炎症细胞因子在心力衰竭发病过程中的作用

在心力衰竭过程中,炎症细胞因子的表达方式与经典的神经激素(如:血管紧张素、去甲肾上腺素)相似,这些炎症细胞因子,包括:肿瘤坏死因子(tumornecrosisfactor-α,TNF-α),白介素1β(interleukin1β,IL-1β)和白介素6(IL-6)等,在心力衰竭的发病过程中发挥重要作用。了解炎症细胞因子在心力衰竭中的作用具有十分重要的临床意义,本文就这方面的研究进展进行综述。     

妊娠期特异性皮肤病

妊娠期特异性皮肤病的命名及分类一直存在争议,最新的分类将其分为妊娠性类天疱疮、妊娠肝内胆汁淤积、疱疹样脓疱病、妊娠性多形疹、妊娠丘疹性皮肤病(包括妊娠痒疹、妊娠瘙痒性毛囊炎及妊娠特应性皮肤病)五类。本文主要介绍妊娠期特异性皮肤病的分类、临床特点、诊断和鉴别诊断、治疗、预后及对胎儿的影响等方面的研究进展。     

脱氢表雄酮对内皮细胞NO,ET-1生成及ICAM-1表达的影响

目的:观察脱氢表雄酮对内皮细胞NO合成、ET-1分泌及细胞表面ICAM-1表达的影响.方法:培养的人脐静脉内皮细胞系ECV304经不同浓度和不同作用时间DHEA处理后,采用硝酸还原酶及放免法分别测定培养液中NO及ET-1水平,用SABC免疫组化法观察细胞表面ICAM-1的表达.结果:与对照组相比,随着DHEA浓度的增加,培养液中NO的含量从(387±12)降至(242±11)μmol/L(P<0.05),而ET-1的浓度却从(397±13)增至(626±29)ng/L(P<0.05).随着时间的延长,各对照组培养液中NO含量均无明显变化(P>0.05),而DHEA组NO生成量却逐渐降低(P<0.05),呈时间依赖.培养液中ET-1浓度无论是对照组还是DHEA组均随时间的延长而升高(P<0.05),但DHEA组升高的更为明显.无论是增加浓度还是延长时间,DHEA均不影响细胞表面ICAM-1的表达.结论:DHEA可通过调节内皮细胞NO及ET-1生成量对血管功能进行调控.     

Uncommon characteristics of the structure and development of Trichosporon asahii

Background Trichosporon asahfi （T. asahii） is one of the most important pathogenic fungus in the genus of trichosporon. Although the species identification of T. asahfi was based upon the complicated results of morphologic, biochemical and biologic examination, the morphology characteristic is still the first clue to the species. Some common structures of T. asahfi had been described such as arthrofilaments and arthroconidia, but other important structures of T. asahii were unclear. Methods Six strains of T. asahiiwere incubated on the slant and micro culture of Sabouraud＇s dextrose agar at 30℃ for 7 days. Samples were fixed using 2% paraformaldehyde and 2.5% glutaraldehyde. T. asahfi was observed under scanning electron microscope and transmission electron microscope. Results The detailed characteristics of the diverse sites of germination, as well as some uncommon structures such as giant cell, sarcinate, and club-shaped macroconidia, were presented. The pseudohyphae of T. asahii were noted to produce true hyphae, either along the longitude axis or on the flank. T. asahii was noted to have blastic and thallic conidiation. Digitated branches, trichoid structures and septa inside the spores were detected. Conclusion These results may add our knowledge to the structure and development of T. asahii.     

肺炎衣原体与突发性耳聋的相关性研究

目的 探讨肺炎衣原体（Cpn）感染与突发性耳聋（SSHL）之间的关系。方法 收集SSHL患者120例(SSHL组),另选120名健康者为对照组。分离人外周血单核细胞（PBMC）,用直接免疫荧光法（DIF）及PCR分别检测PBMC中Cpn特异性抗原（Cpn-Ag）和Cpn-DNA的表达;微量免疫荧光法检测抗Cpn抗体IgA、IgG和IgM。结果 DIF法与PCR法的检测结果比较,差异无统计学意义（P>0.05）。两组代表急性感染的Cpn-Ag和Cpn-IgM的检出率比较,差异有统计学意义（P<0.01）;两组代表慢性感染的Cpn-IgA和Cpn-IgG的检出率比较,差异有统计学意义（P<0.05）。结论 SSHL患者Cpn感染的检出率显著升高,Cpn可能是引起SSHL的一种因素。     

Description of cervical cancer mortality in Belgium using Bayesian age-period-cohort models

Objective

To correct cervical cancer mortality rates for death cause certification problems in Belgium and to describe the corrected trends (1954-1997) using Bayesian models.

