中国HIV-1 B'亚型毒株nef基因多态性及其对疾病进展影响的研究

目的 研究我国北方地区B'亚型HIV-1感染者病毒基因组中nef基因多态性、重要功能区的保守程度,探索其与疾病进展的关系.方法 HIV-1 B'亚型感染长期不进展者(LTNP)30例,典型进展者(TP)42例,从全血标本中提取全前病毒DNA,经nested-PCR扩增nef基因全长,扩增产物纯化后直接测序,对测得的序列进行系统进化和氨基酸变异分析,并计算比较LTNP组与TP的HIV/AIDS组氨基酸突变位置和频率的差异.结果 nef氨基酸序列长度可变区R21K/E/H/I/Q取代,TP组突变频率(59.52%)低于LTNP组(93.33%,P<0.005,OR=0.11).功能区外S15R/K/N取代,TP组突变频率(64.29%)高于LTNP组(33.33%,P<0.01,OR=3.60);K39R/E/N取代,TP组突变频率高于LTNP组(P<0.005).其他功能区内有少数序列发生变异,但在两组间无差异.结论 未发现中国北方地区HIV-1 B'亚型nef基因与疾病长期不进展相关联的明显缺失或缺陷,但nef基因序列长度可变区R21位K/E/H/I/Q取代R可能与疾病缓慢进展有关,S15R/K/N取代、K39R/E/N取代可能与疾病进展相关.nfe氨基酸序列的重要功能区较为保守.     

通便汤为主治疗便秘型肠易激综合征120例

目的:观察以通便汤为主治疗便秘型肠易激综合征的临床疗效.方法:对120例患者予通便汤治疗,配合轴保持短缩法、心理调节和饮食指导等辅助手段.结果:治愈65例,显效41例,有效12例,无效2例,总有效率为98.3％.结论:以通便汤为主治疗便秘型肠易激综合征疗效显著.     

在美国开诊所的中国医生

电影《阿甘正传》讲述的是美国南方阿拉巴马州的故事,重温这部电影时,片中出现的美丽街市,使我的思绪不禁又飘回了在美国阿拉巴马学习生活的日子。     

慢性萎缩性胃炎胃黏膜中医微观辨证与癌前病变的特征分析

目的:探讨慢性萎缩性胃炎(CAG)患者胃黏膜中医微观辨证证型与癌前病变之间的关系。方法:对220例CAG患者胃黏膜进行中医微观辨证分型、病理组织学以及免疫组化检查,比较不同中医微观证型患者癌前病变发生率、免疫组化指标(CD34~+、Ki67)的差异,探讨CAG患者中医微观辨证与癌前病变之间的关系。结果:220例CAG患者的胃黏膜组织中医微观证型中,胃阴不足型72例,脾胃虚寒型36例,肝郁气滞型34例,胃络瘀阻型31例,肝胃郁热型28例,脾胃湿热型19例。不同中医微观证型CAG患者Hp感染阳性率比较,差异无统计学意义(P0.05)。肝郁气滞型与脾胃湿热型患者肠上皮化生率高于脾胃虚寒型与胃阴不足型,差异均有统计学意义(P0.05);肝郁气滞型上皮内瘤变率高于脾胃虚寒型与胃阴不足型,差异均有统计学意义(P0.05)。肝郁气滞型CD34~+平均光密度值高于肝胃郁热型、胃络瘀阻型、脾胃虚寒型、胃阴不足型(P0.05);脾胃湿热型与脾胃虚寒型高于胃络瘀阻型、胃阴不足型(P0.05)。肝郁气滞型、脾胃湿热型Ki67平均光密度值高于脾胃虚寒型、胃阴不足型与胃络瘀阻型(P0.05,P0.01),且脾胃湿热型高于肝胃郁热型(P0.01)。结论:CAG患者胃黏膜中医微观辨证与癌前病变有着密切关系,其中肝郁气滞型与脾胃湿热型患者癌前病变发生率更高,应及早予以有效干预,降低胃癌发生率。     

uPA和FAK在肝癌组织中的表达及相关性研究

目的研究尿激酶型纤溶酶原激活剂(uPA)和黏着斑激酶(FAK)在原发性肝癌中的表达及其意义。方法采用免疫组织化学SP法检测34例原发肝癌组织、14例癌旁正常肝组织中uPA和FAK的表达情况。结果原发性肝癌组织中uPA和FAK表达定位于细胞质和细胞核,其表达明显高于癌旁正常肝组织(P均<0.05)。二者的表达与性别、年龄、肿瘤大小等无显著相关性(P均>0.05),与淋巴结转移、组织分化及癌栓等有显著性关(P均<0.05);uPA与FAK表达呈明显正相关(P<0.05)。结论 uPA与FAK在原发性肝癌呈高表达,且与原发性肝癌的发生、发展和转移密切相关。     

