摘要:目的:了解hMLH1基因Val384Asp错义突变在家族性大肠癌发病中的作用-方法:以1∶2配对病例对照研究设计,于2004年1~12月在江苏省3个消化道肿瘤高发地区收集新发家族性大肠癌患者33例-散发性大肠癌患者66例及66例健康人的外周静脉血,应用PCR-DHPLC 和DNA 序列分析技术,分析hMLH1 基因的第12 外显子;生物信息学相关软件分析Val384Asp-结果:家族性大肠癌患者的Val384Asp检出率与散发性患者间以及正常对照间差异无统计学意义(P > 0.05);但在≥50岁的高龄家族性患者中的检出率显著高于正常对照(P < 0.05),而与散发性患者间的差异处于临界值(P=0.051);生物信息学相关软件分析显示,第384位的撷氨酸(Val)是生物进化中的一个保守位点,其被天冬氨酸(Asp)替代可能影响蛋白质功能;相应位点基因序列T→A的颠换也可能影响剪切调控-结论:Val384Asp不是家族性大肠癌的遗传易感因素,但与其中的高龄患者的发病有密切关系,尚需进一步的大样本研究证实;Val384Asp的致病机制可能与影响蛋白功能及剪切异常有关-

摘要:伊壁鸠鲁是晚期希腊的一位著名的哲学家-他继承德谟克利特的原子论,从感觉主义出发,以幸福和快乐为起点和目标,追求身体的无痛苦和心灵的无纷扰-他本人身体力行,并对人的生死泰然处之,这对现代人培养正确的人生观和价值观具有积极的意义-

摘要:Spinal cord injury disrupts the connections between the brain and spinal cord, often resulting in the loss of sensory and motor function below the lesion site. The most important reason for such permanent functional deficits is the failure of injured axons to regenerate after injury. In principle, the functional recovery could be achieved by two forms of axonal regrowth: the regeneration of lesioned axons which will reconnect with their original targets and the sprouting of spared axons that form new circuits and compensate for the lost function. Our recent studies reveal the activity of the mammalian target of rapamycin (mTOR) pathway, a major regulator of new protein synthesis, as a critical determinant of axon regrowth in the adult retinal ganglion neurons[1]. In this review, I summarize current understanding of the cellular and molecular mechanisms that control the intrinsic regenerative ability of mature neurons.

摘要:采用质性研究方法,对“关怀伦理”在女性志愿者志愿服务动机与目的-志愿服务所遭遇的道德冲突与抉择-志愿服务的困难与坚持-志愿服务对其个人及社会带来的改变与影响中所扮演的角色进行实证分析-以期了解当前社会女性志愿者参与公共事务与公民道德体现的现状,以及影响女性志愿者“关怀伦理”道德思考发展与变化的社会文化因素;希望可提供“关怀伦理”在政治-社会方面公共运用的事实资料,并印证“关怀伦理”的相关理论,进而有助于肯定“关怀伦理”的公民道德价值,为政府有关部门决策提供建议-

摘要:Cardiolipin (CL) is a phospholipid exclusively localized in inner mitochondrial membrane where it is required for oxidative phosphorylation, ATP synthesis, and mitochondrial bioenergetics. The biological functions of CL are thought to depend on its acyl chain composition which is dominated by linoleic acids in metabolically active tissues. This unique feature is not derived from the de novo biosynthesis of CL, rather from a remodeling process that involves in phospholipases and transacylase/acyltransferase. The remodeling process is also believed to be responsible for generation of CL species that causes oxidative stress and mitochondrial dysfunction. CL is highly sensitive to oxidative damages by reactive oxygen species (ROS) due to its high content in polyunsaturated fatty acids and location near the site of ROS production. Consequently, pathological remodeling of CL has been implicated in the etiology of mitochondrial dysfunction commonly associated with diabetes, obesity, heart failure, neurodegeneration, and aging that are characterized by oxidative stress, CL deficiency, and abnormal CL species. This review summarizes recent progresses in molecular, enzymatic, lipidomic, and metabolic studies that support a critical regulatory role of pathological CL remodeling as a missing link between oxidative stress and mitochondrial dysfunction in metabolic diseases and aging.

摘要:目的:观察研究肝细胞生长因子受体Met在胃癌组织及相对应的淋巴结转移灶中的表达水平,同时比较分析抗Met单克隆抗体Met4和多克隆抗体C28在检测Met表达水平中的差别-方法:采用免疫组织化学间接法检测胃癌组织芯片中Met表达水平,比较Met4与C28的检测效能-结果:Met在细胞膜及胞浆阳性表达率在不同病理分级组间无统计学意义(P > 0.05)-Met4组Met的阳性染色部位于细胞膜(浆),而C28组Met阳性染色部位在细胞浆中,二者在Met亚细胞染色定位上有差别-Met4的阳性检出率(58.3%)高于C28阳性检出率(30.5%),具有统计学意义(P < 0.05)-Met4组21例胃癌原发灶Met阳性病例中14例淋巴结转移灶Met表达阳性,C28组11例原发灶Met阳性病例中6例淋巴结转移灶Met表达阳性-原发灶中Met阳性表达与转移淋巴结中Met的阳性表达有显著相关性(P < 0.05)-结论:Met阳性表达可能在肿瘤的淋巴转移过程起重要作用-Met4用于肿瘤的诊断及靶向治疗,具有良好的临床应用前景-

摘要:端午节源于古代人们对“恶月恶日”季候的深刻观察与体验,期祈“驱邪禳灾”而产生的具有现代卫生防疫因子的系列循理应对法式与习俗-建构端午节的民俗活动都汲取着中华医药文明养分,形成了神秘而又极具医学理性的古代社会卫生防疫理念-端午节就是古代社会拥有深刻公共意识和广泛民间基础的卫生防疫节-

摘要:目的:探讨survivin-cyclin D1 在结直肠癌中的表达及其与临床病理特征的关系-方法:43例结直肠癌组织标本,应用实时荧光定量PCR 对survivin-cyclin D1基因在结直肠癌组织及癌旁正常组织中的mRNA 水平进行定量检测,同时应用蛋白免疫印记(Western blot)检测其在结直肠癌组织及癌旁正常组织中蛋白水平的表达-结果:结直肠癌组织survivin-cyclin D1 mRNA 和蛋白水平的表达均较癌旁正常组织表达显著上调,其差异有统计学意义(P﹤0.05);survivin-cyclin D1 mRNA 和蛋白水平的表达与患者性别-年龄-肿瘤部位-肿块大小-浸润深度无显著相关性(P﹥0.05),而与TNM 分期-淋巴结转移有显著相关(P﹤0.05)-结论:提示survivin-cyclin D1基因在结直肠癌的发生-发展过程及预后中可能具有重要作用,有望成为新的肿瘤标志物或预后因子-

摘要:医疗机构在医疗活动中居于主导地位,其自身能动地构建医疗纠纷防范机制是有效预防医疗纠纷的关键,医疗机构构建医疗纠纷防范机制应当从加强职业道德建设-提高专业技术水平,尊重患者权利,加强病案管理,纠正医疗信息的不对称状态,以及注重医患沟通等途径着手-

摘要:Over the last decade, there has been a flurry of research on adjuvants for vaccines, and several novel adjuvants are now licensed products or in late stage clinical development. The success of adjuvants in enhancing the immune response to antigens has led many researchers to re-focus their vaccine development programs. Although several vaccine candidates have been tested against leishmaniasis, there is yet no effective vaccine against this parasitic disease. Recent research has documented that efforts to develop effective Leishmania vaccine have been limited due to lack of an appropriate adjuvant. In view of this, this review paper outlines some of the adjuvants that have been used in Leishmania vaccine candidates and cites a few of the responses obtained from these studies. The aim of the present review is to consolidate these findings to facilitate the application of these adjuvants in general and experimental vaccinology.

