高晶体-高胶体渗透压混合液对人脐静脉内皮细胞内钙离子浓度和线粒体膜电位的影响

目的 探讨高晶体-高胶体渗透压混合液(HHS)对缺氧/氧再灌状态下人脐静脉内皮细胞内钙离子浓度([Ca2 ]i)、线粒体膜电位和细胞存活率的影响.方法 将人脐静脉内皮细胞分为A、B、C、D 4组,A组细胞于常氧状态下(37 ℃,95% 空气, 5%CO2)培养24 h;B组细胞经HHS作用15 min后,在常氧状态下培养24 h;D组细胞先经HHS处理15 min,C、D组细胞在缺氧环境(37 ℃, 95% N2, 5% CO2)中培养8 h,然后在常氧状态下培养16 h.[Ca2 ]i采用Fluo-2荧光分光光度计测定,线粒体膜电位采用罗丹明123(rhodamine123)流式细胞仪测量,细胞存活率则采用锥虫蓝染色法检测.结果 常氧状态下培养的A、B组细胞[Ca2 ]i、线粒体膜电位和细胞存活率间的差异无显著性意义(P>0.05).与A组相比,缺氧/氧再灌状态下,C、D组细胞[Ca2 ]i明显增加(P<0.05), 线粒体膜电位和细胞存活率明显降低(均P<0.05). 而D组细胞[Ca2 ]i 较C组降低,线粒体膜电位和细胞存活率较C组明显增高.结论 HHS可阻止缺氧/氧再灌引起的人脐静脉内皮细胞的钙超载,并减轻线粒体膜电位和细胞存活率的下降.     

高血压患者血压变异性临床分析

目的 探讨高血压病人血压变异的特点与高血压靶器官损害的关系.方法 选择高血压病人Ⅰ期50例,Ⅱ期44例和血压正常人26例进行动态血压检测.结果 高血压组血压变异各参数均显著大于正常组.三组间血压变异相同,白天增高夜间下降,收缩压变异大于舒张压变异.Ⅱ期高血压组血压变异各参数显著大于Ⅰ期高血压组.结论 血压变异增大是高血压患者的一个重要临床特征,血压变异增大与靶器官损害有关.     

急性胰腺炎并肝功能损害的临床探讨

目的:探讨急性胰腺炎(acute pancreatitis,AP)并肝功能损害的临床特点。方法:对153例急性胰腺炎患者的临床资料进行分析,其中78例合并肝功能损害。对比分析两组患者的肝功能,以了解肝功能损害的程度和对病程的影响。结果:重症胰腺炎较轻症胰腺炎并肝功能损害的程度重(P<0.01);胆源性AP肝功能损害比非胆源性AP严重程度重(P<0.01);重症胰腺炎并肝功能损害的患者,其腹痛缓解时间、血淀粉酶复常时间及住院天数均较轻症胰腺炎并肝功能损害的患者明显延长(P<0.01)。结论:急性胰腺炎肝功能损害程度与胰腺炎程度呈正相关,胆源性AP合并肝功能损害明显,肝功能损害延长胰腺炎的病程。     

Preservation of female fertility during cancer treatment

Improvements in the success of cancer treatments have resulted in increased awareness of the long-term effects of treatment, of which gonadal failure is the most significant. Thus, preservation of fertility potential has become a major goal and could be realized by preventing ovarian toxicity or by cryopreservation of reproductive cells/tissues. This review aimed to critically discuss the current protocols for the management of chemotherapy-inducced/radiotherapy-induced premature ovarian failure (POF). A medical approach using the gonadotropin-releasing hormone analog (GnRHa) may act to protect the gonads during radiation and/or chemotherapy by preferentially steering cells into cell cycle arrest with a decline in responsibility to the chemotherapeutic agents. Ovarian protection by GnRHa cotreatment against chemotherapy can enable the preservation of future fertility in survivors and prevent the bone demineralization and osteoporosis associated with hypestrogenism and POF. In vitro fertilization of retrieved oocytes could enable embryo freezing in some patients. Embryo cryopreservation is considered standard practice and widely available, but may seldom be used because of a lack of a male partner, the need to postpone cancer therapy for a few weeks and the possibility that an estrogen rise may be undesirable in sensitive cancer patients. Improvement in oocyte cryopreservation may offer additional possibilities; the prolonged culture of primordial and primary follicles in vitro is still unfeasible. Currently, the cryopreservation of ovarian cortex, which hosts thousands of immature follicles, is an investigational method, but has the advantage of requiring neither a sperm donor nor ovarian stimulation. Fertility preservation is often possible in women undergoing cancer treatment. To preserve the full range of options, fertility preservation procedures should be considered as early as possible during therapy planning. (Reprod Med Biol 2008; 7 : 17–27)     

