Wnt信号转导通路与肝纤维化

Wnt信号通路包括经典通路和非经典通路,其参与调控细胞的分化、癌变、凋亡及机体免疫、应激等生理病理过程。最近有研究表明Wnt信号通路与肝星状细胞的活化及肝纤维化的发生相关,深入研究Wnt信号通路在肝纤维化发生中的作用,将有助于进一步揭示肝纤维化的发生机制,为肝纤维化的防治提供新的可能途径及干预靶点。     

神经生长液对D-半乳糖衰老模型小鼠的影响

目的　观察中药合剂神经生长液对 D-半乳糖衰老模型小鼠的影响。方法　建立 D-半乳糖致小鼠衰老模型 ,以 Y型电迷宫检测其学习记忆能力 ,分别采用黄嘌呤氧化酶法、TBA比色法测定大脑 SOD活性和 MDA含量 ,观察小鼠服用神经生长液后上述指标的变化。结果　与 D-半乳糖模型组相比 ,神经生长液低、中、高剂量均可显著提高衰老模型小鼠的学习记忆能力 (P<0 .0 5或 P<0 .0 1 ) ,显著增加 D-半乳糖所致衰老模型小鼠大脑 SOD活性、降低 MDA含量 (P<0 .0 5或 P<0 .0 1 )。结论　神经生长液能改善 D-半乳糖所致衰老小鼠的多项体征。     

Abnormal autonomic modulation of QT interval in patients with idiopathic ventricular tachycardia associated with clinically normal hearts.

BACKGROUND--Idiopathic ventricular tachycardia (VT) occurs in a small but important subset of patients without clinically overt heart disease. The mechanism of the arrhythmogenesis remains unclear in these patients. This study examines modulation of the QT interval by the autonomic nervous system in a group of patients with idiopathic ventricular tachycardia. METHODS--Cardiac autonomic activity and ventricular repolarisation were studied in 27 patients with VT associated with a clinically normal heart (NHVT) and in 20 normal subjects. All the patients were in sinus rhythm, had normal atrioventricular conduction, and were in a drug free state. Cardiac efferent autonomic activity was measured by spectral analysis of heart rate variability from 24 hour ambulatory electrocardiograms on a Holter analysis system (Marquette). Ventricular repolarisation was evaluated by measuring the QT intervals from the same 24 hour Holter tapes at one hour intervals. RESULTS--There was no difference in any of the QT interval variables including the maximum, minimum, and mean of both the QT interval and its corrected value (Bazett's formula) between patients with NHVT and normal subjects. The high frequency component (0.04-0.15 Hz) of heart rate variability was significantly decreased in patients with NHVT compared with normal subjects (16 (8) v 21 (12) ms, p < 0.05). There was a significant correlation between the spectral variables of heart rate variability and the mean, maximal, and minimal QT intervals in normal subjects, whereas the relation was lost in patients with NHVT. No difference was found in mean heart rate between normal subjects and patients with NHVT (70 (9) v 72 (13) beats/min, NS). CONCLUSIONS--The high frequency component of heart rate variability is significantly decreased and the relation of QT interval to heart rate variability is significantly altered in patients with NHVT as compared with normal subjects. These findings suggest that abnormal modulation of the QT interval by the autonomic nervous system may play an important part in the arrhythmogenesis of NHVT. This might result from impaired vagal efferent cardiac activity in these patients.     

一种新的HBeAg阴性慢性乙型肝炎病毒变异机制

Objective To investigate mutation patterns in core promoter(CP)region of hepatitis B virus(HBV).Methods HBV DNA was extracted from sera of patients with chronic HBV infection.The CP sequence was amplified by polymerase chain reaction(PCR)and cloned into pMD19 T vector.The positive clones were then sequenced.The sequences were compared with known HBV genome in GenBank to identify the mutation sites and patterns of patients with chronic HBV infection.Results There were 74 clones from 21 patients with chronic HBV infection which were sequenced.The sequence comparisons showed that there was a 234-nucleotide deletion in CP region of HBV genome in 54 clones and a 245-nucleotide deletion in one clone.These deletion regions included CP,HBeAg initiation codon and direct repeat sequence(DR)Ⅰ regions,which named CP deletion(CPD).A1585T replacement mutation was also found in HBV strain with CPD,which indicated that there was linkage between these two mutations.Conclusions A novel mechanism of HBeAg negative chronic hepatitis B is observed,which includes deletions of CP and HBeAg initiation codon.Meanwhile,a simple and useful PCR method is developed to detect CPD.     