摘要:目的:研究饮食对健康志愿者口服雷贝拉唑肠溶胶囊在体内吸收的影响-方法:2名健康志愿者通过自身对照,先后口服雷贝拉唑肠溶胶囊各20 mg,并分别于给药后2 h及4 h后进食标准餐-采用反相HPLC-UV法测定血中药物浓度-结果:健康志愿者口服雷贝拉唑肠溶胶囊后,2 h和4 h进食标准餐后的Cmax分别为(263.0±32.8)ng/ml和(360.6±105.0)ng/ml;Tmax分别为(6.5±0.7)h和(3.8±0.4)h;AUC0-10分别为(1203.1±228.0)μg·h/L和(1108.7±267.4)μg·h/L;T1/2分别为(3.2±0.21)h和(1.60±0.05)h-结论:食物可以影响雷贝拉唑肠溶胶囊的人体吸收,药物达峰时间明显延长-

摘要:人体医疗废物属于民法上的物,其原始所有人是患者本人-医疗机构应当依法履行通知-保管等义务,并行使维护社会公共利益的法定职权-

摘要:目的:细胞水平观察不同浓度的辛伐他汀对骨髓间充质干细胞(bone marrow-drived mesenchymal stem cells,BMSCs)的增殖及旁分泌功能的影响并探讨其可能的机制-方法:采用全骨髓贴壁培养法培养SD大鼠的骨髓间充质干细胞,取3代对数生长期细胞,无血清培养12 h,不同剂量的辛伐他汀(0-0.001-0.010-0.100-1.000 -滋mol/L)与MSCs共培养24 h,采用CCK-8试剂盒检测各浓度组BMSCs增殖情况,通过半定量RT-PCR检测不同浓度的辛伐他汀诱导BMSCs中血管内皮生长因子(vascular endothelial growth factor,VEGF)和肝细胞生长因子(hepatocyte growth factor,HGF)的mRNA表达-采用Western blot检测PAkt-AKt的表达-结果:辛伐他汀在一定浓度范围内(0.001~0.100 -滋mol/L)显著提高了BMSCs增殖和VEGF和HGF的mRNA表达水平(与对照组比较,P < 0.01)-辛伐他汀浓度在0.010 -滋mol/L时对BMSCs的增殖和分泌功能的影响最为显著,随着药物浓度的加大,BMSCs的上述功能呈下降趋势-与对照组比较,1.000 -滋mol/L辛伐他汀对BMSCs无显著的促增殖作用,但却明显上调了VEGF和HGF mRNA的表达-0.010 -滋mol/L辛伐他汀组pAKt表达及pAKt/AKt比值显著高于对照组(P < 0.01)-结论:辛伐他汀在一定浓度范围内对骨髓间充质干细胞的增殖及分泌功能有促进作用,其机制可能与Akt信号通路有关-

摘要:文章通过对美国-德国-日本-瑞典四国的药品不良反应救济措施进行分析,研究他们的合理之处,希望对我国药品不良反应救济法律制度的研究提供借鉴,推动我国药品不良反应救济制度的立法与实践-

摘要:在药品和兽药流通的执法监督过程中,会遇到药品经营企业销售兽药和兽药经营企业销售药品的情况-文章分析了药品经营权和兽药经营权的取得及其经营范围,探讨了违规销售药品或兽药的处罚权的归属,并提出相关建议,以期能够为我国药品安全的提升有所助益-

摘要:目的:探讨产前单次联合给药小剂量地塞米松和氨溴索对胎鼠及生后子代大鼠肺形态发育的影响-方法:36只孕鼠随机分成2组:地塞米松加氨溴索干预组(n=9)和生理盐水对照组(n=9)-在妊娠第17天,干预组腹腔注射地塞米松0.2 mg/(kg·d)加氨溴索100 mg/(kg·d),对照组腹腔注射等体积的生理盐水-取两组孕19天,生后3天,生后7天胎(仔)鼠肺组织,通过光镜和电镜技术,观察在大鼠肺发育的不同阶段两组肺组织形态发育差异-结果:①光镜下:孕19天干预组胎鼠肺每视野平均原始肺泡计数大于对照组(P < 0.05),平均原始肺泡腔面积大于对照组(P < 0.01),平均原始肺泡间隔厚度小于对照组(P < 0.01)-生后3天干预组仔鼠肺每视野平均囊泡表面积大于对照组(P < 0.05),平均囊泡间隔厚度小于对照组(P < 0.05),平均囊泡计数与对照组相比无显著差异(P > 0.05)-生后7天干预组仔鼠肺每视野平均肺泡表面积大于对照组(P < 0.05),平均肺泡间隔厚度小于对照组(P < 0.05),平均肺泡计数与对照组相比无显著差异(P > 0.05);②透射电镜观察:孕19天胎鼠肺干预组Ⅱ型肺泡上皮细胞绒毛发育较对照组密集完整,可见板层小体,对照组难见板层小体-生后3天及7天的仔鼠肺干预组和对照组均可见大量板层小体,但干预组较对照组板层小体染色深-致密,且可见大量线粒体等发达的细胞器-结论:小剂量地塞米松联合氨溴索产前单次用药,不仅能促进大鼠胎肺成熟,也可促进其生后一段时期的肺发育且未产生明显不良影响-

摘要:Objective: Nanoparticles are becoming an important method of targeted drug delivery. To evaluate the importance of folate-conjugated human serum albumin (HSA) magnetic nanoparticles (Folate-CDDP/HSA MNP), we prepared drug-loaded Folate-CDDP/HSA MNPs and characterized their features. Methods: First, folate was conjugated with HSA under the effect of a condensing agent, and the conjugating rate was evaluated by a colorimetric method using 2, 4, 6 - trinitrobenzene sulfonic acid. Second, under N2 gas, Fe3O4 magnetic nanomaterials were prepared and characterized by using transmission electron microscopy (TEM), SEM-EDS and X-ray diffraction (XRD). Finally, Folate-CDDP/HSA MNP was prepared by using a solvent evaporation technique. TEM was used to observe particle morphology. The particle size and distribution of the prepared complexes were determined by a Laser particle size analyzer. Drug loading volume and drug release were investigated by a high performance liquid chromatography method (HPLC) in vitro. Results: We successfully prepared folate-conjugated HSA and its conjugating rate was 27.26 μg/mg. Under TEM, Fe3O4 magnetic nanoparticles were highly electron density and had an even size distribution in the range of 10-20 nm. It was confirmed by SEM-EDS and XRD that Fe3O4 magnetic nanoparticles had been successfully prepared. Under TEM, drug-loaded magnetic nanoparticles were observed, which had a round shape, similar uniform size and smooth surface. Their average size was 79 nm which was determined by laser scattering, and they exhibited magnetic responsiveness. Encapsulation efficiency was 89.75% and effective drug loading was calculated to be 15.25%. The release results in vitro showed that the half release time (t1/2) of cisplatin in cisplatin Solution and Folate-CDDP/HSA MNP was 65 min and 24 h respectively, which indicated that microspheres had an obvious effect of sustained-release. Conclusion: Folate-CDDP/HSA MNPs were prepared successfully. The preparation process and related characteristics data provided a foundation for further study, including the mechanism of the nanoparticles distribution in vivo and their intake by tumor cells.

