内皮细胞固有型一氧化氮合酶基因内含子4插入/缺失多态性与糖尿病肾病的关系

目的：对天津地区汉族人内皮细胞固有型一氧化氮合酶（ecNOS)基因内含子4的插入／缺失多态性（ecNOS4b/a)与2型糖尿病肾病（DN）的关联性进行研究。方法：应用PCR－小卫星DNA多态性分析技术对ecNOS4b/a基因型分布进行检测。包括正常对照组70例，2型糖尿病无DN组48例，2型糖尿病有DN无慢性肾功能不全（CRF）组35例，2型糖尿病DN有CRF组45例和非DN导致的CRF组58例。结果：（1）发现1例罕见基因型（女性DN无CRF患者），为447bp 420bp杂合子。（2）2型糖尿病无DN组a等位基因频率高于正常对照组，差异无显著性意义（χ^2=1.672,P=0.196).(3)2型糖尿病伴DN组a等位基因频率低于2型糖尿病无DN组，差异无显著性意义（χ^2=1.082,P=0.298)。（4）DN无CRF组与DN伴CRF组等位基因频率相近（校正χ^2=0.002,P=0.967)。（5）DN伴CRF组a等位基因频率低于其它原因导致的CRF组，差异有显著性意义（χ^2=0.002,P=0.967)。（5）DN伴CRF组a等位基因频率低于其它原因导致的CRF组，差异有显著性意义（χ^2=4.360,P=06037)。结论：a等位基因可能不是天津汉族人DN的危险因素；天津地区汉族健康人群a等位基因频率低于日本；ecNOS在DN导致的CRF中的作用可能与非DN CRF不同。     

慢性阻塞性肺病患者伴发呼吸道感染的诊断和治疗——附101例临床分析

慢性支气管炎和阻塞性肺气肿伴或不伴肺心病(简称慢阻肺病)病人,常因急性呼吸道感染诱发呼吸衰竭或/和心力衰竭,导致死亡。本文通过对两年来住院的101例慢阻肺的病例分析,探讨伴发呼吸道感染的早期诊断和更有效的治疗等问题,希望能对今后的临床工作有所俾益。     

尿毒症患者桡动脉组织学改变及其与动脉血管僵硬度的关系

Objective To examine the changes of histological parameters of radial artery in uremia,and to explore their effects on arterial stiffness.Methods Sixty uremic patients underwent arteriovenous fistula surgery for hemodialysis and 20 healthy subjects received healthy examination were collected as uremia group and control group, respectively.Segments of radial arteries were obtained from all of uremic subjects and were evaluated by HE, Masson, van Kossa staining and electron microscopy.The expressions of osteopontin (OPN), α-SMA and elastin in arterial wall were detected by immunostaining, and apoptotic cells were determined by TUNEL assay.All of the subjects in the two groups received brachial ankle pulse wave velocity (baPWV) examination and the results were compared.The associations among histological parameters and baPWV were analyzed.Results More than one half (34/60) of artery samples presented uniformly thickening intima, in which most of cells expressed α-SMA and a few cells underwent apoptosis.The subendothelial matrix was abundant in collagen fibers, and no calcium deposition was found.The media thickened obviously, with increased collagen fibers, reduced elastin, unchanged α-SMA expression, and a few apoptotic smooth muscle cells.Two thirds uremic arteries expressed OPN, of which only one half had significant calcium deposition.The adventitia thickened and no calcium deposition was found.The baPWV level in uremic subjects was ( 18.5 ± 3.2 ) m/s, far greater than that in control subjects ( P ＜ 0.001 ).Statistical analysis showed that baPWV value was correlated with media thickness, calcification degree, and collagen content positively, and with elastin expression negatively.For diabetic uremic subjects, the OR values of vascular calcium deposition and remarkably-elevated baPWV value were 3.1, 2.3, respectively.Conclusions Radial arterial intima often presents hyperplasia which is not related with baPWV increment in uremia.Arterial media calcification and collagen content incremental are the most two protuberant characteristics in uremia, especially in ones accompanied with diabetes.Medical calcification, collagen accumulation, and e]astin reduction may contribute to the increased arterial stiffness in uremia.     

