彩色多普勒超声在乳腺良恶性肿瘤鉴别诊断中的应用价值

目的:回顾性分析乳腺良恶性肿块的高频二维及彩色多普勒血流表现以提高乳腺恶性肿瘤的早期诊断率。方法:回顾性分析经手术病理证实的167例乳腺肿块患者的超声检查结果,比较并总结良恶性肿瘤的彩色多普勒超声特征。结果:本组超声诊断乳腺恶性肿瘤39例中,在二维声像图上绝大部分有典型的恶性特征,但少部分由于肿块细小超声表现不典型而导致漏误诊(本组漏误诊5例,符合率为87.2%)。良性肿块128例,超声明确诊断113例,符合率为88.3%。乳腺良恶性肿瘤在包膜、形态、边界、内部回声、砂粒状钙化、彩色多普勒血流情况等方面具有明显差异。结论:高频彩色多普勒超声是鉴别诊断乳腺良恶性肿瘤的有效方法,可提高乳腺癌的临床诊断符合率,有利于临床制定合理的治疗方案。     

死因编码与疾病诊断编码的鉴别分析

目的鉴别死因编码与疾病诊断编码的异同。方法结合国际疾病分类的编码规则论述,分析实例。结果很多病例的疾病主要诊断就是根本死因,但也有一些情况二者并不相同。死因编码重点在于确定根本死因,疾病诊断编码重点在于确定主要诊断。结论死因编码与疾病诊断编码在目的、重点及规则等方面都有所不同,因此编码结果不一定相同。     

实验性脑皮层梗死后丘脑netrin-1及其受体的表达

目的观察一侧大脑皮层梗死后远隔丘脑netrin-1及其受体的表达并探讨其可能的作用。方法建立高血压大鼠的右侧大脑中动脉闭塞(middle cerebral artery occlusion,MCAO)模型,假手术组只暴露而不凝闭MCA,每组24只。MCAO或假手术后第8天和第14天,各组各取12只大鼠处死取脑,分别行梗死侧丘脑免疫荧光和western blot检测netrin-1及其受体DCC、UNC5H2的表达水平和表达部位。结果 MCAO术后第8天netrin-1、DCC和UNC5H2表达开始增加,尤以UNC5H2更为明显,并持续至第14天,双重免疫荧光显示这些蛋白主要在神经细胞上表达。结论Netrin-1及其受体DCC和UNC5H2的表达增高,可能与脑梗死后远隔丘脑的神经可塑性有关。     

Netrin-1及其受体在脑缺血中的作用

以netrin-1为代表的netrin家族是目前最受关注的轴突导向因子之一.在胚胎发育期,netrin-1通过吸引/排斥的双重机制对轴突生长和细胞迁移发挥导向作用.同时,netrin-1也在成年神经系统中广泛表达,并参与成年神经系统损伤后的结构和功能重塑.文章综述了netrin-1在缺血性脑损伤中的作用.     

Effect of acupuncture on hippocampal mitochondrial proteome expression in SAMP8 mouse model with Alzheimer disease

Objective

To observe the effect of acupuncture on the expression of mitochondrial proteome in hippocampus of senescence-accelerated mouse prone 8 (SAMP8) mice models with Alzheimer disease (AD), and to explore the possible protective mechanism of acupuncture on mitochondria.

Methods

Sixty 6-month-old male SAMP8 mice were randomly divided into an acupuncture at acupoint group, an acupuncture at non-acupoint group and a model group, 20 mice in each group. The 20 male senescence-accelerated mouse/resistance 1 (SAMR1) mice of the same age were used as a normal control group. Shenshu (BL 23), Baihui (GV 20), Xuehai (SP 10) and Geshu (BL 17) were selected for acupuncture intervention in acupuncture at acupoint group. After an 8-week intervention, mitochondrial tissues were extracted from the hippocampus. Differentially expressed proteins were identified by subcellular organelle proteomics. Western blot was used to verify the expressions of some related proteins in hippocampal mitochondria.

