非脱垂子宫经阴道与经腹切除的比较

目的：对非脱垂的良性子宫疾病全子宫切除的不同方法进行评价,以便合理地制定手术方案,方法：非脱垂子宫行阴道全子宫切除（VH）15例,随机选择同期良性子宫疾病行经腹全子宫切除术（TAH）15例,采用对照研究方法,对一般临床资料,手术、术后恢复、住院日和费用等进行对照分析。结果：VH2例中转经腹手术,成功率87％,两组一般临床资料、诊断、子宫大小、麻醉、手术范围、失血量差异无显著性,VH术后无伤痛,用止痛药仅23％,TAH15例均有伤口痛,用止痛药47％,住院日、经费及总费用VH明显少于TAH,两组差异有显著意义（P＝0．0027、0．0447、0．0162）。结论对良性子宫疾病全子切除VH显示的优势特别适合我国国情,大子宫并非手术禁忌,明确VH的禁忌以利于VH在临床推广应用。     

Efficacy of non-ablative fractional 1440-nm laser therapy for treatment of facial acne scars in patients with rosacea: a prospective,interventional study

Lasers in Medical Science - Acne scarring is one of the most common facial skin disorders. The appropriate treatments for acne scars in patients with rosacea have not been studied. This study was...     

Risk factors and outcomes of cardiovascular disease readmission within the first year after dialysis in peritoneal dialysis patients

BackgroundIn the first year of dialysis, patients are vulnerable to cardiovascular disease (CVD) hospitalization, but knowledge regarding the risk factors and long-term outcomes of cardiovascular readmission within the first year after dialysis in incident continuous ambulatory peritoneal dialysis (CAPD) patients is limited.MethodsThis retrospective cohort study was conducted in incident CAPD patients. The demographic characteristics, laboratory parameters, and CVD readmission were collected and analyzed. The primary outcome was all-cause mortality, and the secondary outcomes included CVD mortality, infection-related mortality and technique failure. A logistic regression was used to identify the risk factors associated with CVD readmission within the first year after dialysis. Cox proportional hazards models were used to evaluate the association between CVD readmission and the outcomes.ResultsIn total, 1589 peritoneal dialysis (PD) patients were included in this study, of whom 120 (7.6%) patients had at least one episode of CVD readmission within the first year after dialysis initiation. Advanced age, CVD history, and a lower level of serum albumin were independently associated with CVD readmission. CVD readmission within the first year after dialysis was significantly associated with all-cause (HR 2.66, 95%CI 1.91–3.70, p < 0.001) and CVD (HR 3.42, 95%CI 2.20–5.31, p < 0.001) mortality, but not infection-related mortality or technique failure, after adjusting for confounders.ConclusionsOur findings suggest that an advanced age, a history of CVD, and a lower level of serum albumin were independently associated with CVD readmission. Moreover, CVD readmission was associated with all-cause and cardiovascular mortality in incident CAPD patients.     

Overlapping obesity-related glomerulopathy and immunoglobulin A nephropathy: clinical and pathologic characteristics and prognosis

Clinical and Experimental Nephrology - In this study, we investigated the clinical and pathologic characteristics and prognosis of overlapping obesity-related glomerulopathy (ORG) and...     

大学生自我表露及其与主观幸福感的关系

目的:探讨大学生自我表露、主观幸福感现况及二者的关系.方法:根据浙江大学164名学生的问卷调查结果对Jourard SM自我表露问卷进行修订,用修订的自我表露问卷和幸福感指数量表对浙江大学的356名学生进行问卷调查.结果:不同信息类别的自我表露评分差异显著(F=50.24,P＜0.001),其中品味和兴趣(1.85±0.41)、学习(工作)(1.87±0.43)的自我表露评分均高于态度和看法(1.70±0.32)(t=7.870、8.256)、金钱(1.60±0.41,t=10.517、11.429)、个性(1.70±0.39)、身体(1.71±0.42)(P均＜0.001).目标人的主效应显著(有男/女朋友者、无男/女朋友者的自我表露问卷评分差异均有显著性,F=21.14、13.88,P＜0.001),信息类别和目标人的交互作用显著(F=76.15,P＜0.001).在金钱、身体、学习或工作方面大学生向父母表露多于向男、女性朋友(如金钱上:母亲1.81±0.59、父亲1.73±0.58,男朋友1.42±0.44,女朋友1.40±0.44;F=116.84,P=0.000).女性的表露程度高于男性(1.79±0.31/1.71±0.32,t=2.03,P=0.044).自我表露与主观幸福感呈正相关(r=0.16,P=0.003).分层回归显示自我表露对预测主观幸福感作出了新的贡献(△R2=0.021,P=0.006).结论:信息类别、目标人、被试性别会影响自我表露的程度,提升表露水平有助于改善主观幸福感.     

The HPV-16 E7 oncogene sensitizes malignant cells to IFN-alpha-induced apoptosis.