曲美他嗪联合川芎嗪对急性有机磷中毒后心肌损伤的保护作用研究

目的研究曲美他嗪联合川芎嗪注射液对急性有机磷农药中毒致心肌损伤的保护作用及其机制。方法41例急性有机磷农药中毒患者,其中轻度中毒者13例、中度中毒者13例、重度中毒者15例。按随机分层原则分为常规治疗组（A组）22例,常规治疗＋曲美他嗪联合川芎嗪注射液组（B组）19例。采用动力学法,分别对肌酸激酶（cK）、肌酸激酶同功酶（CK—MB）、乳酸脱氢酶（LDH）,放射免疫测定法对cTnI（心肌肌钙蛋白I）测定血浆中的生化指标水平;心电图检查,采用床旁心电图监测;观察上述各组指标冶疗前后动态变化情况,并对相关机理进行探讨。结果入院6小时A、B两组血浆生化指标均有升高,但组间指标差异无显著性fP〉0．05）,治疗48h,A组血生化指标增长高于B组,差异有显著性（P〈0．05）,治疗7天后,病人上述指标基本恢复到接近正常范围。床旁24h动态心电图检测,A组出现严重心电图异常的几率较B组更显著。结论曲美他嗪联合川芎嗪注射液对急性有机磷农药中毒致心肌损伤具有显著保护作用。     

泥胡菜总黄酮的最佳提取工艺

目的确定泥胡菜中总黄酮的最佳提取工艺。方法选取料液比、提取时间、乙醇提取浓度为考察因素,以泥胡菜总黄酮得率为评价指标,用正交试验对其提取工艺进行优选。结果泥胡菜总黄酮最佳提取工艺为用10倍量的50%乙醇,回流提取2次,每次1.5 h。结论本优选方法简单快速,方法稳定、可行。     

时效对正畸弓丝摩擦力影响的实验研究

目的探讨不锈钢丝在口内使用一段时间后其摩擦力所受到的影响。方法用0.018英寸的国产不锈钢圆丝、0.018英寸进口的不锈钢圆丝、0.019×0.025英寸进口不锈钢方丝分别在口内使用4周、8周、12周、16周、20周(n=20)。取尖牙远中与磨牙近中之间的弓丝,检测其摩擦系数并与新弓丝做比较。结果与新弓丝相比,使用过的进口不锈钢圆丝、进口不锈钢方丝摩擦力无明显变化,而国产的圆丝使用3个月后摩擦力变大。结论就摩擦力而言进口不锈钢丝在口内的使用周期较长。     

景观疗养社会化保障原则的探索与实

随着旅游业的发展,军队疗养院原有的保障模式已经无法满足疗养员的景观疗养需求。近3年来,作者疗养院对军队疗养院景观疗养社会化保障原则进行了探索与实践,较好地满足了军地疗养员日益增长的景观疗养需求。     

基于UHPLC-QTOF/MSE法研究苓桂术甘汤的主要化学成分

建立了 UHPLC-QTOF/MSE法在正、负离子2种模式下检测苓桂术甘汤中的主要化学成分,并结合自建数据库和在线数据库,通过准确相对分子质量、碎片离子信息、裂解规律和对照品比对等方式鉴定苓桂术甘汤中化学成分.同时,应用UNIFITM的二元比较功能实现了各化合物的归属.结果显示,共从苓桂术甘汤中鉴定出100个化合物,包...     

接受免疫抑制剂治疗的肾脏病患者急性侵袭性肺部真菌感染的诊治体会

侵袭性肺部真菌感染（invasive pul monary fungal infections,IPFI）是一种严重的肺机遇性感染性病变,其发病率及病死率有逐渐升高之势,多并发于免疫力低下的患者,如白细胞减少症、大量使用糖皮质激素或免疫抑制剂、器官移植术后、     

成年患者自体牙移植并正畸治疗1例

报告1例成年患者牙列拥挤并前突,通过把正畸治疗并将需拔除的35移植至25,排齐和内收上下牙列,移植的自体牙同时完成了牙周膜和牙髓愈合,维护了牙弓的完整性。