Results

Compared with the model group, there were 13 differentially expressed protein spots in the acupuncture at acupoint group, of which, 9 were up-regulated, including neurofilament light polypeptide (NFL), actin (cytoplasmic 1, database ID: ACTB), tubulin beta-2A chain (TBB2A), tropomodulin-2 (TMOD2), pyruvate dehydrogenase E1 component subunit beta (PDHE1-β), NADH-ubiquinone oxidoreductase 75 kDa subunit (database ID: NDUS1), heat shock cognate 71 kDa protein (HSC71), pyruvate dehydrogenase E1 component subunit alpha (PDHE1-α) and ATP synthase beta subunit (ATP-β); 4 were down-regulated, including glial fibrillary acidic protein (GFAP), pyruvate dehydrogenase phosphatase 1 (PDP1), mitochondrial-processing peptidase subunit alpha (MMP-α) and adenosine kinase (ADK). According to the information provided in the protein database, most of the differentially expressed proteins involve the regulation of mitochondrial function and structure. The expression levels of NFL and TBB2A in the normal control group and the acupuncture at acupoint group were significantly higher than those in the acupuncture at non-acupoint group (P<0.05). ATP-β and NDUS1 expression levels were significantly higher in the acupuncture at acupoint group than those in the acupuncture at non-acupoint group (P<0.05); there was no significant difference between the acupuncture at non-acupoint group and the model group (P>0.05).

Conclusion

Acupuncture may achieve the potential therapeutic effect on AD by regulating the structure and functional proteins of hippocampal mitochondria.

     

基于药动学的中药配伍研究现状

通过检索查阅近年国内研究文献,从两味中药配伍、中药复方配伍、单体成分之间配伍3方面阐述中药配伍对药动学参数的影响及其存在的问题,为今后进行药动学研究提供有价值的参考。中药配伍主要是为了达到减毒增效的作用,而配伍会对药动学参数产生显著的影响,影响到中药的体内外过程,因此应合理利用中药配伍。     

硒锌制剂拮抗慢性氟中毒的实验研究

目的：探讨硒锌制剂对慢性氟中毒的影响及其机理。方法：Wistar大鼠在饮含50mg/L高氟水的同时通过灌胃方式给予不同剂量的硒锌制剂,2个月后,测量大鼠尿液氟浓度和r-GT活性,血液GSH－Px活性及肾组织中LPO水平,GSH含量和SOD活性,结果：发现硒锌制剂通过促进尿氟排泄,增强全血GSH－PX的肾SOD活性,增加肾GSH含量而抑制氟中毒引起的脂质过氧化作用,从面降低尿r-GT活性和肾LPO含量,结论：提示一定剂量的硒锌制剂对慢性氟中 明显的拮抗作用,其机理可能与通过促进尿氟排泄和抗脂质过氧化作用有关。     

不孕不育夫妇生殖道支原体感染状况及耐药情况分析

目的：探讨不孕不育患者生殖道支原体感染状况及耐药情况。方法：本研究于2013年1月～2013年12月对424例不孕不育患者的泌尿生殖道标本进行了UU和MH的感染检测及药敏分析，目的在于监测支原体对药物的耐药性和敏感性，为合理用药提供参考。结果：经统计学分析研究组的支原体感染率明显高于对照组（χ2=9．67．P〈0．05）。支原体对米诺环素最敏感，本次药敏实验结果显示其敏感率最高，达81．35％，其次是多西环素，敏感率为78．24％；而对沙霉素、克拉霉素、红霉素、罗红霉素和阿奇霉素等大环内酯类交抗生素的耐药率达到30％以上，对环丙沙星、左氧氟沙星和司帕沙星等喹诺酮类抗生素的耐药率则达到60％以上，其中对环丙沙星的耐药率最高，达69．95％。结论：支原体对喹诺酮类和大环内酯类抗生素的耐药率较高，而对米诺环素、多西环素等四环素类抗生素较为敏感，所以临床治疗时必须进行相应的药物敏感性试验，合理使用抗生素。     

脚气病误诊为格林-巴利综合征1例分析

脚气病（即维生素B1缺乏病）目前临床罕见，曾住我院1例误诊为格林-巴利综合征，现报告如下。     

内科医院感染状况及危险因素研究

目的：了解内科医院感染的发生与分布，分析其危险因素。方法：对1787例内科住院病人的病历资料进行流行病学调查，并对查出的医院感染患者进行1：1配比病例对照研究。结果：总的医院感染率为4．09％；其构成比为呼吸道45．52％，伤口15．86％，消化道12．41％；送检病原菌检出率为24．66％。多因素分析结果显示内科发生医院感染的主要危险因素为泌尿道插管、基础疾病严重程度。结论：内科是医院感染的重要科室。医院感染病例漏报率高，送检率低是医院感染管理的薄弱环节。