早期气管切开对重度颅脑外伤患者预后的影响

目的探讨早期气管切开对重度颅脑外伤患者预后的影响。方法回顾156例重度颅脑外伤患者,按气管切开的时间(<12小时,12~24小时,>24小时)分为A,B,C组,对其肺部感染发生率以及存活率进行比较。结果A组患者55例,B组患者49例,C组患者52例,肺部感染发生率分别为45.45%(25/55),55.10%(27/49),78.85%(41/52),差异有显著性(P<0.05);死亡率分别为47.27%(26/55),59.18%(29/49),73.08%(38/52),差异有显著性(P<0.05)。结论对重度颅脑外伤患者早期行气管切开术能有效的降低肺部感染的发生率,提高存活率。     

儿童腺病毒肺炎临床研究进展

腺病毒肺炎是我国儿童常见的急性呼吸道疾病,也是目前造成儿童死亡的重要原因之一。为引起临床医生的重视,降低儿童腺病毒肺炎的发病率和病死率,此文就儿童腺病毒肺炎的最新研究进展展开叙述。     

妊娠高血压患者血浆中降钙素基因相关肽的测定及其临床意义

本文测定了３０例正常育龄妇女，２８例正常妊娠以及３６例妊娠征患者血浆中降钙素基因相关肽的水平，结果发现，轻度妊高生与正常妊娠相比，血浆中ＣＧＲＰＫ是有下降但不显著（Ｐ〉０．０５）。中重度妊高征与正常妊娠相比，差异有非常显著性，因此推测，妊娠状态下血浆中降钙素基因相关肽的减少可能是妊娠高血压症产生的重要原因之一。     

CYP2C9 allele variants in Chinese hypertension patients and healthy controls

BACKGROUND: Cytochromes P450 (CYP) 2C9 are polymorphic enzymes which catalyze a wide spectrum of drugs. It is also responsible for the metabolism of arachidonic acid into EETs. EETs are known to be a vasoactive substance and play an important role in a hypertensive episode. Whether the genetic polymorphism of CYP2C9 will affect the vasoactive effect and consequently affect hypertension formation is still unknown. We investigated the association of CYP2C9*2, CYP2C9*3 and CYP2C9*6 with hypertension. METHODS: Two hundred and thirty-nine hypertension patients and 265 healthy controls participated in our study. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to identify CYP2C9*2, CYP2C9*3 and CYP2C9*6. RESULTS: CYP2C9*2 and CYP2C9*6 were not detected in our study. The allelic frequency of CYP2C9*3 was 0.015 in hypertension patients in our study. In healthy controls, the allelic frequency of CYP2C9*3 was 0.049. Significant difference existed in CYP2C9*3 frequency between hypertension patients and healthy controls (0.015 for hypertension patients vs. 0.049 for healthy controls; chi2 = 9.728, P < 0.005, OR = 0.277, 95% CI: 0.118-0.651). Also, gender-dependent difference was observed. In females, CYP2C9*3 frequency of hypertension patients was significantly lower than that of healthy controls (chi2 = 11.513, P < 0.001, OR = 0.113, 95% CI: 0.026-0.500). CONCLUSION: To our knowledge, this is the first report on CYP2C9 frequencies in hypertension patients. Our study implied that CYP2C9*3 had a secondary protective effect in females, which may be useful for studying hypertension pathogenesis and therapeutics.     

米甜酒中氨基酸和黄曲霉毒素的分析

米甜酒为糯米发酵而得的低醇甜酒,民间饮用普遍。为考察其营养成分,本文用纸层析方法进行了米甜酒的氨基酸分析,从中分离和鉴定了精氨酸(Arginine),瓜氨酸(Citrulline),苏氨酸(Threonine),丝氨酸(Serine),酪氨酸(Tyrosine),苯丙氨酸(Phenylalanine),     

中药联合手术对原发性闭角型青光眼的疗效观察

目的:观察中药联合前房穿刺加小梁切除术对原发性闭角型青光眼视功能恢复作用的疗效。方法:将纳入原发性闭角型青光眼患者43例64眼,随机分成对照组20例(31眼)和治疗组23例(33眼),其中对照组小梁切除术后服用ATP、维生素B1及弥可保治疗。治疗组在使用上述西药的同时给予中药治疗。治疗后分别记录术前及术后每周的视力、眼压、滤泡变化,1个月的视力、眼压、视野、眼底、滤泡。结果:两组治疗后视力以及视野改善情况比较,有显著性差异(P<0.01),说明治疗组疗效优于对照组;两组术后眼压以及功能性滤泡形成情况比较,无显著性差异(P>0.05)。结论:中药联合前房穿刺加小梁切除术对原发性闭角型青光眼视功能恢复有一定的治疗作用。     

