高压氧治疗对急性脑损伤大鼠神经行为学及ERK1/2表达的影响

目的 探讨高压氧治疗对急性创伤性脑损伤(traumatic brain injury,TBI)大鼠神经行为学及细胞外信号调节激酶(extra- cellular signal regulated kinase 1/2,ERKl/2)表达的影响,为临床应用高压氧治疗TBI提供实验依据. 方法 SD大鼠24只,随机数字表法分为假手术组、TBI组和高压氧治疗组,每组8只.假手术组仅行开颅手术不致TBI; TBI组采用Alice打击法以50 g重锤自40 cm垂直高度自由落体打击制作大鼠急性TBI模型;高压氧组在TBI基础上行高压氧治疗(1次/d,连续10 d).各组大鼠于处理后14 d进行神经功能损伤评分(neurological severity scores,NSS).随后处死动物,获取脑组织,用RT - PCR方法测定脑组织内ERK1/2 mRNA的表达.免疫组化染色确定ERK表达的细胞定位,吸光度分析了解ERK蛋白变化. 结果 与TBI组比较,高压氧治疗组14 d NSS评分明显降低(P＜0.01).同时,高压氧治疗组ERK1/2 mRNA和蛋白表达明显降低(P＜0.05). 结论 高压氧治疗能明显降低急性TBI大鼠NSS评分及ERK1/2表达,提示高压氧治疗可能通过下调ERK1/2表达改善神经功能.     

两种给药方案预防胆道手术切口感染效果观察

目的：观察两种给药方案预防胆道手术切口感染效果。方法：2006年6月至2007年12月我院胆道感染并行择期手术162例,全部病例术前应用头孢哌酮／舒巴坦＋克林霉素治疗4d以上,治疗组82例,术前30min给予一剂量头孢呋辛2g,ivd;对照组80例,术前不应用抗菌药物预防感染。结果：治疗组3例发生感染,感染率3．65％,切口愈合平均时间7．8d．对照组2例发生感染,感染率2．56％,切口愈合平均时间7．6d,两组比较,P〉0．05,无统计学差异。结论：术前应用抗菌药物治疗4天以上的胆道感染手术患者不需再用抗生素预防切口感染。     

磷霉素钠172例临床应用分析

目的 了解我院注射用磷霉素钠的临床使用情况,为合理使用该药提供依据.方法 回顾分析我院2007年1～11月172份住院患者使用磷霉素钠的临床资料,根据磷霉素钠的用法、用量、适应性、联合用药等分析该药使用是否正确.结果 172份病历中,磷霉素钠单一用药占50.00%,二联用药占45.34%,三联用药占4.65%:与注射用磷霉素钠联合用药的抗菌药物构成比为,青霉素类占25.28%.喹诺酮类占23.26%,头孢类占20.93%,β-酶抑制剂类占16.28%,氨基糖苷类占13.95%;用药时间构成比为,1～3天占40.70%,4～6天占32.60%,7～9天占12.79%,9天以上占13.95%;临床应用构成比为,治疗用药110例,占64%,预防用药62例,占36%.结论 各科室对磷霉素钠的使用基本正确,但存在用药起点过高.使用时间过长,不必要的联合用药,不作病原学检查等问题.     

血浆IL-23、IL-17水平与慢性阻塞性肺疾病的相关性研究

目的本研究旨在探讨血浆白细胞介素(IL)-23和IL-17水平与慢性阻塞性肺疾病(COPD)的关系。方法收集75例COPD患者和80例正常对照者,采用酶联免疫吸附法检测血浆IL-23和IL-17水平。经t检验比较血浆IL-23和IL-17水平在COPD组和对照组之间的差异,以及其与COPD患者病程的关系。采用Pearson相关分析法检验COPD患者中血浆IL-23与IL-17水平的相关性。结果 COPD患者中血浆IL-23和IL-17的平均水平均显著高于对照组(IL-23:751.17±155.36 vs 686.88±147.36ng/L,t=2.644,P=0.009;IL-17:1.79±0.21 vs 1.71±0.17ng/L,t=2.614,P=0.010)。与稳定期COPD患者相比较,急性加重期患者中血浆IL-23和IL-17的平均水平亦显著升高(IL-23:801.31±141.69 vs 717.75±128.74ng/L,t=2.645,P=0.010;IL-17:2.36±0.12 vs 1.41±0.16ng/L,t=27.714,P<0.001)。采用Pearson相关分析法,结果显示,COPD患者中血浆IL-23水平与IL-17水平呈正相关(r=0.349,P=0.011)。结论血浆IL-23和IL-17水平可能参与COPD的形成,并能影响疾病的病程。COPD患者中血浆IL-23水平与IL-17水平密切相关。     

Expression of C-reactive protein and cyclooxygenase enzyme-2 in clear cell renal cell carcinoma: correlation with pathological parameters in 110 patients

