山东沿海地区高尿酸血症患者SLC22A12基因的多态性

目的:观察山东沿海地区人群SLC22A12基因的多态性,分析其与高尿酸血症的关系。方法:该实验于2005-11/2006-04收集病历于2006-05/07完成实验室部分。纳入青岛大学医学院附属医院门诊或青岛市社区高尿酸血症患者138例为高尿酸血症组,同时选取青岛市区健康者117人健康对照组。两次来访,初访时进行详细的记录,包括用药情况、身高、体质量、腰围、腹围、体质量指数、血压以及家族史。再访时隔夜空腹12h抽血测血尿酸、血糖、血脂、肝酶等,分析两组生化指标的差异。所有标本采用PCR、DNA序列分析、病历对照等方法对138例高尿酸血症者和117例健康对照者基因进行分析。结果:高尿酸血症组患者138例,健康对照组117人全部进入结果分析,无脱失。①健康对照组和高尿酸血症组一般情况比较,年龄、血肌酐、空腹血糖两组比较差异无统计学意义(P>0.05)。体质量指数、腰臀围比、血压、血尿酸、总胆固醇、三酰甘油空腹血糖两组比较差异有显著性意义(P<0.001)。②健康对照组CC CT基因型和TT基因型频率与高尿酸血症组比较差异有非常显著性意义(77.8%,97.1%;22.2%,2.9%;P<0.001)。③健康对照组CC CT基因型和TT基因型相对应的血尿酸值比较差异有显著性意义[(271±33.5),(301±37.8)mmol/L,P<0.01]。高尿酸血症组CC CT基因型和TT基因型相对应的血尿酸比较差异无统计学意义[(457±71.2),(459±80.1)mmol/L,P>0.05]。结论:高尿酸血症和正常人hURAT1基因同样存在多个突变位点,基因的多态性与血清尿酸水平有关。SLC22A12基因C258T位点多态性与中国沿海地区高尿酸血症有关。     

人Persephin基因重组腺病毒载体构建及在C17．2神经干细胞的表达

目的:Persephin是近年来发现的对多巴胺神经元的发育与分化起调控作用重要基因,单纯神经干细胞系C17.2移植治疗帕金森病在体内分化为多巴胺能神经元比例不高。实验构建了人Persephin基因重组腺病毒载体,并观察其在C17.2神经干细胞的表达。方法:实验于2005-06/12在中山大学附属第二医院林百欣实验中心完成(广东省重点实验室)。①实验材料:流产胚胎由中山大学附属第二医院妇产科提供,产妇及其家属均签署知情同意书。病毒骨架质粒载体pAdEasy-1、穿梭载体PAdTrack-CMV(含绿色荧光蛋白基因)、大肠杆菌菌株BJ5183和DH5α、人胚肾293细胞均为本室保存。C17.2神经干细胞由美国哈佛大学医学院Snyder教授惠赠。②实验方法:采用反转录聚合酶链式反应从人胚胎脑获得PersephincDNA。将重组质粒pAdTrack-CMV-Persephin与骨架质粒pAdEasy-1共转染大肠杆菌BJ5183,获得重组腺病毒质粒。将重组腺病毒质粒转染293细胞包装获得重组腺病毒AdCMVPersephin,转化体外培养的C17.2神经干细胞。③实验评估:用原位杂交、免疫组化、Westernblot法检测Persephin在C17.2神经干细胞中的表达。结果:①人Persephin基因的克隆与测序分析:琼脂糖凝胶电泳检测PCR扩增产物,其Persephin基因片段长约310bp,与预期分子量相符。Persephin基因被克隆于载体pMD18-T,以SaiⅠ和XhoⅠ双酶切可回收长约310bp的克隆片段,测序结果证实所克隆的为人PersephincDNA。②大肠杆菌同源重组获得克隆化重组腺病毒基因组及鉴定:Persephin重组腺病毒质粒pAdTrack-CMV-Persephin用PacⅠ酶切可切出4.1kb的目标片断,PCR鉴定可从重组腺病毒质粒中可扩增出PersephincDNA片断(310bp)。病毒滴度在脂质体转染后为1.9×107pfu/L。用收集的上清4次重复感染293细胞扩增重组腺病毒后,病毒滴度经绿色荧光蛋白检测达3.0×1011pfu/L。③Persephin基因在C17.2神经干细胞中的表达:免疫组化与原位杂交显示转染pAdPersephin的C17.2神经干细胞胞浆中有Persephin蛋白和mRNA表达。提取感染病毒的C17.2神经干细胞的总蛋白,经Westernblot检测可见一特异性蛋白条带存在。结论:采用RT-PCR法成功克隆人PersephincDNA并构建其腺病毒载体,获得了稳定表达Persephin的神经干细胞克隆,为进一步分析转基因神经干细胞治疗神经退行性疾病提供可行的操作方法。     

