SARS胸部CT研究现状

目的:探讨胸部CT在SARS诊断中的研究现状.方法:综述近期国内外有关SARS胸部CT研究资料.结果:CT可明显提高肺内SARS小病灶及间质纤维化的显示,特别是薄层CT或HRCT.SARS的CT基本影像表现为磨玻璃样密度影像和肺实变影像.根据CT影像表现,可将SARS分为发病早期,进展期和恢复期.各期具有不同的动态影像表现和相应的肺实质及肺间质病理改变.结论:胸部CT在SARS诊断中是确定诊断和病情观察的重要方法.在SARS特异性IgM和IgG抗体尚待结果,病毒颗粒未分离出之前,更具有特殊意义.     

Inhibition of platelet function by organic nitrate vasodilators

There is evidence that platelet activation in the coronary circulation may be important in the pathogenesis of myocardial ischemia. Since organic nitrate vasodilators are commonly used in coronary artery disease, we have studied the in vitro effects of these drugs on platelet function. Nitroglycerin, isosorbide dinitrate, and their biotransformation product, inorganic nitrite, inhibited platelet aggregation with collagen, epinephrine, arachidonate, and ionophore, and blocked both primary and secondary aggregation in response to ADP. Nitroglycerin was studied in more detail. Its inhibitory effect was reversible and not dependent on external calcium concentration. It inhibited arachidonic acid oxygenation as measured by the arachidonate- induced oxygen burst and malonaldehyde production. These effects were not due to an increase in intracellular cyclic AMP. This unusual generalized inhibition of platelet function by nitroglycerin possibly contributes to its beneficial effect in myocardial ischemia in part by attenuating platelet reactivity in the coronary circulation.     

个体化翼状胬肉逆行切除联合自体角膜缘干细胞移植

目的:确定胬肉下浸润麻醉联合个体化的结膜切口在翼状胬肉逆行切除联合自体角膜缘干细胞移植手术中的疗效.方法:采用胬肉下浸润麻醉联合个体化的结膜切口在翼状胬肉逆行切除联合自体角膜缘干细胞移植手术方式对108例(128眼)胬肉患者实施手术治疗.其中男46例(60眼),女62例(68眼);年龄29～77岁,其中复发胬肉12眼,鼻侧胬肉124眼,颈侧胬肉4眼,侵入角膜2～6 mm;病程最短的1.5年,最长的40年,从事户外工作者80例,其它28例.结果:术后3d内患眼有不同程度的红、异物感、流泪症状,1～3d角膜上皮愈合,移植片均存活,1周左右水肿消退.随访观察半年至3年,1眼复发,复发率为0.93％.均无睑球粘连、眼球活动受限等出现.无植片排斥、融解现象.原取瓣区之角膜缘未见因取瓣而引起的角膜新生血管及浑浊变性和结膜增生入角膜等手术并发症.并有15例(17眼)视力有不同程度提高.结论:胬肉下浸润麻醉和个体化的结膜切口在逆行胬肉切除手术中有其突出的优点,手术更彻底、副损伤非常少,手术时间短,且具有复发率低、治愈率高的优点,值得推广应用.     

特应性皮炎与丝聚蛋白基因突变相关性研究进展

特应性皮炎(AD)是一种常见的慢性反复性炎症性皮肤疾病.遗传因素是特应性皮炎发生、发展的重要因素.丝聚蛋白基因(FLG)被定位于人类染色体1q21的EDC区域内,该基因发生突变后导致丝聚蛋白功能缺失进而皮肤屏障发生破坏,与AD的发生密切相关.研究表明,不同种族和不同区域间AD患者FLG基因突变位点可能不同.FLG基因突变与AD发病关系的研究有利于进一步加深对AD发病机制的认识,并可能为AD的治疗提供新的方向.     

Activation of muscarinic receptors elicits inotropic responses in ventricular muscle from rats with heart failure through myosin light chain phosphorylation

Background and purpose:

Muscarinic stimulation increases myofilament Ca²⁺ sensitivity with no apparent inotropic response in normal rat myocardium. Increased myofilament Ca²⁺ sensitivity is a molecular mechanism promoting increased contractility in failing cardiac tissue. Thus, muscarinic receptor activation could elicit inotropic responses in ventricular myocardium from rats with heart failure, through increasing phosphorylation of myosin light chain (MLC).

Experimental approach:

Contractile force was measured in left ventricular papillary muscles from male Wistar rats, 6 weeks after left coronary artery ligation or sham surgery. Muscles were also frozen, and MLC-2 phosphorylation level was quantified.

Key results:

Carbachol (10 µmol·L⁻¹) evoked a positive inotropic response only in muscles from rats with heart failure approximating 36% of that elicited by 1 µmol·L⁻¹ isoproterenol (20 ± 1.5% and 56 ± 6.1% above basal respectively). Carbachol-evoked inotropic responses did not correlate with infarction size but did correlate with increased left ventricular end diastolic pressure, heart weight/body weight ratio and lung weight, primary indicators of the severity of heart failure. Only muscarinic receptor antagonists selective for M₂ receptors antagonized carbachol-mediated inotropic effects with the expected potency. Carbachol-evoked inotropic responses and increase in phosphorylated MLC-2 were attenuated by MLC kinase (ML-9) and Rho-kinase inhibition (Y-27632), and inotropic responses were abolished by Pertussis toxin pretreatment.

