经导管封堵外科术后心脏瓣周漏的初步经验

目的评估经导管封堵外科术后心脏瓣周漏（PVL）的有效性及安全性。方法对本中心2009～2012年行经导管试封堵的PVL病例进行总结分析。结果共入选12例患者,包括7例主动脉瓣PVL及5例二尖瓣PVL。其中,9例男性和3例女性,平均年龄（60±10）岁;9例有1个PVL,3例有2个PVL;7例PVL（最大的）为新月形,3例为椭圆形,2例为类圆形。操作成功率为83.3%,临床成功率为66.7%,10例操作成功的患者中有8例病例纽约心脏学会（NYHA）分级提高1级以上。术后1个月,操作成功的患者PVL程度由术前平均3.1级降为1.3级（P＝0.007）,NYHA分级由平均2.9级降为1.8级（P＝0.007）,左室舒张末内径由56 mm降为52 mm（P＝0.005）,左房前后内径由69 mm降为60 mm（P＝0.005）,肺动脉收缩压由58 mm Hg降为43 mm Hg（P＝0.01）, NT-proBNP由1697 ng/L降至1066 ng/L（P＝0.02）,左室射血分数改变未达到统计学意义（P＝0.25）。病例8术前有慢性肾功能不全,术后出现造影剂肾病,给予床旁血液透析1周,肾功能无明显改善,后出现心功能恶化,最后死亡。病例6出现溶血,及肾功能一过性损害（肌酐最高至136 mmol/L）。结论初步结果显示,经导管介入封堵外科术后PVL虽然有一定并发症发生风险,但成功率及效果可以接受,可以在有经验的中心开展。     

Mutations in Emery-Dreifuss muscular dystrophy and their effects on emerin protein expression

Seventeen families with Emery-Dreifuss muscular dystrophy (EDMD) have been studied both by DNA sequencing and by emerin protein expression. Fourteen had mutations in the X-linked emerin gene, while three showed evidence of autosomal inheritance. Twelve of the 14 emerin mutations caused early termination of translation. An in-frame deletion of six amino acids from the C-terminal transmembrane helix caused almost complete absence of emerin from muscle with no localization to the nuclear membrane, although mRNA levels were normal. This shows that mutant emerin proteins are unstable if they are unable to integrate into a membrane. A 22 bp deletion in the promoter region was expected to result in reduced emerin production, but normal amounts of emerin of normal size were found in leucocytes and lymphoblastoid cell lines. This shows that DNA analysis is necessary to exclude emerin mutations in suspected X-linked EDMD. Emerin levels in female carriers often deviated from the expected 50% and this was due, in at least two families, to skewed emerin mRNA expression from the normal and mutated alleles. In one family with a novel deletion of the last three exons of the emerin gene, a carrier had a cardiomyopathy and very low emerin levels (<5% of normal) due to skewed X-inactivation. In the three autosomal cases of EDMD, emerin was normal on western blots of blood cells, which suggests that autosomal EDMD is not caused by indirect reduction of emerin levels.      

新型往复运动单支锉根管预备对牙本质微裂的影响

目的 ：比较新一代往复运动单支锉WaveOne Gold和Reciproc Blue与上一代WaveOne和Reciproc在根管预备后产生牙本质微裂的差异。方法：将90颗离体下颌单根前磨牙随机分为6组（n=15）,分别为手用K锉组、WaveOne组、Reciproc组、WaveOne Gold组、Reciproc Blue组和空白对照组。将实验组根管预备至25#,空白对照组不作预备。利用硬组织切片机在距根尖孔3、6和9 mm处水平切割牙根,体视显微镜下放大25倍,观察不同横截面牙本质微裂情况。采用SPSS 17.0软件包对数据进行统计学分析。结果：手用K锉组和空白对照组未发现牙本质微裂;实验组中,WaveOne、WaveOne Gold、Reciproc和Reciproc Blue在根管预备后均产生了牙本质微裂,其中,WaveOne和手用K锉组产生的牙本质微裂纹数目差异有统计学意义（P<0.05）,裂纹主要集中于根管根中段;Reciproc和Reciproc Blue 2种往复运动单支锉造成的牙本质微裂数目相同,与对照组相比无统计学差异。结论：使用新一代往复运动单支锉WaveO...     

