骨质疏松相关基因的研究进展

骨质疏松(osteoporosis,OP)在很大程度上受基因的影响。在OP的相关基因中,维生素D受体(VDR)基因、雌激素受体(ER)基因、Ⅰ型胶原基因及转化生长因子基因都是重要的候选基因。VDR基因中BB基因型者比Bb及bb基因型者的腰椎骨密度(bone mineral density,BMD)低,骨丢失率高。FokⅠ基因型与腰椎BMD降低有明显相关性,ff基因型者腰椎BMDXx基因型者>xx基因型者。Ⅰ型胶原基因与骨量呈显著相关性,COLIA1基因突变可致低骨量、骨脆性增加。转化生长因子β(TGF-β)基因对调节骨形成和骨吸收有重要作用,TGF-β基因中可发生碱基丢失,这种变异多见于OP患者。     

经腹膜后隙途径腹腔镜活体供肾切取32例

目的 探讨经腹膜后隙途径腹腔镜活体供肾切取的技术和效果。方法 32名供者中，男性15名，女性17名。29例取左肾，3例取右肾。供者全身麻醉，取侧卧位，共选3个穿刺点，第1个穿刺点选在12肋缘下2cm与骶棘肌外侧缘1cm交叉点，第2个穿刺点选在第1个穿刺点向前8～10cm，或肋缘下2cm与腋前线交叉点，第3个穿刺点位于髂棘上2cm与腋中线交叉点，分别插入12mm、10mm和5mm的Trocar。以自制水囊扩张器扩张腹膜后隙，游离供肾和输尿管，前6例用直线切割缝合器切断肾动脉和静脉，后26例用带锁的塑料夹夹闭切断肾动脉和静脉，在第1个穿刺点向下的延长切口将肾取出。结果 32只供肾切取顺利，手术耗时60～180min，出血量20～200ml，供肾热缺血时间3～8min，冷缺血时间25～50min。3只肾静脉较短，分别为1cm、1．5cm和2cm，另有1只供肾动脉内膜损伤。移植术后第1d，受者的尿量为2800-10 100ml，无移植肾功能恢复延迟发生。结论 经腹膜后隙途径腹腔镜活体供肾切取是安全、可行的，对供者创伤小，所获供肾的质量较好，但要求有熟练的腹腔镜技术。     

Analysis of the strain relatedness of oral Candida albicans in patients with diabetes mellitus using polymerase chain reaction‐fingerprinting

To increase our understanding of Candida pathogenicity, the identification of those strains most frequently associated with infections is of paramount importance. Polymerase chain reaction (PCR)‐based methods are extremely effective in differentiating and determining reproducibility, they require minimum starting material and are rapid and simple to perform. In this study, the genetic relatedness of Candida albicans was assessed for two geographically different patient groups (London, UK and Parma, Italy) affected by diabetes mellitus. C. albicans samples from the oral cavities of non‐diabetic healthy subjects were also examined by PCR fingerprinting to evaluate the possible genetic differences among endogenous strains in individuals with and without diabetes mellitus. PCR fingerprinting, with subsequent phylogenetic analysis of C. albicans isolates from the diabetic patients from London and Italy and from the non‐diabetic subjects, revealed that there were significant differences (P < 0.0001) between C. albicans isolates indicative of the distinct ecological niches that occur in the oral cavities of these patient cohorts. The most diverse group comprised the isolates from the diabetic patients in the UK, possibly reflecting the antifungal treatment that these patients had received. Further studies that include isolates from patient cohorts with systemic diseases other than diabetes mellitus, and from more diverse geographic localities are required to explain the relatedness of C. albicans isolates in the mouth.     

对血吸虫病患者心理护理问题的思考

长期以来,对血吸虫病患者心理护理方面重视不够。鉴于此,根据湖北省孝感市血吸虫病防治所2003~2004年收治的251例血吸虫病患者的心理状况观察资料,浅谈对不同病型血吸虫病患者心理护理的对策。1不同类型血吸虫病患者的心理特点1.1急性血吸虫病这类患者以新感染者为主。患者对血吸虫病比较陌生,医护人员及家属一举一动直接影响其心理活动。具体表现为:情绪紧张,对该病不了解,经常找医生打听病情,担心病情过重难以医治,因而造成失眠纳差,情绪不安,植物神经功能紊乱等。1.2慢性血吸虫病这类患者多数是疫区20~50岁的青壮年,均为家庭的主要劳动力…     

Pick’s disease with Pick bodies combined with progressive supranuclear palsy without tuft‐shaped astrocytes: A clinical,neuroradiologic and pathological study of an autopsied case