口蹄疫患者的护理1例

0　引言　口蹄疫是由口蹄疫病毒引起的一种人、畜共患的急性传染病 ,主要先流行于偶蹄动物如猪、牛、羊等 ,人与患病动物密切接触而感染 ,以小儿发病为多 .现将我科收治的 1例患儿护理体会报告如下 .1　病例介绍　患者 ,男性 ,3岁 ,因发热 4d,疱疹 2 d入院 .患儿于 4d前因饮用未煮的鲜牛奶后出现发热 ,体温 38.5℃左右 ,伴恶心、呕吐 ,病后 2 d口腔粘膜、舌、手、足底部出现红色斑丘疹 .查体 :体温 38.2℃ ,双手掌、指间、双足底及趾间可见散在的丘疹及疱疹 ,疹间皮肤正常 ,口腔粘膜及舌面、舌缘可见较密集红色粘膜疹 ,疹间皮肤正常 .血常规…     

髓核蛋白多糖含量与退行性变腰椎间盘MRI信号强度的相关性

目的:探讨退行性变腰椎间盘MRI信号强度和髓核蛋白多糖含量之间的相关性,评价MRI在椎间盘生化状态评估中的价值。方法:①对象:随机选择的腰椎间盘髓核样本,取自2006-08/2007-01在山东省千佛山医院手术的33例患有腰椎间盘突出症的患者,患者对实验均知情同意。②方法:术前测量腰椎间盘正中矢状面MRIT2WI信号值;术后用紫外分光光度法测量髓核蛋白多糖的含量。③评估指标:对照研究依据Minnatertti法分为Ⅱ类、Ⅲ类腰椎间盘的MRIT2WI信号强度及髓核蛋白多糖含量,并用Pearson相关检验评估两者之间的相关性。结果:Ⅲ类腰椎间盘正中矢状位T2WI信号强度和髓核蛋白多糖含量明显低于Ⅱ类椎间盘(P<0.001),MRIT2WI信号值和髓核蛋白多糖含量之间的相关系数分别为0.674,0.658(P<0.001)。结论:腰椎间盘MRIT2WI信号强度随髓核蛋白多糖含量的减少而降低,二者之间有明显的相关性。MRI是评价椎间盘生化状态的良好工具。     

