急诊哮喘一氧化氮、肿瘤坏死因子含量测定及意义

目的　测定哮喘患者血浆及豚鼠哮喘模型血浆、肺组织NO及TNF -α的含量 ,观察豚鼠哮喘模型给予皮质激素地塞米松治疗后及L -NAME干预后NO及TNF -α的含量变化 ,了解NO及TNF -α在哮喘发病中的作用 ,探讨其相互关系。方法　采用镉还原法测定血浆、肺组织NO代谢产物 ,应用放免法测定TNF -α含量。结果　哮喘患者血浆及豚鼠哮喘模型血浆、肺组织NO及TNF -α含量均显著高于对照组 (P <0 0 1) ,豚鼠哮喘模型给予皮质激素及L -NAME干预后NO及TNF -α的含量显著低于哮喘模型组 (P <0 0 1)。结论　NO及TNF -α在哮喘发病中起重要作用 ,哮喘患者血浆及豚鼠哮喘模型血浆、肺组织中NO的升高可能与TNF -α产生增多有关。豚鼠哮喘模型应用皮质激素后NO及TNF -α降低表明皮质激素可抑制哮喘时TNF -α生成 ,进而阻止在其刺激下NO的生成与释放。应用NOS抑制剂L -NAME后TNF -α含量亦降低至接近对照组水平 ,提示L -NAME可能抑制过度的TNF -α的生成 ,进而减轻TNF -α诱导的一系列炎症反应。     

一侧性上颌窦密度增高病变的X线诊断（附20例分析）

目的 探讨一侧上颌窦密度增高常见疾病的X线表现，以助于上颌窦疾病的诊断。方法 回顾性分析20例上颌窦密度增高疾病的X表现并与CT和（或）手术病理相比较。结果 20例上颌窦一侧性密度增高病变中，3例为上颌窦癌、8例为慢性化脓性炎、2例上颌窦息肉、2例囊肿、2例上颌窦真菌感染、3例骨纤维异常增殖症。结论 Water＇s位对检出一侧性上颌窦密度增高疾病具有相当的价值，但定性较差，在无典型X线表现时仅能诊断为一侧上颌窦病变。     

轻链型多发性骨髓瘤患者免疫固定电泳检测差异的分析

目的 探讨轻链型多发性骨髓瘤患者实验室检查上的特点.方法 回顾性分析我院2003年5月至2007年9月间采用免疫固定电泳(IFE)检测的30例轻链型患者的实验室结果的特征.结果 轻链型多发性骨髓瘤患者中,κ型患者κ/λ显著升高(P＜0.05),λ型κ/λ显著降低(P＜0.05);两组κ/λ均与正常值差异有显著性(P＜0.05).结论 κ/λ比值可作为多发性骨髓瘤的诊断、鉴别诊断敏感和特异性指标.     

腹腔镜与开腹手术治疗急性胆囊炎的疗效对比分析

目的 比较分析腹腔镜和开腹胆囊切除术治疗急性胆囊炎的临床效果.方法 回顾性分析98例腹腔镜胆囊切除术(LC)与86例开腹胆囊切除术(OC)患者的临床资料,对比两组患者术中情况、术后恢复情况及并发症发生情况.结果 LC组的切口长度、术中出血量、置引流例数、手术时间均显著低于OC组(P<0.05);术后肠鸣音恢复时间、使用止痛剂例数、下床活动时间、住院时间也明显低于OC组(P<0.05);而LC组和OC组的术后并发症发生率分别为7.14%和9.30%,差异没有显著性(P>0.05).结论 腹腔镜胆囊切除术治疗急性胆囊炎的临床效果优于开腹手术,值得临床推广应用.     

硝酸盐类联合恬尔心治疗心绞痛的临床护理分析

目的分析硝酸盐类联合恬尔心治疗心绞痛的临床护理效果。方法选择我院2012年1月至2012年12月收治的108例新绞痛患者为研究对象,将其随机分成观察组和对照组,每组54例,两组患者君给予药物硝酸盐类联合恬尔心治疗,其中给予观察组患者综合干预护理,给予对照组常规护理手段。结果治疗后,观察组患者的心电图改善有效率、心绞痛发作改善有效率分别分别为81.5%、77.8%,明显高于对照组的2个指标数据59.2%、55.6%,数据差异显著,P<0.05;观察组患者的病死率低于对照组。结论采用病情监护、生活护理以及健康教育等综合干预护理措施,能有效促进患者病情的缓解,应予以推广。     

