糖尿病调脂药物治疗的循证医学

本文重点介绍近年来糖尿病患者调脂治疗,主要包括临床常用的他汀类、贝特类、烟酸等药物降胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白-胆固醇(LDL-C)水平、升高高密度脂蛋白-胆固醇(HDL-C),以及减少心血管事件的疗效、不良反应等。     

JX-1对雄性小鼠生殖细胞致突变作用的研究

本文采用小鼠精子试验和小鼠睾丸DNA合成抑制试验,检测了JX-1对雄性生殖细胞的致突变作用。实验结果表明JX-1对小鼠精子总数、精子活动率及精子畸形率均无统计学意义的增加,与小鼠睾丸DNA合成抑制试验阴性反应一致。作者认为JX-1对雄性生殖细胞为一种非诱变剂。     

动态心电图对起搏器间歇性感知功能异常的诊断价值

目的 :探讨动态心电图检测对起搏器间歇性感知功能异常的诊断价值。方法 :采用MarquetteMars30 0 0动态心电图仪 ,对 36例 (4 9例次 )安装起搏器的患者进行随访 ,分析起搏、感知及与起搏器相关的心律失常。结果 :共检出起搏器间歇性感知功能异常 17例 (2 4例次 ) ,检出率为 4 7.2 % ,有 5例 (7例次 )合并两项感知异常。所有感知异常除 1例在常规心电图中检出外 ,其余 16例只在动态心电图中发现。检出与起搏器相关的心律失常 12例。根据动态心电图结果进行相应临床处理后 ,部分起搏器的感知功能异常消失。结论 :起搏器的感知功能异常多为间歇性的 ,动态心电图对间歇性感知异常的检出率较高 ,应是起搏器随访不可或缺的手段。     

Determinantion and evaluation of antisperm antibodies and seminal immunosuppressive material in recurrent aborting couples

Circulating antisperm antibodies (AsAb) and immunosuppressive material in seminal plasma (SPIM)were determined by solid-phase enzyme staining assay and anticomplement test respectively in 686 patients with abortion (including 285 couples) . 241 fertile couple served as control. It's found that the positive rate of AsAb in infertile patients was significantly higher than that in fertile control,being 36.6% vs 3.3% (P<0.001). AsAb was even more offen detected in recurrent aborting patients. Male patients whose spouses aborted 2-6 fetuses had significantly less SPIM than control, sperm count and sperm motility were also significantly decreased. But the incidence of pyospermia was significantly greater than that in control. It is concluded that AsAb and SPIM have played an important role in the development of recurrent abortions.     

硫酸铜对小鼠体细胞和生殖细胞致突变作用研究

报告了多次腹腔注射染毒硫酸铜的小鼠微核试验和精子畸形试验结果。微核试验，动物在出现中毒症状的情况下，骨髓嗜多染红细胞微核率未见增高，精子畸形试验，硫酸铜各组的精子畸形率均不高于空白对照组。     

获得性纯红再障患者外周血T细胞亚群分析

目的　本研究通过分析获得性纯红再障患者外周血T细胞亚群 ,进一步探讨该病的细胞免疫发病机制。方法　用抗人CD3、CD4、CD8、IFN γ及IL 4单抗结合人外周血单个核细胞 ,流式细胞术分析单个核细胞中CD3 +、CD4+、CD8+细胞数Th1、Th2、Tc1、Tc2细胞数以及CD4+/CD8+、Th1/Th2、Tc1/Tc2比值。结果　贫血组患者 ,外周血CD3 +细胞和CD8+细胞明显增加 (P <0 .0 1) ,CD4+/CD8+比例倒置 (P <0 .0 5 ) ;Tc2细胞明显增加 (P <0 .0 5 ) ,Tc1/Tc2比值降低(P <0 .0 5 ) ,治疗后血象恢复的患者各增高的亚群细胞均有所恢复 ,接近正常。结论　在获得性纯红再障患者T细胞明显增高 ,其中主要是CD8+细胞 ,而在CD8+细胞中 ,是Tc2细胞发挥了重要作用。经治疗有效的患者 ,其增高的T细胞亚群降低 ,提示以纠正病人细胞免疫异常为主的治疗方案有益于获得性纯红再障的治疗。     