摘要:辩证思维是科学的思维方法,和医学-护理工作有着密切的联系-文章用辩证思维方法中的系统性原则-否定原则以及内因与外因原则来分析护理实践中存在的实际问题,旨在抛砖引玉,指明护理工作与哲学的联系,培养辩证思维-提高决策能力,让护理工作者在实际工作中能够抓重点,抓本质,提高工作效率和工作质量-

摘要:目的:研究大鼠孕期维生素D缺乏对其子鼠骨发育相关基因BMP-2-Cbfa1-Dmp1表达的影响-方法:成熟雌性SD大鼠36只随机分为模型组和对照组各18只,模型组以不含维生素D的大鼠饲料避光喂养,对照组以标准饲料正常光照喂养-两周后与成熟SD雄性大鼠交配,分别取孕20天(E20 d)-生后1天(B1 d)和生后7天(B7 d) 子鼠左侧股骨-通过Real-TimePCR方法分别比较模型组和对照组胚胎和新生鼠长骨中BMP-2-Cbfa1-Dmp1基因在3个时间点表达的差异-结果:BMP-2 mRNA-Cbfa1 mRNA 及Dmp1 mRNA在E20 d-B1 d和B7 d的表达,模型组均明显低于对照组,差异有统计学意义(P < 0.05) -结论:BMP-2-Cbfa1-Dmp1均为骨发育相关基因,孕鼠维生素D缺乏可下调子鼠长骨中BMP-2-Cbfa1-Dmp1的表达水平,从而可能影响子鼠骨骼的发育-

摘要:“新医改”这个关系到中国民生的重大问题,2009年4月6日在争论中终于破冰而出-新医改对医疗机构来说,是挑战,更是机遇,它的一系列举措将直接影响到护理事业今后的发展-护理的建设发展必须从现在开始,在护理管理模式和护理经营模式上力求突破,不断提高护理质量-加强自身队伍的建设-培养护理人才-培育经营意识-销售护理服务,注重护理发展的独立性,体现出新时代护理服务的真正价值所在,力求为患者提供更优质的服务,为公立医院护理的发展注入新活力-

摘要:文章采用文献计量学方法,对1997~2009年哮喘临床研究领域发表在SCI上的研究论文进行了统计和数据挖掘,分别从论文发表的年代-地区-机构-学科和作者分布进行了分析,并就国内外的研究状况进行了比较,通过对被SCI收录的哮喘方面的研究论文的数量及引用情况-期刊分布和学科分布等因素的统计分析,揭示出国内外哮喘研究的现状和差距,以期为国内的哮喘研究提供参考-

摘要:Small non-coding RNAs with important regulatory roles are not confined to eukaryotes. Recent work has uncovered a growing number of bacterial small RNAs (sRNAs), some of which have been shown to regulate critical cellular processes. Computational approaches, in combination with molecular experiments, have played an important role in the identification of these sRNAs. At present, there is no information on the presence of small non-coding RNAs and their genes in the Agrobacterium tumefaciens genome. To identify potential sRNAs in this important bacterium, deep sequencing of the short RNA populations isolated from Agrobacterium tumefaciens C58 was carried out. From a data set of more than 10,000 short sequences, 16 candidate sRNAs have been tentatively identified based on computational analysis. All of these candidates can form stem-loop structures by RNA folding predictions and the majority of the secondary structures are rich in GC base pairs. Some are followed by a short stretch of U residues, indicative of a rho-independent transcription terminator, whereas some of the short RNAs are found in the stem region of the hairpin, indicative of eukaryotic-like sRNAs. Experimental strategies will need to be used to verify these candidates. The study of an expanded list of candidate sRNAs in Agrobacterium will allow a more complete understanding of the range of roles played by regulatory RNAs in prokaryotes.

摘要:目的:探讨IL12A和IL12B基因多态性与江苏人群原发性肝细胞肝癌的遗传易感性的关系-方法:采用病例对照研究,对明确诊断的原发性肝细胞肝癌新发病例538例按年龄和城乡频数匹配正常对照535例,以聚合酶链式反应-限制性片段长度多态性(PCR-RFLP)方法对IL12A基因的rs568408(3’UTR G>A)-rs2243115(5’UTR T>G)和IL12B基因的rs3212227(3’UTR A>C)进行多态性检测,比较不同基因型与原发性肝细胞肝癌发病风险的关系-结果:携带IL12A rs568408变异等位基因的个体(rs568408 AG/AA)发生原发性肝细胞肝癌的风险较携带野生纯合子(rs568408 GG)增加了35%(调整OR=1.35, 95% CI =1.03~1.79)-进一步对IL12A rs568408位点的作用按年龄-性别-吸烟情况-饮酒情况-HBsAg和抗HCVAb携带情况进行分层分析,结果发现rs568408位点对原发性肝细胞肝癌发病风险的影响在男性和有饮酒史患者中更为显著(调整OR分别为1.46和1.53, 95% CI分别为1.08~1.98和1.07~2.18)-结论:IL12A rs568408可能影响江苏人群原发性肝细胞肝癌发病风险-

摘要:目的:分析江苏省南京地区汉族人群腔隙性脑梗死患者的ALOX5AP基因-PDE4D基因单核苷酸多态性(single nucleotide polymorphism,SNP),并研究其与脑梗死的发病是否存在相关性-方法:运用多聚酶链式反应(polymerase chain reaction,PCR)和连接酶检测反应(ligase detection reaction,LDR),观察280例腔隙性脑梗死患者和258例对照组人群的ALOX5AP基因及PDE4D基因的4个SNP位点,并进一步分析其基因型-结果:PDE4D基因rs966221-rs456009的等位基因-基因型频率在两组间没有显著性差异,单倍体型构成在两组间亦无显著性差异;ALOX5AP基因的两SNP(rs 4073259-rs4769055)的等位基因和基因型频率在两组间差异均有显著性(P < 0.05),SNP单倍体型(GA-GC)在两组间差异更为明显(P < 0.01)-结论:本研究未发现PDE4D基因与腔隙性脑梗死的发病相关,但ALOX5AP基因可能为中国江苏省南京地区腔隙性脑梗死的易感基因-

摘要:自从博耶在20世纪90年代引进“教学学术”这一术语以来,教学学术成为研究大学教师专业发展的一个新的维度-教学学术是一种由学科教育性知识表征的学术-大学教学学术思想的引入有利于强化大学教师的教学观念,明晰大学教师教学学术成长的阶段,并对大学教师教学学术成长的途径提供一些启示-

摘要:Objective: Recent studies have shown that the local expression of soluble interleukin (IL) -1 receptor type Ⅱ (sIL-1 RⅡ) in endometrial tissue of women with endometriosis is decreased, and the depression of IL-1 RⅡ was more significant in infertile women than that in fertile women with endometriosis. In this research, we investigated the remedial effect of sIL-1-RⅡ administration on endometriosis in the nude mouse model. Methods: Nineteen nude model mice with endometriosis were randomly divided into three groups: group A was treated by intraperitoneal administration with only sIL-1 RⅡ for two weeks, group B was similarly treated with only IL-1, and group C (control) was administered saline . After 2 weeks, the size of the ectopic endometrial lesions was calculated, and the expression of vascular endothelial growth factor (VEGF) and B-cell lymphoma leukemia-2 (Bcl-2) were detected by immunohistochemistry. The IL-8 and VEGF levels in the peritoneal fluid (PF) and serum were also measured by enzyme-linked immunosorbent assay (ELISA). Results: The mean size of ectopic endometrial lesion did not differ between the three groups (P > 0.05). Compared with the control, the expression of VEGF and Bcl-2 was significantly lower in group A, and higher in group B. In the three groups, the levels of IL-8 in the PF and serum were highest in group A, and lowest in group B. Conclusion: sIL-1 RⅡ may suppresse hyperplasia of ectopic endometriosis, perhaps by reducing the expression of certain cytokines, such as VEGF, IL-8, and Bcl-2, which could provide a new clinical strategy for the treatment of endometriosis.

