单纯肥胖者与代谢综合征患者血管内皮功能的比较

目的:比较单纯肥胖者与代谢综合征患者的血管内皮功能。方法:观察对象来自石家庄市2000-09/2001-06参加社区健康体检者。①体质量指数≥25kg/m2的超重/肥胖者中,单纯肥胖组295例,代谢综合征组219例,另选172例体质量指数<25kg/m2的健康人作为对照。②将肥胖者按体质量指数分为轻度肥胖(25～29.9kg/m2)和重度肥胖(≥30kg/m2),按腰围分为腹部脂肪轻度堆积(男<104cm,女<88cm)和重度堆积(男≥104cm,女≥88cm)。③血管内皮舒张功能测定:所有受试者采用NAS-1000HF彩超诊断系统测定反应性充血时及含服硝酸甘油后肱动脉内径的变化。结果:686例受试者全部进入结果分析。①单纯肥胖组和代谢综合征组体质量指数、腰围、臀围和腰臀比均高于对照组(P<0.01～0.001),其中体质量指数和臀围在男女间比较差异不显著,腰围和腰臀比男性高于女性(P<0.05),而男性代谢综合征组又高于男性单纯肥胖组(P<0.05)。②血管内皮舒张功能检测显示,反应性充血时,单纯肥胖组和代谢综合征组相对于基础血管内径变化的百分率均低于对照组[(7.79±3.93)%,(5.54±4.46)%,(11.25±3.98)%,P<0.05～0.01];代谢综合征组男性低于单纯肥胖组男性(P<0.05);男性代谢综合征组重度肥胖者低于轻度肥胖者(P<0.05);单纯肥胖组男性重度脂肪堆积低于男性轻度脂肪堆积者(P<0.05),代谢综合征组无论男女,重度脂肪堆积均低于轻度脂肪堆积者(P<0.05)。结论:①单纯肥胖者已存在血管内皮功能异常,而代谢综合征患者中内皮功能损伤程度更显著,并且与腹部脂肪堆积密切相关。②代谢综合征患者中男性血管内皮功能损伤较女性更明显。     

人骨髓间充质干细胞的贴壁分离与体外培养

目的:验证贴壁方式分离人骨髓间充质干细胞,并进行体外扩增培养的可行性。方法:实验于2006-02/12在解放军济南军区总医院脊髓修复科完成。①实验材料:骨髓来源于解放军济南军区总医院脊髓修复科收治的脊髓完全性损伤患者,对本实验知情同意。基础培养液由含体积分数为0.15胎牛血清和低糖α-MEM配置。②实验方法:无菌条件下髂后上棘穿刺抽取骨髓组织6mL,进行细胞培养,观察细胞生长情况,待细胞融合成片、长满培养瓶底部后,用质量浓度为2.5g/L的胰蛋白酶流过所有细胞表面。倒置显微镜下观察细胞变圆、部分脱壁后,立即加入有血清培养液终止消化。③实验评估:取第3代生长状态良好的细胞,胰蛋白酶消化制成细胞悬液,接种,以细胞数为纵坐标,时间为横坐标,绘制细胞生长曲线。同时每隔2h进行细胞贴壁率检测。结果:①骨髓间充质干细胞的形态学观察:倒置显微镜下,骨髓间充质干细胞接种1d即贴壁,去除悬浮细胞后继续培养3d贴壁细胞开始增殖,伸展为椭圆型、短梭型、多角型及不规则型等。至14d细胞密集在集落中心,基本铺满瓶底,第3～5代细胞呈均匀一致的长梭型,排列成旋涡状或放射状。②骨髓间充质干细胞的生长曲线:细胞传代后3d内处于潜伏期,3d后进入生长期,7d后进入平台期。③骨髓间充质干细胞的贴壁率:随着培养时间的延长,骨髓间充质干细胞贴壁率逐渐升高。传代后2,4,6,8,10,12,14,16,18,20h细胞贴壁率分别为(20.20±0.25)%,(33.00±0.29)%,(46.50±0.32)%,(69.20±0.30)%,(76.60±0.34)%,(86.50±0.27)%,(90.30±0.20)%,(96.10±0.28)%,(98.50±0.12)%,(99.00±0.07)%。结论:贴壁法分离骨髓间充质干细胞操作简便,经体外扩增培养后细胞增殖活性强,传代周期为7d,是比较理想的骨髓间充质干细胞培养方法。     

Association of the dominant hand and needle stick injuries for Healthcare Workers in Taiwan

Background

Healthcare workers face the risk of acquiring blood-borne infections from patients through needle stick injuries. Understanding the factors that are associated with increased risk, for example, the role of the dominant hand, is important so that preventive measures can be focused.

