摘要:Chromosome copy number aberrations, anueploidies, are common in the human population but generally lethal. However, trisomy of human chromosome 21 is compatible with life and people born with this form of aneuploidy manifest the features of Down syndrome, named after Langdon Down who was a 19th century British physician who first described a group of people with this disorder. Down syndrome includes learning and memory deficits in all cases, as well as many other features which vary in penetrance and expressivity in different people. While Down syndrome clearly has a genetic cause - the extra dose of genes on chromosome 21 - we do not know which genes are important for which aspects of the syndrome, which biochemical pathways are disrupted, or, generally how design therapies to ameliorate the effects of these disruptions. Recently, with new insights gained from studying mouse models of Down syndrome, specific genes and pathways are being shown to be involved in the pathogenesis of the disorder. This is opening the way for exciting new studies of potential therapeutics for aspects of Down syndrome, particularly the learning and memory deficits.

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摘要:《中华人民共和国侵权责任法》的施行可能缓解当前紧张的医患关系,文章通过阐述侵权责任法中有关医疗过错归责原则-举证责任以及输血相关产品责任等内容,对侵权责任法相关条款的适用提出了自己的见解,对相关条款的不同理解也做了合理的分析-

摘要:医疗技术损害归责原则实现了从过错推定原则向过错责任原则的回归-同时,考虑到患方的实际举证能力,医疗技术损害案件在特定情况下实行举证责任转换制度-患方能够证明医疗行为存在违法-违规等情形,或者医方存在隐匿-篡改-销毁病历资料等情形时,直接推定医疗行为有过错-《侵权责任法》关于医疗技术损害责任立法创新还包括“医疗损害赔偿”概念的使用及“医疗水准说”的引入-

摘要:Objective: Inflammation induced by H.pylori colonization in the stomach is related to the development of gastric cancer and the genetic variations of the genes involved in the immune responses modify the host response to the infection. The aim of this study was to evaluate whether polymorphisms in the toll-like receptor 4 (TLR4) gene, a key regulator of both innate and adaptive immunity, were related to the susceptibility to gastric cancer in a Chinese population. Methods: Two variations in the 5'-flanking region of TLR4 (rs1927914 T > C and rs10759932 T > C) were genotyped by using the PCR-restriction fragment length polymorphism (RFLP) assay in a case-control study of 1,053 incident gastric cancer cases and 1,100 cancer-free controls in a Chinese population. Results: Individuals carrying the C allele of rs10759932 had a significantly reduced risk of gastric cancer (adjusted OR = 0.81; 95%CI = 0.67-0.96), compared with the wild-type homozygote (TT), and the protective effect was not significantly different among subgroups stratified by age, sex, smoking, drinking and H.pylori infection status (P for heterogeneity > 0.05). No significant association was observed between rs1927914 and gastric cancer risk in this study population. Conclusion: The T to C allele substitution of rs10759932 may play a protective role in gastric carcinogenesis in a Chinese population. Large studies with different ethnic populations are warranted to confirm these findings.

摘要:2010年7月1日施行的《侵权责任法》中的医疗损害责任一章与既往的法律法规大有不同,该法实施后举证责任-因果关系与过失责任等一系列医疗损害中最常见的问题都需要重新认识-笔者就上述问题进行分析认为,只要医疗事故需要鉴定,举证责任倒置就存在-如果《侵权责任法》要求的是严格责任,则某些过错的确认,就不再需要确立因果关系-

摘要:药品的质量关乎用药者的生命权和健康权,与基本人权息息相关-2001年2月28日第九届全国人民代表大会常务委员会第二十次会议修订的《中华人民共和国药品管理法》取消了药品致人身损害赔偿的诉讼时效期间为一年的规定,对权利人诉讼维权的存续期延长,强化了公权力对受害人法律救济的保障力度,充分体现了对基本人权的保护,维护人民身体健康和用药合法权益的基本宗旨和立法精神-

摘要:Objective: To evaluate the efficiency of an implanted chip system for the control of heart rate (HR). Methods: The HR was recorded in six conscious Sprague-Dawley (SD) rats. An implanted chip system was designed to regulate the HR by stimulating the right cervical vagus nerve according to the feedback of real time HR. Each rat was subjected to 30-min regulation and 30-min recovery. The change of HR during the regulation period was compared with the control. The ECG was recorded during the experiment for 24 h. Results: The ECG signals were successfully recorded during the experiment. The HR was significantly decreased during the period of regulation compared with control (-79.3 ± 34.5, P < 0.01, n = 6) and then recovered to normal after regulation. Conclusion: The described implanted chip system can regulate the HR to a designated set point.

摘要:为实现医患纠纷中医疗信息的合理公开,文章阐述了我国医疗活动中信息公开的现状,分析医患双方在医疗活动中专业信息不对称的原因与存在的问题,通过医疗信息公开为维护医疗活动中医患双方的权益公平提供构想-

摘要:文章结合《中华人民共和国电子签名法》-《电子病历基本规范(试行)》等法律规范,对电子病历的合法性-电子病历的证据能力-电子病历的证据特征等三个问题进行了较为全面的阐述,并初步探讨了电子病历实践中约定使用-电子签名-患者隐私权保护-电子病历的可溯性-

摘要:This study was designed to measure the pressure distribution of the intervertebral disc under different degrees of distraction of the interspinous process, because of a suspicion that the degree of distraction of the spinous process may have a close relationship with the disc load share. Six human cadaver lumbar spine L2-L5 segments were loaded in flexion, neutral position, and extension. The L3-L4 disc load was measured at each position using pressure measuring films. Shape-memory interspinous process implants (SMID) with different spacer heights, ranging in size from 10 to 20 mm at 2 mm increments, were used. It was found that a SMID with a spacer height equal to the distance of the interspinous process in the neutral position can share the biomechanical disc load without a significant change of load in the anterior annulus. An interspinous process stabilizing device (IPD) would not be appropriate to use in those cases with serious spinal stenosis because the over-distraction of the interspinous process by the SMID would lead to overloading the anterior annulus which is a recognized cause of disc degeneration.

摘要:电子病历是医疗机构信息化发展的重要组成部分-电子病历的法律效力对于电子病历的推广与应用有深远影响-文章分析了电子病历作为证据的法律效力以及电子病历在实际应用中出现的部分与法律相关的问题,并阐述其推广的重要意义-

摘要:医保经办机构的管理目标是用最低廉的医疗费用保障参保人员的基本医疗,并确保医保基金收支平衡-医院从医保角度出发,通过病案质量管理,开展合理医疗,控制不合理费用,取得最大收益-在探究影响医保管理实效的同时,医保定点医院费用结付问题-医疗质量与费用控制问题-患者冒名就医和转院问题值得关注和思考-

摘要:文章对西方国家医院成本管理发展过程进行了较系统的评述,在此基础上,对西方国家医院最新成本管理成果做出详尽说明-文章最后指出,西方国家医院成本管理的系统化和战略化思想值得我国医院借鉴-建议结合国情-院情在实践中去粗取精地为我所用-

摘要:Objective: To investigate the relationship between the expression level of matrix-metalloproteinases (MMPs) with the pathological grades and MRI characteristics of human gliomas. Methods: Prior pre- and post-contrast enhancement MRI was performed on 31 patients with gliomas, which were confirmed by post-operational pathology. The expression of MMP-2 and MMP-9 were determined by immunohistochemical staining in both a low grading group (grades I and II, n = 20) and high grading group (grades III and IV, n = 11). Results: Compared to the low grading group, the expression levels of MMP-2, MMP-9, as well as the tumor edema index (EI), enhanced percentage (EP) and maximum diameters were significantly greater in the high grading group. MMP-2 and MMP-9 expression were correlated with the tumor EI, EP and the maximum diameters. There were no differences in MMP-2 and MMP-9 expression between the unclear border definition group and the clear border definition group, whereas the MMPs expression levels were greater in the heterogeneous signal group than in the homogeneous signal group. Conclusion: The expression level of MMPs is correlated with the invasion ability of human gliomas. The MRI parameters, such as tumor EI, EP, maximum diameter, and signal heterogeneity technically reflect the expression level of MMPs, and can be used to estimate the tumor's malignant behavior, thus providing the guidance for clinical therapies.

