高压氧治疗对阿尔茨海默病大鼠海马内神经元凋亡及p38丝裂原蛋白激酶表达的影响

目的 评价高压氧治疗对阿尔茨海默病(alzheimer's disease,AD)大鼠海马内神经元凋亡及p38丝裂原蛋白激酶(p38 mitogenactivated protein kinases,p38MAPK)表达的影响. 方法 18只雄性SD大鼠,体重260 g～290 g,采用随机数字表法分为3组(每组6只):生理盐水组(NS组),海马区注射生理盐水;阿尔茨海默病组(AD组),海马区注射Aβ1-40;高压氧组(HBO组),海马区注射Aβ1-40,并于术后1 d～7d行每天1次的高压氧治疗.应用脑立体定位仪于大鼠海马区注射Aβ1-40制备AD模型.于术前1d和术后1、7、14、21 d行水迷宫行为学测试.于术后21 d水迷宫行为学测试结束后处死大鼠,采用苏木精-伊红染色(hematoxylin-eosin,HE)方法染色海马组织病理结构,TUNEL法标记检测凋亡细胞,免疫印迹法(Western bolt)法测定海马内p38MAPK蛋白磷酸化水平. 结果 术后21 d时,与NS组比较,AD组大鼠上台前路程和逃避潜伏期增加[(379±41)、(1 978±120) cm,(16.0±2.8)、(78.4±10.8)s](P＜0.05);与AD组比较,HBO组大鼠上台前路程和逃避潜伏期减少[(1978±120)、(1 246±96) cm,(78.4±10.8)、(51.7±6.2)s](P＜0.05).与NS组比较,AD组和HBO组大鼠海马组织细胞凋亡率[(6.3±13)％,(45.2±5.1)％]及p38MAPK蛋白磷酸化表达升高(0.16±0.06),(0.54±0.10)(P＜0.05);与AD组比较,HBO组海马组织细胞凋亡率[(45.2±5.1)％,(22.5±3.7)％]及p38 MAPK蛋白磷酸化表达下降[(0.54±0.10),(0.31±0.08)](P＜0.05).结论 高压氧治疗可有效缓解AD大鼠认知功能障碍,且能够抑制海马内神经元凋亡,其机制与降低p38MAPK的磷酸化水平有关.     

Analyses of Potential Predictive Markers and Response to Targeted Therapy in Patients with Advanced Clear-cell Renal Cell Carcinoma

Background:Vascular endothelial growth factor-targeted agents are standard treatments in advanced clear-cell renal cell carcinoma (ccRCC),but biomarkers of activity are lacking.The aim of this study wa...     

两种硫辛酸对映体对胚胎体外发育的影响

目的：探讨(R)-硫辛酸和(S)-硫辛酸对胚胎体外发育的影响。方法解冻复苏卵裂期胚胎,分别在含不同浓度(R)-硫辛酸和(S)-硫辛酸的GⅡ培养基微滴中培养,观察各组的桑胚率、致密化率、囊胚率和优质囊胚率。结果硫辛酸可提高胚胎体外发育率,(R)-硫辛酸浓度10×10-9 mol/m3组桑胚率、致密化率、囊胚率和优质囊胚率分别达到了59.2%,55.1%,49.0%和54.2%,均高于其他浓度组（P<0.01）。(R)-硫辛酸浓度10×10-9 mol/m3组的桑胚率、致密化率和优质胚胎率均高于(S)-硫辛酸10×10-9 mol/m3组（P<0.05）。结论硫辛酸对胚胎体外发育具有促进作用,特别是对桑胚率和囊胚率具有显著的影响。(R)-硫辛酸10×10-9 mol/m3组的效果最好。     

玻璃酸钠注射配合三色敷药治疗膝关节骨性关节炎的临床研究

目的通过玻璃酸钠注射配合三色敷药外用对膝关节骨性关节炎的疗效观察,根据其膝部症状、体征恢复情况作出客观评价,并进一步探讨其治疗作用机理。方法采用60例膝OA患者作为研究对象,随机分成三组,治疗一疗程(5周)后分别对三组病例进行疗效对比分析。结果三组在治疗后与治疗前积分比较具有显著性差异(P<0.05),治疗后积分明显低于治疗前,尤其是治疗组经治疗后与治疗前比较具有极其显著差异(P<0.01)。治疗组与对照组Ⅰ、Ⅱ经治疗后疗效积分比较有显著差异(P<0.05),对照组Ⅰ、Ⅱ之间比较无显著差异(P>0.05)。治疗组总有效率90%,对照组Ⅰ、Ⅱ有效率均为75%。故治疗组疗效明显优于对照组Ⅰ、Ⅱ,两个对照组之间治疗效果相当。结论玻璃酸钠注射配合三色敷药外用,二者具有协同作用,对膝关节骨性关节炎有明显的治疗效果,且无不良反应。     

