上颌窦良性占位性病变手术入路的探讨

目的探讨鼻内镜下多种手术入路治疗上颌窦良性占位性病变的方法及疗效。方法采用鼻内镜下中鼻道扩大上颌窦自然开口术、鼻内镜下中-下鼻道联合上颌窦开窗术、鼻内镜下鼻腔外侧壁切开上颌窦手术、鼻内镜下上颌窦内侧壁切除术、鼻内镜下改良Denker术等多种入路对136例上颌窦良性占位性病变进行手术治疗。结果除2例上颌窦后鼻孔息肉和1例内翻性乳头状瘤复发,经再次手术治疗痊愈外,其他患者均无复发。结论根据上颌窦良性占位性病变的不同临床特点,采用不同手术入路既可有效治愈上颌窦病变,同时可最大限度地减少手术创伤。     

Effect of storage and ultraviolet B irradiation on CD14-bearing antigen- presenting cells (monocytes) in platelet concentrates

BACKGROUND: Ultraviolet B (UVB) irradiation of platelet concentrate (PCs) reduces platelet alloimmunization, but the mechanism of the effect is unclear. Evidence suggests that UVB may downregulate the expression of surface adhesion molecules on passenger antigen- presenting cells in PCs. STUDY DESIGN AND METHODS: The effect of blood bank storage, platelet preparation from whole blood, and UVB irradiation on the quantitative expression of intercellular adhesion molecule-1 (ICAM-1, or CD54), HLA-DR, CD45, and CD11c on CD14-positive antigen-presenting cells (monocytes) was studied by using two-color flow cytometry. RESULTS: Blood bank storage for 4 days resulted in upregulation of ICAM-1 and HLA-DR and downregulation of CD14 but left the expression of CD11c and CD45 unchanged. Preparation of PCs from fresh whole blood was associated with a rapid increase in CD11c without upregulation of ICAM-1 and HLA-DR. UVB irradiation before storage inhibited the upregulation of ICAM-1 and HLA-DR, resulted in accelerated downregulation of CD14, and was associated with increased loss of monocytes. Agitation of the PC bag during irradiation was of critical importance, since omission of agitation resulted in largely uninhibited upregulation of ICAM-1 but was still associated with significantly higher cell loss than that seen in unirradiated controls. CONCLUSION: UVB exposure nonspecifically affects monocytes in PCs, resulting in downregulation of surface molecules that are important for antigen presentation, as well as in significant cell loss.     

术前预防性使用抗生素对剖宫产切口感染的影响

目的探讨术前预防性使用抗生素对剖宫产术后切口感染的影响。方法以2012年1月至2014年1月间我院收治的106例剖宫产孕妇为研究对象,随机分为术前应用抗生素组(观察组)及术后应用抗生素组(对照组)各53例。比较两组患者术中出血量、术后体温及血液学检查结果,观察患者术后感染情况。结果观察组术中出血量为165.4 mL,对照组为159.2 mL,两组之间差异无统计学意义(P>0.05);观察组甲级愈合率为96.2%,对照组甲级愈合率为90.6%,两组之间差异有统计学意义(P<0.05);观察组术后最高体温>38℃者4例、对照组术后最高体温>38℃者7例,两组之间差异无统计学意义(P>0.05);观察组C反应蛋白异常升高者2例,对照组术后C反应蛋白异常升高者9例,两组之间差异有统计学意义(P<0.05);观察组术后腹部切口感染、产褥感染例数分别为1例和1例,对照组术后腹部切口感染、产褥感染例数分别为5例和3例,两组之间差异有统计学意义(P<0.05);两组术后各有1例泌尿系统感染病例,差异无统计学意义(P>0.05)。结论术前预防性使用抗生素降低患者术后切口感染的发生,有利于切口愈合。     

G-CSF及与辛伐他汀联合应用对大鼠急性心肌梗死后细胞凋亡的影响

随着凋亡相关研究的进展,心肌细胞凋亡与心肌梗死(acute myocardial infarction,AMI)的关系逐渐受到重视.本实验联合应用粒细胞集落刺激因子(granulocyte-colony stimu-lating factor,G-CSF)和辛伐他汀动员干细胞修复AMI后的梗死心肌,通过流式及免疫组化法检测细胞凋亡率和BCL-2/BAX比值,评价其干细胞动员作用对梗死后心肌细胞凋亡的影响.     

二尖瓣环收缩期最大位移达峰时间评价扩张型心肌病患者左心室长轴收缩功能的超声心动图研究

Objective To evaluate the value of peak time(PT) and corrected peak time(PTc) in the assessment of left ventricular long axis systolic function in patients with dilated cardiomyopathy(DCM).Methods Thirty-one DCM cases and thirty-six healthy cases were investigated using echocardiography.To obtain image of apical four-chamber view and apical two-chamber view, PT was measured by the technique of tissue motion annular displacement.The value of PTc was corrected by R-R interval.The critical value of PT and PTc was obtained by ROC curves.Results Compared with the PT of control group, the PT of DCM group at the site of septal and lateral were significantly increased ( P ＜0.05), but the PT at the site of anterior and inferior were no significantly increased ( P ＞0.05).The PTc at the four sites were significantly increased compared with control group ( P ＜0.05).The areas of under the ROC curve of PTc was 0.849 (95 % CI 0.699～0.929, P = 0.000), sensitivity and specificity of diagnosis cardiac dysfunction were 80.6 % and 66.7% respectively.Conclusions The PTc was significantly increased in patients with DCM.PTc was useful to evaluate left ventricular dysfunction in DCM patients.     