野黄芩苷对人舌鳞癌细胞的增殖抑制和Bcl-2蛋白表达的影响

目的:探讨野黄芩苷对人舌鳞癌细胞的增殖抑制作用及Bcl-2蛋白表达的影响。方法:用不同浓度的野黄芩苷处理体外培养的人舌鳞癌Tca8113细胞,用MTT法检测细胞增殖情况,Western-blot法检测Bcl-2蛋白表达情况。结果:野黄芩苷对Tca8113细胞的增殖有明显抑制作用,且在一定的时间和浓度范围内呈时间、浓度依赖性。Westerm-blot结果显示Bcl-2蛋白表达水平随野黄芩苷浓度的增大而逐渐下降。结论:野黄芩苷对人舌鳞癌细胞增殖具有明显的抑制作用,下调Bcl-2蛋白表达可能是野黄芩苷治癌的机制之一。     

337 株肠杆菌科细菌超广谱 β－内酰胺酶的检测及耐药分析

目的：测定３３７株肠杆菌科细菌产超广谱β－内酰胺酶（ＥＳＢＬｓ）情况。了解产酶株组与非产酶株组对临床常用抗生素的耐药情况。方法：用双纸片协同试验筛选产ＥＳＢＬｓ株,采用Ｋ－Ｂ法测定产酶株与非产酶株对临床常用抗生素的敏感性。结果：３１株肠杆菌科细菌为产ＥＳＢＬｓ株。１９９８～１９９９年度产酶率（１２．９％）显著高于１９９６～１９９７年度产酶率（４．２％）。产酶株组对３代头孢和氨曲南、安美汀、特美汀耐     

影像导航引导鼻内镜下前颅底骨化纤维瘤切除术

目的 探讨影像导航系统在经鼻内镜切除前颅底骨化纤维瘤手术中的作用。方法 选择影像导航引导下经鼻内镜手术切除累积眶纸板、颅底骨质的筛窦骨化纤维瘤12例男性患者,初次手术9例,复发病例3例。术前行鼻窦CT连续扫描,骨算法,层厚1mm。结果 CT显示所有病例筛骨水平板、眶纸板受累。4例前界至额隐窝前缘（鼻骨后）;6例累及眶尖与蝶窦外侧壁交界处：1例广泛累及上颔骨、蝶骨大翼、蝶鞍和斜坡。11例彻底切除病灶,1例（病变广泛者）切除大部分肿瘤。平均手术时间3．2小时,影像导航配准过程平均25分钟。1例术中并发脑脊液漏,术中鼻内镜下修补成功;3例术中损伤眶纸板,无手术及术后并发症。术后随访5个月～4年,姑息手术病例肿瘤生长缓慢,其余病例无复发,症状明显改善。结论 借助影像导航引导,经鼻内镜手术切除累及眶纸板、前颅底骨质的骨化纤维瘤,具有一定优势,但病灶不应广泛侵及额隐窝、蝶骨及斜坡。     

计算机断层扫描血管成像在后腹腔镜肾癌根治术中的应用

目的计算机断层扫描血管成像(computed tomography angiography,CTA)作为微创血管造影检查方法在全身各部位血管疾病诊断中已经得到广泛应用,能较好的反映肾血管的解剖结构及肾异位血管,术前了解患肾的血管对术中操作有较好的指导。文中探讨术前行CTA在后腹腔镜肾癌根治术(retroperitoneal laparoscopic radical nephrectomy,RLRN)患者中的应用价值。方法将入院的98例肾细胞癌患者分为2组:实验组68例,术前行肾血管CTA;对照组30例,术前未行CTA。分析行CTA检查的患者其肾动脉变异情况,统计2组患者手术肾蒂处理时间、锁扣夹使用数量、术中出血量及手术并发症等指标。结果实验组患者的病肾25%存在肾动脉变异分支;实验组和对照组患者的肾蒂处理时间分别为(25.1±13.7)min和(35.6±12.2)min、出血量分别为(27.5±14.9)ml和(36.8±17.2)ml,实验组明显少于对照组(P<0.01)。2组间并发症无明显差异(P>0.05)。结论术前行肾动脉CTA能了解肾动脉变异情况,可缩短后腹腔镜肾癌手术时间,减少出血,提高成功率。     

