丙戊酸钠治疗对血清胰岛素、体重指数的影响

目的探讨丙戊酸钠抗癫痫治疗对血清胰岛素、体重指数的影响,血清胰岛素的改变与患者的体重指数的改变的相关性,以及胰岛素抵抗的可能机制。方法以丙戊酸钠治疗超过3个月的25例癫痫患者为治疗组,15例未经丙戊酸钠治疗癫痫患者作为对照组来比较,检测患者体重、身高、血糖、胰岛素水平,比较两组的体重指数(BMI)、稳态模式评估指数(HOMA)和胰岛素水平。结果丙戊酸钠治疗组的HOMA指数(1．6811±0．6492)与对照组(1．1053±0．6129)比较有增高,治疗组BMI(23．634±2．5304)高于对照组(21．8573±2．2458),治疗组血清胰岛素(7．2080±2．5521)MU/L高于对照组(4．5413±1．1767)MU/L。结论丙戊酸钠治疗可能引起血清胰岛素增高并通过诱导导致胰岛素抵抗,从而导致患者体重增加。     

克罗米芬兴奋试验预测卵巢储备功能的价值

目的探讨克罗米芬兴奋试验（CCT）在不孕妇女中预测卵巢储备功能的作用。方法对2001年1月至2005年2月就诊于广东省妇幼保健院的666例不孕症患者作为研究对象，分为A组（≥35岁）461例为高龄组，B组（〈35岁）205例为低龄组，另取156例年龄〈35岁、非女方不孕原因者作为对照组，对三组受试者进行CCT。结果CCT异常发生率A组、B组及对照组分别为27．76％、34．14％、2．56％，A组及B组与对照组比较差异均有非常显著性意义（P〈0．01）。基础卵泡刺激素（FSH）〈10IU／L、雌二醇（E2）〈180pmot／L的不孕患者CCT异常发生率分剐为17．46％、24．19％，均明显低于FSH≥10IU／L、E2≥180pmol／L患者的64．19％及39．4％（P〈0．01）。结论CCT预测卵巢储备功能较基础FSH更敏感，CCT可作为常规了解卵巢储备功能的一项检测方法。     

十二烷基硫酸钠制备脱细胞真皮基质的实验研究

目的 探讨十二烷基硫酸钠制备脱细胞真皮基质的最佳浓度及作用时间.方法 取临床截肢患者废弃的皮肤,分成90块,随机分成6组,每块约1 cm×1 cm,分别置于0.1%、0.25%、0.5%、1.0%、2.5%、5.0%十二烷基硫酸钠溶液中脱细胞,每隔8 h取材一次,分别取材15次.取材标本行大体和组织学观察.结果 肉眼观察十二烷基硫酸钠作用8 h后,0.25%组可将表皮与真皮完整分离;光镜检查显示0.25%十二烷基硫酸钠在作用40 h后,能将真皮内的细胞及细胞碎片脱净,形成脱细胞真皮基质.制备的脱细胞真皮基质,主要由胶原纤维网架构成,其他组作用120 h也无法形成真正的脱细胞真皮基质.结论 十二烷基硫酸钠制备脱细胞真皮基质的最佳浓度为0.25%,最佳时间为40 h.与其他方法比较,具有简便、快捷、有效、价廉、宜推广等特点,可为临床急诊的修复争取宝贵的时间.     

海藻酸钠微球在部分性脾栓塞术中的应用评价

目的 评价海藻酸钠微球（KMG）行部分性脾栓塞术（PSE）治疗肝癌并脾功能亢进（脾亢）的疗效及并发症。资料与方法 58例肝癌并脾亢行PSE患者，依据PSE术所采用的栓塞材料不同分为2组：A组30例，栓塞材料为明胶海绵颗粒；B组28例，栓塞材料为KMG。随访观察两组外周血自细胞（WBC）、血小板（PLT）和红细胞（RBC）计数变化及术后反应。结果 两组患者术后1周、2周、1个月、6个月的WBC和PLT计数均较术前明显升高（P〈0．001）。虽然B组术后WBC和PLT计数较A组升高较多，但两组的疗效差异无统计学意义（P〉0．05）。两组术后RBC计数一直无明显变化（P〉0．05）。随着栓塞程度的增加，外周血WBC和PLT计数升高越明显，但是术后反应加重．并发症也随之增加。结论 KMG可作为PSE术的栓塞材料，将栓塞程度控制在50％～60％可有效治疗脾亢，减轻术后反应。     

碳酸锂合并丙戊酸钠预防双相障碍复发的研究

目的比较碳酸锂合并丙戊酸钠与单用碳酸锂对预防双相障碍复发的疗效。方法对82例临床康复的双相障碍患者随机分为碳酸锂合并丙戊酸钠组及单用碳酸锂组,合并用药组44例,单用碳酸锂组38例,随访观察2年。结果合并用药组有效率为88.6%,单用碳酸锂组有效率为68.4%,两组比较差异有显著性(P<0.05)。结论碳酸锂合并丙戊酸钠对双相障碍有较好的预防复发作用。     

