《数字化卒中单元管理系统》数据库网络版的研究与开发

目的:充分利用现有的计算机网络资源,研究和开发卒中单元计算机管理软件。方法:客户端利用MicrosoftVisualBasic6.0作为计算机语言编写系统前台软件,即《数字化卒中单元管理系统》,给用户提供了人机对话界面。服务器端采用甲骨文公司ORACLE数据库作为系统数据库。通过《数字化卒中单元管理系统》调用后台服务器ORACLE数据库中的数据。结果:成功编写完成了《数字化卒中单元管理系统》软件,是一套网络化、高效、方便快捷、统一有序的卒中单元计算机管理软件。结论:《数字化卒中单元管理系统》为卒中单元的临床和研究积累数据,为组织化卒中医疗提供网络化管理,是建立和运作卒中单元的数字化临床路径,简化和方便了卒中单元的推广和运作。     

The Kmod blood group phenotype in a healthy individual

This report describes a healthy blood donor whose red cells have weakened expression of Kell blood group antigens. Kell antigen activity could not be detected by flow cytometric analysis and was demonstrable only by sensitive serologic techniques. As with normal-strength Kell antigens, reactivity could be abolished by treatment with 2-aminoethylisothiouronium bromide (AET). The donor's red cells have Kx antigen activity. Other commonly tested blood group antigens (MNSs, Rh, P1, Lewis, Duffy, and Kidd systems) appear normal. Clinical and serologic examination showed that this case is different from previously described examples of modified Kell expression. The propositus's phenotype has remained unchanged for 19 months, which suggests that it is not a transient condition. However, family studies provide no evidence that it is inherited. A 93-kD protein, which reacted weakly by Western blot with rabbit antibody to Kell protein, was isolated from the propositus's red cells by immunoprecipitation. This finding was not reproduced in subsequent studies, which suggests that the quantity of Kell protein recovered was at the threshold level detectable by the technique used. The red cell phenotype is categorized as Kmod, of which this is the first example reported in a healthy individual.     

Nonselective inhibition by antisense oligonucleotides of cytosine arabinoside action.

Antisense oligonucleotides can be used in cell cultures to inhibit biosynthesis of neurotransmitter receptors. Hence, they operate as highly specific pharmacological antagonists. In obtaining a pure neuronal primary culture the suppression of non-neuronal cell proliferation is required; usually 1-beta-D-arabinofuranosylcytosine (AraC) is used. We report that in primary cultures of rat cerebellar cells, oligonucleotides, targeted to: (1) glutamate receptor, (2) the seven transmembrane spanning region of receptors coupled to GTP binding proteins, and (3) beta-adrenergic receptor kinase, nonspecifically inhibit the cell incorporation of 3H-AraC and curtail its antiproliferative action. This nonspecific action might occur at the level of the mechanism of action of AraC and should be taken into account when antisense probes as pharmacological antagonists are used.     

Surgical spectrum of aortic stenosis in children: a thirty-year experience with 257 children

Aortic stenosis accounts for 5 to 6% of infants and children seen for surgical repair of congenital heart disease. The clinical presentation and reported results of operation for aortic stenosis are highly variable. This retrospective review was undertaken to assess our operative mortality and the degree of gradient reduction afforded by each of several surgical techniques used to treat aortic stenosis in children over a 30-year period. Two hundred fifty-seven patients ranging in age from 1 day to 19 years were operated on between 1957 and 1986. The indication for operation included asymptomatic patients with gradients greater than 50 mm Hg to patients in profound cardiogenic shock. The operative mortality for children older than 6 months was 4%, whereas neonates seen with critical aortic stenosis had a 60% mortality. The late mortality was 2%. Eighty percent of surviving patients to date have undergone cardiac catheterization after repair. This shows an overall reduction of 57 mm Hg in the left ventricular-aortic gradient. Patients with supravalvular aortic stenosis and discrete subvalvular aortic stenosis as well as patients undergoing aortic valve replacement showed a reduction in or elimination of associated aortic insufficiency, whereas patients undergoing aortic valvotomy or neonates having valvotomy had a significant increase in demonstrable aortic insufficiency. The incidence of third-degree heart block or cerebral emboli following operation for aortic stenosis was less than 1%. However, the incidence of late bacterial endocarditis following repair was nearly 5%; six of eleven cases occurred in the group with discrete subvalvular aortic stenosis. Twenty-nine (13%) of the 223 long-term survivors have undergone a subsequent procedure for relief of residual or recurrent obstruction; 12 have had insertion of an aortic valve prosthesis, 12 have had insertion of an apicoaortic conduit, and 6 have required repeat aortic valvotomy. These data demonstrate the low operative mortality and excellent hemodynamic benefit of surgical relief of single-level aortic stenosis in children older than neonates. Conduits placed for complex obstructions or operative procedures in neonates have acceptable hemodynamic benefits, but operative mortality remains high.