影响早产儿行为神经测定因素的分析

目的 探讨新生儿行为神经测定(NBNA)在早产儿的应用及影响其评估指标的因素.方法 选择2006年1月至2007年6月在我院新生儿科住院治疗的123例早产儿,分别在纠正胎龄40周时进行NBNA评分,分析胎龄、出生体重、是否机械通气以及机械通气时间、围生期是否有致脑损伤的高危因素对NBNA评分的影响.结果 胎龄<30周、～32周、～34周早产儿及出生体重<1 250 g、～1 500 g、～2 000 g早产儿NBNA评分差异均具有显著性(P<0.01),胎龄越低、出生体重越低,NBNA评分越低;需机械通气的早产儿NBNA评分明显低于未上呼吸机者(P<0.01),机械通气时间＞7 d NBNA评分明显低于＜7 d者(P<0.05);围生期有出血性和缺血性脑损伤、间接胆红素≥256.5 μmol/L、血糖反复<2.6 μmol/L、发生感染者NBNA评分明显降低(P<0.01);臀位、钳产、吸引产早产儿NBNA评分明显低于剖宫产和顺产者(P<0.01);Apgar评分为0～3分者NBNA评分明显低于4～7分和≥8分者(P<0.01).结论 胎龄、出生体重、是否机械通气、机械通气时间、异常的分娩方式、合并重度窒息均影响早产儿的NBNA评分.对于早产儿,特别是胎龄<32周,出生体重<1 500 g,存在致脑损伤高危因素的早产儿,生后3～7 d内应行头颅B超检查,及早发现颅内病变,尽早干预,减少后遗症的发生.     

81例小儿肺炎支原体感染肺外表现的临床分析

目的 探讨小儿肺炎支原体(MP)感染的肺外损害表现.方法 回顾性分析383例肺炎支原体感染患儿的临床资料.结果 383例肺炎支原体感染患儿中,81例出现肺外损害的表现,发生率为21.15%.结论 MP感染后导致多脏器损害发生率较高,少数患儿以肺外损害为首发表现,易误诊、漏诊.     

新生儿窒息与脏器功能损害

目的为探讨新生儿窒息与脏器功能损害的关系，以便早期干预和治疗，降低新生儿窒息的死亡率和致残率，提高存活儿的生活质量。方法回顾分析67例新生儿窒息的临床资料，就其并发的脏器损害情况进行总结。结果67例中并发脏器损害者54例（80、60％）。其中脑损害34例（50．75％）；代谢异常29例（43．28％）；肺损害24例（35．82％）；心脏损害23例（34．33％）；肝损害23例（34．33％）；胃肠损害10例（14．93％）；肾损害4倒（5．97％）；多脏器损害34例（50．75％）。结论新生儿窒息多并发脏器损害，以脑、肺、心脏、肝脏为常见的损害脏器。     