不同浓度丁酸钠体外诱导树突状细胞分化的细胞表型研究

目的 探讨不同浓度丁酸钠诱导对体外培养树突状细胞(DC)细胞表型的变化规律.方法 通过粒细胞-巨噬细胞集落刺激因子(rhGM-CSF)和白细胞介素-4(IL-4)体外诱导的人外周血单个核细胞来源的DC,按不同丁酸钠浓度和不同诱导时间分组培养,流式细胞仪检测各组DC的细胞表型.结果 在丁酸钠诱导下,各组DC表面的成熟标志均显著下调,丁酸钠浓度越高下调越明显,随着培养时间的延长,各组DC表面的成熟标志均显著下调;但是细胞的凋亡率也同时上升.结论 丁酸钠在体外可以显著抑制DC的成熟过程,以丁酸钠浓度为0.75mmol/L和培养48h为最佳的诱导浓度和时间.     

Differential effects of the pyrethroid tetramethrin on tetrodotoxin-sensitive and tetrodotoxin-resistant single sodium channels

The differential effects of the pyrethroid tetramethrin on tetrodotoxin-sensitive (TTX-S) and tetrodotoxin-resistant (TTX-R) single sodium channel currents in rat dorsal root ganglion (DRG) neurons were investigated using the outside-out configuration of patch-clamp technique. Channel conductances were 10.7 and 6.3 pS for TTX-S and TTX-R sodium channels, respectively, at a room temperature of 24–26°C. The single-channel current of TTX-S sodium channels at the test potential of −30 mV was −1.27 ± 0.25 pA, and was not changed after exposure to 10 μM tetramethrin (−1.28 ± 0.23 pA). The open time histogram of TTX-S single-channel currents could be fitted by a single exponential function with a time constant of 1.27 ms. After exposure to 10 μM tetramethrin, the open time histogram could be fitted by the sum of two exponential functions with time constants of 1.36 ms (τ_fast) and 5.73 ms (τ_low). The percentage of contribution of each component to the population was 62% for the fast component representing the normal channels and 38% for the slow component representing the tetramethrin modified channels. The amplitudc of TTX-R single-channel currents was slightly changed from −0.72 ± 0.14 to −0.83 ± 0.07 pA by 10 μM tetramethrin. The open time histogram of TTX-R single-channel currents could be fitted by a single exponential function with a time constant of 1.92 ms. In the presence of 10 μM tetramethrin, the open time histogram could be fitted by the sum of two exponential functions with time constants of 2.07 ms (τ_fast) and 9.75 ms (τ_slow). The percentage of contribution of each component was 15% for the fast, unmodified component and 85% for the slow, modified component. Differential effects of tetramethrin on the open time distribution of single sodium channel currents explains the differential sensitivity of TTX-S and TTX-R sodium channels.     

The use of a single non-timed urine collection in the calculation of fractional lithium clearance

Summary The fractional clearance of lithium (CL_Li/CL_cr) calculated in 15 normal healthy adults from a single morning urine aliquot collection, together with a single venous blood sample (FQ) was compared with the average CL_LI/CL_CR obtained from three timed consecutive urine collections with mid-point blood sampling (FABC). Lithium had been ingested 15–18 h prior to the collection of these samples. Mean CL_Li/CL_CR was similar (FQ, 0.186, FABC, 0.177), with a highly significant correlation in each individual of CL_LI/CL_SR measured by either method (r = 0.97,P 0.0001). Proximal tubular reabsorption of sodium using lithium clearance may be calculated from a single urine and blood sample.     

Cerebral sodium sensors in the sodium-deplete sheep

The sodium intake of sodium deplete sheep was studied during local, push-pull perfusion of different solutions within the third cerebral ventricle. Sheep were made sodium deplete by continuous loss of parotid saliva, and were allowed access to 0.6 M NaHCO₃ solution for 2 h daily. Local perfusion within the third cerebral ventricle was performed before and during the access to sodium solution. Four perfusion sites were used: anterior dorsal and ventral, and posterior dorsal and ventral. Perfusion of 200 mM Na-csf caused a decrease in sodium intake at each perfusion site. Perfusion of ouabain, 10⁻⁶M, caused a reduction in sodium intake only during perfusions within the anterior portion of the third ventricle. The results may indicate that specific neuronal elements sensitive to changes in intracellular sodium concentrations are located around the anterior portion of the third cerebral ventricle. These neurones, however, are not exclusive sites from where sodium intake of sodium deplete sheep can be influenced.     

狼疮抗凝物质45例临床分析

本文报道从1985年7月到1993年12月检出有狼疮抗凝物质患者45例,有血栓栓塞现象14例,占31.11％。我们就其病种、临床表现、实验室检查、治疗及预后进行分析。