不监测胃残留量对ICU行肠内营养患者影响的系统评价

目的探讨不监测胃残留量对ICU行肠内营养患者的影响,为临床开展肠内营养护理提供循证依据。方法计算机检索有关不监测胃残留量对ICU行肠内营养患者影响的随机对照试验(RCT)文献,按Cochrane协作网的系统评价方法筛选文献、评价纳入文献质量,使用RevMan5.3软件进行统计分析。结果共纳入5篇RCT,878例研究对象。Meta分析结果显示,不监测胃残留量患者呕吐、腹胀发生率显著高于常规监测胃残留量患者,而喂养不耐受发生率显著降低(均P0.01);不监测胃残留量对肺炎、腹泻、误吸发生率及机械通气时间、住院时间等无影响(均P0.05),对营养摄入量有影响。结论ICU行肠内营养患者不监测胃残留量对其肺炎、误吸及腹泻发生率无明显影响,其呕吐和腹胀发生风险增加,喂养不耐受发生率降低,营养摄入量得到保障。受纳入研究数量和质量限制,研究结果尚需进行大样本、高质量、多中心的RCT加以论证。     

湿润烧伤膏抗感染作用的实验研究

我们采用大鼠20%Ⅲ度烫伤创面接种绿脓杆菌 ATCC-27853作为实验治疗模型,旨在评价湿润烧伤膏外用治疗烧伤的防治感染功效。于接种绿脓杆菌后10分钟、8小时、24小时和48小时开始外用湿润烧伤膏治疗,并以1%的 Ag-SD 霜,1.2%的 Ag-FLX 霜和基础霜剂作为对照。治疗48小时后送血培养,痂下细菌计数及组织病理学检查,以此作为评价指标。4种外用药物在体外对绿脓杆菌,大肠杆菌和金黄色葡萄球菌做抑菌试验,结果表明,Ag-FLX 抗菌作用和疗效最强,Ag-SD 次之,而湿润烧伤膏的各项指标和基础霜剂间差异无显著意义(P>0.05)。说明湿润烧伤膏在防治烧伤感染方面几乎没有作用。     

腰穿术后平卧方法的临床观察

目的 通过腰穿术后病人平卧方法舒适度的临床观察比较,从而探讨选择术后最佳的平卧方法.方法 观察并记录2001-02～2006-09的1070例门诊腰穿术后病人,2种平卧方法(即去枕仰卧位和低枕卧位)的舒适度.结果 随机分2组2种平卧方法临床观察,低枕卧位明显优于去枕仰卧位.结论 腰穿术后低枕卧位方法的选择对病人术后的尽快恢复,有较好的帮助.     

两种根管充填糊剂充填效果的比较

目的比较两种根管充填糊剂充填治疗牙髓坏死和慢性根尖周病的临床疗效。方法将164例患者共198颗患牙随机分为治疗组和对照组,治疗组采用Cortisomol糊剂加牙胶尖侧压行一次性根管充填;对照组用氧化锌糊剂加牙胶尖侧压根管充填,观察两组术后疗效。结果两组疗效比较差异有非常显著性,治疗组优于对照组。结论Cortisomol糊剂一次性根管充填疗法能减轻疼痛,疗效满意。     

Treatment of leiomyomatosis peritonealis disseminata with goserelin acetate: A case report and review of the literature

BACKGROUNDLeiomyomatosis peritonealis disseminata (LPD) is a rare condition characterized by multiple pelvic and abdominal nodules, which are composed of smooth-muscle cells. To date, no more than 200 cases have been reported. The diagnosis of LPD is difficult and there are no guidelines on the treatment of LPD. Currently, surgical excision is the mainstay. However, hormone blockade therapy can be an alternative choice.CASE SUMMARYA 33-year-old female patient with abdominal discomfort and palpable abdominal masses was admitted to our hospital. She had undergone four surgeries related to uterine leiomyoma in the past 8 years. Computed tomography revealed multiple nodules scattered within the abdominal wall and peritoneal cavity. Her symptoms and the result of the core-needle biopsy were consistent with LPD. The patient refused surgery and was then treated with tamoxifen, ulipristal acetate (a selective progesterone receptor modulator), and goserelin acetate (a gonadotropin-releasing hormone agonist). Both tamoxifen and ulipristal acetate were not effective in controlling the disease progression. However, the patient achieved an excellent response when goserelin acetate was attempted with relieved syndromes and obvious shrinkage of nodules. The largest nodule showed a 25% decrease in the sum of the longest diameters from pretreatment to posttreatment. Up to now, 2 years have elapsed and the patient remains asymptomatic and there is no development of further nodules.CONCLUSIONGoserelin acetate is effective for the management of LPD. The long-term use of goserelin acetate is thought to be safe and effective. Hormone blockade therapy can replace repeated surgical excision in recurrent patients.     

