吡嘧司特钾片在中国健康人体内的药动学研究

目的:建立人血浆中吡嘧司特钾浓度的LC-MS/MS测定法,研究吡嘧司特钾片在中国健康人体内的药动学。方法:21例中国男性健康受试者单剂量空腹口服10 mg吡嘧司特钾片,0~24 h间隔采集肘静脉血,血浆样品采用0.1%盐酸化乙腈沉淀蛋白处理,LC-MS/MS法测定吡嘧司特钾血药浓度,DAS 2.0软件计算药动学参数。结果:建立的LC-MS/MS法测定吡嘧司特钾血浆浓度在2.0~400 ng·m L-1范围内线性关系良好,最低定量限为2.0 ng·m L-1,经方法验证符合生物样品测定要求。测得受试者单剂量口服10 mg吡嘧司特钾片后的主要药动学参数:Cmax为(1 007±135)ng·m L-1,Tmax为(1.8±0.6)h,t1/2为(4.1±0.8)h,AUC0~24为(5 851±992)ng·h·m L-1,AUC0~∞为(5 986±1 068)ng·h·m L-1,CL为(1.8±0.3)L·h-1,Vd为(10.5±1.5)L。结论:建立的LC-MS/MS测定法专属、灵敏,满足吡嘧司特钾片药动学研究的要求。     

肾部分切除术后肾功能变化情况观察

目的:了解肾肿瘤行肾部分切除术后肾功能的变化情况。方法:2010年1月~2013年5月施行肾部分切除术61例,采集患者年龄、性别、体质指数(body mass index,BMI)、伴随疾病(高血压、糖尿病、冠心病)、肿瘤的病理类型、采用简化MDRD公式计算出的eGFR、右肾小球滤过率(rGFR)及术后3~6个月的eGFR,分析术前及术后肾功能变化情况及相关因素。结果:术前肾功能Ⅰ级68%,Ⅱ级25%,Ⅲ级7%。21%患者术后肾功能恶化至中度肾功能损伤(Ⅲ级及以上),与患者年龄(OR=0.985,P=0.039)、术前肾功能水平即eGFR(OR=1.328,P=0.002)、肾动脉阻断时间(OR=0.913,P=0.037)、肿瘤直径(OR=0.996,P=0.011)相关。结论:患者增加的年龄、术前肾功能水平、肾动脉阻断时间以及肿瘤直径是术后出现肾功能恶化至中度肾功能损伤(Ⅲ级及以上)的独立危险因素。     

IL-25在旋毛虫ES抗原刺激小鼠小肠中的影响

目的 观察IL-25在旋毛虫ES抗原刺激小鼠小肠中的影响。方法 30只BALB/c小鼠随机分为3组:空白对照组、旋毛虫排泄-分泌(ES)抗原刺激组与IL-25阻断组。空白对照组小鼠腹腔注射PBS;ES抗原刺激组小鼠腹腔注射旋毛虫ES抗原,每天1次,连续7 d;IL-25阻断组小鼠腹腔注射抗鼠的IL-25单克隆抗体3 d后,给予腹腔注射旋毛虫ES抗原。采用酶联免疫吸附法试验检测小鼠小肠组织匀浆IL-25、IL-13、IL-4、IL-5及IL-33水平变化,HE染色镜下观察小肠病理变化以及用阿尔新蓝-核固红染色观察小肠杯状细胞数量变化情况。结果 与空白对照组比较,ES抗原刺激组小鼠小肠组织匀浆IL-25(t=4.675,P<0.05)、IL-13(t=5.392,P<0.05)、IL-4(t=4.275,P<0.05)、IL-5(t=4.675,P<0.05)、IL-33(t=4.644,P<0.05)含量有升高,差异均有统计学意义。与 ES抗原刺激组比较,IL-25阻断组小鼠小肠组织IL-25(t=2.821,P<0.05)、IL-13(t=2.344,P<0.05)、IL-4(t=2.647,P<0.05)、IL-5(t=3.268,P<0.05)、IL-33(t=2.780,P<0.05)含量降低,差异均有统计学意义。结论 旋毛虫ES抗原刺激小鼠小肠黏膜可能经IL-25/ILC2途径产生免疫作用。     

冠状动脉CTA对冠状动脉粥样硬化性心脏病高危人群的随访观察价值

目的 探讨冠状动脉CT血管成像（CCTA）对冠状动脉粥样硬化性心脏病（简称冠心病）高危险因素人群（简称高危人群）的随访观察价值。方法 选取于我院接受CCTA检查且空腹血糖、血脂（甘油三酯、总胆固醇、高密度脂蛋白及低密度脂蛋白）等生化指标及体质量指数有2项或2项以上异常的80例患者,经临床干预后,间隔2年再次行CCTA检查,同时行上述生化指标及体质量指数检测,根据两次CCTA检查结果分为稳定组和进展组,并对2组两次生化指标、体质量指数及其变化率进行统计学分析。结果 稳定组60例,进展组20例。进展组第1次与第2次检查高密度脂蛋白水平差异有统计学意义（t=2.64,P=0.02）;稳定组第2次检查体质量指数、血糖、甘油三酯、总胆固醇及低密度脂蛋白明显小于第1次检查（t=2.10、2.68、3.45、4.26、5.90,P=0.04、0.01、0.001、0.000 1、0.000 1）;进展组第2次检查甘油三酯（t=2.39,P=0.02）和低密度脂蛋白高于稳定组第2次检查（t=3.98,P<0.000 1）;进展组血糖变化率高于稳定组（t=-2.04,P=0.045）。结论 CCTA对于随访观察高危人群冠心病有积极的指导意义,通过加强对冠心病危险因素的积极干预,改变不良生活习惯,可以有效延缓或阻止冠心病的发生及发展。     

