紫外线消毒储血专用冰箱的效果观察

储血专用冰箱为医疗单位储存血液专用,冰箱温控恒定和内部清洁要求远远高于普通冰箱.冰箱内部消毒,常规做法是用一定浓度的84消毒液或戊二醛等消毒剂擦试,由于这些消毒液都对不锈钢等合金板材有一定的腐蚀作用,不仅会减少冰箱的寿命,还会使冰箱内壁粗糙生锈,容易滋生细菌,影响消毒效果.因此我们尝试用紫外线来照射冰箱内部消毒,并对消毒效果进行观察.     

骨髓单个核细胞移植对心肌修复相关因子的调节作用

目的:干细胞移植后可以通过分化为心肌细胞、减少心肌重构等方面发挥改善心功能的作用。观察急性心肌梗死后进行骨髓单个核细胞移植对相关细胞因子的调节作用,探讨干细胞发挥改善心脏重构的可能机制。方法:实验于2006-01/2007-02在福建省高血压研究所完成。①实验材料:清洁级SD大鼠由上海实验动物公司提供。②实验方法:取SD大鼠骨髓,分离出单个核细胞,以DAPI标记骨髓单个核细胞。取体质量200～250g雄性SD大鼠24只,建立急性心肌梗死模型后,随机分为2组,实验组从股静脉注入同种异体大鼠骨髓单个核细胞1.0×107,对照组注入等量的生理盐水。③实验评估:于移植后4周采用免疫组组织化学法检测DAPI阳性细胞、肌钙蛋白阳性细胞、基质细胞源性因子1、转化生长因子β及大鼠心功能改变。结果:24只大鼠均进入结果分析。移植后4周实验组基质细胞源性因子1表达较对照组明显升高,转化生长因子β表达较对照组下降;实验组在免疫荧光显微镜下可观察到DAPI和肌钙蛋白阳性细胞,心功能较对照组明显改善。结论:骨髓单个核细胞移植改善急性心肌梗死大鼠心功能的同时伴有基质细胞源性因子1表达增加及转化生长因子β表达下降。     

失眠症的药物疗法

正谁都有失眠的时候,特别是在充满精神压抑的现代社会。对于脑力劳动者来说,失眠的几率略高一些。每个人差不多都会自己诊断失眠症,但是失眠到何种程度才应去医院治疗,就不是人人皆知的学问了。医学上,一般来说认为失眠症一周发生3次以上,持续一个月,且翌日有头晕、疲劳,以至影响工作者为需要治疗的对象。在治疗前,首先要明确自己属于哪一种失眠症,然后才可对症下药。失眠症的分类失眠症按照发生时间的长短     

2015－2017年上海市儿童医院重症社区获得性肺炎比例与流行特点

目的 了解上海市儿童医院2015－2017年社区获得性肺炎(以下简称肺炎)住院患儿中的重症肺炎比例及其分布和变化特点,为防治儿童重症肺炎、降低死亡率提供参考。方法 在该院已结构化的2015－2017年电子病案数据库中按诊断标准纳入肺炎住院对象15 041例并筛查其中的重症患儿,获取住院病史的一般人口学信息,分析肺炎重症比例及人口学分布的特点,使用logistic回归检验分布差异的统计学意义,计算关联强度OR值。结果 该院肺炎总的重症比例为13.5%(2 028/15 041),2016年相对较低(11.3%),不同年份表现出不同的季节特点,多因素分析显示夏、秋、冬三季的重症比例均高于春季(13.6%、13.1%、 14.6% vs. 12.2%),无论单因素或多因素分析均显示:年龄1~岁、4~岁的肺炎重症比例均高于0~岁(14.2%、 22.9% vs. 7.9%),户籍地外省相对本市的重症比例较高(15.2% vs. 12.5%),中等以上营养风险相对无营养风险的重症比例较高(25.7% vs. 12.2%),上述差异均有统计学意义(P<0.01)。结论 重症肺炎具有一定的季节规律,且与年龄、户籍地、营养情况较为相关,增加了经济负担,同时也增加了潜在的死亡风险,值得引起关注,可采取改善营养、接种肺炎球菌疫苗、注意空气污染、防治上呼吸道感染等措施以期降低重症肺炎比例。     

