二维康口服液对大鼠实验性肝癌的防治作用

目的 研究二维康口服液（刺五加及黄芪）对大鼠实验性肝癌的防治作用；方法 用ＨＥ染色法及常规电镜标本制备方法观察肝脏组织学变化及超微结构变化。免疫学检测指标免疫包括自然杀伤（ＮＫ）细胞活性，白细胞介素２（ＩＬ－２）及肿瘤坏死因子（ＴＮＦ）。结果 致癌剂加用中药级较单纯致癌剂组癌结开形成少且小，癌周组织细胞核及胞浆细胞器基本保持完整，ＮＫ活性及ＩＬ－２活性单位显著升高（Ｐ〈０．０１），结论 二维康口服     

肿瘤坏死因子α和干扰素α对膀胱癌患者LAK细胞增殖和细胞毒作用的影响

为探讨联合应用白细胞介素２（ＩＬ２）和干扰素（ＩＦＮ）或肿瘤坏死因子（ＴＮＦ）对膀胱癌患者ＬＡＫ细胞的增殖和细胞毒作用的影响，采用淋巴细胞分离液梯度离心法从２１例膀胱癌患者外周血分离ＬＡＫ细胞并用ＩＬ２激活培养，细胞于９６孔细胞培养板用细胞计数方法观察不同浓度ＴＮＦα和ＩＦＮα对细胞增殖的影响，用膀胱癌细胞系ＢＩＵ８７和ＥＪ细胞作为靶细胞，用ＭＴＴ法测定ＬＡＫ细胞的细胞毒。结果：ＴＮＦα呈剂量依赖性地加强由ＩＬ２诱导的ＬＡＫ细胞增殖，１０００Ｕ／ｍｌ的ＩＦＮα于４８小时也对ＬＡＫ细胞产生刺激作用，用５０００Ｕ／ｍｌ的ＴＮＦα可增强ＬＡＫ细胞对ＥＪ和ＢＩＵ８７细胞的细胞毒杀伤，ＩＦＮα对此则无明显影响。结果提示ＴＮＦα和ＩＦＮα增强膀胱癌患者ＬＡＫ细胞的增殖并在细胞毒杀伤中起重要作用，对临床膀胱癌的免疫治疗提供一定依据。     

膀胱癌患者血清可溶性白细胞介素2受体的表达及其意义

对２４例膀胱移行细胞癌患者手术前后不同时期可溶性白细胞介素２受体（ＳＩＬ－２Ｒ）表达水平、白细胞介素２（ＩＬ－２）产生能力以及自然杀伤细胞毒因子（ＮＫＣＦ）活性进行了动态观察。结果表明，膀胱移行细胞癌患者ＳＩＬ－２Ｒ表达水平明显高于正常人，且ＳＩＬ－２Ｒ随肿瘤分期增高而逐渐升高；膀胱癌患者ＩＬ－２产生能力、ＮＫＣＦ活性明显低于正常人。术后膀胱移行细胞癌患者免疫功能呈现一个暂时抑制到逐渐恢复的过程。提示机体免疫功能变化与膀胱移行细胞癌的预后密切相关     

肿瘤坏死因子α和干扰素α对膀胱癌患者LAK细胞增殖和细…

为探讨联合应用白细胞介素２（ＩＬ－２）和干扰素（ＩＦＮ）或肿瘤坏死因子（ＴＮＦ）对膀胱癌患者ＬＡＫ细胞的增殖和细胞毒作用的影响，采用淋巴细胞分离液梯度离心法从２１例膀胱癌患者外周血分离ＬＡＫ细胞并用ＩＬ－２激活培养，细胞于９６孔细胞培养板用细胞计数方法观察了不同浓度ＴＮＦα和ＩＦＮα对细胞增殖的影响，用膀胱癌细胞系ＢＩＵ－８７和ＥＪ细胞作为靶细胞，用ＭＴＴ法测定ＬＡＫ细胞的细胞毒。结果：ＴＮＦα呈     

