带有双侧部分输尿管的猪膀胱模型在宫腔镜培训中的应用

目的　为获得最大程度模拟人类子宫的宫腔镜精细电切培训用模型。 方法　获取带有双侧部分输尿管的猪膀胱,指导学员进行宫腔镜手术技巧的培训（实验组模型）,同期使用传统的培训模型四腔猪心（对照组模型）,考核为双向性,指导教师以考核内容进行打分,学员则填写调查问卷来评价模型。 结果　3站宫腔镜手术模拟培训中,两组模型训练学员的成绩及学员对模型的评价均有统计学差异（P<0.05）,认为膀胱模型膨起度良好,视野清晰,便于辨识解剖结构,能够更逼真模拟宫腔实际操作的困难状况。 结论　猪膀胱因其最大程度模拟人类子宫及其术中实际困难情境,是宫腔镜技术培训的理想模型。     

问卷调查在采集女性盆腔脏器脱垂患者病史中的应用

目的:比较问卷调查与回顾性病例分析采集盆腔脏器脱垂(POP)患者信息的异同,从而确定症状问卷调查表的重要性.方法:按照现况调查的方法对2009年11月—2010年4月门诊收治的105例POP患者进行现场问卷调查,按照回顾性分析的方法采集2007年1月—2009年10月因POP住院手术治疗的209例患者的病史.采用SPS...     

The identification of a new HLA-DPB1 allele (*1302) in one family and the detection of a recombination event between the DR and the DQ regions in another Caucasian T1DGC family

The analysis of families collected by the T1DGC and typed at high resolution for the HLA class I and class II loci provided an opportunity for identifying new alleles and rare recombination events. In one American Caucasian family, a novel allele (HLA-DPB1*1302), detected as an unusual pattern of probe binding, was identified in the mother and in one child. Amplicons from both individuals were sequenced and a new variant of DPB1*1301 with an A->T mutation [TAC to TTC in codon 64, (amino acid 35); Y to F] was confirmed. In another American Caucasian family, one child inherited an unusual haplotype, DRB1*1501-DQA1*0102-DQB1*0609-DPA1*0103-DPB1*0601 resulting from a recombination between the DRB1 loci on the maternal chromosomes DRB1*1501-DQA1*0102-DQB1*0602-DPA1*0103-DPB1*0401 and DRB1*1302-DQA1*0102-DQB1*0609-DPA1*0103-DPB1*0601.     

Depression and suicidal behavior in adolescent inpatients with obsessive compulsive disorder

BACKGROUND: To investigate the prevalence and correlations of suicidal behavior in obsessive compulsive disorder (OCD) among adolescent psychiatric inpatients. METHODS: A total of 348 adolescents, representing consecutive admissions to an adolescent inpatient unit, were assessed. Of these, 40 patients had OCD, 118 had schizophrenia, 59 had an affective disorder, 81 had a conduct disorder and 50 had an eating disorder. In addition, 87 normal community controls were assessed. All subjects were assessed for suicidal behavior by the Childhood Suicide Potential Scale (CSPS), for depression by the Beck Depression Inventory, for impulsiveness by the Impulse Control Scale, for anxiety by the State-Trait Anxiety Scale and for aggression by the Yudowsky Overt Aggression Scale. RESULTS: All the psychiatrically ill subjects, including those with OCD, had high levels of depression, anxiety and impulsiveness, which were far higher than those of the controls. The rate of attempted suicide was, however, much lower in the OCD subjects. In addition, there was a significant inverse correlation between suicidal behavior levels on the CSPS and depression in the OCD subjects, while all other subjects showed the expected significant positive correlation between level of suicidal behavior and depression. LIMITATIONS: This study looked at a referred population and generalization to outpatient and community samples cannot be made. Distinguishing between the primary and the comorbid diagnosis is difficult and some findings are based on small sample size and therefore may be vulnerable to type I error. CONCLUSIONS: Although suicidal ideation and depressive symptoms are common in OCD adolescent inpatients, they seem to be protected against suicide attempts. The inverse relationship between suicidal behavior and depression may mean that suicidal behavior is, in some ways, qualitatively different from that seen in other psychiatrically ill adolescents.     

Renal replacement therapies in pediatric intensive care patients: Experiences of one center in Turkey

BACKGROUND: Despite constant improvements in caring for critically ill neonates and infants with congenital cardiac disease, sepsis, bone marrow and solid organ transplantation, acute renal failure (ARF) is an important problem in these children. ARF, severe fluid overload and inborn errors of metabolism are some of the indications for acute dialysis in infants and children. METHODS: The authors had retrospectively evaluated the medical records of Pediatric Intensive Care Unit, Ankara University School of Medicine, Ankara, Turkey patients who had required acute renal replacement therapy between the dates of January 2002 to February 2005. RESULTS: Medical records of 332 patients were reviewed. Acute renal replacement therapy was performed in 21 patients (6.3%; mean age, 9.6 +/- 7.4 years). Dialysis modalities were peritoneal dialysis in 15 patients (71.4%; mean age, 3.9 +/- 5.6 years) and hemodialysis in six patients (28.6%; mean age, 12.1 +/- 3.2 years). A total of 90% of patients had severe systemic disease leading to ARF. A total of 95% of patients had multiple organ dysfunction syndrome. The most common cause of ARF was refractory shock. At the beginning of renal replacement therapy, 10 patients were anuric, nine patients had volume overload, seven patients had decompensated metabolic acidosis and nine patients had hypotension. The average dialysis period was 4.7 +/- 6.4 days. Mortality rate was 66.7%. Eight patients recovered from ARF and chronic renal failure had developed in one patient. CONCLUSION: In the Pediatric Intensive Care Unit, ARF is frequently seen together with multiple organ dysfunction syndrome and the mortality rate is high. Both peritoneal dialysis and hemodialysis are important renal replacement treatment modalities in patients with ARF. The age and hemodynamic status of the patients are important when choosing treatment modality; generally peritoneal dialysis is preferred in infants and toddler, while hemodialysis is preferred in older children.     

