2015—2017年衡水地区农村妇女宫颈病变筛查情况分析

目的 了解2015—2017年河北省衡水地区农村妇女宫颈病变筛查情况及其分布特点。方法 对2015—2017年河北省衡水地区5个县区35~64岁已婚农村妇女81 078例进行妇科检查及液基薄层细胞学检查,细胞学检查异常者行阴道镜检查、组织活检及病理检查。结果 妇科筛查结果异常者 14 699人,异常检出率18.13%,组织病理诊断宫颈上皮内瘤变94例(低级别病变51例;高级别病变43例),宫颈癌22例（微小浸润癌5例;浸润癌17例）。2015—2017年,冀州区宫颈病变异常检出率、微小浸润癌及浸润癌的检出率最高。组织病理学异常检出率2017年为86.36%,三年检出率差异有统计学意义（χ2=26.321,P<0.001）,2017年高级别病变及宫颈浸润癌的检出率均最高,三年检出率比较差异有统计学意义（χ2=10.123,P=0.006;χ2=8.120,P=0.017）。55~64年龄段宫颈浸润癌构成比最高,且差异有统计学意义（χ2=6.815,P=0.022）,教育程度在小学及以下人群中,检出浸润癌的人群构成比最高40%,差异有统计学意义（χ2=11.854,P=0.001） 。结论 衡水地区5个县区宫颈病变的检出率存在地区差异,浸润癌年龄分布特点基本符合全国调查的发病趋势,宫颈癌筛查项目在该地区达到一定的筛查目的及效果,但仍需优化。     

诱导型一氧化氮信号通路在代谢型谷氨酸受体2/3介导的脑缺血耐受中的作用

AIM: To explore the role of NO/ inducible nitric oxide synthase (iNOS) in the metabotromi glutamate receptor 2/3C (mGluR2/3) mediated-brain ischemic tolerance induced by cerebral ischemic preconditioning (CIP), and to observe the influences of α-methyl- (4-tetrazolyl- phenyl) glycine (MTPG), an antagonist of mGluR2/3, on the expression of iNOS during the induction of brain ischemic tolerance. METHODS: Thirty-six Sprague-Dawley rats were subjected to four vessel occluding global brain ischemic model. Thionin staining and immunohistochemistry were used for neuropathological evaluation and assay of iNOS expression in the hippocampal CA1 subregion of the rats. RESULTS: In the sham group, weak expression of iNOS was detected. The expression of iNOS in the CIP and CIP+ischemic insult groups were increased significantly compared with that in the sham group. Administration of MTPG via lateral cerebral ventricle 20 min before CIP blocked the up-regulation of iNOS induced by CIP, but had no influence on the pyramidal neuron survival. However, in the MTPG+CIP+ischemic insult group, the expression of iNOS was extremely intensive compared to that in CIP and MTPG+CIP groups. Importantly, this up-regulation was accompanied with obvious delayed neuronal death. CONCLUSION: NO/iNOS pathway plays an important role in the process of mGluR2/3 mediated-brain ischemic tolerance induced by CIP.     

食管癌囊性膨胀性骨转移1例

骨转移瘤占全身转移性肿瘤的15%~20%,是骨原发肿瘤的30多倍,其中囊状膨胀性改变的骨转移瘤相关文献甚少,对患者生活质量有着严重影响[1]。随着恶性肿瘤疗效的提高和生存期的延长,治疗骨转移瘤、缓解癌性疼痛、减少骨相关事件的发生及提高患者生活质量,越来越迫切。本例患者系囊性膨胀性骨转移瘤应用125I放射性粒子组织间植入治疗结合局部及全身药物治较为成功的案例。现报道如下。     

胶原蛋白膜包裹藻酸钙凝胶/骨髓基质细胞/BMP-2复合体修复兔桡骨缺损

[目的]探讨在外源性生长因子(BMP -2)作用下,使用胶原蛋白膜包裹经体外培养扩增的骨髓基质干细胞(BMSCs)与藻酸钙凝胶形成的复合物修复骨缺损的可行性.[方法]选用成年新西兰白兔36只.手术造成两侧桡骨标准缺损后,左侧植入复合体,右侧空白对照.取自体BMSCs,经体外分离培养扩增后,与BMP -2、藻酸钙凝胶及胶原蛋白膜形成复合体修复骨缺损,于2、4、8、12周时行大体、X线片、免疫组织化学观察.[结果]整个过程中可见实验组缺损区新生骨组织增殖明显、持续时间较长,且无过量的结缔组织生长;X线早期可见连续性骨痂通过缺损区,分布均匀;免疫组织化学可见多个成骨中心,骨小梁排列有序,成熟骨替代完全,BMP分布持续时间长,且在新骨组织中分布范围大.[结论]复合体能修复骨缺损,并且能够阻挡周围软组织进入缺损区,为新骨生长提供空间;同时作为BMP的载体,能减少外溢,提高其疗效.     