C-reactive protein is produced in response to cytokines such as interleukin (IL)-6. It is known that increased plasma IL-6 levels induce increased hepatic and intratumoral production of C-reactive protein. Cyclooxygenase enzyme-2 is induced by various stimuli, including inflammation and various growth factors. Expression of these two markers has not been well studied in clear cell renal cell carcinoma. The objective of this study is to correlate the expression of C-reactive protein and cyclooxygenase enzyme-2 in clear cell renal cell carcinoma with pathologic parameters. A search of the surgical pathology and consultation files at our institution was performed for nephrectomy specimens with clear cell renal cell carcinoma from 2007 to 2008. Immunohistochemical stains for C-reactive protein and cyclooxygenase enzyme-2 were performed. Staining intensity was graded as 0, 1+, 2+, and 3+. The staining intensity was then correlated with pathologic stage and Fuhrman nuclear grade for each case. A total of 110 cases were identified. Strong expression of C-reactive protein was associated with higher Fuhrman nuclear grade and pathologic stage, and the strength of correlation was statistically significant (p = 0.01 and p = 0.001), respectively. However, cyclooxygenase enzyme-2 expression did not show statistically significant correlation with both pathologic stage and Fuhrman nuclear grade (p = 0.1 and p = 0.15), respectively. To our knowledge, this is the largest study to date correlating the expression of both C-reactive protein and cyclooxygenase enzyme-2 in tissue with pathologic parameters in patients with clear cell renal cell carcinoma, which could have significant prognostic and therapeutic implications.     

16层螺旋CT冠状动脉图像质量评估

目的量化评估16层螺旋CT冠状动脉各分支图像质量,探讨冠状动脉CT成像的临床应用效果。方法采用16层螺旋CT对102例患者行回顾性心电门控冠状动脉成像,男60例,女42例,平均年龄（57．8±9．4）岁,平均心率（62．8±10．2）次／min。心率〈60次／min（n=40）为I组,60～70次／min（n=35）为Ⅱ组,〉70次／min（n=27）为Ⅲ组。4条冠状动脉分支（左主干、左前降支、左回旋支、右冠状动脉）分别用于图像质量分析。扫描原始数据以间隔10％在20％～80％时相分别回顾性重建冠状动脉图像,用横断面、曲面重建、容积再现等方法对冠状动脉显示率评估。用曲面重建方法测量冠状动脉各分支长度及近段和远段对比噪声比。结果①冠状动脉各分支平均显示长度：左主干（10．9±3．0）mm,左前降支（130．3±29．7）mm,左回旋支（82．8±19．8）mm,右冠状动脉（150．5±27．5）mm;②Ⅰ组60％和70％为最佳时相图像质量优,Ⅱ组60％时相为最佳时相图像质量优,Ⅲ组RCA较优的时相为40％,LM、LAD、LCX较优时相为60％。③所有冠状动脉分支平均对比噪声比10．9±3．2。结论16层螺旋CT有较好质量的冠状动脉图像,心率和时相影响冠状动脉的成像质量。     

以“三全育人”为导向开展高校专业思想教育实践探索

在医学院校,预防医学专业普遍存在学生专业思想不稳定、入校后转专业人数较多等问题。立德树人是新时代高校的主要任务,专业思想教育在专业人才培养过程中起着至关重要的作用。文章阐述了全员、全过程、全方位育人(简称"三全育人")理念,探讨了如何以"三全育人"为导向开展预防医学专业本科生的思想教育实践,并对具体的教学改革措施、成效及未来发展方向进行了深入分析,为高校开展专业思想教育提供了借鉴经验。     

Genetic variations in CYP17A1, CACNB2 and PLEKHA7 are associated with blood pressure and/or hypertension in She ethnic minority of China

Objectives

Two large-scale genome-wide association studies (GWAs) have identified multiple variants associated with blood pressure (BP) or hypertension. The present study was to investigate whether some variations were associated with BP traits and hypertension or even prehypertension in adult She ethnic minority of China.

Methods

The population of the present study comprised 4460 (1979 males and 2481 females, respectively) unrelated she ethnic minority based on a cross-sectional study from Ningde City in Fujian province of China. There were 1692 hypertensives, 1600 prehypertensives and 1168 normotensive controls, respectively. We genotyped 7 variants in CYP17A1, PLEKHA7, CACNB2, ATP2B1, TBX3-TBX5, CSK-ULK3 and SH2B3 reported by the previous GWAs on Europeans. All analyses were performed in an additive genetic model.

Results

As the minor allele of rs653178 in/near SH2B3 was very rare with the frequency of 0.018, we excluded this single nucleotide polymorphism (SNP) in the further analyses. Of the other 6 loci, linear regression analyses revealed that rs11191548 in CYP17A1 and rs11014166 in CACNB2 were significantly associated with systolic BP (β = −1.17, P = 0.002 and β = −0.50, P = 0.006, respectively), while only SNP rs11191548 was significantly associated with diastolic BP (β = −0.56, P = 0.002) after adjusted by age, sex and BMI. Two variants in CACNB2 and PLEKHA7 were found to be significantly related to hypertension (odds ratios [OR] and (95% confidence interval [CI]): 0.79 (0.65–0.97) and 1.19 (1.01–1.41), respectively) in logistic regression analyses after adjusted by age, sex and BMI. In addition, we found that combined risk alleles of the 6 SNPs increased risk of hypertension in a stepwise fashion (P for trend < 0.001). However, none of the 6 SNPs was significantly associated with BMI or prehypertension status. While logistic analysis showed that subjects with cumulative risk alleles more than 9 had significantly higher risk for prehypertension (adjusted OR: 3.10, P < 0.001) compared with those with risk alleles less than 4.

Conclusions

We replicated that variations in CYP17A1, CACNB2 and PLEKHA7 were related to BP traits and/or hypertension in She population. In addition, although we failed to observe single gene associated with prehypertension, we first found that conjoint effect of multiple risk alleles on BP might increase the risk of progressing to prehypertension.