消毒供应室人员职业损伤因素分析与防护对策

目的分析消毒供应室人员存在的职业损伤并探讨其防护对策。方法回顾总结我院消毒供应室人员2008年1月至2010年9月期间发生的职业损伤。结果共发生145起职业损伤,其中物理性损害最为多见,占55．9％。化学性损害次之,占25．5％。其余分别为生物性损害（14．5％）,工种相关性损害（4．1咖。物理性损害中以皮肤划伤,割伤、刺伤最为多见,占75．3％（61/81）,其次为烧烫伤。化学性损害以消毒剂引起的皮肤损害曩为多见。结论针对各危害因素进行针对性防护,能有效减少职业危害,为工作人员身体健康提供保障。     

前列腺增生患者下尿路功能评估的意义

目的 探讨前列腺增生症(Benign Prostatic Hypertrophy,BPH)患者排尿功能改变方法 应用国际前列腺症状(International Prostate Symptom Score,I-PSS)评分表、生活质量指数(Quality of Lift,QOL)评分表,结合尿动力学技术,检查1029例BPH患者的自由尿流率、测定剩余尿量、膀胱充盈期和排尿期压力、膀胱感觉,评估膀胱的稳定性、顺应性及逼尿肌功能.结果 1029例患者中最大尿流率(9.3±5.8)ml/s,膀胱顺应性下降87例(占8.5%);逼尿肌收缩无力43例(占4.2%),不稳定膀胱(DI)762例(占74.1%),膀胱出口梗阻(BOO)841例(占81.7%),膀胱出口梗阻可疑117例(占11.3%),膀胱出口无梗阻者81例(占7.8%),表明BPH可引起膀胱下尿路功能变化.结论尿动力学对判断下尿路功能状况,确定排尿功能障碍原因、选择药物治疗或手术适应证有重要意义.     

携带超抗原SEA基因的白蛋白纳米载体的构建及其治疗膀胱癌潜能研究

目的 构建一种非病毒载体基因投递系统-携带超抗原葡萄球菌肠毒素A(SEA)基因的白蛋白纳米载体,观察白蛋白纳米粒表征并探讨其潜在的靶向基因投递作用和强大的抗瘤机制.方法 采用去溶剂化法制备白蛋白纳米粒,平均粒径(253.1±11.9)nm,Zeta电位(-34.0±4.5)mV,PDI 0.43±0.04;抽提SEA基因质粒(pSEA)260/280:1.84±0.02,pSEA浓度:(85.54±1.43)mg/L;经生物活性及基因测序鉴定后耦合SEA基因质粒和白蛋白纳米载体,并观察耦合物的稳定性及白蛋白纳米载体对SEA基因的保护作用.结果 成功构建携带超抗原SFA基因的白蛋白纳米载体,平均粒径(118.9±4.8)nm,Zeta电位(-43.9±10.5)mV,PDI 0.19±0.02,基因转载率为(97.61±0.06)%,性质稳定、分散性较好,体外实验表明白蛋白纳米载体能保护SEA基因免受DNase Ⅰ的降解.结论 获得符合超抗原SEA基因转染要求的白蛋白纳米载体.

Abstract：

Objective To assess the characteristics of human serum albumin nanoparticles (HSA-NP) as a nonviral vector system for delivery staphylococcal enterotoxin A (SEA) gene and probe into its potential targeted antitumor mechanism.Methods HSA-NP and plasmid containing SEA gene (pSEA)encapsulated in HSA (pSEA-HSA-NP) were prepared by a desolvation-crosslinking method.HSA-NP had a mean size of (253.1 ± 11.9) nm,zeta potential of ( -34.0 ±4.5) mV,polydispersity index of 0.43 ±0.04.The superantigen SEA gene was extracted by the Endo-Free Plasmid Maxi Kit,260/280 of pSEA was 1.84 ±0.02 and the concentration of pSEA was ( 85.54 ± 1.43 ) mg/L.pSEA was verified by sequencing and biological activity survey,the stability of pSEA-HSA-NP was investigated by laying for 10 days at room temperature,and the size and zeta potential were remeasured and contrasted with the samples 10 days before.HSA-NP protecting pSEA from degradation of DNase I was detected by gel electrophoresis.Results Electrophoretic mobility analysis and fluorescent labeling revealed that pSEA-HSA-NP was successfully constructed.PSEA-HSA-NP had a mean size of ( 118.9 ±4.8) nm,zeta potential of ( -43.9 ± 10.5 ) mV,polydispersity index of 0.19 ±0.02 and pSEA encapsulation efficiency of (97.61 ±0.06)%.The characteristics of pSEA-HSA-NP solution laying for 10 days at room temperature indicated a better stability and polydispersity.HSA-NP stabilizing pSEA against DNase I in vitro was also testified by gel electrophoresis.Conclusion pPSEA-HSA-NP served the transfecting needs of superantigen SEA gene.     

