关节部位瘢痕形成后的康复治疗

介绍关节部位瘢痕增生的主要原因及预防原则,并综述瘢痕形成后的主要康复治疗方法。     

慈溪市护士心理健康状况调查及分析

目的对慈溪市在职护士的心理健康状况进行调查，以了解护士的心理现状，分析心理失衡的原因，为护理管理者提供依据。方法用症状自评量表对护士进行心理测试。结果护士群体与常模比较，除偏执因子与常模无显著差异外，其他各项均明显高于常模。不同级别医院护士、私营与公立医院护士、管理者与非管理者的因子分比较，部分因子分存在统计学差异。结论慈溪市大部分护士存在心理问题，其影响因素分别为社会因素、职业因素和自身因素，对此应针对性进行干预。     

人羊膜间充质干细胞移植对荷瘤鼠C6胶质瘤生长的抑制

背景:实验室前期课题成果显示,脐血或羊膜间充质干细胞具有亲肿瘤及抑瘤特性。目的:探讨人羊膜间充质干细胞对C6胶质瘤细胞生长的抑制作用。设计、时间及地点:细胞学体内对照观察,于2008-06/09在郑州大学微生物与免疫教研室完成。材料:胎盘来源于郑州大学一附院妇产科健康剖宫产产妇,C6胶质瘤细胞株由北京神经外科研究所惠赠,10只BALR/c裸鼠由上海斯莱克实验动物有限责任公司提供。方法:无菌条件下取胎盘,分离部分羊膜,体外分离培养人羊膜间充质干细胞,传至第3代用于实验。10只裸鼠背部双侧皮下注射含3×106个C6胶质瘤细胞的DMEM/F12培养基,建立双侧荷瘤鼠模型。成功造模后,模型对照组于裸鼠左侧皮下注射DMEM/F12培养基50μL,细胞移植组于同一裸鼠右侧皮下注射含2×106个羊膜间充质干细胞的等量DMEM/F12培养基。主要观察指标:肿瘤生长情况,周围组织浸润及新生血管形成等病理学观察,免疫组化法检测肿瘤中细胞周期素D1的表达。结果:细胞移植后14,21d,细胞移植组肿块体积明显小于模型对照组(F=54.127,P<0.05)。模型对照组瘤体呈结节状,部分肿瘤组织中心有坏死现象,内部有新生血管形成,肌层及皮肤浸润较明显,已达腹膜;细胞移植组瘤体分叶较少,无新生血管形成,仅有局部的皮肤浸润,未见肌层浸润。模型对照组细胞周期素D1蛋白呈阳性表达,而细胞移植组表达阳性率较低。结论:人羊膜间充质干细胞可明显抑制荷瘤鼠C6胶质瘤细胞的生长,同时可抑制细胞周期素D1蛋白的异常表达。     

血小板胶原受体糖蛋白Ⅵ体外表达及功能研究

为了深入研究血小板胶原受体糖蛋白Ⅵ(glycoproteinⅥ，GPⅥ)功能及筛选特异性抑制剂，利用基因重组技术体外表达GPⅥ胞外区片段。采用PCR方法扩增GPⅥ胞外区片段eDNA，构建表达载体pET-20b( )-GPⅥ，转化大肠杆菌BL21(DE3)pLysS，经IPTG诱导表达。表达产物经Ni—NTA Resin纯化、复性：使用Western blot方法鉴定重组蛋白性质；采用胶原结合试验测定重组蛋白的胶原结合能力。结果表明，经测序证明PCR扩增产物与GPⅥ胞外区eDNA序列完全一致；酶切分析证明成功构建了表达载体pET-20b( )-GPⅥ；原核细胞经诱导表达后出现新的相对分子量32kD蛋白条带，诱导产物以包涵体形式存在；Western blot分析表明重组蛋白可与抗Penta—His抗体和抗GPⅥ多抗特异性结合；胶原结合试验表明重组蛋白拥有较好的生物学功能。结论：正确构建了GPⅥ表达载体并成功表达重组蛋白，纯化、复性后的重组蛋白具有良好的抗原性和生物学活性。     

