我省流通领域阿莫西林制剂质量现状

目的:了解流通领域中阿莫西林制剂的质量状况。方法:在全省各市县的部分医药经营企业,抽取阿莫西林胶囊及干糖浆共54批样品,按国家药品标准进行全检后,对其检验结果进行统计分析。结果:不合格的项目有含量、胶囊剂溶出度、干糖浆粒度。该药物制剂的标示百分含量普遍偏低。结论:影响该产品质量的主要项目是含量和溶出度,含量偏低的主要原因是厂家的低限投料,应予以充分重视。     

吸入一氧化氮对心瓣膜置换术后肺动脉高压患者血流动力学的影响

目的：观察吸入一氧化氮（ＮＯ）对心瓣膜置换术后肺动脉高压患者血流动力学的影响。方法：选择９例心瓣膜置换术后伴肺动脉高压的病人，吸入ＮＯ０．００３％，观察三个时象点：吸入ＮＯ前；开始吸入ＮＯ后１５分钟；停止吸入ＮＯ后１５分钟。结果：吸入ＮＯ能显著降低肺动脉压和肺循环阻力指数（Ｐ＜０．０１），停止吸入ＮＯ１５分钟后，肺动脉压和肺循环阻力指数恢复到原有水平。在整个观察过程中，心率、平均动脉压、中心静脉压、肺动脉楔压、体循环阻力指数和心脏指数均无显著变化（Ｐ＞０．０５）。结论：吸入ＮＯ具有选择性肺血管扩张作用，是治疗心瓣膜置换术后肺动脉高压的较理想药物。     

Gene expression of LDL receptor, HMG-CoA reductase, and cholesterol-7 alpha-hydroxylase in chronic renal failure

BACKGROUND: Chronic renal failure (CRF) is associated with an atherogenic lipid profile and an increased risk of ischaemic cardiovascular disease. The associated hyperlipidaemia is reportedly ameliorated by erythropoietin (Epo) therapy. According to a recent report, rats studied 3 weeks after 5/6 nephrectomy and fed a high- protein diet exhibited increased activities of hepatic HMG-CoA reductase (HMG-CoAR) and cholesterol 7 alpha-hydroxylase (Ch-7 alpha- H), despite normal corresponding mRNA values. DESIGN AND METHODS: This study was designed to examine the effects of naturally progressing CRF of longer duration as well as those of Epo therapy on gene expressions of the key factors involved in hepatic cholesterol metabolism, i.e., LDL receptor (LDLR), HMG-CoAR, and Ch-7 alpha-H. Sprague-Dawley rats were randomized to the CRF group (5/6 nephrectomy), Epo-treated CRF group (given Epo 150 U/kg/twice weekly) and sham-operated, placebo- treated normal controls. They were allowed free access to regular rat chow and studied 6 weeks after surgery. Liver mRNAs and protein mass or activities of the above factors were studied. RESULTS: Plasma cholesterol concentration was significantly increased in the CRF group (P < 0.001) and was modestly lowered (P < 0.05) by Epo therapy. However, microsomal cholesterol concentration and LDLR, HMG-CoAR, and Ch-7 alpha-H mRNA as well as HMG-CoAR activity, and Ch-7 alpha-H and LDLR protein mass measurements were virtually identical in the three groups. Thus, hepatic LDLR, HMG-CoAR, and Ch-7 alpha-H mRNA and protein measurements in rats with CRF were similar to those of the normal control group representing an inappropriate response to the associated hypercholesterolemia. Epo therapy led to partial amelioration of CRF- associated hypercholesterolaemia with no discernible effect on hepatic tissue expression of the above factors.      

磁共振尿路成像对泌尿系疾病的诊断价值

目的评价磁共振尿路成像(Magneticresonanceurography,MRU)对泌尿系疾病的诊断价值。方法对36例泌尿系疾病患者进行MRU检查,并结合临床手术、病理资料和其他影像学资料进行回顾性分析。结果36例患者中,均有MRU阳性结果,3例肾盂、肾盏癌,4例前列腺癌,8例前列腺增生症,2例输尿管癌定性、定位明确;9例肾盂、输尿管移行段梗阻定位明确,定性有帮助;10例输尿管下段梗阻中6例诊断明确,4例未能确诊。结论MRU在泌尿系疾病的诊断中,对肿瘤的定位、定性参考价值较高,对尿路梗阻定位诊断有价值,对定性诊断帮助有其局限性。     

嘉兴外来人员生活环境与肠道传染病相关知信行现况调查分析

目的了解城郊结合部外来人员聚集地生活环境现况和霍乱等肠道传染病健康知信行情况,进一步明确肠道传染病防治健康教育与健康促进工作的重点开展方向。方法采用随机抽样的方法,运用统一设计的调查问卷对嘉兴市5县2区城郊结合部等外来人员聚集地进行流行病学调查。结果93.06%的调查对象以租房为主,90.61%的生活用水来源于自来水,9.25%用井水;78.61%的人知道霍乱传播途径,21.53%的人知道霍乱主要临床症状,28.03%的人知道肠道传染病全部预防措施;77.31%的知识来源于电视,其他顺位依次为书刊、广播、家人或朋友处;希望获得宣传资料形式:传单占46.68%,墙报占31.21%。结论外来人员租房人数居多,有部分人使用井水;肠道传染病相关知识了解的较少。应采取多部门齐抓共管来改善外来人员聚集地的生活环境,因地制宜地对外来人员开展有针对性的预防肠道传染病健康教育。     

Fracture of the patella treated by open reduction and external compressive skeletal fixation

Open reduction combined with external compressive skeletal fixation was used to treat twenty-seven patients who had a separated fracture of the patella. Fixation was obtained by the use of two compressive clamps applied to stainless-steel pins that were inserted just proximal and distal to the proximal and distal poles of the patella. Range-of-motion exercises for the knee were begun at two weeks and the pins were removed at three to four weeks. All of the fractures healed. Twenty-four patients regained a range of motion that was equal to that of the opposite knee. There was no evidence of chronic osteomyelitis. Osteoarthritis was noted in one patient who refused excision of a portion of the patella.     