摘要:加强独立学院校园文化建设,提高人才培养质量,是社会普遍关注的问题-文章分析了当前独立学院校园文化建设中存在的主要问题,提出了加强独立学院校园文化建设的思路和对策-

摘要:目的:建立猪自体肺移植实验动物模型,为临床开展自体肺移植术提供实验基础-方法:健康杂种猪18只,分别行左侧第四肋间开胸,游离肺门后行左全肺切除,予修剪左下肺后,将离体的左下肺重新植入胸腔,即把下肺静脉重植于上肺静脉残端,并依次完成支气管和肺动脉吻合-依据术中左下肺叶是否行灌注和灌注液的不同,分为3组,每组6只,分别为:A组(未灌注组)-B组(常温肝素灌注组)及C组(低温Euro-Collins液灌注组)-分别于移植前-移植后0.5 -1.0-2.0-4.0 h检测移植肺的肺静脉血氧分压(PaO2)-湿干重比(W/D ratio)-氧自由基髓过氧化物酶(MPO)活性;观察移植肺组织的光镜及电镜结构变化-结果:手术无一例失败,均存活-移植前,移植后0.5-1.0-2.0 h 3组移植肺的肺静脉血PaO2 -肺组织的MPO和W/D无显著性差异(P > 0.05);与对A组相比,B组和C组移植后4 h的PaO2 -MPO和W/D均有显著性差异(P < 0.05)-与A组相比,B组及C组病理损伤较轻,且两组损伤程度相似-结论:本模型稳定-可靠-重复性好,是研究自体肺移植较为理想的动物模型;常温肝素灌注后的供肺叶能满足自体肺移植的要求-

摘要:目的:探讨甲状腺激素对大鼠肝脏缺血再灌注损伤的保护作用及其可能作用机制-方法:建立大鼠70%的肝脏缺血再灌注模型,将64只健康雄性SD大鼠随机分成4组:正常对照组(S组),缺血再灌注组(IR组),缺血预处理组(IPC)组,甲状腺激素干预组(T3组)-缺血1 h再灌注6 h-24 h后,检测血清丙氨酸转氨酶(ALT)-天门冬氨酸转氨酶(AST)-肿瘤坏死因子(TNF-α)水平以及肝脏组织超氧化物歧化酶(SOD)的活性及丙二醛(MDA)-还原型谷胱甘肽(GSH)的含量,病理切片HE染色和免疫组化方法分别检测肝脏组织的病理改变和肝细胞核因子-κB(NF-κB)阳性表达-结果:肝脏缺血再灌注后,IR 组的ALT-AST 水平及MDA-TNF-α-NF-κB 阳性表达明显高于S 组,GSH含量-SOD 活性明显下降(P < 0.01),肝组织病理损伤较S组严重,T3组-IPC组均能改善以上情况(P < 0.01),而T3组及IPC组之间无明显差异(P > 0.05)-结论:甲状腺激素和缺血预处理一样对大鼠肝脏缺血再灌注损伤具有一定的保护作用-其机制可能通过减少氧自由基的产生及减轻脂质过氧化反应,降低TNF-α的表达和抑制NF-κB 的活化来实现-

摘要:师德是教师最根本-最重要的素质-高校师德的建设对培养社会主义事业建设者和接班人具有重要的影响-当前高校出现师德滑坡与失范,亟待以社会主义荣辱观作为当今高校师德建设的主要内容,从宣传教育-理论研究-自省自律-师德评价等方面加以引导-

摘要:Objective: Colorectal cancer is one of the major contributors to cancer death worldwide. Lack of reliable colorectal cancer markers has hampered the management of these cancer patients. Our main purpose was to study the correlation between histopathological variables of colorectal adenocarcinomas and identify histopathological markers that are of prognostic value in patients with colorectal cancer. Methods: In the present study, we examined the expression of carcinoembryonic antigen (CEA), p53, Ki-67 and glutathion Stransferase (GST) -π by using immunohistochemical staining methods in 126 colorectal carcinoma patients and evaluated the lymph node metastasis status in these patients by histopathological examination. Results: The positive rates of CEA, p53, Ki-67 and GST-π expression in the colorectal cancer tissue specimens examined were 95.23%, 55.56%, 53.38% and 82.30%, respectively. Expression of p53 and Ki-67 was significantly correlated with the Dukes stages of the tumor, with higher levels of these proteins in Dukes’C and D tumors than those in Dukes’ A and B tumors. Furthermore, the expression of p53, GST-π and Ki-67 correlated with prognosis of patients with colorectal cancer. Additionally, the expression of p53 in colorectal cancer was closely related to the expression of Ki-67 and the expression of GST-π was directly correlated with that of p53. Conclusion: The expression of CEA, p53, Ki-67 and GST-π was correlated with various clinical features of patients with colorectal cancer. The combined use of these histopathological markers appeared to be a promising tool in predicting the prognosis of patients with this type of cancer.

摘要:目的:探讨团体心理训练教学法对大学生成长与发展的影响,以促进医学人才整体心理素质的提高-方法:将239名大学生随机分为试验组和对照组,试验组予以团体心理训练教学,对照组不予干预措施,干预前后用社交能力自测量表-社会适应能力自测量表-自卑倾向自测量表-焦虑自评量表和抑郁自评量表对两组学生进行测量-结果:团体心理训练后,试验组的抑郁-焦虑-社会交往能力和5项自卑指标的得分均低于对照组(P均<0.05);试验组的社会适应能力得分高于对照组(P < 0.01)-结论:团体心理训练教学能增强大学生人际交往能力-社会

摘要:目的:探讨大鼠骨髓间充质干细胞体外向神经细胞诱导分化的潜能,及分化后的凋亡情况-方法:体外培养大鼠骨髓间充质干细胞,用含有表皮生长因子(EGF),碱性成纤维细胞生长因子(bFGF)的诱导培养基对第三代MSCs进行诱导分化,诱导分化的细胞按分化时间3-7-14 d分成A-B-C三组-三组诱导分化细胞分别进行NSE免疫组织化学,MAP2免疫荧光化学以及TUNEL凋亡细胞检测-结果:A-B-C三组细胞在细胞形态上与神经细胞相似,并且表达神经细胞特异性标记抗原NSE-MAP2,但是C组细胞表达强度弱于B组,并且阳性细胞比例少于B组(P < 0.05)-A-B-C三组TUNEL凋亡阳性细胞比例呈逐渐增多趋势(P < 0.05)-结论:含有表皮生长因子(EGF),碱性成纤维细胞生长因子(bFGF)的诱导培养基可以诱导大鼠骨髓间充质干细胞向神经细胞分化,随着诱导时间的推移,分化细胞状态下降,凋亡比例增多-