We report clinical, neuroradiologic features, and neuropathologic findings of a 76‐year‐old man with coexistent Pick’s disease and progressive supranuclear palsy. The patient presented with loss of recent memory, abnormal behavior and change in personality at the age of 60. The symptoms were progressive. Three years later, repetitive or compulsive behavior became prominent. About 9 years after onset, he had difficulty moving and became bed‐ridden because of a fracture of his left leg. His condition gradually deteriorated and he developed mutism and became vegetative. The patient died from pneumonia 16 years after the onset of symptoms. Serial MRI scans showed progressive cortex atrophy, especially in the bilateral frontal and temporal lobes. Macroscopic inspection showed severe atrophy of the whole brain, including cerebrum, brainstem and cerebellum. Microscopic observations showed extensive superficial spongiosis and severe neuronal loss with gliosis in the second and third cortical layers in the frontal, temporal and parietal cortex. There were Pick cells and argyrophilic Pick bodies, which were tau‐ and ubiquitin‐positive in neurons of layers II–III of the above‐mentioned cortex. Numerous argyrophilic Pick bodies were observed in the hippocampus, especially in the dentate fascia. In addition, moderate to severe loss of neurons was found with gliosis and a lot of Gallyas/tau‐positive globus neurofibrillary tangles in the caudate nucleus, globus pallidus, thalamus, substantia nigra, locus coeruleus and dentate nucleus. Numerous thorned‐astrocytes and coiled bodies but no‐tuft shaped astrocytes were noted in the basal ganglion, brainstem and cerebellar white matter. In conclusion, these histopathological features were compatible with classical Pick’s disease and coexistence with progressive supranuclear palsy without tuft‐shaped astrocytes.     

移植人羊膜细胞对大鼠创伤性脑损伤的实验研究

目的 探究大鼠TBI后脑内移植人羊膜细胞（HACs）对大鼠运动功能的影响。方法 HACs经分离、Hoechst33342标记后重悬调整细胞浓度为10^5/μl；采用改进的Feeney自由落体法打击大鼠脑皮层后肢运动区域，损伤后24h经微量注射器和立体定向仪将Hoechst33342标记的HACs 10μl分别移植于挫伤灶中心和挫伤灶边缘；在TBI后的28d内采用钉板平衡木行走测试大鼠运动功能变化，运动功能检测结束后取出脑组织行组织学检测。结果 治疗组滑落脚步数明显少于对照组（P〈0．05）；移植的HACs呈蓝色荧光；部分移植HACs可见MAP-2阳性表达。结论 移植HACs使大鼠TBI后运动功能明显改善。     

口内入路下颌角弧线形截骨术

目的:探索更好的下颌角肥大截骨缩小术式。方法:为获得更好的术后效果,我们采用口内入路下颌角弧形截骨术,将弧形截骨线延长到颏神经处,并对颏结节进行打磨,使截骨线延续流畅,伴小颏者同时行隆颏或颏截骨前移。结果:自2002年以来,我科采用口内入路下颌角长弧线形截骨术矫正320例下颌角肥大患者,均取得了良好的效果。结论:口内入路延长弧形截骨术缩小下颌角可以获得更好术后效果。     

MRV检测脑静脉窦血栓的作用

目的探讨磁共振静脉血管成像(MRV)用于检测脑静脉窦血栓(CVT)的应用价值。方法8例CVT患者均行MRI标准自旋回波T1WI、T2WI和VEN/3D/PCA。结果VEN/3D/PCA比标准SE序列T1WI和T2WI多检测出CVT3处,与脑血管造影的结果完全相符。结论MRV可以准确无创的诊断CVT。     

Pharmacokinetics of Moxifloxacin in Rabbits After Intravenous,Subcutaneous and a Long‐acting Poloxamer 407 Gel Formulation Administration

The pharmacokinetics (PK) of moxifloxacin in healthy white New Zealand rabbits was studied following intravenous (IV) and subcutaneous (SC) administration routes as well as a SC long‐acting poloxamer 407 gel formulation (SC‐P407). Moxifloxacin concentrations were determined by high‐performance liquid chromatography assay with fluorescence detection. Mean half‐life for IV, SC and SC‐P407 routes was 2.15, 5.41 and 11.09 h. Clearance value after IV dosing was 0.78 l/kg/h. After SC administration, the mean absolute bioavailability was 117% and the C_max was 1.61 ± 0.49 mg/l. After SC‐P407 administration, the bioavailability was 44% and the C_max 1.83 was ±0.62 mg/l. No adverse effects were observed in any of the rabbits following IV, SC and SC‐P407 administration of moxifloxacin. Minimal inhibitory concentrations of moxifloxacin against different strains of Staphylococcus aureus from different european countries were used to compute the main pharmacodynamic (PD) surrogate markers of efficacy. The high tolerability of this SC‐P407 formulation and the favourable PK behaviour such as the long half‐life, acceptable bioavailability and excellent PK–PD ratios achieved indicate that it is likely to be effective in rabbits.