氢质子磁共振波谱对创伤性脑损伤的分析

目的探讨氢质子磁共振波谱(1Hmagneticresonancespectroscopy1HMRS)分析对创伤性脑损伤(traumaticbraininjuryTBI)受伤程度、预后预测的临床价值。方法对25例TBI患者和10例正常志愿者进行1HMRS检查,观察患者与正常对照组及患者患侧与正常侧间N-乙酰天门冬氨酸(NAA)、胆碱(Cho)肌酸(Cr)、乳酸(Lac)及NAA/Cr、NAA/Cho、Cho/Cr值的变化,分析这些指标与格拉斯哥昏迷评分(GCS)及格拉斯哥预后评分(GOS)的相关性;结果TBI患者较正常对照组及其患者患侧脑白质较对侧同一位置常规MRI检查表现正常脑白质(nomal-appearingwhitematterNAWM)的NAA/Cho、NAA/Cr值下降更明显,而Cho/Cr值上升更明显;出现Lac水平上升患者的GCS为重度,其预后不良,NAA/Cr、NAA/Cho、Cho/Cr值变化与TBI患者GCS、GOS存在相关性;结论1HMRS对脑外伤的程度及预后预测有重要价值。     

抗HLA和抗MICA抗体的表达对移植肾功能和急性排斥反应的预示作用

Objective To investigate the prediction of anti-human leukocyte antigen antibodies (HLA) and anti-major histocompatibility complex class I-related chain A antibodies (MICA) to the development of acute rejection (AR) and kidney allograft function. Methods Forty-one kidney transplant patients were prospectively tested for anti-HLA and anti-MICA. Thirty-seven patients were screened using Luminex/single-antigen beads to determine the HLA and MICA-specific antibody levels at 0,30,90, 180,360,720 and 1080 days post-transplantation. The patients and donors of HLA and MICA allele typing were determined by PCR-SSOP, and donor specific antibody (DSA) and non-donor specific antibody (NDSA) were identified.Simultaneously,their serum creatinine (SCr) levels and clinical data were analyzed. Results Nine patients (21.95 % ,9/41 ) had pre-existing anti-HLA and(or) anti-MICA, including 6 cases of anti-MICA,2 cases of anti-HLA, and one case of anti-MICA and anti-HLA. Nine patients had pre-existing DSA and NDSA. In the 37 patients, 6 patients (16.2% ) developed de novo anti-HLA, and 3 (8.1%) developed de novo antiMICA. In patients positive for de novo anti-HLA, the titer of antibody was gradually increased during the follow-up of three years. Four patients out of 9 patients with pre-existing antibodies were suffered from AR (44.4%); In 6 patients positive for de novo anti-HLA,three cases (50.0%) were suffered from AR; In three patients positive for de novo anti-MICA,no AR occurred (P＜0.05). In two patients positive for DSA of HLAⅡ antibody detected at the third and seventh day after transplantation, the renal grafts were renovecd due to rejection. The Scr levels in patients positive for pre-existing MICA with AR were higher than in those positive for pre-existing MICA without AR at each scheduled time point during the follow-up period (P＜0.05). The Scr levels in patients negative for antibodies pre-transplantation and having AR were higher than in those having no AR at each scheduled time point during the follow-up period (P＜0. 01 ). The Scr levels in patients positive for de novo HLA and MICA and having AR one month following transplantation were higher than in those negative for antibodies and having no AR (P＜0.01 ). Conclusion Pre-existing and de novo anti-HLA were the irnportant factors for the development of AR, but the mismatch of HLA and MICA alleles in donors and patients was primary causes for generation of de novo antibodies.     

经阴道超声血管定量检测对卵巢肿瘤的临床诊断价值

目的探讨经阴道彩色多普勒超声（TVCDU）及经阴道超声三维彩色能量血管成像（TV3D-CPA）对卵巢良、恶性肿瘤的诊断价值。方法对70例卵巢肿瘤（47例恶性肿瘤、5例交界性肿瘤、18例良性肿瘤）患者术前行TVCDU、TV3D-CPA检查,计算肿瘤彩色血流平均密度（MCVD）,计数肿瘤内血管指数（VI）。术后确定肿瘤性质及恶性肿瘤临床分期,分析上述指标在良、恶性肿瘤中的差异性及其与恶性肿瘤临床分期的关系。结果卵巢恶性肿瘤MCVD与VI值均高于卵巢良性肿瘤（P〈0.05）,以VI≥0.035条/cm^3诊断卵巢恶性肿瘤敏感性84.2%,特异性70.0%;以MCVD≥0.025诊断卵巢恶性肿瘤敏感性75.6%,特异性83%。卵巢恶性肿瘤Ⅲ、Ⅳ期VI及MCVD值均高于Ⅰ、Ⅱ期（P〈0.05）。结论应用经阴道超声定量检测卵巢肿瘤内血管是鉴别卵巢良、恶性肿瘤的有效方法 ,是预后评价的重要指标。     

