简介美国肝移植护理新角色—临床护理协调员

自1963年Starzl完成了第1例人体原位肝脏移植以来,肝脏移植在全球范围内得到迅猛发展,并正在以每年10,000例的速度增长。成功的移植不仅帮助那些危重患者重新获得新生,而且对于护理领域也产生了直接深远的影响。由此产生了新型的护理角色———临床护理协调员(Clinic Nursing C     

中医辨证治疗重症妊娠恶阻115例

按肝胃不和、脾胃虚弱、痰湿内阻、气阴两虚4类辨证施治,呕吐严重者配合中药浓煎取汁雾气吸入。经2～3周治疗,本组115例中痊愈78例,显效30例,有效7例。总有效率100％。其中肝胃不和型疗效最佳,气阴两虚型痊愈率较低。     

滋阴补肾法治疗系统性红斑狼疮的临床疗效评价

目的:观察补肾中药联合西药治疗肾阴虚证型系统性红斑狼疮(SLE)的临床疗效及安全性。方法:62例符合纳入标准的SLE患者随机分为治疗组和对照组,治疗组给予滋阴补肾中药联合西药治疗,对照组仅采用西药治疗,疗程为24周。治疗前后对两组患者的临床疗效进行评估,同时观察肾阴虚证候积分、SLEDAI评分变化,如实记录药物不良反应、糖皮质激素的撤减和反跳现象,以及患者血脂、血糖等变化情况。结果:治疗前后比较,两组患者肾阴虚证候积分、SLEDAI评分均有显著改善(P<0.05);治疗后各项指标治疗组优于对照组(P<0.05);临床疗效评定有效率治疗组为90.32%,对照组为67.74%,两组有显著差异(P<0.05)。治疗后治疗组患者体质量指数、血糖、血脂变化较小,其药物不良反应的发生较对照组明显较少,有显著性差异(P<0.05)。治疗组激素撤减明显较快,反跳现象少,优于对照组,差异有统计学意义(P<0.05)。结论:补肾法联合西药治疗SLE具协同作用,能增加临床疗效,减少西药不良反应。     

Latent membrane protein-1 of Epstein-Barr virus inhibits cell growth and induces sensitivity to cisplatin in nasopharyngeal carcinoma cells.

Nasopharyngeal carcinoma is closely associated with Epstein-Barr virus (EBV) and the EBV encoded latent membrane protein-1 expression (LMP1) is commonly found in the tumour cells. LMP1 has been shown to be involved in modulation of cell growth in B cells but the biological properties of LMP1 expression in nasopharyngeal carcinoma cells are less defined. In this study, a full length LMP1 gene was introduced into an EBV negative nasopharyngeal carcinoma cell line, CNE2, and five LMP1-expressing clones were isolated. Expression of LMP1 did not confer cell growth advantage in CNE2 cells; instead, it induced growth inhibition both in vitro and in vivo. In addition, the LMP1 transfected cells were more susceptible to cisplatin-induced cell death and showed 1.4-4.0-fold increased sensitivity to cisplatin compared to the vector infected control clones. The effect of LMP1 on the balance of Bcl-2 and Bax ratio may play a role in inducing susceptibility to cisplatin-induced cell death. These results demonstrated that LMP1 did not confer growth advantage in CNE2 cells, suggesting that expression of LMP1 may not be crucial in sustaining cell growth in established cell lines. Alternatively, LMP1 alone may not be sufficient to facilitate nasopharyngeal carcinoma cell growth and additional oncogenic factors may be needed along with LMP1 in modulating the malignant property of nasopharyngeal carcinoma.     

