对围绝经期妇女激素补充治疗的认知度调查

目的探讨医护人员和妇女主任对激素补充治疗(HRT)的知晓率及培训需求情况。方法采用自行设计的调查问卷,对桐乡市医护人员和妇女主任进行问卷调查,调查表的主要内容分为一般情况、对HRT的利弊认知度、推荐与否、培训需求等方面。结果共调查医护人员430人、妇女主任206人,两组人员在平均年龄、工作年限、文化程度等基本特征方面无统计学差异。68.9%的妇女主任认为围绝经期妇女有必要应用HRT,明显高于医护人员。只有8.6%的医护人员表示一定会推荐患者使用HRT,明显低于妇女主任。医护人员不推荐使用HRT的原因主要是对副作用的担心。医务人员组更倾向于从相关书籍、期刊获得信息,而妇女主任组更倾向于从医生及媒体获得相关信息。结论桐乡市部分医护人员对HRT的相关知识了解不够,担心HRT发生不良反应,HRT的推荐率低。医护人员和妇女主任在HRT的认知上存在差异。针对不同人群,开展形式多样的HRT知识宣教及培养妇女主任成为HRT知识的传播者是提高HRT应用的关键措施。     

Nardostachys jatamansi extract protects against cytokine-induced β-cell damage and streptozotocin-induced diabetes

AIM: To investigate the anti-diabetogenic mechanism of Nardostachys jatamansi extract (NJE). METHODS: Mice were injected with streptozotocin viaa tail vein to induce diabetes. Rat insulinoma RINm5F cells and isolated rat islets were treated with interleukin1β and interferon-γ to induce cytotoxicity. RESULTS: Treatment of mice with streptozotocin resulted in hyperglycemia and hypoinsulinemia, which was conf irmed by immunohistochemical staining of the islets. The diabetogenic effects of streptozotocin were c...     

A Case of Primary Cutaneous Mucinous Carcinoma with Neuroendocrine Differentiation

Primary cutaneous mucinous carcinoma is a rare malignant tumor that originates from the deepest portion of the eccrine sweat duct. Common sites of involvement are the face and scalp. Biopsy shows dermal epithelial cell islands embedded in mucin pools separated by fibrous septae. It is difficult to differentiate this tumor histologically from metastatic adenocarcinoma. Recurrence after excision is common but metastases are rare. We report a primary cutaneous mucinous carcinoma with neuroendocrine differentiation on the right cheek of a 63-year-old man.     

Role of Aggregatibacter actinomycetemcomitans in glutathione catabolism

Introduction:  Our previous studies demonstrated that three enzymes, γ-glutamyltransferase (GGT), cysteinylglycinase (CGase) and cystalysin, are required for the catabolism of glutathione to produce hydrogen sulfide (H₂S) in Treponema denticola . In this study, we examined glutathione catabolism in Aggregatibacter actinomycetemcomitans .
Methods:  The GGT and CGase of A. actinomycetemcomitans were determined by biological methods and GGT was characterized using a molecular biological approach.
Results:  A. actinomycetemcomitans showed GGT and CGase activity, but could not produce H₂S from glutathione. The addition of recombinant T. denticola cystalysin, an l -cysteine desulfhydrase, to whole cells of A. actinomycetemcomitans resulted in the production of H₂S from glutathione. Subsequently, we cloned A. actinomycetemcomitans GGT gene ( ggt ) and overexpressed the 63 kDa GGT protein. The recombinant A. actinomycetemcomitans GGT was purified and identified. The K _cat/ K _m of the recombinant GGT from N -γ- l -glutamyl-4-nitroaniline as substrate was 31/μ m /min. The activity of GGT was optimum at pH 6.9–7.1 and enhanced by thiol-containing compounds.
Conclusion:  The results demonstrated that A. actinomycetemcomitans had GGT and CGase activities and that the GGT was characterized. The possible role of A. actinomycetemcomitans in glutathione metabolism and H₂S production from oral bacteria was discussed.     

糖尿病病人胰岛素泵应用及相关知识调查

[目的]探讨糖尿病病人应用胰岛素泵强化治疗的相关知识及需求情况.[方法]采用自行设计的问卷调查表,对60例糖尿病胰岛素泵强化治疗病人进行调查.[结果]病人对胰岛素泵了解甚少,相关知识缺乏,希望接受胰岛素泵知识教育.[结论]胰岛素泵应用现状存在较多问题,影响病人血糖的良好控制,应提高病人对胰岛素泵的认可程度和依从性,提高生活质量.     

Is the early cyclosporine A level predictive of the outcome of immunosuppressive therapy in severe aplastic anemia?