骨髓移植患儿移植前后饮食摄入的改变

目的分析骨髓移植患儿移植期间营养摄入及营养状况的改变,评估营养干预的重要性。方法以2012年1月至2012年11月在上海交通大学医学院附属上海儿童医学中心血液肿瘤科行骨髓移植的共计65名患儿为研究对象。以预处理前收集的患儿资料为基线值。预处理开始后至移植后30d每周2次、移植后30-100d每周1次收集患儿营养相关资料,并对患儿日常营养摄入进行膳食分析。在相应时间点收集患儿24h小便行定氮分析。结果患儿总能量和各项宏量营养素口服摄入基线值分别为：总能量（5844．9±2490．4）kJ/d,蛋白质（56．4±28．6）g/d,脂肪（49．7±38．9）g／d,碳水化合物（190．9±91．1）g/d。随着移植预处理开始,各项摄入均明显减少（P均=0．000）。移植后恢复期,患儿能量摄人自第6周开始与基线值差异无统计学意义,蛋白质自第13周开始与基线水平差异无统计学意义,碳水化合物和脂肪摄入分别自第4周和第6周起与基线水平差异无统计学意义。移植前患儿尿氮排出量为（3．9±2．4）g/d,进行预处理后尿氮量达到（16．7±11．0）g／d,显著高于基线尿氮量（P=0．000）。患儿移植后第1周的体重（P=0．000）、三头肌皮褶厚度（P=0．003）、中上臂围（P=0．000）、血清白蛋白（P=0．000）、前白蛋白（P=0．000）均显著低于基线值;移植后第9周的去脂百分比（P=0．010）、肌肉百分比（P=0．001）和蛋白质百分比（P=0．000）显著低于基线值,体脂百分比显著高于基线值（P=0．000）。结论骨髓移植患儿早期即有营养摄入量的改变,在移植恢复期逐渐恢复,其中蛋白质摄入恢复最慢,可能是影响患儿血清蛋白水平的重要因素。因此,骨髓移植患儿需要更为详细的营养指导,尽量以口服摄入满足营养需求,必要时可提供高蛋白营养配方。     

Differential patterns of insulin secretion and sensitivity in patients with type 2 diabetes mellitus and nonalcoholic fatty liver disease versus patients with type 2 diabetes mellitus alone

Aim

The aim of this study was to estimate the prevalence, awareness, treatment, and control of dyslipidemia in Xinjiang, China.

Method

Stratified sampling method was used to select a representative sample of the general population including Chinese Han, Uygur, and Kazak in this geographic area. Seven cities were chosen. Based on the government records of registered residences, one participant was randomly selected from each household. The eligibility criterion for the study was?≥?35 years of age.

Results

A total of 14,618 participants (5,757 Han, 4,767 Uygur, and 4,094 Kazak), were randomly selected from 26 villages in 7 cities. The prevalence of dyslipidemia was 52.72% in the all participants. The prevalence of dyslipidemia was higher in Han than that in the other two ethnic (58.58% in Han, 48.27% in Uygur, and 49.60% in Kazak, P?<?0.000). The prevalence of dyslipidemia was higher in men than that in women (56.4% vs. 49.3%, P?<?0.000). Among the participants with dyslipidemia, the proportion of those who aware, treat, control of dyslipidemia were 53.67%, 22.51%, 17.09% in Han, 42.19%, 27.78%, 16.20% in Uygur, 37.02%, 21.11%, 17.77% in Kazak.

Conclusion

Dyslipidemia is highly prevalent in Xinjiang. The proportion of participants with dyslipidemia who were aware, treated, and controlled is unacceptably low. These results underscore the urgent need to develop national strategies to improve the prevention, detection, and treatment of dyslipidemia in Xinjiang.     

乡村医生一体化管理的实践与思考

面对改建后的标准化社区卫生服务站（村卫生室）,宁波市鄞州区对纳入管理的乡村医生进行了调查,针对乡村医生队伍存在的问题,实施了乡村卫生服务一体化管理改革,将现有的乡村医生纳入到社区卫生服务中心统一管理,加大人财物投入,提高其收入和保障水平,改进了一体化管理的实践效果。     

甘肃省11 358名医务人员锐器伤现状调查

目的对甘肃省不同层次医院的医务人员锐器伤（SI）现状进行调查,为提高临床医务人员的防护意识,规范操作行为以及制定职业防护措施提供指导。方法2012年1-12月,采用多阶段分层整群随机抽样的方法,对甘肃省6市州共38所医疗机构的医务人员进行现场问卷调查和访谈。结果共回收问卷11 358份,SI发生率为9.87%（1 121例）,例次率为12.60%（1 431例次）,发生密度为1.05次/(人·月)。不同性别、岗位、工作年限组医务人员SI发生率差异均有统计学意义（均P<0.05）;不同岗位人群,容易发生SI的地点不同;造成医务人员SI的主要医疗器具是注射器针头、静脉输液头皮针及手术缝针。已知暴露源的SI有1 099例次(76.80%);发生污染SI 980例次(68.48%),其中474例次（48.37%）为血源性疾病暴露,血源性疾病暴露率为33.12%。在调查的血源性暴露中,乙型肝炎病毒(HBV)占74.25%,梅毒螺旋体（TP）占13.10%,丙型肝炎病毒（HCV）占12.01%,人免疫缺陷病毒（HIV）占0.64%。 结论甘肃省医务人员锐器伤发生率处于较高水平,探索适合区域性医疗机构医务人员职业安全监控和管理体系,是一个亟待解决的社会问题。     

四维CT技术在放疗中的应用

介绍了四维CT技术在国内肿瘤放疗中的应用现状,阐述了四维cT图像采集的软件参数设置方法和具体操作步骤,以及使用四维CT图像勾画肿瘤靶区的应用方法,以期提高诊断的准确率,更好地为临床服务。     

新型野战综合手术救治方舱使用管理探讨

介绍了新型野战综合手术救治方舱的功能及结构特点,通过参与卫勤演练与动物实验、巡回医疗相结合的方式进行人装结合训练,对新型野战综合手术救治方舱使用中的管理流程进行探讨,解决其使用管理中存在的问题,使综合手术救治方舱的综合效能及卫勤保障能力得到提升。