SD大鼠视网膜微动脉平滑肌细胞分离和消化方法

目的:探讨分离、消化SD大鼠视网膜微动脉平滑肌细胞(RMASMCs)的方法。方法:取正常SD大鼠眼球,分离视网膜微动脉,利用不同消化酶消化不同时间后,分离RMASMCs,在倒置显微镜下观察RMASMCs形态,并行免疫组化法鉴定。结果:解剖显微镜下成功急性分离视网膜动脉分支,即视网膜微动脉(直径40.23±5.61μm)。1、2、3号消化酶各消化10-16min,RMASMCs数量逐步增多,16min时最多(13.4±1.3个/低倍视野),与其它消化时间相比,差异有统计学意义(P0.05)。倒置显微镜下观察收获的RMASMCs呈长梭形、细胞膜完整、边缘光滑;免疫组化染色鉴定其胞浆呈α-action阳性表达。结论:采用急性分离、逐步消化的方法能成功获取较多数量和较高质量的RMASMCs。     

前外侧入路双钢板治疗肱骨干远端骨折

目的探讨前外侧入路双钢板治疗肱骨干远端骨折的临床疗效。方法采用前外侧入路、切开复位双钢板治疗25例肱骨干远端骨折患者。结果患者均获随访,时间12~24个月。25例骨折于术后5~7个月愈合。根据Mayo肘关节功能评分标准评估疗效:优24例,良1例。结论前外侧入路双钢板治疗肱骨干骨折,手术操作简单,固定牢靠,能早期进行肘关节功能锻炼,术后效果满意。     

Efficacy of artemether and artesunate in mice infected with praziquantel non-susceptible isolate of Schistosoma japonicum

Praziquantel is currently the only drug of choice for the treatment of human Schistosoma japonicum infections, and praziquantel-based chemotherapy has been proved to be generally effective to control the morbidity and reduce the prevalence and intensity of S. japonicum infections. However, the potential emergence of praziquantel resistance in S. japonicum seriously threatens the elimination of this neglected tropical disease in China. The purpose of this study was designed, in mouse animals, to evaluate the in vivo efficacy of artemether and artesunate against praziquantel non-susceptible S. japonicum. Mice infected with a praziquantel non-susceptible isolate and a praziquantel-susceptible isolate of S. japonicum were treated with artemether and artesunate at a single oral dose of 300 mg/kg given once on each of days 7–8 and 35–36 post-infection to assess the efficacy against juvenile and adult worms. Administration with artemether and artesunate at a single oral dose of 300 mg/kg on each of days 7–8 post-infection resulted in total worm burden reductions of 72.8 and 73.5 % in mice infected with praziquantel-susceptible S. japonicum, and 77.9 and 74.1 % in mice infected with the non-susceptible isolate (both P values >0.05), while the same treatments given on days 35–36 post-infection reduced total worm burdens by 71.4 and 69.6 % in mice infected with the susceptible isolate, and 75.3 and 69.6 % in mice infected with the non-susceptible parasite (both P values >0.05). It is concluded that there is no evidence for reduced susceptibility of artemether and artesunate in praziquantel non-susceptible S. japonicum.     

Is there a reduced sensitivity of dihydroartemisinin against praziquantel-resistant Schistosoma japonicum?

Praziquantel is currently the only drug of choice for the treatment of human schistosomiases. However, it has been proved that Schistosoma japonicum subjected to drug pressure may develop resistance to praziquantel. To evaluate the efficacy of dihydroartemisinin against praziquantel-resistant S. japonicum, mice infected with a praziquantel-resistant isolate and a praziquantel-susceptible isolate of S. japonicum were treated with dihydroartemisinin at a single oral dose of 300 mg/kg given once on each of 35–36 post-infection days, while infected but untreated mice served as controls. All mice were sacrificed 50 days post-infection, and the worm burden reductions were estimated. Administration of dihydroartemisinin at a single oral dose of 300 mg/kg on each of 35–36 post-infection days reduced total worm burdens of 69.8 % and female worm burdens of 86 % in mice infected with the praziquantel-susceptible isolate, and total worm burdens of 66.1 % and female worm burdens of 85.1 % in mice infected with the praziquantel-resistant isolate (both P values?>?0.05). It is concluded that the sensitivity of artemisinin derivative dihydroartemisinin does not reduce in praziquantel-resistant S. japonicum.     

