糖尿病人群中胰岛素和游离脂肪酸水平的相关性研究

目的探讨糖尿病人群中胰岛素和游离脂肪酸水平的相关性。方法选取2009年1月至2014年8月成都市第四人民医院就诊的2型糖尿病患者及同期门诊体检的健康人群,观察比较各人群各项生化指标。结果 2组人群生化特征比较,其中体质量指数、空腹血糖、餐后2h血糖、空腹血清胰岛素(FINS)、三酰甘油、高密度脂蛋白胆固醇、游离脂肪酸(FFA)、胰岛素敏感指数(IAI)差异有统计学意义(P0.05);糖尿病组中FINS与FFA呈正相关(r=0.678,P0.05),IAI与FFA呈负相关(r=-0.654,P0.05)。健康组FINS与FFA呈正相关,相关系数为0.447(P0.05)。结论糖尿病人群血清FFA升高,胰岛素分泌增加,IAI下降,而健康人群血清FFA升高与胰岛素分泌增加有关。     

甲氧西林耐药／敏感金黄色葡萄球菌基因分型和毒力基因检测

目的：分析耐甲氧西林金黄色葡萄球菌（金葡菌）（MRSA）和甲氧西林敏感金葡菌（MSSA）临床分离株基因分型及毒力基因分布特征是否存在差异,了解金葡菌耐药性演变与毒力变迁之间的相关性。方法采用脉冲场凝胶电泳（PFGE）方法和多位点序列分型（MLST）方法对呼和浩特地区住院患者中分离的30株 MRSA 和30株 MSSA 进行分子分型,同步采用聚合酶链反应（PCR）方法检测菌株毒力基因。结果60株金葡菌 PFGE 分型共分19个型,MSSA 菌株分布在 I 和 H 型等16个基因型中,而 MRSA 株主要集中分布在 K 和 M 2个基因型中。20株不同 PFGE 型菌株 MLST 分型结果显示,MRSA 株主要为 ST-239型;MSSA 株呈多样性分布特征,主要以 ST-5型、ST-7型、ST-15型为主。毒力基因在 MRSA 和 MSSA 中分布差异显著。MSSA 毒力基因整体携带率明显高于 MRSA（53．9％对40．0％,χ2＝32．7,P ＜0．01）。MRSA 株 sea、cna 和 cap 8基因携带率明显高于 MSSA 携带率（P ＜0．01）,而 sec、seg 、sei、sem、sen、seo、fnbB、ebpS、cap5基因携带率明显低于 MSSA（P＜0．05）。结论呼和浩特地区金葡菌临床分离株基因型呈现多样化分布特点,MRSA 主要以 ST-239型为主。MSSA 毒力基因携带率高,特定毒力因子在 MRSA 和 MSSA 株中呈现一定聚集分布特征,金葡菌特定耐药性的获得可能伴随特定毒力特征的变化。     

影响医院中心注射室护理工作满意度的相关因素调查

目的对中心注射室护理工作的满意度进行调查,了解影响医院护理工作满意度的因素。方法选择2011年1～12月在中心注射室接受治疗的患者252例为研究对象,采用问卷法对患者进行调查,并分析影响注射室护理工作满意度的因素。结果接受调查的住院患者中,患者的满意度得分与患者的年龄、受教育程度、收入水平、住院科室、住院天数以及是否手术存在相关性。结论护理人员应重视和加强护理工作质量和效率,提高临床患者对护理工作的满意程度。     

The effect of recombinant GM-CSF on the recovery of monkeys transplanted with autologous bone marrow

