6024例分娩的方式选择与新生儿结局

目的探讨阴道分娩和剖宫产对新生儿的风险。方法对6024例妊娠的分娩方式、剖宫产指征以及新生儿结局回顾性分析。结果剖宫产率为35.3%,其指征主要是头盆不称、社会因素、宫内窘迫、臀位等。分娩新生儿6016例,其中因各种疾患转儿科822例,占13.5%。主要转科原因为早产儿低体重、窒息、高胆红素血症和吸入综合症,各疾病发病率与分娩方式无关。结论剖宫产没有增加新生儿的风险,仍是解决难产的重要手段,但应严格控制手术指征。     

Intracellular factors, but not virus receptor levels, influence the age-related outcome of DHBV infection of ducks.

Previous serological studies of experimental infection with duck hepatitis B virus (DHBV) have shown that the outcome of infection depends largely on the age of the duck at the time of inoculation. To examine the hypothesis that decreased susceptibility with increased age might be due to the loss of the virus receptor on hepatocyte membranes in adult ducks, we performed receptor binding studies using intact serum-derived DHBV virions and purified liver plasma membranes from both young ducklings and adult ducks. These studies showed that (1) DHBV was able to bind specifically to duck liver plasma membranes but not to internal membranes; (2) this binding could be inhibited by a monoclonal antibody to DHBV preS, a corresponding region in hepatitis B virus that binds to human hepatocytes; and (3) there was no significant difference in the receptor binding ability between plasma membranes from ducklings and from adult ducks. Since hepatocytes in the neonatal ducks are actively dividing, in contrast to the situation in adult ducks, we examined the effect of partial hepatectomy on DHBV-carrier ducks. A sharp increase was noted in the level of DHBV in the serum after partial hepatectomy suggesting that DHBV replication was enhanced in dividing hepatocytes. Thus the age-related difference in susceptibility of ducks to DHBV infection is not due to loss of the receptor but may be related to an intracellular event associated with cell division.     

重组促红细胞生成素对血透患者NO的影响研究

目的 :探讨基因重组促红细胞生成素 (rHuEpo)对维持性血透患者血管活性介质一氧化氮 (NO)的影响。方法 :将长期规律性血透尿毒症患者 80例分为血液透析应用rHuEpo者 (HDepo组n =4 3例 ) ,血液透析不应用rHuEpo者 (HD组n =37例 ) ,根据血压情况两组再分为HDepo高血压亚组 (HDepo - 1组 ,n =2 3)、HDe po血压正常亚组 (HDepo - 2组 ,n =2 0 )和HD高血压亚组 (HD - 1组 ,n =19)、HD血压正常亚组 (HD - 2组 ,n =18)。另选尿毒症未透析患者 2 0例 (NHD组 )、原发性高血压患者 2 0例、健康对照组 35例 (CON组 )。HDepo组患者均接受rHuEpo治疗 3个月以上 ,用比色法测定血NO水平。结果 :尿毒症未透析患者血清NO水平明显高于正常对照组 ,p <0 0 0 1;尿毒症透析患者血清NO浓度较正常对照组高 ,p <0 0 0 1,但经透析治疗的尿毒症患者与尿毒症未透析者比较 ,血清NO水平较未透析者低 ,p <0 0 5 ;HDepo组经rHuEpo治疗三月后血NO浓度下降 ,与用药前及对照组比较 ,p<0 0 0 1,p <0 0 5。且用rHuEpo治疗后 ,HDepo组收缩压、舒张压、平均动脉压均较HD组高 ,p <0 0 0 1,血压增高与NO浓度的降低有相关性。结论 :rHuEpo可使尿毒症透析患者血NO浓度降低 ,rHuEpo致高血压与血NO浓度降低有一定的关系     

急性胰腺炎患者空腹高血糖发生率及其危险因素分析

目的:回顾性分析急性胰腺炎(AP)患者空腹高血糖发生率及其危险因素。方法:收集2018-01—2018-12武汉大学人民医院胰腺外科133例AP且无糖尿病(DM)病史的住院患者病历资料,按照不同性别、年龄、AP临床分型、病因、CT指数评分(CISI)等分组,χ2检验分析各组临床因素与空腹高血糖(FPG≥6.1mmol/L)发生率的关系,多因素二元logistic回归分析空腹高血糖独立危险因素。结果:AP临床分型(χ2=5.494,P=0.019)和CTSI(χ2=6.236,P=0.013)与AP患者空腹高血糖相关(P<0.05)。CTSI≥6分(P=0.015,OR=2.920,95%Cl=1.234—6.905)为AP患者空腹高血糖的独立危险因素(P<0.05)。结论:临床分型中重症+重症及CTSI≥6分的AP患者易发生空腹高血糖,尤其CTSI≥6分是AP后空腹高血糖的独立危险因素,临床应高度关注。     

盲人智能探路手杖的研究

本文介绍了盲人智能探路手杖的研究.该系统由单片机控制,采用两只超声波传感器的探测模式,对盲人行进路上的路况进行探测和分析,并针对不同的路况发出相应的提示信息,以达到辅助盲人安全行走的目的.     

