肺复张策略对成人瓣膜置换术后肺换气功能的影响

【目的】研究肺复张策略（RM）改善成人体外循环（CPB）心脏换瓣术后肺换气功能的作用。【方法】选择30例心阿直视换瓣手术患者,随机分成常规机械通气组（A组）、早期肺复张组（B组）、晚期肺复张组（C组）。B组在劈开胸骨后实施肺复张策略,C组在到达重症监护室（ICU）后循环稳定后实施肺复张策略。分别于术前（T1）、CPB后（T2）、到达ICU后1h（T3）、2h（T4）、12h（T5）5个时间点记录各项呼吸指标并测动脉和混合静脉血血气,并根据公式计算肺换气功能指标。【结果】B、C组在T2、T3、T4和T5时,氧合指数（OI）高于A组（P〈0．05）,而肺泡-动脉血氧分压差（PA-aO2）和肺内分流量（Os／Qt）低于A组,C组各肺换气功能指标在T4时间内与B组无统计学意义（P〉0．05）,而T5时OI高于B组（P〈0．05）,PA-aO2、Qs／Qt低于B组（P〈0．05）。【结论】肺复张策略能减轻CPB后肺损伤,且晚期肺复张策略优于早期肺复张策略。     

丙型肝炎病毒抗体诊断试剂盒的诊断性能评价

目的 通过与Ortho3．0丙型肝炎病毒（HCV）抗体诊断试剂盒比较，分析评价EIAgenHCV抗体诊断试剂盒（EIAgen）的诊断性能。方法应用考核试剂EIAgen和参比试剂Ortho3．0HCV抗体诊断试剂盒对2881份样本进行检测，检测结果不一致时，应用重组免疫印迹试验（RIBA）确证试剂RIBAHCV3．0或核酸试验（NAT）确证试剂进行确证，以对结果进行综合分析。结果2881份样本中，考核试剂及参比试剂检测结果均为阳性，且参比试剂的测量值／临界值（S／CO）≥3．8，或检测结果符合确证试验阳性结果的阳性标本为274份，考核试剂及参比试剂检测结果均为阳性且参比试剂的S／CO〈3．8为59份，阴性标本2539份，不确定的9份被剔除。考核试剂检测真阳性274份，无假阴性结果；真阴性2527份，假阳性12份。考核试剂敏感度为100％，高于参比试剂的98，91％；特异度为99．53％，略低于参比试剂的99．88％。考核试剂对部分国内常见HCV基因型（1a型、1b型、2a型、3型和6型）样本27份，均为真阳性，敏感度为100％，对于非HCV感染的病毒性肝炎、自身免疫性疾病及妊娠样本具有良好的特异度，特异度均为100％。溶血、脂血样本对考核试剂检测结果无影响。考核试剂阳性预测值为95．80％，阴性预测值为100％，准确性为99．57％。考核试剂S／CO≥5．9的样本301份，其中用参比试剂检测S／CO≥3，8占88．70％；考核试剂S／CO〈5．9的29份，其中用参比试剂检测S／CO〈3．8占86．21％。结论EIAgen敏感度100％，特异度较好，是一种优秀的检测抗-HCVEIAgen试剂，尤其适用于阳性样本的筛选。采用EIAgen试剂检测样本，当S／CO≥5．9时，样本的阳性预测值较高。     

改良自乳化溶剂扩散法制备MePEG-PLA纳米粒对成骨细胞的毒性

背景:两亲性嵌段聚合物由于其较强的载药能力强、纳米级大小、血液中长循环等优点在载药系统中得到广泛的应用。目的:评估改良自乳化溶剂扩散法制备的甲氧基封端的聚乙二醇-聚乳酸(MePEG-PLA)纳米粒对人骨肉瘤细胞MG63的毒性。方法:通过改良自乳化溶剂扩散法制备MePEG-PLA纳米粒,MTS法测定纳米粒培养1,2,3d后对MG63的毒性。激光粒度分析仪测定纳米颗粒的粒径大小、粒径分布及Zeta电位;透射电镜表征纳米胶束外观形态;酶标仪检测培养1,2,3d细胞吸光度值。结果与结论:MePEG-PLA纳米粒的平均粒径为25.7nm,分布均匀,呈球形,Zeta电位为-8.06mV,MePEG-PLA毒性为0级。提示改良自乳化溶剂扩散法制备纳米粒简单易行,制备的纳米粒无毒,具有良好的应用前景。     

