唇腭裂患者AF-BF距及AXB角的测量分析

目的 研究唇腭裂患者AF-BF距和AXB角.方法 选取20例替牙期及30例恒牙期唇腭裂患者拍摄头颅定位侧位X线片,测量其AF-BF距及AXB角与北京市同龄、同性别正常儿童、青少年的AF-BF距及AXB角值进行比较.结果 替牙期和恒牙期唇腭裂患者AF-BF距及AXB角值无性别差异(P > 0.05).新疆地区替牙期和恒牙期唇腭裂患者AF-BF距小于北京市正常儿童、青少年(P < 0.05),而AXB角值差异无统计学意义(P > 0.05).结论 AF-BF距可以作为评价唇腭裂患者上下颌骨间矢状关系的指标之一,但最好进行综合分析.     

缺氧诱导因子-1α在子宫内膜癌组织中的表达及其临床意义

目的探讨缺氧诱导因子1α在子宫内膜癌组织中的表达及其意义。方法用免疫组化法检测21例正常子宫内膜组织、29例不典型增生子宫内膜组织、44例子宫内膜癌组织中HIF-1α的表达情况,并分析其与子宫内膜癌临床病理特征的关系。结果 HIF-1α在子宫内膜癌和不典型增生子宫内膜组织中的阳性率明显高于正常子宫内膜组织（P〈0.05）。在子宫内膜癌组织中HIF-1α阳性表达率与手术病理分期有关（P〈0.05）,但与肌层浸润、组织病理学分级、淋巴结转移无关（P〉0.05）。在子宫内膜癌组织中HIF-1α阳性表达与雌激素受体呈正相关（P〈0.01）。结论 HIF-1α的过表达参与了子宫内膜癌的发生、发展,HIF-1α和雌激素受体在子宫内膜癌中表达具有相关性。     

Reduced Arterial Compliance Associated with Metabolic Syndrome in Chinese Children and Adolescents

Objective To explore the metabolic syndrome and its association with arterial compliance in Chinese children and adolescents. Methods 337 participants aged 6 to 18 years with males accounted for 55.8% were grouped according to their traits of metablic syndrome. Anthropometry, blood pressure, fasting plasma glucose, insulin and serum lipid profile were measured. Homeostasis model was assessed and insulin resistance （HOMA-IR） index was measured and calculated for estimating individual insulin resistance. Arterial compliance was also measured using digital pulse wave analyzing method （Micro medical, London）, and stiffness index was calculated. Results The stiffness index in participants with metablic syndrome was significant higher than that in participants with no riskof metablic syndrome [（7.69±1.63） vs （6.25±0.86） m/s, P〈0.01] and stiffness index and HOMA-IR were progressively increased with the increase of traits of metablic syndrom （P for linear trend 〈0.001）. After gender, age, and pubertal development were adjusted, both traits of metablic syndrome and HOMA-IR were correlated positively with stiffness index （both P〈0.05）. Conclusion The clustering of metablic syndrome was closely associated with risk at increased arterial stiffness in Chinese children and adolescents. It was suggested that arterial compliance assessment of children and adolescents might be an important measure for prevention of cardiovascular diseases.     

KPC型碳青霉烯酶分子进化及与底物结合自由能分析

目的 分析KPC-2、KPC-5和KPC-10型碳青霉烯酶的分子进化及与10种β-内酰胺类药物的结合自由能.方法 用MEGA 4.1软件中的Minimum Evolution法分析KPC-2、KPC-5和KPC-10型碳青霉烯酶的分子进化,用ArgusLab 4.1软件中的Dock模块作这3种酶与10种β-内酰胺类药物的分子对接,并计算酶与底物的结合自由能（△G）.结果 有碳青霉烯酶活性的A类β-内酰胺酶在同一簇且保守性较好,无碳青霉烯酶活性的普通A类β-内酰胺酶则在另一簇.KPC-2、KPC-5和KPC-10型碳青霉烯酶与碳青霉烯类药物结合自由能均下降,且降幅居前,它们的结合自由能比第三代头孢类抗生素更低.结合自由能较高的为氨曲南和克拉维酸.结论 KPC型碳青霉烯酶对碳青霉烯类药物的催化能力高于对第三代头孢类抗生素的催化能力,对氨曲南和克拉维酸的催化活性最低.     

人工髋关节置换手术的手术室护理干预

目的探讨人工髋关节置换手术的手术室护理干预的方法。方法结合该院2011年6月—012年5月间收治的62例人工髋关节置换手术病例,对其护理方法进行总结研究,以髋关节Harris评分作为指标。结果 62例髋关节置换术的手术时间为（87＋13）min,髋关节Harris评分（89.45±5.6）分。55例患者获得随访,随访时间为12个月,全部病例术后良好。结论手术室实行规范化的护理方法,对保证人工髋关节置换手术的成功具有重要意义。     

星形胶质细胞与认知功能

星形胶质细胞是中枢神经系统中数量最多的一类胶质细胞,不仅为神经元提供能量和代谢的支持,而且在形成和维持血脑屏障、调节突触可塑性等方面发挥重要作用.尤其是在以认知功能障碍为主要表现的神经退行性疾病的发生发展过程中发挥了神经损伤和保护的双重作用.本文结合近年来研究,从生理和病理调节两个方面综述星形胶质细胞对机体认知功能的影响.     