抗白介素2受体α链单抗及AK细胞治疗肝癌的实验研究

探讨一种新的过继免疫治疗肝癌方法,方法将肝癌细胞株接种于近交系ＢＡＬＢ／ｃ小鼠皮下,制成荷瘤小鼠模型,用ＩＬ－２／ＡＫ细胞／抗白介素２受体α链单抗治疗,以发现其抗肿瘤作用。结果荷瘤小鼠脾淋巴细胞ＮＫ活性无明显变化,ＬＡＫ和ＣＴＬ活性及淋巴细胞刺激指数在联合治疗组均高于其他各组;肝癌皮下结节在联合治疗组明显受到抑制成荷瘤小鼠模型 肿瘤小鼠生存期明显延长。结论ＩＬ－２,αＩＬ－２αＭＡｂ及ＡＫ细胞联合     

膀胱肿瘤患者可溶性白细胞介素_Ⅰ受体抑制自然杀伤细胞毒因子抗瘤活性的研究

对３１例膀胱移行细胞癌患者血清可溶性白细胞介素＿Ⅱ受体（ＳＩＬ－２Ｒ）表达水平、白细胞介素Ⅱ（ＩＬ－２）产生能力、自然杀伤细胞毒因子（ＮＫＣＦ）活性进行研究。结果表明：膀胱移行细胞癌患者血清ＳＩＬ－２Ｒ表达水平显著高于正常人，且血清ＳＩＬ－２Ｒ水平与肿瘤分期有关。ＳＩＬ－２Ｒ与ＩＬ－２产生能力，ＮＫＣＦ活性间呈显著负相关关系，体外研究也证实ＳＩＬ－２Ｒ能够抑制ＮＫＣＦ活性。提示ＳＩＬ－２Ｒ表达水平能反映机体抗肿瘤细胞免疫活性水平的高低，可作为评价膀胱移行细胞癌患者病情严重程度与预后的一个监测指标。     

膀胱肿瘤基因瘤苗诱导的抗肿瘤作用

报道转染白细胞介素２（ＩＬ－２）ｃＤＮＡ制备的膀胱肿瘤基因瘤苗诱导的抗肿瘤作用并讨论其在膀胱肿瘤治疗中的应用价值。逆转录病毒载体介导ＩＬ－２ｃＤＮＡ转染鼠源性膀胱肿瘤细胞ＢＴＴ７３９后，阳性转染克隆ＢＴＴ７３９／ＩＬ－２每１０￣（１０）细胞分泌ＩＬ－２为４～１３２Ｕ·ｍｌ￣（－１）·２４ｈ￣（－１），在同基因小鼠Ｔ７３９同时接种ＢＴＴ７３９和ＢＴＴ７３９／ＩＬ－２或接种ＢＴＴ７３９后不同时间再接种ＢＴＴ７３９／ＩＬ－２，可抑制肿瘤形成；先用ＢＴＴ７３９／ＩＬ－２细胞免疫小鼠，可诱导免疫保护，再次接种ＢＴＴ７３９时不形成肿瘤。我们认为基因瘤苗诱导的抗肿瘤作用对提高膀胱肿瘤患者的免疫功能，抑制术后残余瘤细胞和多中心病变，提高治疗效果具有重要的应用价值。     

支气管动脉灌注LAK细胞白细胞介素－Ⅱ及化疗药物联合治疗原发性肺癌的疗效及病理

本组５４例原发性肺癌经支气管动脉灌注（ＢＡＩ）化疗１次后，经３～４周开始用ＬＡＫ细胞及白细胞介素－Ⅱ（ＩＬ－Ⅱ）治疗，我们采用肿瘤缩小、疗后免疫指标、疗后病人的生活质量、肿瘤经ＬＡＫ／ＩＬ－Ⅱ治疗后病理变化四项指标。ＬＡＫ细胞围绕在癌灶周围，与癌细胞密切接触癌细胞有变性、坏死，证实经ＢＡＩ给予ＬＡＫ／ＩＬ－Ⅱ治疗肺癌方法可行，疗效确实。经ＢＡＩ联合化疗治疗总有效率可达８７％，明显高于单纯ＢＡＩ化疗组的７０％（Ｐ＜０．０５）。     

