阿昔洛韦联合中草药粉治疗扁平疣

扁平疣是皮肤科常见病，好发于青壮年。皮疹为针帽头至黄豆大小扁平光滑丘疹，虽然治疗方法很多。但至今无满意的特殊疗法。我院自2002年5月-2004年7月应用阿昔洛韦加中草药粉治疗扁平疣，取得较好疗效。现报告如下。     

静脉穿刺套管针行胸腔闭式引流效果观察

气胸为脏层或壁层胸膜破裂，空气进入胸腔所形成。由于空气进入胸膜腔，改变了胸腔的负压状态，肺可部分或完全被压缩，静脉回心血液受阻，产生不同程度的肺心功能障碍，是呼吸科急症之一。我院近年来应用静脉穿刺套管针代替传统胸腔闭式引流治疗气胸28例，取得较好效果，现将治疗体会报告如下。     

基于慢病毒的SHARP-2特异的RNA干扰延长肾移植受者大鼠存活时间

Objective To investigate if rat enhancer of split- and hairy-related protein-2 (SHARP-2) short hairpin RNA interference (shRNAi) prolongs the survival time of rat kidney transplant recipients. Methods Gene recombinant procedures, transfection and co-transfection were carried out to introduce short hairpin RNA interference sequences target for SHARP-2 into 3rd generation self-inactivated lentiviral-ViraPower packaging mix. Limiting dilution method was used for viral titration. Real-time PCR was employed for quantification of gene expression. Rat kidney transplantation was utilized to investigate the effect of SHARP-2 gene silence on the recipient survival. Results A lentiviral-based shRNAi construct LV-SHARP-2iC showed 84% SHARP-2 gene silence efficiency in normal rat kidney cells. At multiplicity of infection 20, 57% T cells could be transfected by lentivirus with spinoculation method. In activated T cells, SHARP-2 g ene silence resulted in 61.3% and 68.7% reduction of intedeukin 2 (IL-2) and interferon γ (IFN-γ) gene expression. When donor kidney was perfused with 5×107 TU LV-SHARP-2iC, the median survival time prolonged for 4-5 days as compared to blank and scramble control groups. Conclusions A recombinant lentivirus LV-SHARP-2iC that effectively silence SHARP-2 gene expression is constructed successfully, leading to the inhibition of IL-2 and IFN-γ. LV-SHARP-2iC treatment can prolong the survival time of rat kidney transplant recipients.     

与《浅谈Ridit分析法在医疗工作中的应用》一文作者的商榷

《浅谈Ridit分析法在医疗工作中的应用》一文(见中国卫生统计1990:7(1):5)中谈到“总的看来,各年份的R值相差不大;即各年份的治疗水平近似”。这个结论似乎不妥。既然应用了Ridit分析,那么就     

北京市东城区高血压合并代谢综合征的调查

2002-2004年我院内分泌科对东城区交道口地区社区居民代谢综合征的发病率及伴高血压的代谢综合征发病率进行调查总结如下。     

基于慢病毒的SHARP-2特异的RNA干扰延长肾移植受者大鼠存活时间

Objective To investigate if rat enhancer of split- and hairy-related protein-2 (SHARP-2) short hairpin RNA interference (shRNAi) prolongs the survival time of rat kidney transplant recipients. Methods Gene recombinant procedures, transfection and co-transfection were carried out to introduce short hairpin RNA interference sequences target for SHARP-2 into 3rd generation self-inactivated lentiviral-ViraPower packaging mix. Limiting dilution method was used for viral titration. Real-time PCR was employed for quantification of gene expression. Rat kidney transplantation was utilized to investigate the effect of SHARP-2 gene silence on the recipient survival. Results A lentiviral-based shRNAi construct LV-SHARP-2iC showed 84% SHARP-2 gene silence efficiency in normal rat kidney cells. At multiplicity of infection 20, 57% T cells could be transfected by lentivirus with spinoculation method. In activated T cells, SHARP-2 g ene silence resulted in 61.3% and 68.7% reduction of intedeukin 2 (IL-2) and interferon γ (IFN-γ) gene expression. When donor kidney was perfused with 5×107 TU LV-SHARP-2iC, the median survival time prolonged for 4-5 days as compared to blank and scramble control groups. Conclusions A recombinant lentivirus LV-SHARP-2iC that effectively silence SHARP-2 gene expression is constructed successfully, leading to the inhibition of IL-2 and IFN-γ. LV-SHARP-2iC treatment can prolong the survival time of rat kidney transplant recipients.     