摘要:Objective: To explore the role that ceramide plays in the activation of mitogen-activated protein kinases (MAPKs) during cerebral ischemia and reperfusion. Methods: Rats were subjected to ischemia by the four-vessel occlusion (4-VO) method. The sphingomyelinase inhibitor TPCK was administered to the CA1 subregion of the rat hippocampus before inducing ischemia. Western blot was used to examine the activity of extracellular-signal regulated kinase (ERK) and c-Jun N-terminal protein kinase (JNK) using antibodies against ERK, JNK and diphosphorylated ERK and JNK. Results: At 1h reperfusion post-ischemia, JNK reached its peak activity while ERK was undergoing a sharp inactivation (P < 0.05). The level of diphosphorylated JNK was significantly reduced but the sharp inactivation of ERK was visibly reversed (P < 0.05) by the sphingomyelinase inhibitor. Conclusion: The ceramide signaling pathway is up-regulated through sphingomyelin hydrolysis in brain ischemia, promoting JNK activation and suppressing ERK activation, culminating in the ischemic lesion.

摘要:西方的菲德勒权变理论与中国儒家传统文化中的“通权达变”的思想为社会的各类管理活动提供了坚实的理论依据和明确的方法指向-鉴于此,文章以权变思想为视角,在分析提升领导科学发展能力困境的基础上,从理论思维-优化领导选才用人-强化领导的学习力方面探讨提升领导科学发展能力的路径-

摘要:运用卡特尔十六种人格因素量表(16PF)对南京地区8所有代表性的高校中253名教师进行人格测量,结果显示,南京地区部分高校教师与全国常模相比具有非常显著的统计学差异,表现为高恃强性-高兴奋性-高敢为性,低聪慧性-低有恒性-低敏感性-低怀疑性-低忧虑性-低实验性-低独立性-低自律性-不同性别-年龄-学历-职称-年收入水平-学科门类-学科等级-岗位性质的高校教师,其人格特征存在显著的差异-

摘要:Objective: Retinopathy of prematurity is becoming obvious with the improvement of neonatal ambulance. However there is still not a good treatment. The present study is to observe the effect of 17 beta-estradiol (E2) on oxygen-induced retinopathy (OIR), and explore the relationship between the changes of avascular area and malondialdehyde (MDA) in retina. Methods: Newborn oxygen-exposed mice underwent subcutaneous injections of different dose of E2 (0.1 μg, 1.0 μg, 10.0 μg ), tamoxifen or phosphate buffered saline (PBS; controls)everyday from post-natal day (p)7 to p17. At p17, retinal flat mounts were scored for the percentage of avascular/total retinal area, and pathological changes during revascularization. The MDA concentration in the retina was determined also. In the most efficacious E2 group (10.0 μg), 100.0 μg tamoxifen was also administered, and the percentage of capillary-free/total retinal area determined, and the retinal malondialdehyde concentration assayed. Results: The mean percentage of capillary-free area over total retinal area was 0(PBS, in room air), 34.197±1.301(PBS, in hyperoxia), 23.685±0.407 (0.1 μg E2), 14.648±0.355 (1.0 μg E2), 4.693±0.450 (10.0 μg E2) and 32.240±0.654 (10.0 μg E2 +100.0 μg tamoxifen). The difference was significant (F = 2778.759, P < 0.01), and the difference between any two groups were also significant (all P value were less than 0.01). The predilection of tufts and clusters during revascularization was mainly aggregated in zones 2 and 3, but the difference of retinal neovascular clusters and tufts in fourth zone among different groups were significant [clusters (F = 44.719, P < 0.01) vs tufts (F = 39.997,P < 0.01)]. The mean MDA concentration were 0.711±0.037(PBS, in room air), 2.084±0.066 (PBS, in hyperoxia), 1.829±0.091(0.1 μg E2), 1.152±0.067(1.0 μg E2), 0.796±0.027(10.0 μg E2), 1.988±0.049(10.0 μg E2 +100.0 μg tamoxifen) (F = 628.103, P < 0.01). The difference between any two groups were also significant (all P value were less than 0.05). The close relation between the percentage of avascular/total retinal area and MDA concentration was also verified (r = 0.981, P < 0.01). Conclusion: Oxidative stress responses play a pivotal role in OIR, by means of receptor pathway. E2 can alleviate oxidative stress reaction, and thus ameliorate the severity of oxygen induced retinopathy.

摘要:目的:探讨Huh7细胞中边缘群细胞的分选及边缘群细胞在增殖及分裂能力方面与非边缘群细胞的差异,为肝癌的治疗探索新的思路-方法:采用流式细胞仪分选Huh7细胞中的边缘群细胞和非边缘群细胞,用荧光显微镜观察其胞内Hoechst33342荧光染色强度差异;以半定量RT-PCR测定ABCG2 mRNA表达水平的差异;应用免疫荧光染色检测ABCG2蛋白表达的差异并观察其增殖和不对称分裂能力的差异-结果:非维拉帕米处理组边缘群细胞比例约为2.22%,经维拉帕米阻断后边缘群细胞比例减少至0.74%;边缘群细胞中Hoechst33342的荧光强度明显较非边缘群细胞弱,在边缘群细胞中ABCG2 mRNA表达水平是非边缘群细胞的4.32倍(P < 0.01),增殖能力是非边缘群细胞的2.7倍(P < 0.01),且边缘群细胞能产生ABCG2(+)和ABCG2(-)子代细胞,而非边缘群细胞只能产生ABCG2(-)子代细胞-结论:Huh7细胞中存在少量边缘群细胞(2.22%),其增殖能力较非边缘群细胞强且具有不对称分裂能力(自我更新和定向分化),具有肿瘤干细胞的特性;因此边缘群细胞分选可以作为肿瘤干细胞分离的一种方法,并且在肿瘤的耐药和进展中具有更重要作用,进一步探讨针对Huh7边缘群细胞生物学行为的研究有望开辟肝癌治疗的新思路-

摘要:社会主义核心价值体系是社会主义中国的精神旗帜-高校是建设社会主义核心价值体系的重要阵地-如何引导大学生对社会主义核心价值体系的认同已经成为当今高校德育工作的一个重要课题-笔者通过问卷调查-个别访谈-座谈会等形式,分析当前大学生对社会主义核心价值体系认同度的现状及原因,并提出相关的对策-

