采用基因配型行同种异体肾移植术

目的 探讨基因配型技术在同种异体肾移植中的应用。方法采用顺序特异引物聚合酶链反应法(PCR-SSP)分别进行供、受体的基因分型，为3例配型适当的终末性肾病患者行同种异体肾移植术，并观察其术后肾功能恢复情况。结果所有接受肾移植的患者于术后2d肾功能恢复至正常水平，无急性和超急性排异发生。随访11-15个月，各项检查指标均正常。结论 基因配型的准确率较之传统的血清学配型显著增加，显著提高同种异体肾移植的成功率。     

医用低值材料采供管理的探讨

医疗消耗材料是医疗工作开展的基础，本文从医用低值消耗材料的计划制定、材料采购、库房库存结构、材料供应、成本核算等多方面探讨了如何对医疗消耗材料进行科学管理，这对医院的医疗发展和管理建设有着重要意义。     

8～12岁单纯性肥胖儿童心功能研究

利用多导生理仪，同步记录心电图、心音图、颈动脉搏动图和心阻抗微分图，测试８～１２岁肥胖儿童９４名，对照组儿童７６名，分析比较有关心功能数据。结果显示肥胖儿童收缩压、舒张压、平均动脉压、左室射血时间和心搏出量高于对照组儿童，心输出量与对照组比较差异无显著性，心功能指数低于对照组儿童。提示肥胖儿童由于回心血量增加，血压增高，而使心脏前、后负荷加重，心肌收缩力代偿性增强，单位体表面积心输出量下降，部分心功能指标已受到影响。     

Image restoration of digital radiography using dual sensor Wiener filter.

A dual sensor Wiener filter (DSWF) technique was used to improve the image quality of a scanning type digital radiographic system. In a digital radiographic system, image quality is evaluated by resolution and SNR (signal-to-noise ratio), which are two important parameters representing the objective performance of the system. In this method, when two images are acquired in the same region using two sensors with different characteristics of resolution and SNR, they are processed simultaneously using DSWF, which is the extended concept of a Wiener filter to two dimensions. DSWF uses the cross power spectrum between dual sensor outputs of the same chest radiographic image in the design of filter parameters. It has been implemented with fast algorithm using FFT (fast Fourier transform). The performance of the proposed method is compared with that of conventional methods (Wiener filter and parametric projection filter). In simulation studies, it is shown in 12 cases that this new method has SNR improvement of 1-2 dB better than conventional methods.     

Statistical MUNE: A comparison of two methods of setting recording windows in healthy subjects and ALS patients

OBJECTIVE: To address the issue as to how best to perform statistical MUNE, we applied two different approaches and compared results in healthy subjects and ALS patients. METHODS: Twelve normal subjects (women 8, mean age 52years) and 11 ALS patients (women 4, mean age 54years) underwent two consecutive MUNE studies, which differed in terms of setting and modifying the recording window. These are referred to as the 'expansion' and 'narrowing' methods, respectively. Size-weighted average (Av) SMUP and MUNE values were obtained using the two methods, and compared in control and patient groups. RESULTS: Expansion method-derived Av SMUP sizes and MUNE values differed only slightly from those obtained using the narrowing method in healthy subjects, whereas the narrowing method resulted in significantly larger Av SMUP sizes and smaller MUNE values than the expansion method in ALS patients (Wilcoxon signed ranks test, p=0.003). The sizes of tested areas (mean+/-SD) were significantly larger for the narrowing method than the expansion method in both subject groups with much greater difference in ALS patients; 9.6+/-3.1% vs. 7.9+/-1.7% in healthy subjects and 16.1+/-5.1% vs. 11.2+/-3.0% in ALS patients (Student t-test, p<0.01). CONCLUSIONS: The present study shows, unlike that found in normal subjects, that the results of statistical MUNE in ALS patients are heavily dependent on the approach used to set and modify recording windows. SIGNIFICANCE: The expansion method using a 10%-sized window is likely to suffer from systemic errors due to the ceiling effect and the sampling of artifactually small motor units in ALS patients. The authors recommend that the narrowing method be considered as an alternative that avoids these problems.     

