经皮肾取石术体位改变对呼吸循环功能的影响及护理

目的探讨微创经皮肾穿刺输尿管镜取石术(mini-PCNL)2次较大的体位改变对血压、心率、脉搏血氧饱和度的影响及相应的护理措施。方法对32例行mini-PCNL病人监测血压(SBP、DBP)、心率(HR)、脉搏血氧饱和度(SPO2)以及病人的反应和感受,记录麻醉后20min、截石位后、俯卧位后10min、30min、1h、2h及术毕血压、心率及血氧饱和度的变化与基础值比较。结果32例病人从麻醉20min后开始,血压、心率、血氧饱和度均有不同程度的变化,以体位改变特别是俯卧位后影响最明显,血压、血氧饱和度显著下降(P<0.01),手术超过2h以上出现肌颤或躁动而影响循环呼吸功能者占一定的比例。结论采取相应的护理措施,维持病人生命体征平稳,可减少并发症的发生。     

慢性体外反搏对高胆固醇血症猪动脉内皮细胞的影响

目的 探讨慢性增强型体外反博（EECP）能否在体修复高胆同醇血症引起的猪动脉内皮细胞（ECs）损伤。方法 高胆固醇血症猪反搏36h后，取前降支进行扫捕电镜检查，收集胸主动脉ECs进行蛋白质组学检查。结果 高脂组冠脉ECs排列不规则、大量脱落、斑块形成，反搏组ECs呈流线型排列、脱落程度显著减轻：与高脂组相比，在反搏组的ECs检测到6种高表达的蛋白。结论 慢性EECP可能通过调节ECs蛋白表达，改善ECs粘附性和代谢及减轻ECs内皮凋亡，从而修复高胆固醇血症对动脉内皮形态和功能的损伤：     

当前PCO行业和市场问题的浅析

广州鼠害与卫生虫害防治协会(以下简称协会)成立于2001年5月18日,截止2003年11月31日止,现有团体会员238个(其中厂家9个),个人会员93个,在团体会员中,领有灭鼠杀虫服务资质证有220个(其中街镇124个占56%,社会PCO公司96个占44%),从事灭鼠杀虫的从业人员近1 600人.2002、2003年已进行"病媒生物防治工"职业培训,并领取中华人民共和国职业资格证书共1 354人,除去外地区22人,实际本市1 332人,占从业人员的83.3%,以后每年都进行初级、中级的培训.协会作为行业协会"应定位在自律性行业管理组织上,应以服务为宗旨,同时做好自律、协调、监督工作"."改革逼使我们尽快培育和发展行业协会,使行业协会的作用真正得到发挥,并承担起政府转移出去的一些职能".协会成立二年来,为政府、社会、会员的服务中在市爱卫办的指导和会员单位的大力支持下,摸着石头过河,取得了一点成绩,但我市协会在实际工作中,碰到一些急待探讨的问题,部分问题通过协会的自治管理是可以解决的,有些问题不是协会本身能解决的.     

Sertoli细胞诱导大鼠肝内胰岛移植物免疫豁免的实验研究

目的 探究睾丸Sertoli细胞能否对肝内共移植的胰岛移植物提供免疫豁免作用以及共移植的睾丸Sertoli细胞最佳数量。方法将同种大鼠胰岛及不同数量的睾丸Sertoli细胞同时移植于糖尿病受体的肝内,观察移植物存活情况、胰岛功能、并检测移植物内胰岛素和Fas配体(FasL)表达以及浸润淋巴细胞凋亡情况。结果单纯胰岛移植组平均存活期为(5.6±0.8)d,同时与胰岛细胞在肝内共移植的睾丸细胞数增加至1×107个时,平均存活期为(41.4±4.61)d,明显延长(P<0.05),胰岛移植物中有大量表达FasL的睾丸细胞和表达胰岛素的胰岛细胞.在移植物周围有大量浸润的淋巴细胞凋亡。结论睾丸Sertoli细胞与胰岛细胞同时在肝内共移植,通过诱导局部豁免而延长胰岛移植物的存活时间,且同时共移植1×107个Sertoli细胞时效果最好。     

心肌缺血再灌注损伤时细胞核被膜钙泵活性特征的研究

目的　研究心肌缺血再灌注损伤时Ca2 + 、ATP、ADP和AMP对细胞核被膜钙泵 (Ca2 + ATPase)活性的调节。方法　采用大鼠心肌缺血再灌注模型 ,密度梯度分离纯化细胞核 ,定磷法测定Ca2 + ATPase活性。结果　与正常大鼠相比 ,缺血再灌注损伤动物血浆MDA和FFA显著升高 (P <0 0 1) ;细胞核Ca2 + ATPase活性下降 ,对Ca2 + 亲和力降低 ;ADP、AMP对核Ca2 + ATPase活性的影响明显减弱 ;ATP对Ca2 + ATPase的作用在 [ATP]小于 1 0mmol L时 ,与正常细胞Ca2 + AT Pase活性无显著差异 ,浓度增至 2 0mmol L时 ,活性低于正常细胞 ,ATP浓度继续增加 ,核Ca2 + ATPase活性快速增加。结论　心肌缺血再灌注损伤时Ca2 + 、ATP、ADP、AMP对心肌细胞核Ca2 + ATPase活性的影响发生了明显改变 ,其病理生理意义值得进一步探讨。     