摘要:目的:观察RNA干扰沉默缺氧诱导因子-1α(HIF-1α)对胃癌细胞增殖﹑凋亡﹑侵袭性的影响并探讨其可能的分子机制-方法:将HIF-1α短发夹RNA(shRNA)重组质粒pGCsi-shHIF-1α稳定转染人胃癌细胞SGC-7901;采用RT-PCR和Western blot法检测HIF-1α mRNA-蛋白表达水平,Western blot法检测葡萄糖转运蛋白1(Glut-1)-基质金属蛋白酶2(MMP-2)及趋化因子受体CXCR4蛋白表达;MTT法-流式细胞仪-transwell试验分别检测转染细胞的增殖-凋亡及侵袭迁移能力-结果:稳定转染pGCsi-shHIF-1α后,SGC-7901细胞HIF-1α表达在mRNA及蛋白水平均受到明显抑制,Glut-1﹑MMP-2﹑CXCR4蛋白表达较对照组降低;细胞增殖能力较对照组明显降低,细胞凋亡率明显高于对照组(P < 0.05);细胞体外侵袭迁移能力受到明显抑制(P < 0.01)-结论:pGCsi-shHIF-1α能有效沉默胃癌细胞SGC-7901 HIF-1α基因表达,抑制胃癌细胞增殖-迁移及侵袭并诱导其凋亡,提示HIF-1α可能通过上调Glut-1﹑MMP-2和CXCR4等从而调节肿瘤细胞生长及转移-

摘要:Objective: Endothelial nitric oxide synthase (eNOS) and nitric oxide (NO) have been implicated in protection against myocardial ischemia injury. This study was designed to explore a new method of therapy for myocardial injury by eNOS gene transfection. Methods: A rat model of myocardial infarction (MI) was established by left anterior descending (LAD) coronary artery ligation. eNOS gene in an adenovirus vector was delivered locally into the rat heart and hemodynamic parameters were examined after 3 weeks, Matrix metalloproteinase-2 and 9 (MMP-2, MMP-9) mRNA were measured by reverse transcription polymerase chain reaction (RT-PCR), and the protein levels of eNOS, caspase-3, and transforming grouth factor β1 (TGF-β1) were determined by western blot assay. Results: eNOS gene transfer significantly reduced cardiomyocyte apoptosis and improved cardiac function. In addition, eNOS significantly reduced the mRNA levels of MMP-2 and MMP-9. In the eNOS gene transfected group, the activation of caspase-3 and TGF-β1 were decreased. However, the protection was reversed by administration of the NOS inhibitor, N(ω)-nitro-l-arginine methyl ester (L-NAME). Conclusion: These results demonstrate that the eNOS provides cardiac protection after myocardial infarction injury through inhibition of cardiac apoptosis and collagen deposition, and suppression of TGF-β1.

摘要:随着“开心农场”等娱乐游戏风靡互联网,“偷菜”瞬间蹿红网络,席卷网民生活-越来越多的大学生也加入到“偷菜”的队伍中来,每天在“偷”与防“偷”中乐此不疲-文章试图从社会学和心理学的角度分析大学生热衷于“偷菜”的原因和“偷菜”行为对大学生的影响,并对如何引导大学生回到正常的生活轨道上来提出几点对策与建议-

摘要:目的:研究卡波济肉瘤相关疱疹病毒(KSHV)是否能够感染前列腺非致瘤性上皮细胞系RWPE-1及前列腺癌细胞系PC-3,并初步探索其相关信号通路变化-方法:将12-O-十四烷酰佛波醇-13-乙酯(TPA)刺激人原发性渗出性淋巴瘤细胞系BC-3,收集细胞上清(含KSHV病毒颗粒),感染RWPE-1及PC-3,观察前列腺细胞的细胞病变效应(CPE)-采用RT-PCR检测KSHV即刻基因ORF50 mRNA转录状况;进一步运用Western blot检查病毒裂解期产物病毒白细胞介素6(vIL-6)的蛋白表达水平;最后采用Western blot法检测被感染细胞胞浆和胞核中β-catenin表达水平-结果:PC-3细胞感染KSHV后未见明显CPE,但RT-PCR和Western blot均在预期位置检测到KSHV基因ORF50和vIL-6的mRNA及其编码的蛋白条带-RWPE-1细胞感染KSHV后可出现明显的CPE,感染后24 h可以检测到vIL-6的表达-Wnt通路蛋白β-catenin在感染KSHV的RWPE-1细胞胞浆和胞核均呈上升趋势-结论:KSHV可以感染前列腺细胞系并有可能激活Wnt通路-

摘要:医学生的人文精神培育是医学人文发展的基础-医学的本质以及新时期人类对健康的需求,要求我们培养出大批具备高尚人文精神的医学人才-意欲取之,必先予之-医学院校在培养-训练医学人才的过程中,首先要用人文知识去浇灌他们,用人文精神去熏陶他们-在医学教育过程中必须结合医学专业特点,用人文的精神去关怀-滋润-影响在校医学生,提升他们的人文情怀-

摘要:Objective: Ethanol treatment induces an increase in oxidative stress. As licorice compounds are potent antioxidants, our aim was to examine whether magnesium isoglycyrrhizinate attenuated lipid peroxidation, the major end-point of oxidative damage resulting from ethanol administration. Methods: Four groups(18 animals in each group) of male Kunming mice were used. The first group served as control and received 0.4 ml normal saline daily for 18 days orally. The second group of mice was given 56% ethanol at 16 ml/kg body weight per day for 18 days orally. The third group was given the same dose of ethanol and administrated magnesium isoglycyrrhizinate (15 mg/kg.d, i.p.) for 18 days. The fourth group was given the same dose of ethanol and administrated with magnesium isoglycyrrhizinate (45 mg/kg.d, i.p.) for 18 days. Twenty four hours after 9 days or 18 days of treatment the mice were sacrificed using 10% chloral hydrate. Sperm counts and motility in the epididymis were assessed. The lipid peroxidation and antioxidants of testicular mitochondria were also determined. The pathological changes of testicle tissue of the mice were observed by light microscopy. Results: Magnesium isoglycyrrhizinate effectively prevented the ethanol-induced seminiferous epithelium disorganization and degeneration of Sertoli cells and germ cells. Sperm counts and motility of the magnesium isoglycyrrhizinate treated groups were higher than those of the alcohol treated group, but were lower than those of the control group. The drug exhibited an ability to counteract ethanol induced oxidative challenge as it effectively reduced testicular malondialdehyde (MDA) and increased the activities of superoxide dismutase and glutathione peroxidase. Conclusion: Magnesium isoglycyrrhizinate is able to inhibit the ethanol-induced lipid peroxidation and has a protective effect against testicular oxidative injury.

