军事飞行人员甲状腺肿块87例分析

为了了解军事飞行人员甲状腺肿块的患病特点，加强飞行人员甲状腺疾病的防治，我们对自2000年6月～2008年8月在本院年度体检中发现的87例甲状腺肿块男性飞行人员的患病情况作一回顾性分析，现报道如下：     

神经内科重症监护病房卒中相关性肺炎非发酵菌的构成及耐药性研究

了解神经内科重症监护病房卒中相关性肺炎非发酵菌构成及病原菌耐药特点.方法:对2008年1月至2009年6月我院神经内科重症监护病房急性脑卒中卒中相关性肺炎患者下呼吸道标本中分离到的非发酵菌进行鉴定、药敏试验.结果:经培养鉴定共取得211株致病菌,革兰阴性杆菌125株(59.2％),革兰阳性球菌66株(31.3％),真菌20株(9.5％),其中非发酵菌89株,占革兰阴性杆菌的71.2％,在89株非发酵菌中铜绿假单胞菌位于首位,其次是鲍曼不动杆菌、嗜麦芽窄食单胞菌、洋葱假单胞菌.药敏结果表明铜绿假单胞菌呈多重耐药,鲍曼不动杆菌对常见头孢菌素和喹诺酮类抗菌药物耐药严重,但对碳青霉烯类、舒巴坦与β内酰胺类复合剂仍保持较高敏感性.结论:该医疗单元非发酵菌病原菌构成以铜绿假单胞菌及鲍曼不动杆菌为主,非发酵菌呈多重耐药现象,临床上应高度重视卒中相关性肺炎的防治,加强病原菌的诊断及药敏监测,合理使用抗生素.     

某中心疗养歼击机飞行员超重和肥胖的流行特点

目的 分析近10年我军歼击机飞行员超重和肥胖流行特点,为军事飞行员心脑血管疾病和其它相关疾病的一级预防提供依据.方法 收集2001-2010年在本中心保健疗养的歼击机飞行员体检资料,根据BMI分为超重组(26≤BMI＜28)、肥胖组(BMI≥28),分析超重和肥胖与年龄和相关疾病的关系;比较行政团职及以上飞行员与团职以下飞行员超重和肥胖情况;探索近10年歼击机飞行员超重和肥胖的变化趋势.结果 (1)近10年歼击机飞行员总超重率为15.19％,肥胖率为5.61％.(2)超重和肥胖率随年龄增长而增加(P＜0.05).(3)行政团职及以上飞行员超重率18.25％、肥胖率10.53％,明显高于团职以下飞行员超重率(14.34％)和肥胖率(4.24％).(4)歼击机飞行员高血压、脂肪肝、胆囊结石患病率与超重肥胖密切相关,与肝内胆管结石患病率无明显关联.(5)近10年歼击机飞行员超重总体呈上升趋势,肥胖呈缓慢下降.结论 加强对超重和肥胖飞行员健康管理是降低飞行员心脑血管疾病和其它相关疾病患病率、延长飞行寿命的重要措施.     

中国人阿尔茨海默病与乙二醛酶Ⅰ基因A111E多态性相关分析

目的 探讨乙二醛酶Ⅰ(GLO-Ⅰ)基因A111E多态性在中国汉族人中的分布特点及其与阿尔茨海默病(AD)的相关性.方法 收集102例AD者和121例健康对照者,使用限制性内切酶SfaNI的PCR-RFLP法检测乙二醛酶Ⅰ基因多态性.结果 AD组A111E位点E型等位基因型频率(18.6%)明显高于健康对照组(9.9%)(P＜0.05);E型等位基因者发生AD的危险性增加;AD组与健康对照组比较,基因多态性频率分布(AA:68.6%,81.8%;AE:25.5%,16.5%;EE:5.9%,1.7%),差异有统计学意义(χ2=6.185,P＜0.05).结论 GLO-Ⅰ基因多态引起的GLO-Ⅰ功能性氨基酸突变与AD的发生及进展相关.     