中药黄斑颗粒对大鼠视网膜光损伤的防护作用

目的：观察中药复方制剂黄斑颗粒对大鼠视网膜光损伤的防护作用。方法：雄性SD大鼠24只,随机分为正常对照组、模型组和黄斑颗粒组,每组8只。黄斑颗粒组采用黄斑颗粒3.125g/kg,1次/d,灌胃10d。暗适应24h后,采用自制光损伤箱,平均光照强度2800Lux,散瞳放入光损伤箱中持续光照5h后,置于暗环境饲养,继续用药。2周后做视网膜电流图（electroretinogram,ERG）,记录最大反应a、b波及振荡电位（oscillatory potentials,OPs）,并留取眼球HE染色,光学显微镜测算外核层层数。结果：光照2周后,与模型组相比,黄斑颗粒组视网膜结构保存完好,正常对照组外核层平均有9－11层,黄斑颗粒组外核层平均仍有7－9层,而模型组仅有3－6层,差异有统计学意义（P〈0.01）。黄斑颗粒组ERG反应振幅明显高于对照组,其中b波黄斑颗粒组为（319.38±71.96）μV,模型组为（135.16±42.30）μV;a波振幅黄斑颗粒组为（184.63±47.23）μV,模型组为（83.35±27.75）μV;OPs黄斑颗粒组为（239.38±20.19）μV,模型组为（125.44±26.23）μV。两组间差异有统计学意义（P〈0.01）。a、b波潜伏期差异无统计学意义。结论：中药复方制剂黄斑颗粒对大鼠视网膜光损伤在形态和功能上有明显的防护作用。     

曲普瑞林对化疗药物引起卵巢损伤的预防作用

目的:探讨化疗对卵巢的损害和促性腺激素激动剂(GnRHa)曲普瑞林对化疗中卵巢的保护作用及机制。方法:选用2～3月龄、体重(250±10)g的SD雌性大鼠40只,随机分为正常对照组、顺铂(DDP)组、GnRHa组及GnRHa+DDP组,比较用药后4组大鼠卵巢、子宫湿重和形态学变化,采用放射免疫法测大鼠血清雌二醇(E2)、卵泡生成素(FSH)水平,免疫组织化学方法检测4组大鼠卵巢中Bcl-2、Caspase-3的表达。结果:DDP组与对照组比较大鼠体重明显减轻(P<0.05),卵巢、子宫重量明显下降(P<0.05);光镜下DDP组各期卵泡总数显著减少,GnRHa使生长卵泡数、成熟卵泡数减少,初级卵泡数及总卵泡数增加。GnRHa+DDP组可见GnRHa能明显改善化疗药物对卵巢的损害,保存了大部分初级卵泡且总卵泡数增加。结论:GnRHa的先期预防性应用对化疗所致的大鼠卵巢损伤有一定的保护作用。     

DNA Damage and Cell Killing by Camptothecin and Its Derivative in Human Leukemia HL-60 Cells

Camptothecin (CPT) has heen recognized as a topoisomerase I (Topo I) inhibitor. However, the mechanism of cytotoxicity of this agent remains unknown. In the present study, we analyzed the kinetics of Topo I-mediated DNA single-strand breaks and internucleosomal DNA cleavage produced by CPT and its derivative, 7-ethyl-10-hydroxycamptothecin (SN-38), in HL-60 cells. DNA single- strand breaks were detected using alkaline sucrose gradient centrifugation when HL-60 cells were incubated with 10 μM CPT or 10 μM SN-38 for 30 min. These DNA single-strand breaks were rapidly repaired after drug removal, while the cytotoxic action of these drugs was sustained. Treatment of HL-60 cells with CPT or SN-38 for 3 h produced extensive degradation of DNA. Agarose gel electrophoresis showed a ladder of DNA fragments consisted of multimers of approximately 200 base pairs, characteristic of apoptosis. Interestingly, this type of DNA fragmentation was also induced within 4 h after repair of DNA single-strand breaks, and subsequently loss of cell viability was observed. When zinc ion, a potent inhibitor of endonuclease, was added to drug-free medium after treatment with CPT or SN-38, internucleosomal DNA cleavage was abolished. Furthermore, addition of zinc ion reduced the loss of cell viability. These data suggest that Topo I-mediated DNA single-strand breaks may be necessary but are not sufficient for cell death, and the endonuclease involved in induction of internucleosomal DNA cleavage may play an important role in HL-60 cell death induced by Topo I inhibitor.