维生素C对葡萄糖测定的干扰及其作用机制

（1）目的 探讨维生素C对葡萄糖测定的干扰及其作用机制。（2）方法 用葡萄糖氧化酶-过氧化物酶（GOD-PAP）法和己糖激酶（HK）法测定葡萄糖浓度。（3）结果 用GOD-PAP法测定葡萄糖浓度相同、维生素C浓度不同的系列溶液时,所测葡萄糖浓度随着维生素C浓度的增高而降低;用HK法进行测定时,所测葡萄糖浓度基本恒定,用GOD-PAP法测定不含葡萄糖的过氧化氢溶液时,葡萄糖表观浓度随着过氧化氢稀释度的增大而降低;当过氧化氢浓度相同时,葡萄糖表观浓度随着维生素C浓度的增高而降低。（4）结论 维生素C可能通过使区应的中间产物过氧化氢及最终产物苯醌亚胺还原而干扰GOD-PAP法对葡萄糖的测定结果。     

变异型CD44在胃腺癌中的表达及其临床意义

目的探讨胃腺癌组织中变异型ＣＤ４４（ＣＤ４４ｖ）的表达及其与淋巴结转移和预后的关系。②方法应用链霉菌抗生物素蛋白－过氧化酶（Ｓ－Ｐ）免疫组织化学技术,对１０５例胃腺癌ＣＤ４４ｖ６的表达进行了检测。③结果ＣＤ４４ｖ６蛋白的阳性表达率为４８．６％,ＣＤ４４ｖ６在胃腺癌的表达与肿瘤分化、浸润深度、临床分期和预后均有关系（χ２＝４．４１～８．９７,Ｐ均＜０．０５）,与淋巴结转移关系密切（χ２＝９．２３,Ｐ＜０．０１）。④结论ＣＤ４４ｖ６表达是判断胃腺癌淋巴结转移及病人预后有价值的指标之一。     

护士站前移的做法和体会

护士站前移并不是字面上理解的将护士站位置向前移,是根据"三贴近"原则,不断改革临床护士工作模式,逐步实行护士管床、管病人的大包干责任制,实施"护士床边工作制",把护士工作站前移到病房,改病人铃声呼叫护士为护士主动下病房的新模式。我科自2011年2月开始试行护士站前移的护理工作新模式——"流动护理工作站",效果良好。现报道如下。1病房情况介绍     

经支气管镜激光烧灼治疗呼吸道阻塞性病变患者的护理

目的探讨经支气管镜Nd-YAG激光烧灼治疗呼吸道阻塞性病变患者的护理方法。方法回顾性分析并总结2003年5月至2011年8月解放军第401医院呼吸内科收治的67例经支气管镜激光烧灼治疗呼吸道阻塞性病变患者的临床资料。结果经支气管镜激光烧灼治疗,本组48例恶性肿瘤患者中,19例患者肿瘤部分缩小或脱落,达到呼吸道开通1/3～1/2以上的疗效;7例气管支气管肉芽肿患者中,1例外伤性患者及1例气管切开性肉芽组织增生患者达治愈标准,其余5例患者治疗效果为有效;5例放射损伤性坏死物阻塞呼吸道患者,治疗结果均为有效;7例支气管息肉性良性肿瘤患者,Nd-YAG激光烧灼治疗均达治愈标准。结论 Nd-YAG激光烧灼气管和支气管内阻塞性病变患者,能够迅速缓解呼吸道阻塞症状,具有安全有效和损伤小的优点。术前充分的黏膜麻醉、护士在操作中的密切配合、细致观察是治疗顺利进行的重要保证。     

M2 polarization of monocytes in ankylosing spondylitis and relationship with inflammation and structural damage