摘要:医学生就业力的高低,关系到他们能否顺利就业及个人职业生涯的发展-在高等教育大众化的阶段,思考如何培养医学生的就业力,对于提高医学院校的人才培养质量,促进我国医疗卫生事业的发展,具有重要的意义-文章通过分析医学生就业力现状,对医学生就业力培养模式进行了积极的探索-

摘要:Objective: To construct a lentiviral vector expressing HIV-1 Tat and identify its expression in 293T cells. Methods: The gene fragment of HIV-1 Tat101 was subcloned to lentiviral transfer vector pHAGE-CMV-MCS-IZsGreen, which was named pHAGE-Tat. Then the constructed pHAGE-Tat was used to co-transfect the packing 293T cells, together with the packaging plasmids pMD2.G and psPAX2. The packaged viral particles designated LV-Tat were used to infect the 293T cells and the viral titer was calculated. The expression of HIV-1 Tat in 293T cells was confirmed using RT-PCR and western blot. Results: The recombinant lentiviral vector was successfully constructed and could express HIV-1 Tat in 293T cells. The virus titer was 5.73×106 ifu/ml. Conclusion: The successfully constructed recombinant lentiviral vector makes a strong foundation for further exploring the possible role of HIV-1 Tat in the development of prostate cancer.

摘要:目的:模仿产伤和破坏大鼠尿道周围组织两种方法建立压力性尿失禁动物模型,并对两种动物模型进行鉴定和比较-方法:雌性成年未生产过的Sprague-Dawley 大鼠45只,取5只直接开腹测量尿动力学作为对照组,其余分为A组 20 只,B组 20 只-A组行阴道损伤和双侧卵巢切除术,B组行尿道分离术和双侧卵巢切除术-A和B组大鼠各分为4小组,分别称A1-A4和B1-B4,每小组为 5只,分别在术后1周,1-2-3月后测量尿动力学指标LPP 和ALPP-每组各取2只大鼠行组织学鉴定-结果:与对照值相比A1~A4组LPP值有统计学意义(A1~A3 P < 0.01,A4 P < 0.05),ALPP值有统计学意义(A1~A3 P < 0.01,A4 P < 0.05),A1~A4组间比较P > 0.05,无明显统计学差异-与对照值相比B1~B4组LPP值有统计学意义(B1~B4 P < 0.05),ALPP值有统计学意义(B1~B4 P < 0.01),B1~B4组间比较P > 0.05,无明显统计学差异-A组和B组组间比较无明显差异(P > 0.05)-动物模型尿道组织学上表现为即肌肉成分的萎缩,断裂及神经分布的减少-结论:两种方法均能成功建立SUI动物模型,两种建立方法无明显差异-两种方法建立的模型在3个月内可维持比较良好的稳定性-模拟产伤法具有操作相对简单-风险小-学习曲线短等特点,值得推广-

摘要:目的:分析试卷命题中存在的问题及其原因并提出相关建议,为今后教学改革及题库建设提供科学依据-方法:应用教育测量学对南京医科大学五年制临床医学专业2003~2005级病理学和药理学(代表基础医学课程)-妇产科学和内科学(代表临床课程)试卷的质量进行统计分析-结果:各年级四门课程信度系数都达到了0.6分以上,且91.7%在0.7分以上,显示了较高的信度,但是难度普遍中等偏低,区分度不高-结论:在未经教育测量学原理指导的试题编制状态下,该校临床医学专业基础课和临床专业课部分课程考试试题存在一些问题,表现为信度仍

摘要:Objective：A major problem in the chemotherapy of colon caner may be due to those cells that are in residence in the G0 phase where they are less vulnerable to conventional therapy. To overcome this phenomenon, we attempted to recruit the reentry of these cells into the cell cycle via a signaling pathway that manipulates tumor growth. Methods: Epidermal growth factor (EGF) was used to stimulate colon cancer caco-2 cells. FACS analysis and proliferating cell nuclear antigen (PCNA) staining were used to estimate the cell cycle transition and cell proliferation activated by EGF, and a MTT assay was used to evaluate the synergistic effect of EGF and chemotherapy. Results: The percentage of caco-2 cells in the G0/G1 phase was significantly reduced by nearly 20% and the percentages in the S and G2/M phases were increased by EGF. The combined use of EGF and 5-fluorouracil (5-FU) enhanced the caco-2 cell chemosensitivity to 5-FU, reaching a maximum of an approximately threefold greater sensitivity than to 5-FU alone as judged by the 50% inhibiting concentration (IC50). Conclusion: Our study demonstrated that stimulation by EGF enhanced the chemosensitivity of caco-2 cells to 5-FU, which may be a novel therapeutic protocol in colon cancer.

摘要:肺癌已成为人类癌症死亡的主要原因之一,其发病率及病死率仍在迅速增长-目前X线胸片-计算机体层摄影(computed tomography,CT)扫描能帮助医师对大部分肺癌作出诊断和分期判定,但对于一些早期病变的判定帮助有限-正电子发射断层摄影(positron emission tomography,PET)在肿瘤的早期诊断-分期和疗效评估方面有较高的敏感性和特异性,但其空间分辨力较差-PET/CT的出现弥补了这两方面的缺憾,它融合专用的PET扫描仪和CT扫描仪的技术,提供了来自两种显像方式的独特信息-本文就PET/CT在肺癌诊断中的应用进行了综述-

摘要:目的:评价用机用镍钛器械ProTaper预备老年人后牙弯曲根管的临床疗效-方法:选取患有牙髓炎或根尖周炎的具有弯曲根管的老年人后牙82例,随机分为实验组(41例)和对照组(41例),实验组采用机用镍钛器械ProTaper以冠根向深入法进行根管预备,对照组采用手用不锈钢K锉以标准的逐步后退法进行根管预备,根据治疗前-中-后的X线片评价根管预备和充填的效果-结果:与对照组相比,实验组ProTaper能很好地维持根管的弯曲度和走向,根管的锥度和流畅度极佳,且操作时间短,少有术后疼痛的发生,但实验组有2例器械折断-每根管预备时间实验组为5.5±1.2 min,对照组为9.5±1.1 min;根管预备后疼痛发生率实验组为12.2%,对照组为43.9%;根充适充率实验组为87.8%,对照组为68.3%;断针率实验组为4.9%,对照组为0-结论:机用镍钛器械ProTaper预备老年人后牙弯曲根管快速,高效,成形效果好,根充适充率高,术后疼痛少,但须注意预防器械折断-

摘要:Objective: To evaluate the changes in Tp-e interval (an interval from the peak to the end of the T wave), QT interval and Tp-e/QT ratio of the body surface ECG in patients with left ventricular hypertrophy (LVH). Methods: The Tp-e interval and QT interval were measured on body surface ECGs in 42 patients without either hypertension or LVH (control group), 41 patients having hypertension but not LVH (non-LVH group), and 38 patients with both hypertension and LVH (LVH group). Results: The mean corrected QT (QTc) interval, and mean corrected Tp-e[T(p-e)c] interval were significantly longer in the LVH group (0.430±0.021s vs. 0.409±0.019s, p < 0.01; 0.098±0.013s vs. 0.088±0.011s, respectively) than those in the control group. The Tp-e/QT ratio was also amplified in LVH group (0.232±0.028 vs.0.218±0.027) (p < 0.05). Conclusion: LVH increased the QT interval, Tp-e interval and Tp-e/QT ratio of the body surface ECG.

