线粒体DNA3160-3755区域基因突变与2型糖尿病的关系

目的研究线粒体DNA3160-3755区域基因在延边地区2型糖尿病（T2DM）患者中的突变情况,探讨该区域线粒体基因突变与2型糖尿病的关系。方法应用聚合酶链反应-限制性片段长度多态性（polymorphismchainreaction-restrictionfragmentlengthpolymorphism,PCR-RFLP）技术和直接测序法对延边地区人群108例正常健康体检者、328例T2DM患者（其中2例合并耳聋）,进行线粒体DNA3160-3755区域基因突变筛查。结果线粒体DNA3316G-A在糖尿病组和正常对照组中的突变率分别为3．7％和3．8％。两组间差异无统计学意义（P〉0．05）;3394T→C在糖尿病组和正常对照组中的突变率分别为7．3％和1．9％,两组间差异有统计学意义（P〈0．05）;在糖尿病组及正常对照组中均未检测到线粒体DNA3243A→G、3593T→C和3714A→G突变。结论线粒体DNA3316G→A突变与延边地区T2DM的发生无关;线粒体DNA3,394T→C突变与延边地区T2DM的发生有关;线粒体DNA3423A→G,3593T→C,3714A→G突变在延边地区T2DM中的发生率为0,提示上述位点基因突变率极低。     

银屑病患者外周血CD4＋CD25＋调节性T细胞水平的研究

调节性T细胞（regulatory T cell，Treg）是一组具有免疫调节功能的T细胞亚群．对于维持机体内环境的稳定有着重要的作用。根据CD4^＋CD25^＋Treg来源的不同将其分为固有CD4^＋CD25^＋Treg和适应性CD4^＋CD25^＋Treg。固有CD4^＋CD25^＋Treg是由胸腺T细胞自然分化发育而来的一个主要Treg亚群，而适应性CD4^＋CD25^＋Treg是在特定的免疫环境中，经抗原刺激后成熟的T细胞。我们测定银屑病患者外周血中CD4^＋CD25^＋Treg，分析研究其与银屑病的相关性。     

Expression of integrin β3 and osteopontin in endometrium of patients with adenomyosis

Objective To investigate the expression of integrin β3 and osteopontin(OPN) in eutopic and ectopic endometrium of adenomyosis. Methods From January 2007 to July 2008, the endometrium specimens were collected from 43 patients with adenomyosis undergoing hysterectomy in Peking University First Hospital. Eutopic endometrium were 11 in proliferative phase and 32 in secretory phase (18 cases in mid-secretory phase) were collected. Ectopic endometriums were also collected. In the mean time, it was chosen 41 cases with pure subserous uterine myoma or cervical intraepithelial neoplasia (CIN) Ⅱ-Ⅲ treated by hysterectomy as controls including 12 endometrium in proliferative phase and 29 endometrium in secretory phase (19 cases in mid-secretory phase). The expression of Integrin β3 subunit and OPN in the endometrium were assessed by immunohistochemical staining and quantitative real-time polymerase chain reaction. Results (1)Immunohistochemical staining showed that positive staining of integrin β3 and OPN were present predominantly in eutopic and ectopic endometrial glandular epithelium. There was significant different protein expression of integrin β3 and OPN, which were 1.6±0.8 and 1.7±0.7 in eutopic endometrium,1.7±0.7 and 1.8±0.9 in ectopic endometrium,2.1±0.9 and 2.0±0.9 in control endometrium (P<0.05). The protein expression of integrin β3 and OPN in eutopic endometrium of adenomyosis in the proliferative phase(0.8±0.4 and 0.7±0.3) were remarkably lower than those of the secretory phase(1.8±0.8 and 1.9±0.8,P<0.01). The protein expression of integrin β3 and OPN in the endometrium of controls in the proliferative phase(1.0±0.4 and 1.0±0.4) were significantly lower than those of the secretory phase(2.5±0.7 and 2.5±0.7)(P=0.000). In the mid-secretory phase, the protein expression of integrin β3(2.0±0.9) and OPN (2.1±0.8)in eutopic endometrium of adenomyosis were significantly lower than that of control endometrium(2.7±0.5 and 2.7±0.7)(P<0.01). (2)The mRNA expression level of integrin β and OPN in eutopic and ectopic endometrium were assessed by quantitative real-time PCR(result was shown by median index). It was observed that integrin β3 mRNA and OPN mRNA were significantly lower in the eutopic endometrium of adenomyosis (4.69 and 4.23), when compared with ectopic endometrium(7.96 and 14.84)and controls (13.47 and 17.40) (P<0.05). Eutopic endometrium had higher mRNA expression of integrin β and OPN mRNA in the secretory phase (5.54 and 11.40) than that in the proliferative phase(2.69 and 3.30) (P<0.01).The mRNA expression level of integrin β and OPN of control endometrium in the proliferative phase (3.12 and 4.75)were significantly lower than that in the secretory phase(19.94 and 21.00, P=0.000). The mRNA expression of integrin β and OPN were 10.10 and 14.34 in the mid-secretory phase, which were significantly lower than 21.50 and 24.18 in control endometrium(P<0.05). Conclusions High expression of integrin β3 and OPN in ectopic endometrium of adenomyosis may cause endometriotic lesions; abnormal expression of integrin β3 and OPN in the endometrium of adenomyosis during the implantation window may contribute to infertility in some patients.     