肥胖与蛋白酪氨酸磷酸酶-1B的研究现状

蛋白酪氨酸磷酸酶-1B(protein tvrosine phosphatase 1B，PTP-1B)在人类各组织细胞中广泛表达，没有特异性受体，与细胞内不同蛋白底物作用可产生不同的生理反应，在体内主要受生长因子、蛋白激酶等的调节。目前研究发现在肥胖人群中存在胰岛素抵抗、瘦素抵抗、脂代谢异常等现象，这些现象与肥胖症的发病及发展关系密切；同时肥胖人群细胞内PTP-1B也表达明显增多，提示PTP-1B可能参与了肥胖症的发病。在动物实验中发现肥胖动物模型的PTP-1B表达增多；而其体重下降，PTP-1B表达也随之减少。PTP-1B基因缺失的小鼠在致肥胖饮食条件下也不出现肥胖，一系列动物实验进一步证实了PTP-1B与肥胖症之间的关系。这使人们普遍关注PTP-1B特异性抑制剂在肥胖治疗中的价值，文章主要介绍了PTP-1B的研究现状及其引起肥胖症的可能机制。     

代谢综合征患者内脏脂肪组织蛋白酪氨酸磷酸酶1B表达增多

目的研究蛋白酪氨酸磷酸酶1B(PTP-1B)在代谢综合征(MS)发病中的作用。方法51例患者分为对照(NC)组、2型糖尿病(T2DM)组和MS组,测定FPG、FIns,Western印迹法测定内脏脂肪组织PTP-1B表达水平。结果与NC组相比,T2DM组和MS组FPG、Ln(HOMA-IR)和PTP-1B表达水平明显升高。与T2DM组相比,MS组腰围和PTP-1B显著升高。校正年龄后PTP-1B与FPG、Ln(HOMA-IR)、腰围(WC)和SBP均呈正相关。结论内脏脂肪组织PTP-1B表达升高与肥胖、糖代谢紊乱等MS危险因素明显相关,可见内脏脂肪组织PTP-1B表达异常与MS发生发展关系密切。     

右美托咪啶辅助表面麻醉用于患者支气管肺泡灌洗术的效果

Objective To investigate the efficacy of dexmedetomidine-assisted topical anesthesia in patients undergoing bronchoalveolar lavage ( BAL). Methods Twenty-four ASA Ⅱ or Ⅲ patients in ICU, aged 24-64 yr, weighing 50-80 kg, scheduled for BAL, were randomly divided into 2 groups ( n = 12 each) : topical anesthesia group (group A) , topical anesthesia + dexmedetomidine group (group B) . In group A, 0.9% normal saline 5 ml was injected intravenously 30 min before operation, 2% lidocaine 5-10 ml was given via a tracheal tube or cannula 5 min before operation and then an increment of 2% lidocaine 5 ml was given using fibreoptic bronchoscope every 15-30 min as required (the total amount was within 20 ml) . In group B, dexmedetomidine 0.5-1.0 μg/kg was injected (time of injection≥ 10 min) followed by infusion at 0.1-0.5 μg·kg-1 ·h-1 and the topical anesthesia was performed as the method described in group A. The time of lavage, adverse reactions and adverse cardiovascular events were recorded. Blood samples were taken 20 min before lavage, 20 min after the start of lavage and 20 min after the end of lavage (T1-3 ) for determination of the concentrations of plasma catecholamine and serum cortisol. Results The incidences of adverse reactions and adverse cardiovascular events were significantly lower and the operation time was significantly shorter in group B than in group A ( P < 0.05). The concentrations of plasma catecholamine and serum cortisol were significantly higher at T2,3 in group A, while lower at T2,3 in group B than at T1 ( P < 0.05) . The concentrations of plasma catecholamine and serum cortisol were significantly lower in group B than in group A ( P < 0.05). Conclusion Dexmedetomidine-assisted topical anesthesia can be used safely and effectively in BAL.     

