老年病房分离铜绿假单胞菌的耐药性分析

目的分析老年病房分离铜绿假单胞菌对临床常用抗菌药的耐药特征，为临床用药提供参考。方法收集我院老年病房2004年1月至2005年12月的住院患者分离菌株，药敏试验采用K-β扩散法。结果共分离出230株铜绿假单胞菌，其中224株来自痰标本。哌拉西林／他唑巴坦的敏感率最高，为64．8％，其他依次为阿米卡星、环丙沙星、头孢哌酮-舒巴坦；头孢他啶的耐药率最高，为50．9％，其他依次为哌拉西林、头孢吡肟、亚胺培南等。其对头孢他啶、头孢吡肟、亚胺培南的耐药率皆显著高于同期非老年病房分离株（P〈0．01）；多重耐药铜绿假单胞菌（MDRP）105株，占分离菌株的45．6％；71．5％的患者在标本分离的前2月里，接受过多种抗菌药物治疗。结论密切结合药敏试验，合理有序的应用抗生素、减轻抗生素的选择性压力，对于防治铜绿假单胞菌的耐药及传播，控制老年病房的院内感染具有重要意义。     

急性脑梗死患者可溶性细胞间黏附分子-1和某些凝血指标的变化及其意义

目的:探讨急性脑梗死患者血清可溶性细胞间黏附分子-1(sICAM-1)和某些凝血指标的变化及其意义。方法:用双抗夹心酶联免疫吸附法测定69例急性脑梗死患者和30名健康对照者sICAM-1含量,并检测他们的某些凝血指标,包括血小板计数、凝血酶原时间(PT)、活化的部分凝血激酶时间(aPTT)、凝血酶时间和纤维蛋白原(FIB)含量。结果:脑梗死患者血清sICAM-1和FIB含量明显高于对照组(P<0·01),PT较正常对照组明显延长(P<0·05),sICAM-1含量与梗死面积显著相关(P<0·01)。结论:急性脑梗死患者血清sICAM-1和FIB浓度显著增高,前者与脑梗死面积相关。     

80岁以上老年患者心脏手术77例临床分析

目的:对80岁以上患者心脏手术结果资料进行临床分析,评价临床选择标准和手术疗效。方法:2002年7月至2009年5月接受心脏手术的≥80岁患者77例,其中瓣膜病7例,冠心病65例,先天性心脏病1例,大血管病等4例。结果:66例患者手术后痊愈出院,治愈率85.7%。手术死亡11例,全部为冠心病行冠状动脉旁路移植手术患者,病死率为14.3%,其中男性9例,女性2例。死亡原因为心力衰竭(心衰)7例,呼吸衰竭3例,大出血1例。重症监护室时间为(3.5±3.3)d,住院时间为(25.1±13.1)d。并发症发生率为32.5%。结论:虽然80岁以上心脏手术并发症发生率高,住院时间长,手术死亡率高,但是手术使患者摆脱心脏疾病症状,80岁以上老年患者进行心脏手术是可行的。     

胃肠道间质瘤预后研究进展

胃肠道间质瘤(GIST)是人类胃肠道最常见的间叶源性肿瘤,大多数GIST有原癌基因c-kit突变.近年的研究发现,在无c-kit突变的胃肠道间质瘤中,存在血小板源性生长因子受体-α(PDGFR-α)基因的突变.此外,尚存在很多基因和蛋白参与了GIST的发生和发展.与一般胃肠道肿瘤相比,GIST在组织发生、临床病理、诊断治疗、预后等方面有着不同的特点.本文主要综述有关GIST预后的相关指标的研究进展.     

肺炎支原体CARDS毒素对小鼠IgE反应的影响及机制

目的 通过肺炎支原体产生的特异性CARDS毒素对血清总IgE的作用,研究其对机体过敏反应的影响.方法 60只SPF级BALB/c小鼠分为对照组和感染组,采用CARDS毒素暴露小鼠模型,评价CARDS毒素特异性反应;肥大细胞脱颗粒研究确定CARDS毒素特异性IgE的功能;Western blot检测JAK3及STAT6的...     

Four cases of distinctive meningiomas with Zellballen growth pattern

Dong Y, Zhou X, Wu B, Wang J, Ma H, Zhou H, Jiang S, Lu G, Hu Q. Four cases of distinctive meningiomas with Zellballen growth pattern. APMIS 2009; 117: 936–40. Meningiomas are attributed to those tumours with slow‐growing pattern occurring predominantly in middle‐aged or elderly patients. Fifteen histological variants have been described based on the variable histomorphological features. Herein we report four cases with specific Zellballen growth pattern, giving the tumours a ‘paraganglioma‐like’ general aspect. The diagnosis of meningiomas was confirmed by immunohistochemical and ultrastructural findings. Histopathologists should be aware of this specific morphology which can lead to misdiagnosis.     