液基薄层细胞学检查用于宫颈疾病筛查的临床应用

目的讨论液基薄层细胞学检查在宫颈疾病筛查中的临床应用。方法随机提取2012年1¹2月在我院妇科门诊及住院就诊的宫颈病变患者,结合Bethesda2001报告分类标准,采用TCT制片技术,随机对这60例宫颈病变患者进行宫颈细胞学筛查。并对非典型鳞状上皮以上病例进行宫颈组织病理学检查。结果 60例患者取材均为满意涂片:检出异常结果非典型鳞状上皮8例,不除外高度病变的非典型鳞状上皮5例,低度鳞状上皮内病变2例,高度鳞状上皮内病变1例。病理组织学结果为上皮内病变(≥LSIL)14例,病理符合率为87.5%。结论在宫颈疾病筛查中应用液基薄层细胞学检查,可早期发现宫颈病变和癌前病变甚至宫颈癌变,可临床推广应用。     

美国国家哮喘教育认证委员会关于哮喘教育者资格认证的概述

概述美国国家哮喘教育者认证委员会(NAECB)关于哮喘教育者资格认证的背景、目的、方法、现状及发展,重点介绍哮喘教育者资格认证考试,以期为我国未来专业的哮喘教育者资格认证提供参考。     

复方阿嗪米特肠溶片联合莫沙必利治疗慢传输型便秘295例临床研究

目的观察复方阿嗪米特联合莫沙必利治疗慢传输型便秘(简称STC)的疗效。方法 295例患者随机分为3组,治疗组113例给予复方阿嗪米特联合莫沙必利治疗,对照A组98例给予复方阿嗪米特治疗,对照B组84例给予莫沙必利治疗。3组均治疗3个月后观察疗效。结果总有效率治疗组为89.4%,对照A组为66.3%,对照B组为70.2%,治疗组优于对照A、B组(P均<0.05),两对照A、B组间差异无显著性意义(P>0.05)。结论与莫沙必利联合治疗慢传输型便秘的疗效较单纯复方阿嗪米特或莫沙必利治疗更为显著,并能显著缓解腹胀等慢传输型便秘的相关症状,值得临床推广及进一步观察研究。     

Schiff’s base derivatives bearing 2-thiophenoxyquinoline nucleus as new antibacterial agents

A series of new Schiff’s base derivatives 4a–x bearing 2-thiophenoxyquinoline nucleus have been designed and synthesized by reaction of 2-thiophenoxyquinoline-3-carbaldehydes 2a–d with various benzohydrazides 3a–f in the presence of Ni(NO₃)₂·6H₂O as a catalyst. In vitro antibacterial screening was carried out against two Gram-positive bacteria (Bacillus subtilis ATCC 6633 and Staphylococcus aureus ATCC 6538) and two Gram-negative bacteria (Escherichia coli ATCC 35218 and Pseudomonas aeruginosa ATCC 13525). Of the compounds studied, compound 4e showed chief activity (MIC = 3.13 μg/mL) against S. aureus, and compounds 4p, 4k, and 4w were found to possess effective antibacterial activity against employed strains compared with standards used. The structures of Schiff’s base derivatives were established by using various spectroscopic methods. A crystal structure of compound 4k has been determined by X-ray diffraction analysis.     

Effects of SKF83959 on the excitability of hippocampal CA1 pyramidal neurons： a modeling study

Aim： 3-Methyl-6-chloro-7,8-hydroxy-1-（3-methylphenyl）-2,3,4,5-tetrahydro-1H-3-benzazepine （SKF83959） have been shown to affect several types of voltage-dependent channels in hippocampal pyramidal neurons. The aim of this study was to determine how modulation of a individual type of the channels by SKF83959 contributes to the overall excitability of CA1 pyramidal neurons during either direct current injections or synaptic activation.
Methods： Rat hippocampal slices were prepared. The kinetics of voltage-dependent Na^＋ channels and neuronal excitability and depolarization block in CA1 pyramidal neurons were examined using whole-cell recording. A realistic mathematical model of hippocampal CA1 pyramidal neuron was used to simulate the effects of SKF83959 on neuronal excitability.
Results： SKF83959 （50 μmol/L） shifted the inactivation curve of Na^＋ current by 10.3 mV but had no effect on the activation curve in CA1 pyramidal neurons. The effects of SKF83959 on passive membrane properties, including a decreased input resistance and depolarized resting potential, predicted by our simulations were in agreement with the experimental data. The simulations showed that decreased excitability of the soma by SKF83959 （examined with current injection at the soma） was only observed when the membrane potential was compensated to the control levels, whereas the decreased dendritic excitability （examined with current injection at the dendrite） was found even without membrane potential compensation, which led to a decreased number of action potentials initiated at the soma. Moreover, SKF83959 significantly facilitated depolarization block in CA1 pyramidal neurons. SKF83959 decreased EPSP temporal summation and, of physiologically greater relevance, the synaptic-driven firing frequency.
Conclusion： SKF83959 decreased the excitability of CA1 pyramidal neurons even though the drug caused the membrane potential depolarization. The results may reveal a partial mechanism for the drug’s anti-Parkinsonian effects and may also suggest that SKF83959 has a potential antiepileptic effect.