脑卒中急性期空腹胃电图动态变化分析

目的观察脑卒中患者急性期空腹胃电图参数的动态变化,并探讨其相关发生机制。方法应用体表胃电图检测127例急性脑卒中患者入院24 h及入院1周时空腹胃电参数变化,并与34名健康对照组相对比。结果与正常组相比,脑卒中患者入院24 h胃窦及胃体部胃电振幅明显降低,入院1周时两部位胃电振幅则升高接近正常水平。胃窦及胃体部两不同时间的胃电频率与正常组相比无统计学意义。同时,脑出血患者入院24 h胃窦及胃体部的胃电振幅与正常组相比均明显降低（P〈0.05）,入院1周时已升高至正常水平。而脑梗死患者胃窦及胃体部两不同时间胃电振幅与正常组相比均无统计学意义。结论脑卒中患者急性期胃窦、胃体部的蠕动频率未见明显改变,而胃窦、胃体部的蠕动强度受到抑制,且不同性质的脑卒中类型对胃动力的影响亦不相同,其中脑出血患者胃窦、胃体部的蠕动强度降低尤为明显。     

生脉饮调控STZ诱导糖尿病大鼠心肌脂质代谢作用机制研究

目的：探讨生脉饮调控磷酸腺苷蛋白激酶（AMPK）信号通路改善链脲佐菌素（STZ）诱导糖尿病大鼠心肌脂质代谢作用机制。方法：72只STZ诱导糖尿病模型大鼠随机分成6组（对照组、模型组、生脉饮预防组、高、中、低治疗组）,每组12只。对照组和模型组均给予饮用水12 ml?kg-1,预防组在造模前灌胃给予生脉饮12 ml?kg-1,高、中、低剂量治疗组在造模成功后分别灌胃给予12、6、3ml?kg-1生脉饮。对照组喂以普通饲料,其余组喂以高脂高热量饲料。15周时,检测血糖血脂,剖杀,心脏称重,计算心脏系数;应用Western blotting检测心肌p-AMPK、乙酰辅酶A 羧化酶（ACC）、脂肪酸合成酶（FAS）、核转录因子固醇调控元件结合蛋白（SREBP1）、羟甲基戊二酰辅酶A 还原酶（HMG-CoA）蛋白的表达。结果：生脉饮预防组心脏系数低于模型组[（0.3236±0.0075）比（0.3589±0.0164）,P＜0.001],低密度脂蛋白低于模型组[（0.28±0.14 mmol?L-1）比（0.42±0.14 mmol?L-1）,P＜0.05],高密度脂蛋白高于模型组[（2.12±0.27 mmol?L-1）比（1.65±0.41 mmol?L-1）,P＜0.01],载脂蛋白比值高于模型组[（0.917±0.204）比（0.588±0.242）,P＜0.05];Western blotting结果显示生脉饮干预各组的心肌p-AMPK蛋白表达升高,而ACC、FAS、SREBP1、HMG-CoA蛋白的表达较模型组降低。结论：生脉饮可改善糖尿病大鼠心肌的脂质代谢,其可能的机制是调节AMPK途径相关靶蛋白发挥保护心肌的作用。     