摘要:目的:探讨护理本科生人格特质与学习成绩的相关性,为培养具有较高综合素质的高等护理人才提供依据-方法:采用NEO-PI-R大五人格量表对结束理论课程的护理本科生进行问卷调查,并选取学生5门专业课程期末成绩平均分值与其人格特质进行相关分析-结果:护理专业本科生神经质性-宜人性和严谨性人格特质与学习成绩存在不同程度相关;并且学习成绩高-中-低3组在NEO-PI-R分量表得分上也存在一定差异-结论:护理专业本科生某些人格特质对学习成绩有影响,护理教育工作者应加强其人格培养-

摘要:Objective: To summarize the clinical experiences of 21 patients treated with tricuspid valve replacement (TVR) and investigate the surgical indications and methods. Methods: Data from 21 patients who underwent TVR from December 2002 to March 2009 were retrospectively collected and analyzed. The mean age was 48.86±15.37 years (range: 20-72 years). The underlying disease of the patients was classified as rheumatic (n = 10), congenital (n = 8), endocarditis (n = 2) or chest trauma (n = 1). Previous cardiac surgery had been performed in 12 patients (57.14%). Results: In-hospital death occurred in two patients (9.52%). Postoperative morbidities included cardiac failure (n = 2), bleeding related re-operation (n = 1), and plural effusion (n = 2). Conclusion: The early outcomes of TVR were acceptable. At the present time TVR can be performed through optimal perioperative management.

摘要:目的:探讨弹性髓内钉(ESIN)治疗儿童股骨干骨折的疗效-方法:2006年8月~2008年l2月共收治儿童股骨干骨折68例,在骨科牵引床上复位,采用C型臂X线机透视下行顺行或逆行弹性髓内钉固定术-不稳定性骨折患儿术后行髋人字石膏固定4周,去除石膏后进行功能锻炼-结果:68例患者术后经平均10个月(6~30个月)随访-骨折愈合时间平均为l1周(8~12周),无再骨折-骨不连的发生,髋-膝关节活动正常-出现钉尾激惹反应8例-肢体短缩2例-拔钉困难5例-结论:弹性髓内钉治疗儿童股骨干骨折,具有微创-避免骨折端2次损伤的优点,疗效好,并发症少,可作为治疗移位明显的儿童股骨干骨折的首选方法-

摘要:临床实习是高等医学院校教学过程的重要组成部分-文章通过对外科实习生出科量化考核结果的研究分析,探讨外科临床实习教学存在的问题并提出相应对策,旨在提高外科实习质量,培养合格的高质量医学人才-

摘要:A 69-year-old woman with angina had a lesion in the left lower lobe on chest film. Angiography revealed coronary artery disease in three vessels. Combined off pump coronary artery bypass grafting (CABG) and left lower lobectomy were performed through median sternotomy. This approach avoids complications due to staged operations and cardiopulmonary bypass (CPB). This report shows that simultaneous off pump CABG and pulmonary operations can be performed safely in patients with coronary artery disease (CAD) associated with lung cancer.

摘要:目的:探讨肝移植术后胆道铸型的风险因素,回顾治疗方法-方法:回顾性总结本院自2005年1月~2005年12月肝脏移植受体中发生胆道铸型的患者的材料-结果:112例肝移植受体中发生胆道铸型共15例-结论:供肝缺血时间过长和胆道狭窄的患者更容易发生胆道铸型,在外科手术之前可以进行内镜治疗并能够获得满意的效果-

摘要:实习教学是实现理论与实践结合的重要教学实践模式,同时它又是教学改革的瓶颈和关键-文章从加大病例分析教学力度-运用启发式教学方法及信息技术的应用等方面探讨如何有效提高医学影像专业实习生临床实习效果-

摘要:目的:分析探讨儿童过敏性紫癜外科并发症的诊断和治疗-方法:对14例本院的有外科并发症的过敏性紫癜患儿的诊断和治疗经过(包括:临床特点-典型皮疹的例数-B超及X线表现-外科手术所见-治疗结果及预后)进行回顾性分析-结果:所有14例患儿均以腹痛为首发症状,出现典型皮肤紫癜11例(78.6%),其中肠套叠4例,肠梗阻5例,自发性肠穿孔2例,胆囊水肿2例,阑尾脓肿1例-予解痉-抗过敏,辅以抑酸-对症治疗-对于腹痛仍难以缓解者加用氢化可的松5~l0 mg/(kg·d)静滴,症状消失后可改用强的松口服,总疗程为2~3周-其中手术治疗9例(64.3%),手术中均见浆膜下广泛出血点,部分融合成片-全部14例均临床治愈-结论:过敏性紫癜的外科并发症多样,在出现外科并发症而保守治疗无效时应尽早手术探查,以使患儿尽快恢复和降低病死率-

摘要:A 41-year-old woman presented with a pruritic rash on the face that was of 3 months duration. During that time, it had been successively misdiagnosed as psoriasis vulgaris, systemic lupus erythematosus, facial dermatitis at other hospitals, and had been treated with agents that included acitretin and prednisone. Finally, fungi were found in the lesions by optical microscopy, and the fungal culture was positive for Microsporum gypseum, and was diagnosed as a Microsporum gypseum infection. The lesions eventually cleared completely after 8 weeks of antifungal treatment.

摘要:目的:了解本院鲍曼不动杆菌中I类整合子的分布与基因盒结构,并探讨整合子与鲍曼不动杆菌耐药的关系-方法:收集鲍曼不动杆菌临床株,用纸片扩散法(K-B法)测定77株鲍曼不动杆菌对18种抗生素的敏感性,采用PCR法检测鲍曼不动杆菌Ⅰ类整合酶基因(intI 1)并扩增其可变区,对PCR产物进行酶切分析,并测序分析整合子可变区携带的耐药基因盒-结果:鲍曼不动杆菌耐药现象十分严重-77株菌株中有49株含Ⅰ类整合子,阳性率63.64%,其中有45株(91.84%)整合酶阳性株扩增出可变区,共检测出4种耐药基因盒组合形式:aacA4(0.8 kb)-dfrXII-orfF-aadA2(1.8 kb)- aacA4-catB8-aadA1(2.3 kb)-aacC1-orfX-orfX-orfX’-aadA1a(3.0 kb)-整合子阳性菌株与整合子阴性菌株对多种抗生素耐药性存在差异-结论:Ⅰ类整合子与鲍曼不动杆菌耐药性密切相关,在多重耐药鲍曼不动杆菌耐药机制中起重要作用-

摘要:骨髓穿刺术是临床常用的四大穿刺术之一,对相关疾病的诊断-治疗和预后有重要意义,但其对操作者理论-技能和心理素质的要求均较高-医学实习生刚刚接触临床,如按照以往的方式教学,熟练掌握骨穿技术需要较长时间-作者以独创的“骨穿五字诀——净准好直快”为核心,实施循证教学,突破了以往的教学瓶颈,在大规模培训中取得了良好的效果-