腺苷蛋氨酸治疗药物性肝损害52例疗效观察

目的观察两种疗程的腺苷蛋氨酸对药物性肝损害的疗效。方法 52例药物性肝损害患者,分为两组,A组28例予以腺苷蛋氨酸,2.0 g/d,疗程4周;B组24例予以5%葡萄糖500 ml+腺苷蛋氨酸每天2.0 g,疗程2周,其后继续使用常规保肝药物至4周。两组患者基线指标具有可比性,观察患者肝功能指标ALT、AST、TBil、DBil、r-GT、ACP、TBA的变化。结果治疗2周时,2组患者肝功能指标与治疗前ALT、AST、TBil、DBil相比差异有统计学意义(P<0.05),但2组间比较无差异;治疗4周时,肝功能指标明显改善,与基线及2周组患者相比ALT、AST、TBil、DBil差异均有统计学意义(P<0.05)。结论腺苷蛋氨酸在治疗药物性肝损害上有较好疗效,4周的疗效明显高于2周。延长治疗周期,以4周为1个疗程可以在临床取得更好的疗效。     

Fas/Fas配体系统及其下游信号转导通路的激活促进酒精性肝炎及酒精性肝纤维化的进展

目的 探明Fas/Fas配体(FasL)系统及其主导信号转导通路在酒精性肝炎和肝纤维化发生、发展中的作用及其机制. 方法 C57BL/6J小鼠以含4％(V/V)乙醇的Lieber-DeCarli液体饲料喂养4周,自第5周起联合微量CCl4腹腔注射至第8周,分别建立酒精性肝炎和肝纤维化模型.脱氧核糖核苷酸末端转移酶介导的缺口末端标记法(TUNEL)检测肝细胞凋亡.分别采用逆转录-聚合酶链反应、westem blot及免疫组织化学染色检测肝组织Fas、FasL、天冬氨酸特异性半胱氨酸蛋白酶3(caspase3)及细胞色素P450 2E1(CYP 2E1)的mRNA及蛋白质表达.多组样本均数间差异比较用单因素方差分析或Kruskal-Wallis H检验,组间比较用LSD-t检验或Mann-Whitney U检验. 结果 应用含4％(V/V)乙醇的Lieber-DeCarli液体饲料联合微量CCl4腹腔注射可快速建立小鼠酒精性肝炎和肝纤维化模型.肝细胞凋亡数随肝脏炎症及纤维化的加重而增高,并伴有凋亡相关基因表达增强.对照组、酒精性肝炎组、酒精性肝纤维化组小鼠细胞凋亡相关基因表达水平依次升高:Fas mRNA的相对表达量分别为0.50±0.05、0.61±0.10、0.76±0.03(H=12.137 P＜0.05),Fas蛋白的相对表达量分别为0.52±0.14、0.86±0.10、0.99±0.09(F=12.758P＜0.01);FasL mRNA相对表达量分别为0.31±0.03、0.53±0.02、1.02±0.04(F=153.260 P＜0.01);caspase3mRNA对表达量分别为0.86±0.11、0.85±0.05、1.33±0.16(F=8.740,P＜0.01),caspase 3蛋白相对表达量分别为0.40±0.03、0.69±0.06、1.02±0.10(F=90.785,P＜0.01);CYP 2E1 mRNA相对表达量分别为0.72±0.14、1.00±0.15、1.30±0.20(H=4.713,P＜ 0.01);各组间比较,P值均＜0.05.免疫组织化学染色结果显示,FasL及CYP 2E1的蛋白与mRNA的表达趋势一致. 结论 Fas/FasL系统及其下游信号转导通路的激活可能是酒精性肝病中诱导肝细胞凋亡的主导因素,可进一步促进酒精性肝炎和肝纤维化的发生与进展.     

LC-MS法测定人血浆中人参三醇二琥珀酸酯钠含量的方法学研究

目的：建立测定人血浆中人参三醇二琥珀酸酯钠的液相色谱-质谱联用法。方法：色谱柱为Shimadzu VP-C₁₈柱（150 mm×2.0 mm,5 μm）; 乙腈-10 mmol/L乙酸铵水溶液（55∶45）为流动相,体积流量0.3 mL/min;柱温40 ℃;内标物吲达帕胺。质谱条件为电喷雾离子源（ESI）,选择负离子提取方式检测,人参三醇二琥珀酸酯钠和吲达帕胺的选择检测离子分别为m/z 675.5（[M-Na+H] ⁺）、m/z 364.1（[M+H] ⁺ ）。结果：人参三醇二琥珀酸酯钠线性范围为0.030 4～101.3 μg/mL,定量下限为0.030 4 μg/mL。准确度、精密度以及稳定性均符合有关要求。结论：本方法专属性强,灵敏度高,适用于人血浆中人参三醇二琥珀酸酯钠的药代动力学研究。     

An empirical study of countertransference reactions toward patients with personality disorders

OBJECTIVE: The study examined to what extent patients with cluster A + B personality disorders (PDs) evoked other countertransference reactions among psychotherapists compared with patients with cluster C PDs as well as the relationship between the different countertransference reactions and outcome. METHODS: A total of 11 therapists at the Department for Personality Psychiatry, Ullevaal University Hospital, Oslo, Norway, filled out the Feeling Word Checklist-58 (FWC-58), 2 weeks after admission and 2 weeks before discharge, for 71 patients admitted to the day treatment program. The patients were diagnosed with the Structured Clinical Interview for DSM-IV Axis II Disorders (SCID-II). RESULTS: The study revealed that patients with cluster A + B PDs evoked more negative and less positive countertransference reactions than those with cluster C PDs. The psychotherapists varied significantly more in their reported countertransference reactions toward patients with cluster A + B PDs than toward those with cluster C PDs. Patients who dropped out of treatment evoked significantly more negative countertransference reactions after 2 weeks than patients who completed the treatment. In addition, the study revealed strong correlations between countertransference feelings and change during the treatment. CONCLUSIONS: This empirical study confirms clinical narratives on specified relationships between countertransference reactions, different PDs, and treatment course.