肾综合征出血热脑炎

肾综合征出血热脑炎济南市传染病医院（２５００２１）张作卿韩夏肾综合征出血热（ＨＦＲＳ）合并神经系统（ＮＳ）损害均见于危重型、重型患者。我们曾收治４６例ＨＦＲＳ合并ＮＳ损害患者，其中ＨＦＲＳ脑炎占７６．７４％。现将ＨＦＲＳ脑炎的临床分型和治疗原则介绍如...     

钴原卟啉诱导大鼠骨髓间充质干细胞血红素加氧酶-1过表达及其对IL-10分泌的影响

本研究探讨不同浓度钴原卟啉(CoPP)诱导大鼠骨髓间充质干细胞(BMMSC)血红素加氧酶-1(hemeoxygenase-1,HO-1)过表达的效应关系及其对BMMSC分泌IL-10的影响。分离培养BMMSC,用流式细胞术检测BMMSC中CD34、CD45、CD44和CD71的表达;应用茜素红染色和油红染色检测BMMSC向成骨及成脂诱导情况。BMMSC随机分为4组,分别置于CoPP浓度为0、25、50和75μmol/L的培养液中进行诱导。用MTT法分析BMMSC增殖情况。采用RT-PCR检测各试验组HO-1的表达水平,筛选出诱导HO-1表达上调的最适合的CoPP浓度。用ELISA试剂盒检测各组IL-10的分泌量。结果表明,体外分离培养的BMMSC中CD34、CD45表达呈阴性,CD44和CD71表达呈阳性;BMMSC经成骨及成脂诱导后出现钙沉积和脂滴,茜素红染色和油红染色呈阳性。各个浓度的CoPP对细胞增殖无显影响,CoPP 50μmol/L能强烈诱导BMMSC的HO-1表达,其在试验组的表达高于对照组,与此同时IL-10分泌量也较对照组增多。结论:CoPP对细胞增殖活性无促进作用,CoPP50μmol/L是诱导BMMSC HO-1表达上调的最适合的浓度,HO-1表达上调可诱导IL-10分泌增加。     

低剂量X射线照射对脐带间充质干细胞增殖及成脂成骨分化的影响

目的 探讨低剂量照射对人脐带间充质干细胞(hucMSCs)增殖及成脂、成骨分化的影响.方法 采用组织块贴壁法从人脐带沃顿胶样组织中分离出hucMSCs,并采用流式细胞术检测表面特异性标记.随机分为未予照射的对照组,以及50、100和200 mGy照射组.采用MTT法检测hucMSC在不同照射剂量和不同时间(1～7 d)的增殖情况.取第3代细胞,随机分为照射组(给予200 mGy照射)和对照组(不予照射),在体外诱导其向脂肪、成骨细胞分化,并通过油红O染色、检测碱性磷酸酶(ALP)活性,用RT-PCR检测成骨细胞核结合因子α1的mRNA表达,比较照射组与对照组细胞成脂、成骨分化的不同.结果 9～12 d开始有成纤维细胞从组织块游出贴壁,2周左右达到80%.低剂量照射后2、3、4、5和6 d,不同照射剂量组的细胞增殖均高于对照组(F=159.17、448.81、265.15、183.93、181.83,均P＜0.01),其中以100 mGy组促进细胞增殖作用最明显.照射组成脂诱导2 d后细胞内即有脂滴出现,且第21天成脂率明显高于对照组(t=28.25,P＜0.01).成骨诱导后,照射组ALP活性明显高于对照组(t=16.87,P＜0.01),且成骨细胞核结合因子α1的mRNA水平明显增高(t=14.16,P＜0.01).结论 低剂量照射可以促进hucMSC增殖,并加速其向成脂、成骨细胞分化.

