介入方法安置生物主动脉瓣的临床应用现状

当经皮导管人工主动脉瓣植入术(TAVI)首次用于治疗严重主动脉狭窄以来,手术的可行性、复杂性及其短期临床效果一直都是主要的讨论焦点。基于部分研究结果,我们可以很清楚地得出一个结论：目前,TAVI已成为高危患者的一种治疗方式,但仍遗留的重要问题是瓣膜反流、血管相关并发症和脑卒中,这些都需要持续不断地更新及进步。更多新的装置系统,通过提供比如更精细的手术相关器械,取得更多的手术相关经验,可能会改善这些问题,现在经皮人工生物瓣膜使用了抗钙化等防老化处理。这种TAVI有转变面向低危患者趋势,目前已完成和正在进行临床观察的病例不少,其中位及远期随访结果将提供关键的有利数据,有广泛的推广前景。     

P2X4受体在糖尿病神经病理性疼痛模型中的作用

目的通过建立糖尿病神经病理性疼痛大鼠(DM)模型,观察P2X4受体在糖尿病神经病理性疼痛大鼠模型中的作用和意义。方法 40只SD大鼠随机分为制模组(DM组,n=30)和正常对照组(C组,n=10)。按60mg/kg一次性腹腔注射链脲佐菌素(STZ)建立糖尿病大鼠模型。于STZ注射前、注射后第7、14、28d分别测定大鼠血糖、体重以及机械性痛阈变化。DM组又均分为制模1周组(DM1组)、制模2周组(DM2组)、制模4周组(DM4组)三个亚组。在制模前及制模后1、2、4周利用von Frey hairs法测定大鼠机械痛阈,并通过real-time法测定每个时间点大鼠脊髓背根神经节(DRG)P2X4R的表达水平。结果 DM组机械痛阈在制模1周后即明显下降,并持续至4周;在制模1周以后脊髓背根神经节内P2X4R表达水平出现显著上调。大鼠P2X4R表达水平变化与机械痛阈的下降存在相关性。结论糖尿病早期大鼠脊髓背根神经节P2X4R表达即出现上调,并与疼痛相关。这些结果说明P2X4R可能在DM大鼠周围神经疼痛的发生及痛敏的维持阶段起重要作用。     

Non-Hodgkin Lymphomas of the Oral Cavity in AIDS Patients in a Reference Hospital of Infectious Diseases in Argentina: Report of Eleven Cases and Review of the Literature

Introduction

Extranodal non-Hodgkin lymphoma (NHL) were commonly described in AIDS patients and are related with an atypical morphology and aggressive clinical course.

Materials and Methods

In this single institutional study we evaluated the epidemiological, clinical, immunological, virological, histopathological and the outcome of eleven HIV/AIDS patients with oral cavity lymphomas (OCL).

Results

Nine were males and seven intravenous drug abusers. The median of age was 33 years and the median of CD4 T cell counts at the time of diagnosis was 97 cell/µL. The majority of tumors presented as large and ulcerated masses involving the gingiva, the palate and the jaw. Six of these tumors were diffuse large B-cell lymphomas (DLBCL); three were Burkitt’s lymphomas and the final case was a plasmablastic lymphoma. An association with Epstein-Barr virus (EBV) was found in three of the ten tested cases by in situ hybridization (EBER 1 and 2 probes) and immunohistochemistry (LMP-1). Human herpes virus-8 (HHV-8) was detected by polymerase chain reaction (PCR) in only one neoplasm. Six patients died without specific treatment; four received chemotherapy and highly active antiretroviral therapy (HAART) and three of them presented a prolonged survival.

Discussion

Combination of HAART and chemotherapy should modify the poor prognosis of AIDS patients with OCL.     

儿童青少年2型糖尿病的流行现状与影响因素

糖尿病已成为全球性公共健康问题,不论在成人还是儿童青少年中,糖尿病的患病率在逐年上升[1].中国20岁以上的成年人中糖尿病的患病率已经上升为9.7%[2].过去认为,2型糖尿病(T2DM)是成人疾病,在儿童青少年中发生的糖尿病主要是1型糖尿病(T1DM).     

Reduced Arterial Compliance Associated with Metabolic Syndrome in Chinese Children and Adolescents

Objective To explore the metabolic syndrome and its association with arterial compliance in Chinese children and adolescents. Methods 337 participants aged 6 to 18 years with males accounted for 55.8% were grouped according to their traits of metablic syndrome. Anthropometry, blood pressure, fasting plasma glucose, insulin and serum lipid profile were measured. Homeostasis model was assessed and insulin resistance （HOMA-IR） index was measured and calculated for estimating individual insulin resistance. Arterial compliance was also measured using digital pulse wave analyzing method （Micro medical, London）, and stiffness index was calculated. Results The stiffness index in participants with metablic syndrome was significant higher than that in participants with no riskof metablic syndrome [（7.69±1.63） vs （6.25±0.86） m/s, P〈0.01] and stiffness index and HOMA-IR were progressively increased with the increase of traits of metablic syndrom （P for linear trend 〈0.001）. After gender, age, and pubertal development were adjusted, both traits of metablic syndrome and HOMA-IR were correlated positively with stiffness index （both P〈0.05）. Conclusion The clustering of metablic syndrome was closely associated with risk at increased arterial stiffness in Chinese children and adolescents. It was suggested that arterial compliance assessment of children and adolescents might be an important measure for prevention of cardiovascular diseases.     

KPC型碳青霉烯酶分子进化及与底物结合自由能分析

目的 分析KPC-2、KPC-5和KPC-10型碳青霉烯酶的分子进化及与10种β-内酰胺类药物的结合自由能.方法 用MEGA 4.1软件中的Minimum Evolution法分析KPC-2、KPC-5和KPC-10型碳青霉烯酶的分子进化,用ArgusLab 4.1软件中的Dock模块作这3种酶与10种β-内酰胺类药物的分子对接,并计算酶与底物的结合自由能（△G）.结果 有碳青霉烯酶活性的A类β-内酰胺酶在同一簇且保守性较好,无碳青霉烯酶活性的普通A类β-内酰胺酶则在另一簇.KPC-2、KPC-5和KPC-10型碳青霉烯酶与碳青霉烯类药物结合自由能均下降,且降幅居前,它们的结合自由能比第三代头孢类抗生素更低.结合自由能较高的为氨曲南和克拉维酸.结论 KPC型碳青霉烯酶对碳青霉烯类药物的催化能力高于对第三代头孢类抗生素的催化能力,对氨曲南和克拉维酸的催化活性最低.     

非洛地平缓释微丸的制备

目的制备非洛地平缓释微丸。方法采用离心造粒法,在离心造粒机内通过制备母核、制备含药微丸、包衣3步完成。结果释放度符合缓释要求,工艺重现性好。结论离心造粒法可用于制备非洛地平缓释微丸。     

局部晚期宫颈癌介入治疗的现状及进展

宫颈癌为妇科最常见的恶性肿瘤,在我国发病率为妇科恶性肿瘤的首位,然而局部晚期宫颈癌尚无理想的治疗方法 ,传统的治疗方法一般为手术治疗、放射治疗和静脉化疗的联合治疗,疗效不佳。介入治疗作为一种新兴的治疗宫颈癌的方法 ,在局部晚期宫颈癌的治疗中起到了重要作用,特别术前新辅助介入化疗更显示了良好的疗效。