Platelet-activating factor (PAF)-dependent biochemical, morphologic, and physiologic responses of human platelets: demonstration of translocation of protein kinase C associated with protein phosphorylation

Platelet-activating factor (PAF) is a potent stimulus for platelet aggregation and secretion. PAF has been shown to stimulate the phosphatidylinositol (PI) pathway in platelets, which implies that PAF should activate protein kinase C. In this study, measurements of PI metabolites, the elevation of intracellular free calcium concentration, (Ca2+)i, the activation of protein kinase C, and the phosphorylation of platelet proteins (using a two-dimensional gel electrophoretic technique) were performed before and after the addition of 10(-8) M PAF to human platelets. These findings were correlated with morphologic changes in the platelets as determined by immunoelectron microscopic studies on the cytoskeleton and by X-ray analysis of dense bodies. The results show that PAF stimulates the production of PI metabolites and causes an increase in the membrane-associated activity of protein kinase C. These changes are accompanied by a rise in the (Ca2+)i and protein phosphorylation. The increase in protein kinase C activity reaches a maximum at approximately 60 s, a time frame that is consistent with the protein phosphorylation and the subsequent morphologic and secretory events. X-ray analysis revealed two types of dense bodies containing various amounts of calcium which appeared to be released sequentially after PAF activation. These results suggest that the protein phosphorylation that controls the physiologic events resulting from PAF activation of human platelets is catalyzed by protein kinase C.     

慢性乙型肝炎患者肝组织中HBV抗原表达特征及其临床意义

目的探讨慢性乙型病毒性肝炎肝活检组织中检测乙肝表面抗原(HBsAg)和乙肝核心抗原(HBcAg)表达强度及表达方式的必要性。方法采用EnVision免疫组织化学法检测196例慢性乙型肝炎患者肝穿组织中HBsAg和HBcAg的表达水平,并用荧光定量PCR检测其血清中的HBV DNA的含量。对肝组织进行炎症活动度分级和纤维化分期。结果肝组织中的HBsAg表达强度和表达方式与炎症分级、纤维化分期和血清乙肝病毒载量均无相关性(P>0.05)。HBcAg表达强度与炎症分级无相关性(r=-0.02,P>0.05);与纤维化分期呈负相关(r=-0.28,P<0.01);与血清乙肝病毒载量呈正相关(r=0.53,P<0.01)。HBcAg表达方式与炎症分级为负相关(r=-0.27,P<0.01),其中浆型组炎症活动度分级高于核型组和混合型组(P<0.01),混合型组高于核型组(P<0.01)。HBcAg表达方式与纤维化分期亦呈较弱的负相关(r=-0.23,P<0.01),其中浆型组纤维化分期高于核型组和混合型组(P<0.05)。HBcAg表达方式与血清乙肝病毒载量呈正相关(r=0.22,P<0.01)。结论区分肝组织中的HBsAg表达强度和表达方式无益于了解慢性乙型肝炎患者肝损害的程度,而检测肝组织中的HBcAg则有助于临床抗病毒治疗。     

A Ser(365)-->Cys mutation of fibroblast growth factor receptor 3 in mouse downregulates Ihh/PTHrP signals and causes severe achondroplasia

Missense mutations in fibroblast growth factor receptor 3 (FGFR3) result in several types of human skeletal dysplasia, including the neonatally lethal dwarfism known as thanatophoric dysplasia. An engineered Ser(365)-->Cys substitution in mouse FGFR3, which is equivalent to a mutation associated with thanatophoric dysplasia-I in humans, has now been shown to cause severe dwarfism but not neonatal death. The mutant mice exhibit shortened limbs as a result of markedly reduced proliferation and impaired differentiation of growth plate chondrocytes. The receptor-activating mutation also resulted in downregulation of expression of the Indian hedgehog (IHH) and parathyroid hormone-related protein (PTHrP) receptor genes, both of which are important for bone growth. Interactions between FGFR3- and PTHrP-receptor-mediated signals during endochondral ossification were examined with embryonic metatarsal bones maintained in culture under defined conditions. Consistent with the in vivo observations, FGF2 inhibited bone growth in culture and induced downregulation of IHH and PTHrP receptor gene expression. Furthermore, PTHrP partially reversed the inhibition of long bone growth caused by activation of FGFR3; however, it impaired the differentiation of chondrocytes in an FGFR3-independent manner. These observations suggest that FGFR3 and IHH-PTHrP signals are transmitted by two interacting parallel pathways that mediate both overlapping and distinct functions during endochondral ossification.     

经皮微创植入锁定钢板治疗胫骨远端骨折

目的探讨应用胫骨远端锁定钢板经皮微创植入治疗胫骨远端骨折的疗效。方法自2010年1月~2012年12月应用小切口植入胫骨远端锁定钢板治疗32例胫骨远端骨折,男19例,女13例,年龄13~77岁,平均39.8岁。其中开放性骨折4例,闭合性骨折28例,均为新鲜骨折。结果 29例获得随访,随访时间6~15个月,平均11.7个月。所有骨折均愈合,平均愈合时间为13.6周,均无感染、骨不连、钢板松动等并发症。按照Mazur踝关节功能评分:优19例,良8例,可2例,优良率为93.1%。结论微创钢板内固定手术创伤小,固定可靠,骨折愈合率高,符合生物学固定原则。