喂养方式对乳牙龋病的影响

目的:探讨喂养方式与乳牙龋齿之间的关系。方法:调查260例具有完整乳牙列儿童的喂养方式、患龋率、dmft情况,并对喂养方式与乳牙患龋率进行卡方检验,喂养方式与乳牙患者龋均进行方差分析。结果:母乳喂养者,乳牙患龋率、龋均发病率均最低,与混合喂养者、人工喂养者相比,有显著性差异;混合喂养者与人工喂养者之间无显著性差异。结论:正确的母乳喂养对预防乳牙龋齿的发生有重要意义。     

护理干预对经皮肾镜钬激光碎石术后患者疼痛的影响

目的 探讨护理干预对经皮肾镜钬激光碎石术后患者疼痛的影响.方法 选择我科86例肾结石,随机分为对照组和护理干预组,对照组经皮肾镜钬激光碎石术前后接受常规护理,护理干预组除接受常规护理外还予特殊护理干预,术后对两组疼痛程度进行比较.结果 经皮肾镜钬激光碎石术后,护理干预组疼痛程度明显低于对照组,对照组疼痛评分(38.66 ±1.48)分,护理干预组疼痛评分(27.32±2.16)分,两组比较差异具有统计学意义(t=3.6895,P＜0.05).结论 护理干预可减轻经皮肾镜钬激光碎石术后患者的疼痛程度,提高医疗护理质量.     

布托啡诺预先给药对大鼠心肌缺血再灌注损伤的影响

Objective To investigate the effects of butorphanol pretreatment on myocardial ischemia-reperfusion (IR) injury in rats. Methods Forty healthy male SD rats weighing 200-250 g were randomly divided into 5 groups (n = 8 each) : sham operation group (group S); IR group; butorphanol pretreatment group (group B); Nor-BNI group (group N) and glibenclamide group (group G) . In group IR, B, N and G, myocardial IR was produced by occlusion of left anterior descending artery (LAD) for 30 min followed by 120 min reperfusion. In group S and IR, normal saline S ml/kg was injected via femoral vein 10 min before ischemia and then continuously infused at a rate of 5 ml· kg -1· h-1 iv. In group B, butorphanol 25 μg/kg was injected via femoral vein 10 min before ischemia and the rest method was the same as that described in group IR. In group N, Nor-BNI 2 mg/kg (a selective κ-opioid receptor antagonist) was injected via femoral vein 20 min before ischemia and the rest method was the same as that described in group B. In group G, glibenclamide 1 mg/kg (a KATP channel blocker) was injected via femoral vein 10 min before ischemia and the rest method was the same as that described in group B. Blood samples were taken from femoral artery at 120 min of reperfusion for determination of the concentrations of serum TNF-α, IL-6 and IL-10 by ELISA. Myocardial infarct area and ischemic area were measured by TTC staining and myocardial infarct size was calculated. Results The concentrations of serum TNF-a, IL-6 and IL-10 were significantly higher in the other four groups than in group S (P < 0.05) . The concentrations of serum TNF-α andIL-6 were significantly decreased while IL-10 increased, and the myocardial infarct size was significantly decreased in group B, N and G as compared with group IR ( P < 0.05) . The concentrations of serum TNF-α and IL-6 were significantly increased while the concentration of IL-10 decreased) and the myocardial infarct size was significantly increased in group N and G as compared with group B ( P < 0.05). Conclusion Butorphanol pretreatment can protect the myocardium against IR injury in rate via activating κ receptor and KATP channel.     

地震后被困196 h严重脑损伤一例

1 病历资料 伤者,男,44岁.汶川大地震发生后196 h被救并转送来院.极度脱水,意识不清、谵妄,体温35.2℃,心率118次/min,呼吸浅快32次/min,血压70/40 mm Hg(1 mmHg=0.133 Kpa),SO20.6～0.7,无尿,多处外伤并感染、流脓.