慢性心力衰竭中胃肠系统变化的意义

慢性心力衰竭(chronic hean failure,CHF)是多脏器受累的临床综合征,其中胃肠道系统的变化逐渐引起人们关注．心衰发生后,胃肠道低灌注,胃肠黏膜缺血缺氧,肠道屏障功能障碍, 从而发生肠道细菌移位和肠源性内毒素血症．内毒素激活体内细胞因子和炎性介质的释放, 此过程可进一步引起肠道屏障功能障碍和心肌细胞损害,从而形成恶性循环,引起心衰进展．国内外有研究发现,对心衰胃肠道发生的改变进行干预与治疗,对改善心衰症状,阻止心衰进展具有良好效果．     

Reassessment of Defibrase in the treatment of Acute Cerebral lnfarction

Objective: to assess the safety and efficacy of defibrase in the treatment of acute cerebral iinfarction by a large sample, multicerter, randomized, double-blind, and placebo-controlled clinical trial Methods: 2244 cases with acute infarction in 41centers were randomly allocated to receive either an imitial intrdvcnons infusion of defibrase 10Bu or placebo in 250ml of normal saline within 24 hours of stroke onset Subsequent in fusions of defibrase 5Bu or placebo on the third and fifth days respectively. This treatment protocol was determined on the bases of the pretrial of 114 patientsin 8 centers The end points fincluded Climcally Neurological De ficits Scale of Stroke, Barthel Index, Mortality, adverse reaction and the level of plasma fibrinogen (FIB)Results: (1) the level of plasma FIB in defibrase group was reurarkably declied after treatment whereas the bleeding evcnts and other adverse reaction was not incteased in comparison with control group There was difference in the imtcnsity of degrading plasna FIB between defibrase from Agkistrodon halys and that frorn Agkistrodon acutns. (2) Theare were no statistically significant differences at Clinically Neurological Deficits Scale of Stroke at 2 weeks, Barthel Index sc ore and mortality at 3 months between two groups. Conclutions: This study showed that defibrase atppears safe and effective in degading plastua FIB.The dose of defibrase should regnlate propcrly according to preparations from diffcrent snake venom .This study did not show that clinical efficacy of defibrase was supetior to those present used medicines for acute cerebral infarction It is necessary to further study about the relations between its clinical efficacy and the dose,protocol of drug administration and indication.     

Nd:YAG laser iridotomy in uveitic glaucoma

Purpose : To determine the survival of Nd:YAG laser peripheral iridotomy in those patients with angle closure glaucoma and iris bombé associated with uveitis. Methods : A retrospective review was performed on 11 patients of the Ocular Immunology Clinic of the Royal Victorian Eye and Ear Hospital who presented with uveitis, iris bombé due to extensive posterior synechiae and angle closure glaucoma. The date of iridotomy and where poss‐ible the degree of inflammation were noted, as was the date of failure of the iridotomy. A control group was constructed consisting of 65 patients who presented with acute angle closure glaucoma without a history of uveitis, who underwent Nd:YAG peripheral iridotomy. The survival of the peripheral iridotomies in the two groups was calculated using Kaplan–Meier survival analysis. Median survival was compared using log–rank test. Results : In the study group of 11 patients, 28 iridotomies were performed on 15 eyes; of these 28 iridotomies, 17 failed. Using Kaplan–Meier survival analysis the median time to failure was 85 days. In the control group of 65 patients, 66 iridotomies were performed on 66 eyes. None of the iridotomies in the control group failed. There was a significant difference in the survival of the Nd:YAG iridotomies (P = 0.00015) between groups. Conclusion : There is a high early failure rate of Nd:YAG iridotomies in patients with angle closure glaucoma and iris bombé associated with uveitis.     

Genome-wide mapping of unselected transcripts from extraembryonic tissue of 7.5-day mouse embryos reveals enrichment in the t-complex and under-representation on the X chromosome

Mammalian embryos can only survive if they attach to the uterus (implantation) and establish proper maternal-fetal interactions. To understand this complex implantation pathway, we have initiated genomic analysis with a systematic study of the cohort of genes expressed in extraembryonic cells that are derived from the conceptus and play a major role in this process. A total of 2103 cDNAs from the extraembryonic portion of 7.5-day post-conception mouse embryos yielded 3186 expressed sequence tags, approximately 40% of which were novel to the sequence databases. Furthermore, when 155 of the cDNA clones with no homology to previously detected genes were genetically mapped, apparent clustering of these expressed genes was detected in subregions of chromosomes 2, 7, 9 and 17, with 6.5% of the observed genes localized in the t-complex region of chromosome 17, which represents only approximately 1.5% of the mouse genome. In contrast, X-linked genes were under-represented. Semi-quantitative RT-PCR analyses of the mapped genes demonstrated that one third of the genes were expressed solely in extraembryonic tissue and an additional one third of the genes were expressed predominantly in the extraembryonic tissues. The over-representation of extraembryonic-expressed genes in dosage- sensitive autosomal imprinted regions and under-representation on the dosage-compensated X chromosome may reflect a need for tight quantitative control of expression during development.      

Use of the Phoenix system for bacteriology

A dedicated microbiology data processing system with remote batched job entry to an obsolete computer, has been superseded by the inclusion of bacteriology in an on-line interactive clinical pathology system which had previously incorporated chemical pathology and haematology. The original Phoenix system has been adapted to allow for the entry of bacteriology data using mnemonic codes and to deal with the problems caused by the longer processing time of bacteriology specimens. Particular advantages of the new system include the immediate linkage of all specimens for each patient and an easy recall and display of results in the laboratories and on the wards.