后腹腔镜肾上腺切除术的临床分析

目的探讨后腹腔镜切除肾上腺病变的手术方法和效果。方法对23例肾上腺病变患者行后腹腔镜肾上腺切除术。经腰部置入3个Trocar,手指法建立后腹膜气腹,建立腹膜后操作通道。游离出病变肾上腺达中央静脉后以钛夹夹闭后切断,将切除的肾上腺置入标本袋后取出。结果本组除2例改为开放手术外均获得成功,手术时间55～300min,平均70min。术中出血10～100ml,平均30ml,所有病例均未输血。2例中转开放手术,均为腹膜破裂致后腹腔显露困难所致。无大出血、感染、腹腔脏器损伤等并发症发生。随访1～24个月,平均8个月,未发现肿瘤复发和转移。结论后腹腔镜肾上腺切除术是治疗肾上腺疾病的一种微创、安全、有效的手术方式。     

磷酸化肌球蛋白轻链在大鼠慢性移植肾肾病早期病变中的作用及其机制

目的 探讨磷酸化肌球蛋白轻链(pMLC)在慢性移植肾肾病(CAN)中的作用与机制.方法 依照标准的CAN大鼠模型进行左肾原位移植,受者为LEW大鼠,供者为F344大鼠,另取雄性F344大鼠和LEW大鼠仅行单肾切除术,分别作为对照.分别于术后4、8及12周时,收集各组大鼠的24 h尿量,并检测其尿肌酐水平,计算肌酐清除率.然后取各组大鼠血液标本,测定血清肌酐水平.采用Banff分级标准评定各组肾小球肾病、肾小管萎缩、间质纤维化及血管内膜增厚程度.采用免疫组织化学法和采用蛋白质印迹法检测肾组织中磷酸化MLC(pMLC)和整合素连接激酶(ILK)的表达部位及表达水平.结果 移植组大鼠术后4周时肾间质可见单个核细胞浸润,12周时可见血管平滑肌细胞的移行与增殖.移植组大鼠各时相肾组织pMLC和ILK表达水平显著高于Lewis对照组及F344对照组,且随着移植时间的延长有逐渐增高趋势.大鼠移植肾组织中pMLC表达水平与24 h尿蛋白定量、血清肌酐水平、肾间质单个核细胞浸润、肾小动脉血管平滑肌细胞数量、Banff评分等呈显著正相关,相关系数(r)分别为0.273(P＜0.05)、0.434(P＜0.01)、0.525(P＜0.01)、0.676(P＜0.01)、0.570(P＜0.01),在移植后4周时,pMLC表达水平与肾小管间质ILK表达水平呈显著正相关,r=0.778(P＜0.01).结论 pMLC在慢性移植肾病早期病理变化中发挥重要作用,移植肾肾小管间质及肾小动脉中pMLC表达上调与ILK的作用机制相关.

Abstract：

Objective To investigate the role and mechanism of phosphate myosin light chain (pMLC) in the rat kidney of chronic allograft nephropathy (CAN) model. Methods The left donor kidneys from Fisher (F344) rats were orthotopically transplanted into Lewis recipients. Meanwhile, the F344 rats and LEW rats with resection of the right kidney served as control groups. Animals were harvested respectively at the 4th, 8th and 12th week after transplantation. The creatinine clearance rate (CCr) was calculated by urine creatinine of 24-h urine. Blood samples were collected from rats for determination of serum creatinine. The expression of pMLC was detected by using Western blotting and immunohistochernistry, and that of integrin-linked kinase (ILK) by using immunohistochemistry. Results Mononuclear cells infiltration of allografts was markedly aggravated as compared to the controls. Allografts got severe interstitial fibrosis and tubular atrophy at 12th week after transplantation. The expression of pMILC and ILK was up-regulated in the kidney of CAN rats after transplantation, and increased more significantly as the time went on. The expression of pMILC was significantly correlated with 24-h urine protein excretion (r= 0. 273, P＜0. 05), serum creatinine levels (r = 0. 434, P＜0. 01 ), the number of tubulointerstitial infiltrated mononuclear cells (r = 0. 525, P＜0. 01 ), the number of smooth muscle cells (SMC) in vascular wall (r= 0. 676, P＜0. 01 ) and the extent of interstitial fibrosis (r= 0. 570, P＜0. 01 ).There was a significantly positive correlation between ILK and pMLC in CAN rats at the 4th week after transplantation (r= 0. 778, P＜0. 01 ). Conclusion pMLC might play an key role in CAN, and the over-expression of ILK might be involve in the pathogenesis of CAN.     

