季节性面部接触性皮炎患者血清总IgE、特异性IgE及其皮肤划痕试验的相互关系

采用ＩＲＭＡ对季节性面部接触性皮炎患者进行血清总ＩｇＥ测定，同时用南京地区常见致敏花粉进行皮肤划痕试验及ＥＬＩＳＡ检测血清特异性ＩｇＥ。结果：血清总ＩｇＥ与特异性ＩｇＥ有明显相关（Ｐ＜０．０１）、符合率为７０．７％，血清总ＩｇＥ与皮肤划痕试验有明显相关（Ｐ＜０．００５）、符合率为７５．６％，皮肤划痕试验与血清特异。性ＩｇＥ有明显相关（Ｐ＜０．００５）、符合率为７５．６％。三者总符合率为６４．９％。     

Targeting NF-κB c-Rel in regulatory T cells to treat corneal transplantation rejection

The relevance of Tregs in the induction of tolerance against corneal allografts has been well established. Although it is well known that the conversion of Tregs into effector-like cells contributes to the loss of corneal immune privilege, the underlying mechanism is still not fully understood. Using heterologous penetrating keratoplasty model, we found that Tregs from corneal allograft rejected mice (inflam-Tregs) exhibit impaired function and characteristics of effector T cells. Further study showed that the expression of NF-κB c-Rel, a key mediator of effector T cell function, was significantly increased in inflam-Tregs. Mechanistic study revealed that elevated NF-κB c-Rel level in inflam-Tregs impaired Treg function through the promotion of inflammatory cytokine production and glycolysis. More importantly, we demonstrated that targeting NF-κB c-Rel was able to improve the immune suppressive function of inflam-Tregs in vitro and enhance the potential of them to suppress corneal transplantation rejection. Therefore, our current study identified NF-κB c-Rel as a key mediator of the conversion of Tregs into effector-like cells when under inflammatory environment.     

安达美在不同溶液中的稳定性研究

目的探讨安达美在不同浓度葡萄糖注射液及不同种类氨基酸注射液中的稳定性。方法分别测定10%葡萄糖注射液、5%葡萄糖注射液、3种氨基酸注射液的pH值,再分别测定安达美加入以上注射液中的pH值及变色现象,同时观察在上述溶液中添加安达美与电解质的先后顺序不同其pH值及变色情况。结果 10%葡萄糖注射液pH值平均3.46,5%葡萄糖注射液平均4.53;安达美加入葡萄糖注射液后溶液变色,pH值下降明显。3种氨基酸的平均pH值分别为5.50、6.70、6.61;安达美加入氨基酸注射液不变色,pH值变化较小。在氨基酸注射液中添加安达美与电解质的先后顺序不同未见明显颜色改变。结论安达美最好加入氨基酸注射液中,以避免其理化性质发生改变,保证配制后营养液的稳定性。     

雷米芬太尼控制性降压对颅脑手术患者血液动力学的影响

目的观察神经外科手术中雷米芬太尼控制性降压对血液动力学的影响。方法20例ASAⅠ~Ⅱ级择期行颅脑手术患者,采用全凭静脉复合麻醉,术中持续泵注雷米芬太尼行控制性降压,维持MAP 60~70 mmHg,观察降压前(T0)、降压达目标时(T1)、维持降压15 min(T2)、30 min(T3)、停降压15 min(T4)3、0 min(T5)6个时点的MAP、HR、心输出量(CO)、心脏指数(CI)、心室收缩加速度指数(ACI)、左心做功(LCW)、外周血管阻力(SVR)的变化。结果与T0比较,T1、T2、T3时点MAP、SVR、LCW均显著降低(P<0.01);HR亦明显减慢(P<0.05);CO、CI、ACI无明显降低。结论神经外科手术中行雷米芬太尼控制性降压安全、有效,具有对心功能影响小的优点。     

印象管理策略及其在护患沟通中的应用

患者对护理人员的看法直接影响到护患沟通的有效性.实施印象管理策略可对护患的有效沟通提供帮助,护理人员的印象管理策略有两种,一种是获得患者积极看待,包括完善自己、表现耐心和爱心、学会自我控制、自我展示、构建权威形象;一种避免患者消极看待,包括合理化理由、预告风险、承认错误,赔礼道歉.护理人员将印象管理策略运用于护患沟通中有助于改善护患关系,有助于使患者产生期望的行为模式,提高患者的依从性和满意度.     

