不同胆道灌洗液对肝移植供体胆道冷保存损伤的影响

目的：冷保存/再灌注损伤是导致非外科性移植物胆管树损害最重要的始动因素。观察不同胆道灌洗液对大鼠肝移植供肝胆道保存的影响，以筛选出一种较为理想的胆道灌洗液，使胆道在冷保存期间获得器官水平上的最佳保护。方法：实验于2006-08／12在中国医科大学附属盛京医院动物实验中心完成。①实验设计及分组：实验因素包括胆道灌洗液与冷保存时间，不同的灌洗液分别为胆道灌洗液a（生理盐水、HCA液），胆道灌洗液b（HTK液、UW液）；冷保存时间为4h，8h，12h。采用正交设计方法，选用[L9（3^4）]正交表对实验因素随机分组，共分为9组。②实验方法：选择雄性Wistar大鼠45只，分为9组，每组5只。制作大鼠取供肝模型，按照实验设计分别选择不同的胆道灌洗液进行胆道灌洗，在相应的冷保存时间取胆管组织进行检测。③实验评估：采用原位末端标记法进行胆管上皮细胞凋亡检测，计算凋亡指数；在电镜下观察胆管细胞的病理形态变化，并利用图像分析系统求出每张照片中所有胆管上皮细胞的线粒体平均体积和数密度。结果：45只大鼠全部进入结果分析。通过正交设计的方差分析与直观分析得出下列结果。①胆管上皮细胞凋亡指数的正交设计结果：胆道灌洗液a、胆道灌洗液b及冷保存时间是决定大鼠供肝胆道冷保存损伤的主要因素（P均〈0．01）；其中HCA液、HTK液及4h冷保存时间较为理想，且三者结合效果更好。②胆道上皮细胞线粒体平均体积及数密度的正交设计结果：胆道灌洗液a、胆道灌洗液b及冷保存时间是决定大鼠供肝胆道冷保存损伤的主要因素（P均〈0．01）；其中HCA液、HTK液及4h冷保存时间较为理想，且三者结合效果更好。结论：①正确选择胆道灌洗液可以大幅度减轻肝移植供肝胆道的冷保存损伤，保护胆管上皮细胞。②胆道灌洗液以选择HCA液与HTK液结合灌洗的方式较为理想，冷保存时间越短越理想。     

Study of Clinicobiochemical Spectrum of Hypothyroidism

Background

The aim of this study was to assess the clinico biochemical spectrum of hypothyroidism and the relative importance of thyroid function tests, clinical symptoms and signs in thyroid dysfunction.

Methods

A retrospective study was done and 1702 requisitions for screening of hypothyroidism were analysed. The clinical presentation of cases was correlated with the results of thyroid profile tests.

Results

31.5% of the 1702 cases referred had thyroid dysfunction in the form of subclinical or overt hypothyroidism. In the hypothyroid group generalized weakness, weight gain and myxoedema was common. In cases of primary infertility and depression, subclinical and overt hypothyroidism was high (40% and 45.8% respectively). The average age of females with subclinical hypothyroidism was 30.8 years, 5.4 years less than females with overt hypothyroidism.

Conclusion

We conclude that hypothyroidism is common and often under-diagnosed. Therefore routine evaluation of female patients with weight gain, generalized weakness, infertility, depression and mood changes should include thyroid profile.Key Words: Hypothyroidism, Thyroid profile, Screening, Infertility, Depression     

Hepatitis A virus infections associated with clotting factor concentrate in the United States

BACKGROUND: Two cases of hepatitis A among persons exposed to the same lot of solvent/detergent-treated antihemophilic factor VIII concentrate were reported to a surveillance system. An investigation was conducted to find additional cases and determine the source of infection. STUDY DESIGN AND METHODS: A seroprevalence study was conducted among persons with exposure to the suspect lot for serologic evidence of recent infection with hepatitis A virus (HAV). RESULTS: Six cases of recent HAV infection were discovered: four of the patients had been infused with material from the suspect lot of factor VIII, and two had received infusions of factor IX concentrate made from plasma pools common to the suspect factor VIII lot. HAV was identified in one of the plasma pools, in the factor VIII product, and in serum or stool from two factor VIII recipients and one factor IX recipient. The genetics sequence of the virus in the plasma pool, the factor VIII lot, and the factor VIII recipients were identical, while that of the virus in the factor IX recipient differed by a single base. CONCLUSION: These data document the transmission of HAV by a factor VIII concentrate and implicate factor IX products manufactured from a common source-plasma pool.     

The effect of diabetes on mortality in critically ill patients: a systematic review and meta-analysis

Introduction  

Critically ill patients with diabetes are at increased risk for the development of complications, but the impact of diabetes on mortality is unclear. We conducted a systematic review and meta-analysis to determine the effect of diabetes on mortality in critically ill patients, making a distinction between different ICU types.     

高效液相色谱法测定人血清中酒石酸美托洛尔浓度

目的：建立测定人血清中酒石酸美托洛尔浓度的ＨＰＬＣ方法,为临床药理研究提供科学的分析技术。方法：血清样品萃取纯化后溶于流动相中,进样分析。测定使用Ｃ１８色谱柱,甲醇－水相（５０：５０,水相中含０．１６％戊烷磺酸钠和０．０１４％无水乙酸钠）为流动相,以纳多洛尔为内标,用荧光检测Ｅｘ＝２７７ｎｍ,Ｅｍ＝２９９ｎｍ。结果：本方法线性范围为１０～３００ｎｇ／ｍｌ,最低检测浓度为１ｎｇ／ｍｌ。平均回收率为（     

反相离子对-高效液相色谱法测定河豚毒素

目的建立了反相离子对-高效液相色谱法测定河豚毒素含量的方法。方法选用SHIMADZUODS色谱柱(150×6mm5μm),以0．2％(v／v)醋酸液为流动相,流速为1．2mL／min,检测波长为230nm。结果河豚毒素线性范围20～100μg／mL,r=0．9960(n=5);回收率为93．32％,RSD=5．41％(n=5);日内精密度为6．10％,日间精密度为7．42％(n=5)最低检测限50ng。结论方法准确、快速、简便,可作为迅速确定河豚毒素含量的测定方法。