肾移植术中新尿路留置双J管的体会

目的探讨肾移植术中留置双J管对防治新尿路并发症的价值。方法本组在对218例次同种异体肾移植手术中新尿路建立时留置半根双J管作为支架引流管,留置时间2～4周。结果留置半根双J管后发生尿漏5例,其中3例手术修补,2例留置尿管后自行愈合,3例发生输尿管梗阻,其中2例结石,1例半根双J管脱落,均手术解除梗阻。结论肾移植术中留置双J管可以明显降低泌尿系统的术后并发症的发生。     

Effects of tetrandrine on phenotypic modulation of vascular smooth muscle cells and expression of p38 MAPK as well as MKP-1 after intimal injury of rabbit carotid arteries

Objective： To study the effects of tetrandrine （Tet） on phenotypic modulation of vascular smooth muscle cells （VSMCs） and expression of p38 mitogen-activated protein kinase （p38MAPK） as well as mitogen-activated protein kinase phosphatase-1 （MKP-1） after vascular intimal injury. Methods： HE staining was used to analyze vascular morphology of sham-injured group, injured group and Tet-treated group at day 28. lmmunohistochemistry, Western blot and RT-PCR were respectively used to detect the expression change of smooth muscle a-actin （SMa-actin）, proliferation cell nuclear antigen （PCNA）, p38MAPK and MKP-1 of injured group and Tet group at days 7, 14 and 28 after balloon injury. Results： ① All layers of vascular wall in sham-injured group were intact at day 28. The neointimal area was significantly increased and the lumen area notably decreased in injured group at day 28. The neointimal proliferation in Tet treated group was less than that in injured group, and the lumen area of Tet group was significantly increased than that of injured group at day 28. ②Compared with the injured group, the expression of SMa-actin, PCNA, p38MAPK and MKP-1 of vascular wall in Tet group was no difference, and the neointimal proliferation condition was also basically as same as injured group at day 7 after injury. The expression of PCNA and p38MAKP in Tet group was obviously lower than that in injured group, and the expression of MKP-1 in Tet group was obviously higher than that in injured group at days 14 and 28 after injury. The expression of SMa-actin in Tet group was slightly higher than that in injured group at days 14 and 28 after injury. Conclusions： Tet could reduce neointimal proliferation by inhibiting VSMCs phenotypic modulation and p38MAPK signaling transduction pathway as well as its down regulation.     

孕早期子宫颈管脱落滋养细胞的收集与影响因素探讨

目的:探讨孕早期子宫颈管脱落滋养细胞的收集与影响因素,为进一步的孕早期无创性产前诊断奠定基础。方法:从早孕妇女的宫颈管获取脱落的滋养细胞并探讨影响因素。结果:双取器宫颈管毛刷法获取的阳性率最高;孕5~7周是取材较适宜的时间;妊娠囊下缘至宫颈内口的距离对获取的滋养细胞影响较小。结论:孕早期获取宫颈管脱落滋养细胞是可行的;取材工具,取材孕周对获取孕早期脱落滋养细胞有一定的影响。     

妊娠期高血压疾病肿瘤坏死因子-α及IL-6 IL-8在胎盘及血清中的表达及意义

目的 探讨肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）和白细胞介素-8（IL-8）与妊娠期高血压疾病的关系。方法 2002-06—2005-02哈尔滨医科大学第一临床医学院采用免疫组化法和ELISA法检测49例子痫、子痫前期患者，22例正常妊娠孕妇胎盘中TNF-α、IL-6和IL-8表达状况和外周血中TNF-α、IL-6和IL-8水平。结果 TNF-α、IL-6和IL-8在妊娠期高血压疾病胎盘和正常妊娠胎盘中均有表达，而在疾病组中上述因子表达均较正常妊娠组明显增加（P〈0．01），且随着病情加重其表达增强。妊娠期高血压疾病组血清中TNF-α、IL-6和IL-8水平均明显高于正常妊娠组（P〈0．05），同样随着病情加重，升高明显。结论 炎性细胞因子TNF-α、IL-6和IL-8在妊娠期高血压疾病发病机制中具有重要作用，其产生与胎盘有关。     

头位梗阻性难产的临床特点分析

目的探讨头位梗阻性难产的现状、特点及其原因.方法采用回顾性分析方法对天津市中心妇产科医院1986年住院分娩的6667例中发生头位梗阻性难产925例和2004年住院分娩的4098例中发生或接受转诊的头位梗阻性难产148例 ,进行比较和分析.结果两个时期内造成梗阻性难产的最主要因素是持续性枕横位(ODP)和持续性枕后位(OPP),但2004年高龄产妇、非致死性畸形胎儿引产造成的梗阻性难产有增加趋势.结论密切观察产程进展和儿头下降是早期发现头位梗阻性难产的重要手段,提高妇产科医师的阴道助产水平是提高围生期质量的保证.     