113例病灶分泌物真菌分布及药物敏感试验结果

目的 分析113例病灶分泌物真菌分布及药物敏感试验结果,更好地为临床提供确切的治疗药物。方法 收集113例真菌感染病灶分泌物标本,对其进行真菌鉴定及药物敏感试验。结果 113例真菌感染病灶分泌物标本中,白色念珠菌75株(66.4%),都柏林念珠菌29株(26.7%),近平滑念珠菌6例(5.3%),克柔念珠菌3例(2.7%)。5-氟胞嘧啶和两性霉素B对白色念珠菌的敏感度较高,分别为94.7%和97.3%;两性霉素B对都柏林念珠菌的敏感率为93.1%;伏立康唑和两性霉素B对近平滑念珠菌的敏感率均为83.3%;5-氟胞嘧啶和两性霉素B对克柔念珠菌的敏感率均为100.0%。结论 加强用药前病灶分泌物的真菌培养和药物敏感试验,合理应用抗菌药物有助于患者的治疗。     

中药酒剂配合电磁治疗仪治疗颈肩腰腿痛效果观察与护理

目的：探讨中药酒剂配合电磁治疗仪治疗颈肩腰腿痛的疗效。方法将80例颈肩腰腿痛患者分为治疗组和对照组,每组各40例,治疗组使.用中药酒剂加电磁治疗仪治疗,对照组采.用单纯电磁治疗仪治疗。分别在治疗前,治疗3 d、7 d后,采.用数字等级评分（numerical rating scale,NRS）对两组患者进行测评。结果治疗后,治疗组患者NRS评分低于对照组,两组比较,差异具有统计学意义（均P＜0.01）。结论中药酒剂配合电磁治疗仪治疗颈肩腰腿痛效果满意,值得临床应.用推广。     

半导体激光介入治疗腋臭的围术期护理

[目的]总结采用半导体激光介入治疗腋臭的围术期护理方法。[方法]对我科200例腋臭病人在局部浸润麻醉下使用半导体激光介入治疗腋臭的病人实施围术期护理,包括术前心理干预、术中护理、术后护理。[结果]200例半导体激光介入治疗腋臭病人中,痊愈160例,痊愈率80%;复发40例,复发率20%;4例病人出现术后并发症。病人随访0.5年—1.0年,腋窝处皮肤无瘢痕,部分腋毛生长或无腋毛生长,治疗效果满意。[结论]半导体激光介入治疗腋臭的围术期护理,很大限度地保障了手术效果,病人痛苦小、换药次数少,大大提高病人舒适性及满意度。     

改良自乳化溶剂扩散法制备MePEG-PLA纳米粒对成骨细胞的毒性

背景：两亲性嵌段聚合物由于其较强的载药能力强、纳米级大小、血液中长循环等优点在载药系统中得到广泛的应用。目的：评估改良自乳化溶剂扩散法制备的甲氧基封端的聚乙二醇-聚乳酸（MePEG-PLA）纳米粒对人骨肉瘤细胞MG63的毒性。方法：通过改良自乳化溶剂扩散法制备MePEG-PLA纳米粒,MTS法测定纳米粒培养1,2,3d后对MG63的毒性。激光粒度分析仪测定纳米颗粒的粒径大小、粒径分布及Zeta电位;透射电镜表征纳米胶束外观形态;酶标仪检测培养1,2,3d细胞吸光度值。结果与结论：MePEG-PLA纳米粒的平均粒径为25.7nm,分布均匀,呈球形,Zeta电位为-8.06mV,MePEG-PLA毒性为0级。提示改良自乳化溶剂扩散法制备纳米粒简单易行,制备的纳米粒无毒,具有良好的应用前景。     

The effects of interfering in COX-2 gene expression on malignant proliferation of the human lung adenocarcinoma A2 cell in vitro