Hallervorden-Spatz综合征的临床、影像学特点及脑深部电刺激治疗

目的 分析Hallervorden-Spatz综合征(HSS)的临床、影像学特点及脑深部电刺激术(DBS)治疗后效果. 方法 回顾性分析南方医科大学珠江医院于2010年6月收治的l例HSS患者的临床、影像学特点及DBS治疗后预后. 结果 本例患者男性,12岁,发病年龄较早,临床以肌张力障碍、智能障碍、构音困难、锥体束受累为主要症状,病程进展较快;头颅MRI表现为典型的“虎眼征”；采用DBS[刺激靶点为双侧苍白球内侧部]治疗后半年患者运动症状明显改善,但言语及智能改善不明显,随访1年患者病情平稳. 结论 典型影像学特点和临床症状是临床诊断HSS的重要依据,DBS能改善HSS患者的运动症状,是该病是有限的可选择治疗手段之一.     

空勤疗养科医师应具备的“六种意识”

为了更好的适应空军战略转型,提高空军高技术条件下整体作战航卫保障能力,对空勤疗养科医师也提出了新的要求。在新军事发展时期,空勤疗养科医师应具备“六种意识”。     

军事飞行员年度体检发现发作性睡病1例分析

2009年我们在对军事飞行员进行年度体检中发现发作性睡病（Narcolepsy）1例，分析如下。     

JAK/STAT信号转导通路在IGF-1抑制左旋多巴诱导的多巴胺能神经元凋亡中的作用

目的 探讨胰岛素样生长因子1(IGF-1)通过JAK/STAT信号转导通路对左旋多巴诱导的多巴胺能神经元凋亡的保护作用.方法 应用100μg/L β神经生长因子(β-NGF)将体外常规培养的PC12细胞诱导分化为多巴胺能神经元.MTT比色法筛选左旋多巴的神经损伤浓度和IGF-1的神经保护浓度(150μmol/L、100nmol/L),实验分为4组:(1)左旋多巴+IGF-1组;(2)左旋多巴+IGF-1+AG490组,AG490(10 μmol/L)在给予左旋多巴和IGF-1前20 min加人;(3)左旋多巴组;(4)对照组.Western blotting检测4组细胞P-JAK2、P-STAT3蛋白表达,Hoechst33258染色和流式细胞仪分别检测细胞凋亡和凋亡率.结果 Westen blotting法检测显示对照组和左旋多巴组P-JAK2、P-STAT3蛋白表达阴性,而左旋多巴+IGF-1组和左旋多巴+IGF-1+AG490组表达阳性.左旋多巴+IGF.1+AG490组P.JAK2、P.STAT3表达强度低于左旋多巴+IGF.1组,差异有统计学意义(P<0.05):Hoechst33258染色结果显示左旋多巴组细胞核固缩及碎裂最明显,较多凋亡小体形成,而左旋多巴+IGF-1组与左旋多巴+IGF-1+AG490组仅有少量凋亡小体形成.流式细胞仪检测显示4组多巴胺能神经元凋亡率不同,差异有统计学意义(F=180.991,P=0.000);与对照组比较,另3组细胞凋亡率均增高,差异有统计学意义(P<0.05);其中左旋多巴组细胞凋亡率最高,其次为左旋多巴+IGF-1+AG490组、左旋多巴+IGF-1组.结论 大剂量左旋多巴对多巴胺能神经元具有毒性作用.IGF-1对左旋多巴诱导的神经细胞毒性作用呈保护作用,JAK2/STAT3信号转导通路参与了此过程.

Abstract：

Objective To explore the protective effect of insulin-like growth factor 1 (IGF-1) on apoptosis of dopaminergic neurons induced by L-dopa via JAK/STAT signaling pathway. Methods PC12 cells were induced to differentiate into dopaminergic neurons with 100 μg/L β-NGF; MTT assay was employed to identify the changes in the viability of PC12 cells following L-dopa treatment at 0, 10,20, 50, 100, 150 and 200 μmol/L, and the different concentrations of IGF-1 at 0, 10, 25, 50 and 100 nmol/L with the same concentration of L-dopa (150 μmol/L); Western blotting was used to detect the levels of P-JAK2/P-STAT3 in PC12 cells treated with PBS (controls), L-dopa, L-dopa+IGF-1 and L-dopa+IGF-1+AG490 for 24 h, and then the apoptosis rate was assessed by flow cytometry and Hchest33258 staining. Results Western blotting showed that the expressions of P-JAK2 and P-STAT3 were detected in the L-dopa+IGF-1 and L-dopa+IGF-1+AG490 treatment groups but not in the control group or L-dopa treatment group; the expression of P-STAT3 in the L-dopa+IGF-1+AG490 treatment group was obviously lower than that in the L-dopa+IGF-1 treatment group (P<0.05). Hchest33258 staining indicated that L-dopa treatment group had the most obvious karyopyknosis and karyorrhexis,much more apoptotic bodies than the L-dopa+IGF-1 and L-dopa+IGF-1+AG490 treatment groups. Flow cytometry showed that the apoptosis rate was significantly different among the 4 groups (F=180.991,P=0.000): as compared with the control group, the other 3 groups had a higher apoptosis rate (P<0.05);L-dopa treatment group (38.13 ±2.54 %) enjoyed the highest level, followed by L-dopa+IGF-1 +AG490treatment group (25.60±1.30 %) and L-dopa+IGF-1 treatment group (20.17±1.54 %). Conclusion L-dopa has toxic effect on PC12 cells; IGF-1 could protect the PC12 cells from the neurotoxic effect of L-dopa and JAK2/STAT3 signaling pathway is activated in this procedure.     