Recent increase in antibiotic-resistant microorganisms in patients with spontaneous bacterial peritonitis adversely affects the clinical outcome in Korea

BACKGROUND AND AIM: Recently, antibiotic-resistant microorganisms have been increasingly noted in Korean patients with spontaneous bacterial peritonitis (SBP). The present study investigated the changing pattern of antibiotic resistance and its effects on the clinical outcome in treating SBP. METHODS: The present study retrospectively analyzed 87 episodes of SBP in 1995, 222 in 1998, and 271 in 1999. The isolated microorganisms and their antibiotic susceptibility were compared, and prognostic factors for survival were analyzed. RESULTS: Microorganisms were isolated in 41% of total episodes. The three most frequently isolated organisms were Escherichia coli (48%), Klebsiella pneumoniae (15%), and Aeromonas (8%). Strains that were resistant to cefotaxime in Gram-negative bacilli significantly increased from 7% in 1995 to 28% in 1999, and those to ciprofloxacin increased from 10% to 32%. Treatment failure also increased from 6% to 23%. Combined hepatocellular carcinoma and SBP caused by extended-spectrum beta-lactamase-producing strains were two independent prognostic factors for survival. CONCLUSION: Considering the increase in antibiotic-resistant microorganisms related to SBP, measures to prevent the in-hospital spread of resistant strains and the indiscriminate use of antibiotics should be instituted more stringently.     

黑白高频超声对小儿肠套叠的诊断价值

目的:探讨小儿肠套叠的黑白高频超声特征及诊断意义。材料与方法:回顾性分析2012年01月至2014年01月我院小儿外科80例小儿肠套叠患者,78经黑白高频超声确诊,2例漏诊,所有患者经空气灌肠或手术复位证实为小儿肠套叠。结果:80例小儿肠套叠,76例为右侧腹部肠套叠,4例为非右侧腹部肠套,均先行黑白高频超声检查,经超声透视空气灌肠成功复位73例,手术5例,肠套叠的超声特征性改变为"同心圆征"和"套筒征",2例漏诊。结论:黑白高频超声检查对小儿肠套叠的诊断明确,且具有特异性,是目前诊断小儿肠套叠行之有效的方法之一。黑白超声普及率高,检查简便、费用低,对指导临床治疗有着重要的参考价值。     

椎动脉供血不足的MRI诊断

目的:分析椎动脉供血不足的各种MRI征象,探讨其临床价值。材料与方法:收集临床拟诊椎动脉供血不足而行MRI检查的患者86例,进行MRI检查,对其MRI及CEMRA重建图像进行分析,对椎动脉的MRA评价主要包括其血管形态的观察以及周围组织结构改变。结果:椎动脉可见多段发病或多种病变形态共存的特点,椎动脉形态异常主要为先天发育畸形,包括管腔纤细,双侧椎动脉变细,单侧椎动脉变细以及椎动脉走行变异。血管局部狭窄,包括椎动脉起始段狭窄;颈椎段狭窄,包括椎间盘压迫、钩突关节增生压迫、横突孔增生;椎动脉颅内段扭曲狭窄等。结论:MRI尤其是MRA技术可以简便、直观显示椎动脉以及全面多方位观察它的形态,在一定程度上能够为临床准确诊断椎动脉供血不足提供直接证据。     

Decidualization of intranodal endometriosis in a postmenopausal woman

Here we describe an unusual case of decidualized endometriosis detected in pelvic lymph nodes. The presence of intranodal ectopic decidua in pregnant women has been described. A few cases of decidualization of endometriotic foci in the pelvic or para-aortic lymph nodes have also been associated with pregnancy. However, decidualized intranodal endometriosis occurring in a postmenopausal woman has not been described. A 52-year-old woman presented with a very large adnexal mass. Menopause occurred at the age of 47, and she had been treated with hormone replacement therapy. She received a total abdominal hysterectomy with bilateral salpingo-oophorectomy and pelvic and para-aortic lymphadenectomy for clear cell carcinoma of the right ovary. Histological examination revealed the presence of ectopic decidua in several pelvic lymph nodes. The deciduas consisted of sheets of loosely cohesive, large, uniform, round cells with abundant eosinophilic cytoplasm. Typical of decidualization of intranodal endometriosis, a few irregularly shaped, inactive endometrial glands lined by single layers of columnar to cuboidal epithelium were present within the decidua. An immunohistochemical study revealed that the decidual cells were positive for CD10, vimentin, estrogen receptor and progesterone receptor, which indicated that progestin-induced decidualization had occurred in the intranodal endometriotic stroma. To the best of our knowledge, this case represents the first report of decidualized intranodal endometriosis occurring in association with hormone replacement therapy in a postmenopausal woman. Misdiagnosis of this condition as a metastatic tumor can be avoided by an awareness of these benign inclusions, supported by immunohistochemical staining results.