原发性高血压合并脑梗塞患者血管紧张素Ⅱ-1型受体基因多态性的研究

目的 探讨血管紧张素Ⅱ－1型受体（angiotensin Ⅱ type 1 receptor,AT1R)基因A1166／C多态性与原发性高血压及合并脑梗塞的关系。方法 应用聚合酶链反应－限制性片段长度多态性方法检测70名健康人、72例原发性高血压无合并症患者及70例原发性高血压合并脑梗塞患者的AT1R基因型；生化技术测定血脂水平。结果 原发性高血压无合并症组及合并脑梗塞组的C等位基因频率分别为11．1％和10．7％，均显著高于正常对照组的3．6％（P＜0．05）；而两者之间的C等位基因频率差异无显著性（P＞0．05）；牟发性高血压患者血浆脂蛋白a水平与AT1R基因正相关。结论 提示AT1R基因可能是原发性高血压的重要遗传因素，但与高血压病患者是否易患脑梗塞无关。     

多囊卵巢综合征患者复方醋酸环丙孕酮治疗前后激素和糖代谢变化的临床观察

为观察达英-35治疗多囊卵巢综合征(PCOS)在明显降低黄体生成素(LH)及睾酮(T)水平,改善患者内分泌状况的同时,是否改善其胰岛素抵抗(IR),35例PCOS患者服用复方醋酸环丙孕酮(达英-35)治疗3个周期,观察用药前后临床特征、血清激素水平、空腹血糖、空腹胰岛素(FIN)的变化.结果显示,治疗后34例PCOS患者月经恢复,多毛及痤疮评分下降(P<0.01),双侧卵巢体积明显缩小(P<0.01).血清LH、FSH、T水平和LH/FSH明显下降(P<0.01).FIN水平明显下降(P<0.01),IR也有相应降低(P<0.01),空腹血糖(FBG)和胰岛素敏感性指数(ISI)无明显改变(P>0.05).达英-35有很强的抗雄作用,明显改善了PCOS患者的内分泌状况和临床症状.     

The cytoplasmic domain of tissue factor contributes to leukocyte recruitment and death in endotoxemia

Tissue factor (TF) is an integral membrane protein that binds factor VIIa and initiates coagulation. The extracellular domain of TF is responsible for its hemostatic function and by implication in the dysregulation of coagulation, which contributes to death in endotoxemia. The role of the cytoplasmic domain of tissue factor in endotoxemia was studied in mice, which lack the cytoplasmic domain of TF (TF(deltaCT/deltaCT)). These mice develop normally and have normal coagulant function. Following i.p injection with 0.5 mg of lipopolysaccharide (LPS), TF(deltaCT/deltaCT) mice showed significantly greater survival at 24 hours compared to the wt mice (TF(+/+)). The serum levels of TNF-alpha and IL-1beta were significantly lower at 1 hour after LPS injection and IL-6 levels were significantly lower at 24 hours in TF(deltaCT/deltaCT) mice compared to TF(+/+)mice. Neutrophil recruitment into the lung was also significantly reduced in TF(deltaCT/deltaCT) mice. Nuclear extracts from tissues of endotoxemic TF(deltaCT/deltaCT) mice also showed reduced NFkappaB activation. LPS induced leukocyte rolling, adhesion, and transmigration in post-capillary venules assessed by intravital microscopy was also significantly reduced in TF(deltaCT/deltaCT) mice. These results indicate that deletion of the cytoplasmic domain of TF impairs the recruitment and activation of leukocytes and increases survival following endotoxin challenge.     

血管内超声对冠状动脉临界病变的临床应用

目的应用血管内超声(IVUS)对冠状动脉造影(CAG)提示冠状动脉临界病变的患者检查,评价IVUS在冠状动脉临界病变诊断及治疗中的应用价值。方法选择经CAG诊断为冠状动脉存在临界狭窄的78例患者,其中男性56例,女性22例;年龄34～71岁,平均年龄55.4岁。行IVUS检查和CAG,对照分析两种检查结果。结果CAG检测发现偏心性斑块31处,向心性斑块82处;而行IVUS检测发现偏心性斑块56处,向心性斑块57处。IVUS清楚显示软斑块54处,硬斑块23处,混合性斑块36例,其中探查血栓1处,溃疡2处;而CAG不能显示管腔形态及斑块特点。病变最窄处血管面积狭窄率IVUS所测值明显高于CAG,分别为68%±21%、58%±19%(P<0.05),两者比较差异具有统计学意义。结论对于CAG显示的临界狭窄病变,IVUS能更准确地判定管腔形态、病变性质及狭窄程度,对冠心病特别是有冠心病症状的患者的诊断及临床介入治疗有重要意义.     

力学载荷对破骨细胞凋亡的影响及其调节机制

破骨细胞是参与骨代谢的基本功能细胞之一.破骨细胞在骨重建过程中主要承担旧骨组织的破坏和吸收,因此,破骨细胞凋亡的微小变化都可能会改变骨重建的进程.调节破骨细胞凋亡的因素有很多,如雌激素、二磷酸盐等生物化学因素,但力学载荷对于破骨细胞生物学活性影响的研究相对较少.综述了力学载荷对破骨细胞生物学活性的影响以及细胞凋亡与破骨细胞凋亡的调节.