Immunosuppressive therapy (IST) has provided an alternative treatment option for cure of aplastic anemia patients who cannot receive bone marrow transplantation. Although there have been many recent studies on the efficacy of antithymoglobulin (ATG) combined with cyclosporine A (CsA), there is no data on the correlation between the variability of CsA levels and the response to IST. Therefore, we retrospectively assessed the factors associated with IST efficacy in patients with acquired severe aplastic anemia (SAA). Sixty‐six patients were treated with ATG combined with CsA for 6 months. In the response group, the CsA levels were increased rapidly to more than 200 ng/mL within the first 2 wk after starting the IST. However, the non‐response group had a pattern of slower increase of the CsA levels. The CsA levels, during the first and second week of treatment with IST, were significantly different in the responders and non‐responders. The factors predictive of response to IST and survival were analyzed. The univariate analysis showed that a younger age at the initiation of IST, a high absolute neutrophil count prior to starting IST, a short interval between the diagnosis and initiation of IST, and high CsA levels during the first and second week of IST treatment were positively associated with the response rate and overall survival. The multivariate analysis showed that these four factors were independent factors associated with a longer patient survival. A high response rate was associated with a short interval between diagnosis and initiation of IST as well as high CsA levels during the first and second week of IST. Therefore, early intensification of CsA levels might improve patient outcome.     

江西省山丘型血吸虫病传播控制地区野生动物血吸虫感染调查

目的　掌握江西省山丘型血吸虫病传播控制地区野生动物血吸虫感染情况，为实施精准防控措施及实现血吸虫病传播阻断和消除目标提供科学依据。方法　选择江西省血吸虫病疫情较重的山丘型流行区瑞昌市和彭泽县的5个流行村作为调查村。在调查村有螺环境捕捉野鼠等野生动物，收集来自调查村的野生动物肝脏，检查其血吸虫感染情况。在调查村采用间接血凝试验（IHA）筛查、粪便尼龙绢袋集卵孵化法和改良加藤厚涂片法检测人群血吸虫感染，采用粪便塑料杯顶管孵化法检测家畜血吸虫感染；采用系统抽样结合环境抽查法调查钉螺分布，采用环介导等温扩增技术（LAMP）检测钉螺血吸虫感染。结果　在调查村捕获、收购野鼠、黄鼠狼、野猪、麂子和野兔等野生动物或肝脏样本240只（份），其中捕获野鼠172只，血吸虫感染率为2.91%，其他野生动物未发现血吸虫感染；野鼠、麂子和野猪肝毛细线虫感染率分别为12.21%、1.96%和12.50%。调查村人群和家畜中均未发现血吸虫感染；各村平均钉螺密度在0.13～0.80只/0.1 m2，在1个村发现2只检测管钉螺有血吸虫阳性。结论　江西省山丘型传播控制地区野生动物在血吸虫病传播中的作用和潜在风险仍不可忽视；应继续加强监测，并采取有针对性防治措施，以巩固血吸虫病防治成果。     

应用高效液相色谱检测慢性肾炎肾功能不全患者尿纤维蛋白肽A及其临床意义

应用高效液相色谱法（ＨＰＬＣ）检测４２例正常人，２４例肾功能正常之慢性肾炎，１２例慢性肾炎肾功能不全氮质血症期患者及２１例尿毒症期患者尿ＦＰＡ水平，其均值分别为：２５．４０±１０．３０ｎｇ／ｍｇＣｒ、２６．９９±５．７７ｎｇ／ｍｇＣｒ、３８．８１±６．２８ｎｇ／ｍｇＣｒ、７９．７４±１８．７６ｎｇ／ｍｇＣｒ。结果显示：氮质血症期组尿ＦＰＡ水平明高于正常对照及肾功能正常之慢性肾炎组（Ｐ＜０．０１），尿毒症期组尿ＦＰＡ显著高于氮质血症期组（Ｐ＜０．０１）。监测尿ＦＰＡ水平与血浆肌酐浓度显示二者呈正相关性（ｒ＝０．９１２０，Ｐ＜０．０１）。揭示，慢性肾炎肾功能不全患者循环血液处于异常高凝状态，其严重程度与疾病的发生、发展密切相关，监测其尿ＦＰＡ水平能较敏感地反映肾功能状态。     

脾虚患者胃粘膜超氧化物歧化酶与前列腺素的关系

目的 观察脾虚患者胃粘膜超氧化物歧化酶(SOD)活性与前列腺素(PG)的关系。 方法 72例慢性胃病住院患者,按中医辨证分成脾虚组和肝气犯胃组,分别测出胃粘膜SOD活性,以及前列腺素和血栓素A_2的代谢产物6-酮-PGF_(1a)和血栓素B_2(TXB_2)的含量,分析SOD与6-酮-PGF_(1a)和TXB_2的相关性。 结果 脾虚组患者胃粘膜SOD活性为2.7±1.1 U/mg湿重,明显低于肝气犯胃组的4.2±1.7 U/mg湿重(P<0.01);脾虚组胃粘膜6-酮-PGF_(1a)含量为115.7±60.7 pg/mg湿重,亦明显低于肝气犯胃组的289.6±154.2 pg/mg湿重(P<0.01)。SOD活性与6-酮-PGF_(1a)含量呈线性正相关(P<0.05)。 结论 脾虚证患者胃粘膜内自由基代谢紊乱,表现为SOD活性及抗氧化能力低下,并且与胃粘膜PG代谢的改变存在着一定的关系。