Clinical characteristics of pediatric synovitis,acne, pustulosis,hyperostosis, and osteitis (SAPHO) syndrome: the first Chinese case series from a single center

Clinical Rheumatology - Pediatric SAPHO syndrome is regarded as the equivalent of chronic recurrent multifocal osteomyelitis or chronic non-bacterial osteomyelitis. This study aimed to evaluate the...     

急性白血病患者Bcl-2／Jh基因的研究

目的 探讨急性白血病（AL）患者t（14；18）融合基因Bcl-2／Jh突变点，在AL诊治过程中的变化及预后判断的意义。方法 采集AL患者和正常人外周血，PCR方法检测Bcl-2／Jh基因3种不同重排方式的发生率。结果 完全缓解期白血病患者体内mbr、mcr和mdr的发生率分别为46．6％、41．2％和13．8％。发生3种易位的机率为1．72％、2种易位的机率为5．2％。结论 Bcl-2／Jh在AL患者治疗前后的发生率和重排率虽有不同，可在一定程度上反映疗效。     

C-kit expression in renal oncocytomas and chromophobe renal cell carcinomas

C- kit encodes the membrane-bound tyrosine kinase KIT, whose expression has been identified in several types of human neoplasms. Recently, KIT has been reported to be a marker for chromophobe renal cell carcinoma (RCC) and renal angiomyolipoma. However, expression of this molecule has not been adequately studied in other renal tumors, particularly oncocytoma, which may morphologically resemble chromophobe RCC. In this study, we analyzed c- kit messenger RNA (mRNA) levels in 17 chromophobe RCCs and 20 renal oncocytomas obtained from complementary DNA (cDNA) microarrays. Furthermore, comprehensive immunohistochemical analysis of KIT protein using a monoclonal antibody was performed in 226 renal tumors including chromophobe RCC (n=40), oncocytoma (n=41), clear-cell RCC (n=40), renal angiomyolipoma (n=29), and papillary RCC (n=21) on tissue microarrays (TMAs) and was compared with immunostaining results from 25 chromophobe RCCs and 30 oncocytomas using standard sections. The staining intensity was semiquantitatively graded on a 3-tier scoring system. All chromophobe RCCs and oncocytomas showed significant overexpression of c- kit mRNA. The average increase of mRNA compared with normal kidney tissue was 7.4-fold for chromophobe RCCs and 7.4-fold for oncocytomas. Immunohistochemical expression of KIT was found in most chromophobe RCCs (95% in TMAs and 96% in conventional sections) and oncocytomas (88% in TMAs and 100% in conventional sections) but was infrequently observed in renal angiomyolipomas (17%), papillary RCCs (5%), and clear-cell RCCs (3%). Furthermore, the average KIT immunoreactivity in TMAs was stronger in chromophobe RCC (1.93) and oncocytoma (2.07) than in other subtypes of renal tumors tested, including angiomyolipomas (0.17), papillary RCCs (0.05), and clear-cell RCCs (0.03). In conclusion, we found a significant elevation of c- kit mRNA by cDNA expression microarrays and overexpression of KIT protein by immunohistochemistry not only in chromophobe RCCs but also in oncocytomas. In contrast, immunohistochemical expression of KIT was not detected in most other types of renal cell tumors evaluated. The differential expression of c- kit in these renal tumors may have diagnostic and therapeutic implications.     

A two-dimensional electrophoresis reference map of human ovary

The ovary plays a central role in oogenesis and gonadal hormone secretion. Proteomic analysis is a valuable approach for gaining an increased understanding of the molecular nature of the ovary. In this work, two-dimensional electrophoresis for protein separation followed by matrix-assisted laser desorption/ionization mass spectrometry and database searches, identified 231 protein spots corresponding to 138 individual proteins that were found in gels representing both the follicular and luteal phases. The data were used to construct a database online (). The identified proteins were functionally classified into seven groups: (1) cell signaling/communication, (2) cell division, (3) gene/protein expression, (4) metabolism, (5) cell structure and motility, (6) cell/organism defense, and (7) unclassified. Among the proteins identified, 47% had not been previously reported in the human ovary. In addition, a number of disease-related proteins were identified in this protein map, including some cancer- and polycystic ovarian syndrome-related proteins. Two proteins with phosphorylation were verified by Western blot analysis. Comparison of protein abundance between follicular and luteal stages produced seven protein spots that had been identified in our database. This study provides a preliminary reference map of normal human ovary that will form a basis for comparative studies on normal and pathological conditions of the human ovary and may serve as a potential tool for clinical diagnosis, therapeutics, and prognosis.Electronic Supplementary Material Supplementary material is available in the online version of this article at L. Wang and Y.-F. Zhu contributed equally to this work