甲基丙二酸血症伴同型半胱氨酸血症患儿临床及基因突变分析

例为609G>A纯合突变,5例为609G>A伴658_660delAAG(2例)、567_568insT、394C>T和217C>T杂合突变,其中658_660deIAAG和567_568insT为尚未报道的突变.结论 甲基丙二酸血症合并同型半胱氨酸血症患儿经合理治疗可达到较好的临床效果.基因突变检测表明609G>A为中国患儿的热点突变.     

胰腺癌的基因不稳定性

目的分析胰腺癌细胞和组织的基因不稳定性. 方法应用RAPD方法7种引物扩增4株胰腺癌细胞株BxPC-3、AsPC-1、SW1990和PaTu8988,3例手术切除胰腺癌及其癌旁组织,1例正常胰腺组织的DNA片段.结果PaTu8988与SW1990扩增的DNA片段类型基本一致,但与BxPC-3、AsPC-1的类型不同;胰腺癌和癌旁组织扩增的DNA类型多数相同,少数存在差异,但与正常胰腺组织及胰腺癌细胞株不同.结论胰腺癌组织中存在着基因不稳定性,这是造成肿瘤异质性的基础.     

急性冠脉综合征患者D31阳性CD42阴性内皮微粒的检测及其临床意义

目的 研究血浆CD31阳性CD42阴性的细胞微粒（CD-31 CD-42EMP）能否作为急性冠状动脉综合征患者危险程度的标志物.方法 收集62例急性冠脉综合征和62例稳定型冠心病患者及62例健康志愿者的血浆,用流式细胞术测定CD＋31 CD-42EMP水平,同时测定血浆超敏C-反应蛋白的水平.结果 与健康志愿者组比较,稳定型冠心病组患者CD＋31 CD-42EMP水平和超敏C-反应蛋白的水平明显升高,差异有显著性;与稳定型冠心病组患者及健康志愿者组比较,急性冠脉综合征组患者的CD＋31 CD-42EMP水平和超敏C-反应蛋白的水平明显升高,差异具有显著性.结论 CD＋31 CD-42EMP水平能作为急性冠脉综合征危险程度的标志物,且与超敏C-反应蛋白的水平有明显相关性.     

Clinical analysis of inpatients with hyperglycemia in the medical intensive care units——Data of Shanghai Renji Hospital from 2002 to 2009

Objective To analyze the association of the morbidity,the management of blood glucose,and the prognosis of patients with hyperglycemia in the medical intensive care units(ICU).Methods Medical records of ICU patients of Renji Hospital from 2002 to 2009 were reviewed using Medical Record Inquiry System,and the data were retrospectively analyzed.Results(1)2631 subjects were included in the present study,blood glucose was determined at least once during hospitalization in 2168 of them.The incidence of hyperglycemia was 26.3%,in which 12.9% presented a known history of diabetes and 13.4% without.In the patients with diabetes history,93.2% of them received anti-diabetic treatment during hospitalization.mainly with oral anti-hyperglyeemic agents (53.0%)or subcutaneous insulin injection(24.9%).However,in the patients without diabetes history,84.4% were not treated against hyperglycemia.The mortality was increased in the latter group(30.4% vs13.9%,P<0.01).(2)In the patients with diabetes history,the mortality in patients whose blood glucose>10 mmol/L was higher than those with blood glucose≤7.0 mmol/L(20.5% vs 9.9%,P<0.05):while in the patients without diabetes history,the mortality began to rise as blood glucose>7.0 mmol/L(P<0.01).(3)Multiple stepwise regression analysis revealed that the average blood glucose level was an independent risk factor for death(OR=1.26).Conclusions The ICU patients showed a high prevalence of hyperglycemia,the management of hyperglycemia should be emphasized.Hyperglycemia in critically ill patients might be an independent risk factor of increased mortality.     

人NPTX2真核表达载体的构建及稳定转染细胞系的建立

目的 构建入神经元正五聚蛋白2(NPTX2)真核表达载体.转染人胰腺癌细胞PANC1,建立稳定转染的细胞系.方法 通过双酶切的方法获得人NPTX2全长cDNA,利用Not I和EcoR I酶切位点将其插入到真核表达载体pcDNA3.1(+),经酶切和测序验证盾,用脂质体转染法转染PANC1细胞,通过G418筛选,建立稳定转染的PANC1细胞,用实时定量PCR方法筛选NPTX2 mRNA高表达克隆.结果 成功构建了pcDNA3.1(+)-NPTX2真核表达载体.并建立了稳定转染的PANC1细胞,成功表达了目的 基因.结论 真核表达载体的构建和稳定转染PANC1细胞系的建立为进一步研究NPTX2基因在胰腺癌细胞的作用奠定了良好的基础.     

早期微创置管持续腹腔灌洗引流治疗急性胰腺炎的疗效观察

目的:探析早期微创置管持续腹腔灌洗引流治疗重症急性胰腺炎（SAP）的疗效。方法:选取衢州市人民医院2016年1月至2020年6月收治的170例SAP患者,用随机数字表法将患者分为观察组（85例）与对照组（85例）。对照组接受综合内科治疗,观察组在对照组治疗基础上加以早期微创置管持续腹腔灌洗引流干预。治疗1周后评价疗效、...     

抗狂犬被动免疫制剂研究进展

狂犬病是由狂犬病毒(rabies virus,RV)引起的人畜共患疾病,一旦感染,如不及时采取有效防治措施,其病死率接近100％.狂犬病的暴露后预防(post-exposure prophylaxis,PEP)是防治狂犬病的主要措施.为获得快速的保护作用,世界卫生组织建议,对于严重暴露者应同时使用注射狂犬疫苗和狂犬病毒免疫球蛋白(rabies immune globulin,RIG)进行主动和被动免疫治疗[l].     

本科护生参与院级护理质量检查的实践

护理质量是护理工作的核心，是护理管理的重点。护理质量不仅取决于护理人员的素质和技术质量，更直接依赖于护理管理的水平，尤其是护理质量管理的方法。为建立科学严谨的护理质量检查方法，注重为病人服务的实效，培养具有临床实践工作能力、管理能力、科研基本能力于一体的综合性人才，     

微创腔镜联合气压弹道碎石在泌尿系统结石治疗中的应用

目的探讨微创腔镜联合气压弹道碎石治疗泌尿系统结石的疗效。方法采用经皮肾镜下气压弹道碎石治疗肾结石30例,输尿管镜下联合气压弹道碎石治疗输尿管结石71例,膀胱结石5例。结果一次性碎石成功率99.1%(105/106),并发症发生率1.8%(2/106)。结论微创腔镜下联合气压弹道碎石方法安全,疗效确切,损伤小,可作为治疗泌尿系统结石及体外冲击波碎石失败的首选方法。     

去骨瓣减压术并发症分析

Objective To discuss the surgical complications secondary to decompressive craniectomy as well as the clinical factors related to these complications. Methods We reviewed a series of 83patients undergone surgical decompression and analyzed the incidence of surgical complications as well as the relationship of the complications with GCS score and operation opportunity selection. Results There were 51 patients (61%) with surgical complications after decompression, among whom 30 patients ( 36% ) had more than two kinds of complications. The trauma severity would increase with the incidence of surgical complication, with statistical difference between groups. The late operative group ( ≥ 12hours) showed higher incidence of complication than the early operative group ( < 12 hours), with no statistical difference. Conclusion The procedure of decompressive craniectomy develops kinds of complications which should be prevented, detected and treated early for an optimal prognosis.