腹腔镜下扩大性膀胱部分切除联合盆腔淋巴结清扫术治疗脐尿管癌

Objective To discuss the techniques and clinical efficacy of laparoscopic partial cystectomy with bilateral pelvic lymphadenectomy for urachal adenocarcinoma. Methods From July 2006 to April 2008, 4 patients with urachal adenocarcinoma were managed by the laparoscopic procedure. Three patients were male, the other one was female, with a median age of 51 (range 42 to 66)years. The mean size of tumors was 3.4(rang 1.9 to 5.4)cm in diameter. Three of them were diagnosed as mucinous adenocarcinoma, the other one was adenocarcinoma. There was 1 patient at stage Ⅱ , and the other three as stage Ⅲ according to Sheldon Stage. Four patients were performed by transperitoneal approach. The boundaries of resection were similar to the open surgery, including resection of the tumor with normal margins, the peritoneum lateral to the two medial unbilical ligaments,the posterior sheath of the rectus muscle and the muscle fibers of the rectus muscle below it, and bilateral pelvic lymphanodes. Results The procedure was successfully in all 4 patients, with a mean operative time of 220(range 150 to 350)min, a mean estimated blood loss of 180 (range 120 to 290)ml.No significant intraoperative or postoperative complications occurred, except for an inferior epigastric artery injury in 1 case. The mean postoperative in-dwelling urinary catheter time was 6 (range 5 to 7)d, and the mean postoperative hospital stay was 6 (range 5 to 8)d. All 36 resected lymph nodes (range 8 to 11) were negative. At a median follow-up of 25(range 15 to 36) months, there was no evidence of recurrent disease by radiologic or cystoscopic evaluation. Conclusion Laparoscopic partial cystectomy and bilateral extended pelvic lymphadenectomy in selected patients with urachal tumors could be a safe, feasible, minimally invasive procedure.     

人工合成锰（Ⅱ）-天冬氨酸SOD模拟物的毒性检测

目的：对人工合成的SOD模拟物——锰（Ⅱ）-天冬氨酸进行初步毒理检测。方法：通过灌胃造成急性毒性确定半数致死量（LD50），并对小鼠亚急性毒性、骨髓嗜多染红细胞（PCE）微核试验进行了研究。结果：受试物对小鼠的LD50大于5000mg／kg，属于无毒。以亚急性毒性剂量500mg／kg连续灌胃给药8天后，心、肝、脾、肺、肾和肠胃等器官在形状、大小、颜色等指标上与阴性对照组无明显差异。分别以500、1500、2500mg／kg的剂量给小鼠连续灌胃两天，低剂量组的PCE微核率与阴性对照组比较无显著性差异，中剂量组与阴性对照组有显著性差异（P〈0．05），高剂量组与阴性对照组有极显著性差异（P〈0．01）。结论：锰（Ⅱ）-天冬氨酸属于微毒性，在大剂量使用时可导致一定程度的染色体损伤，但可在适当的剂量范围内控制使用。     

川芎嗪对免疫性肾损伤大鼠肾脏形态及功能的影响

目的探讨中药川芎嗪对免疫性肾损伤大鼠肾组织形态及功能的影响。方法猪血清复制大鼠肾损伤动物模型,川芎嗪注射液治疗4周。观察肾小球毛细血管基底膜厚度、系膜增生等形态学改变以及尿蛋白与血清MDA含量、SOD活性的变化。结果模型组基底膜厚度明显大于正常组(P<0.01),川芎嗪组明显低于模型组(P<0.05),明显减轻肾脏病理形态损害。川芎嗪组和模型组比较大鼠尿蛋白、血清MDA含量明显下降(P<0.01);SOD活性明显升高(P<0.01)。结论川芎嗪可以明显改善免疫性肾损伤大鼠肾脏病理形态和功能,减少尿蛋白,对抗自由基引起的脂质过氧化损伤。     

中华大蟾蜍皮的化学成分

目的研究中华大蟾蜍皮的化学成分。方法利用反复硅胶柱、ODS反相柱、制备液相、重结晶等手段分离分离纯化化学成分,根据化合物的理化性质和光谱数据并参考文献鉴定其化学结构。结果从中华大蟾蜍皮中分离得到6个化合物:胆甾醇(cholesterol,1)、棕榈酸胆甾烯酯(palmitatic acid cholesteryl ester,2)、蟾毒它灵(bufotalin,3)、沙蟾毒精(arenobufagin,4)、嚏根草配基(hellebrigenin,5)、嚏根草配基-3-辛二酸半酯(hellebrigenin-3-hemisuberate,6)。结论化合物6为新化合物。