交联型猪脱细胞真皮基质与自体微粒皮复合移植的临床应用

目的:观察交联型异种(猪)脱细胞真皮基质与自体微粒皮复合移植修复大面积深度烧伤早期切痂创面的疗效。方法:选择2001-09/2006-10在珠海市人民医院暨南大学医学院第三附属医院整形烧伤科就诊的中面积和大面积深度烧伤患者16例共48个观测创面,患者均知情同意。患者于伤后3～5d休克期平稳渡过后行肢体创面切痂术,自体微粒皮移植组观测24个创面,均位于复合皮移植组创面的邻近或对侧肢体相同部位。①复合皮移植组:切痂创面用交联型异种(猪)脱细胞真皮基质(由江苏启东医疗用品研究所提供) 自体微粒皮复合移植 异体皮覆盖。②自体微粒皮移植组:切痂创面用自体微粒皮移植 异体皮覆盖。术后6周异体皮脱落,两组散在肉芽创面行小邮票状皮片补充移植修复创面。术后定期观察创面愈合情况,计算创面愈合率及收缩率,并行创面组织学检测。结果:两组48个创面均进入结果分析,无脱落。①两组异体皮成活情况相近。②术后6周,复合皮移植组患者的创面愈合率均显著低于自体微粒皮移植组(P<0.05);经补充植皮后即术后8周两组创面愈合率差异无显著性意义(P>0.05)。③移植术后6,8,12周,复合皮移植组患者的移植创面收缩率均显著低于自体微粒皮移植组[(10.28±2.36)%,(16.25±3.78)%;(15.68±1.79)%,(30.42±3.65)%;(22.07±1.39)%,(42.83±2.74)%(P<0.05)]。④术后8周组织学观察结果显示,复合皮移植组创面愈合处上皮化良好,胶原纤维排列有序,基底膜结构完整;自体微粒皮移植组上皮层仍较薄,细胞分化不良,真皮内胶原排列较紊乱。结论:交联型异种(猪)脱细胞真皮基质与自体微粒皮复合移植修复大面积深度烧伤早期切痂创面,能够抑制瘢痕增生,改善创面愈合质量,疗效满意。     

An interactive technology approach to educate older adults about drug interactions arising from over-the-counter self-medication practices

An interactive computer program (Personal Education Program [PEP]) designed for the learning styles and psychomotor skills of older adults was used to teach older adults about potential drug interactions that can result from self-medication with over-the-counter (OTC) agents and alcohol. Subjects used the PEP on notebook computers equipped with infrared sensitive touchscreens. Subjects were recruited from senior centers. Those who met age, vision, literacy, independence, and medication use criteria were randomly assigned to one of three groups: (1) PEP plus information booklet; (2) information booklet only; or (3) control. A repeated measures (three time periods 2 weeks apart), three-group design was used. Users of PEP had significantly greater knowledge and self-efficacy scores than both the conventional and control groups at all three time points. The PEP group reported fewer adverse self-medication behaviors over time. Reported self-medication behaviors did not change over time for either the conventional or control groups. Subjects indicated a high degree of satisfaction with the PEP and reported their intent to make specific changes in self-medication behaviors.     

Comparison of cytopathic changes in oral hairy leukoplakia with in situ hybridization for EBV DNA

OBJECTIVE: It has been observed that the cytopathic changes in hairy leukoplakia (HL) correlate with ultra-structural evidence of intra-keratinocyte herpes-type viral particles. In situ hybridization is considered to be the definitive confirmation of Epstein-Barr virus (EBV)-induced HL. This study evaluated the consistency of histopathological findings, which many believe to be diagnostic, with in situ hybridization for EBV-DNA in 60 patients with lesions clinically suggestive of HL.
MATERIALS AND METHODS: Hematoxylin and eosin (H&E)-stained sections were reviewed independently by three oral pathologists who did not know the hybridization results. The presence in keratinocytes of nuclear inclusions and/or homogenization, believed to be specific for EBV in these lesions, was used as an indicator for infection. Cytoplasmic changes were evaluated separately.
RESULTS: With in situ hybridization, 48 cases were positive and 12 were negative. When the two methods were compared, pathologist concurrence ranged from 83% to 92%. False negatives ranged from 6% to 19%, and false positives ranged from 8% to 25%. Cytoplasmic ballooning, homogenization, and perinuclear clearing were evident in all cases of hybridization-confirmed HL; however, these changes were also noted in 75% (9/12) of the cases with negative hybridization results. Most confirmed HL cases exhibited both nuclear homogenization and inclusions, although the former was more consistently seen.
CONCLUSION: Cytoplasmic changes did not agree well with EBV-DNA hybridization results, whereas nuclear changes demonstrated good, but not complete, agreement. In appropriate clinical settings, the finding of nuclear inclusions and/or homogenization may be of diagnostic value. However, because the potential for false positives and negatives is high, H&E cytopathology should not be used as a substitute for in situ hybridization in the definitive diagnosis of oral hairy leukoplakia.