摘要:目的:探讨大蒜素对急性单核细胞白血病细胞株THP-1凋亡及凋亡基因Fas/FasL表达的影响-方法:采用四甲基偶氮唑蓝(MTT) 法测定大蒜素对THP-1细胞增殖抑制率;AO/EB染色观察细胞凋亡形态;Annexin V-FITC/PI双染法流式细胞术(FCM)检测凋亡率的变化;FCM检测细胞凋亡率和细胞周期分布;免疫细胞化学法和Western blot观察细胞Fas-FasL蛋白表达-结果:MTT显示大蒜素能抑制THP-1细胞增殖,呈时间-剂量依赖性,72 h中效浓度(IC50)为12.8 mg/L-Annexin V-FITC/PI检测凋亡率随大蒜素浓度增加而增加-6.4-12.8 mg/L大蒜素作用THP-1细胞72 h后,FCM检测G0/G1期细胞比率明显上升,而S期比率明显下降,均出现凋亡峰,凋亡率分别为(22.93±2.93)%和(36.73±2.88)%,呈剂量依赖性,与对照组比较有显著差异(P < 0.01)-在荧光显微镜下可区分早-晚期凋亡细胞-活细胞和坏死细胞-免疫组化显示大蒜素作用后Fas/FasL蛋白上调,主要分布在细胞浆和细胞膜-Western blot结果显示Fas/FasL蛋白表达量随大蒜素浓度的升高而增加,呈剂量依赖性-0-6.4-12.8 mg/L大蒜素分别作用后Fas蛋白表达水平(相对灰度值)分别为0.287 4±0.009,0.427±0.008和0.597±0.011;FasL蛋白表达水平分别为0.212±0.014,0.299±0.028和0.409±0.027;差别均有显著性意义(P < 0.01)-结论:大蒜素可诱导THP-1细胞发生凋亡,诱导凋亡的机制可能部分与其上调Fas及FasL表达有关-

摘要:马克思主义的“人的全面发展理论”是大学生职业生涯指导与高校思想政治教育有机结合的理论基础-大学生职业生涯指导与高校思想政治教育在教育理念-教育内容和服务目标等方面存在的内在关联性是二者之间有机结合的契机;以职业生涯规划为载体,加强课程建设,优化教师素质结构,开展教育实践活动是二者实现有机结合的主要路径-

摘要:文章通过问卷调查了解了临床医学专业本科学生就业面临的主要问题,分析原因,提出相应对策,强调要进一步加强毕业生就业指导工作,实现临床医学专业本科毕业生最大限度的就业-

摘要:Objective: To investigate the synergistic anti-tumor effect of QHF (a Chinese medicine formula with anti-tumor active ingredients, including 800 mg/kg Cinobufotalin, 14 mg/kg Ginsenoside Rg3, 5.5 mg/kg Notoginseng and 100 mg/kg Lentinan) when combined with the chemotherapy drug cisplatin (DDP). Methods: Hepatocellular carcinoma H22 cells were implanted into mice and after the transplants were successfully established the animals were divided into four groups, namely a normal saline(NS) control group, QHF group, DDP group and QHF+DDP group. The tumor growth was monitored and the survival time determined. In vitro studies employing H22 cells used the first three groups, and determined the effects of QHF and DDP on tumor cell cycle distribution, apoptosis and morphologic changes in vitro. Results: QHF significantly inhibited the growth of tumors and prolonged the survival time of mice with hepatocellular carcinomas. QHF combined with DDP could attenuate DDP-induced leucopenia, spleen and thymus atrophy and other indicators of toxicity. The inhibition rate of tumor growth reached 82.54% with QHF+DDP, and QHF prolonged the life span of DDP-treated mice by 66.83%. In the in vitro experiments tumor cells showed morphological changes characteristic of apoptosis by both light and transmission electron microscopy in the QHF group, and the apoptosis rate was 33.85%. Moreover, the proportion of cells in the G0/G1 phase was increased and those in the S-phase decreased. Conclusion: QHF combined with DDP could significantly inhibit tumor growth, induce the apoptosis of tumor cells and effectively attenuate DDP toxicity.

摘要:目的:研究选择性β2肾上腺素能受体激动剂福莫特罗(Formoterol)和阻滞剂ICI118551对体外由大鼠骨髓间充质干细胞(MMSCs)诱导分化的成骨样细胞增殖和凋亡的影响,探讨β2肾上腺素能受体信号对骨代谢的影响-方法:取3周龄雌性SD大鼠,全贴壁筛选法培养MMSC,用条件培养液诱导向成骨细胞分化后分别加入不同浓度Formoterol和ICI118551,检测细胞增殖率和细胞凋亡率-结果:MMSC成功诱导分化为成骨样细胞,不同浓度(10-5~10-9 mmol/L)的Formoterol均可抑制成骨样细胞增殖-高浓度ICI118551(10-5和10-6 mmol/L)抑制成骨样细胞细胞增殖,低浓度ICI118551(10-8和10-9 mmol/L)则可促进成骨样细胞增殖-不同浓度(10-5~10-9 mol/L)的福莫特罗和ICI118551对成骨样细胞的凋亡无明显影响-结论:β2肾上腺素能受体激动剂可抑制体外大鼠成骨样细胞增殖,而阻滞剂对成骨样细胞增殖的影响与其浓度有关-β2肾上腺素能受体激动剂和阻滞剂对大鼠成骨样细胞凋亡无明显影响-

摘要:随着高校师资-招生人数-校舍等规模的快速发展,高校中经济活动日趋频繁,当前高校财务管理体制-机制-管理水平-人员素质等已不能满足形势发展的需要,难以有效保障学校事业又好又快发展-文章试从目前高校财务管理工作的几个突出问题入手,分析影响和制约目前高校财务管理有序运行的因素及其存在的原因,并对提高高校财务管理工作水平的途径进行探索-

摘要:目的:研究CS-CPC/BMP-2/bFGF支架材料的生物相容性,为骨组织工程提供一种新型复合支架材料-方法:制备CS-CPC/BMP-2/bFGF支架材料-将大鼠骨髓间充质干细胞(BMSCs)与CS-CPC/BMP-2/bFGF支架材料联合培养,体外成骨诱导培养2周,扫描电镜观察细胞黏附情况,MTT法分析细胞增殖情况以评价其组织相容性-结果:扫描电镜示细胞在新型支架上吸附-生长良好-MTT示BMSCs在材料上和单纯诱导的细胞增殖能力基本相同-结论:CS-CPC/BMP-2/bFGF支架材料是一种具有良好生物相容性的支架材料,有望在骨组织工程中得到广泛应用-

摘要:外科学基础实践教学中在培养学生的创新能力方面进行了大胆的改革和探索-采用普遍开展和重点培养相结合的方式,指导学生进行自主实践,一定程度上解决了学生创新理念缺乏-创新方法缺乏-教师对学生的创新性评价困难等问题,使学生创新能力得到显著提高-

摘要:医学教育的评价不能只以临床活动中成功或失败的概率来评判一个医学生的能力高低-为更好的评价外科学实践教学,外科学实践课程采用师生互动的形成性评价体系(formative assessment,FA),即以督导专家为基础,构建学生与带教老师之间及带教老师相互之间,以及实习单位-用人单位对学生以及单位之间的相互评价和信息反馈系统,以确保外科实践课程能紧密结合临床,切实提高医学生外科临床操作能力-通过在2006级临床医学各专业中推广及运用,获得良好的教学效果,为医学生外科临床实践打下良好的基础-

摘要:目的:探讨正常及高葡萄糖环境下,Fe2+对人脐静脉平滑肌细胞(HUVSMC)增殖及基质金属蛋白酶-2(MMP-2)分泌的作用-方法:以相同浓度接种普通培养液及高浓度葡萄糖培养液培养的3~5代HUVSMC为正常组及高糖组,分别以不同浓度Fe2+处理-培养24 h后,四甲基氮唑盐(MMT)比色法测定细胞增殖水平,ELISA试剂盒检测细胞培养上清中MMP-2含量-结果:不同浓度葡萄糖环境下,0.012 5~0.100 0 g/L浓度Fe2+均能促进HUVSMC增殖,且高糖组作用较正常组强;正常组Fe2+浓度在0.1 g/L时能促进HUVSMC分泌MMP-2,高糖组所有浓度Fe2+均表现促分泌作用-结论:适当浓度的Fe2+能影响HUVSMC的生物学特性,促进HUVSMC的增殖与MMP-2的分泌,且高糖环境下促进作用更为显著-

