非体外循环冠状动脉搭桥手术的麻醉

目的对非体外循环下冠状动脉搭桥手术(OPCAB)的麻醉方法和效果进行总结和探讨。方法回顾分析笔者进修期间连续实施OPCAB麻醉40例及我院2004年1月～2005年10月30例,共计70例。多数病人心功能差并伴有其他器官功能不全,麻醉诱导用小剂量咪唑安定和氯胺酮以及中小剂量芬太尼,麻醉维持以异氟醚复合小剂量异丙酚,术中随手术操作出现血流动力学的骤然变化,应用血管活性药物及时处理。结果麻醉效果满意,术中血压心率调控基本稳定。本组病人术后苏醒时间(2.3±0.8)小时,拔管时间术后(3.2±1.2)小时。ICU停留时间0.5天～1.0天,术后(7.0±1.6)天出院。无脑血管意外、心肌梗死等并发症,无住院期间死亡。结论对于OPCAB麻醉,合理应用麻醉药物和血管活性药物维持循环稳定,对于保证手术实施和病人安全至关重要。     

组合靶基因自动检测仪应用软件的设计

目的：研制与开发组合靶基因自动检测仪应用软件。方法：应用VB6．0编程语言及Access 97数据库实现压电石英谐振频率的实时检测与分析。结果：实现了组合靶基因自动检测仪压电石英谐振频率的实时检测。数据分析，结果保存与数据转换等。结论：组合靶基因自动检测仪应用软件是一类可实时检测与分析压电石英谐振频率的新型实用性软件，可广泛应用于压电石英谐振频率的检测。     

霍乱毒素B亚单位基因的克隆和表达

用DNA重组技术构建CT-B表达性质粒pXB1及进一步修饰的pXB2,使CT-B基因在大肠杆菌中得到较高水平的表达(280～350ng/ml),且有71.5％分泌率。表达动力学研究阐明,克隆子培养24h产物收率较高。一定浓度的Mg~(2+)、L-组氨酸和天冬酰胺能刺激CT-B的表达。GM1-ELISA、CHO细胞测毒结合间接免疫荧光检测和家兔肠段结扎试验证实,表达的CT-B能与游离的或活细胞膜上的GM1受体结合,但无细胞和肠段毒性。这种细胞测毒结合免疫荧光序贯试验,为客观证实CT-B的生物学活性开拓了新途径。     

2型糖尿病患者载脂蛋白E基因多态性的研究

目的：探讨中国人2型糖尿病患者载脂蛋白E（apoE)基因多态性及其与血脂和载脂蛋白水平的关系。方法：采用聚合酶链反应－限制性酶切片段长度多态性法，分别对74例2型糖尿病患者及191例血脂、血糖正常且无糖尿病史者的apoE基因型、空腹血脂及载脂蛋白AI、AⅡ、B100、CⅡ、CⅢ及E进行全面分析。结果：2型糖尿病患者的血清甘油三酯（TG）、总胆固醇（TC），低密度脂蛋白胆固醇（LDLC），非高密度脂蛋白胆固醇（nHDLC),载脂蛋白B100、CⅡ、CⅢ、E水平及TG／HDLC比值较对照组显著升高（P＜0．01）；血清高密度脂蛋白胆固醇（HDLC），apoE/apoCⅢ比值显著降低（P＜0．05）。2型糖尿病组与对照组apoE基因频率分布无显著性差异（P＞0．05）。携带ε2等位基因组血清TG／HDLC比值较E3／3基因型显著降低；而携带ε4等位基因组血清apoAⅡ水平较E3／3基因型及携带ε2等位基因组显著升高（P＜0．001）。结论：2型糖尿病患者apoE基因多态性与血TG／HDLC及apoAⅡ有一定关联。     

延边地区各种肝病患者HBsAg携带者及单项ALT增高者中抗-HCV分布

自1991年11月到1992年2月,用酶联免疫吸附试验对延边地区87例各种肝病患者.65例HBsAg携带者及5例单项ALT增高者血清共157份进行了抗-HCV检测.33例呈阳性,总阳性率为21.0％,其中单项ALT增高者高达80.O％.其次.急性肝炎为35.2％.慢性迁延性肝炎为18.2％.HBsAg携带者为6.2％,肝硬化为0％.     

Release of Proinflammatory Cytokines During Pediatric Cardiopulmonary Bypass: Heparin-Bonded Versus Nonbonded Oxygenators

Background. Heparin bonding of the cardiopulmonary bypass (CPB) circuit may be associated with a reduced inflammatory response and improved clinical outcome. The relative contribution of a heparin-bonded oxygenator (ie, >80% of circuit surface area) to these effects was assessed in a group of pediatric patients.

Methods. Twenty-one pediatric patients undergoing CPB operations were assigned randomly to receive either a heparin-bonded oxygenator (group H, n = 11) or a nonbonded oxygenator (group C, n = 10) in otherwise nonbonded circuits. The two groups were similar in pathology, age, weight, CPB time, and cross-clamp time. Plasma levels of the cytokines tumor necrosis factor-, interleukin-6, and interleukin-8, as well as terminal complement complex, neutrophils, and elastase, were analyzed before, during, and after CPB.

