手术治疗自发性小脑出血深昏迷患者的预后相关因素分析

目的 探讨手术治疗白发性小脑出血深昏迷患者的必要性以及影响治疗效果的因素.方法 回顾性分析广东省肇庆市第一人民医院神经外科2002年3月至2012年1月收治的23例因自发性小脑出血导致深度昏迷患者的临床资料,将接受手术治疗的18例患者按预后分为2组,分析其治疗效果及预后影响因素.结果 预后较好组与预后差组患者发病后至接受手术的时间差异有统计学意义(P=0.023),2组患者间年龄、血肿量大小及住院时间差异无统计学意义(P＞0.05),2组患者并发脑积水、环池受压程度及呼吸循环紊乱差异亦无统计学意义(P＞0.05).结论 自发性小脑出血患者发病后迅速发展至深昏迷不是手术禁忌证,及时的手术解除脑干受压是降低自发性小脑出血患者病死率的关键因素.     

常规胸部CT扫描发现额外征象有助于预测心血管疾病事件

目的越来越多的CT检查可发现临床指征以外的异常征象,这些额外发现的临床意义尚不清楚。本项目为首次随访研究,研究常规胸部CT扫描显示无症状的冠状动脉     

洁净ICU病房人物流管理与医院内感染发生的研究分析

[目的]通过规范空气层流洁净病房内人员流动与物质流动,探讨洁净ICU区域人物流管理对医院内感染发生率的影响。[方法]制定ICU人物流进出的相关制度并严格执行,每月两次不定期对洁净ICU病区进行空气培养,与采取传统模式管理的专科ICU病区的空气培养进行对比分析。[结果]2009～2010年对洁净ICU及普通ICU各进行48次的空气培养,每月2次,洁净ICU细菌超标1次,合格率97.9%;普通ICU细菌超标7次,合格率85.4%两组的合格率相比差异有统计学意义(χ2=5.79,P﹤0.05)。[结论]规范的人员流动与物质流动管理能有效降低层流洁净环境的空气污染程度,控制或降低医院内感染发生。     

Genome-wide association study with 1000 genomes imputation identifies signals for nine sex hormone-related phenotypes

Genetic factors contribute strongly to sex hormone levels, yet knowledge of the regulatory mechanisms remains incomplete. Genome-wide association studies (GWAS) have identified only a small number of loci associated with sex hormone levels, with several reproductive hormones yet to be assessed. The aim of the study was to identify novel genetic variants contributing to the regulation of sex hormones. We performed GWAS using genotypes imputed from the 1000 Genomes reference panel. The study used genotype and phenotype data from a UK twin register. We included 2913 individuals (up to 294 males) from the Twins UK study, excluding individuals receiving hormone treatment. Phenotypes were standardised for age, sex, BMI, stage of menstrual cycle and menopausal status. We tested 7 879 351 autosomal SNPs for association with levels of dehydroepiandrosterone sulphate (DHEAS), oestradiol, free androgen index (FAI), follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin, progesterone, sex hormone-binding globulin and testosterone. Eight independent genetic variants reached genome-wide significance (P<5 × 10⁻⁸), with minor allele frequencies of 1.3–23.9%. Novel signals included variants for progesterone (P=7.68 × 10⁻¹²), oestradiol (P=1.63 × 10⁻⁸) and FAI (P=1.50 × 10⁻⁸). A genetic variant near the FSHB gene was identified which influenced both FSH (P=1.74 × 10⁻⁸) and LH (P=3.94 × 10⁻⁹) levels. A separate locus on chromosome 7 was associated with both DHEAS (P=1.82 × 10⁻¹⁴) and progesterone (P=6.09 × 10⁻¹⁴). This study highlights loci that are relevant to reproductive function and suggests overlap in the genetic basis of hormone regulation.     

颞下颌关节骨关节病发展过程中诱导型一氧化氮合酶在其软骨组织内的表达和意义

目的研究颞下颌关节骨关节病（TMJOA）发生发展过程中诱导型一氧化氮合酶（iNOS）在其软骨组织内的表达和作用。方法采用山羊建立TMJOA动物模型,在各组动物注射胶原酶后的2、4、12、24周时,分别切取其TMJ标本做EnVision二步法免疫组化检测。结果正常组TMJ软骨无iNOS表达,在实验组动物TMJOA发病过程中其软骨组织iNOS的表达有明显增加,且随着病变过程的发展与病变组织有一定的对应性。结论iNOS在TMJOA发生发展过程中起着重要的作用,抑制iNOS的生成有可能会阻断TMJOA的发生和发展。     

Participation of ADP in the binding of fibrinogen to thrombin- stimulated platelets

Thrombin and adenosine diphosphate (ADP) supported the binding of 125I- fibrinogen to washed human platelets with similar kinetics and affinity. Platelet secretion, as measured by 14C-serotonin release, and fibrinogen binding exhibited an identical dependence on thrombin concentration. Enzymatic removal of ADP with apyrase or creatine phosphate/creatine phosphokinase (CP/CPK) from thrombin-stimulated platelets markedly inhibited 125I-fibrinogen binding, but pretreatment of platelets with CP/CPK prior to thrombin stimulation was without effect. Thus, ADP, released from the platelet, participates in the binding of fibrinogen to thrombin-stimulated platelets.     

Cytochemically demonstrable B-glucuronidase activity in normal and neoplastic human lymphoid cells

Mononuclear cell suspensions were prepared from 40 normal peripheral blood and lymphoid tissue specimens and 42 neoplastic specimens obtained from patients with malignant lymphoma and lymphocytic leukemia. These suspensions were analyzed for la antigens, surface immunoglobulin (Slg), sheep erythrocyte (E) rosette formation and, in some instances, acid alpha-naphthyl acetate esterase (ANAE) activity. The results of these studies were correlated with the expression of cytochemically demonstrable BG activity. The percentage of BG+ lymphocytes was found to be comparable, within 10%, to the percentage of E+ (T) cells in the majority of normal, non-neoplastic peripheral blood, tonsil, spleen, and lymph node specimens examined. Occasionally, the percentage of E+ cells exceeded the percentage of BG+ cells by 20% or more, suggesting the presence of an E+BG- T cell subpopulation. BG+ B lymphocytes were only demonstrated in 1 of 40 non-neoplastic lymphoid specimens. The neoplastic B cells in each of 14 B cell (la+Slg+E-) lymphomas were BG-. However, a variable proportion of the neoplastic cells isolated from 6 cases of B cell chronic lymphocytic leukemia and neoplastic plasma cells isolated from 7 cases of multiple myeloma expressed BG activity. Thus, it appears that both normal and neoplastic BG- and BG+ B lymphocyte populations exist; the latter may be related to a state of activation or a stage of B cell differentiation. The neoplastic cells isolated from 4 T cell (la-Slg-E+) malignancies were BG+ while those isolated from 3 T cell malignancies were BG-. The variable expression of BG activity by T cell malignancies may be related to T cell differentiation. Investigation of BG expression by T cell derived malignancies may prove useful in sorting out T cell phenotypes.