Inner ear changes in fetal asphyxia

Deafness following complications of pregnancy and obstetrics occurs frequently. The temporal bones of stillborn or neonates who died several days after delivery have often been examined, and haemorrhage and serous labyrinthitis have been found in infections, diabetes and trauma. In this study, pathological findings in the temporal bones of foetuses who died of chronic asphyxia in utero are described. 7 out of 15 cases had no labyrinthine pathology. Four had haemorrhage into the tissue or into perilymphatic or endolymphatic spaces. Likewise, four had developed eosinophilic precipitates in the liquid spaces of the inner ear. If the foetus survives such phases of hypoxia in utero, this might be the morphological correlate of developing deafness. Similar findings in infections such as rubella or cytomegalovirus infection are discussed.     

Central and regional vascular hemodynamics following intravenous milrinone in the conscious rat: comparison with dobutamine

This study examined the hemodynamic and regional vascular profile of intravenous (i.v.) milrinone during increasing doses (3, 6, 12 micrograms/kg/min, n = 8) and by intraindividual comparison of milrinone and dobutamine (n = 10) in normal conscious rats. At 3 micrograms/kg/min, Milrinone increased coronary and cerebral blood flow (radioactive microspheres 15 +/- 5 microns) (7.7-9.8 and 1.05-1.27 ml/min/g respectively, both p less than 0.05) without significant changes in systemic hemodynamics. At 6 micrograms/kg/min milrinone increased skeletal muscle blood flow (0.19-0.24 ml/min/g, p less than 0.05) along with increases in cardiac output, stroke volume, and stroke work (all p less than 0.05), while systemic vascular resistance decreased (-51%, p less than 0.05). When compared with dobutamine, milrinone caused a greater increase in cardiac output (+26% vs. +17%) and a greater reduction in systemic vascular resistance. Milrinone and dobutamine increased renal, intestinal, cerebral, and coronary flow to a similar extent, but only milrinone enhanced hepatic arterial blood flow (+26%, p less than 0.05) and tended to increase flow to skeletal muscle (+35%, p = 0.07). We conclude that milrinone exerts significant regional vasodilating effects in a conscious rat model, being most prominent in the coronary and cerebral circulations at a dosage that does not alter central hemodynamics. At higher doses, milrinone causes a balanced increase in regional blood flow including enhanced flow to skeletal muscle. The hemodynamic (particularly as compared with dobutamine) and regional vascular profile of milrinone suggests a predominant vasodilating effect in the rat. Given a similar limited response of rat and diseased human myocardium to milrinone, these findings may have important clinical implications.     

针刺控制人工流产反应的效果研究

将妊娠时间在 40～ 70天之间孕妇 70例 ,随机分为针刺组、安慰针 1组、安慰针 2组、空白组及栓剂组。针刺及安慰针组采用单盲法。结果显示针刺组的疗效最好 ,对手术中临床表现、下腹疼痛及揪拽酸坠感的疗效 ,针刺组明显优于空白组和安慰针组 ;安慰针 1组和安慰针 2组术中下腹部揪拽酸坠感均明显轻于空白组。表明针刺合谷、三阴交两穴具有镇痛、减少人工流产反应的作用 ,在针刺的临床研究中设立安慰针作为对照是必要的。     

人类男性Y染色体变异对男性生育力影响的临床分析

目的:探讨Y染色体异常对男性生育能力的影响。方法:对因不育而就诊的4 238例男性患者进行G显带核型分析。结果:共检出Y染色体异常核型550例,占全部被检者12．98％,其中大Y 染色体异常497例;小Y染色体21例;倒位染色体13例;缺失Y染色体12例;47,XYY 4例;45,XO／ 46,XY嵌合体3例;48,XXYY 1例;环状Y染色体1例;Y染色体的平衡易位46,X,t(Y;17)(q12; q25)1例、46,X,t(Y;3)(q11;p11)1例、46,X,t(Y;14)(q12;q22)1例和1例46,X,t(Y;15) (p11;q13)。结论:Y染色体数目与形态结构的异常对男性生育能力有重要影响。     

Unterscheidung der Echten Paratyphus-B-Von den Breslau-Enteritisbakterien auf Ammonchlorid-Rhamnose-Agar

Zusammenfassung Ammonchlorid als alleinige Stickstoff- und Rhamnose als alleinige Kohlenstoffquelle ermöglichen den Breslaubakterien zu wachsen, Schottmüller- und Gärtnerbakterien dagegen nicht. Das Entstehen oder Nichtentstehen der Kolonien auf Ammonchlorid-Rhamnose-Agar nach 2 Tagen Brutschrankaufenthalt ist ein deutliches Unterscheidungsmerkmal für die Differenzierung dieser nahe verwandten Bakterienarten.     

