血管内皮损伤标志物在肾移植患者中的应用价值

目的 :通过对肾移植患者血浆可溶性血栓调节蛋白 (solublethrombomdulin ,sTM)、可溶性血管内皮细胞蛋白C受体 (endothelialproteinCreceptor ,sEPCR)、血管性血友病因子 (vonWillebrandfactor,vWF)含量水平的动态检测分析 ,探讨其在肾移植及移植排斥反应中的应用价值。方法 :采用双抗体夹心ELISA法检测 4 2例肾移植患者手术前后、排斥反应治疗过程中的sTM、sEPCR、vWF含量。结果 :肾移植术后sTM、sEPCR、vWF含量水平较术前明显增高 (P <0 0 5 )、与正常对照组比较有显著性差异 (P <0 0 1) ;发生移植排斥反应者较无排斥者有明显差异 (P <0 0 5 ) ;肾移植术前、排斥反应有效治疗后与正常对照组比较无显著差异 (P >0 0 5 ) ;肾移植患者sTM、sEPCR、vWF各指标间呈正相关 (r =0 5 95 ,P <0 0 1,r =0 5 81,P <0 0 1,r =0 6 0 6 ,P <0 0 1)。结论 :sTM、sEPCR、vWF均可作为肾移植患者血管内皮的免疫损伤标志物 ,联合动态监测sTM、sEPCR、vWF的含量在观察肾移植手术创伤程度、排斥反应的早期诊断和治疗效果的监测等方面均有重要的临床应用价值。     

骨组织工程用聚磷酸钙的结构和性能的研究

多孔聚磷酸钙（Calcium polyphosphate，CPP）生物陶瓷是一种新型的骨组织工程支架材料，国外有研究表明聚磷酸钙作为骨组织工程支架材料具有良好的生物相容性及可降解性。通过对原料煅烧过程的研究，探索了聚合度的计算方法，制备出不同聚合度的材料。通过对材料烧结温度的试验，制得了不同晶型的聚磷酸钙多孔材料。在Tris—HCl缓冲液中进行的体外降解实验表明，CPP多孔支架材料是可控降解的，不同聚合度和晶型的支架材料力学强度和降解性能不同。随着聚合度的增加，材料的力学强度增大，降解速率变小；非晶态的CPP17d就可以完全降解，7晶型的CPP25d可完全降解，β和α晶型的CPP降解缓慢，30d分别降解了大约12％和5％。因此聚磷酸钙是一种很有前途的骨组织工程支架材料，凭借其独特的无机聚合物结构及降解性能，有望实现可控速率的降解。     

Population survey of CCR5 delta32, CCR5 m303, CCR2b 64I,and SDF1 3'A allele frequencies in indigenous Chinese healthy individuals,and in HIV-1-infected and HIV-1-uninfected individuals in HIV-1 risk groups

The aim of this study is to determine in indigenous Chinese ethnic groups the frequencies of the chemokine (SDF1 3'A) and chemokine receptors (CCR5 delta32, CCR5 m303, and CCR2b 64I) HIV-1/AIDS restriction alleles. The study includes two cohorts; the first comprised 3165 indigenous healthy subjects representing eight ethnic groups: Han (n = 1406), Uygur (n = 316), Mongolia (n = 134), Hui (n = 386), Tibetan (n = 330), Zhuang (n = 378), Dai (n = 101), and Jingbo (n =114). The second cohort consisted of 330 HIV-1-infected (86 subjects infected by sexual transmission and 198 subjects infected by HIV-1-contaminated blood or by sharing injection equipment; the remaining 46 subjects said nothing about HIV-1 transmission) and 474 HIV-1-uninfected Han Chinese belonging to one of two HIV-1 high-risk groups: intravenous drug users (n = 215) and individuals with sexually transmitted diseases (n = 259). Genotypes for the four genes were obtained using PCR (CCR5 delta32) or PCR-restriction fragment length polymorphism. Randomly selected amplified PCR products were further confirmed by direct DNA sequencing. The variant allele frequencies were determined to be 0% to 3.48% for CCR5 delta32, 0% for CCR5 m303, 16.23% to 28.79% for CCR2b 64I, and 17.70% to 27.76% for SDF1 3'A in Chinese healthy individuals from eight ethnic groups. These findings show that allele frequencies differ among the eight Chinese ethnic groups for CCR5 delta32, CCR2b 64I, and SDF1 3'A and that the CCR5 m303 and CCR5 delta32 mutant alleles were absent or infrequent in Chinese, which may be helpful for studies of specific anti-HIV-1 vaccine trials and coreceptor inhibitor drug targets in Chinese populations. Furthermore, we observed no significant differences in allele or genotypic frequencies between HIV-1-infected and HIV-1-uninfected groups from the Han ethnic group. Our finding is the first reporting that there is likely no effect of the examined polymorphisms in our study on HIV-1 transmission in the Chinese Han population, However, the genetic effects of these and other AIDS-modifying polymorphisms on the pathogenesis and clinical outcome of HIV-1/AIDS diseases is under investigation in Chinese populations.     