The regulatory function of recombinant human granulocyte-macrophage colony stimulating factor (rhGM-CSF) on granulocyte production in vivo was evaluated in an autologous bone marrow transplantation model using rhesus monkeys. Monkeys were exposed to 9.0 Gy total body irradiation and then transplanted with 5.0 x 10(7) low-density bone marrow cells/kg. Alzet miniosmotic pumps were subcutaneously implanted to deliver rhGM-CSF at a rate of 50,400 U/kg/d. Minipumps, containing either rhGM-CSF or saline, were implanted between zero and five days after transplantation for seven days. Kinetic recoveries of peripheral blood cells after either saline or rhGM-CSF treatment were compared. Treatment with rhGM-CSF accelerated the recovery of neutrophils. Neutrophils in rhGM-CSF-treated animals recovered to 80% (3.4 x 10(3)/mm3) pre-irradiation control levels by day 20, in comparison with only 33% (0.9 x 10(3)/mm3) recovery for saline control monkeys. In addition, the recovery of neutrophils was enhanced over that of the controls, reaching 140% v 70% on day 30. Another prominent feature of rhGM-CSF-treated monkeys was the accelerated recovery of platelets, reaching near 50% normal levels by day 24 in comparison with 20% of normal levels for controls. The infusion of rhGM-CSF was shown to be an effective regulator of early hematopoietic regeneration, leading to the accelerated recovery of both neutrophils and platelets and then providing a consistent sustained increase of neutrophils even in the absence of rhGM-CSF.     

Harvesting and enrichment of hematopoietic progenitor cells mobilized into the peripheral blood of normal donors by granulocyte-macrophage colony-stimulating factor (GM-CSF) or G-CSF: potential role in allogeneic marrow transplantation

To explore the use of stem/progenitor cells from peripheral blood (PB) for allogeneic transplantation, we have studied the mobilization of progenitor cells in normal donors by growth factors. Normal subjects were administered either granulocyte-macrophage colony-stimulating factor (GM-CSF) at 10 micrograms/kg/d, or G-CSF at 10 micrograms/kg/d, or a combination of G- and GM-CSF at 5 micrograms/kg/d each, administered subcutaneously for 4 days, followed by leukapheresis on day 5. Mononuclear cells expressing CD34 (CD34+ cells) were selectively enriched by affinity labeling using Dynal paramagnetic microspheres (Baxter Isolex; Baxter Healthcare Corp, Santa Ana, CA). The baseline CD34+ cells in peripheral blood before mobilization was 0.07% +/- 0.05% (1.6 +/- 0.7/microL; n = 18). On the fifth day after stimulation (24 hours after the fourth dose), the CD34+ cells were 0.99% +/- 0.40% (61 +/- 14/microL) for the 8 subjects treated with G-CSF, 0.25% +/- 0.25% (3 +/- 3/microL, both P < .01 v G-CSF) for the 5 subjects administered GM-CSF, and for the 5 subjects treated with G- and GM-CSF, 0.65% +/- 0.28% (41 +/- 18/microL, P < .5 v GM-CSF). Parallel to this increase in CD34+ cells, clonogenic assays showed a corresponding increase in CFU- GM and BFU-E. The total number of CD34+ cells collected from the G-CSF group during a 3-hour apheresis was 119 +/- 65 x 10(6) and was not significantly different from that collected from the group treated with G- and GM-CSF (101 +/- 35 x 10(6) cells), but both were greater than that from the group treated with GM-CSF (12.6 +/- 6.1 x 10(6); P < .01 for both comparisons). Analysis of the CD34+ subsets showed that a significantly higher percentage of cells with the CD34+/CD38- phenotype is found after mobilization with G- and GM-CSF. In the G-CSF group, immunomagnetic selection of CD34+ cells permitted the enrichment of the CD34+ cells in the apheresis product to 81% +/- 11%, with a 48% +/- 12% yield and to a purity of 77% +/- 21% with a 51% +/- 15% recovery in the G- and GM-CSF group. T cells were depleted from a mean of 4.5 +/- 2.0 x 10(9) to 4.3 +/- 5.2 x 10(6) after selection, representing 99.9% depletion. We conclude that it is feasible to collect sufficient numbers of PB progenitor cells from normal donors with one to two leukapheresis procedures for allogeneic transplantation.(ABSTRACT TRUNCATED AT 250 WORDS)