Sexual discordance in monozygotic twins

We report on monozygotic (MZ) twins who were discordant for phenotypic sex and Ullrich-Turner syndrome (UTS). The nonviable female was hydropic with cystic hygromas, ventricular septal defect, bicuspid aortic valve, polysplenia, intestinal malrotation, and small ovaries. The male was phenotypically normal. The monochorionic, diamniotic placenta had hydropic changes limited to the UTS infant's side. Skin samples from the infants and blood from their parents were obtained for cytogenetic and molecular analysis. Karyotypes of the twins were 45,X and 46,XY. Quinacrine polymorphisms on 7 chromosomes and RFLP analysis at 8 loci showed complete identity. MZ twins discordant for phenotypic sex have been described previously. Most of these show evidence of mosaicism in a 45,X patient with a normal 46,XY cell line, and a normal 46,XY male. While the issue of mosaicism in our case cannot be fully resolved, no mosaicism was found in 50 cells analyzed cytogenetically from each culture or by PCR analysis of a Y-specific sequence. The twins probably originated from either postzygotic nondisjunction or anaphase lag, followed or accompanied by twinning. The discordant placental morphology suggests an embryonic origin of at least part of the placental mesenchymal core.     

Plasma steroid concentrations during alternate-day treatment with prednisone

Plasma steroid concentrations were measured in asthmatic children 24 and 48 hours after administration of alternate-day treatment with prednisone, and the results were compared with those of control patients who did not receive corticosteroid treatment as well as those of patients who were treated with prednisone each day. It was found that 24 hours after administration of prednisone in any dose, plasma steroid concentrations were significantly lower than those of the control group. The degree of suppression in plasma steroid concentration was less marked in patients who received treatment on alternate days than in those who received the same doses of prednisone each day. Within 48 hours after administration of alternate-day treatment, plasma steroid concentrations approached the values observed in the control group and were independent of the magnitude of the prednisone dose. Although alternateday steroid treatment was associated with transient and incomplete suppression of pituitary-adrenal function, patients whose therapy was changed from a daily to an alternate-day regimen sometimes exhibited prolonged suppression of adrenal cortical function.     

静脉用药调配中心干预不合理医嘱的效益分析

目的对静脉用药调配中心(pharmacy intravenous admixture services,PIVAS)干预临床不合理用药产生的经济效益、社会效益、人力资源效益进行分析,促进临床合理、安全、经济用药。方法采用回顾性分析方法,调取2018年10月1-31日山东大学齐鲁医院PIVAS接收的全部静脉用药医嘱及对不合理用药医嘱的干预结果,分析PIVAS干预不合理用药医嘱产生的药品资源、人力资源节约情况。结果2018年10月1-31日PIVAS药师共审核用药医嘱412782组,其中不合理医嘱1967组,占0.417%,包括不规范、不适宜及超常医嘱等类型。通过PIVAS药师干预不合理用药医嘱,及时纠正医师用药医嘱错误,节约了药品资源及护理工时。结论PIVAS进行用药医嘱审核对于保障患者临床合理用药具有积极意义,有利于节约医疗资源。     

胺碘酮合用小剂量β受体阻滞剂治疗老年阵发房颤临床观察

目的 比较胺碘酮与小剂量β受体阻滞剂合用对老年阵发性房颤的疗效。方法 回顾分析30名老年阵发房颤患者,根据房颤复律后维持用药的不同,分为3组：单用胺碘酮组（n=11);单用β阻滞剂组（n=9);胺碘酮与小剂量β阻滞剂合用组（n=10)。比较3组患者用药后12个月中房颤控制情况及心室率、心脏传导情况。结果 单用胺碘酮组显效率54．5％,有效率45．5％,无效率0％;单用β受体阻滞剂组显效率22．2％,有效率44．5％,无效率33．3％;胺碘酮与小剂量β受体阻滞剂合用治疗房颤,显效率90％,有效率10％,其疗效明显优于单用胺碘酮（P＜0．05）或单用β阻滞剂（P＜0．01）组,且未见明显副作用：3组间心室率未见显著差别。结论 胺碘酮与小剂β受体阻滞剂合用可有效地控制老年阵发性心房纤颤的发作。     

喉癌中EGFR基因扩增、表达及临床意义

目的研究喉癌中表皮生长因子受体(EGFR)基因的扩增、表达,探讨其在喉癌发生、发展中的作用及临床意义。方法采用差异PCR(differential PCR)方法检测40例喉鳞状细胞癌及配对癌旁正常组织中EGFR基因的扩增(即基因拷贝数增加);应用RT-PCR方法检测EGFR mRNA水平;应用SPSS13.0软件对数据进行统计学分析。结果喉癌组织中有13例(占32.5%)EGFR基因拷贝数增加,癌旁对照组中则未检测到(χ2=15.537,P<0.005);喉癌组织中EGFR mRNA平均积分光密度为872.356±62.340,癌旁对照组为346.425±57.380(t=5.959,P<0.001);喉癌组织分化程度越低,病理分期越晚,EGFR基因扩增和mRNA表达水平越高(P<0.05)。结论喉癌中EGFR基因在DNA水平上的扩增是EGFR mRNA过表达的原因之一,EGFR的扩增和过表达在喉癌的发生、进展中发挥一定作用。     

