Brevibacterium sp.DGCDC-82发酵罐中生产胆固醇氧化酶

用Brevibacterium sp.DGCDC-82在7L发酵罐中分批培养.分别对添加剂吐温-80、培养温度、培养基的pH、通风量和搅拌速度在胆固醇氧化酶的生产中的影响进行了研究.结果显示以上条件均对产酶有影响.在不同的发酵阶段改变发酵操作条件,发酵20 h最高酶活可达1203U/L,生产强度可达60 U/(L·h).既有效地提高了胆固醇氧化酶的产量,又防止了发酵过程中的泡沫外溢.     

踝部开放性骨折的急症手术治疗

目的探讨踝部开放性骨折的损伤特点及相关的急症手术技术特点。方法2001年8月至2006年4月，急症手术治疗踝部开放性骨折51例，男39例，女12例；年龄18-72岁，平均36岁。伤口Gustilo分度，Ⅰ度3例，Ⅱ度37例，ⅢA度7例，ⅢB度3例，ⅢC度1例。急诊给予有效抗生素治疗，尽早开始手术。冲洗及彻底清创后，根据骨折类型、粉碎程度及伤口情况制定骨折处理的顺序，依次完成骨折复位、固定。结果48例患者获得随访，随访时间8-48个月，平均26个月。无一例发生深部感染。12例伤口发生浅表皮缘坏死，2例伤口延迟愈合，2例伤口发生浅表感染。踝部骨折在10-18周（平均13周）愈合。采用AOFAS踝后足功能评分标准，48例评分在76-100分，平均90分。结论踝部开放性骨折在急症手术时应彻底清创，注意保护皮肤活力。在处理后踝骨折时，可采用胫骨远端脱出法。多数手术应先精确复位、固定外踝骨折，对旋后内收型、外踝严重粉碎的踝部骨折应先进行内踝骨折的复位、固定。对严重的下胫腓联合分离，应直视下复位且常规使用下胫腓螺钉固定。     

高渗盐水与甘露醇对颅脑手术患者脑氧代谢的影响

目的 比较3％高渗盐水（HTS）与20％甘露醇对颅脑手术患者脑氧代谢的影响。方法 择期大脑半球胶质瘤切除术患者40例，ASAⅠ级或Ⅱ级，随机分为2组（n=20）：3％HTS组（HTS组）和20％甘露醇组（M组）。采用静吸复合麻醉，呼气末异氟醚浓度为1 MAC、血液动力学稳定15．min后，分别于15 min内静脉输注3％HTS 5．35 ml／kg或20％，甘露醇1 g／kg。L3，4珠网膜下腔置管测脑脊液压力（CSFP），行右颈静脉球穿刺置管、采血，测定颈静脉球氧饱和度。分别于输注前（T0）、输注完即刻（T1）、输注完15min（T2）、30min（T3）、60min（T4）、120min（T5）监测CSFP;于T0、T3-T5时监测平均动脉压，采集颈静脉球部和桡动脉血，进行血气分析，计算动脉-静脉氧含量差（Da-jvO2）、脑氧摄取率（CERO2）。结果 与T0比较，2组CSFP在T2-T5时降低，Da-jvO2和CERO2在T4，5时降低（P〈0．05）;与M组比较，HTS组CSFP在T2时降低（P〈0．05）。结论 3％HTS与20%甘露醇均可有效地降低颅内压，改善颅脑手术患者的脑氧代谢。     

医疗器械包装设计浅谈

本文介绍了医疗器械之无菌包装系统的设计之关键要素和要求,介绍了目前流行的灭菌方式以及对无菌包装系统的要求和影响。本文最后还列举了常见的医疗器械包装系统。     

成牙本质细胞中上游刺激因子1对骨桥素表达调控的研究

目的检测成牙本质细胞中上游刺激因子1（upstream stimulatory factor 1，USF1）对骨桥素表达的影响。方法培养成牙本质细胞MDPC-23，稳定转染PCMV-USF1和酸性-USF（A-USF）质粒，提取总RNA，半定量反转录聚合酶链反应检测骨桥素的表达水平，并对结果进行统计学分析。结果筛选出稳定转染USF1和A-USF的抗性克隆，USF1、A-USF转染组和对照组骨桥素相对灰度比值分别为：60．33％±4．51％、229．33％±7．09％、110．00％±15．62％，转染组与对照组差异有统计学意义（P〈0．01）。结论USF1可调控成牙本质细胞骨桥素mRNA转录，该作用被A-USF部分阻断。     