吸烟,高镉与尿石形成的关系

为进一步研究吸烟、高镉与尿石形成的关系,选用20只Wistar雄性大鼠,在膀胱内植入直径4mm的圆形金属锌片,后将动物随机分成实验组及对照组。两组均同时饮用1％乙二醇水,实验组每周吸烟5次,持续4周。实验前后测定大鼠24小时尿草酸、钙、磷、镉、β2-微球蛋白排泄量,用分级法评价结石形成及肾损伤程度,膀胱结石称其干重。结果显示吸烟组动物结石发生率高于对照组（P<0.01）,24小时尿草酸、钙、磷、镉和β2-微球蛋白排泄量显著高于实验前及对照组（P<0.01）,膀胱结石的体积、数目亦较对照组增加（P<0.01）。表明镉增高可促进泌尿系结石的形成。     

前列腺特异性抗原检测在前列腺癌诊断中的作用

目的探讨前列腺癌集团检诊对临床前列腺癌诊断的影响。方法门诊检查40岁以上男性患者前列腺特异性抗原(PSA)共计400例,活检筛查出前列腺癌病例数,将患者分组进行比较。分别分为前列腺癌组(PCa组),前列腺增生组(BPH组),其他疾病组(对照组)。3组患者采用酶联免疫分析方法(ELISA)检测TPSA,FPSA,FPSA/TPSA和PSAD值分别进行组间对比分析。结果PSA界限值定为4ng/ml时,其诊断前列腺癌的敏感度为90.0%,特异度为53.3%,准确度为68.0%;PSA界限值定为10ng/ml时,敏感度为80.0%,特异度为83.3%,准确度为82.0%。用PSAD诊断前列腺癌,敏感度为85.0%,特异度为86.7%,准确度为86.0%。BPH组与PCa组的FPSA,TPSA水平均明显高于对照组(P<0.01);PCa癌组的FPSA/TPSA值明显小于对照组及前列腺增生组(P<0.01);PCa组PSAD明显大于对照组和BPH组(P<0.01)。结论将PSA与PSAD结合使用,可提高特异度和敏感度。检测FPSA/TPSA和PSAD比单一检测FPSA,TPSA可显著提高对PCa诊断的特异性及符合率,对前列腺体积较大的BPH和PCa患者,检测PSAD更有意义。集团检诊可以真正揭示国人前列腺癌的发病现状,可明显增加临床前列腺癌特别是早期癌的诊断例数,是实现前列腺癌早期诊断与治疗的最佳途径。     

男性膀胱癌患者血清性激素水平的检测

目的　探讨性激素在膀胱癌发病中的意义。方法 :采用放射免疫法检测 31例男性膀胱癌患者及 2 7例同年龄正常人对照组血清中的雌二醇 (EstradiolE2 )、孕酮 (ProgesteroneP)及睾酮 (TestosteroneT)水平。结果 :男性膀胱癌患者血清E2 、P、T分别为 44.98± 2 0 .96pg ml( x±s) ,0 .37± 0 .18ng ml( x±s) ,6 .2 5± 2 .37ng ml( x±s) ,而正常对照组E2 、P、T分别为 5 6 .0 1± 13.5 0pg ml( x±s) ,1.14± 0 .37ng ml( x±s) ,5 .15± 1.37ng ml( x±s) ,两者比较膀胱癌组T明显高于对照组 (P <0 .0 5 ) ;而E2 、P明显低于对照组 (P <0 .0 5 )。结论 :膀胱癌的发生可能与性激素代谢失衡有一定的关系