人外周血单核细胞和脐血CD34+细胞来源的树突细胞比较

目的比较从人外周血单核细胞及脐血CD34+细胞诱导树突细胞(DC)的方法及其特性.方法用淋巴细胞分离液分离外周血单个核细胞,贴壁法获得单核细胞;经GM-CSF及IL-4诱导获得DC.磁性活化细胞分选系统(MACS)分选脐血CD34+细胞,以GM-CSF、IL-4、TNF-α、SCF、FL、TPO等细胞因子诱导获得DC.用电镜、普通显微镜观察DC形态;流式细胞仪分析DC表型;同种混合淋巴细胞反应(allo-MLR)观察DC刺激T淋巴细胞增殖的能力.结果外周血单核细胞在因子GM-CSF、IL-4、TNF-α,脐血CD34+细胞在GM-CSF、IL-4、TNF-α、SCF、FL、TPO等因子作用下,可生成DC,并表达相应的DC分化抗原CD14、CD80、CD83、CD86、HLA-DR.脐血CD34+细胞具有较强的扩增能力,经2周诱导,体系细胞数可增加173.8士26.7倍,两种来源的DC均能刺激同种异体淋巴细胞的增殖反应.结论外周血单核细胞与脐血CD34+细胞,在体外均可诱导成DC,并具有相应的DC分化抗原和功能.     

Factors affecting the neonatal response to artificial surfactant

Objective : To define the individual neonatal response to the artificial surfactant, Exosurf, and factors that may influence the response.
Methodology : Eighty-two consecutive, preterm neonates with respiratory distress syndrome, who received Exosurf at <12h of age were studied. Their response was categorized from the graphical change in the oxygenation index with postnatal age, for 12h after each of two doses of surfactant and assessed independently by two observers. Clinical factors were analysed for their effect on the four pre-defined categories of response, namely: none; mild; good; relapsed; and good: sustained.
Results : Within the first 12h, 11% of the neonates showed no response, 5% a mild response and 84% a good response, but 34% relapsed. By 24h, 6% still showed no response (all died), 11% showed a mild response and 83% a good response, of whom half relapsed. At 24h, no response was significantly associated with low gestational age and asphyxia mild response with less severe lung disease. According to the response there was a gradation in the risk of death during the first week.
Conclusions : The response to Exosurf can be individually and reproducibly categorized and demonstrated that 83% of neonates had a good response but half relapsed. No response was associated with extreme prematurity and asphyxia     

腹部创伤的影像学诊断(附87例分析)

本文报道腹部创伤的X线、CT诊断 ,结合临床采用X线 ,CT常规检查。CT增强扫描 ,膀胱逆行造影 ,对 87例腹部创伤病例进行简单X线及CT影像分析 ,探讨CT、X线在腹部创伤中的价值。     

脊柱后入路显微内窥镜下手术治疗侧隐窝狭窄

目的 探讨脊柱后入路显微内窥镜下手术治疗侧隐窝狭窄的手术方法。方法 采用自行研制的异型骨凿，于显微内窥镜下手术治疗38例确诊为侧隐窝狭窄的患。结果 经6～12个月随访，所有患均无神经损伤等并发症；疗效评价：32例，良5例，可1例。结论 本术式具有创伤小，对术后脊柱的稳定性破坏小，疗效确切等优点。     

Adenovirus-mediated human β-nerve growth factor gene transfer has a protective effect on cochlear spiral ganglion after blast exposure

Objective：To study whether adenovirus-mediated human β-nerve growth factor （Ad-hNGFβ） gene has any protective effect on blast hearing impairment. Methods：Deafness was induced by blast exposure （172.0 dB） in 30 healthy guinea pigs. On day 7 of blast exposure, Ad-hNGFβ was infused into the perilymphatic space of 20 animals as the study group （hNGFβ group）, and artificial perilymph fluid （APF） was infused into the perilymphatic space of the other 10 animals as the control group. At weeks 1, 4 and 8 after blast exposure, the animals were sacrificed and the cochleae were removed for immunohistochemical and HE stainings. Results： Expression of Ad-hNGFβ protein was detected in each turn of the cochlea at the 1st week, with almost equal intensity in all turns. At the 4th week, the reactive intensity of the expression of Ad-hNGFβ protein decreased. At the 8th week, no expression was detectable. The results of HE staining showed that the amount of spiral ganglions in hNGFβ group was significantly greater than that of the control group at week 4 （P〈0.01）. Conclusion： Ad-hNGFβ can be expressed at a high level and for a relatively long period in the blast impaired cochlea, suggesting that Ad-hNGFβ has a protective effect on cochlear spiral ganglion cells after blast exposure and the efficient gene transfer into cochlea had been achieved without toxicity.