Objective： We explored the interfering effect of COX-2 gene expression and the influence on the malignant proliferation of A2 cells by RNAi after quenching COX-2 in vitro. Methods： COX-2 was selected as the subject. Three COX-2 siRNA expression vectors with human U6 promoter were constructed and three vectors and the vacant vector （pEGFP） were transfected into A2 cells with lipofectamine respectively. The cell strains transfected were constructed. The change of COX-2 expression levels was examined by Western blot and RT-PCR. The effects on the proliferation of A2 cells after silencing COX- 2 were studied by cell growth curve and clonogenic assay in vitro. Results： The three siRNA and U6 promoter cloned into pEGFP plasmid were validated by PCR, restriction endonucleases identification, DNA sequencing and BLAST alignment. The cell strains transfected were named as A2-3, A2-7, A2-10 and A2-p respectively. Green fluorescence was seen in A2-p cells and not in A2-3, A2-7 and A2-10 cells in 24, 48 and 72 h after transfected. The results of RT-PCR and Western blot showed the three siRNA expression vectors produced effects and the expression of COX-2 was inhibited in different extent. In contrast to A2 cells, the levels of COX-2 mRNA of A2-3, A2-7 and A2-10 cells reduced 15.6%, 20.4% and 64.2% respectively; the levels of COX-2 protein of A2-3, A2-7 and A2-10 cells reduced 23.7%, 36.7% and 60.2% respectively. The results of cell growth curve and clonogenic assay showed the growth of A2-10 cell slowed and the colonial formation rate reduced but the growth of A2-3 and A2-7 cells had not obvious changes in contrast to the controls （A2 and A2-p）. Conclusion： Silencing the COX-2 gene in vitro by RNAi technique can significantly inhibit the malignant proliferation of A2 cells.     

硫酸氢氯吡格雷改善慢性稳定型心绞痛患者阿司匹林抵抗的临床研究

目的研究硫酸氢氯吡格雷（秦嘉）对慢性稳定型心绞痛阿司匹林抵抗患者的治疗价值。方法610例慢性稳定型心绞痛患者依照血小板聚集率分为阿司匹林敏感（AS）者和阿司匹林抵抗（AR）者,将138例AR者随机分为阿司匹林治疗组（AR—A组）、泰嘉治疗组和泰嘉联合阿司匹林治疗组（AR～C组）。472例AS者中随机选取40例设为对照组。4组患者给予严格的药物治疗后随访1年,观察4组患者在治疗前后的血小板聚集率变化,以及治疗后缺血性心脑血管病的发生率和出血性事件的发生率。治疗1月后行12导联24h动态心电图检查,计算24h内缺血型ST段变化的次数、持续时间、心肌缺血总负荷。结果泰嘉可以有效地降低慢性稳定型心绞痛AR患者的血小板聚集率（P〈0．01）;较少发生缺血性心脑血管事件（P〈0．01）,且不增加出血事件的发生（P〉0．05）。对存在AR的慢性稳定型心绞痛患者,单用泰嘉和联合服用阿司匹林治疗,其缺血性ST段变化的次数、持续时间及心肌缺血总负荷明显低于单用阿司匹林治疗（P〈0．05或P〈0．01）。结论泰嘉与阿司匹林联合使用不仅安全,而且能提高慢性稳定型心绞痛AR患者的临床疗效。     

Mechanisms of Panax ginseng in preventing rat pheochromocytoma cells from apoptosis

Aims of the study

Although ginseng root possesses dominant central therapeutic effects and has recently undergone investigations for treating different neuronal diseases, most of its mechanisms are still unknown. Therefore, the neuroprotective mechanisms of ginseng were studied.

Materials and methods

The protection afforded by different methanol extracts of Panax ginseng (PG) was tested in a serum deprivation-induced apoptotic model using neuronal-like pheochromocytoma (PC12) cells. An MTT assay, annexin V-FITC staining, and Western blots were, respectively, applied to identify the viability of cells, the apoptotic form of cell death, and the activity of antiapoptotic signaling.

Results

The known antiapoptotic PI3-K/Akt and MEK/ERK pathways in this system were ruled out due to failure of LY 294002 and PD 98059 to block the protection by PG. A protein kinase A (PKA) inhibitor was found to block the protection by PG and PG-induced CREB phosphorylation, suggesting that the PKA/CREB pathway mediates the protective effect of PG. Downregulation of classical and novel PKCs failed to block the protection by PG, while an atypical PKC inhibitor blocked protection by PG.

Conclusions

PKA and atypical PKC are important for the protection afforded by PG in preventing serum deprivation-induced PC12 cell apoptosis.