摘要:目的:构建大鼠野生型干扰素调节因子1(interferon regulatory factor-1,IRF-1)基因及其特异性短发夹状小干涉RNA(shRNA)真核表达质粒,并观察IRF-1在大鼠肾小球系膜细胞(GMC)中过表达及沉默IRF-1基因的情况-方法:用DNA重组技术将针对大鼠IRF-1基因的CDS区序列和针对其不同位点所设计的3种shRNA序列分别克隆到pcDNA3.1及pGCsi.U6.neo.GFP真核表达质粒中-在酶切鉴定及序列测定正确后,用GenEscortTM Ⅲ转染试剂将上述两种质粒分别转染入培养的大鼠GMC中,然后用Western blot检查IRF-1融合蛋白的表达,同时筛选最佳沉默效率的shRNA-结果:限制性酶切及核酸序列分析证明,两种重组质粒均构建成功-Western blot证实构建的pcDNA3.1/IRF-1质粒在大鼠GMC中能正确表达,且IRF-1 shRNA-2具有最佳沉默效率-结论:本实验成功构建了大鼠野生型IRF-1及其特异性的shRNA真核表达质粒,为进一步研究IRF-1基因的生物学功能提供了必要的实验材料-

摘要:探索新的教学方法-教学手段和考核方式,通过对学生临床实践技能的培训和综合素质的教育,使医学生在临床实践技能和综合知识方面均得到提高和强化,同时紧紧围绕国家执业医师资格考试,让学生提前得到熟悉和适应,有利于将来的临床工作和服务于社会-

摘要:目的:构建带Myc标签的大鼠μ型阿片受体的pIRES2-EGFP表达质粒(μ-Myc-pIRES2-EGFP),并实现其在CHO细胞中的表达-方法:以含大鼠全长μ阿片受体基因的μ-pMD20 T载体为模板,通过引物设计和扩增,在μ基因C端引入Myc标签,AT克隆至pMD20-T载体中,测序鉴定,经酶切连接克隆入pIRES2-EGFP中,将获得的μ-Myc-pIRES2-EGFP转染入CHO细胞中,应用荧光显微镜观察EGFP表达情况,并用细胞免疫荧光和蛋白印迹检测μ-Myc的表达-结果:测序及酶切结果表明获得带Myc标签的μ基因,构建入pIRES2-EGFP表达质粒中,在荧光显微镜下,转染细胞可以观察到绿色荧光,应用免疫荧光和蛋白印迹观察到目的基因表达-结论:成功构建了μ-Myc-pIRES2-EGFP表达质粒,并在CHO细胞中实现了高效表达-

摘要:目的:对人神经轴突导向因子Slit2(hSlit2)全长cDNA进行真核表达并进行鉴定-方法:采用分段克隆的方法获得hSlit2全长cDNA的克隆,并构建hSlit2全长cDNA真核表达重组质粒pCMV-GFP-C/hSlit2,用磷酸钙共沉淀法将其转染到人胚肾细胞HEK-293细胞中,通过免疫印迹法鉴定其蛋白表达-结果:经酶切鉴定证实hSlit2全长cDNA的真核表达载体构建成功,免疫荧光蛋白和Western blot结果证实hSlit2全长cDNA在HEK-293细胞中的表达-结论:人神经轴突导向因子hSlit2真核表达载体构建成功,为进一步完善hSlit2蛋白及各水解片段功能研究提供了实验基础-

摘要:目的:探讨孕鼠被动吸烟对幼鼠学习记忆功能的影响及其机制-方法:采用反映学习记忆功能的水迷宫法测试幼鼠学习能力的改变,放射免疫测定法(IRMA)测定幼鼠小脑皮质神经生长因子的含量变化-结果:孕期被动吸烟使幼鼠学习记忆能力下降,小脑皮质神经生长因子(NGF)含量明显降低-结论:孕期被动吸烟降低幼鼠学习记忆功能可能与小脑皮质神经生长因子的合成及分泌减少有关-

摘要:目的:探讨18F-FDG PET/CT显像诊断肺癌的价值-方法:对2006年10月~2009年1月经病理证实的115例肺癌和53例肺良性病变的PET/CT显像进行回顾性分析-分别观察肺部病灶的CT形态及PET显像的FDG最大标准摄取值(SUVmax);结合临床-病理诊断及治疗资料,分析PET-CT-PET/CT对肺癌原发灶及转移灶诊断的灵敏度-特异性及准确性-结果:CT对168例肺部病变患者诊断的灵敏度-特异性和准确性分别为73.9%(85/115)-73.6%(39/53)-73.8%(124/168);PET分别为82.6%(95/115)-62.3%(33/53)-76.2%(128/168);PET/CT分别为90.4%(104/115)-81.1%(43/53)-87.5%(147/168)-55例行肺癌根治术患者中纵隔-肺门淋巴结转移31例,PET诊断肺癌纵隔-肺门淋巴结转移的灵敏度-特异性及准确性分别为70.9%- 95.8%-81.8%;CT分别为41.9%-87.5%-65.5%;PET/CT分别为90.3%-95.8%-92.7%-肺癌远处转移41例,PET/CT发现105处骨转移,单纯CT只发现25处-结论:PET/CT对肺癌原发灶及转移灶较单纯PET-单纯CT的诊断灵敏度-特异性及准确性高,在肺癌的诊断和分期中具有较高的应用价值-

摘要:目的:探讨PET/CT与胸部诊断CT在乳腺癌术后随访中的应用价值-方法:70例乳腺癌术后患者,共进行18F-脱氧葡萄糖(FDG)PET/CT检查81人次;同日行胸部诊断CT扫描-以活检或手术后病理或随访结果作为参考标准,比较PET/CT与胸部诊断CT图像-结果:其中31人次PET/CT及对应的胸部诊断CT图像均未见病灶-另外50人次共检出372个病灶-PET/CT的总体灵敏度-特异性-准确性-阳性预测值-阴性预测值分别为88.0%-50.0%-84.9%-95.3%-26.8%;而胸部诊断CT检查分别为60.5%-31.6%-57.5%-88.6%-8.3%-对淋巴结转移,PET/CT的灵敏度(100%)高于胸部诊断CT的灵敏度(52.3%)-对骨骼及胸壁软组织转移,PET/CT的灵敏度(98.1%)也高于胸部诊断CT的灵敏度(25.0%)-但是,PET/CT对肺转移灶检测的灵敏度(58.8%)低于胸部诊断CT(98.9%)-结论:对乳腺癌术后淋巴结-骨骼与软组织转移的检测PET/CT优于胸部CT-但PET/CT一次成像技术并不能取代胸部CT,对于怀疑肺部小结节转移的患者,胸部诊断CT扫描是必要的-有益的-

摘要:目的:探讨肺黏膜相关性淋巴瘤(MALT淋巴瘤)的18F-脱氧葡萄糖(18F-FDG) PET/CT显像特点及其诊断价值-方法:回顾性分析3例经病理证实的肺MALT淋巴瘤的临床资料和PET/CT影像特点-结果:胸部CT表现为单发或多发实变影-肿块影-磨玻璃样影,内可有达肺外带的支气管充气征;少数可合并胸腔积液-胸膜不规则结节样增厚,可伴有淋巴结增大-3例病灶18F-FDG代谢增高-结论:肺MALT淋巴瘤是非霍奇金淋巴瘤一独特亚型,影像学表现为边缘模糊的肿块或实变影,内可有达肺外带的支气管充气征,FDG PET代谢增高,确诊主要依靠病理组织学和免疫组化-