基于PGMY09/11引物的PCR法检测高危型HPV的效果观察

目的评估基于PGMY09/11引物的PCR法检测高危型人乳头瘤病毒（HPV）效果。方法采用HC II试剂盒和基于PGMY09/11引物的PCR技术检测感染HPV16的50份样品和感染HPV18的50份样品,样品模板DNA分别按照1∶1、1∶2、1∶4、1∶8和1∶16倍比稀释,比较2种方法检测的敏感性和一致性。同时采用HC II试剂盒和基于PGMY09/11引物的PCR技术检测感染单纯疱疹病毒（HSV）和沙眼衣原体（CT）的20份样品及单一感染HPV16和HPV18的10份样品,评估基于PGMY09/11引物的PCR检测HPV的特异性。结果 HC II试剂盒和基于PGMY09/11引物的PCR对1∶1、1∶2稀释的HPV16和HPV18的检出率均为100%;HC II对1∶4稀释的HPV16和HPV18的检出率为36%和46%,但不能检出1∶8和1∶16稀释的HPV16和HPV18样品;基于PGMY09/11引物的PCR对1∶4、1∶8和1∶16稀释的HPV16检出率分别为100%、90%和32%,对1∶4、1∶8和1∶16稀释的HPV18样品检出率分别为100%、86%和40%。HC II试剂盒和基于PGMY09/11引物的PCR对HPV16检测的整体一致性为84.1%（Kappa值为0.674）,对HPV18检测的整体一致性为81.7%（Kappa值为0.598）。基于PGMY09/11为引物的PCR方法不能检测HSV和CT合并感染。结论基于PGMY09/11为引物的PCR方法检测出高危型HPV具有较高的敏感性和特异性,与市售HC II试剂盒检测结果具有较高一致性,可用于HPV感染诊断。     

不同他汀类药物标准剂量对稳定性斑块的影响

目的探讨不同他汀类药物标准剂量对稳定性斑块的影响。方法入选经冠状动脉造影和血管内超声检查确定为稳定性斑块的135例患者,分为3组：辛伐他汀20mg组47例,阿托伐他汀20mg组45例,瑞舒伐他汀10mg组43例。随访3-6个月,观察给予不同他汀类药物标准剂量的3组血清低密度脂蛋白-胆固醇（10wdensitvlipoprotein-cholesterol,LDL—C）、高密度脂蛋白-胆固醇（highdensitylipoprotein—cholesterol,HDL．C）、高敏C反应蛋白（high—sensitivityC．reactionprotein,hs—CRP）浓度变化及斑块坏死核所占百分比、斑块体积的动态变化。结果3组血清LDL—C、HDL—C、hs．CRP浓度及斑块坏死核所占百分比、斑块体积的基线资料比较,差异无统计学意义（P〉0．05）。随访3-6个月后,他汀类药物标准剂量治疗的3组血清LDL．C浓度与基线相比均有明显下降,均达标（P〈0．01）,且瑞舒伐他汀最优,阿托伐他汀其次,辛伐他汀最后（P均〈0．01）。辛伐他汀组血清HDL-C浓度与基线比较。差异无统计学意义（P〉0．05）,但阿托伐他汀组、瑞舒伐他汀组明显高于基线,差异有统计学意义（P=0．001．P=0．048）,且两组间比较,差异无统计学意义（P=0．852）。辛伐他汀组血清hs—CRP浓度与基线比较,差异无统计学意义（P〉0．05）,但阿托伐他汀组、瑞舒伐他汀组明显低于基线,差异有统计学意义（P=0．015,P=0．025）．且两组间比较,差异无统计学意义（P=0．411）。通过血管内超声虚拟组织成像技术（intravascularuhrasound—virtualhistology,IVUS—vH）检测,斑块坏死核所占百分比在辛伐他汀组明显高于基线,差异有统计学意义（16．33％-＋15．38％眦7．87％-＋1．04％,P〈0．01）;阿托伐汀组治疗后与基线相比,斑块坏死核所占百分比明显减少,差异有统计学意义（6．64％±3．25％帆7．91％±1．27％,P=0．007）;瑞舒伐他汀组斑块坏死核所占百分比与基线相比,差异无统计学意义（P=0．133）。斑块体积在辛伐他汀组治疗前、后比较,差异无统计学意义（P=O．286）;但阿托伐他汀组、瑞舒伐他汀组斑块体积明显低于基线,差异有统计学意义[（28．65±10．77）mm。vs．（33．31±10．75）mm3,P=0．041;（30．69_＋8．12）mm3ys．（36．337-＋12．15）mm。,P=0．013],且治疗后两组体积比较,差异有统计学意义（P=0．322）。结论不同种类他汀类药物标准剂量对稳定性斑块疗效不同：对于LDL—C,辛伐他汀、阿托伐他汀、瑞舒伐他汀标准剂量治疗后均可达标;阿托伐他汀、瑞舒伐他汀能升高HDL—C,降低hs—CRP;辛伐他汀无遏制斑块向不稳定进展的作用,阿托伐他汀有促进斑块稳定,逆转斑块的作用,瑞舒伐他汀可阻止斑块进展及逆转斑块的作用。     

