血小板活化因子与新生儿坏死性小肠结肠炎

新生儿坏死性小肠结肠炎(necrotizing enterccolitis,NEC)是新生儿(特别是早产儿)最常见和最严重的疾病之一。由于肺表面活性物质的应用及医务人员综合素质的提高,许多小早产儿得以存活,然而近30年来NEC的发病率并未下降,主要原因是NEC的发病机制尚不十分清楚。     

糖皮质激素诱导试验与儿童急性淋巴细胞性白血病预后的关系

目的　通过糖皮质激素早期诱导试验评估儿童急性淋巴细胞性白血病的预后。方法　诱导试验是根据初发病时外周血幼稚细胞计数及服用糖皮质激素 (GC) 7d后外周血中幼稚细胞的动态变化。此后 ,所有病例都接受同样强烈的化疗方案。结果　 6 0例患儿中对泼尼松诱导试验敏感 (PGR)者为 4 9例 ,占 81 7% ,其中高危患儿 6例 ,中危患儿 8例 ,低危患儿 35例。在 4 9例PGR患儿中 38例 (77 6 % )处于持续缓解状态 (CCR) ,中位缓解期为 2 2 5个月 ;复发 3例 ,占 6 1%。 6 0例患儿中对泼尼松诱导试验不敏感 (PPR)者为 11例 ,占 18 3%。在PPR 11例中 ,5例早期复发 ,占 4 5 5 % ;2例达CCR ,占 18 2 %。从治疗第 19天、第 30天的骨髓检查 ,PPR组 19dM1、M2 、M3分别为 72 7%、18 1%、9 2 % ;PGR组 19dM1、M2 分别为 96 %、4 % ,无一例为M3 。达CR时间 ,PPR组明显迟于PGR组。结论　GC在用于治疗恶性淋巴细胞增生性疾病中 ,起到了重要作用。     

从试卷分析结果探讨《预防医学》教学现状及对策

目的:通过对本校近期预防医学考试结果的试卷分析,总结我校非预防医学专业预防医学教学现状,探讨如何进一步提高预防医学教学质量.方法:对2009-2010学年第一学期182份预防医学试卷结果进行分析.结果:各班均分都低于期望均分75分,均无90分以上者;试题平均区分度较强,平均难度较大.结论:我校非预防专业预防医学教学中存在一定问题,对<预防医学>教学应采取一些改革措施,以有效提高学生对本课程的掌握,引导并提高学生对课堂知识的综合运用能力,从而提高教学质量,达到教学目的.     

纤维鼻咽喉镜下低温等离子治疗会厌囊肿

目的探讨纤维鼻咽喉镜下低温等离子治疗会厌囊肿的疗效。方法表面麻醉下纤维鼻咽喉镜下切除会厌囊肿。结果喉镜检查囊肿消失,随访6～12个月,无一例复发。结论纤维鼻咽喉镜下低温等离子治疗会厌囊肿微创安全,值得临床推广应用。     

外周血CD34+造血干细胞加适量T细胞输注进行HLA半相合的异体移植

对1例Ph+染色体的急淋患儿进行母子间HLA半相合的异体外周血造血干细胞移植 ,为避免由于HLA不相合所产生的由T细胞介导的严重移植物抗宿主病(GVHD) ,采用了CD34+细胞正性分离去除淋巴细胞 ;同时为避免由于T细胞过度去除而引起宿主抗移植物反应(HVG)导致植入失败 ,在移植次日又加入部分T细胞 ,使病儿接受CD34 +细胞6×106/kg 和CD3 +细胞1.05×107/kg。结果 :随访1年来 ,红系、粒系和巨核系均恢复正常 ,临床上仅出现一过性的IIOaGVHD以及轻微的局限于口唇粘膜的cGVHD。STR位点DNA检验以及染色体检查 :移植后 +180天受体已从供体型嵌合体转为完全供体型 ,病儿获得植入成功。结果表明 ,常规剂量的CD34 +细胞移植加以适量CD3 +T细胞 ,可克服HLA部分不相配的难点 ,减轻GVHD ,同时也可避免由于过度的T细胞去除而出现的HVG。     

