散发型Creutzfeldt-Jakob病的MRI表现

目的探讨散发型Creutzfeldt-Jakob病（sCJD）的MR特点。方法回顾性分析3例临床诊断为sCJD的患者资料，MR采用SE T1 WI、快速自旋回波（FSE）T2 WI、扩散加权成像（DWI）扫描，观察其MR表现特征。结果3例SE TI WI和FSE T2 WI序列对基底节区和皮质的病变显示不佳，DWI则可清晰地显示病变，额、顶、枕叶皮质最常受累，表现为高信号，病变可对称，也可不对称，皮层下区脑白质信号未见异常。双侧尾状核、丘脑也可受累，DWI上呈高信号。晚期脑实质广泛萎缩，以皮质为著。结论sCJD采用DWI序列结合其特征性的临床表现可作出较为准确的诊断。     

计算机导航在骨科手术中的应用

目的将计算机导航技术应用于骨科手术,并对其进行初步分析。方法2004年2～12月,计算机导航系统辅助下共行134枚椎弓根螺钉固定,51枚股骨颈骨折空心钉内固定,58枚交锁髓内钉远端交锁螺钉固定。结果所有病例全部在导航下完成手术,术中明显减少C型臂X线机透视次数,未发生血管和神经损伤并发症。结论计算机导航手术安全有效,更有利于微创手术的开展。     

骨髓间充质细胞与速固化磷酸钙支架共培养的实验研究

[目的]观察人骨髓间充质干细胞在速固化磷酸钙骨水泥支架中的增殖和生长情况。[方法]将速固化壳聚糖-磷酸钙骨水泥支架材料预先成形。采用全骨髓法分离人骨髓间充质细胞并在体外对细胞进行培养和扩增。72h首次换液,细胞融合80%传代,取第3代细胞用于实验。将细胞与磷酸钙骨水泥支架复合培养,分别利用四甲基偶氮唑蓝MTT法及扫描电镜等检测细胞在材料中的增殖和生长情况。[结果]用酶标仪检测OD值提示共培养后,支架内的细胞数量逐渐增加。扫描电镜结果显示支架材料内部为多孔结构,孔内见有细胞生长,细胞表面可见分泌颗粒。[结论]速固化壳聚糖-磷酸钙骨水泥对人骨髓间充质干细胞有较好的细胞相容性,细胞可在材料内黏附和增殖,是理想的骨组织工程支架材料。     

感染科护理人员负性情绪的调查

目的 探讨从事传染病护理工作的护理人员焦虑、抑郁情绪及其影响因素,为制定相关政策提供依据.方法 采用焦虑自评量表(SAS)和抑郁自评量表(SDS)对289名感染科护理人员(研究组)及310名一般护理人员(对照组)进行心理评定,同时对研究组进行心理健康访谈问卷调查.结果 研究组SAS、SDS评分显著高于对照组(均P＜0.01).感染科护理人员产生负性情绪的主要因素是缺乏家庭和社会支持、理解,自身感染传染病的危险,工作、生活环境差,任务繁重、责任大.结论 家人和社会的支持与理解对从事传染病护理的护理人员减轻负性情绪有特殊重要意义;加强个人防护,创造安全的工作、生活环境是护理人员保持较好心理素质的保障,医院应高度重视感染科护理人员身心健康.     

Triptolide inhibits T cell activation and proliferation via multiple pathways

Triptolide is potent immunosuppressive has been reported to inhibit autoimmunity, compound isolated from Chinese herbal medicine. Triptolide allograft attributed to the suppression of T cells via NF - kB rejection and GVHD, and its efficacy was previously pathway and apoptosis. In the present study, we detailedly analyzed Triptolide＇ s function on murine primary T cell. We found that Triptolide could inhibit T cell activation and proliferation by dramatically down - regulating cell division and cell cycle. Triptolide inhibited T cell activation in a dose- dependent manner, and the inhibition was mediated by both NF- kB pathway and AP - 1 pathway.     

胰岛素强化治疗对严重创伤患者炎性反应及预后的影响

Objective To investigate the effects of intensive insulin therapy on inflammatory re-sponse and prognosis of patients with severe trauma. Methods Eighty severely injured patients were di-vided into intensive insulin therapy group (n = 40, IT) and routine therapy group (n = 40, RT) in random pair. At the time of admission, a continuous infusion of insulin (2 -4 U/h) was pumped into the patients of IT group to maintain blood glucose level at 6 -8 mmol/L. Patients in RT group were given routine treatment without administration of insulin. Fever, organ injury, and mortality of patients in 2 groups were recorded. Venous blood was drawn from patients of 2 groups on the morning of post treatment day (PTD) 1, 3, 5, and 7. Values of TNF-α, C-reactive protein (CRP), IL-2, and IL-10 in plasma were assayed. Results High fever appeared in 9 patients in IT group, and WBC exceeded 10.0×109 for more than 3 days in 17 patients in this group, versus 20 and 29 patients respectively in RT group. Dysfunction of 1 organ appeared in 31 pa-tients in IT group and 30 patients in RT group. Dysfunction of 3 organs appeared in 10 patients in IT group and 19 patients in RT group. Dysfunction of 4 organs appeared in 7 patients in IT group and 12 patients in RT group. In IT group, 4 patients died within 3 post-injury day (PID), and 1 patient died after PID 3 (total case fatality: 12.5% ). In RT group, 5 patients died within 3 PID, and 4 patient died after PID 3 (total case fatality: 22.5%). Plasma levels of TNF-α and CRP of patients in IT group were significantly lower than those of patients in RT group on PID 3 - 7 ( P<0.05 or P<0.01 ), while levels of IL-2 and IL-10 of patients in IT group were significantly higher than those of patients in RT group ( P<0.05 or P<0.01 ). Plasma levels of TNF-α ( 1.3±0.6 μg/L) and CRP (55±16 mg/L) of patients in IT group on PTD 7 were lowered to the trough level, and they were significantly lower than those of patients in RT group (3.0±0.8μg/L, 89±20 mg/L, respectively, P <0.01 ). Conclusions Intensive insulin therapy can mitigate systemic inflammatory response and improve prognosis of patients with severe trauma.     