Interferons (IFNs) exert antitumor effects in several human malignancies, but their mechanism of action is unclear. There is a great variability in sensitivity to IFN treatment depending on both tumor type and the individual patient. The reason for this variable sensitivity is not known. The fact that several IFN-induced anticellular effects are exerted through modulation of proto-oncogenes and tumor suppressor genes may indicate that the malignant genotype may be decisive in the cell's sensitivity to IFN. To determine if a deregulated oncogene could alter the cellular response to IFN, a mouse lymphoma cell line (J3D) was stably transfected with the viral human papillomavirus-16 (HPV-16) E7 oncogene. The E7-transfected cells and their respective mock-transfected sister clones were treated with IFN-alpha and examined for possible IFN-induced anticellular effects. We found that the E7-transfected clones were greatly sensitized to IFN-alpha-induced apoptosis compared with their mock-transfected counterparts. Induction of apoptosis in the transfected cells correlated with the ability of IFN to activate parts of the proapoptotic machinery specifically in these cells, including activation of caspases and the proapoptotic protein Bak. In summary, our data suggest that transfection of malignant cells with the E7 oncogene can sensitize them to IFN-alpha-induced apoptosis. This demonstrates that an oncogenic event may alter the cellular sensitivity to IFN and might also have implications for treatment of HPV-related diseases with IFN.     

造血干/祖细胞的体外扩增培养研究

利用旋转壁式生物反应器(Rotating wall vessel,RWV)体外培养脐带血干细胞,使其大量扩增,以满足临床应用对造血干/祖细胞的数量与质量要求。从脐带血分离得到的单个核细胞(Mononuclear cells,MNC)在T-flask中培养24h,之后接种到RWV反应器中,培养200h。每24h细胞计数,测量培养基的pH和渗透压变化;在144h和197h测CD34 细胞含量并做CFU-GM半固体培养。有核细胞(Nucleated cells,NC)与CD34 细胞在第197h,分别扩增了435.5±87.6倍和32.7±15.6倍,CFU-GM(Colony-forming unit-granulocyte/macrophage)细胞扩增了21.7±4.9倍。整个培养过程中,RWV反应器中的pH和渗透压都保持在造血细胞最佳的扩增条件内,pH基本保持在7.2~7.4之间,渗透压基本保持在290~310mmol/kg之间。由于旋转壁式生物反应器(RWV)结构上的特殊性,可以保证细胞在悬浮流动的状态下生长,很好地模拟了脐带中的造血微环境,使脐带血造血干细胞在该反应器中短期内得到大量扩增。     

Hypothermia after cardiopulmonary bypass in man: effects of prostaglandin E1 and phentolamine

The "afterdrop" in body temperature (TEMP) following adequate rewarming from hypothermic cardiopulmonary bypass (CPB) is frequently observed. This temperature drop sometimes accompanied by shivering results in increased myocardial oxygen demand. We investigated the relations between the afterdrop and use of vasodilators after CPB. For vasodilator therapy, PGE1 at the rate of 0.025-0.088 microgram.kg-1.min-1 (Prostaglandin Low Doses, PLD; n = 8), 0.107-0.136 microgram.kg-1.min-1 (Prostaglandin High Doses, PHD; n = 7), or phentolamine at 4.1-5.9 micrograms.kg-1.min-1 (PHENT; n = 8) were intravenously infused in 23 adult patients after CPB. During three hour period after CPB, esophageal, rectal, and forehead TEMP are lower in PHENT than in PGE1 groups. There were significant differences between PHD and PHENT group. Finger tip TEMP was lower in PGE1 groups than in PHENT group. There were significant differences between PHD and PHENT group. There were no differences in systemic arterial pressure, cardiac index (CI) and systemic vascular resistance (SVR) at any point between PHD and PHENT groups. It is concluded that PHENT increases the peripheral skin blood flow and TEMP but decreases the visceral TEMP possibly due to vasodilatation of the skin vessels, while PGE1 decreases skin blood flow and TEMP but increases the visceral TEMP, although SVR clearly decreases at the same rate in the two groups.     

Elimination of polychlorinated dibenzofurans (PCDFs) and polychlorinated biphenyls (PCBs) from human blood in the Yusho and Yu-Cheng rice oil poisonings

The pharmacokinetics of polychlorinated dibenzofurans (PCDFs) and polychlorinated biphenyls (PCBs) in humans was studied by monitoring the blood concentrations of individuals who ingested a contaminated rice oil in Japan (yusho) in 1968 and in Taiwan (yu-cheng) in 1979. Sixteen yusho patients were followed from 1982 to 1990 and three yu-cheng individuals from 1980 to 1989. From the three yucheng patients, blood lipid values for the two persistent toxic congeners, 2,3,4,7,8-pentachlorodibenzofuran (PnCDF) and 1,2,3,4,7,8-hexachlorodibenzofuran (HxCDF), varied from 50 g/kg at first sampling to about 1 g/kg at last sampling corresponding to half-lives for elimination (t_1/2) of 2-2_1/2 years. The blood lipid values for the same PCDF congeners in yusho patients varied from 5 g/kg down to 0.1 g/kg. The calculated t_1/2 were more variable with median values closer to 10 years. Planar PCBs #126 and #169 were present at lower concentrations than the PCDFs. For seven of the other PCB congeners, half-lives for elimination in the yu-cheng individuals varied from 1.2 up to 4.6 yr depending on the degree of chlorination. For the yusho patients, the elimination for the PCBs was longer. These results show that clearance of the toxic PCDFs and PCBs in humans is non-linear with faster elimination at higher exposure followed by slower decreases as background levels are approached. Such a clearance pattern can best be explained by a two compartment liver and fat pharmacokinetic model.