Abstract：

Objective To observe the effects of low dose irradiation (LDR) on proliferation,adipogenesis and osteogenic potential of human umbilical cord mesenchymal stem cells (hucMSCs).Methods hucMSCs were isolated from Wharton's jelly tissue of human umbilical cord by modified tissuepiece inoculation,and flow cytometry was used to detect the expression of specific marker in the hucMSCs.The hucMSCs were randomly divided into two groups:irradiation group undergoing irradiation with the doses 50,100,or 200 mGy respectively,and control group without irradiation.MTT method was applied to evaluate the proliferation of the hucMSCs at different time points with various doses irradiation.The third passage hucMSCs were randomly divided into two groups:irradiation group undergoing low dose irradiation of 200 mGy,and control group without irradiation,and then underwent induction by adipocytic and oesteocytic differentiation induction fluids respectively so as to differentiate into adipocytes and osteoblasts.Oil red O staining was used to detect the activity of alkaline phophatase (ALP),and RT-PCR was used to detect the mRNA expression of core binding factor alpha 1 in human osteoblast.Results After 9-12days,fibroblasts began to swim out of the tissue piece with a confluence rate of 80% 2 weeks later.Within 7 days the absorption values of the hucMSCs undergoing different irradiation doses 2,3,4,5,and 6 days later were all significantly higher than those of the control group(F = 159.17,448.81,265.15,183.93,and 181.83 ,all P <0.01),with the proliferation rates of the 100 mGy subgroup being the highest.After being induced liquid,vacuoles were observed in the irradiated group 2 days later.21 days later,the adipogenic rates of irradiated group was significantly higher than that of the control group (t = 28.25,P <0.01).The ALP activity increased in the irradiated group compared with control group (t=16.87,P <0.01) .The expression level of Cbf-α1 mRNA was up-regulated obviously (t = 14.16,P＜0.01).Conclusions LDR promotes the proliferation of hucMSCs,and accelerates the hucMSCs' differentiation into adipocytes and osteoblasts.     

HFRS并发非酮症性高渗性糖尿病昏迷

ＨＦＲＳ并发非酮症性高渗性糖尿病昏迷济南市传染病医院（２５００２１）张作卿，韩夏ＨＦＲＳ并发非酮症性高渗性糖尿病昏迷（ＮＨＤＣ）病死率高达４０％以上，主要见于重症ＨＦＲＳ患者的少尿期、移行阶段和多尿早期，多为中、老年人，患者多无糖尿病史。１机理和诱因...     

静脉滴注脂肪乳诱发痛风1例分析

对静脉滴注脂肪乳诱发痛风1例分析如下。1病历摘要 男，50岁。既往有高血压、痛风病史。因过量饮酒而致上腹部胀痛不适伴恶心呕吐2d来院。门诊B超检查发现胆囊稍肿大，胆囊壁粗糙不平，胰腺中度水肿；血淀粉酶1522U／L。诊断急性胆原性胰腺炎收住院。查体：T36．8℃，P80次／min；BP140／90mmHg，痛苦面容，巩膜无黄染，心肺无异常，腹平坦，腹肌软，肝脾未触及，满上腹部压痛，无反跳痛，无移动性浊音，肠鸣音活跃，四肢关节无肿痛，     

浅析药师职责与临床合理用药

每个医院都应重视合理用药、安全用药，使医师、药师、患者形成一个互联的循环体系，以避免药品不良反应及药源性疾病造成的危害。     

乙肝免疫球蛋白对于阻断乙肝病毒母婴传播的效果研究

目的:分析乙肝免疫球蛋白对于阻断乙肝病毒母婴传播的效果.方法:病例选至我科室门诊2009年1月至2011年3月接受孕期检查的HBV携带的132例孕妇,大三阳和小三阳的孕妇于孕24周开始接受HBIG注射治疗,携带者孕妇于孕28周开始接受HBIG注射.结果:孕24周与分娩前的乙肝标志物与HBV-DNA检查结果无明显差异,.HBIG阻断HBV母婴传播疗效,总有效率为75.71%.而HBIG阻断HBV疗效大三阳孕妇较携带者和小三阳孕妇疗效不佳,存在明显差异.新生儿接受疫苗接种和HBIG注射后12个月,HBsAb(+)率为86.43%,与新生儿出生时HBsAb(+)率75.71%相比,有较大改善,存在明显差异.结论:对HBV感染的孕妇在孕24周后注射HBIG,阻断乙肝病毒母婴传播效果明显,新生儿出生后采用HBIG和HBV疫苗联合阻断HBV母婴传播临床效果显著.     

肠易激综合征118例临床分析

肠易激综合征(IBS)一种持续存在或反复发作的一组包括腹痛、腹胀、排便习惯改变和大便性状异常等表现,而缺乏明显形态学、生化和感染性原因的临床综合征[1].本病是一种常见的功能性肠道疾病,笔者对我科2005年1月-2010年12月结合内镜检查确诊的118例IBS患者进行分析如下.