摘要:目的:探讨骨梗死的影像学特点-方法:对l3例累及44处骨骼的骨梗死患者进行X线-CT及MRI检查,将骨梗死分为早-中-晚期,分析其影像学特征-结果:病变主要累及股骨下端和胫骨上端,呈双侧对称发病-骨梗死X线-CT表现为阴性或不典型局部斑点状钙化,MRI表现为早期病灶中心基本等同于正常骨髓信号,或者为轻度水肿-出血的信号特点;中期病变中心T1WI呈等或稍低信号,T2WI呈等或稍高信号,早中期周边线样影均呈长T1长T2改变;晚期病灶中央信号不均匀减低,周边线样影均呈低信号改变-结论:MRI显示骨梗死敏感而且其影像学表现有特征性,是早期检测和正确诊断的最佳方法-

摘要:目的:探讨磁共振血管成像(MRA)在颅内动脉瘤弹簧圈栓塞后远期随访的可行性-方法:应用3D时间飞跃法MRA (3D TOF-MRA)对38例患者用弹簧圈栓塞3年以上的38个颅内动脉瘤进行扫描,并同期进行数字减影血管造影(DSA)检查-以DSA结果为标准,对MRA图像显示的动脉瘤的残留及载瘤动脉通畅情况进行分析-结果:38个动脉瘤中,DSA证实稳定33个,复发5个,载瘤动脉通畅36例,闭塞2例;MRA发现动脉瘤稳定32个,复发6个,载瘤动脉通畅34例,闭塞4例-MRA判断动脉瘤残留的敏感度-特异度分别为84.6%-92.0%;判断动脉瘤复发的敏感度-特异度分别为80.0%-93.0%;判断载瘤动脉是否通畅的敏感度-特异度分别为94.4%-100%-结论:3D TOF MRA是长期随访栓塞后颅内动脉瘤的有效-可靠的方法,但需进一步积累经验-

摘要:目的:以超声心动图为标准,探讨64层螺旋CT(64-MSCT)和超声心动图对左心室功能各评价指标的相关性,评价64-MSCT测量左心室功能的准确性及可行性-方法:22例64-MSCT冠状动脉造影患者,使用circulation软件测试左心室功能,并与超声心动图所得左心室功能指标相比较-结果:64-MSCT和超声心动图对左心室功能各评价指标差异无统计学意义,两者相关性较高,r在0.69~0.88之间,EDV-ESV-SV值:64-MSCT>超声,EF值:64-MSCT<超声-结论:64-MSCT在左心室功能定量评价方面准确可靠-1次64-MSCT冠状动脉造影可以同时评估冠脉狭窄情况及左心室功能-

摘要:目的:探讨胎儿心脏四腔切面加主动脉短轴切面在产前筛查胎儿先天性心脏病的临床应用价值-方法:对2 516例孕妇常规行胎儿心脏四腔切面与主动脉短轴切面的扫查,对异常者行胎儿超声心动图检查,并与产后尸解或产后超声心动图的检查结果进行比较-结果:心脏四腔切面与主动脉短轴切面检出异常23例(23/2 516),均经胎儿超声心动图证实,最终尸解证实11例,产后超声心动图证实6例-结论:胎儿心脏四腔切面及主动脉短轴切面探测方法简单,易于掌握,对产前筛查胎儿心脏病具有重要的临床应用价值-

摘要:目的:应用超声观察正常成人坐骨神经及其主要分支胫神经和腓总神经的超声图像特征,为超声引导下肢神经阻滞麻醉及下肢神经病变的诊断提供影像学依据-方法:40例无下肢疾病及肢体残疾的正常成年人,应用超声观察臀区至腘窝水平的下肢神经,分别测量两侧坐骨神经在臀区-臀下区-股后区及胫神经和腓总神经在腘窝水平的宽径和厚径-结果:坐骨神经-胫神经-腓总神经超声图像长轴切面呈细条状低回声和高回声平行状间隔结构,外缘呈清晰-光整的高回声;横切面为类圆形或椭圆形稍高回声,内部呈细小筛孔状或蜂窝状结构,外缘为清晰欠光整的稍高回声-两侧测量值对比无统计学差异-结论:超声可以清晰显示坐骨神经及其主要分支,可以为超声引导下肢神经阻滞麻醉及下肢神经病变的诊断提供新的影像学依据-

摘要:目的:探讨妊娠晚期妇女脂肪组织中11β-羟类固醇脱氢酶Ⅰ型(11β-HSD1)及脂联素mRNA表达水平的变化及其临床意义-方法:取剖宫产妇女33例(正常妊娠22例,妊娠糖尿病11例)以及14例开腹手术的育龄期非妊娠妇女(非妊娠组)的皮下和网膜脂肪组织,应用实时定量PCR方法测定脂肪组织11β-HSD1和脂联素mRNA水平-结果:与非妊娠妇女比较,孕晚期正常妊娠和妊娠糖尿病妇女皮下和网膜组织11β-HSD1基因mRNA表达水平均明显增加(P<0.001),而脂联素基因mRNA表达水平均明显下降(P < 0.01)-皮下和网膜配对比较显示,孕晚期正常妊娠和GDM妇女网膜脂肪组织11β-HSD1基因表达水平均明显高于皮下(P < 0.05),而脂联素表达水平无显著部位差异(P=0.08)-相关分析显示,妊娠糖尿病妇女皮下脂联素表达与母血胆固醇(r=-0.779,P=0.003)-低密度脂蛋白(r=-0.664,P=0.029)负相关,而网膜11β-HSD1与孕期增加的BMI(r=0.323,P=0.043)及新生儿胰岛素抵抗指数呈正相关(r=0.618,P=0.032)-结论:妊娠晚期脂肪组织11β-HSD1mRNA表达增加和脂联素mRNA表达水平的下降,这可能是妊娠期间脂肪组织积聚,能量代谢增加产生的一种适应性分子变化,其在妊娠糖尿病的发生发展中的作用值得关注和进一步研究-

摘要:目的:探讨热休克蛋白70(HSP70)与血管性认知功能损害(VCI)的关系-方法:运用蒙特利尔认知评估量表(MoCA)检测入组患者认知功能,将其分为2组,即认知功能正常组(NCI,n=52)和VCI组(n=129),分别用酶联免疫吸附试验(ELISA)测定2组患者血浆HSP70浓度-结果:NCI组和VCI组患者血浆HSP70浓度分别为(11.29±2.66)ng/ml和(19.92±5.98)ng/ml,差异有统计学意义(P < 0.01);相关性分析显示,VCI患者血浆HSP70浓度与MoCA得分呈负相关(r=-0.742,P < 0.01);对VCI患者各个认知领域的分值与血浆HSP70水平进行多元线性回归分析显示,血浆HSP70水平与患者记忆能力-视空间执行能力和定向能力存在负相关性-结论:血浆HSP70浓度测定有可能作为判断VCI患者认知功能损害程度的生化指标-