C-反应蛋白全基因测序及基因变异与血清水平的关联

目的:对我国汉族人群C-反应蛋白(C-reactive protein,CRP)基因进行测序并探讨CRP基因多态性与血清CRP水平的关系。方法:在北京市汉族自然人群中,按CRP血清水平进行十分位分层,分别从最低十分位(低水平组)和最高十分位(高水平组)随机抽取30人进行全基因测序,并分析CRP基因多态性与血清浓度的关联。结果:1.全基因测序分析共发现7个单核苷酸多态性(rs3091244,rs1417938,rs1130864,3689CG,rs17860479,rs1205和rs3093068),其中3689CG在既往研究中未见报道。2.CRP高水平组中rs3091244T等位基因频率高于CRP低水平组(P=0.017);显性遗传模式下T等位基因与CRP水平升高有关(OR=1.13,95%CI:1.00～1.27)。3.基因联合分析显示在rs1205T等位基因携带者中,rs3091244T个体的血清CRP水平是rs3091244GG个体的21倍(P=0.013)。结论:rs3091244与汉族自然人群中血清CRP水平有关,rs1205对rs3091244与CRP水平的关系有效应修正作用。     

针刺解痉调气法治疗脑卒中痉挛期患者疗效观察

目的观察改良的针刺疗法（针刺解痉调气法）治疗疗效。方法将98例脑卒中痉挛期患者随机分为两组。治疗组50人,取肩髃、肩髎、尺泽、天井、合谷、极泉、后溪、三阴交、血海、解溪、足三里、委中穴,头针患侧对应运动区;手法为行浅刺多捻,针前注重押手的作用,在施术部位切按重压,快速进针,深度约0.5～1.0寸,行小幅提插捻转,得气后留针30min。对照组48人,康复训练采用常规Bobath康复训练手法进行治疗;1次/d,40min/次。5次/周,15次为一疗程。完成2个疗程后做疗效评价。结果治疗组总有效率为70%,对照组总有效率为52.08%;两组患者治疗后均有明显改变（P〈0.05）,治疗组疗效明显优于对照组（P〈0.05）。结论针灸解痉调气法能有效缓解脑卒中痉挛期症状,值得临床推广。     

Effect of Smac on TRAIL-induced apoptosis of prostate cancer cell line PC-3 and the molecular mechanism

The effect of Smac gene on the TRAIL-induced apoptosis of the prostate cancer cell line PC-3 and the molecular mechanism were investigated. The Smac gene was transfected into PC-3 cells under the induction of liposome. The intrinsic Smac gene expression was detected by Western blotting. After treatment with TRAIL as an apoptosis inducer, in vitro cell growth activity was as-sayed by MTT colorimetry. The apoptosis rate of PC-3 cells was determined by annexin Ⅴ-FITC and propidium iodide staining flow cytometry. The expression of cellular XIAP and caspase-3 genes was examined by Western blotting. Smac-transfected cells (PC-3/Smac group) had significantly in-creased Smac protein level as compared with PC-3 controls (P<0.01). After induction with 100-200 ng/mL TRAIL for 12-36 h, cellular proliferation rate in PC-3/Smac group was significantly lower than in PC-3 controls (P<0.05). After induction with 100 ng/mL TRAIL for 24 h, the apoptosis rate in PC-3/Smac group was significantly enhanced as compared with that of PC-3 controls (P<0.05). Ac-cordingly, the XIAP expression level was down-regulated significantly (P<0.05) and caspase-3 sub-unit P20 was up-regulated significantly (P<0.05). It is suggested that the over-expression of cellular Smac can inhibit inhibitor of apoptosis proteins (IAPs), enhance caspases activity and the apoptosis rate of PC-3 cells induced by TRAIL, which may provide a useful experimental basis for prostate cancer therapy.