Clinical characteristics,rates of blindness,and geographic features of PACD in China

ObjectiveTo analyze the rates of blindness with the demographics and clinical characteristics of patients with primary angle-closure disease (PACD) to provide a comprehensive epidemiologic reference in China.MethodsA retrospective analysis was conducted in the Chinese Glaucoma Study Consortium database, which is a national multicenter glaucoma research alliance of 111 hospitals participating between December 21, 2015 and September 9, 2018. The diagnosis of PACD was made by qualified physicians through examination. Comparison of sex, age, family history, subtypes of PACD, and blindness were analyzed.ResultsA total of 5762 glaucoma patients were included, of which 4588 (79.6%) had PACD. Of PACD patients, 72.1% were female with the sex ratio (F/M) of 2.6, and the average age of patients was 63.8±9.3 years with the majority between 60 and 70 years. Additionally, 30% of these patients had low vision in one eye, 8.8% had low vision in both eyes, 1.7% had blindness in one eye, and 0.3% had blindness in both eyes. There were statistical differences with regards to age between male and female patients with PACD, with male patients being older on average. Primary angle-closure glaucoma was more commonly diagnosed in males (60%) compared to females (35.9%), whereas acute primary angle closure (APAC) was more commonly diagnosed in females (54.3%) compared to males (37.7%). The visual acuity in APAC patients was lower and the rate of low vision and blindness was higher than other subtypes.ConclusionPACD was the major type of glaucoma in Chinese hospitals. There were more female patients with PACD, mostly between 60 and 70 years old, with higher rates of APAC in women. APAC resulted in the worst visual outcomes of all PACD subtypes.     

Special safety considerations in preparation of technetium Tc-99m DTPA for cerebrospinal fluid–related imaging procedures

ObjectiveTo review special safety considerations in the preparation of technetium 99m (Tc-99m) diethylenetriaminepentaacetic acid (DTPA; generic name, pentetate) for cerebrospinal fluid (CSF)–related imaging procedures.Data sourcesReview of practices and results at one institution supplemented with findings and recommendations from the literature. Literature searches were conducted via Medline/PubMed using the following terms: Tc-99m DTPA/pentetate, CSF, cisternography, intrathecal, and adverse reactions. The author's own files were also searched for articles (e.g., in newsletters) not indexed by Medline/PubMed.Study selectionArticles considered appropriate for review included all human research studies, reviews, case reports, abstracts, and letters published in English on Tc-99m DTPA use in CSF-related imaging procedures, especially with regard to safety or adverse reactions.Data extractionAll information related to safety precautions and adverse reactions associated with Tc-99m DTPA injected intrathecally or otherwise used for CSF-related imaging procedures were considered.Data synthesis18 years’ experience in one institution was reviewed with the added perspective of literature findings and recommendations.ConclusionWith proper attention to safety considerations, Tc-99m DTPA can be safely used in CSF-related imaging procedures.     

乳腺癌两种常用影像学诊断比较分析

目的：比较分析高频＋彩色多普勒超声和计算机X线钼靶摄影诊断乳腺癌的临床价值和二者联合应用的临床实用意义。方法对74例经手术和（或）穿刺病理学检查确诊的乳腺癌患者二维超声声像图特征＋彩色多普勒血流显像（CDFI）及计算机X线钼靶摄影图像进行分析比较,对二者联合应用与单独使用一种方法病灶检出情况进行对照分析。结果71例乳腺癌在高频＋彩色多普勒超声上的检出率为98．59％,其中乳腺癌诊断符合率为87．32％,误诊率为11．27％,漏诊率为1．41％。70例乳腺恶性肿瘤在计算机X线钼靶检查通过直接与间接征象诊断检出率为95．71％,其中乳腺癌的诊断符合率为84．29％、误诊率为11．42％、漏诊率为4．29％。二者联合应用后74例乳腺癌的诊断符合率为93．24％,误诊率为5．41％,漏诊率1．35％。结论高频＋彩色多普勒超声病灶检出率高于计算机x线钼靶摄影检查,而乳腺癌诊断符合率略高于X线钼靶摄影检查,二者联合应用可明显提高乳腺肿块的检出率与鉴别能力,减少误诊和漏诊,具有较好的临床实用价值。