白细胞介素10抑制核因子кB介导的肾小管上皮细胞表达细胞间黏附分子1

目的研究白细胞介素１０（ＩＬ－１０）对人近端肾小管上皮细胞（ＨＫ－２细胞）在促炎症因子肿瘤坏死因子α（ＴＮＦα）作用下表达细胞间黏附分子１（ＩＣＡＭ－ｌ）及其相关核转录途径的影响。方法 用ＨＫ－２细胞作靶细胞，用细胞酶联免疫吸附法（ＥＩＪＳＡ）和Ｎｏｒｔｈｅｒｎ杂交观察ＩＣＡＭ－１的蛋白和基因的表达，以电泳迁移率变动法测定转录因子核因子ｋＢ （ＮＦｋＢ）和激活蛋白 Ｉ（ＡＰ－１）的活性。结果ＴＮＦα呈剂量依赖地诱导ＨＫ－２细胞ＮＦｋＢ的活化及ＩＣＡＭ－１的基因和蛋白表达，这些作用可以被ＮＦｋＢ的抑制剂对甲苯磺－Ｌ－苯丙氨酸氯甲基甲酮（ＴＰＣＫ）所抑制，但ＴＮＦα对ＨＫ－２细胞的ＡＰ－１活性无影响。 ＩＬ－１０（１～ ２０ｎｇ／ｍｌ）可抑制 ＴＮＦα诱导的 ＨＫ－２细胞 ＩＣＡＭ－ｌ基因和蛋白表达及 ＮＦｋＢ的活化。结论ＴＮＦα诱导人肾小管上皮细胞ＨＫ－２的ＮＦｋＢ活化，进而促进ＩＣＡＭ－ｌ基因和蛋白表达，ＩＬ－１０可抑制ＴＮＦα诱导的上述炎症效应。     

自体LAK细胞和rIL—2治疗晚期肾癌的实验与临床研究

应用自体ＬＡＫ细胞和重组白细胞介素－２（ｒＩＬ－２）治疗２０例晚期肾癌患者。自患者周围血分离到的单个核细胞体外经ｒＩＬ－２短期培养，其ＮＫ、ＬＡＫ活性明显增强并于第５、７天达高峰。当这些ＬＡＫ细胞与ｒＩＬ－２过继回输给同一患者后，病人周围血ＮＫ、ＬＡＫ活性明显增加（Ｐ＜０．０１），ＮＫ比率、ＩＬ－２受体表达明显增加（Ｐ＜０．０５），提示对肾癌患者的免疫调节作用。本组病人获部分缓解（ＰＲ）１例，轻度     

Quantitative heel ultrasound in a population-based study in Italy and its relationship with fracture history: the ESOPO study

We assessed the clinical usefulness of quantitative ultrasound (QUS) in defining the prevalence rates of osteoporosis and osteopenia and their association with fractures of the forearm, vertebrae, and hip. The ESOPO study was conducted in 2001 and assessed a random sample of 11,011 women and 4,981 men, in 83 centers spread all over Italy. A large array of risk factors was investigated, and self-reported history of fractures was collected in a questionnaire. After the patient had undergone interview and a brief physical examination, QUS of the heel was performed, using the Achilles apparatus (GE-Lunar, Madison, USA). The prevalence rate of osteoporosis in women 40–79 years old was approximately 18.5%, while the rate of osteopenia was about 44.7%; in men 60–79 years of age the rates were 10% and 36%, respectively. A strong association with fractures was found for osteoporosis and osteopenia in both men and women, independently of all traditional risk factors, including age. These results confirm the suitability of US measurements as a tool for detecting individuals at risk of fractures.The authors wrote this article on behalf of the ESOPO Study Group     

Methodological index for non-randomized studies (minors): development and validation of a new instrument

Background: Because of specific methodological difficulties in conducting randomized trials, surgical research remains dependent predominantly on observational or non-randomized studies. Few validated instruments are available to determine the methodological quality of such studies either from the reader's perspective or for the purpose of meta-analysis. The aim of the present study was to develop and validate such an instrument. Methods: After an initial conceptualization phase of a methodological index for non-randomized studies (MINORS), a list of 12 potential items was sent to 100 experts from different surgical specialities for evaluation and was also assessed by 10 clinical methodologists. Subsequent testing involved the assessment of inter-reviewer agreement, test-retest reliability at 2 months, internal consistency reliability and external validity. Results: The final version of MINORS contained 12 items, the first eight being specifically for non-comparative studies. Reliability was established on the basis of good inter-reviewer agreement, high test-retest reliability by the κ-coefficient and good internal consistency by a high Cronbach's α-coefficient. External validity was established in terms of the ability of MINORS to identify excellent trials. Conclusions: MINORS is a valid instrument designed to assess the methodological quality of non-randomized surgical studies, whether comparative or non-comparative. The next step will be to determine its external validity when used in a large number of studies and to compare it with other existing instruments.     