大鼠神经系统发育过程中神经元特异性烯醇酶的出现和意义

用自行提纯的人脑和牛脑神经元特异性烯醇酶(NSE)分别免疫家兔,制备兔抗人和抗牛NSE血清(抗NSEh和抗NSEb)。以PAP免疫组织化学染色,系统观察3O只发育出SD大鼠的脑、脊髓与脊神经节。发现NSE最先出现于胚胎15d的脊神经节神经元,随后相继出现于三叉神经节、脊髓、嗅皮质、海马、扣带回和外侧皮质神经元。表明NSE先后出现于周围神经和中枢神经系统,由脊髓向大脑、原始皮质及新皮质发展的顺序,与神经系统发育过程中的头向发展规律相一致。     

脐带夹对防止脐部感染和出血的临床与实验研究

目的应用国产脐带夹用于农村山区破伤风高发区，并经离体试验验证其可靠性。方法经湖南、江西、广西等省基层接生员临床应用、并与当地同期或前一年未用夹者进行对照；同时经离体脐带用脐带夹、气门芯或纱线结扎阻断血管后进行金黄色葡萄球菌和破伤风毒素通透试验以及测试承受气压程度试验。结果1年临床使用2296例中，无1例发生破伤风和败血症。可靠性试验结果证明，粗纱线结扎最差，气门芯虽优于前者，但不如脐带夹。结论该脐带夹由于夹持力持久有力，细菌、毒素难以通过、安全可靠，因此能降低新生儿“病从脐入”的发病率和死亡率，有利干优生优育的贯彻．这是一项花费少、收效大的简而易行的适宜技术，值得推广。     

Prostaglandin D2 measurement in nasal secretions is not a reliable marker for mast cell activation in atopic patients

Background Prosia gland in D2 (PGD2) is a very important mast cell product during the early-phase nasal allergic reaction. However, the quantification of PGD2 in nasal secretions has not yet been well established. Objective Quantitative determination of PGD2 in nasal secretions of atopic patients (n=17) after nasal allergen challenge (NAC) and in non-allergic healthy volunteers (n=10). Methods The nasal microsuction sampling technique was used to obtain the nasal secretions with an exactly known and minimally diluted volume. A sensitive and specific enzyme immunoassay was chosen to measure the more stable 11-methoxime derivative of PGD2. which was obtained after extraction in acelone/ethanol and conversion using methoxamine-HCl. The concentrations of PGD2 in nasal secretions obtained from 10 non-allergic healthy volunteers were used as reference values. Results There was no significant difference in the concentrations of PGD2 between men (median: 569pg/mL) and women (median: 407pg/mL), nor between the baseline concentrations from atopic patients (median: 410pg/mL) and non-allergic controls (median: 477 pg/mL). In the atopic patient group, PGD2 did not significantly increase during the entire sampling period after NAC. The absence of PGD2 response contrasted with the nasal symptoms manifested by sneezing, increased nasal airway resistance, and the significant increases of the concentrations of histamine, tryptase, and leukotriene C4 (LTC4) 5min after NAC. Conclusion This observation suggests that the measurement of PGD2 alone in the nasal secretions does not give reliable information on mast cell activation during a nasal allergic reaction.     

Changes of hepatic and systemic haemodynamics following somatostatin administration in patients with hepatitis B-related cirrhosis

Abstract Somatostatin has been used to effectively control acute variceal haemorrhage, with conjectured mechanisms on portal hypertension. We, therefore, evaluated the effects of somatostatin on hepatic and systemic haemodynamics in 15 patients with hepatitis B-related cirrhosis and portal hypertension. All patients received an intravenous, continuous infusion of somatostatin 250 μg/h, following a bolus injection of 250 μg. In systemic haemodynamics, the mean arterial pressure (MAP) increased ( P < 0.05), associated with a reflex bradycardia within 3 min following bolus injections, compared with basal values. The right atrial pressure, pulmonary capillary wedge pressure, inferior vena cava pressure, cardiac index, and systemic vascular resistance remained unaffected after drug infusion. In hepatic haemodynamics, the wedge hepatic vein pressure remained unchanged after drug administration. However, there was an increase in free hepatic vein pressure (FHVP; P < 0.05), and a trend toward a decrease in the hepatic vein pressure gradient (HVPG; P = 0.063), within 3 min after bolus injection. Furthermore, the hepatic blood flow decreased significantly at 10 and 30 min after somatostatin infusion ( P < 0.05). The effective sinusoidal perfusion assessed by indocyanine green infusion also decreased progressively at 10 min ( P = 0.057) and 30 min ( P < 0.05). We concluded that somatostatin, at the dose used in this study, caused a transient and bolus-related vasoconstrictive effect, resulting in increases in MAP and FHVP, a decrease in heart rate, and a trend toward lower HVPG. In addition, somatostatin reduced the hepatic blood flow and effective sinusoidal perfusion which may be hazardous to cirrhotic patients during variceal haemorrhage.