深静脉血栓形成患者凝血因子ⅩⅢ Val34Leu基因多态性检测

目的:探讨凝血因子ⅩⅢ(FⅩⅢ)Val34Leu基因多态性与中国人群深静脉血栓形成(DVT)发病的相关性.方法:利用聚合酶链反应和限制性片段长度多态性(PCR-RFLP)方法,检测了103例DVT患者与106例正常对照的FⅩⅢVal34Leu基因多态,并加以对照分析.结果:103例DVT患者FⅩⅢVa134Leu基因型均为野生型V/V,未见突变类型;106例对照组中发现1例突变杂合子V/L.2组基因型频率、等位基因频率相互比较,差异均无统计学意义(P＞0.05).结论:FⅩⅢVal34Leu对中国人群DVT有保护作用的可能性极小.     

Serial CT findings of Paragonimus infested dogs and the Micro-CT findings of the worm cysts.

OBJECTIVE: To investigate the serial CT findings of Paragonimus westermani infected dogs and the microscopic structures of the worm cysts using Micro-CT. MATERIALS AND METHODS: This study was approved by the committee on animal research at our institution. Fifteen dogs infected with P. westermani underwent serial contrast-enhanced CT scans at pre-infection, after 10 days of infection, and monthly thereafter until six months for determining the radiologic-pathologic correlation. Three dogs (one dog each time) were sacrificed at 1, 3 and 6 months, respectively. After fixation of the lungs, both multi-detector CT and Micro-CT were performed for examining the worm cysts. RESULTS: The initial findings were pleural effusion and/or subpleural ground-glass opacities or linear opacities at day 10. At day 30, subpleural and peribronchial nodules appeared with hydropneumothorax and abdominal or chest wall air bubbles. Cavitary change and bronchial dilatation began to be seen on CT scan at day 30 and this was mostly seen together with mediastinal lymphadenopathy at day 60. Thereafter, subpleural ground-glass opacities and nodules with or without cavitary changes were persistently observed until day 180. After cavitary change of the nodules, the migratory features of the subpleural or peribronchial nodules were seen on all the serial CT scans. Micro-CT showed that the cyst wall contained dilated interconnected tubular structures, which had communications with the cavity and the adjacent distal bronchus. CONCLUSION: The CT findings of paragonimiasis depend on the migratory stage of the worms. The worm cyst can have numerous interconnected tubular channels within its own wall and these channels have connections with the cavity and the adjacent distal bronchus.     

岗位业绩导向的医院薪酬设计

基于现代管理理论和医院的实际情况，设计了一种以岗位和业绩为导向的医院薪酬制度。该设计的主要特点是：①薪酬结构以岗位工资和绩效工资为主体，同时兼顾稳定和逐步过渡原则，原档案工资的固定部分(约占档案工资的60％)保留。②岗位工资采用全院统一的等级薪酬结构，等级的评定基于全院统一的指标体系和权重，岗位工资每年随绩效考核结果在工资带宽中升降；③绩效工资与岗位等级和绩效考核紧密挂钩，考核的依据是全院统一模式的岗位绩效合同；④整个薪酬设计建立在岗位调查、岗位评价和岗位说明书等的科学规范的工作基础之上。     

肺癌患者胸腔积液中α2-巨球蛋白含量的测定及其临床意义

目的为了研究肺癌病人胸腔积液中α2-巨球蛋白(α2-M)含量的变化,分析其与肺癌发展、转移的关系,探讨肺癌胸腔积液诊断的新方法及恶性胸腔积液治疗的新思路. 方法 采用免疫浊度法分别测定了肺癌病人、肺结核病人胸腔积液和漏出性胸腔积液中α2-M的含量,并对测定结果进行统计学处理.结果肺癌病人胸腔积液中α2-M的含量较肺结核病人胸腔积液中的含量有显著降低(P<0.001),而漏出性胸腔积液中α2-M的含量与结核性、肺癌性胸腔积液相比较有显著性降低(P<0.001,P<0.05).结论肺癌病人胸腔积液中存在α2-M的代谢紊乱.监测胸腔积液中α2-M的含量有利于良性、恶性胸腔积液的鉴别诊断.使用α2-M制剂可能有助于抑制恶性肿瘤的发展、有利于恶性胸腔积液的治疗.