The aim of this study was to evaluate the polarization of peripheral blood monocytes in the patients with ankylosing spondylitis (AS) and to determine the correlations between monocyte polarization and inflammation and structural damage. A total of 120 AS patients, 50 rheumatoid arthritis (RA) patients and 100 healthy controls were enrolled in the study. M1 (CD68+CD192+) and M2 (CX3CR1+CD163+) monocytes were characterized by flow cytometry. Demographic, clinical, radiographic and laboratory data were collected and analyzed. A large increase in M2 (CX3CR1+CD163+) monocytes was observed in AS, and M2/M1 ratio was 7.18 ± 6.12, 2.54 ± 3.14 and 35.61 ± 20.04 in control, RA and AS, respectively. The M2/M1 ratio correlated with modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) (r = 0.565; p < 0.001), ESR (r = ?0.321; p < 0.001, CRP (r = ?0.265; p < 0.001) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) (r = ?0.201; p = 0.028). Anti‐TNF‐α therapy induced a significant reduction in the percentage of M1 monocyte, ESR, CRP and BASDAI in AS patients. The present results demonstrated that M2 type polarized monocytes are predominant in the peripheral blood in AS and the M2/M1 ratio is correlated with structural damage (mSASSS), inflammatory biomarkers (ESR and CRP) and BASDAI.     

左卡尼汀缓解顺铂造成急性肾损伤的血清代谢组学研究

目的 利用血清代谢组学探究顺铂诱导小鼠急性肾损伤的特异性变量,同时评价左卡尼汀的干预作用。 方法 将19只小鼠分为正常对照组、模型组和干预组,适应3 d后,对干预组给予左卡尼汀(400 mg/kg,ip)干预,2 d后给予模型组和干预组顺铂(20 mg/kg,ip)造模,每天称量各组小鼠的体质量,2 d后取小鼠血清进行LC-MS分析,结合模式识别分析各组间代谢组差异,并评价左卡尼汀的干预作用。 结果 代谢组学分析共鉴别28个差异代谢物,顺铂诱导的急性肾损伤主要涉及磷脂类、氨基酸类和脂肪酸类代谢途径的改变,而左卡尼汀有改善作用。 结论 左卡尼汀可改善顺铂诱导的急性肾损伤,其机制可能是通过调控色氨酸代谢、谷氨酸代谢和能量代谢,从而减缓急性肾损伤的疾病进程。     

320排螺旋CT对多发性肋骨骨折的诊断价值

目的 收集整理2012年1月～2013年12月我院收治的重症多发性肋骨骨折患者临床资料,分析并探讨320排螺旋CT在多发性肋骨骨折诊断中的临床应用价值。方法 对86例多发性肋骨骨折的患者进行320排螺旋CT扫描,重建全肋骨三维图像,并与胸部X线检查和普通螺旋CT的三维重建图像进行分析比较。结果 所有患者均顺利完成320排螺旋CT扫描,扫描时间均在3~5 s以内。与普通螺旋CT相比,320排螺旋CT重建的三维图像更加清晰细腻,且在线性骨折、凹陷性骨折以及肋软骨骨折的显示上存在显著统计学差异(p < 0.01)。结论 相对于普通螺旋CT,320排螺旋CT具有扫描速度更快、放射剂量更低、图像质量更好等特点,在一定程度上提高了肋骨骨折检出率,使诊断的准确性更高,具有明显的优势。     

Treatment of thoracolumbar fracture with pedicle screws at injury level: a biomechanical study based on three-dimensional finite element analysis

The aim of this study was to investigate the biomechanical mechanisms of treatment of thoracolumbar compression fracture with pedicle screws at injury level based on a three-dimensional finite element method. We constructed one three-dimensional finite element model of T11-L1 in a patient with a compression fracture of the T12 vertebral body(anterior edges of vertebral body were compressed to 1/2, and kyphosis Cobb angle was 18.6°) fixed by four pedicle screws and another model fixed by six pedicle screws at the injured vertebrae, and then assigned different forces to the two models to account for axial compression, flexion, extension, left lateral bending, and rightward axial rotation by Ansys software. After different loading forces were applied to the models, we recorded stress measurements on the vertebral pedicle screws, as well as the maximum displacement of T11. The stress distribution suggested that stress concentration was appreciable at the root of the pedicle screws under different loading modalities. Under axial compression, flexion, extension, left lateral bending, and rightward axial rotation load, the stress for the superior screw was significantly greater than the stress for the inferior screw (P < 0.05). The stress in the six pedicle screw fixation model was significantly decreased compared to the four screw interbody fusion model (P < 0.05), but the maximum displacement of T11 between two models under different loadings was not statistically different. The use of pedicle screws at injured vertebral bodies may optimize internal fixation load and reduce the incidence of broken screws.