心肺复苏早期应用大剂量肾上腺素的临床研究

探讨了心肺复苏（ＣＰＲ）早期应用大剂量肾上腺素（ＨＤＦ）对动脉压及临床效果的影响。将６２例心骤停（ＣＡ）患者根据ＨＤＦ用法分为早期组和非早期组进行抢救，于肾上腺素（Ｅ）首剂量后对两组各５例患者行动脉压测定。结果显示，ＣＰＲ成功率、出院存活率、主动脉舒张压和收缩压早期组明显高于非早期组（Ｐ〈０．０１，Ｐ〈０．０５）。证明早期应用ＨＤＦ具有临床价值。     

Study to track benefits of compliance intervention

The main reason people fail their HIV treatment is lack of adherence to their prescribed regimen. Judith A. Erlen of the University of Pittsburgh School of Nursing will conduct a study on how habit training, problem solving, and intervention can affect patient adherence to protease inhibitor therapy. The study will be conducted via telephone for 12 weeks followed by a 12-week maintenance program. The subjects will then be followed for an additional 6 months. The study will examine two different outcomes of adherence: clinical measures and quality of life.     

Genetic Approaches to the Study of Aging

Can mouse genetics teach us enough about the biology of aging to guide the search for anti-aging medicines that can delay late-life illness? Recent progress gives reason for optimism, with new data showing that changes in single genes can extend average and maximal life span by 40%. Mice with these genetic variants remain healthy, active, and cognitively intact at average ages that correspond to 110–120 years of human life span. Multiple lines of evidence now point to a hormone, IGF-I, as a key influence on life span, with low IGF-I levels associated with extended longevity in multiple model systems. The goal of this research is not gene therapy—we have no idea of what genes to change, how to change them, or what harm such changes might do—but instead to use insights from the cell biology and endocrinology of genetically long-lived mice and other species to help develop drugs that manipulate aging and thus postpone the many diseases and disabilities that are typically troublesome in old age. The complete conquest of cancer or heart disease would each lead to an increase of a mere∼3% in mean life span in humans, i.e. about a tenth of what can be accomplished, today, in laboratory animals of delayed aging. In this context the paltry commitment to research in biological gerontology (six cents per $100 of NIH funding, for example) seems worth reconsideration.     

类艾滋病病毒单克隆抗体的研究

本文采用类艾滋病病毒(SAIDV)D型抗原免疫BALB/C小鼠,取其脾细胞与小鼠骨髓瘤细胞SP2/0在40％PEG作用下进行细胞融合,杂交瘤细胞经HAT筛选,用ELISA法检测阳性抗体,经3次克隆和3个月的传代及液氮保存试验,获得一株能分泌抗SAIDV的单克隆抗体的淋巴细胞杂交瘤,编号为WA-B_1,其腹水滴度为1:1×10~(-6),经蛋白亚类测定为IgG2a,能被特异性抗SAIDV血清所阻断,证明该单克隆抗体具有抗SAID病毒的特异性,为此作为第一个建立抗SAIDV(D)型单克隆抗体杂交瘤细胞株而闻世。     

加强肝细胞对乙型肝炎病毒调节作用机制的研究

乙型肝炎病毒 (HBV)DNA的克隆化是 1 979年完成的 ,这在当时分子生物学理论和技术还不是十分成熟的年代显得难能可贵。HBVDNA克隆化完成以后 ,将HBVDNA序列分成了 4段编码区、4段启动子区、2段增强子区、顺向重复序列DR1、DR2 ,还有糖皮质激素应答元件等[1] 。 2 0 0 3年 ,董菁     

不典型风湿活动临床表现的研究

目的：探讨风湿性心脏病不典型风湿活动的临床表现,以指导治疗和判断预后。方法：选择风湿性心脏病伴风湿活动患者60例,分析其临床表现、辅助检查和实验室检查情况。结果：风湿性心脏病不典型风湿活动临床表现以心悸（58％）、气促（67％）、心动过速（75％）和第一心音减弱（55％）为主．心脏超声心动图表现为心脏增大（43％）和瓣口返流（17％）。实验室检查外周血淋巴细胞促凝血活性（PCA）和抗链球菌多糖抗体（ASP）阳性率较高（分别为75％,72％）。结论：对不典型风湿活动病例,应综合分析其临床表现、辅助检查和实验室结果．力求较准确地判断出风湿活动性。     