中药挥发油作为透皮吸收促进剂的研究进展

近年来,透皮吸收制剂正受到人们的普遍关注,而其中存在的一个难题就是吸收率低,难以达到有效的治疗浓度。透皮吸收促进剂的应用可以有效地解决这一难题。中药挥发油作为透皮吸收促进剂不良反应小,有促渗、治疗双重作用,因此逐渐引起了广大医药工作者的注意。就中药挥发油作促透剂的研究现状做一综述。     

尾叶香茶菜二萜类化合物B对人宫颈癌细胞的生长抑制作用及其机制

目的:观察尾叶香茶菜二萜类化合物B(DB)对人宫颈癌细胞株Hela细胞的生长抑制作用并探讨其机制。方法:处于对数生长期的Hela细胞分为正常对照组,0.5、1.0、2.0、4.0、8.0、16.0、32.0mg.L-1DB实验组,MTT法观察不同剂量DB作用24和48h后Hela细胞增殖抑制率,相差显微镜观察DB作用后Hela细胞形态的改变,RT-PCR和Western blotting分别观察DB作用后Hela细胞P53、P21、CDK2mRNA和蛋白表达水平。结果:MTT检测,24h时2.0、4.0、8.0DB组Hela细胞增殖抑制率分别为18.18%、28.89%和32.84%,48h时2.0、4.0、8.0DB组Hela细胞增殖抑制率分别为26.64%、47.03%和51.90%,呈时间-剂量依赖性(P<0.05或P<0.01);形态学观察,DB作用后Hela细胞变圆、体积缩小,有部分细胞漂浮;2.0、4.0和8.0mg.L-1DB分别作用Hela细胞24和48h后,P53和P21mRNA和蛋白表达水平明显高于正常对照组(P<0.01),CDK2mRNA和蛋白表达水平明显低于正常对照组(P<0.01)。结论:DB可抑制Hela细胞生长,其机制可能与上调细胞周期相关基因p53、p21的表达,下调CDK2表达,从而影响细胞从G1期进入S期有关。     

排毒养生胶囊配合针刺疗法治疗海洛因依赖临床研究

目的:对照观察排毒养生胶囊配合针刺疗法对海洛因依赖临床治疗效果。方法:采用中药复方制剂排毒养生胶囊配合针刺治疗海洛因成瘾临床戒断综合征226例,以单用排毒养生胶囊组为对照(单药组),观察药物配合针刺(针药组)对海洛因依赖戒断综合征治疗效果。结果:观察12天临床脱毒结果显示:单药组和针药组临床脱毒率均为100%,两组无显著性差异(P>0.05),但观察临床脱毒戒断症状分项对比结果:针药组对厌食、恶心呕吐、睡眠障碍等主显症状的疗效明显优于单药组(P<0.05)。结论:研究结果显示:药物配合针刺可提高临床脱毒疗效。     

中小学传染病防治工作现状调查

目的为了解和掌握许昌市某区中小学校传染病防治工作现状,加强学校传染病防治和卫生监督工作。方法对许昌某区53所中小学,采取查阅资料、现场查看、询问调查相结合的方式,对学校传染病防治工作进行调查。结果许昌市某区中小学传染病管理及责任制建立为90.57%,卫生室为83.02%,晨检及因病缺课登记为88.68%、83.02%,厕所类型中水冲式的为58.49%,提供饮水服务的占47.17%等。结论许昌市某区中小学传染病防治整体较好,在卫生设施建设方面需要加强。     

大于50岁亲属活体供肾移植效果分析

目的探讨50岁亲属活体供肾移植的移植效果。方法 1993年4月～2007年12月施行亲属活体供肾移植107例,按照供者年龄分为两组,其中50岁为研究组,45例,≤50岁为对照组,62例。随访时间12～180个月,平均49个月。比较两组受者术后肾功能恢复情况、并发症及近、远期移植肾功能、人/肾存活率等。结果移植手术均获成功。两组受者在年龄、术前透析时间、配型、肾缺血时间、抗排斥方案应用等方面比较显示均衡性良好,术后1周、1月、1年、3年Scr水平及1、3、5、8年人/肾存活率组间比较差异均无统计学意义(P0.05)。结论供者年龄50岁亲属活体供肾移植效果,满意年龄非亲属活体供肾绝对禁忌症。     

注射用骨肽联合阿仑膦酸钠治疗骨质疏松症的临床研究

目的探讨注射用骨肽联合阿仑膦酸钠治疗骨质疏松症的临床疗效。方法将128例骨质疏松症患者随机分入对照组与观察组,对照组患者给予阿仑膦酸钠片联合钙尔奇D治疗,观察组患者给予骨肽、阿仑膦酸钠及钙尔奇D治疗。比较两组患者临床疗效及治疗前后前臂骨密度、骨矿含量的改变。结果观察组与对照组临床治疗总有效率分别为92.4%和74.2%,差异具有统计学意义(P<0.05);治疗前两组前臂近端骨密度(PBD)、近端骨矿含量(PBMC)、远端骨密度(DBD)和远端骨矿含量(DBMC)差异无统计学意义,治疗后6个月观察组上述指标显著优于对照组(P<0.05)。结论注射用骨肽联合阿仑膦酸钠治疗骨质疏松症可显著增加骨密度,临床疗效确切。