炎性肠梗阻15例诊治体会

目的探讨炎性肠梗阻的诊断和治疗。方法分析15例炎性肠梗阻的临床特点和治疗。结果15例经保守治疗,其中1例因肠扭转缺血损伤严重,出现全身性炎症反应综合征致多脏器衰竭死亡外,其他病例均痊愈,平均治愈时间为12.6d。结论炎症性肠梗阻由无菌性炎症致广泛肠粘连引起,应用小剂量激素减缓炎症反应,抗生素防止肠道菌群易位,经内镜逆行置入肠减压管及营养支持治疗,多数病例可保守治愈。     

丙型肝炎患者外周血单核细胞中丙型肝炎病毒复制的研究

９例临床诊断为丙型肝炎患者，研究其外周血单核细胞中ＨＣＶＲＮＡ的存在及复制。９例患者血清标本抗－ＨＣＶ及ＨＣＶＲＮＡ均为阳性，采用高敏感的逆转录一套式ＰＣＲ法测定其外周血单核细胞中ＨＣＶ正、负链ＲＮＡ，结果９例患者外周血单核细胞中７例ＨＣＶ正链ＲＮＡ阳性，３例ＨＣＶ负链ＲＮＡ阳性，证实部分丙肝患者外周血单核细胞中存在ＨＣＶ的复制，表明肝细胞并非为ＨＣＶ感染与复制的唯一场所。     

医院内感染病原菌及其对抗生素的耐药状况

调查1988年3月～5月我院591例住院病例,发生96例次院内感染,总发病率16.2％。院内感染病原菌中,革蓝氏阴性杆菌占72.9％,革蓝氏阳性球菌占12.9％,念珠菌属占14.1％。院内感染病原菌的耐药性明显高于院外菌株。绿脓杆菌对庆大霉素和羧苄青霉素的耐药率分别为63.6％和54.5％。其它革蓝氏阴性杆菌院内株对常用抗生素如氨苄青霉素、羧苄青霉素、庆大霉素和妥布拉霉素的耐药率分别为82.5％、 67.5％、47.5％和45％。革蓝氏阳性球菌院内株的耐药性也很严重,表葡菌对多种半合成青霉素类、红霉素、复方新诺明甚至万古霉素的耐药率达60％以上。同时分离出耐甲氧西林金葡菌。     

In vitro metabolic study of temsirolimus: preparation, isolation, and identification of the metabolites.

The in vitro metabolism of temsirolimus, (rapamycin-42-[2,2-bis-(hydroxymethyl)]-propionate), an antineoplastic agent, was studied using human liver microsomes as well as recombinant human cytochrome P450s, namely CYP3A4, 1A2, 2A6, 2C8, 2C9, 2C19, and 2E1. Fifteen metabolites were detected by liquid chromatography (LC)-tandem mass spectrometry (MS/MS or MS/MS/MS). CYP3A4 was identified as the main enzyme responsible for the metabolism of the compound. Incubation of temsirolimus with recombinant CYP3A4 produced most of the metabolites detected from incubation with human liver microsomes, which was used for large-scale preparation of the metabolites. By silica gel chromatography followed by semipreparative reverse-phase high-performance liquid chromatography, individual metabolites were separated and purified for structural elucidation and bioactivity studies. The minor metabolites (peaks 1-7) were identified as hydroxylated or desmethylated macrolide ring-opened temsirolimus derivatives by both positive and negative mass spectrometry (MS) and MS/MS spectroscopic methods. Because these compounds were unstable and only present in trace amounts, no further investigations were conducted. Six major metabolites were identified as 36-hydroxyl temsirolimus (M8), 35-hydroxyl temsirolimus (M9), 11-hydroxyl temsirolimus with an opened hemiketal ring (M10 and M11), N- oxide temsirolimus (M12), and 32-O-desmethyl temsirolimus (M13) using combined LC-MS, MS/MS, MS/MS/MS, and NMR techniques. Compared with the parent compound, these metabolites showed dramatically decreased activity against LNCaP cellular proliferation.     