脊柱结核致隐匿性椎管内结核15例诊疗分析

背景:脊柱结核引起的隐匿性椎管内结核临床上较少报道。本病形成的椎管内结核肉芽肿和脓肿可直接对相邻脊髓神经等产生压迫,可较早产生神经受累的并发症。目的:探讨脊柱结核致隐匿性椎管内结核的诊断及治疗方法。方法:对2005年3月至2010年5月收治的15例脊柱结核致隐匿性椎管内结核患者术前行FSET1压脂序列强化,治疗上进行病灶清除和脊柱稳定性重建,动态观察结核中毒症状、脊髓功能的改善情况和病灶愈合情况。结果:随访时间18～24个月,平均(21±3)个月。入院时红细胞沉降率平均为69.5mm/h,C反应蛋白平均为51.6mg/L。术后红细胞沉降率降至41.8mm/h,C反应蛋白降至22.3mg/L,结核中毒症状明显改善。术后第8～12周红细胞沉降率和CRP检测结果正常;病椎椎间植骨融合时间平均4.5个月,结核病灶治愈率为95.3%。13例神经症状明显改善,2例胸椎结核术后6个月复诊时有部分改善。ODI评分术前为(35.56±9.15)分,末次随访时为(12.46±2.41)分。VAS评分术前为(9.9±1.5)分,末次随访时(4.25±1.9)分。术前与末次随访时的ODI评分和VAS评分差异有统计学意义(P<0.05)。术前Frankel分级B级2例、C级6例、D级7例,末次随访时C级2例、D级3例、10例E级。结论:脊柱结核致隐匿性椎管内结核术前MRI强化可为诊断提供有力依据;治疗上宜抗结核化疗同时进行病灶清除、椎板减压和神经松解。     

SEVENTY-TWO HOUR COMPARISON OF METHYLPREDNISOLONE SULEPTANATE AND METHYLPREDNISOLONE SODIUM SUCCINATE IN PATIENTS WITH ACUTE ASTHMA

SUMMARY The efficacy and safety of the methylprednisolone prodrugs methylprednisolone suleptanate and methylprednisolone sodium succinate were evaluated in a multicentre, randomised, double-blind, double-dummy parallel study of 88 patients hospitalised with acute asthma. Each study drug was administered as a bolus intravenous injection of 40mg methylprednisolone equivalents every 6 hours for 48 hours. Methylprednisolone 32mg was administered orally 6 hours after the last dose. Pulmonary function, medical events, and clinical laboratory values were assessed at predefined intervals before and during the 72-hour study. The primary response measure of pulmonary function was per cent predicted forced expiratory volume in one second (FEV₁) at 48 hours. Secondary response measures were peak expiratory flow rate (PEFR) and FEV₁/forced vital capacity (FVC) ratio. Although both drugs demonstrated within-group mean changes from baseline (starting at 6 hours) that were statistically significant for each response, there were no statistically significant differences between the two groups. The mean percent predicted FEV₁ at 48 hours and mean per cent change from baseline were 64% and 13% (p<0.0001) for the methylprednisolone suleptanate group and 67% and 17% (p<0.0001) for the methylprednisolone sodium succinate group, respectively. The mean PEFR and FEV₁/FVC ratio at 48 hours were 5.77 l/s and 73% for the methylprednisolone suleptanate group and 5.78 l/s and 76% for the methylprednisolone sodium succinate group, respectively. There were no clinically or statistically significant between-group differences in any of the safety parameters. In this study, methylprednisolone suleptanate and methylprednisolone sodium succinate have been shown to be therapeutically equivalent in the treatment of patients hospitalized with acute asthma.     