肥厚型心肌病肌球蛋白结合蛋白C基因突变研究

肥厚型心肌病（HCM）是以左心室和（或）右心室及室间隔非对称性肥厚为特征的一组疾病．属常染色体硅性遗传疾病．该病约有55％发病呈家旗聚集性。分子遗传学研究证实HCM是一种基因多态性疾病，编码肌小节结构蛋白的基因突变与其有关．数个基因中一个发生突变即可致病。目前，已发现了可以导致HCM的许多基因突变，包括编码可收缩肌小节的11个基因，超过200余种不同突变。     

超声引导下喉上神经阻滞联合环甲膜穿刺麻醉在清醒气管插管中的应用

目的:探讨超声引导下喉上神经阻滞联合环甲膜穿刺麻醉在清醒气管插管中的应用效果.方法:选择在全麻下实施手术的ASA分级Ⅰ～Ⅱ级的困难气道患者30例,随机分为超声引导组(U组,n=15)和解剖定位组(A组,n=15).全部患者均选择纤维支气管镜引导下经鼻腔气管插管.U组在超声下显示呈高回声的甲舌膜,观察到无回声的喉上动脉穿出甲舌膜,喉上神经内支位于喉上动脉内侧,通过超声引导下平面内技术在此区域注入局麻药,以相同的方法阻滞对侧喉上神经内支.超声下显示呈高回声的环甲膜,通过超声引导下平面内技术进行环甲膜穿刺,气管内表面麻醉.A组依靠传统的解剖标志定位方法触诊舌骨大角和甲状软骨上角,进行双侧喉上神经阻滞.触诊甲状软骨和环状软骨等解剖标志,通过环甲膜穿刺进行气管内表面麻醉.确定气管插管成功后,各组患者均进行快速麻醉诱导.比较2组患者间环甲膜穿刺成功率、各级呛咳发生率和围插管期血流动力学变化.应用SPSS 20.0软件包对数据进行统计学分析.结果:与A组相比,U组患者的环甲膜穿刺成功率更高(P＜0.05),呛咳发生率更低(P＜0.05).与A组相比,U组患者T1(入室后)、T2(插管前)和T5(插管后3min)HR、SBP、DBP的差异无统计学意义(P＞0.05);T3(插管时)、T4(插管后1min)心率增快和血压增高的幅度较小(P＜0.05).结论:超声引导下双侧喉上神经阻滞联合环甲膜穿刺麻醉,在清醒气管插管时安全、有效、优势明显.     

瑞芬太尼、丙泊酚复合七氟烷控制性降压在颅颌面正颌手术中的应用

目的探讨瑞芬太尼、丙泊酚复合七氟烷控制性降压,在颅颌面正颌手术中的麻醉效果和安全性。方法选择择期术中需行控制性降压的颅颌面正颌手术患者210例,随机分为两组,分别应用瑞芬太尼（R组）和硝酸甘油（A组）,联合丙泊酚、七氟烷进行控制性降压,每组105例。麻醉前（TO）、麻醉诱导后（T1）、降压开始5min（T2）、10min（T3）、20min（T4）和30min（T5）,记录心率、动脉收缩压、动脉舒张压、动脉平均压。结果两组患者在T2、T3、T4的MBP均有明显下降,与基础值比较差异有统计学意义（P〈0．01）;R组T2、T3时间点的HR较A组明显减慢（P〈0．01）;R组停止降压后血压回升较缓慢,而A组停止降压后血压回升较快。结论瑞芬太尼、丙泊酚复合七氟烷能有效平稳地降低血压．是颅颌面正颌手术中安全、有效的降压方法。     

静脉留置针留置时间影响因素调查及相关性研究

目的:探讨静脉留置针留置时间影响因素及其影响程度。方法:对335例患者留置静脉针使用情况进行调查,分析影响留置时间因素及其影响程度。结果:肝素封管、加强固定、选择手背血管、血管充盈、输注等渗(含钾或不含钾)液体、一次穿刺、依从性高较盐水封管、一般固定、选择其他部位血管、血管不充盈、输注高渗液体、多次穿刺、依从性低的患者留置针留置时间长。多元逐步回归分析显示留置时间达到3天与封管液选择、固定方法、血管部位、输注液体种类、穿刺次数、依从性6个条目有关。结论:留置时间达到3天的影响因素有封管液选择、固定方法、血管部位、输注液体种类、穿刺次数、依从性等。