老年2型糖尿病患者胰岛素抵抗相关指标的检测和意义

目的:探讨老年2型糖尿病胰岛素抵抗(IR)及其相关性,为老年2型糖尿病的合理防治提供临床依据。方法:选择120例老年2型糖尿病患者,按胰岛素敏感指数(HOMA)胰岛素抵抗(HOMA-IR)50百分位点将患者分为两组:胰岛素相对敏感组(HOMA-IR<3.56)和胰岛素相对抵抗组(HOMA-IR≥3.56),比较体重指数(BMI)、腰/臀比(WHR)、血压、血生化学检查等指标。用年龄>40岁,<60岁的2型糖尿病患者做对照组。结果:两组老年患者在年龄、性别、舒张压、空腹血糖、胆固醇、高密度脂蛋白、糖化血红蛋白、HOMA胰岛β细胞功能方面无差异;但BMI、WHR、收缩压、甘油三脂、空腹胰岛素、HOMA-IR差异具有显著性。多线性回归分析后,只有腰/臀比、收缩压、甘油三脂、HOMA-IR存在统计学差异。老年患者与对照组相比,IR发生率明显增加,且两者腰/臀比、收缩压、甘油三脂方面也差异显著。结论:IR与老年2型糖尿病密切相关,是临床防治糖尿病的重要靶点。     

日本血吸虫副肌球蛋白T细胞表位的预测和鉴定

目的鉴定日本血吸虫副肌球蛋白的T细胞表位。方法用SYFPEITHI软件预测日本血吸虫(中国大陆株)副肌球蛋白的T细胞表位，候选表位分别命名为P20、P21、P22、P23、P24。设计并合成候选表位的编码核苷酸，定向克隆入融合表达载体pET-32c( )，经酶切及测序鉴定出重组克隆。阳性克隆经IPTG诱导表达，表达产物以Ni^2 -NTA柱亲和层析及透析纯化。纯化后的硫氧还蛋白(Trx)融合蛋白体外刺激C3H／HeJ及C57BL／6小鼠腹股沟淋巴结或脾脏单个核细胞，^3H-TdR掺入法检测其增殖。结果候选表位中P20、P21、P22、P23能有效刺激C3H鼠致敏淋巴细胞细胞增殖，P20、P22能刺激C57鼠致敏淋巴细胞增殖。结论P20和P22可能是日本血吸虫副肌球蛋白的通用性T细胞表位。     

椎管内肿瘤显微外科手术治疗

本组收集自2000年2月至2005年12月我院椎管内肿瘤患者64例,通过显微手术治疗,取得满意效果,报告如下。一、资料与方法1.一般资料:在64例椎管内肿瘤中男性36例,女性28例;年龄最小12岁,最大76岁,平均38岁。2.主要症状与体征:(1)疼痛:疼痛为常见的首发症状,共有18例。常表现为根性疼痛,有时可误诊为肋间神经痛或坐骨神经痛。(2)感觉障碍:常见,共有54例。有不同程度的感觉障碍,表现为有感觉障碍平面并常伴有麻木或束带感。髓内肿瘤则常表现有不同程度的节段性感觉障碍,感觉障碍平面与脊髓肿瘤所在部位相关。(3)运动障碍:有52例入院时在肿瘤压迫…     

家庭护理的危险因素分析及对策

随着人们法制观念的增强,对自身合法权益的维护越来越重视,对医疗护理质量的需求也越来越高。近年来,人民生活水平的不断提高,患心脑血管疾病、肿瘤等慢性疾病者增多,护理需求量增加,需要护理人员从医院走向社区,走入家庭,为个人、家庭、社会提供直接、连续、全面、方便、快捷、经济、优质的家庭护理服务,以满足社区居民的需求。我院于2002年5月开设了家庭护理,现已开展了12项服务内容,共对27例病人(149例次)实施家庭护理服务,护理服务对象平均年龄为74.8岁,其中脑梗死23例,多伴有偏瘫、失语,合并有高血压、糖尿病等疾病;恶性肿瘤2例;肾衰竭…