基于中药质量标志物和传统用法的中药饮片标准汤剂传承发展研究思路与建议

中药汤剂(也称煎剂)是中医师最常用的中药复方剂型,也是中药历史上应用最久和最广的制剂。药材是饮片的原料,饮片是制备提取物、构成中医处方和中药制剂的原料,更体现了传承发展中药的重要性。基于中药饮片标准汤剂,科学认识汤剂质量,提高药典饮片和中成药质量评价研究理论和方法是科学发展的重要策略。开展以中医药理论为指导、临床应用为基础的中药饮片标准汤剂研究,基于中药质量标志物理论和研究方法探讨饮片和煎煮工艺的影响,形成标准汤剂的质量评价体系,既有利于确保中医处方用药的安全和疗效,也有利于认识标准汤剂在"药材-饮片-中成药"的质量及其标准的差异和价值,提升国家对中药饮片监管水平,保障人民用药安全和有效;还有利于认识标准汤剂在中药饮片生产、中药配方颗粒及经典名方的传承研发中的重要意义。     

脑内Glycine受体的结合特性与甾体激素相关性研究

目的研究甾体激素对脑内Glycine受体结合的影响。方法制备大鼠脑突触质膜,排除胞液污染,用放射配体结合的方法,以[3H]甘氨酸为标记配体。结果测出甘氨酸受体结合的饱和曲线,Scatchard作图为一条直线,结合容量Bmax为每毫克蛋白(26±4)pmol,平衡解离常数Kd为(173±15)nmol.L-1,士的宁取代实验显示:脑干部甘氨酸受体为士的宁敏感型,其余脑部为士的宁不敏感型。甾体激素取代实验显示:孕酮对甘氨酸受体的结合有快速的抑制作用。结论孕激素对甘氨酸受体的结合有影响。     

Differential impact of TGF-beta and EGF on fibroblast differentiation and invasion reciprocally promotes colon cancer cell invasion

Several studies indicate that cancer-associated fibroblasts play a critical role in cancer cell invasion and metastasis, the hallmarks of malignancy. To better understand the mechanisms underlying such effects, we established a heterotypic model of human fibroblasts (primary colon fibroblasts and immortalized human dermal fibroblasts) in co-culture with human colon cancer cells (HCT-8/E11), using three-dimensional collagen type-I and Matrigel matrices. We report that TGF-beta is the unique and dominant factor to provide pro-invasive signals to HCT-8/E11 colon cancer cells from TGF-beta-treated human fibroblasts in three-dimensional collagen type I and Matrigel matrices. These effects are not mimicked or reversed by EGF or bFGF, and are associated with the TGF-beta-mediated induction of myofibroblast differentiation and functional markers, such as alpha-SMA, the haptotactic matrix molecule TNC, collagen type 1 maturation enzyme P4H, serine protease FAP, and myofibroblast contractility. Accordingly, TGF-beta induced a strong activation of RhoA and stress fiber formation in fibroblasts, with no impact on Rac1-GTP levels. In contrast, EGF down-regulated Rho-GTP levels in fibroblasts, giving permissive signals for Rac1 activation, fibroblast polarization, and invasion. Taken together, our data imply that TGF-beta and EGF exert invasive growth-promoting actions in human colon tumors through a differential and cumulative impact on the stromal and cancer cell compartments. Our data predict that inhibitors directed at this reciprocal molecular and cellular crosstalk will have therapeutic applications for targeting the invasive growth of human primary tumors and their metastatic spread.     

两种喹诺酮类滴眼液治疗细菌性角膜炎的动物实验与临床试验观察

目的：比较喹诺酮类抗菌药加替沙星和左氧氟沙星滴眼液治疗细菌性角膜炎的疗效。方法：动物实验：建立兔细菌性角膜炎模型,随机分为接种菌基线组、空白对照组、0.5%左氧氟沙星组、0.3%加替沙星组。按预定给药方案给药,观察兔角膜炎情况,同时进行房水细菌培养,评价细菌学变化。临床试验：44例患者随机分为加替沙星组和左氧氟沙星组,观察用药后疗效。结果：加替沙星和左氧氟沙星对金葡菌的MIC分别为0.062 5 mg·L~（-1）和0.125 mg·L~（-1）,加替沙星组的角膜菌落计数为1.68±0.36,显著低于左氧氟沙星组的3.73±0.39（P〈0.01）;症状体征总评分加替沙星明显低于左氧氟沙星（3.21±1.44vs 6.92±3.88,P〈0.01）;临床治疗中加替沙星和左氧氟沙星的有效率分别为95.45%和86.36%,但差异无统计学意义（P〉0.05）。结论：菌落计数、症状体征评分显示加替沙星优于左氧氟沙星,提示加替沙星相对于左氧氟沙星而言,在眼局部给药用于治疗金葡菌性角膜炎方面具有一定的优势。在临床试验中,两组疗效差异无显著性意义。