甲型肝炎患儿腹腔淋巴结肿大的超声诊断及临床意义

为探讨甲型肝炎（甲肝）患儿腹腔淋巴结肿大的发生率、声像图特点及临床意义 ，用超声诊断仪作纵、横、斜向多方位超声切面，清晰显示肝门区卵圆形低回声区，并可与邻近脏器及血管分开，确认为肿大淋巴结。结果发现60例甲肝患儿显示肝门淋巴结肿大53例（88．33％），分布于门静脉主干两侧及后方。提示：①甲肝患儿肝门淋巴结肿大发生率高，可能与淋巴系统发育旺盛、对抗原的应答反应异常敏感有关；②肿大淋巴结分布于门脉主干两侧及后方，故并不压迫门脉右前言的胆总管而造成胆道梗塞；③肿大淋巴结的消失远迟于血清肝功能指标的恢复。     

Popularizing labor analgesia in China.

In China many women in labor are young primigravidas whose fear of labor pain leads them to request cesarean deliveries. While the rate of cesarean deliveries has reached 50% in many hospitals, less than 1% of women in labor are given neuraxial analgesia. The necessary equipment is seldom available in China and many physicians have misconceptions about the risks associated with neuraxial analgesia, which are low with the ultra-low-dosages used today. However, attitudes have begun to change. Meetings held in China have brought together Chinese physicians and world experts on the various epidural and combined spinal-epidural techniques. Thanks to the information and support provided at these meetings clinical trials were carried out, more than 5000 women benefited from labor analgesia, and publications appeared in Chinese journals. An effective, safe, and cost-effective way to provide analgesia to women in labor may slow the increase in cesarean delivery rates across China and improve women's health in general.     

Mechanical properties and in vitro biocompatibility of porous zein scaffolds

A porous scaffold utilizing hydrophobic protein zein was prepared by the salt-leaching method for tissue engineering. The scaffolds possessed a total porosity of 75.3-79.0%, compressive Young's modulus of (28.2+/-6.7)MPa-(86.6+/-19.9)MPa and compressive strength of (2.5+/-1.2)MPa-(11.8+/-1.7)MPa, the percentage degradation of 36% using collagenase and 89% using pepsin during 14 days incubation in vitro. The morphology of pores located on the surface and within the porous scaffolds showed good pore interconnectivity by scanning electron microscopy (SEM). Rat mesebchymal stem cells (MSCs) could adhere, grow, proliferate and differentiate toward osteoblasts on porous zein scaffold. With the action of dexamethasone, the cells showed a relative higher activity of alkaline phosphatase (ALP) and a higher proliferating activity (p<0.05) than those of MSCs without dexamethasone.     

新生儿肺动脉高压101例超声评价

目的探讨超声心动图对新生儿肺动脉高压(PH)的诊断及分类价值。方法回顾性分析经本院诊治的新生儿PH患者的资料内容,入选标准为1.对吸氧治疗无明显效果的发绀和低氧血症;2.经胸超声心动图证实心房和(或)动脉导管水平的右向左分流。结果共诊断101例新生儿PH,肺动脉收缩压为(95.6±15.0)mmHg,肺动脉舒张压为(62.0±10.3)mmHg。先天性心脏病致新生儿PH80例(79.2%)。其中完全性大动脉转位17例(16.8%),室间隔缺损并主动脉缩窄16例(15.8%),右室双出口12例(11.9%),完全性肺静脉畸形引流12例(11.9%),房室间隔缺损并主动脉缩窄9例(8.9%),三房心9例(8.9%),二尖瓣狭窄或闭锁5例(4.9%)。新生儿持续性PH(持续性胎儿循环)21例(20.8%)。经造影、手术及临床治疗所证实。结论超声心动图为新生儿PH提供快速、可靠的无创性诊断,对治疗方案的制定及疗效观察有重要价值。