MCP-1在小型猪慢性阻塞性胰腺炎组织中的表达及其意义

目的 检测慢性阻塞性胰腺炎小型猪血单核细胞趋化蛋白-1(MCP-1)含量及胰腺组织MCP-1蛋白表达,探讨其在胰腺纤维化中的作用.方法 采用不全结扎主胰管方法建立小型猪慢性阻塞性胰腺炎模型,术后4、6、8 周分批处死动物.观察胰腺病理变化;胶原(VG)染色评估胰腺纤维化程度;ELISA法检测血MCP-1浓度;免疫组化法检测胰腺组织MCP-1、α-SMA、PDGF、TGF-β1和NF-κB表达.结果 造模成功14头(58.3%).术后4周起胰腺体尾部呈萎缩性改变,间质纤维组织增生,炎细胞浸润,第8周改变最明显.胰腺纤维化Ⅰ期5头(35.7%),Ⅱ期4头(28.6%),Ⅲ期5头(35.7%).术后4、6、8周造模成功组血MCP-1含量分别为(102.44±36.25)pg/m1、(97.84±28.67)pg/ml、(94.32±28.42)pg/ml,显著高于对照组的(10.42±5.86)pg/ml、(8.58±4.86)pg/ml、(8.22±4.58)pg/ml(P值均＜0.01).对照组胰腺无MCP-1蛋白表达,造模成功组胰腺组织内见MCP-1蛋白表达,且MCP-1表达与α-SMA、PDGF、TGF-β1和NF-κB表达呈正相关.结论 MCP-1在慢性阻塞性胰腺炎胰腺纤维化过程中起重要作用.     

甲氧西林耐药／敏感金黄色葡萄球菌基因分型和毒力基因检测

目的：分析耐甲氧西林金黄色葡萄球菌（金葡菌）（MRSA）和甲氧西林敏感金葡菌（MSSA）临床分离株基因分型及毒力基因分布特征是否存在差异,了解金葡菌耐药性演变与毒力变迁之间的相关性。方法采用脉冲场凝胶电泳（PFGE）方法和多位点序列分型（MLST）方法对呼和浩特地区住院患者中分离的30株 MRSA 和30株 MSSA 进行分子分型,同步采用聚合酶链反应（PCR）方法检测菌株毒力基因。结果60株金葡菌 PFGE 分型共分19个型,MSSA 菌株分布在 I 和 H 型等16个基因型中,而 MRSA 株主要集中分布在 K 和 M 2个基因型中。20株不同 PFGE 型菌株 MLST 分型结果显示,MRSA 株主要为 ST-239型;MSSA 株呈多样性分布特征,主要以 ST-5型、ST-7型、ST-15型为主。毒力基因在 MRSA 和 MSSA 中分布差异显著。MSSA 毒力基因整体携带率明显高于 MRSA（53．9％对40．0％,χ2＝32．7,P ＜0．01）。MRSA 株 sea、cna 和 cap 8基因携带率明显高于 MSSA 携带率（P ＜0．01）,而 sec、seg 、sei、sem、sen、seo、fnbB、ebpS、cap5基因携带率明显低于 MSSA（P＜0．05）。结论呼和浩特地区金葡菌临床分离株基因型呈现多样化分布特点,MRSA 主要以 ST-239型为主。MSSA 毒力基因携带率高,特定毒力因子在 MRSA 和 MSSA 株中呈现一定聚集分布特征,金葡菌特定耐药性的获得可能伴随特定毒力特征的变化。     

Cervical wear and occlusal wear from a periodontal perspective

Summary The aim of this study was to investigate whether cervical wear was associated with occlusal wear and clinical periodontal parameters in relatively older adults. A total of 30 patients, with multiple non‐carious cervical lesions (NCCLs) and without a disease or condition that could cause heavy tooth wear, were included in the study. The periodontal parameters including plaque index, probing pocket depth, gingival recession (GR) and tooth mobility were obtained from 641 teeth of which 475 (74·1%) displayed NCCLs. The levels of cervical wear and occlusal wear were determined according to a tooth wear index. Premolars were more likely to develop cervical wear than canines, molars and incisors. Cervical wear was significantly associated with less plaque accumulation and the presence of shallow pockets. The teeth with advanced GR and without increased mobility were 2·583 and 1·715 times more likely to develop deeper cervical lesions, respectively. Age and the level of occlusal wear were not linked to the bucco‐lingual depth of cervical wear. In conclusion, the significant association of advanced cervical wear with the relatively healthy periodontal status suggested the role of abrasion and its possible combined action with erosion in the aetiology of NCCLs. The rate of GR and the lack of tooth mobility could constitute predisposing factors for the progression of cervical wear because the exposed root surfaces could be more susceptible to abrasion and/or erosion, and the non‐mobile teeth resisting strongly against frictional forces, thus abrasive effects, could possibly develop cervical wear.