孕激素联合化疗治疗卵巢上皮性癌

目的 分析孕激素联合以铂类为主的常规化疗对卵巢上皮性癌1～4期患者的临床疗效。方法 以已行瘤体减灭术的卵巢上皮性癌患者1～4期为研究对象，分为单纯化疗组、己酸孕酮组和普维拉组。随访、统计各组各期患者的生存率及复发率、血清激素水平、骨密度变化以及化疗副反应。结果 孕激素联合以铂类为主的化疗对早期卵巢上皮性癌的预后无明显影响，但对晚期(3期)卵巢上皮性癌的术后近期以及远期(2～5年)生存率及复发率均有改善趋势。单纯化疗组、己酸孕酮组、普维拉组3期患者术后3年生存率分别为34．8％、66．2％、73．9％，复发率分别为72．2％、47．3％、40．6％；单纯化疗组、己酸孕酮组术后5年生存率分别为17．4％、48．4％，复发率分别为81．5％、62．4％。孕激素的使用不影响患者血清激素水平，也不增加化疗的毒、副作用。联合孕激素治疗的患者术后骨密度下降较一般绝经后妇女慢。结论 孕激素联合以铂类为主的常规化疗可改善晚期卵巢上皮性癌的预后，并且不增加化疗的毒副作用，可改善患者的骨量丢失。     

Comparison of redox and D29 phage methods for detection of isoniazid and rifampicin resistance in Mycobacterium tuberculosis

Rapid, accurate and inexpensive methods are essential to detect drug-resistant Mycobacterium tuberculosis and allow timely application of effective treatment and precautions to prevent transmission. The proportion method, the MTT and Alamar Blue redox methods, and the D29 mycobacteriophage assay, were compared for their ability to detect resistance to isoniazid and rifampicin. When tested against a panel of known M. tuberculosis strains, the redox methods and the D29 assay showed good sensitivity and specificity compared to the proportion method, suggesting that they could be useful alternatives for identifying multidrug resistance in M. tuberculosis.     

PCR-SSCP法检测结核分枝杆菌耐药性

目的：探讨耐多药结核分枝杆菌耐药基因突变与耐药性的关系以及聚合酶链反应-单链构象多态性分析(poly merase chain reaction-single strand cinfomlation polymorphism，PCR-SSCP)方法的临床应用价值。方法：用PCR-SSCP方法检测58株结核分枝杆菌临床分离株katG，rpoB，rpsL基因突变并与常规药敏试验检测结果进行对比。结果：经常规药敏试验检测，58株结核分枝杆菌临床分离株中共有41株耐药，其中，耐异烟肼(INH)为35株，高耐药株27株；耐利福平(RFP)为31株，高耐药株24株；耐链霉素(SM)有31株，高耐药株26株。同时耐3种药物的有21株(51．2％)，耐2种药物的14株(34．1％)，单耐药株6株(14．6％)．PCR-SSCP方法对58株临床分离株katG，rpoB，rpsL基因突变的检测率为40％(23／58)，45％(26／58)，38％(22／58)，其中检出3个基因同时突变的有13株(32％)，2种基因突变的12株(29％)，1种基因突变的有10株(23．8％)．常规药敏试验与PCR-SSCP法检出结核分枝杆菌同时耐3种药物的符合率为61．9％(13／21)，检出耐2种药物的符合率为85．70k，(12／14)，检出耐1种药物的符合率为50％(3／6)．高耐药株中突变率为80．5％(62／77)，低耐药株中突变率为60％(12／20)．结论：PCR-SS-CP方法对耐2种以上药物的结核杆菌检出率较高，且耐药基因突变率随着耐药浓度增高而增高。将PCR-SSCP法与药敏试验联合应用可互相弥补，已成为临床指导用药的好方法。     

克罗米酚对血清雌激素和孕激素水平的影响

目的探讨克罗米酚(CC)在诱发排卵过程中对雌、孕激素水平的影响。方法采用放射免疫法,测定16例不明原因不孕妇女在自然周期和用药周期的排卵前1天和排卵后10天血清雌二醇(E2)和孕酮(P)浓度。结果排卵前1天和排卵后10天,用药周期的E2、P浓度均高于自然周期(P<0.05)。结论克罗米酚在诱发排卵过程中可导致内源激素平衡紊乱。     

The resurgence of tuberculosis in the Republic of Ireland: Perceptions and reality

Tuberculosis remained a very significant cause of death in Ireland until the mid-20th century and still occupies a prominent position in the folk memory. As I show with reference to recent Irish media coverage, the global resurgence of tuberculosis is therefore viewed with concern in Ireland. Using data collated by the Health Protection Surveillance Centre between 1998 and 2005 however, I show that the recent increase in tuberculosis incidence in Ireland is less than is popularly perceived. This increase is largely associated with economic immigrants attracted to Ireland by the ‘Celtic Tiger’ economic boom, but there is little evidence to suggest that this has had a negative impact on the Irish-born population. Drug resistance is still a small but growing problem. Whilst vigilance is required, it is argued that the recent increase does not at present indicate a likely return to the situation in the mid-20th century.     