摘要:通过科研实践活动的开展,本科生的自主学习能力-沟通能力-团队合作能力-创新能力-动手能力和观察能力都得到了显著提高,因此科研实践是培养本科生各项能力的重要手段-

摘要:师德是教师最根本-最重要的素质-高校师德的建设对培养社会主义事业建设者和接班人具有重要的影响-当前高校出现师德滑坡与失范,亟待以社会主义荣辱观作为当今高校师德建设的主要内容,从宣传教育-理论研究-自省自律-师德评价等方面加以引导-

摘要:目的:探讨重症手足口病的危险因素-方法:对2008年4月~2009年6月留观和住院的手足口病患儿的临床表现进行回顾性分析-结果:对全部被调查者的11个项目进行单因素相关分析,其中8项有显著性(P < 0.05),分别是精神差-惊跳-嗜睡-发热天数≥3天-热峰≥38.5℃-呕吐-头痛-皮疹分布(无口腔溃疡)-热程≥3天的灵敏度-特异性-阳性预测值-阴性预测值分别为:61.8%,80.2%,58.9%,82.0%;热峰≥38.5℃的灵敏度-特异性-阳性预测值-阴性预测值分别为:39.8%,88.4%,91.6%,31.6%;惊跳的灵敏度-特异性-阳性预测值-阴性预测值分别为:72.7%,80.2%,96.6%,90.3%;呕吐的灵敏度-特异性-阳性预测值-阴性预测值分别为:82.6%,76.4%,40.2%,95.8%;精神的灵敏度-特异性-阳性预测值-阴性预测值分别为:67.4%,90.2%,82.2%,80.4%-精神差是中枢神经系统感染的独立危险因素-结论:精神差-惊跳-嗜睡-发热天数≥3天-热峰≥38.5℃-呕吐-头痛-皮疹分布(无口腔溃疡)为手足口病的危险症状,确定这些危险症状,有助于早期识别重症病例,早期治疗,降低死亡率-

摘要:目的:观察动态血糖监测仪(continuous glucose monitoring system,CGMS)联合胰岛素泵(insulin pump)治疗儿童1型糖尿病的临床效果-方法:64例儿童1型糖尿病患者均采用胰岛素泵持续皮下输注(continuous subcutaneous insulin infusion,CSII)进行治疗,其中42例(微量血糖仪组)采用每天8次微量血糖仪监测,22例(CGMS组)在每天8次微量血糖仪监测基础上采用CGMS监测血糖,对两者血糖稳定达标天数和低血糖发生次数进行比较-结果:CGMS组血糖稳定达标所需天数(3.81±0.95)天,少于微量血糖仪组(5.54±1.19)天(P < 0.01)-而CGMS组低血糖发现次数显著高于微量血糖仪组(P < 0.01)-结论:胰岛素泵联合CGMS与胰岛素泵联合微量血糖仪监测治疗儿童1型糖尿病均能很好控制血糖,胰岛素泵联合CGMS临床达标时间短,易发现低血糖事件-

摘要:目的:提高临床医生对重症监护病房(PICU)遗传代谢病的认识,探讨筛选PICU遗传代谢病高危患儿的方法,尽早明确诊断-方法:对本院PICU18例确诊遗传代谢病的临床表现-实验室检查-入院诊断进行总结分析-结果:甲基丙二酸血症2例,乳糖不耐症4例,半乳糖血症2例,高乳酸血症1例,丙酸血症1例,异戊酸血症1例,尿素循环异常1例,戊二酸尿症1例,乙酰乙酰辅酶A硫解酶缺乏症1例,酪氨酸血症1例,枫糖尿症1例,苯丙酮尿症1例,citrin缺陷导致的新生儿肝内胆汁淤积症(NICCD)1 例-结论:对不明原因的肝肿大,不能解释的代谢异常-神经疾病等尽早进行气相色谱—质谱检查;临床诊断为瑞氏综合征的患儿,不能排除遗传代谢病-

摘要:目的:探讨肺炎支原体DNA(MP-DNA),超敏C反应蛋白(SCRP)对诊断支原体肺炎的敏感性和特异性,为临床提供准确快速的诊断依据-方法:采用MP荧光定量PCR法检测患儿呼吸道分泌物标本中的MP-DNA水平,同时检测血清SCRP和MP-IgM的浓度,并与WBC计数进行比较-结果:MP-DNA和SCRP对诊断支原体肺炎的敏感性均高于WBC计数,3个指标的敏感性以SCRP最高;特异性和阳性预测值以MP-DNA最高;阴性预测值和约登指数,MP-DNA和SCRP两者相差无几-结论:MP-DNA检测对肺炎支原体的早期诊断有一定价值-

摘要:目的:探讨儿童阻塞性睡眠呼吸暂停低通气综合征(OSAHS)病因中腺样体-扁桃体的作用-方法:对94例经多导睡眠检测确诊的OSAHS儿童患者进行扁桃体大小及腺样体大小的评价,并进行统计学处理和分析-结果:单纯腺样体肥大29例(30.85%),单纯扁桃体肥大8例(8.51%),两者均大52例(55.32%),两者均不大5例(5.32%)-单纯扁桃体肥大与单纯腺样体肥大-腺样体合并扁桃体肥大的AHI-最低SaO2 比较有显著性差异(P < 0.05);单纯腺样体肥大与腺样体合并扁桃体肥大比较差异无显著性意义(P > 0.05)-AHI轻-中-重度各组间扁桃体各级分布较均匀,差异无显著性意义,腺样体各级分布差异有显著性意义-腺样体大小与AHI相关系数r=0.522,扁桃体大小与AHI相关系数r=0.125-结论:在引起OSAHS的阻塞性原因中,腺样体肥大与OSAHS之间有相关性,扁桃体作用不明显,两者同时存在可产生相加效应-

摘要:目的:探讨手术治疗不稳定性齿状突骨折的方法和效果-方法:回顾性分析了32例不稳定性齿状突骨折颈后路融合手术治疗病例并对其结果进行随访-结果:2001年至2007年共收治32例不稳定性齿状突骨折,单纯寰枢椎融合术18例,单纯枕颈融合术5例,寰椎后弓切除减压加枕颈融合术2例,枕骨大孔-寰枢后弓减压-枕颈融合4例,枕骨大孔-寰枢后弓减压-硬膜成形-枕颈融合3例-术后随访为1年半至3年,手术后患者神经功能明显恢复,无并发症,植骨均获骨性融合-结论:颈后路植骨融合是治疗不稳定性齿状突骨折安全有效的方法-

摘要:

摘要:目的:探讨彩色多普勒超声诊断在小儿睾丸及附件扭转中的临床应用价值-方法:利用二维及彩色多普勒超声对14例睾丸及附件扭转患者进行术前监测,用二维超声测定睾丸位置-大小-方向-形态-内部回声及周围组织病变,用彩色多普勒探查睾丸内血流情况,与术中所见及术后病理切片相比较-结果:14例病例中,10例手术证实为睾丸扭转,其中8例彩色多普勒超声睾丸内未见血流显示,术中发现睾丸坏死,予以切除;2例彩色多普勒见少量星点状血流,术中发现睾丸尚有生机,予以保留-4例为附件扭转,手术切除扭转附件,睾丸-附睾得以保留-结论:高频彩色多普勒在睾丸及附件扭转中有较高临床诊断价值,有助于早期诊断,可避免睾丸切除-