儿科护士离职原因的质性研究

目的了解儿科护士离职的真正原因,为采取针对性措施稳定护士队伍提供参考。方法对14名从事儿科护理且自愿离职护士进行深度访谈,采用现象学分析法分析资料。结果儿科护士离职原因主要有3个主题:不能缓解的压力,包括不满意的工作环境、不完善的管理体系、不认可的工作性质和不稳定的专业思想;社会家庭的支持;获取外部工作的机会。结论儿科护士承受着来自各个方面的压力,护理管理者应关心员工的工作状态,使其更好地应对压力,减少离职行为。     

The use of fluoride cement: preliminary experimental study and clinical application

One of the most common complications of cemented prostheses is aseptic loosening of the implant, which is often due to mechanical breakdown at the bone-cement interface. To improve the characteristics of PMMA, the addition of fluoride has been proposed, which, without jeopardising its mechanical qualities, should provide better integration with the surrounding bone. An experimental study was performed in 4 sheep. A cylinder of cement (with and without fluoride) was inserted in the meta-epiphysis of the distal femur. A clinical study followed 7 patients. The cement with added fluoride was used as a filler after the curettage of a benign tumour located in the meta-epiphysis around the knee. Histological results in animals combined with long-term radiographic results in humans have shown the positive influence of fluoride in the cement, as it allows better integration of the cement with the surrounding bone.     

A New Methodology for Laboratory Evaluation of Neurosurgical Approaches Based on the Volume and Shape of the Surgical Space with a Mathematical Model to Quantify the Surgical Maneuverability in Laboratory Settings

We conducted this study to validate the volume/shape of the surgical exposure and to introduce a mathematical model to quantify the maneuverability in a surgical space. We executed the pterional and lateral supraorbital approach four times in fresh cadavers in skull base laboratory. The surgical volumes were filled with a computed tomography (CT)-imageable mixture; CT scans were obtained to evaluate the volume and shape of the surgical space. The volume of the surgical space was 23.60 and 32.90 mL for the lateral supraorbital and pterional approach, respectively, (p < 0.05). The three-dimensional shape of the lateral supraorbital approach was cylindrical and that of the pterional approach pyramidal. The volume of the surgical approach can be used to define, together with other variables, the maneuverability (maneuvering in a surgical volume) by using the following formula where M, A, V, and L represent the maneuverability, the degree of the surgical freedom, the volume of the surgical exposure, and the surgical depth, respectively. Volume and shape of the surgical exposure are two objective parameters that can be used to define and contrast different microsurgical approaches in a laboratory setting. The volume of the surgical exposure may be integrated into a mathematical formula defining maneuverability.     

黄芪润肠丸治疗慢传输型便秘的临床与实验研究

为探索黄芪润肠丸治疗慢传输型便秘（STC）的机理,进行了临床与实验研究。结果显示,黄芪润肠丸（治疗组）治疗STC有效率达92．5％,优于西沙必利（对照组）（P〈0．05）。动物实验表明,小鼠排便颗粒数和炭末推进百分率治疗组均优于对照组和生理盐水组（空白组）;家兔结肠电波波幅和频率均高于正常组;治疗组小鼠结肠P物质（SP）和血管活性肠肽（VIP）物质含量均高于对照组。结果表明,由于黄芪润肠丸能通过提高结肠内SP和VIP物质含量,激活结肠电活动,加快结肠肠蠕动,故对STC有明显治疗作用。     

Japanese study of FK 506 on kidney transplantation: 2. Follow-up study of FK 506-treated patients

Thirty-seven primary renal transplant patients were enrolled in the early phase II study on kidney transplantation. All grafts survived during the follow-up period. However, 10 of the 37 patients were changed from FK 506 to conventional drugs, and 3 were treated concomitantly with azathioprine (AZA) or mizoribine (MZR) in the 3-month period of observation. After 3 months posttransplantation, an additional 10 patients were treated continuously with AZA or MZR. In addition, 3 were converted from FK 506 to conventional drugs. No additional conversion was observed after 4 months. Trough level monitoring was effective enough to regulate the FK 506 dosage. Nephrotoxicity and hyperglycemia were associated with a high trough level of FK 506 (whole blood, > 20 ng/ml).