常温与低温体外循环心脏直视手术对细胞因子及补体的影响

目的探讨常温及低温体外循环心脏直视手术对细胞因子及补体的影响。方法选择先天性和风湿性心脏病患者40例,随机分为常温组及低温组各20例,分别于术晨、体外循环结束时及术后1、4、7、14 d抽取患者静脉血标本,测定血浆TNF、IL-2、C3、C4值。结果两组术前各项检查指标无显著差异。(1)两组术后1~4 d的IL-2水平较术前显著下降,至术后7 d恢复正常。体外循环结束至术后4 d,低温组IL-2显著低于常温组。(2)体外循环结束时以及术后1、4、7 d,常温组TNF水平显著低于低温组。两组体外循环结束时及术后1、4 d均高于术前,常温组至术后7 d、低温组术后14 d恢复正常。(3)体外循环结束时及术后1、7 d,常温组C3水平高于低温组,术后4 d两组无差别;常温组及低温组于体外循环结束时、术后1、4 d均低于术前,至术后7 d常温组恢复正常,低温组至术后14 d恢复至术前水平。(4)两组体外循环结束时及术后1、4 d C4水平均低于术前。体外循环结束时、术后1 d,常温组C4水平高于低温组。结论常温体外循环心脏直视手术对细胞因子及补体的影响显著轻于低温组,因而对术后机体的恢复优于低温方法。     

自拟白术桃花汤治疗习惯性便秘临床观察

目的　观察白术桃花汤治疗习惯性便秘的疗效。方法　自拟白术桃花汤 (白术 30g ,桃花 12g ,生地黄 30g ,枳实 10g) ,每日服 1剂 ,7d为 1个疗程。对照组服用果导片作对比观察。结果　白术桃花汤治疗习惯性便秘 117例 ,治愈 10 6例 ,好转 4例 ,总有效率 94 .0 2 %;果导片治疗 6 6例 ,治愈18例 ,好转 30例 ,总有效率 72 .73%。两组总有效率比较 ,经统计学处理P <0 0 1,差异有非常显著性意义。结论　白术桃花汤功能为补气除湿 ,增液行气 ,通调大便 ,治疗习惯性便秘疗效满意。     

单纯性肥胖及2型糖尿病儿童胰岛素受体底物-1的研究

目的:探讨单纯性肥胖及2型糖尿病儿童胰岛素受体底物-1(IRS-1)表达的改变。方法:对20例单纯性肥胖儿童,20例2型糖尿病儿童及20例对照组儿童,采用细胞免疫技术进行白细胞染色,运用图像分析软件计算光密度值,从而定量分析白细胞中IRS-1的含量变化。结果:肥胖组、2型糖尿病组白细胞中IRS-1表达下降,且与对照组相比有统计学意义(P<0.05)。结论:肥胖组、2型糖尿病组白细胞中IRS-1表达下降,与对照组相比有统计学意义(P<0.05),提示肥胖组与2型糖尿病组儿童胰岛素信号传递中受体后作用的关键底物缺陷,影响了胰岛作用的发挥。提示IRS-1与胰岛素抵抗有关,有利于进一步理解2型糖尿病的发病机制,指导临床治疗。     

貌似脑瘤的脑型血吸虫病15例临床分析

目的 探讨脑瘤型脑血吸虫病的临床及MRI的特点.方法 对收治的15例脑瘤型脑血吸虫病的临床资料、实验室检查及MRI资料进行回顾性分析.结果 均为慢性脑型血吸虫病肉芽肿型,表现为脑瘤型.脑瘤型脑血吸虫病的MRI表现具有特征性.结论 脑瘤型脑血吸虫病的MRI易误诊为肿瘤,应结合实验室及影像学检查综合分析.     

中西医结合治疗慢性肾炎疗效观察及其与血液流变学和微循环的相关意义分析

本文对比观察了中西医结合治疗与单纯西药治疗慢性肾炎的临床疗效,结果表明,前者缓解率及总有效率分别为79.8%和92.1%,显著高于对照组(均P<0.01)。治疗组各临床类型及各中医证型的疗效亦均明显高于对照组相对应的各型肾炎(P<0.05～0.01)。治疗组各型肾炎之血液流变学及甲皱微循环改善均较对照组为显著。两组中完全缓解加基本缓解者,该两类检查指标改善极为显著(P<0.05～0.01),而好转及无效者则无明显改善(P>0.05)。提示临床疗效与之密切相关。     

Post-prandial cardiovascular responses in man after ingestion of carbohydrate,protein or fat