摘要:目的:评价俯卧位通气对小儿肺炎肺不张的临床疗效-方法:2006年10月~2008年12月苏州大学附属儿童医院儿科重症监护病房收住的25例患儿,均因低氧血症行机械通气,通过胸部X线和CT诊断肺炎-肺不张,随机分成2组,仰卧位通气组和俯卧位通气组,通气模式为压力控制模式(PC mode),以监测呼出潮气量6~10 ml/kg反馈调节控制压力,吸气时间0.6~1.0 s,呼吸频率25~40次/min,吸入氧体积分数350~1 000 ml/L,呼气末正压5~12 cmH2O(1 cm H2O=0.098 kPa)-比较2组呼吸循环指标-影像学肺复张时间-机械通气时间-结果:俯卧位通气组的氧合指数(PaO2/FiO2)和动脉血氧分压(PaO2)显著高于仰卧位通气组(P < 0.05),俯卧位通气组的肺复张时间和机械通气时间显著少于仰卧位通气组(P < 0.05)-而心率-血压-动脉血二氧化碳分压-呼吸系统动态顺应性-呼吸道阻力-呼吸道峰压比较差异无统计学意义-结论:俯卧位通气可改善肺炎肺不张患儿的氧合,促进肺复张,减少机械通气时间-

摘要:目的:研究高血压脑出血围术期应用乌司他丁对神经元特异性烯醇化酶的影响和脑保护作用-方法:高血压脑出血发病7 h内的手术患者40例,随机分为乌司他丁组(A组)和对照组(B组)-测定两组术前和术后12-36 h血清神经元特异性烯醇化酶(neuron-specific enolase,NSE)的浓度及术前和术后第8天的格拉斯哥(glasgow coma scale,GCS)的评分-结果:术后12 h和36 h,A组NSE浓度明显低于B组,术后第8天A组GCS评分明显高于B 组-结论:高血压脑出血术中早期应用乌司他丁有利于神经保护-

摘要:目的:探讨彩色多普勒超声对原发性甲状旁腺功能亢进症的诊断及术前定位应用价值-方法:回顾性分析1998年8月~2009年4月本院手术的46例原发性甲状旁腺功能亢进患者,应用高频彩色多普勒超声技术检查甲状旁腺及超声为外科手术做术前定位的结果-结果:超声检出41例甲状旁腺肿块共计43个,检出率为89.1%(41/46),二维超声多表现为甲状旁腺区圆形或卵圆形低回声肿块,边界光滑整齐,多有包膜,常为单发,多位于甲状腺下动-静脉后方,彩色多普勒可见丰富的血流环绕肿块或深入肿块内部,血流多来源于甲状腺下动脉;频谱多普勒可探及动-静脉血流频谱-超声检出的甲状旁腺肿块均经手术证实,定位准确率为100%-结论:彩色多普勒超声是诊断原发性甲状旁腺功能亢进症的有效手段,并可作为临床术前定位的最理想方法-

摘要:目的:研究抗癌药物羟基喜树碱(HCPT)新剂型羟基喜树碱脂质体(LHCPT)在Beagle犬体内的毒物代谢动力学,探讨该药物是否在血液中有蓄积作用-方法:采用HPLC-荧光检测法测定全血中LHCPT的浓度-结果:在第1天和连续给药第30天后Cmax和AUC值存在剂量相关性;药物半衰期t1/2不同剂量之间无显著变化(P > 0.05)-AUC-Cmax-t1/2值多次给药与单次给药后比较,同剂量下均未见显著提高(P > 0.05)-结论:LHCPT连续静脉给药后未见血液中有明显蓄积现象-

摘要:目的:通过比较自行研配的培养液与商品化培养液在卵母细胞体外成熟中的运用效果,为进一步优化体外成熟培养体系提供依据-方法:分别选择使用自行配制培养液的(IVM-A组)110个周期和使用商品化(IVM-B组)培养液的99个周期,并以同期行ICSI的治疗周期为对照(ICSI-C1和ICSI-C2),比较两组在体外成熟-胚胎发育-胚胎种植-临床妊娠及结局等方面的差异-结果:在两对照ICSI-C1和ICSI-C2各项指标无差异的情况下,IVM-A组体外成熟和胚胎发育等方面均高于IVM-B组,且可移植胚胎率-优质胚胎率明显提高(P < 0.05或P < 0.01),可移植胚胎率已达到ICSI组水平-虽然表面上IVM-A组在胚胎种植率-妊娠率(临床妊娠率)-活产率等指标低于IVM-B组,但不同阶段的对照组其指标明显改变,ICSI-C2(2006年以后)明显好于ICSI-C1-这种差异可能与近年来的临床治疗方案的改善及宫腔镜的使用有关-值得注意的是,IVM-A的流产率只有10.53%,显著低于其他3组,而同期的对照(ICSI-C1)却明显高于ICSI-C2,提示使用自行配制培养液培养的胚胎可显著降低流产的发生-但由于样本量还不够大,结果尚待进一步验证-结论:自行配制的培养液具有较好的运用效果,可能与其中额外添加的mHFF及E2等有关-但系统尚需进一步优化,以保证其高效-安全-价廉-

摘要:目的:了解江苏省手足口病(Hand-foot-mouth disease,HFMD)肠道病毒阳性检出率相关因素,并对其EV71病毒的VP1基因特征进行分析-方法:在2008年4~12月份,通过监测哨点医院收集全省手足口病病例的咽拭子-粪便或肛拭子-疱疹液-脑脊液-血清标本,并填写病例相关基本信息-结果:共采集手足口病病例的各种类型标本2 082份,咽拭子-肛拭子-疱疹液-粪便-脑脊液-血清的总肠道病毒阳性检出率分别为53.52%-41.12%-40.74%-27.27%-25.00%-9.80%,EV71阳性检出率分别为47.03%-30.84%-33.33%-22.73%-25.00%-2.94%,CoxA16阳性检出率分别为5.34%-8.41%-3.70%-0.00%-0.00%-6.68%,不同类型标本的肠道病毒阳性检出率和阳性检出构成均有差异(P值均< 0.0001)-总肠道病毒阳性检出率在发病后第2天最高(56.59%),不同发病与采样时间间隔的总肠道病毒阳性检出率和EV71病毒阳性检出率均有统计学意义(P值分别为0.0019-0.0139),而与CoxA16阳性检出率没有统计学意义(P = 0.2558)-总肠道病毒阳性检出率在就诊后第2天最高(59.90%),不同就诊与采样时间间隔的总肠道病毒与EV71病毒阳性检出率有统计学差异(P值分别为0.0228-0.0333),与CoxA16阳性检出率没有统计学差异(P = 0.3958)-分离的4株EV71病毒均为C4.3基因亚群-结论:标本类型-采样与发病时间间隔-采样与诊断时间间隔均与手足口病病例的肠道病毒阳性检出率密切相关,分离的EV71毒株为C4亚型-

摘要:目的:分析江苏省不同地区和年代分离的Escherichia coli O157:H7(E. coli O157:H7)之间的同源性-方法:用扩增片段长度多态性(amplified fragment length polymorphism,AFLP)分析法对113株 E. coli O157:H7菌株进行分子分型,采用软件BioNumerics Version 4.0对分型数据进行处理和分析-结果:113株E. coli O157:H7共分37个型别,不同来源的菌株存在相同的基因型别,不同的地区和物种之间存在着相互传播-结论:AFLP可以用于对不同来源的E. coli O157:H7进行分子分型-