肿瘤抗原冲击致敏的IL-2基因修饰的巨噬细胞治疗肾癌的实验研究

目的 :观察体外肿瘤抗原冲击致敏的白细胞介素 2 (IL 2 )基因修饰的巨噬细胞对肾癌小鼠的治疗效果并探讨其相关的免疫机理。方法 :通过重组腺病毒的介导 ,将IL 2基因转入新鲜分离的小鼠腹腔巨噬细胞 ,经肿瘤抗原冲击致敏后回输治疗原位肾癌小鼠 ,采用 4h5 1 Cr释放法检测脾脏NK和CTL活性。结果 :IL 2基因修饰的巨噬细胞经肿瘤抗原冲击后体内回输可使肾癌小鼠肺转移结节明显减少 ,存活期明显延长 ,40 %肾癌小鼠达到长期存活。治疗后荷瘤小鼠脾脏NK和CTL活性显著提高。结论 :IL 2基因修饰的巨噬细胞经肿瘤抗原冲击后自体回输是治疗肾癌的有效方法。     

三种烤瓷贴面牙体预备的临床修复效果评价

:【目的】评价 3种烤瓷贴面 (PLV)牙体预备的近期临床效果。【方法】根据贴面形态和覆盖牙体范围将PLV牙体预备分为I型、L型和U型 3种 ,用于着色牙和前牙间隙、缺损等修复 ,PLV采用长石质PLV瓷系统制作 ,双重固化树脂粘结系统粘结 ,观察 6～ 2 2个月 ,考察 3种牙体预备类型的适应证、最终美学效果、粘接强度及牙本质敏感性等。【结果】 35例 2 0 3个瓷贴面修复后形态、颜色满意 ,美学效果佳 ;无脱落 ,仅局部崩折 2例 ,近期粘接效果满意 ;备牙时牙本质暴露率达 95 16 % ,粘固后牙本质过敏症状不同程度缓解。【结论】合理选择适应证、足够的牙体制备及高强度树脂粘结系统 ,可保证 3种牙体预备类型均能使PLV获得良好的外形、满意的颜色及可靠的临床近期粘接强度 ;但牙本质过敏问题应予重视     

髂内动脉注入鸦油乳对狗正常膀胱组织影响的研究

目的 为鸦油乳掏膀胱肿瘤生长提供组织学依据。方法 正常狗随机分为：注药组（７只）和对照组（３只）,分别经髂内动脉注入鸦油乳０．１ｍｇ／ｋｇ、美蓝０．１ｍｌ／ｋｇ。１周后,随机活检膀胱各个部位作光镜及电镜观察。结果 注药组光镜可见粘膜上皮细胞脱落、坏死、肌层和浆膜充血、水肿、坏死以及急、慢性炎性细胞浸润;电镜发现在微血管内有鸦油乳微栓形成,并见细胞质膜结构的破坏。而对照组未发现明显变化。结论 鸦油乳     

鼠源性单克隆抗体F(ab′)2片段制备工艺

目的制备符合临床应用质量标准的鼠源性mAb F(ab′)2片段.方法采用胃蛋白酶消化小鼠腹水抗体,疏水作用色谱法纯化F(ab′)2片段的新工艺,替代原有的木瓜蛋白酶消化IgG,阴离子交换色谱法纯化的旧工艺.结果新工艺所制备的F(ab′)2 片段经SDS-PAGE检测纯度达98%以上,ABC免疫组化法测定免疫活性为1∶8000,回收率大于 50%,核酸含量及热原均合格,整个工艺流程可在48 h内完成.结论新工艺制备人用鼠源性mAb F(ab′)2片段更简便高效、安全实用,能够适应中试放大及大规模生产的要求.     

Study of the Complex Between the Contrast Agent lobitridol (Xenetix®) and Elastase (PPE): A Model for Hydrophobic Site Protection in Drug-Protein Interactions

Purpose. The concept of Hydrophilic Sphere Stabilization, or Hydrophobic Shielding, has been postulated in the synthesis of biocompatible contrast agents in vascular imaging. To improve the safety of these polyiodinated agents, interactions with protein hydrophobic sites in biomacromolecules should be kept as low as possible. In order to evaluate the level of interactions with proteins, we have selected the serine proteinase Elastase, in presence of Iobitridol (Xenetix^®), as a model. Methods. The complex between Iobitridol and Pancreatic Porcine Elastase was investigated by X-ray diffraction techniques, on saturated monocrystals, using the synchrotron radiation at 0.98. Results. In contrast to Iohexol, which displays several interactions including one in the active site, Iobitridol is unable to interact directly with elastase. Only one partially occupied site is found in between two molecules of the crystal packing. Conclusions. The validation of the 'hydrophobic shielding' concept, which was at the origin of the design of the Iobitridol molecule, has been proven to be an essential feature in minimizing in vivo protein interactions.