Organ distribution of severe acute respiratory syndrome (SARS) associated coronavirus (SARS-CoV) in SARS patients: implications for pathogenesis and virus transmission pathways

We previously identified the major pathological changes in the respiratory and immune systems of patients who died of severe acute respiratory syndrome (SARS) but gained little information on the organ distribution of SARS-associated coronavirus (SARS-CoV). In the present study, we used a murine monoclonal antibody specific for SARS-CoV nucleoprotein, and probes specific for a SARS-CoV RNA polymerase gene fragment, for immunohistochemistry and in situ hybridization, respectively, to detect SARS-CoV systematically in tissues from patients who died of SARS. SARS-CoV was found in lung, trachea/bronchus, stomach, small intestine, distal convoluted renal tubule, sweat gland, parathyroid, pituitary, pancreas, adrenal gland, liver and cerebrum, but was not detected in oesophagus, spleen, lymph node, bone marrow, heart, aorta, cerebellum, thyroid, testis, ovary, uterus or muscle. These results suggest that, in addition to the respiratory system, the gastrointestinal tract and other organs with detectable SARS-CoV may also be targets of SARS-CoV infection. The pathological changes in these organs may be caused directly by the cytopathic effect mediated by local replication of the SARS-CoV; or indirectly as a result of systemic responses to respiratory failure or the harmful immune response induced by viral infection. In addition to viral spread through a respiratory route, SARS-CoV in the intestinal tract, kidney and sweat glands may be excreted via faeces, urine and sweat, thereby leading to virus transmission. This study provides important information for understanding the pathogenesis of SARS-CoV infection and sheds light on possible virus transmission pathways. This data will be useful for designing new strategies for prevention and treatment of SARS.     

Inhibitory effect of intrathecal meptazinol on carrageenan-induced thermal hyperalgesia in rats

The effect of meptazinol in the spinal cord on carrageenan-induced hyperalgesia was investigated. The latency of paw withdrawal (PWL) to a thermal stimulus was used as an index of inflammatory hyperalgesia in awake rats. Intrathecal (i.t.) injection of 10 and 100 microg meptazinol markedly increased the PWL of the carrageenan-injected paw (P<0.01). The PWL of the non-injected paw was not detectably affected by the administration of meptazinol at the doses tested. I.t. injection of naloxone (5 microg) or atropine (1 microg) alone exhibited no effect on the PWLs of either the carrageenan-injected or non-injected paw. Pretreatment with naloxone, but not atropine, completely blocked the meptazinol-induced anti-hyperalgesia. These observations suggested that mu opioid receptor rather than muscarinic acetylcholine receptor may be involved in the anti-hyperalgesia of meptazinol in the spinal cord.     