Effects of chronotropic incompetence on exercise capacity in people with heart failure versus age-matched controls

Heart Failure Reviews - Chronotropic incompetence (CI) is an inability to adequately raise heart rate during physiological stress. We established CI prevalence and exercise capacity in heart...     

Osteolipoma of the buccal mucosa: a case report

Lipomas are benign mesenchymal neoplasms of soft tissue that can be found commonly in any part of the human body. Their presence in the oral mucosa is uncommon, however, with approximately 4% of the cases occurring in the oral cavity. Oral lipomas are likely to have originated from mature adipose tissue and there are several histological variants of lipomas described, which are identified according to the predominant type of tissue in addition to adipose tissue. A rare lipoma variant, known as an osteolipoma or an ossifying lipoma, may occur; however, little has been written this type of lipoma characterized by a classical lipoma with areas of osseous metaplasia. This paper describes a case of an osteolipoma involving the buccal mucosa of an adult patient.     

应用胱抑素C早期诊断造影剂肾病的价值

目的探讨胱抑素C在早期诊断造影剂肾病中的应用价值。方法选取本院经皮冠状动脉介入治疗术(PCI)及冠状动脉造影术的患者96例,根据造影后48 h内是否发生造影剂肾病(CIN)分为观察组和对照组。比较2组患者造影剂用量、术后输液量及造影前后相关指标水平。结果观察组造影剂用量显著高于对照组(P0.05);观察组造影后Cys-C水平显著高同组造影前及同期对照组(P0.05);观察组造影后2 d的Scr水平显著高于同组造影前及同期对照组(P0.05);以Cys-C水平升高超过基线水平的25%为诊断标准,造影后CIN发生率为16.7%,高于以Scr水平为诊断标准的4.2%,差异有统计学意义(P0.05)。结论 Cys-C能很好地反映肾功能变化情况,可用于造影剂肾病的早期诊断。     

Reticulocytes. I. Isolation and in vitro maturation of synchronized populations

Studies of reticulocyte maturation have been limited by the inability to obtain pure populations of age-synchronized reticulocytes and by the absence of well-defined methods for the maturation of reticulocytes in vitro. Many of these problems were overcome using temporary suppression of erythropoiesis with thiamphenicol and phlebotomy resulting in a highly reproducible reticulocyte response, Percoll density gradient separation of cells yielding essentially pure populations of age- synchronized reticulocytes, and liquid culture techniques where cell lysis is minimal. The system allows reproducible study of well-defined cohorts of reticulocytes as they mature into erythrocytes. During in vitro maturation we serially monitored changes in reticulocyte count, glucose consumption, 125I-transferrin binding, fluorescein (FITC)- labeled transferrin binding, the activities of four erythrocyte enzymes (glucose-6-phosphate dehydrogenase, pyruvate kinase, phosphofructokinase, and lactate dehydrogenase) and the appearance of cells on scanning electron microscopy. These variables changed at different rates suggesting that multiple mechanisms underlie these maturational events. Transferrin binding and reticulocyte count decreased most rapidly and reached values near zero after three to four days in culture. The four enzyme activities decreased much more slowly, and only two reached pretreatment values after seven days in culture. In contrast to the findings of others, scanning electron microscopy suggested that cells do not assume the normal biconcave shape in this system. The methods described make it feasible to study the process of reticulocyte maturation in vitro. The data presented represent a first step in the study of the coordination and interrelationships of various maturational processes.     

基于深度学习的肺结节检测算法对不同大小肺结节的检出效果

目的 探讨基于深度学习（DL）的肺结节检测算法对不同大小肺结节的检出效果。方法 回顾性分析344例肺结节患者的胸部CT图片,计算并比较基于DL的肺结节检出模型对不同大小肺结节的检出率（相对于医师诊断结果）,分析模型检出假阳性结节的类别。结果 344份CT图像中,医师共诊断710个0~30 mm肺结节。模型共检出2 495个候选肺结节,其中真阳性675个（相对于医师诊断结果）,模型对结节的检出率为95.07%（675/710）。模型对0~4 mm肺结节的检出率为82.80%（77/93）,0~5 mm结节为90.15%（238/264）,0~6 mm结节为92.94%（395/425）,5~10 mm结节为97.94%（381/389）,10~20 mm结节为98.21%（55/56）,20~30 mm结节为100%（1/1）,模型对不同大小肺结节的检出率差异无统计学意义（χ²=21.72,P>0.05）。模型检出假阳性结节中,50.38%（917/1 820）为医师最初诊断漏诊者,32.53%（592/1 820）为血管断面。结论 DL肺结节检出模型对肺结节的整体检出率较高（95.07%）,且不受结节大小的影响。