Early life exposure to sevoflurane impairs adulthood spatial memory in the rat

Sevoflurane is a general anesthetic commonly used in the pediatric setting because it is sweet-smelling, nonflammable, fast acting and has a very short recovery time. Although recent clinical data suggest that early anesthesia exposure is associated with subsequent learning and memory problems, it is difficult to determine the exact scope of developmental neurotoxicity associated with exposure to specific anesthetics such as sevoflurane. This is largely due to inconsistencies in the literature. Thus, in the present studies we evaluated the effect of early life exposure to sevoflurane (1%, 2%, 3% or 4%) on adulthood memory impairment in Sprague-Dawley rats. Animals were exposed to different regimens of sevoflurane anesthesia on postnatal days (PNDs) 3, 7, or 14 or at 7 weeks (P7W) of age and spatial memory performance was assessed in adulthood using the Morris Water Maze (MWM). Rats exposed to sevoflurane exhibited significant memory impairment which was concentration and exposure duration dependent. Disruption of MWM performance was more severe in animals exposed on both PNDs 3 and 7 than in animals exposed on both PNDs 3 and 14. The younger the animal's age at the time of exposure, the more significant the effect on later MWM performance. Compared to the neonates, animals exposed at P7W were relatively insensitive to sevoflurane: memory was impaired in this group only after repeated exposures to low doses or single exposures to high doses. Early life exposure to sevoflurane can result in spatial memory impairments in adulthood and the shorter the interval between exposures, the greater the deficit.     

丁苯酞氯化钠注射液联合降纤酶治疗进展性卒中的疗效观察

目的观察丁苯酞氯化钠注射液联合注射用降纤酶治疗进展性卒中的疗效。方法将120例急性进展性卒中患者随机分为治疗组（n=60）和对照组（n=60）,治疗组在常规治疗的基础上加用丁苯酞氯化钠注射液25 mg（100mL）中静滴,2次/d,连用14 d,同时给予降纤酶10 U加入生理盐水250 mL静滴,1次/d,连用4 d,对照组在常规治疗的基础上只加用降纤酶,于治疗前及治疗第1、5、15天分别进行临床疗效及神经功能缺损评分。结果两组于治疗前后神经功能缺损评分、临床疗效均有改善,治疗组总有效率为88.33%,对照组总有效率为73.33%,治疗组改善更明显,与对照组相比差异有统计学意义（P〈0.05）。结论丁苯酞氯化钠注射液联合降纤酶治疗进展性卒中疗效确切,不良反应少,值得推广。     

参芪扶正注射液联合甲地孕酮对晚期癌症患者生存质量的影响

目的观察参芪扶正注射液联合甲地孕酮对晚期癌症患者生活质量的影响。方法将90例晚期恶性肿瘤患者随机分为2组,对照组44例给予对症及支持治疗,治疗组46例在对照组的基础上应用参芪扶正注射液和醋酸甲地孕酮分散片。采用生活质量问卷(QLQ-C30)中文版和卡氏功能量表(KPS)于治疗前和治疗后测查2次,评定2组患者的生活质量状况及其影响因素。结果与对照组比较,治疗组患者疲乏、恶心和呕吐及食欲丧失明显改善,整体生活质量提高,社会功能、躯体功能和疼痛均得到改善,但感觉经济困难。结论参芪扶正注射液联合甲地孕酮可以改善晚期癌症患者的生活质量,但增加了患者的经济负担。     

Ryanodine受体在心力衰竭和心律失常中的作用

Ryanodine受体（ryanodine receptor,RyR）是肌浆网膜上的钙释放通道。钙释放失调在心力衰竭发展过程中具有关键作用。此外,RyR基因突变会导致肌浆网钙渗漏触发心律失常。因此,针对RyR已成为心力衰竭和心律失常治疗的一个新的策略。     

2型糖尿病干眼患者与正常干眼患者睑板腺及泪膜脂质层特征比较

目的 观察不同病程的2型糖尿病干眼患者与正常干眼患者睑板腺结构及泪膜脂质层厚度变化,探讨糖尿病患者干眼的发病特点,进一步指导临床治疗.方法 经泪膜破裂时间(BUT)测定和眼表疾病指数(OSDI)量表确诊的糖尿病干眼患者130例(130眼,糖尿病组)及正常干眼患者46例(46眼,正常对照组),其中糖尿病组以病程为界再分为...     

高胆固醇血症患者枯草溶菌素转化酶9基因突变研究

目的探讨国人单纯性高胆固醇血症患者人类枯草溶菌素转化酶9基因突变情况。方法排除载脂蛋白B100基因Q3500R位点突变及低密度脂蛋白受体基因突变后的100例单纯性高胆固醇血症患者,提取其基因组DNA,采用聚合酶链反应方法扩增枯草溶菌素转化酶9基因的12个外显子,进行DNA测序分析,同时选100例健康人群作为对照。结果 100例高胆固醇血症患者中,6例发现3处错义突变(D320N、V312F、R319E)、1处框移突变(934delGV312S)、3处同义突变(A305A、Q342Q、K125K)和1处剪接点突变(第2内含子5’剪接位点突变)。结论枯草溶菌素转化酶9基因在以上位点发生的突变可引起单纯性高胆固醇血症。枯草溶菌素转化酶9基因突变可能与国人高胆固醇血症有关。