the RRIS is sensitive to recent changes in alcohol intake. Subject to a more intensive and detailed validation, it is thus promising as a tool for tapping and characterising fluctuations in behavioural control and for exploring a range of factors to which this might be associated.     

腹腔内灌注紫杉醇治疗恶性腹水近期疗效

目的：观察紫杉醇腹腔内灌注对治疗恶性腹水的近期疗效。方法18例恶性腹水患者随机、双盲分为紫杉醇组和顺铂组,采用对照研究,分别于腹腔积液尽量排净后,给予腹腔内灌注紫杉醇或顺铂。每周1次,连续3周。结果紫杉醇组临床总有效率为88.9%,顺铂组临床总有效率为55.6%,两组相比差异具有统计学意义（P〈0.05）。紫杉醇组生活质量改善较顺铂组明显,两组药物不良反应差异无统计学意义（P〉0.05）。结论腹腔内灌注紫杉醇治疗恶性腹水近期疗效较好,操作简单方便、不良反应少,是一种前景较好的治疗方法。