Methods

The EPINet (Exposure Prevention, Information Network-a trade mark of Virginia University) questionnaire was used to collect the data. The EPInet system started 2003 in Taiwan under C-MESH. When healthcare workers sustain sharp injury, they complete the injury report form, and report to infection control personnel, who then transmitted the data to EPINet website monthly.

Results

93.5% of the healthcare workers reported being right handed and only 6.5% reported being left handed. About two-thirds (65%) of the reported injuries were by self, 30% injuries were by others and 5% were reported as injured by unknown.There was an association between the dominant hand injury and the needle stick original HCW user, p<0.0001. There is a significant difference between the dominant hand and the needlestick original HCW user.HCW whose dominant hand was the right hand were most likely at risk to be injured by “others” than “self” or “unknown HCW”; OR≤ 18.39; CI (0.42 ± 2.33).

Conclusion

Needlestick injuries among health care workers in Taiwan continue to pose a serious occupational problem. Historically, prevention has focused on the use of protective wear than assessment of which hand may be at greater risk than the other. There is a greater need to prevent hand injuries as the dominant hand remains the most used and injured in process of patient care.     

Recurrent Implantable Cardioverter‐Defibrillator Replacement Is Associated with an Increasing Risk of Pocket‐Related Complications

Background: Despite beneficial effects of implantable cardioverter‐defibrillator (ICD) therapy, limited service life results in replacement within the majority of patients. Data concerning the effect of replacement procedures on the occurrence of pocket‐related adverse events are scarce. In this study, the requirement for pocket‐related surgical re‐interventions following ICD treatment and the effect of device replacement were evaluated. Methods: From 1992 to 2008, 2,415 patients receiving an ICD at the Leiden University Medical Center were analyzed. Pocket‐related complications requiring surgical re‐intervention following ICD implantation or replacement were noted. Elective device replacement, lead failure, and device malfunction were not considered pocket‐related complications. Results: A total of 3,161 ICDs were included in the analysis. In total, 145 surgical re‐interventions were required in 122 (3.9%) ICDs implanted in 114 (4.7%) unique patients. Three‐year cumulative incidence for first surgical re‐intervention in all ICDs was 4.7% (95% confidence interval [CI] 3.9–5.5%). Replacement ICDs exhibited a doubled requirement for surgical re‐intervention (rate ratio 2.2, 95% CI 1.5–3.0). Compared to first implanted ICDs, the occurrence of surgical re‐intervention in replacements was 2.5 (95% CI 1.6–3.7) times higher for infectious and 1.7 (95% CI 0.9–3.0) for noninfectious causes. Subdivision by the number of ICD replacements showed an increase in the annual risk for surgical re‐intervention, ranging from 1.5% (95% CI 1.2–1.9%) for the first, to 8.1% (95% CI 1.7–18.3%) for the fourth implanted ICD. Conclusions: ICD replacement is associated with a doubled risk for pocket‐related surgical re‐interventions. Furthermore, the need for re‐intervention increases with every consecutive replacement. (PACE 2010; 1013–1019)     