生脉饮调控糖尿病模型大鼠心肌脂质代谢作用机制研究

目的探讨生脉饮调控磷酸腺苷蛋白激酶(AMPK)信号通路改善糖尿病模型大鼠心肌脂质代谢作用机制。方法 Wistar大鼠72只,随机分成对照组、模型组、生脉饮预防组、生脉饮高、中、低剂量组六组,各12只。STZ诱导糖尿病大鼠模型,对照组和模型组均予饮用水12mL/kg灌胃,预防组造模前4周开始予生脉饮12mL/kg灌胃,生脉饮高、中、低剂量组造模成功后分别予12、6、3mL/kg生脉饮灌胃。对照组喂以普通饲料,其余组喂以高脂高热量饲料。造模后15周,自动生化仪检测血糖、血脂,计算心脏系数,Western blotting法检测心肌磷酸化(p)-AMPK、乙酰辅酶A羧化酶(ACC)、脂肪酸合成酶(FAS)、核转录因子固醇调控元件结合蛋白(SREBP1)、羟甲基戊二酰辅酶A还原酶(HMG-CoA)蛋白的表达。结果生脉饮预防组心脏系数(×100)低于模型组[(0.3236±0.0075)比(0.3589±0.0164),P0.01],低密度脂蛋白低于模型组[(0.28±0.14)mmol/L比(0.42±0.14)mmol/L,P0.05],高密度脂蛋白高于模型组[(2.12±0.27)mmol/L比(1.65±0.41)mmol/L,P0.01],载脂蛋白比值高于模型组[(0.917±0.204)比(0.588±0.242),P0.05];Western blotting结果显示,与模型组比较,生脉饮预防组心肌p-AMPK蛋白表达升高(P0.05),ACC蛋白表达降低(P0.05),生脉饮中剂量组FAS蛋白表达降低(P0.05),生脉饮预防组SREBP1、HMG-CoA蛋白表达较模型组降低(P0.05)。结论生脉饮可改善糖尿病大鼠心肌脂质代谢,可能的机制是调节AMPK途径相关靶蛋白发挥保护心肌的作用。     

应用流式细胞术评分诊断骨髓增生异常综合征

目的 采用流式细胞术（FCM）评分对骨髓增生异常综合征（MDS）与非MDS（主要为非克隆性血细胞减少患者）患者进行鉴别.方法 应用FCM四参数（CD34＋髓系原始细胞占所有有核细胞百分比、B系祖细胞占CD34＋细胞百分比、髓系原始细胞CD45表达水平、成熟粒细胞SSC峰通道值）对50例MDS患者和20例非MDS患者进行评分,每个参数异常时计1分,评分≥2分时诊断为MDS.结果与非MDS对照组比较,MDS患者CD34＋髓系原始细胞比例增高,B系祖细胞比例降低,成熟粒细胞SSC水平降低,差异有统计学意义（P＜0.05）;而CD34＋髓系原始细胞CD45表达水平差异无统计学意义（P=0.06）.MDS组FCM评分高于非MDS组,差异有统计学意义（P＜ 0.001）.45例患者用此方法正确诊断为MDS,敏感度为90％;1例患者为假阳性,特异度为95％.结论 采用FCM四参数评分可帮助诊断MDS,可行性好,简单方便.     

康复医学信息数字化体系的构建

为适应我国康复医学发展,确保广大康复工作者获取康复医学信息,结合数字图书馆发展趋势,提出康复医学信息数字化建设目标、建设内容与功能、实施步骤与方法.     

浅谈成分输血的优点

随着医学科学的发展，有关输血技术也在不断发展提高，传统的输“全血”治疗已成为旧的概念，不合理地滥输全血，非但无益反而有弊的观点已逐渐为广大医务人员所接受。首先是全血并不全，存在各种缺陷，临床使用的库血，随着保存期的延长，所有成份都在变化，有效成份不断损失，活性下降。其次库血在保存过程中血钾、乳酸、氨、各种代谢产物不断增加，这样的全血不可能达到良好疗效。许多病人实质上只需全血中的某种或几种，但由于全血中单一成份含量少，浓度低，为了达到治疗效果，只能大量输库血，[第一段]     

多巴酚丁胺联合硝酸甘油治疗妊娠合并心衰32例疗效观察

1对象和方法1.1对象妊娠合并心衰60例,诊断符合美国纽约心脏病协会的标准[1]。分为两组:治疗组32例,年龄23～32岁,平均27.5岁,孕36～36+6周14例,38～39周18例,其中风心病16例,妊高征12例,心肌炎4例,心功能级7例,级16例,级9例;对照组28例,年龄21～30岁,平均25.5岁,孕36～36+6周10例,38～39周18例,其中风心病14例,妊高征11例,心肌炎3例,心功能级6例,级14例,级8例。两组年龄、心功能及原发病均无显著性差异(P>0.05),具有可比性。1.2方法对照组采用常规治疗如低盐饮食、氧疗、强心、利尿(应用西地兰、速尿、氨茶碱三联)等综合纠正心衰[2],治疗…