改良沙堡弱琼脂培养基（MSDA）方法在一次性使用卫生用品真菌定量检测中的应用研究

摘要 目的 研究改良沙堡弱琼脂培养基(MSDA)方法在一次性使用卫生用品真菌定量检测中的应用价值。方法 参照2015年版《中国药典》非无菌产品微生物限度检查（通则1105）的适用性试验方法,验证MSDA方法对一次性使用卫生用品真菌菌落总数检测适用性。结果 MSDA方法检测接种白色念珠菌和黑曲霉的19种供试品适用性试验回收率范围在82.76%～105.74%。市场购买的某品牌成人纸尿裤和某品牌婴儿柔肤湿巾两种产品真菌菌落总数＞100 cfu/g。市场购买的4大类产品中均有真菌检出,共有9个产品真菌菌落总数≥5 cfu/g。结论MSDA方法适用于一次性使用卫生用品真菌菌落总数的检测。     

Effect of brucine on mouse nonspecific immune responses

目的：观察镇痛有效剂量的布鲁生（Ｂｒｕ）对正常小鼠及Ｃｙｃ所致免疫低下小鼠非特异免疫功能的影响．方法：测定小鼠碳粒廓清能力、免疫器官重量及外周血ＷＢＣ，小鼠ＰＭ吞饮中性红及产生ＩＬ１能力．结果：Ｂｒｕ对正常鼠碳粒廓清能力、免疫器官重量、外周血ＷＢＣ、ＰＭ吞噬功能及产生ＩＬ１能力仅有轻微促进作用（Ｐ＞００５），而对被Ｃｙｃ降低的上述非特异免疫反应，Ｂｒｕ呈剂量依赖性的增强作用（Ｐ＜００５或Ｐ＜００１），作用以１０ｍｇ·ｋｇ－１时最好．结论：Ｂｒｕ在镇痛有效剂量ｉｐ时，对小鼠非特异免疫功能有剂量依赖性及功能依赖性的调节作用．     

Effect of cyclosporin A on rat mucosal mast cells and the associated protease RMCPII.

The effects of Cyclosporin A (CyA) on rat mucosal mast cells (MMC) have been investigated by cell counts in the jejunal mucosa and assays of the MMC-specific granule protease RMCPII in tissues and serum. CyA was administered by subcutaneous injection; for the majority of experiments the rats received 50 mg/kg daily for 3 days as a loading dose, then 50 mg/kg on alternate days. Treatment with this drug has two actions on MMC, a gradual reduction in the number of MMC and in the tissue content of RMCPII in the jejunum; and a rapid fall in the serum concentration of RMCPII, detectable 3 h after i.v. administration of CyA, 50 mg/kg. These phenomena were demonstrated in normal rats and in animals with an expanded jejunal MMC population due to graft vs host reaction or recent helminth infection. The functional relevance of the MMC depletion was demonstrated in immune rats given CyA for 3 days prior to induction of systemic anaphylaxis; intestinal permeability to i.v. Evan's blue was significantly reduced by CyA treatment. We suggest that CyA depletes intestinal MMC by suppression of T-cell-mediated regulatory stimuli to proliferation of mast cell precursors and/or their migration. The effects of the drug on serum RMCPII, evident before there were changes in the number of intestinal MMC, indicate that it also suppresses the secretion of granule mediators by MMC, probably indirectly via effects on mucosal T cells.