生物玻璃和生物胶原膜联合应用于即刻义齿种植

目的：建立即刻种植动物模型,观察生物玻璃和生物胶原膜在即刻种植中引导骨组织再生、促进骨愈合效果. 方法：实验方法：取成年家犬12只,随机编号后分为4个组,在全麻下分别拔除双侧下颌第一双尖牙,制备近中拔牙窝并即刻植入种植体.前3个组分别应用生物玻璃填塞种植体与拔牙窝骨壁之间的间隙,或在种植床上方覆盖生物胶原膜,并尝试两种方法的联合应用,空白组不采用特殊处理.②观察指标：术后观察记录种植床愈合情况.术后4,8,12周分批处死动物并取其下颌骨标本,采用大体观察、X射线、普通光镜组织学方法和扫描电镜方法观察其在种植床中引起的骨组织再生变化过程和骨结合率,统计比较各种方法的成功率. 结果：①即刻种植成功率：总体成功率为95.8%,其中应用生物玻璃填塞种植体周围间隙可以诱导骨组织再生,其成功率均为100%,在种植床上方覆盖生物胶原膜者成功率为91.7%.②诱导骨组织再生作用：单用生物玻璃或两种方法联合应用诱导骨再生效果均较快,8周时表现骨质沉积量明显较多,其成骨呈多中心性,12周时可以诱导再生成熟的骨组织,并使种植体达到骨结合;应用生物胶原膜成骨呈向心性,成骨速度稍慢,12周时可以引导再生成熟的骨组织,并使种植体达到骨结合;空白组12周时在种植体的上部仍有较大部分软组织存在. 结论：在即刻种植中应用生物玻璃和生物胶原膜均可以诱导骨组织再生,促进骨愈合,获得较高的种植成功率;两者联合应用的成骨效果较单独应用生物胶原膜好.     

Premature centromere division of metaphase chromosomes in drug addicts and alcoholics

The study of metaphase chromosomes in peripheral blood lymphocytes from alcoholics and drug addicts revealed enhanced incidence of chromosomes with premature centromere division. The mean proportion of such metaphases was 14.8% in patients in the abstinent state, which is related to drastic disturbances of physiological homeostasis. The detoxification course decreased this proportion to 6%, which is comparable to the value of 5.1% in the control group. Individual differences were found in the incidence of metaphases with premature centromere division. Translated fromByulleten' Eksperimental'noi Biologii i Meditsiny, Vol. 124, No. 9, pp. 322–326, September, 1997     

一种新的阿片受点不可逆激动剂7α-二(β-氯乙基)胺甲基-6,14-乙烯撑基四氢奥利文的药理研究

α-CAM是一新的阿片受点不可逆激动剂,在离体组织(GPI,MVD,RVD和RbVD)及大鼠脑P_2膜制备上均表现不可逆作用。对小鼠镇痛(icv)ED_(50)为0.12 nmol/鼠,镇痛作用可持续2～3 d,是迄今所知镇痛时间最长的化合物。一次注射(icv)即可使小鼠成瘾,可作为研究成瘾机理的工具药。     

一种新的阿片受点不可逆激动剂7α-二(β-氯乙基)胺甲基-6,14-乙烯撑基四氢奥利文的药理研究

α-CAM是一新的阿片受点不可逆激动剂,在离体组织(GPI,MVD,RVD和RbVD)及大鼠脑P₂膜制备上均表现不可逆作用。对小鼠镇痛(icv)ED₅₀为0.12 nmol/鼠,镇痛作用可持续2～3 d,是迄今所知镇痛时间最长的化合物。一次注射(icv)即可使小鼠成瘾,可作为研究成瘾机理的工具药。     

烟酰胺类和吡啶丙烯酰胺类衍生物的合成及扩血管活性

Eighteen nicotinamides(I_1～12)and pyridylacrylamides(II_1～15)have beensynthesized. All synthesized amides were submitted to phannacological screening and 0.1um·L^-1(10^-7M)-noradrenaline induced contraction of the rat aortic strip was taken aS criterion,The amidesI_3,4 and II_1,2 showed more potent vasodilating activity than compounds I_12,13 and II_3,4.     

药用鼠尾草属植物中7种脂溶性成分的HPLC法分析

采用YWG-C₁₈H₃₇柱,以甲醇-水(77:23)为流动相,在254nm检测波长下用内标法测定了9种药用鼠尾草属植物中丹参酮Ⅱ-B、紫丹参甲素、二氢丹参酮Ⅰ、隐丹参酮、丹参酮Ⅰ、丹参酮Ⅱ-A及红根草邻醌的含量。