氨乙基氨丙基聚二甲基硅氧烷改性水性聚酯型聚氨酯的研究

由聚酯二元醇、异佛尔酮二异氰酸酯和二羟甲基丙酸合成聚氨酯预聚体，以氨乙基氨丙基聚二甲基硅氧(AEAPS)为扩链剂，制备了AEAPS改性聚氨酯水分散液。与未改性的聚氨酯水分散液相比，AEAPS改性聚氨酯水分散液的粒径增大，但粒径分布和表面张力基本不变，说明疏水的聚二甲基硅氧烷侧链被包裹于分散颗粒的内部；此外，改性聚氨酯水分散液的冻融稳定性显著增强。AEAPS改性聚氨酯水分散液成膜后，吸水率明显下降，水在膜表面的接触角增加，400℃时热失重下降，具有良好的疏水性和耐热性。     

穹窿体与肿瘤多药耐药

穹窿体是真核细胞中的核糖核蛋白颗粒,由肺耐药蛋白、穹窿体多聚腺苷二磷酸聚合酶、端粒酶相关蛋白和穹窿体RNA构成,其主要成分为肺耐药蛋白。肺耐药蛋白是介导肿瘤多药耐药的蛋白之一,可能与肿瘤的治疗效果和临床预后相关。穹窿体可能通过介导药物转运或者信号转导引起肿瘤的多药耐药。文章介绍了穹窿体的结构、成分及其介导多药耐药机制研究的新进展。     

Metabolic Characterization of Nondiabetic Severely Obese Patients Undergoing Roux-en-Y Gastric Bypass: Preoperative Classification Predicts the Effects of Gastric Bypass on Insulin–Glucose Homeostasis

Introduction Obese individuals may have normal insulin–glucose homeostasis, insulin resistance, or diabetes mellitus. Whereas gastric bypass cures insulin resistance and diabetes mellitus, its effects on normal physiology have not been described. We studied insulin resistance and β-cell function for patients undergoing gastric bypass. Methods One hundred thirty-eight patients undergoing gastric bypass had fasting insulin and glucose levels drawn on days 0, 12, 40, 180, and 365. Thirty-one (22%) patients with diabetes mellitus were excluded from this analysis. Homeostatic model of assessment was used to estimate insulin resistance, insulin sensitivity, and β-cell function. Based on this model, patients were categorized as high insulin resistance if their insulin resistance was >2.3. Results Body mass index did not correlate with insulin resistance. Forty-seven (34%) patients were categorized as high insulin resistance. Correction of insulin resistance for this group occurred by 12 days postoperatively. Sixty (43%) patients were categorized as low insulin resistance. They demonstrated an increase of β-cell function by 12 days postoperatively, which returned to baseline by 6 months. At 1 year postoperatively, the low insulin resistance group had significantly higher β-cell function per degree of insulin sensitivity. Conclusions Adipose mass alone cannot explain insulin resistance. Severely obese individuals can be categorized by degree of insulin resistance, and the effect of gastric bypass depends upon this preoperative physiology.     

鲍氏不动杆菌致慢性阻塞性肺疾病患者肺部感染临床及耐药性分析

目的 探讨慢性阻塞性肺疾病(COPD)患者肺部鲍氏不动杆菌感染的临床特点和耐药情况.方法 对78例COPD患者肺部鲍氏不动杆菌感染的临床表现及药敏情况进行回顾分析.结果 药物敏感性测定提示该菌对头孢哌酮/舒巴坦耐药率最低,为14.9%,其次为亚胺培南和美罗培南,分别是24.8%和28.2%;对氨苄西林、头孢他啶,头孢吡肟、哌拉西林、左氧氟沙星、莫西沙星、阿米卡星、氨曲南和替卡西林/克拉维酸有较高耐药率,为48.5%～74.8%.结论 COPD患者肺部鲍氏不动杆菌感染与年老体弱,广谱抗菌药物及激素应用、呼吸道侵入性操作及呼吸机使用有关,临床表现无特异性,耐药严重,病死率高,应注意预防.     

Entomological survey and report of a knockdown resistance mutation in the malaria vector Anopheles gambiae from the Republic of Guinea

The purpose of our entomological survey was to estimate mosquito biodiversity, infectivity rates and insecticide resistance levels in Anopheles species in four study sites in a mining area with high malaria transmission in southeastern Guinea. Anopheles gambiae s.l. (77%) was the most common Anopheles collected followed by An. funestus (20%). The specimens of the An. gambiae complex were predominantly An. gambiae S form (97.6%) with 1.4% of An. gambiae M form found in Kérouané only, and 1% of An. arabiensis which was present in all four study sites. Anopheles gambiae S form and An. funestus were found to be infected with Plasmodium falciparum, with infectivity rates of 4.1% and 4.4% and inoculation rates of 0.60 and 0.19 infected bite/person/night, respectively. In addition, a high level (79%) of the knockdown resistance (kdr) L1014F mutation was reported in the populations of An. gambiae S form. The high malaria transmission that occurs in the prospected area of Guinea requires a long-term vector control programme. However, such a control programme will have to consider the presence of the kdr gene at a surprisingly high level within the dominant vector, which could reduce the expected impact of vector control.