住院新生儿感染产超广谱β-内酰胺酶大肠埃希菌的临床分析

目的 探讨住院新生儿感染产超广谱β-内酰胺酶(ESBLs)大肠埃希菌的临床特点、菌株耐药性、感染的危险因素和疾病转归.方法 选取2010年1月至2013年1月宁波市妇女儿童医院新生儿病房产ESBLs大肠埃希菌感染患儿68例(产酶组),选取同期上报的多重耐药菌感染病例中不产ESBLs大肠埃希菌感染新生儿共81例为对照(不产酶组).对分离的产ESBLs大肠埃希菌采用K-B法进行药敏试验.结合患儿出生体质量、胎龄、分娩方式、感染部位和疾病转归等相关临床资料进行分析,采用Logistic回归方法分析新生儿感染产ESBLs大肠埃希菌的危险因素.结果 从68例新生儿采集的样本中,痰液样本产ESBLs大肠埃希菌的分离率最高(49/68,72.1％),其次为血液(7/68,10.3％)和尿液(6/68,8.8％).产ESBLs大肠埃希菌对氨苄西林、头孢噻肟、头孢吡肟和头孢他啶的耐药率均较高(61.8％～100.0％),但对头孢西丁、头孢哌酮/舒巴坦及阿米卡星的耐药率较低(2.9％～10.3％),对碳青霉烯类药物的耐药率均为0.产酶组和不产酶组新生儿均以下呼吸道感染为主.产酶组中,晚期新生儿以下呼吸道感染为主,与早期新生儿比较差异有统计学意义(x2=12.879,P＜0.05).多因素Logistic回归分析发现,胎龄＜37周(Exp (B) =0.352,95％ CI:0.134 ～0.929)、剖宫产(Exp (B)=0.488,95％ CI:0.243 ～0.984)、有侵入性操作(Exp(B)=0.363,95％CI:0.142 ～0.927)、母亲产前一周使用激素和/或抗菌药物(Exp (B) =0.325,95％CI:0.127 ～0.833)是新生儿感染产ESBLs大肠埃希菌的独立危险因素.结论 住院新生儿产ESBLs大肠埃希菌感染以呼吸道为主,感染菌株耐药性强,减少侵入性操作、严格掌握剖宫产以及产前使用激素和抗菌药物指征可减少产ESBLs大肠埃希菌感染的发生.     

螺旋CT三维成像术-SSD的应用

目的：对三维成像技术SSD的临床应用进行探讨。材料与方法：开展SSD病人20例，其中男13例，女7例，年龄24－69岁，采用西门子Balance CT机，进行容积扫功，层厚2mm-4mm，螺距1－2，三维重建图像后处理采用SSD并采取多个角度观察，分析。结果：20例SSD检查成像良好。结论：SSD是非创伤性影像检查，具有安全、简便、价廉的优点，是一种适合临床广泛应用的影像检查方法。     

A highly efficient and consistent method for harvesting large volumes of high-titre lentiviral vectors

Lentiviral vectors pseudotyped with vesicular stomatitis virus glycoprotein (VSV-G) are emerging as the vectors of choice for in vitro and in vivo gene therapy studies. However, the current method for harvesting lentivectors relies upon ultracentrifugation at 50,000 g for 2 h. At this ultra-high speed, rotors currently in use generally have small volume capacity. Therefore, preparations of large volumes of high-titre vectors are time-consuming and laborious to perform. In the present study, viral vector supernatant harvests from vector-producing cells (VPCs) were pre-treated with various amounts of poly-L-lysine (PLL) and concentrated by low speed centrifugation. Optimal conditions were established when 0.005% of PLL (w/v) was added to vector supernatant harvests, followed by incubation for 30 min and centrifugation at 10,000 g for 2 h at 4 degrees C. Direct comparison with ultracentrifugation demonstrated that the new method consistently produced larger volumes (6 ml) of high-titre viral vector at 1 x 10(8) transduction unit (TU)/ml (from about 3,000 ml of supernatant) in one round of concentration. Electron microscopic analysis showed that PLL/viral vector formed complexes, which probably facilitated easy precipitation at low-speed concentration (10,000 g), a speed which does not usually precipitate viral particles efficiently. Transfection of several cell lines in vitro and transduction in vivo in the liver with the lentivector/PLL complexes demonstrated efficient gene transfer without any significant signs of toxicity. These results suggest that the new method provides a convenient means for harvesting large volumes of high-titre lentivectors, facilitate gene therapy experiments in large animal or human gene therapy trials, in which large amounts of lentiviral vectors are a prerequisite.     

汉族正常人群与血栓性疾病患者vWF裂解酶C1423T基因多态性调查

目的　研究我国汉族人群中血管性血友病因子裂解酶 (vWF cp)基因C14 2 3T多态性的分布频率及其与血栓性疾病的相关性。方法　应用PCR技术结合酶切分析、聚丙烯酰胺凝胶电泳研究来自我国三个不同地区 4 0 0名汉族人vWF cp中C14 2 3T多态性的分布特点。同时 ,根据病例对照研究 ,比较了健康对照和血栓性疾病患者中该多态性的分布频率。结果　我国汉族人群中C14 2 3T的基因频率分别为 98.5 %和 1.5 % ,总理论杂合率为 2 .96 % ,不同地区人群杂合率不同 ,但未发现 14 2 3T T纯合子。该多态性的基因型与基因频率在健康对照和血栓性疾病患者中相似。结论　vWF cp基因C14 2 3T多态性在我国汉族人群中频率较低 ,尽管它影响vWF cp的酶活性。