Reconstruction of the thumb and radial side of palm--a report of 6 cases

Since 1985, on the basis of anatomic study of dorsal pedal artery, thumb and radial side of palm reconstruction have been successfully performed in one stage by using opposite composite dorsal pedal flap including the second toe, the second metatarsal and the first toe web. Because they were all distributed by dorsal pedal artery and great saphenous vein, dissecting these tissues was not difficult. Good function and cosmetic appearance were achieved following reconstruction.     

氧化亚氮联合利多卡因行无痛人工流产术280例临床分析

目的: 探讨吸入 50%氧化亚氮 (N2O) 与 50%氧气 (O2 ) 的混合气体联合宫颈注射 2%利多卡因进行无痛人工流产术 (人流术) 的有效性和安全性。方法: 将人流术 580例分为A、B两组。其中A组 280例吸入 50%氧化亚氮 (N2O)与 50%氧气的混合气体联合宫颈注射 2%利多卡因进行无痛人流术, 称为联合组; B组 300例, 不用任何药物, 为对照组, 分析比较两组手术中镇痛效果, 宫口松弛情况, 手术出血量, 人流综合反应。结果: 联合组镇痛完全, 有效率达 97 5%。宫口完全松弛率 97 9%。两组比较有显著性差异 (P<0 05)。结论: 吸入氧化亚氮联合宫颈注射利多卡因进行无痛人流术, 镇痛效果确定, 人流时受术者意识处于朦胧状态, 安静, 无痛苦, 不良反应少, 苏醒快等。     

VITROS 250全自动干化学分析仪的评价

目的评价美国强生VITROS250全自动干化学分析仪器。方法运用相关统计学方法对VITROS250全自动干化学分析仪的精密度、相关性、抗胆红素干扰方面进行分析。结果VITROS250全自动干化学分析仪精密度高,回收率高,相关性好,抗干扰能力强。结论VITROS250全自动干化学分析仪适用于临床实验诊断中心(检验科)急诊化验室生化项目的检测。     

Hemoglobin constant spring defined by specific oligonucleotide hybridization and hemoglobin D Punjab (beta 121----Gln) in a Batak Indonesian family

A Batak Indonesian from North Sumatra with hemoglobin (Hb) D Punjab (alpha 2 beta 2 121----Gln) and hemoglobin Constant Spring (Hb CoSp) is described. The 24-year-old man did not have clinical symptoms, and his hematological indices were normal. However, he had a persistent slight elevation of fetal hemoglobin level. His mother and his brother were heterozygous for Hb D Punjab; his father had Hb CoSp trait. A sister did not have any abnormal hemoglobin. To show the exact molecular defect leading to the synthesis of Hb CoSp in this family, genomic DNA from the father was analyzed by hybridization with synthetic oligonucleotides. Genomic DNA was digested with Sst I and Hind III producing a 1.05-kb fragment from the 3' end segment of the alpha 2-globin gene, including the termination codon. Two nonadecamers were synthesized to serve as probes: one, entirely homologous to the normal 3' end of alpha 2A-globin gene sequence, including the termination codon TAA, the other different from it by a replacement of the T in the termination codon TAA with C, changing it to CAA, the codon for the amino acid glutamine. DNA from normal controls gave a positive signal with the normal alpha 2TAA oligonucleotide probe but negative with the alpha 2 CAA probe. The father of propositus who had Hb CoSp trait gave a positive signal with the normal alpha 2TAA oligonucleotide probe as well as with the alpha 2CAA oligonucleotide probe, showing him to be heterozygous for the alpha 2CAA-globin gene. This result shows that the Hb CoSp in the Batak family is indeed due to a replacement of T by C in the TAA termination codon of the alpha 2-globin gene changing it to CAA the condon for glutamine. This explains the resulting readthrough of the untranslated sequence of the mRNA.     

Effect of Cycloheximide on the Adaptive Response Induced by Low Dose Radiation

Human lymphocytes pre-exposed to 10 mGy or 50mGy of X-rays become less sensitive to subsequent large dose irradiation,exhibited lower rate of chromosome aberration than expected.This adaptive response could be inhibited by cycloheximide,a protein synthesis inhibitor for successive 2h period ranging from 0.5h before to 4h after the low dose exposure,indicating that the adaptive response was directly related with the protein synthesis.