摘要:目的:探讨高血糖对2型糖尿病患者认知功能的影响-方法:对135例2型糖尿病患者进行认知功能问卷,评定认知功能,同时测定问卷当日三餐前后及睡前血糖-比较不同血糖组间认知功能差异,并将空腹血糖(FPG)-餐后血糖(PPG)-最高血糖及平均血糖(MBG)与认知功能作相关性分析-结果:FPG≥6.1 mmol/L和<6.1 mmol/L组间-PPG≥10.0 mmol/L组和<10.0 mmol/L组间-最高血糖≥10.0 mmol/L组和<10.0 mmol/L组间认知功能差异均有显著性(P < 0.05)-以日7次血糖平均值的中位数8.7 mmol/L作为切点,≥8.7 mmol/L组和<8.7 mmol/L组间在MMSE定向-MMSE构图-听觉词语延时记忆等方面差异有显著性(P < 0.05);FPG-PPG-最高血糖及MBG水平与认知功能均呈负相关关系-结论:高血糖可加重认知功能损害;空腹血糖≥6.1 mmol/L或非空腹血糖≥10.0 mmol/L就可出现认知功能减退;控制高血糖-减少血糖波动对保护认知功能有着重要意义-

摘要:目的:探讨宫颈癌中干细胞关键转录因子Foxd3 的表达情况及意义-方法:采用RT-PCR方法检测21例宫颈癌组织及15例正常宫颈组织中的Foxd3 mRNA表达水平;采用组织芯片及免疫组织化学技术对31例宫颈癌组织和12正常宫颈组织中Foxd3的蛋白表达进行检测-结果:宫颈癌组织中Foxd3 mRNA的表达水平要高于正常宫颈组织(P < 0.05),绝大多数的宫颈癌标本中都可见Foxd3蛋白在癌组织中表达,其表达概率要高于正常组织(P < 0.05)-结论:宫颈癌组织中存在着干细胞性质的癌细胞,可能为宫颈癌治疗的一个潜在靶点-

摘要:目的:探讨肿瘤抑制基因PTEN及血管内皮生长因子(VEGF)及其受体FLT1(VEGFR1)在白血病中的表达及其相关性-方法:应用实时荧光定量PCR(FQ-PCR)检测50例初治急性髓系白血病(AML),10例缓解期AML,10例慢性粒细胞白血病慢性期(CML-CP)-10例CML急变期(CML-BC)患者和10例正常人骨髓单个核细胞(MMNCs)中PTEN-VEGF-FLT1 mRNA的表达-结果:初治AML患者PTEN mRNA表达水平明显低于缓解组AML和正常对照组,CML-BC患者PTEN mRNA表达水平低于CML-CP患者,在AML初治白血病中PTEN mRNA与VEGF和FLT1 mRNA表达负相关,PTEN低表达-VEGF和FLT1高表达与AML缓解率及髓外浸润相关-结论:髓系白血病患者中低表达PTEN基因,高表达VEGF及FLT1基因,并与白血病预后不良及髓外浸润密切相关,三者相互作用共同参与了白血病的发病-

摘要:目的:探讨急性淋巴细胞白血病(ALL)患儿血清CD105-血管内皮生长因子(VEGF)及其受体Flt-1的水平和临床意义-方法:用双抗体夹心酶免疫吸附法(ELISA)检测31例初诊ALL患儿及10例健康对照组儿童血清CD105-VEGF及其受体Flt-1水平-结果:初诊ALL患儿血清VEGF及Flt-1水平与对照组无显著差异,而CD105水平明显高于对照组(P < 0.01)-高危组ALL患儿CD105水平明显高于低危组(P < 0.05)-CD105水平与患儿性别-年龄-初诊白细胞计数及免疫分型有无髓系抗原表达等因素无关,染色体核型正常与异常组间也无显著差异,但在有不同的肝脾淋巴结等髓外浸润表现及不同的早期治疗反应的患儿间差异有统计学意义(P < 0.05)-结论:初诊ALL患儿VEGF及Flt-1水平与健康对照组无显著差异-血浆CD105水平有助于临床指导治疗和判断预后-

摘要:目的:通过研究急性丙型肝炎病毒(HCV)感染患者外周血中FOXP3的表达,初步探讨其在急性丙型肝炎发病机制中的临床意义-方法:选择急性丙型肝炎患者与健康人各21例,用流式细胞仪检测外周血CD4+CD25+T细胞的数量;ELISA试剂盒检测患者和正常对照组外周血培养上清中Th2型细胞因子(IL-10)和Th1型细胞因子(IL-2)的表达;RT-PCR检测FOXP3的mRNA表达-结果:在急性HCV患者外周血中CD4+CD25+T细胞约占CD4+T细胞(28.2±2.1)%,显著高于正常人外周血中CD4+CD25+T细胞(2.7±0.7)%(P=0.032);急性HCV组外周血CD4+CD25+T细胞高表达FOXP3;急性HCV组外周血单个核细胞(PBMC)培养上清主要分泌IL-10,而IL-2分泌无显著变化-结论:急性HCV感染者Th1免疫抑制可能与外周血CD4+CD25+T细胞高表达FOXP3有关-

摘要:目的:探讨自然周期与替代周期法准备内膜对冷冻胚胎移植结局的影响-方法:在冷冻胚胎移植周期中,分别采用自然周期(n=149)-替代周期(n=578)准备内膜,比较周期妊娠率-流产率-种植率-多胎妊娠率等指标-结果:2组移植周期临床妊娠率分别为39.6%-41.2%(P > 0.05);流产率分别为5.4%-5.0%(P > 0.05);种植率分别为28.3%-27.6%(P > 0.05)-冷冻囊胚移植妊娠率66.7%,分裂期胚胎移植妊娠率39.9%,差异有显著性(P < 0.05)-自然周期与替代周期相比单胎-多胎妊娠率差异无显著性(P > 0.05)-移植3个胚胎妊娠率较移植2个胚胎显著增加,多胎妊娠率显著增加(P < 0.05)-结论:在冷冻胚胎移植周期,采用自然周期或替代周期法准备内膜的妊娠率-流产率无明显差异,对于排卵正常患者采用自然周期法更经济-简单,增加移植胚胎数在提高妊娠率的同时明显提高了多胎妊娠率-

摘要:目的:研究体外过敏原与潮气呼吸肺功能测定在喘息性支气管炎中的作用-方法:喘息性支气管炎(喘支组)86例-婴幼儿哮喘(哮喘组)81例-支气管肺炎(肺炎组)72例纳入本次研究-应用瑞典Pharmacia UniCAP免疫检测分析仪,进行吸入过敏原-食入过敏原筛查,同时检测尘螨特异性IgE-血总IgE和血嗜酸性粒细胞阳离子蛋白(ECP)-患儿镇静后进行潮气呼吸肺功能检测,主要测定参数为每公斤体重潮气量(VT)-达峰时间比(TPTEF/TE)-达峰容积比(VPTEF/VE)-结果:喘支组与哮喘组吸入过敏原-食入过敏原阳性率和总IgE水平均高于肺炎组;喘支组VT值-TPTEF/TE值-VPTEF/VE值与哮喘组相比,差异无统计学意义;血ECP水平哮喘组大于喘支组大于肺炎组,哮喘组和喘支组血ECP与TPTEF/TE-VPTEF/VE均呈负相关-结论:通过检测过敏原-ECP和肺功能,有助于了解喘息性支气管炎气道炎症变化及肺部阻塞情况-

