三种细菌生物被膜中超广谱β-内酰胺酶的检测

目的检测肺炎克雷伯氏菌、大肠埃希氏菌、铜绿假单胞菌三种细菌的生物被膜(biofilm,BF)中超广谱β-内酰胺酶(Extended-spectrumβ-lactamases,ESBLs)的产生。方法用改良平板培养法在硅胶膜上建立肺炎克雷伯氏菌、大肠埃希氏菌、铜绿假单胞菌BF的体外模型。用银染法及扫描电镜对BF进行鉴定。用双纸片试验检测ESBLs,等电聚焦电泳测定β-内酰胺酶的等电点。结果三种细菌的各30株中,BF肺炎克雷伯氏菌组(A2组)中ESBLs的产生率最高(14株,46.7%),其浮游菌组(A1组)检出8株(26.7%);BF大肠埃希氏菌组(B2组)有10株(33.3%)产生ESBLs,其浮游菌组(B1组)检出6株(20.0%);BF铜绿假单胞菌组(C2组)有3株(10%)产ESBLs,其浮游组(C1组)为2株(6.7%)。浮游菌组中ESBLs的产生率低于BF菌组,其中肺炎克雷伯氏菌及大肠埃希氏菌的BF组和浮游菌组的检出率之间有显著差异(P<0.05)。A2组共检出14株产生ESBLs,有4种ESBLs,等电点分别为8.2(4株)、7.6(8株)、6.3(1株)和5.6(1株),A1组检出8株产生ESBLs,为3种ESBLs,等电点分别为8.2(2株)、7.6(5株)和5.6(1株);B2、B1组检出2种相同等电点分别为7.6(B1组4株,B2组6株)、8.2(B1组2株,B2组4株)的ESBLs;C1、C2组检出一种等电点为6.4的ESBLs(C1组2株,C2组3株)。以pI为7.6的β-内酰胺酶的检出率最高,其     

鼓室置管治疗儿童分泌性中耳炎疗效观察

目的 探讨鼓室置管治疗儿童分泌性中耳炎(SOM)的疗效和并发症。方法 回顾性分析了我科1997年～2001年经鼓室置管治疗的45例(78耳)儿童SOM的临床资料。结果 45例随访1-2年，85％耳(35例，66耳)听力明显改善，鼓室导抗图恢复成A型。结论 积极改善咽鼓管功能并适当延长留管时间，防止过早脱管对提高儿童SOM的治愈率有着积极的意义。     

地塞米松体外诱导宫颈癌细胞株凋亡及其机制的研究

目的 :研究地塞米松 (Dex)体外能否诱导宫颈癌细胞株 (HeLa细胞 )发生凋亡及其机制。方法 :采用透射电镜、DNALadder、流式细胞仪等方法进行凋亡检测 ,用ECLWesternblot方法检测凋亡过程中相关基因表达的变化。结果 :地塞米松体外作用于HeLa细胞后 ,透射电镜观察到了凋亡小体 ;DNALadder法也检测到了凋亡时DNA降解形成的梯带 ;流式细胞仪检测到了细胞凋亡峰 ,且峰值随着处理时间的延长而增高。在凋亡过程中 ,凋亡相关基因bcl 2表达下调 ,而p5 3基因表达无明显改变。结论 :地塞米松体外能诱导HeLa细胞发生凋亡 ,其机制与bcl 2基因的表达下调有关     

Radio frequency transmyocardial revascularization enhances angiogenesis and causes myocardial denervation in canine model

BACKGROUND AND OBJECTIVE: Transmyocardial revascularization (TMR) relieves angina and improves exercise tolerance in patients. Angiogenesis and myocardial denervation have been proposed as factors contributing to these benefits. To test whether radio frequency transmyocardial revascularization (RF-TMR) enhances angiogenesis and causes myocardial denervation. STUDY DESIGN/MATERIALS AND METHODS: RF-TMR channels were created in 12 dogs which survived up to 4 weeks. Bromodeoxyuridine was administered subcutaneously to mark proliferating cells as an assay of angiogenesis. Western blot analysis of tyrosine hydroxylase and blood pressure response to topical bradykinin were used as indices of myocardial denervation. RESULTS: RF-TMR increased local vascularity by an average of 50%, whereas the rate of vascular cell proliferation was tripled over that of the untreated region. Changes in mean arterial pressure with bradykinin and tyrosine hydroxylase content were significantly decreased in RF-TMR regions as compared with normal myocardium in the same hearts. CONCLUSION: RF-TMR enhances angiogenesis and causes myocardial denervation in canine myocardium as with laser TMR.     

