雷帕霉素药物洗脱支架直接置人术治疗急性冠脉综合征的临床研究

目的 评价直接置入雷帕霉素药物洗脱支架(CYPHER^TM,codis治疗急性冠脉综合征(ACS)罪犯病变的安全性、可行性。方法 32例接受CYPHERTM支架直接置入的患者(直接支架组)和一般情况匹配的34例球囊扩张后行冠脉支架术的患者(常规支架组),比较两组的一般情况,冠脉造影及介入治疗即刻和临床随访结果。结果 直接支架组和常规支架组的成功率分别为97％和100％,直接支架组1例支架无法通过病变,球囊预扩张后成功置入原支架。两组无一例发生介入治疗相关的的严重心脏事件。随访期间两组严重心脏不良事件发生率无明显统计学差异。结论 CYPHER^TM支架直接置入术治疗ACS罪犯病变安全可行,成功率高。     

鼠巨细胞病毒感染小鼠骨髓单个核细胞亚群的研究

本研究旨在探索鼠巨细胞病毒(MCMV)在小鼠骨髓单个核亚群细胞中的感染特性。采用免疫磁珠分选法(MACS)分选小鼠骨髓单个核亚群细胞,包括lin+细胞、lin-细胞、lin-CD117+和lin-CD117-细胞;用MCMV攻击分选的各组分细胞并以细胞因子和诱导剂诱导细胞分化,最后检测病毒核酸及相关蛋白。结果表明:在MCMV感染的lin+细胞中可检测到病毒DNA和立即早期基因的转录产物及其蛋白,而在感染的lin-细胞中则未检测到任何病毒产物。通过添加细胞因子GM-CSF、rhEPO或佛波酯,则可以在感染的lin-细胞中检测到MCMV的立即早期和早期基因转录产物以及蛋白表达。在lin-CD117+和lin-CD117-细胞中也未检测到病毒基因转录产物,但MCMV感染可抑制lin-CD117+造血干/祖细胞集落的形成以及下调其表面标志CD117抗原的表达。结论:MCMV可在小鼠骨髓单个核亚群细胞中潜伏感染;小鼠骨髓中具有原始干/祖细胞性质的细胞群对MCMV不易感,但MCMV感染可对这些细胞的功能产生抑制作用,可使细胞表面标志表达下调。     

2型糖尿病健康教育的研究进展

从2型糖尿病健康教育团队的组成、教育模式、教育内容（2型糖尿病的危害、预防、饮食、运动、心理、药物及血糖监测的护理）及效果评价概括2型糖尿病健康教育的研究进展，归纳总结出2型糖尿病健康教育中存在的不足，并提出相关对策，以提高2型糖尿病健康教育的质量。     

护理教育中的生死教育

回顾了生死教育的缘起和发展,讨论了生死教育实施的必要性和合理的内容结构及开展形式。提出生死教育能够赋予学生人文关怀的意愿和能力,最终提升医疗护理品质,理当作为医学教育的组成部分。     

婴幼儿泪囊炎的治疗与护理

婴幼儿泪囊炎是婴儿常见病，为婴儿出生后或更长时间有溢泪、眼红、黏脓性分泌物，压迫泪囊区有反流物溢出。用眼药水治疗效果欠佳，加之患儿对各种治疗方法的不合作，为临床治疗和护理带来不便。我科2002年3月-2005年3月治疗110例（124眼）婴幼儿泪囊炎患儿，获得满意效果。现总结如下。     

中药镇痛膏治疗癌性疼痛的临床研究

目的观察对60例癌症病人的疗效。方法治疗组：先确定痛点，然后清洁皮肤，根据病灶疼痛范围大小选用不同剂量止痛膏，膏药厚度为0．1cm，外盖以无纺纱布固定，每24小时换1次。对照组：选用强痛定100mg肌注，至疼痛再发作时用。临床观察30d。结果镇痛膏对癌性疼痛具有较好的镇痛效果，其有效率为83.3％，略高于强痛定对照组；在起效时间上与强痛定对照组无差异，而在持续减轻时间上优于对照组（P〈0．05）：从其疗效与中医辨证分型，疼痛程度的关系看：镇痛膏对气滞血淤型疼痛最好，缓解率为90．91％；痰湿夹瘀型次之，缓解率为81．82％；气阴两虚型疗效最差，缓解率为75％。统计学处理无意义：对中度疼痛显著缓解率为91．67％，对重度疼痛缓解率为77，78％，统计学处理无意义。结论该药癌症病人癌性疼痛的疗效是有效的。     

Differential Regulation of Lipid Metabolism Genes in the Brain of Acetylcholinesterase Knockout Mice

Mice deficient in acetylcholinesterase (AChE; EC3.1.1.7) exhibited significant phenotypical and biochemical changes when compared with wild-type littermates. They showed a delay of growth in weight and size, immature external ears, and persistent body tremor, and they circled when walking. The molecular mechanisms underlying these changes have not been investigated yet. Here, we studied the profiles of both the messenger RNA (mRNA) and protein expression in the brain of AChE-deficient mice using mRNA microarray, quantitative PCR, and two-dimensional difference gel electrophoresis (2D DIGE) coupled to protein identification with matrix-assisted laser desorption/ionization time of flight (MALDI-TOF) mass spectrometry. Analysis of gene expression profile was conducted by DAVID (http://david.abcc.ncifcrf.gov) and Ingenuity Pathway Analysis (IPA, http://www.ingenuity.com). Previous results implicated that there is a close relationship between lipid metabolisms which were associated with central nervous system development. Here, we demonstrated that the mRNA expressions of brain specific fatty acid protein 7 (fabp-7) and phospholipase A2 group IV (pla2g4) were significantly downregulated in AChE-deficient mice. These results suggested that AChE may play a role in neurogenesis and neurodegeneration by specifically regulating lipid metabolism in the brain.     

Is wound drainage necessary in hip arthroplasty? A meta-analysis of randomized controlled trials

Purpose

The use of closed suction drainage systems for hip arthroplasty (HA) is a common practice. However, the effectiveness and safety are still questionable. Thus, the aim of this meta-analysis was to review the advantages and adverse effects of closed suction drainage systems in hip arthroplasty.

Methods

All randomized or quasi-randomized trials comparing the use of closed suction drainage systems with no drainage systems for hip arthroplasty were searched in PubMed, Medicine, EMBASE and other internet databases. We assessed the methodological quality of the studies and abstracted the relevant data independently.

Results

Sixteen studies involving 1,663 participants with surgical wounds comparing HA with and without the use of drainage were included in our analysis. Our results demonstrated blood transfusion was required more frequently the same as the persistent discharge in those who received drains. No significant differences in the incidence of wound hematoma, dehiscence or deep vein thrombosis were found between those allocated to drains and the non-drained wounds. Wound infection and the range of movement of the joint after surgery were similar between the two groups.

Conclusions

Based on the current evidence, there is insufficient evidence to support the routine use of closed suction drainage in hip arthroplasty. At the same time, our meta-analysis study suggested that using of closed suction drainage in HA increased requirement for postoperative blood transfusion. However, there is a moderate possibility of selection bias and publication bias in this review. Because of the limited number of studies which may weaken the strength of the evidence of our results, more samples, high-quality randomized trials are needed to increase the reliability of evidences.

Level of evidence

II.