引导管芯在更换经口气管导管的应用

目的 观察应用引导管芯做引导，更换经口气管内导管的临床效果。方法 随机选择26例已完成气管内插管的病人，将引导管芯插入气管导管内至隆突水平，并拔出气管导管；将欲更换的气管导管套在引导管芯外，在管芯引导下将气管导管插入气管内，完成换置；结果 全部病例均顺利完成更换导管，换管过程中病人氧合良好，术后未发生与更换导管相关并发症；结论 应用引导管芯更换气管内导管，方法安全，简便易行，可替代传统换管方法。     

Narrowly Distributed Surfactant‐Free Polystyrene Latex with a Water‐Soluble Comonomer

Summary: The surfactant‐free synthesis of latex polymers of styrene and sodium styrenesulfonate (NaSS) was investigated. The development of size and size distribution of the particles was studied by photo‐correlation spectroscopy (PCS) and transmission electronic microscopy (TEM). The effects of NaSS concentration and the order of addition of reactants were examined in detail. The results showed that the particle size decreases with an increase in the styrene sulfonate concentration. The polydispersity index can be reduced by mixing NaSS with styrene homogeneously before adding initiator, but this leads to a slightly larger mean particle size.

TEM image of surfactant‐free polystyrene latex made by the modified method.     

Effects of a Short-Term “Fat Adaptation with Carbohydrate Restoration” Diet on Metabolic Responses and Exercise Performance in Well-Trained Runners

Periodized carbohydrate availability can enhance exercise capacity, but the effects of short-term fat adaptation carbohydrate restoration (FACR) diets on metabolic responses and exercise performance in endurance athletes have not been conclusively determined. This study aimed to investigate the effect of a FACR diet on measures of resting metabolism, exercise metabolism, and exercise performance. Well-trained male runners (n = 8) completed a FACR dietary intervention (five days’ carbohydrate < 20% and fat > 60% energy, plus one-day carbohydrate ≥ 70% energy), and a control high-carbohydrate (HCHO) diet for six days (carbohydrate > 60% energy; fat < 20% energy) in a randomized crossover design. Pre- and post-intervention metabolic measures included resting metabolic rate (RMR), respiratory quotient (RQ), maximum fat oxidation rate during exercise (MFO), and maximum fat oxidation intensity (FATmax). Measures of exercise performance included maximal oxygen uptake (VO₂max), running economy (RE), and 5 km running time trial (5 km-TT). In FACR compared with HCHO, there were significant improvements in FATmax (p = 0.006) and RE (p = 0.048). There were no significant differences (p > 0.05) between FACR and HCHO in RMR, RQ, VO₂max, or 5 km-TT. Findings suggest that a short-term (six days) FACR diet may facilitate increased fat oxidation and submaximal exercise economy but does not improve 5 km-TT performance.     

耳鼻喉科住院患者医院感染的原因分析及对策

耳鼻喉科患者具有基数大、病情差异较大的特点,在临床多种因素的影响下,极易导致患者在诊疗的过程中并发感染,促使患者的治疗周期延长,加剧患者的痛苦,严重影响患者的治疗效果,而治疗效果的优劣与医院的声誉和形象之间关系密切,自身的免疫能力低下、气管插管引发的误吸等患者因素;临床护理人员经验的缺乏,未严格遵守无菌操作原则等护理因素;侵入性的操作治疗、手术病灶切除的大小和抗菌药物的使用等治疗因素以及院方的重视度等管理因素均是导致感染症状发生的主要原因。该文对导致耳鼻喉患者发生医院感染的上述原因进行分析,并针对性地提出相关策略,为降低医院感染方案的制定提供借鉴。     

血肿穿刺抽吸治疗对高血压性脑出血患者血糖及按期预后的影响

目的：探讨治疗创伤对高血压性脑出血患者血糖及按期预后的影响。方法：采用局麻血肿穿刺抽吸治疗（治疗组32例）及全麻外科手术血肿清除治疗（对照组30例）,比较术后的血糖变化,结果：治疗组血肿穿刺抽吸后血糖高峰值水平显著低于对照组（P＜0．01）,而治疗后第1,2,周血糖降至正常者治疗组显著高于对照组（P＜0．05）,病死率治疗组6．25％,对照组26．7％）,两组比较差异显著（P＜0．05）,结论：高血压性脑出血患者血肿穿刺抽吸治疗较外科手术血肿清除治疗有血糖峰值低,恢复正常的速度快,病死率低,对脑组织的损伤小等优点,值得临床推广。