Conclusion and implications:

In failing ventricular muscle, muscarinic receptor activation, most likely via M₂ receptors, provides inotropic support by increasing MLC phosphorylation and consequently, myofilament Ca²⁺ sensitivity. Enhancement of myofilament Ca²⁺ sensitivity, representing a less energy-demanding mechanism of inotropic support may be particularly advantageous in failing hearts.     

蒙古族及汉族胃癌患者血清胃蛋白酶原水平的研究

目的：研究蒙古族、汉族胃癌患者血清胃蛋白酶原（Pepsinogen PG）水平,探讨血清PG的地域和民族特征及规律,提供有价值的临床流行病学资料。方法：选择2008年10月~2009年10月在包头市肿瘤医院经内镜检查和病理学确诊的胃癌患者68例（3代人均为同一民族,蒙古族30例,汉族38例）,选择42例健康体检者做正常对照组。应用酶联免疫方法进行血清PGⅠ、PGⅡ的检测,并计算PGⅠ/PGⅡ比值。结果：蒙古族、汉族胃癌组血清PGⅠ及PGⅠ/PGⅡ值明显低于正常对照组,具有显著性差异（P〈0.05）,各组血清PGⅡ水平之间无显著性差异（P〉0.05）;蒙古族胃癌组血清PGⅠ及PGⅠ/PGⅡ值低于汉族胃癌组,具有显著性差异（P〈0.05）,两组血清PGⅡ水平之间无显著性差异（P〉0.05）。结论：蒙古族、汉族胃癌患者血清PGⅠ及PGⅠ/PGⅡ值较正常对照组降低,提示血清PGⅠ及PGⅠ/PGⅡ值降低有助于胃癌的诊断,可以作为地区人群筛查和辅助诊断胃癌的一项血清学指标;蒙古族胃癌患者血清PGⅠ及PGⅠ/PGⅡ值低于汉族胃癌患者,提示血清PG水平在不同种族人群中存在着差异。     

82例早期糖尿病肾病患者尿微量白蛋白的检测结果分析

目的：探讨尿液微量白蛋白（UMA）检测在糖尿病肾病早期诊断中的价值。方法：检测82例2型糖尿病患者的尿液微量白蛋白,并与58例健康体检者检测结果进行对比分析。结果：糖尿病组UMA阳性率明显高于健康体检组,且差异有显著性。结论：尿微量白蛋白的出现常反映肾脏结构与功能已经轻度受损,测定UMA有助于糖尿病肾病的早期诊断和早期预防。     

经腹膜后精索静脉高位结扎术与腹腔镜下改良Palomo术治疗精索静脉曲张的疗效比较

目的：比较经腹膜后精索静脉高位结扎术与腹腔镜下改良Palomo术两种方法治疗精索静脉曲张的效果。方法：收集我院1994年1月～2008年11月行手术治疗并获得随访的Ⅱ度及以上的精索静脉曲张患者305例,根据手术分为两组：A组263例行经腹膜后精索静脉高位结扎术;B组42例行腹腔镜下改良palomo术。对比观察两组术后阴囊水肿、辜丸萎缩、复发等,近、远期并发症及精液质量改善和生育情况。结果：术后阴囊水肿发生率B组为16．7％,A组为2．3％,两组比较差异有统计学意义（P〈0．05）;术后3个月睾丸萎缩发生率B组为9．5％,A组为1．1％,两组比较差异有统计学意义（P〈0．05）;≤30岁患者A组术后6个月精液质量提高率为82％,高于B组术后6个月的74．2％（P〈0．05）;两组≤30岁患者术后1～2年内配偶自然怀孕率为69．5％、55．6％,A组高于B组（P〈0．05）。结论：经腹膜后精索静脉高位结扎术术式简单易掌握且术后阴囊水肿和睾丸萎缩发生率低,术后精液质量提高率和术后1～2年内配偶自然怀孕率高,值得广泛推广。     

吲哚胺2,3-双加氧酶(IDO)的色胺酮类抑制剂筛选及其体外抗肿瘤作用

 目的  评价色胺酮衍生物吲哚胺2,3-双加氧酶 (indoleamine 2,3-dioxygenase,IDO)的抑制活性,并研究其作为 IDO 抑制剂的抗肿瘤作用。方法  采用基因工程手段表达、纯化重组人 IDO (rhIDO),建立 IDO 活性检测体系;以色胺酮衍生物作为对象,进行 IDO 抑制活性初筛,对抑制类型、半数抑制浓度以及抑制常数进行测定;构建高表达人 IDO 的 pcDNA3.1(+) hIDO 转染 HEK 293 细胞,评价色胺酮衍生物在细胞水平上的 IDO 抑制活性;采用 MTT 比色法考察色胺酮衍生物3对人非小细胞肺癌A549细胞的生长抑制作用。结果  6个被测色胺酮衍生物均具有IDO抑制活性,且细胞水平上的抑制效力高于酶活水平,抑制效力均优于目前通用的IDO抑制剂1 甲基色氨酸(1-methyl-tryptophan,1-MT)。色胺酮衍生物 3 作为最强的 IDO 抑制剂,其Ki值为 0.161 μmol/L。MTT 实验结果显示,色胺酮衍生物3 显著抑制 A549 细胞生长,IC50 为 8.77 μmol/L。结论  色胺酮衍生物是一类新型高效的 IDO 抑制剂,在体外对 A549 细胞具有较强的抗肿瘤活性。