摘要:目的:评价眉弓-翼点-颞下锁孔手术入路以及神经内镜下经鼻蝶入路的优劣-方法:对56例鞍区病变进行微创手术,其中垂体瘤26例,动脉瘤15例,脑膜瘤8例,蛛网膜囊肿5例,颅咽管瘤2例-分别采用不同入路进行手术-结果:所有垂体瘤患者全切除21例,近全切除4例,大部分切除1例;视力减退及视野缺损改善11/13例,异常增高的激素水平降至正常15/20例;随访2年MRI检查尚无一例复发-动脉瘤患者Hunt-Hess临床分级:Ⅰ级4例,Ⅱ级8例,夹闭后恢复满意,3例Ⅲ级病例中有1例术后发生迟发性脑血管痉挛,枕叶梗塞,另2例效果满意-8例脑膜瘤均做到SimpsomⅡ切除,视力明显改善,无并发症发生-蛛网膜囊肿大部分切除囊壁,效果满意-结论:神经内镜下的手术术野较显微镜更清晰,手术盲区少;但在处理主要向鞍上池-额叶及视交叉池扩展的垂体瘤时该入路有明显缺陷-巨大型主体在鞍上-分叶状或哑铃型向鞍旁-前中后颅窝生长的肿瘤仍以经颅锁孔手术为佳-根据鞍区病变部位不同而采取相应的微创手术入路可提高手术的全切率-降低致残率-

摘要:目的:探讨腓浅血管筋膜蒂胫腓骨膜瓣治疗胫骨骨不连的治疗方法及疗效-方法:采用腓浅血管筋膜蒂胫腓骨膜瓣转位并取胫骨远端少许松质骨植骨,并行交锁髓内钉固定治疗胫骨骨不连15例-结果:随访12~36个月,平均21个月,采用Paley骨折愈合评分标准:优11例,良3例,一般1例,优良率为93.3%-本组全部治愈(15/15)-结论:以腓浅血管筋膜蒂胫腓骨膜瓣治疗胫骨骨不连,促进骨折愈合,疗效可靠,值得推广应用-

摘要:目的:探索可吸收螺钉治疗成人肱骨内上髁骨折的效果-方法:2002年1月~2008年12月,采用可吸收螺钉及可吸收缝线治疗成人肱骨内上髁骨折30例-结果:本组30例术后均获随访,随访时间5~32个月,平均13.1个月,根据手外科分会肘关节功能评定试用标准进行肘关节功能评定,总优良率93.3%-结论:可吸收螺钉治疗成人肱骨内上髁骨折,具有良好的生物相容性,对人体无毒无害,无需2次手术取出,在骨折端面产生自动加压作用,可吸收线张力带加强固定,可以早期功能锻炼,效果良好-

摘要:目的:观察异位妊娠手术前后D-二聚体的含量变化和意义-方法:选择异位妊娠孕囊破裂出血患者78例,分别于手术前-术后1 h-3天及7天测定D-二聚体的含量,与异位妊娠孕囊未破裂患者组21例-宫内早孕患者组49例及32例健康对照进行比较-结果:异位妊娠孕囊破裂组手术前D-二聚体含量[(821.42±201.88)μg/ml]与异位妊娠孕囊未破裂组[(177.56±40.18)μg/ml]-宫内早孕组[(167.80±34.02)μg/ml]及健康对照组[(52.71±10.44)μg/ml]比较均呈显著性增加(P < 0.01)-异位妊娠孕囊破裂组术后1 h时D-二聚体含量达到高峰,至术后第3天恢复至术前水平,至第7天时恢复至健康对照组水平-结论:异位妊娠孕囊破裂患者纤溶系统被激活,D-二聚体含量升高,手术能加重纤溶系统的激活作用-监测异位妊娠患者D-二聚体含量改变,对于监控其纤溶状态具有重要的意义-

摘要:目的:评估成人肝移植术后的依从性及影响因素,为改善其依从性提供依据-方法:采用问卷调查方法对46例肝移植术后超过6个月的成人受者进行随访和调查-结果:成人肝移植术后具有较好的总依从性[(40.02±4.79)分],其中服用免疫抑制药物依从性最好[(3.70±0.37)分],其次为良好生活习惯依从性[(3.30±0.51)分],再次为随访依从性[(3.24±0.80)分],自我监测依从性最差[(2.24±0.85)分]-影响成人肝移植术后依从性的主要因素有移植术后时间(r=-0.445,P=0.002)-职业(t=-2.08,P=0.044)-有势力的他人(r=0.415,P=0.007)和社会支持(r=0.577,P=0.000)-结论:应加强肝移植术后受者随访和自我监测的依从性教育,帮助受者寻求更多的社会支持,尤其是医护人员的专业支持,对术后时间较长的受者和非干部人群给予更多关注-

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摘要:目的:观察参芪扶正注射液在减轻肿瘤化疗不良反应中的临床疗效-方法:恶性肿瘤患者96例,按数字表法随机分为单纯化疗组(对照组)和化疗+参芪扶正注射液组(观察组),比较两组患者化疗后的不良反应-结果:在客观缓解率方面:观察组有效率为64.58%,对照组有效率为58.33%,两组间有效率比较无显著性差异(P > 0.05)-在提高生活质量方面:观察组有效率为83.33%,对照组有效率为58.33%,两组间有效率比较具有显著性差异(P < 0.05)-在减轻不良反应方面:观察组有效率为81.25%,对照组有效率为60.42%,两组间有效率比较具有显著性差异(P < 0.05)-结论:参芪扶正注射液有提高生活质量,减轻化疗不良反应的功能-

摘要:目的:比较同步化放疗与序贯化放疗对Ⅲ期未手术食管癌的近期疗效,不良反应和1-2-3年生存率-方法:76例Ⅲ期食管癌患者随机分为同步化放疗组37例,序贯化放疗组39例-两组采用相同的放疗和化疗方案-同步化放疗组在化疗第1天即进行放疗,序贯化放疗组在2个疗程化疗后即第56天起放疗-结果:同步化放疗组CR+PR率78.4%;序贯化放疗组CR+PR率56.4%-两组的有效率有显著差异(χ2=4.151,P=0.042)-两组的第1年生存率相当,从第2年开始,同步化放疗组生存率高于序贯化放疗组,但差异无显著性(χ2=1.576,P=0.209)-同步放化疗组的1-2-3年局控率有显著差异(χ2=5.263,P=0.022)-同步化放疔组的不良反应尤其是血液学毒性大于序贯化放疗组,差异有统计学意义(P=0.042)-两组的放射性食管炎和放射性肺炎发生率无明显差异-结论:同步化放疗可提高Ⅲ期食管癌的近期有效率和局控率,有延长2-3年生存率的可能,是非手术食管癌患者确切有效的治疗方法-

摘要:目的:评估纤维支气管镜对老年慢性阻塞性肺疾病(COPD)合并单纯性支气管结核(EBTB)患者的诊断价值及安全性-方法:回顾分析13例经纤维支气管镜确诊的65岁以上COPD合并EBTB患者的临床资料-镜下表现及病理类型-结果:13例老年患者男女比例1∶0.44,临床症状及体征无特异性-镜下检查均有异常改变,其中浸润型4例,非特异性支气管炎型4例,淋巴支气管瘘(穿孔后期)2例,溃疡型2例,增殖型1例-镜下活检6例,阳性4例;刷检13例,阳性8例;支气管灌洗9例,阳性5例-13例老年患者均顺利完成支气管镜检查,未出现严重并发症-结论:纤维支气管镜对老年COPD合并EBTB患者的诊断安全有效,活检联合刷检-灌洗,可以相互补充,提高阳性率-

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