A novel in vivo lecithin-cholesterol acyltransferase (LCAT)-deficient mouse expressing predominantly LpX is associated with spontaneous glomerulopathy

Complete lecithin cholesterol acyltransferase (LCAT) deficiency is a rare genetic cause of extreme reduction in high density lipoproteins and there is a high prevalence of chronic renal dysfunction that may progress to renal failure. Previous in vitro studies suggest the vesicular lipoprotein X (LpX) particles commonly seen in LCAT-deficient plasmas may be causative. To test this hypothesis, we have generated a novel murine model that selectively accumulate LpX in the circulation by cross breeding the sterol regulatory element binding protein (SREBP) 1a transgenic mice (S+) with the LCAT knockout (lcat-/-) mice. Fast protein liquid chromatography fractionation of pooled plasma lipids revealed that virtually all cholesterol is concentrated in the very low density lipoprotein (VLDL)-sized fractions. These fractions are enriched in free cholesterol and phospholipid but extremely poor in triglyceride. Electron microscopy of the d <1.063 g/ml fraction of the S+lcat-/- mice revealed abnormal large vesicular particles, suggestive of LpX. The S+lcat-/- mice developed glomerular lesions spontaneously evident at 6 months with glomerular and tubulointerstitial lipid-deposits. Immunohistochemical staining with RhoA showed marked positive focal staining in glomeruli in the S+lcat-/- mice and undetectable in the S+/lcat+/+ control. By 10 months of age, the kidneys showed progressive glomerular injury including segmental foam cell infiltrates, mesangial expansion, and hyalinosis. Renal abnormalities are very similar to those seen in human LCAT deficiency. We conclude that the selective high-level accumulation of plasma LpX in the S+lcat-/- mice is strongly associated with a spontaneous glomerulopathy, providing in vivo evidence that LpX contributes to the LCAT deficiency-related nephropathy.     

脐血移植治疗儿童骨髓增生异常综合征

骨髓增生异常综合征 (myelodysplasticsyndrome,MDS)是一组由造血干细胞突变而引起的恶性克隆增殖性疾病 ,以骨髓无效造血、三系细胞减少和形态异常为特征。近年来 ,随着对MDS认识的深入及诊断标准的完善 ,儿童患者有增多趋势。与此同时 ,人们对MDS的治疗也进行了各种探索 ,但迄今为止MDS的疗效仍不能让人满意。我们最近为 1例MDS患儿进行同胞脐血移植治疗 ,取得了满意的疗效 ,现报告如下。病例和方法1 患儿男 ,12岁。因面色苍白伴皮肤出血点 4年 10个月于 2 0 0 2年 5月 12日入院。 1997年 7月出现皮肤出血点、鼻衄 ,面色苍白 ;查血…     

Dominant factors affecting reproductive outcomes of fertility-desiring young women with intrauterine adhesions

Purpose

To identify the dominant factors affecting reproductive outcomes of fertility-desiring young women with intrauterine adhesions (IUA) after hysteroscopic adhesiolysis.

Methods

This prospective observational study included 104 cases of women with IUA. Logistic regression analysis was applied to analyze the value of the location and extent of adhesions, the number of previous uterine cavity surgery, menstrual patterns, and second look hysteroscopy time.

Results

In the total 104 patients with IUA, 91 patients (87.5%) had a history of at least one previous uterine cavity surgery. Hypomenorrhoea and amenorrhoea were two most common presenting menstrual abnormalities occurring in 59 (56.7%) and 28 (26.9%) cases, respectively. The clinical pregnancy rate was 60.6% (63/104) and the live birth rate was 39.4% (41/104). Pregnancy rate was higher in patients having mild IUA (81.5%) as compared to moderate (61.3%) or severe type (20.0%) (p?<?0.001). The bivariate and binary logistic regression analysis revealed that the location and extent of adhesions were the independent parameters related to the reproductive outcome after hysteroscopic adhesiolysis for fertility-desiring women with IUA (p?=?0.011 and p?=?0.003, respectively), but not the number of previous uterine cavity surgery, menstrual patterns, and second look hysteroscopy time (p?=?0.232, p?=?0.239 and p?=?0.120, respectively).

Conclusion

The extent and location of IUA are the dominant factors affecting reproductive outcomes, which are possibly regarded as a potential predictor evaluating prognosis of IUA after hysteroscopic adhesiolysis.