男性不育病人精浆血管紧张素Ⅱ测定及临床意义

目的 :探讨人精浆血管紧张素Ⅱ(AngⅡ)对精液常规指标的影响及其与男性不育症的关系。　方法 :通过固相提取 高效液相分离 放免法 (SPE HPLC RIA)测定 4 3例不育男性 (无精子症 13例 ,少弱精子症 8例 ,弱精子症17例 ,精液常规正常 5例 )和 10例正常生育男性对照组的血浆和精浆AngⅡ 。　结果 :精浆AngⅡ 水平明显高于血浆AngⅡ 水平 ,为血浆值的 3倍多 (P <0 .0 1) ;无精子症组精浆AngⅡ 浓度明显高于其他生育与不育男性 (P <0 .0 5 ) ;血浆、精浆AngⅡ与精子密度、活力、存活率、畸形率和精子顶体反应率等均无相关性。　结论 :精浆AngⅡ很可能由男性生殖道局部产生 ,除睾丸、附睾外 ,前列腺和 (或 )精囊也可能是其来源 ;无精子症病人精浆高AngⅡ 水平的原因及精浆AngⅡ在男性生育调节中可能发挥的具体作用 ,还需要进一步研究。     

Decision-making after ultrasound diagnosis of fetal abnormality

During the last few decades, the use of ultrasonography for the detection of fetal abnormalities has become widespread in many industrialised countries. This resulted in a shift in timing of the diagnosis of congenital abnormalities in infants from the neonatal period to the prenatal period. This has major implications for both clinicians and the couples involved. In case of ultrasound diagnosis of fetal anomaly, there are several options for the obstetric management, ranging from standard care to non-aggressive care and termination of pregnancy. This essay explores the context of both clinical and parental decision making after ultrasound diagnosis of fetal abnormality, with emphasis on the Dutch situation. While normal findings at ultrasound examination have strong beneficial psychological effects on the pregnant woman and her partner, the couple is often ill prepared for bad news about the health of their unborn child in the case of abnormal findings. This is, in particular, true in settings where ultrasonography for the detection of fetal abnormalities is offered as an integral part of antenatal care without appropriate counselling. An important question is to what extent the couple should be supported in decision making when a fetal abnormality is diagnosed. In this context, the parental perception of having a choice varies markedly. When parents consider end-of-life decisions, they experience both ambivalent and emotional feelings. On the one hand, they are committed to their pregnancy, while on the other hand, they want to protect their child, themselves and the family from the burden of severe disability. These complex parental reactions have implications for the counselling strategy.

Histopathology of the teeth in segmental odontomaxillary dysplasia: new findings

Histological examination of the deciduous teeth in two cases of segmental odontomaxillary dysplasia (SOMD) showed fibrous enlargement of the pulps, an irregular pulp/dentine interface displaying many pseudoinclusions and pulp stones. There were tubular defects in the coronal dentine from pulp horn to cusp tip, an irregular tubular structure to the circumpulpal dentine of the apical half, a focally deficient odontoblast layer and widespread external resorption. Together with the clinical features of unilateral maxillary enlargement, upper alveolar expansion in the distal segment, increased spacing and delayed eruption of the deciduous molars and absence of premolar teeth, these histological appearances allow distinction of this condition from fibrous dysplasia (FD), segmental hemifacial hypertrophy (SHH) and regional odontodysplasia (ROD).     

福建莆田739例遗传咨询者细胞遗传学分析

目的 :探讨福建莆田遗传咨询者的医学细胞遗传学主要特征。方法 :采用细胞遗传学方法对 739例遗传咨询者进行外周血淋巴细胞检查。结果 :739例遗传咨询者中发现染色体异常 5 6例 ,异常率为 7.5 8% ,其中常染色体数目结构异常 4 3例 ,占 76 .9% ,性染色体异常 13例 ,占 2 3.1%。结论 :智力低下、不良孕产史、性发育异常与遗传染色体异常密切相关 ,不良孕产史推出异常核型率 3.31% ,较正常群体的 0 .5 %显著性增高 ,与文献报道基本符合