Method

Cervical cancer (cervix uteri (CVX), corpus uteri (CRP), not otherwise specified (NOS) uterus cancer and other very rare uterus cancer (OTH) mortality data were extracted from the WHO mortality database together with population data for Belgium and the Netherlands.Different ICD (International Classification of Diseases) were used over time for death cause certification. In the Netherlands, the proportion of not-otherwise specified uterine cancer deaths was small over large periods and therefore internal reallocation could be used to estimate the corrected rates cervical cancer mortality. In Belgium, the proportion of improperly defined uterus deaths was high. Therefore, the age-specific proportions of uterus cancer deaths that are probably of cervical origin for the Netherlands was applied to Belgian uterus cancer deaths to estimate the corrected number of cervix cancer deaths (corCVX).A Bayesian loglinear Poisson-regression model was performed to disentangle the separate effects of age, period and cohort.

Results

The corrected age standardized mortality rate (ASMR) decreased regularly from 9.2/100 000 in the mid 1950s to 2.5/100,000 in the late 1990s. Inclusion of age, period and cohort into the models were required to obtain an adequate fit. Cervical cancer mortality increases with age, declines over calendar period and varied irregularly by cohort.

Conclusion

Mortality increased with ageing and declined over time in most age-groups, but varied irregularly by birth cohort. In global, with some discrete exceptions, mortality decreased for successive generations up to the cohorts born in the 1930s. This decline stopped for cohorts born in the 1940s and thereafter. For the youngest cohorts, even a tendency of increasing risk of dying from cervical cancer could be observed, reflecting increased exposure to risk factors. The fact that this increase was limited for the youngest cohorts could be explained as an effect of screening.Bayesian modeling provided similar results compared to previously used classical Poisson models. However, Bayesian models are more robust for estimating rates when data are sparse (youngest age groups, most recent cohorts) and can be used to for predicting future trends.

     

约束带的改良与应用

在ICU病房中,常常可以看到术后患者麻醉未清醒、情绪不稳定、意识障碍等原因引起躁动的病人,且ICU无家属陪伴,护士人手少,患者往往会自行拔除各种管道,甚至坠床,对治疗护理工作造成不必要的麻烦,更甚者影响患者的生命安全,因此对患者的约束非常重要,以往我科常用棉垫包裹患者的手腕或踝部,然后再用宽绷带打成双套结,套在棉垫上,然后再将带子系于床栏上.     

小鼠毒理基因芯片的可靠性验证

背景与目的建立小鼠毒理基因芯片杂交检测方法,同时验证芯片数据的可靠性。材料与方法采用数据的标准化处理、芯片内的参照点分析、自身比较实验以及差异分析实验方法,检验芯片数据的可靠性。结果局部均值化标准化方法使数据的线性趋势更加明显;参照点分析显示芯片无非特异性杂交,芯片内部基因表达的重复性较高;自身比较实验中各个批次芯片的假阳性率在1%以下,并且无明显差异;差异分析实验中荧光交换标记方法可以减少染色误差的影响。结论以上结果初步表明,所建立的基因芯片制作和检测技术能保证获得可靠性较好的数据。     

移动ICU在危重伤员院外急救中应用研究

移动重症监护病房（MICU）在2009年乌鲁木齐“7·5”暴力事件用于院外急救转运危重伤员,所有危重伤员均安全送达医院,无一例死亡。我们的经验是应用多辆监护型救护车组。对伤情进行快速判定、创伤评分,头颅外伤伤员采用Gcs评分,多发伤伤员采用Iss评分,按先急后缓,先重后轻的原则实施抢救。在长时间机动运行中需加强护理和仪器维护,并注意车载设备的合理性和科学性,以及配备充足的气源或更换的氧气储罐,在出车间隔时间内及时更换和补充物品。