JAK/STAT信号转导通路在IGF-1抑制左旋多巴诱导的多巴胺能神经元凋亡中的作用

Objective To explore the protective effect of insulin-like growth factor 1 (IGF-1) on apoptosis of dopaminergic neurons induced by L-dopa via JAK/STAT signaling pathway. Methods PC12 cells were induced to differentiate into dopaminergic neurons with 100 μg/L β-NGF; MTT assay was employed to identify the changes in the viability of PC12 cells following L-dopa treatment at 0, 10,20, 50, 100, 150 and 200 μmol/L, and the different concentrations of IGF-1 at 0, 10, 25, 50 and 100 nmol/L with the same concentration of L-dopa (150 μmol/L); Western blotting was used to detect the levels of P-JAK2/P-STAT3 in PC12 cells treated with PBS (controls), L-dopa, L-dopa+IGF-1 and L-dopa+IGF-1+AG490 for 24 h, and then the apoptosis rate was assessed by flow cytometry and Hchest33258 staining. Results Western blotting showed that the expressions of P-JAK2 and P-STAT3 were detected in the L-dopa+IGF-1 and L-dopa+IGF-1+AG490 treatment groups but not in the control group or L-dopa treatment group; the expression of P-STAT3 in the L-dopa+IGF-1+AG490 treatment group was obviously lower than that in the L-dopa+IGF-1 treatment group (P<0.05). Hchest33258 staining indicated that L-dopa treatment group had the most obvious karyopyknosis and karyorrhexis,much more apoptotic bodies than the L-dopa+IGF-1 and L-dopa+IGF-1+AG490 treatment groups. Flow cytometry showed that the apoptosis rate was significantly different among the 4 groups (F=180.991,P=0.000): as compared with the control group, the other 3 groups had a higher apoptosis rate (P<0.05);L-dopa treatment group (38.13 ±2.54 %) enjoyed the highest level, followed by L-dopa+IGF-1 +AG490treatment group (25.60±1.30 %) and L-dopa+IGF-1 treatment group (20.17±1.54 %). Conclusion L-dopa has toxic effect on PC12 cells; IGF-1 could protect the PC12 cells from the neurotoxic effect of L-dopa and JAK2/STAT3 signaling pathway is activated in this procedure.     

22例颅内静脉窦血栓形成临床分析

目的 加深对脑静脉血栓形成的认识、提高诊疗水平.方法 回顾性分析南方医科大学附属珠江医院22例脑静脉血栓形成病例的年龄、病因、临床症状、实验室及影像学资料、治疗方法.结果 22例患者中,男:女比例1:1;年龄自16岁到61岁;临床症状以头痛最为常见,可伴发呕吐、视乳头水肿、癫痫、肢体偏瘫、语言障碍、动眼神经麻痹等局灶性神经功能损害及意识障碍;影像学检查可采用MRV/DSA/CTV,血栓累及侧窦、上矢状窦最常见,且常合并累及多个静脉/静脉窦;经抗凝、降颅压、对症等治疗,有 20例症状缓解,复查提示原来血栓形成的静脉/静脉窦不同程度的再通; 2例病情加重,其中1例死亡.结论 颅内静脉窦血栓形成病因多种,发病形式多样,临床表现无特异性,随着磁共振MRV、CTA、DSA的应用,脑静脉血栓形成的诊断已不是难题,且治疗效果较好;另外神经介入治疗值得关注与期待.