免疫酶斑点技术应用于布鲁氏菌病诊断的研究

本研究应用免疫酶斑点试验（ＤＩＢＡ），是酶联免疫吸附试验衍生的新技术，经过３１３份皮内变态反应阳性者血清（及部分全血）和４７份健康者血清，与布鲁氏菌病常规血清学诊断方法相比较，用流行病学和成本一经济效益分析对ＤＩＢＡ进行综合分析，结果表明：ＤＩＢＡ在布病实验室诊断方法上有较高的实用价值。其灵敏度、特异度均高于其他方法（分别为２１％、９５％），并可用微量全血替代肘静脉血作为检测样品，稳定性强，与耶尔     

Reply to “Study of Early Chronic Pancreatitis Needs to be Improved”

Journal of Gastroenterology -     

New Opportunities to Study Real-World Patient Management

Measurements of faecal fat in a group of patients with chronic liver disease have shown that steatorrhoea is common. The steatorrhoea appears related to the severity of the liver dysfunction, and it is suggested that this may be related to abnormalities of bile salt production. Steatorrhoea should be considered in the explanation of the malnutrition occurring in patients with chronic liver disease.     

幽门螺杆菌对左氧氟沙星耐药的研究

背景：耐药菌株的出现是近年来药物根除幽门螺杆菌（H．pflori）成功率下降的主要原因，尤其是对常用抗生素克拉霉素和甲硝唑耐药。左氧氟沙星是一个新近用于根除H．pylori的抗生素，含左氧氟沙星的方案是有效的补救方案，但关于左氧氟沙星的耐药率以及耐药机制目前知之甚少。目的：监测H．pylori对左氧氟沙星的耐药率，观察耐药倾向．探讨可能的耐药机制。方法：对2003年在仁济医院内镜中心行胃镜检查的连续26株临床菌株行左氧氟沙星、克拉霉素和甲硝唑敏感性试验；选取8株敏感株（2株标准菌株）行左氧氟沙星体外选择耐药试验；以修饰内切酶位点的指定引物人工将Hinf Ⅰ酶切位点引入左氧氟沙星耐药菌株（体外人工选择分离株和临床株）的聚合酶链反应（PCR）产物．然后以Hinf Ⅰ行酶切以鉴别gyrA基因91位密码子是否存在突变。结果：左氧氟沙星的耐药率为3．8％（1/26），2株对克拉霉素耐药的菌株均对左氧氟沙星敏感。体外选择耐药试验的8株菌株中有5株选择分离出耐药菌株，但均为低度耐药菌株。4株体外人工选择分离耐药菌株均为gyrA基因喹诺酮耐药决定区域（QRDR）中编码Asp91的密码子突变，5株临床耐药株中有4株为91位密码子突变。结论：目前Mpylori对左氧氟沙星的耐药率低．左氧氟沙星是较好的根除H．pylori方案的可选药物之一。由于体外试验较易选择出耐药，因此需监测左氧氟沙星的耐药率。gvrA基因0RDR中编码91位Asp的密码子突变在左氧氟沙星的耐药机制中占主导地位。     

重视自身免疫性胰腺炎的临床研究

自身免疫性胰腺炎(autoimmune pancreatitis,AIP)是由自身免疫介导,以胰腺肿大、胰管不规则狭窄为特征的一种特殊类型的慢性胰腺炎(CP).虽然AIP已作为CP的独立分型之一[1],但目前国内尚无符合AIP诊断标准的病例报道.徐欣萍等[2]于1996年报道1例中年男性被诊断为CP 1年后患干燥综合征(sjogren's syndrome,SS);2004年唐令诠等[3]报道1例AIP患者经泼尼松治疗后好转,但该病例无主胰管不规则狭窄的证据.我国的AIP发病率是否真的如此低呢?这很可能与医师对AIP认识不足导致漏诊有关,正如韩国于2002年才发现首例AIP,但此后不到两年就有30余例AIP的报道[4].约半数AIP表现为局限性肿块,而局限性AIP是最常见的因疑诊为胰腺癌而行外科手术的良性病变[5],占所有胰腺切除术的2.2%～2.5%[6～9].由于激素治疗AIP的疗效好,提高对AIP的诊断率可以减少不必要的手术.因此,应重视AIP的临床研究以提高我国临床医师对AIP的认识.