Results. Significant levels of tumor necrosis factor- were not detected in either group. Plasma levels of all other markers increased during and after CPB compared with baseline. Plasma levels of interleukin-6 peaked in both groups 2 hours after the administration of protamine but remained significantly higher in group C 24 hours after operation. Plasma concentrations of interleukin-8 peaked at similar levels in both groups 30 minutes after protamine administration and returned to baseline thereafter. Levels of terminal complement complex and elastase peaked in both groups 30 minutes after protamine administration. Plasma levels of terminal complement complex were significantly higher at the end of CPB and after protamine administration in group C. Elastase levels were significantly higher 2 and 24 hours after CPB in group C. The ventilation time of patients in group H was significantly lower than that of patients in group C: 10 (range, 3 to 24) versus 22 (range, 7 to 24) hours, respectively (p < 0.01).

Conclusions. The present study confirms the proinflammatory nature of pediatric operations and demonstrates a lessened systemic inflammatory response with the use of heparin-bonded oxygenators. This is achieved without bonding of the entire circuit, which could have significant cost-benefit implications by negating the need for custom-built heparin-bonded circuitry.     

Strength and fracture toughness of MgO-modified glass infiltrated alumina for CAD/CAM.

OBJECTIVE: This study was conducted to investigate the effect of MgO additive to Al2O3 on the flexural strength, fracture toughness of glass infiltrated alumina for CAD/CAM application. METHODS: Alumina blanks with additive of 0.5 wt% MgO were prepared via isostatic pressing and sintering at 1400 degrees C for 2h, and then alumina-glass composites were fabricated by infiltrating the molten glass into the partially sintered alumina compact. Flexural strength and fracture toughness were determined using three point bending methods and a single edge notched beam method. The mechanism of crack propagation was observed under a field emission scanning electron microscope. RESULTS: The three-point flexural strength and fracture toughness of partially sintered alumina and alumina-glass composite were 210 MPa, 1.86 MPam(1/2), and 432.2 MPa, 5.12 MPam(1/2), respectively, and they were free of shrinkage during the processing of glass infiltration. The field emission SEM micrograph indicated that indentation caused a non-planar crack propagation including crack deflection and crack bowing. SIGNIFICANCE: MgO was used as an additive to alumina to improve the strength and fracture toughness of partially sintered alumina and alumina-glass composite. The high strength and toughness are related to toughening by the distribution of alumina with uniform particle sizes, crack bowing, crack deflection and the beneficial wetting properties of the particle surface.     

少弱精子症与精浆附性腺标志物的相关性分析

目的分析少弱精子症患者精液参数与精浆附性腺标志物的相关性,探讨附性腺功能对男性生育力的影响。方法采用精液常规、精子形态、精浆附性腺标志物分析方法,检测正常供精者和门诊就诊的少弱精子症患者的精液相关指标。结果少弱精子症组正常形态精子百分数、精子穿透功能、精浆中性α-糖苷酶显著低于正常对照组。相关分析结果显示,少弱精子症患者组,精液量与精子活动率呈负相关(r=-0.415,P<0.05),精子数与形态呈正相关(r=0.393,P<0.05)。结论少弱精子症患者同时存在不同程度的附睾功能障碍,精子功能下降,精子畸形率显著升高,睾丸生精功能越低下,精子畸形发生率越高。     

牙胚组织中成釉蛋白表达免疫组织化学和原位杂交的特点

目的:观察人牙胚组织中成釉蛋白的表达特点。方法:实验于2002-02/04在解放军第四军医大学口腔内科实验室完成。取孕5个月流产男性胎儿(产妇知情同意),截取上、下颌骨,常规方法制备人牙胚组织石蜡切片。用兔抗人AMBN多克隆抗体,对人牙胚组织石蜡切片和正常狗牙周组织石蜡切片进行免疫组织化学染色。标记人成釉蛋白cDNA探针,对人牙胚组织石蜡切片进行原位杂交。结果:①免疫组织化学染色发现成釉蛋白由内釉上皮细胞在分化为成熟成釉细胞前开始表达,分泌期成釉细胞高度表达并持续整个釉质形成期,新形成的牙釉质染色阳性;成牙本质细胞在分泌牙本质基质之前开始表达成釉蛋白,在牙本质形成过程中成牙本质细胞持续表达成釉蛋白,呈弱阳性,前期牙本质中呈弱阳性染色;上皮根鞘细胞染色阳性。狗牙周组织染色发现牙骨质表层细胞呈强阳性染色,新形成的牙骨质中可见阳性染色颗粒,呈网状分布。②对人牙胚组织石蜡切片的原位杂交显示,成釉蛋白在成釉细胞、成牙本质细胞、上皮根鞘细胞中有表达,表达部位与免疫组织化学结果一致。结论:内釉上皮首先表达成釉蛋白,之后前成牙本质细胞达成釉蛋白。成釉细胞、成牙本质细胞、上皮根鞘细胞表达成釉蛋白。