后腹腔镜手术在泌尿外科的应用

目的　探讨后腹腔镜手术治疗泌尿系疾病的方法及疗效。方法　采用后腹腔镜手术治疗泌尿系疾病3 5例 ,其中肾上腺肿瘤及肾上腺囊肿切除 13例 ,肾囊肿去顶术 15例 ,精索静脉曲张高位结扎术 4例 ,UPJ成形术 1例 ,乳糜尿行肾蒂淋巴管结扎术 1例 ,肾切除 1例。结果　 3 5例手术全部成功。手术时间 3 0～ 13 0分钟 ,术中平均出血 2 0ml。术后住院时间 1.5～ 14天 ,平均 4.5天。结论　腹腔镜手术治疗泌尿系疾病 ,具有损伤小 ,住院时间短 ,恢复快 ,并发症少等优点 ,值得临床推广应用     

力学刺激对3月龄骨质疏松大鼠成骨细胞增殖与合成功能的影响

探讨周期性双轴力学应变对成骨细胞增殖与分化合成功能的影响。将正常 3月龄雌性 SD大鼠和骨质疏松大鼠颅顶骨分离的成骨细胞分别在含 10 %胎牛血清的 F- 12培养液中培养 ,并接种在双轴力学应变装置中。当细胞生长至亚融合状态 (Subconfluence) ,给细胞施加力学刺激 ,频率为 1Hz,力学刺激分别为 4 0 0、10 0 0、4 0 0 0μ strain;作用时间分别为每天 30 m in,2、4、8h,共加载两天。以未受力学刺激的细胞为对照组 ,受力学刺激的细胞为实验组 ,并进行比较。采用流式细胞技术测定细胞增殖变化 ;采用同位素标记方法检测成骨细胞骨钙素、I型胶原 C端前肽 (PICP)和总蛋白的分泌量。结果表明 :1)在静态培养条件下 ,3ovx组与 3control组比较 ,其细胞功能活性无明显变化 ,但 3ovx组大鼠成骨细胞增殖活性明显增高 ,这与绝经后骨质疏松骨代谢的高转换率相一致。 2 )4 0 0、10 0 0 μstrain力学刺激可以促进 3control组成骨细胞 I型胶原、骨钙素和总蛋白的分泌量增加 ,促进成骨细胞的分化成熟 ;在 10 0 0μstrain力学刺激下 ,成骨细胞合成骨基质的能力增加最为明显。同时 ,在 4 0 0、10 0 0μstrain力学刺激的初期也可以促进成骨细胞的增殖 ,而促进成骨细胞的分化成熟的作用大于促进细胞增殖的作用。 3)在4 0 0 0 μ     

Gains of chromosomes 7, 17, 12, 16, and 20 and loss of Y occur early in the evolution of papillary renal cell neoplasia: a fluorescent in situ hybridization study.

It has been suggested that gains of chromosomes 7 and 17 and loss of Y occur in renal papillary adenoma and that progression to papillary renal cell carcinoma is marked by gains of additional chromosomes, most frequently 12, 16, and 20. Previous studies have included very few lesions of <5 mm in diameter, a requirement of the present definition of papillary adenoma. Ten papillary adenomas (ranging from 1 to 5 mm in diameter) from autopsy material and 10 surgically resected papillary renal cell carcinomas were studied with fluorescence in situ hybridization in paraffin sections using centromeric probes for chromosomes 7, 12, 16, 17, 20, and Y diluted 1:100 with tDenHyb1 buffer. The signals in 50 to 150 nuclei were counted in each tumor. Controls for all the probes were normal renal tissues from the same patients. Three or more signals per nucleus were frequently observed in papillary adenomas: chromosome 7 (range, 10 to 50%; > or = 30% in 9 of 10), 17 (range, 10 to 47%; > or = 30% in 7), 16 (range, 1 to 63%; > or = 10% in 5), 12 (range, 0 to 32%; > or =10% in 4), and 20 (range, 5 to 49%; > or = 10% in 5). Loss of the Y chromosome was observed in 80 to 90% of nuclei in 9 adenomas from males. Three or more signals were frequent in papillary renal cell carcinomas: chromosome 7 (range, 32 to 63%; > or =30% in 10 of 10), 17 (range, 28 to 61%; > or = 30% in 7), 16 (range, 0 to 45%; > or = 10% in 6), 12 (range, 1 to 37, > or = 10% in 5), 20 (range, 2 to 44%; > or = 10% in 4). No signal for Y was observed in 12 to 88% (> or = 81% in 6) of nuclei in 7 carcinomas from males. Statistical analysis showed no difference between adenomas and carcinomas. Gains of chromosomes 7, 17, 16, 12, and 20 and loss of the Y chromosome occur early in the evolution of papillary renal cell neoplasia in tumors that are only a few millimeters in diameter. Progressive gains of these chromosomes do not appear to correlate with the transition from adenoma to carcinoma.     

Percutaneous transluminal coronary angioplasty in a patient with paroxysmal nocturnal hemoglobinuria

Paroxysmal nocturnal hemoglobinuria (PNH) is an acquired chronic hemolytic anemia associated with an unusual susceptibility to hemolytic crisis, infection, and venous thrombosis which would be aggravated by a number of factors including surgery. We report a case of PNH undergoing percutaneous transluminal coronary angioplasty and discuss the corresponding perioperative management.