碱性成纤维细胞生长因子对兔关节软骨全层缺损的修复作用

目的：利用注射型活性材料碱性成纤维细胞生长因子（bFGF）修复兔关节软骨缺损，观察其治疗效果。方法：实验尝试在兔的膝关节软骨缺损区应用碱性成纤维细胞生长因子，分别于10周，14周，18周处死，观察大体和形态学特征，组织学评分。结果：A组于10、14周时，软骨缺损被白色半透明坚硬组织平滑修复，富有光泽，与正常软骨边界清楚，18周时修复组织与正常软骨边界模糊，质地坚硬，表面平滑光润。对照组于10、14、18周时均未见软骨修复。组织学评分A组明显优于对照组。结论：碱性成纤维细胞生长因子可以有效修复兔关节软骨的缺损，为组织工程化软骨的临床应用提供理论基础。     

双心室同步起搏治疗顽固性心力衰竭的临床研究

目的：观察双心室同步起搏对扩张型心肌病顽固性心力衰竭的治疗效果。方法：10例扩张型心肌病病人，男6例，女4例，所有病人符合NYHA心功能Ⅲ—Ⅳ级，心电图呈窦性心律，完全性左束支传导阻滞，QRS时限〉120ms，射血分数〈35％。左室内径〉60mm。因严重心力衰竭而长期卧床，经多种抗心衰药物治疗效果不佳。分别植入右心房、右心室和冠状静脉左室分支电极导线，行房室顺序双心室同步起搏，观察起搏前、后QRS时限、NYHA心功能分级、左室内径、射血分数及6min步行试验的变化。结果：右心房、右心室和左心室电极导线感知和起搏参数均符合起搏要求。起搏后QRS时间明显缩短（P〈0．01），（NYHA）心功能分级进一步改善（P〈0．01），左室射血分数及6min步行增加（P〈0．01）。结论：双心室同步起搏治疗可缓解心衰的症状，改善心功能，增加射血分数，提高运动耐量。     

Construction of eukaryotic expressing plasmids encodingHA andHA 1 of influenza A virus and their transient expression in HEK293 cells

Summary In order to explore the feasibility and protective efficiency of influenza DNA vaccine, we constructed eukaryotic expressing plasmids encodingHA andHA ₁ of influenza A virus (A/PR/8/34) and studied their expression in HEK293 cells.HA andHA ₁ genes were amplified by RT-PCR and cloned into pcDNA3. 1(+) to generate pcDNA3. 1(+)/HA and pcDNA3.1(+)/HA₁, respectively. After verification of the cloning fidelity by restriction endonuclease digestion, PCR, and sequencing, pcDNA3. 1(+)/HA and pcDNA3.1(+)/HA₁ were transfected into HEK293 cells using PolyFect Transfection Reagent. Immunofluorescence assay was used to detect the transient expressing cells. Fluorescence microscopy revealed strong expression of target gene in HEK293 cells transiently transfected with either pcDNA3.1(+)/HA or pcDNA3.1(+)/HA₁. Therefore, the results confirm the successful construction of eukaryotic expressing plasmids capable of driving the eukaryotic expression of influenza virus antigen HA and HA₁, which is likely to provide a basis for both further investigation of the mechanism of influenza viral infection and the development of influenza DNA vaccine. Zhang Weidong, female, born in 1970, M. D., Ph. D. This project was supported by a grant from the National Natural Sciences Foundation of China (No. 39970830).     

共轭亚油酸异构体对人类癌细胞增殖的抑制作用研究

目的研究不同共轭亚油酸对人类胃癌细胞AGS、肝癌细胞Bel7402和肠癌细胞Lovo细胞增殖的影响。方法采用体外培养的AGS、Bel7402和Lovo细胞为模型,测定不同处理后活细胞数量。结果研究采用的5种共轭亚油酸异构体都对AGS、Bel7402和Lovo细胞增殖表现出了抑制作用,对AGS的抑制作用要普遍高于对Bel7402和Lovo的抑制作用,并且浓度不同,抑制作用也具有差异。结论五种共轭亚油酸异构体都具有抑制癌细胞增殖的作用,并且这种作用受到共轭亚油酸浓度的影响。     

无创正压通气治疗的护理

通过17例呼吸衰竭患者应用无创正压通气(NIPPV)的临床观察与护理,结合治疗前后血气参数值的对比分析,总结出以下护理体会:心理护理,选择合适的体位及鼻(面)罩是应用NIPPV的前提;防止漏气和面部皮肤压迫性损伤,保持呼吸道通畅,密切观察患者通气效果及呼吸机性能是应用NIPPV的护理重点;密切观察患者病情变化,进行氧疗,协助患者排痰是NIPPV治疗后的护理措施。