Study of drug control over postoperative hemorrhage after selective caesarean section

Objective: To compare the efficacy and safety of carbetocin and oxytocin in the prevention of postpartum hemorrhage after selective caesarean section. Methods: Two hundred and sixteen pregnant women who were going to deliver by caesarean section were randomly divided into two paralleled and controlled groups, of which the oxytocin group(group A) contained 105 women and the carbetocin group(group B) 111 women. 20 IU of oxytocin was administrated during operation for both groups, 10 IU directly into uterus and 10 IU intravenously. When the operation was over, 20 IU of oxytocin was dripped for group A lasting for 8 hours, while for group B 100μg of carbetocin was immediately injected intravenously for 1 minute. Blood loss as well as hemoglobin alteration was measured for the comparison of the effect of the two drugs. Blood biochemical indicators were introduced for the evaluation of the safety of carbetocin including the function of liver and kidney and the fasting glucose.Results: No significant difference was revealed between the two groups concerning the postpartum hemorrhage within 24 hours, the postpartum hemorrhage incidence and the changes of hemoglobin. There was no significant difference in the change of liver and kidney function, fasting glucose and electrolyte changes as well.Conclusions: Carbetocin has a similar effect and safety of oxytocin in controlling the blood loss of selective caesarean section.     

严重继发性甲状旁腺功能亢进症临床分析

目的调查血液透析患者全段甲状旁腺激素（iPTH）、血清钙和血清磷的水平,了解严重的继发性甲状旁腺功能亢进症（SHPT）的发病情况。方法选择血液透析治疗超过1年,行3次以上iPTH、Ca和P检查的患者,以血iPTH〉800ng／ml为界定点,分析严重的SHPT发病率与年龄、性别、透析龄、原发病（糖尿病或非糖尿病）、血清钙和血清磷的关系。结果139例患者中有27例是严重的SHPT患者,发病率为19．4％（27／139）,它们拥有较长的透析龄（P〈0．05）;其糖尿病的发生率明显低于非糖尿病（P〈0．05）,而且存在明显的高磷血症和高钙磷乘积（P〈0．05）。Logistic回归分析显示,年龄、高钙磷乘积是严重的SHPT的独立危险因素（P〈0．05）。结论严重的SHPT的发病率与年龄、高钙磷乘积有关。因此,临床上必须早治疗,严格控制高磷血症。     

穿心莲内酯对TBHP诱导的椎间盘髓核细胞凋亡的作用及机制研究

目的：探讨穿心莲内酯（andrographolide,ANDRO）对叔丁基过氧化氢（tert-butyl hydroperoxide,TBHP）诱导的椎间盘髓核细胞（nucleus pulposus cells,NPC）凋亡的作用及其机制。方法：用TBHP诱导NPC建立细胞模型。将NPC分为5组：对照组、模型组（100μmol/L TBHP）、ANDRO低剂量组（100μmol/L TBHP+9μmol/L ANDRO）、ANDRO中剂量组（100μmol/L TBHP+18μmol/L ANDRO）和ANDRO高剂量组（100μmol/L TBHP+36μmol/L ANDRO）。流式细胞术检测细胞凋亡和活性氧（reactive oxygen species,ROS）水平,ELISA试剂盒检测氧化应激相关指标超氧化物歧化酶（superoxide dismutase,SOD）、谷胱甘肽过氧化物酶（glutathione peroxidase,GSH-PX）和过氧化氢酶（catalase,CAT）水平,JC-1探针法检测线粒体膜电位,Western blot检测动力相关蛋白1(dynam...     

用可疑化妆品对化妆品皮炎作斑贴试验的研究

为了研究用化妆品进行斑贴试验时所需浓度，探讨用患者使用过的可疑化妆品进行斑贴试验在诊断化妆品皮炎中的应用价值，将各种化妆品以不同浓度对３５例健康者，３８例非接触性皮炎湿疹类患者进行斑贴试验。然后用患者各自的可疑致敏化妆品对６２例化妆品皮炎患者进行斑贴试验。结果：初步认为护肤类膏剂、唇膏、护发类发乳、头油、摩丝等类产品可用原物进行斑贴试验，染发剂、清洁类香皂、护发类油用２％，清洁类香波用２％和５％，冷烫精、指甲油、香水用５％或１０％。可疑化妆品斑贴试验的阳性率为９５．１６％。本研究表明：用可疑化妆品作斑贴试验时，不同类型的产品，其斑贴试验浓度并不相同，用患者的可疑化妆品进行斑贴试验是诊断化妆品皮炎的重要手段。这项研究为进一步研究我国化妆品皮炎标准筛选系列抗原提供了必要资料。