住院电子病历系统实施及应用中若干管理问题的探讨

论述了住院电子病历系统建设过程中所面临的若干管理问题,强调了在进行电子病历总体功能设计时既要满足临床工作需求,也要兼顾医院管理需求。提出了在电子病历项目实施过程中所应考虑到的项目管理问题及解决方法。同时提出了电子病历系统不仅仅为技术解决方案,还要在其建设过程中着重解决与疾病诊断、病历质控、用户权限管理等多方面的病历内涵建设。     

头孢硫咪体外抗菌活性测定

目的：评价第一代头孢菌素头孢硫脒对近期从临床分离的致病菌的体外抗菌活性。方法：用对倍稀释法测定头孢硫咪的最小抑菌浓度（ＭＩＣ）并与头孢唑啉、头孢呋辛、头孢他啶体外抗菌活性进行了对比。结果：头孢硫脒对肺炎球菌、化脓性链球菌、ＭＳＳＡ、ＭＳＳＥ和卡他布汉氏菌有较强的抗菌活性。结论：头孢硫脒对Ｇ^＋球菌有较强的抑菌活性和杀菌活性,对肠球菌亦显示有很强的体外抗菌活性。     

Ephrin-B2 controls PDGFRβ internalization and signaling

B-class ephrins, ligands for EphB receptor tyrosine kinases, are critical regulators of growth and patterning processes in many organs and species. In the endothelium of the developing vasculature, ephrin-B2 controls endothelial sprouting and proliferation, which has been linked to vascular endothelial growth factor (VEGF) receptor endocytosis and signaling. Ephrin-B2 also has essential roles in supporting mural cells (namely, pericytes and vascular smooth muscle cells [VSMCs]), but the underlying mechanism is not understood. Here, we show that ephrin-B2 controls platelet-derived growth factor receptor β (PDGFRβ) distribution in the VSMC plasma membrane, endocytosis, and signaling in a fashion that is highly distinct from its role in the endothelium. Absence of ephrin-B2 in cultured VSMCs led to the redistribution of PDGFRβ from caveolin-positive to clathrin-associated membrane fractions, enhanced PDGF-B-induced PDGFRβ internalization, and augmented downstream mitogen-activated protein (MAP) kinase and c-Jun N-terminal kinase (JNK) activation but impaired Tiam1–Rac1 signaling and proliferation. Accordingly, mutant mice lacking ephrin-B2 expression in vascular smooth muscle developed vessel wall defects and aortic aneurysms, which were associated with impaired Tiam1 expression and excessive activation of MAP kinase and JNK. Our results establish that ephrin-B2 is an important regulator of PDGFRβ endocytosis and thereby acts as a molecular switch controlling the downstream signaling activity of this receptor in mural cells.     

抑郁症的非药物治疗现状

抑郁症是一种发病率、复发率、致残率及致死率均较高的严重精神疾患。药物治疗抑郁症可以有效改善患者的临床症状,但起效滞后,且存在不良反应,从而影响了患者的治疗依从性。非药物治疗研究的不断发展为抑郁症的治疗开辟了新的有效途径。本文对抑郁症非药物治疗的研究现状进行了回顾与总结,了解非药物治疗的方法及优势,便于临床工作中尽快给予全面抗抑郁治疗,以提高临床缓解率。     

中国MSM中HIV原发耐药的Meta分析

目的了解中国男男性行为人群(MSM)中艾滋病病毒(HIV)原发耐药水平。方法检索5个数据(万方、CNKI、VIP、CBM及Pubmed)并提取HIV耐药的原始数据,根据异质性检验结果,选择模型对原始数据进行合并分析。结果共纳入28个研究。中国MSM未治疗HIV感染者总耐药率、蛋白酶抑制剂(PI)耐药率、核苷类反转录酶抑制剂(NRTI)耐药率、非核苷类反转录酶抑制剂(NNRTI)耐药率分别为3.59%[95%可信区间(CI):2.40%~4.96%]、1.69%(95%CI:0.74%~2.90%)、0.52%(95%CI:0.14%~1.05%)、0.54%(95%CI:0.16%~1.08%)。总耐药率及PI耐药率存在地区差异,华北、东北、华东地区耐药率更高些。结论当前中国MSM的HIV感染者原发耐药水平低,抗病毒治疗政策实际且可行。但是在一些高发地区,更需加强监测,以便提供最优治疗方案。