Changes in cardiac output and in superior mesenteric arterial flow were followed with Doppler ultrasound techniques in five young, healthy persons for 2 h after ingestion of medium-sized (4 MJ), fluid meals containing either carbohydrate, protein, fat or water only. Measurements were carried out before meals and at regular post-meal intervals, during which mean arterial blood pressure was also followed. All energy-containing meals caused marked and gradually developing post-prandial increases in cardiac output as well as in superior mesenteric arterial flow. The maximum flow levels were reached in the course of 30–60 min and maintained until the observations ended after 2 h. The intake of water caused no such flow increases. There were considerable interpersonal variations in the size and in the speed of development of the flow increases after the three types of energy-containing meals. The flow-increasing effects of the three meal types were not significantly different, even if the most marked increases (median values about 1 1 min^-1 for both cardiac output and superior mesenteric arterial flow) occurred after carbohydrate meals. The marked effects on circulation of the three food components were also revealed in the calculated, integrated amounts of ‘extra’ cardiac output and superior mesenteric arterial flow observed in the course of the 2 h following the meal. Values of more than 100 1 for such ‘extra’ flows were seen after carbohydrate meals. The marked ingestion-released increase in blood flow to the splanchnic organs is apparently partly met by an increase in cardiac output, and partly by some redistribution of flow, which benefits the digestive system.     

An epidemiological study of methicillin-resistant Staphylococcus aureus (MRSA) isolated from medical staff, inpatients, and hospital environment in one ward at our hospital.

Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most important causative microorganisms for nosocomial infections. Recently, the incidence of isolation of MRSA has been increasing every year in Japan and is, notably, much more frequently found in inpatients than in outpatients. Therefore, we have done epidemiological studies of MRSA isolated from medical staff, inpatients, and the hospital environment in one ward of our hospital. Thereafter, we examined the antibiotic susceptibility (ABPC, DMPPC, CET, CMZ, IPM, GM, MINO, OFLX, EM, CLDM, VCM), phage typing, and coagulase typing of these MRSA. MRSA were isolated more frequently from anterior nares of inpatients than from doctors and nurses. MRSA were isolated more frequently from the environment near carriers of MRSA. Coagulase type II and phage type N.T. (not typable) were the dominant types of MRSA in our hospital (69% and 61%). MRSA strains were resistant to most antibiotics with a few exceptions (VCM, IPM, CMZ, CET). The high isolation frequency of MRSA in our hospital seems to suggest that inpatients who are carrying MRSA spread MRSA throughout the hospital environment and that the anterior nares of inpatients are the major MRSA harbor.     

Understanding the choroid

Based on previous work, this paper describes the anatomical and functional characteristics of the choroidal vasculature, namely the choriocapillaris, the arterial and arteriovenous anastomosis, the segmental distribution of the short posterior ciliary arteries, and the choroidal veins. The characteristics of the choroidal innervation with reference to the sensory nerve endings are reviewed. Some features of Bruch's membrane may explain the fundoscopic and angiographic appearance of the angioid streaks and the role of its basement membranes in the formation and transport of drusen.     

An adenovirus type 5 (AdV5) vector encoding an envelope domain III-based tetravalent antigen elicits immune responses against all four dengue viruses in the presence of prior AdV5 immunity

Dengue is a mosquito-borne viral disease caused by four antigenically distinct serotypes of dengue viruses (DENVs). This disease, which is prevalent in over a hundred tropical and sub-tropical countries of the world, represents a significant global public health problem. A tetravalent dengue vaccine capable of protecting against all four DENV serotypes has been elusive so far. Current efforts are focused on producing a tetravalent vaccine by mixing four monovalent vaccine components. In this work, we have utilized a discrete carboxy-terminal region of the major DENV envelope (E) protein, known as domain III (EDIII), which mediates virus entry into target cells and contains multiple serotype-specific neutralizing epitopes, to create a chimeric tetravalent antigen. This antigen derived by in-frame fusion of the EDIII-encoding sequences of the four DENV serotypes was expressed using a replication-defective recombinant human adenovirus type 5 (rAdV5) vaccine vector. This rAdV5 vector induced cell-mediated immune responses and virus-neutralizing antibodies specific to each of the four DENVs in mice. Interestingly, anti-AdV5 antibodies did not suppress the induction of DENV-specific neutralizing antibodies. We observed that anti-AdV5 antibodies in the sera of immunized mice could promote uptake of a rAdV5-derived reporter vector into U937 cells, suggesting that pre-existing immunity to AdV5 may in fact facilitate the uptake of rAdV5 vectored vaccines into antigen presenting cells. This work presents an alternative approach to developing a single component tetravalent vaccine that bypasses the complexities inherent in the currently adopted four-in-one physical mixture approach.     

体外循环浅低温心脏不停跳心内直视手术的临床研究

目的:探讨体外循环浅低温心脏不停跳心内直视手术的方法、疗效评价及其对心肌保护作用。方法:总结2004年3月～2008年12月间12例施行浅低温心脏不停跳心内直视手术病例,并行循环不阻断主动脉,鼻咽温维持在32～35℃,阻断上、下腔静脉,完成心内直视手术。结果:全组无围手术期死亡,心脏手术结束能顺利停机,术后血流动力学平稳,无严重心律失常,血尿发生率0%,无1例发生空气栓塞。1例心房切口缝合针眼渗血,行再次开胸止血,1例术后第32h发生急性肺梗塞,均经治疗痊愈。结论:浅低温心脏不停跳心内直视手术技术安全可行,是一种接近生理状态的心肌保护方法,可避免再灌注损伤,有较理想的心肌保护效果。