Cardiac anomalies in chronic renal failure

PRINCIPAL CARDIOVASCULAR COMPLICATIONS IN END STAGE RENAL DISEASE: Cardiovascular diseases are the leading causes of morbidity and mortality in end stage renal disease patients. Very often, complications observed are left ventricular hypertrophy and various forms of arterial degenerative lesions involving coronary arteries, less frequently pericarditis and calcifying valvulopathy are diagnosed. THE REASONS ARE COMPLEX: Risk factors can be either specific of uremia per se such as anemia, overhydration, fistula or the same as in the general population. Hemodynamic alterations including tensile stress or blood flow play a major role associated to various locally or generally generated substances whose role remains currently to be determined. THEIR TREATMENTS: Treatments of cardiovascular complications are not specific in this end stage renal disease population but are more often the treatment of the etiology: reduction of fistula blood flow, increase of hemoglobin, best control of weight gain between two hemodialysis sessions or blood pressure control.     

F-actin fiber distribution in glomerular cells: structural and functional implications

BACKGROUND: Glomerular distention is associated with cellular mechanical strain. In addition, glomerular distention/contraction is assumed to influence the filtration rate through changes in filtration surface area. A contractile cytoskeleton in podocytes and mesangial cells, formed by F-actin-containing stress fibers, maintains structural integrity and modulates glomerular expansion. In this study, the glomerular cell distribution of F-actin and vimentin filaments was studied in normal control and nine-month streptozotocin-diabetic rats. Results in situ were compared with observations in tissue culture. METHODS: Microdissected rat glomeruli were perfused to obtain a physiological 25% glomerular expansion over the basal value. Fixation was done without change in glomerular volume. Dual fluorescent labeling of F-actin and vimentin was carried out, and samples were examined by confocal laser scanning microscopy. RESULTS: The podocyte cell bodies and their cytoplasmic projections, including the foot processes, contained bundles of vimentin-containing fibers. Except for a thin layer at the base of foot processes, they did not demonstrate F-actin. While mesangial cells in culture had F-actin as long stress fibers resembling tense cables, mesangial cells stretched in situ contained a maze of short tortuous F-actin fibers organized in bundles that often encircled vascular spaces. This fibrillar organization was disrupted in diabetic glomeruli. CONCLUSION: Mesangial cells, but not podocytes, contain a cytoskeleton capable of contraction that is disorganized in long-term diabetes. Together with previous observations, the distribution of this cytoskeleton suggests that mesangial cell contraction may be involved in the redistribution of glomerular capillary blood flow, but not substantially in the modulation of glomerular distention. Disorganization of stress fibers may be a cause of hyperfiltration in diabetes.     

脉冲角加速度刺激诱发豚鼠短潜伏期前庭诱发电位

以脉冲角加速度刺激在豚鼠记录出短潜伏期诱发反应，反应由发生于刺激开始后10ms以内的5～7个波组成，高强度刺激时反应振幅数微伏，I波潜伏期约2．5ms，不同动物及同一动物不同时间测试反应非常稳定。系列实验结果表明脉冲角加速度刺激诱发的豚鼠短潜伏期诱发反应系前庭诱发电位。     

Auditing paediatric diabetes care and the impact of a specialist nurse trained in paediatric diabetes

AIMS: To define outcome measures for auditing the clinical care of children and adolescents with insulin dependent diabetes mellitus (IDDM) and to assess the benefit of appointing a dedicated paediatric trained diabetes specialist nurse (PDSN). METHODS: Retrospective analysis of medical notes and hospital records. Glycaemic control, growth, weight gain, microvascular complications, school absence, and the proportion of children undergoing an annual clinical review and diabetes education session were assessed. The effect of the appointment of a PDSN on the frequency of hospital admission, length of inpatient stay, and outpatient attendance was evaluated. RESULTS: Children with IDDM were of normal height and grew well for three years after diagnosis, but grew suboptimally thereafter. Weight gain was above average every year after diagnosis. Glycaemic control was poor at all ages with only 16% of children having an acceptable glycated haemoglobin. Eighty five per cent of patients underwent a formal annual clinical review, of whom 16% had background retinopathy and 20% microalbuminuria in one or more samples. After appointing the PDSN the median length of hospital stay for newly diagnosed patients decreased from five days to one day, with 10 of 24 children not admitted. None of the latter was admitted during the next year. There was no evidence of the PDSN affecting the frequency of readmission or length of stay of children with established IDDM. Non-attendance at the outpatient clinic was reduced from a median of 19 to 10%. CONCLUSIONS: Outcome measures for evaluating the care of children with IDDM can be defined and evaluated. Specialist nursing support markedly reduces the length of hospital stay of newly diagnosed patients without sacrificing the quality of care.     

Phenotypic diversity in siblings with partial androgen insensitivity syndrome

The androgen insensitivity syndrome is a heterogeneous disorder with a wide spectrum of phenotypic abnormalities, ranging from complete female to ambiguous forms that more closely resemble males. The primary abnormality is a defective androgen receptor protein due to a mutation of the androgen receptor gene. This prevents normal androgen action and thus leads to impaired virilisation. A point mutation of the androgen receptor gene affecting two siblings with partial androgen insensitivity syndrome is described. One had cliteromegaly and labial fusion and was raised as a girl, whereas the other sibling had micropenis and penoscrotal hypospadias and was raised as a boy. Both were shown to have the arginine 840 to cysteine mutation. The phenotypic variation in this family is thus dependent on factors other than abnormalities of the androgen receptor gene alone.