影响急诊满意度因素分析

目的了解急诊患者满意度的影响因素.方法通过问卷方式对急诊患者满意度进行调查,并予统计描述及回归分析,建立数学模型.结果满意度与患者是否再就诊、医务人员是否告诉患者等待时间、是否给予帮助、是否告诉返回复诊时间、是否对疾病已经解释清楚、是否解释化验结果、是否告诉正常生活时间等有相关性.结论患者满意度与多个因素有关,急诊医护人员应加强服务方式的培训.     

分光检影装置和初试报告

目的设计研制半反半透镜分光式动态检影装置,用此装置检测眼调节状态.方法改良旧式的注视和检影同方向检影法为两者成90°角的检影法,使动态检影法的适应性明显扩大.结果更为准确.并利用此装置对一个小样本双眼视的眼调节状态进了检测,包括双眼注视阅读视力表和观看三维彩色体视图.结果双眼视的实际调节平面远于目标平面,彩色体视图有较大深度感.结论分光式动态检影法比普通动态检影法对于双眼视调节的测定具有特殊意义.     

Effects of di-(2-ethylhexyl)-phthalate (DEHP) and its metabolites on fatty acid homeostasis regulating proteins in rat placental HRP-1 trophoblast cells.

Di-(2-ethylhexyl)-phthalate (DEHP) is a widely used plasticizer and ubiquitous environmental contaminant. The potential health hazards, including teratogenicity, from exposure to DEHP may be related to the role of DEHP or its metabolites in the trans-activation of peroxisome proliferator-activated receptors (PPARs). Fetal essential fatty acid (EFA) homeostasis is controlled by directional transfer across the placenta through a highly regulated process, including PPAR activation. Using HRP-1 rat trophoblastic cells, the effects of DEHP and two of its metabolites, mono-(2-ethylhexyl)-phthalate (MEHP) and 2-ethylhexanoic acid (EHA), on the mRNA and protein expression of the three known PPAR isoforms (alpha, beta, and gamma), fatty acid transport protein 1 (FATP1), plasma membrane fatty acid binding protein (FABPpm), and the heart cytoplasmic fatty acid binding protein (HFABP) were investigated. This study also investigated the functional effects of exposure on the uptake and transport of six long chain fatty acids (LCFAs): arachidonic acid (AA), docosahexaenoic acid (DHA), linoleic acid (LA), alpha-linolenic acid (ALA), oleic acid (OA), and stearic acid (SA). In the presence of DEHP, MEHP, and EHA, the expression of PPARalpha, PPARgamma, FATP1, and HFABP were up-regulated in a dose- and time- dependent manner, while PPARbeta and FABPpm demonstrated variable expression. The uptake rates of EFAs (AA, DHA, LA, ALA) increased significantly upon exposure, and the transport of AA (omega-6) and DHA (omega-3) were directionally induced. These results suggest that DEHP, MEHP, and EHA can influence EFA transfer across HRP-1 cells, implying that these compounds may alter placental EFA homeostasis and potentially result in abnormal fetal development.     

Foreign metallothionein-I expression by transient transfection in MT-I and MT-II null astrocytes confers increased protection against acute methylmercury cytotoxicity

The mechanisms associated with metallothionein (MT) gene regulation are complex and poorly understood. Only a modest increase in brain MT expression levels is attained by exposure to metals, MT gene transfection, and MT gene knock-in techniques. Accordingly, in the present study, MT null astrocytes isolated from transgenic mice deficient in MT-I and MT-II genes were introduced as a zero background model of MT expression. MT protein levels were determined by western blot analysis. MT proteins in MT-I and MT-II null astrocytes were undetectable. Transient MT-I gene transfection increased the levels of foreign MT expression in MT-I and MT-II null astrocytes by 2.3-fold above basal levels in wild-type astrocytes. Intracellular Na(2)51CrO(4) efflux and D-[2,3-3H]aspartate uptake were studied as indices of acute methylmercury (MeHg) (5 microM) cytotoxicity. In MT-I and MT-II knockout astrocytes MeHg led to significant (p<0.01) increase in Na(2)51CrO(4) efflux and a significant (p<0.05) decrease in the initial rate (1 min) of D-[2, 3-3H]aspartate uptake compared to MT-I and MT-II knockout controls. Transfection of the MT-I gene in MT-I and MT-II null mice significantly (p<0.01) decreased the effect of MeHg on Na(2)51CrO(4) efflux in MT null, as well as wild-type astrocytes. MT-I gene transfection in MT-I and MT-II null astrocytes reversed the inhibitory effect of MeHg on D-[2,3-3H]aspartate uptake, such that initial rates of uptake in MT-I transfected cells in the presence and absence of MeHg (5 microM) were indistinguishable. These results demonstrate that: (1) astrocytes lacking MTs are more sensitive to MeHg than those with basal MT protein levels, (2) the MT-I gene can be overexpressed in MT-I and MT-II null astrocytes by transient MT-I gene transfection, and (3) that foreign MT expression endows astrocytes with increased resistance to MeHg.     

Adenosine release upon spinal cord injury

The hypothesis that release of adenosine following spinal cord injury (SCI) may provide neuroprotective feedback is explored. Consistent with this hypothesis, substantial release of adenosine, estimated to reach 100 microM in the extracellular space, was detected by microdialysis sampling immediately following contusion SCI. There is also considerable release of excitatory amino acids following SCI. The latter was not affected by administration of the general adenosine receptor antagonist theophylline and the A1 antagonist 8-cyclopentyl-1,3-dipropylxanthine, implying that the adenosine released following SCI does not significantly influence the release of neurotoxic amino acids. Administration of the concentration of glutamate released upon SCI into the spinal cord caused only about 1% as much release of adenosine as did injury, evidence that elevated excitatory amino acids do not elicit an appreciable fraction of the release of adenosine that follows SCI. Results obtained suggest that release of endogenous adenosine is not neuroprotective by blocking release of excitatory amino acids following SCI.     

Marked enhancement of anti-allodynic effect by combined intrathecal administration of the adenosine A1-receptor agonist R-phenylisopropyladenosine and morphine in a rat model of central pain

BACKGROUND: There is often no satisfactory treatment for chronic pain after spinal cord injury. We have previously reported that intrathecal (i.t.) administration of the adenosine A1-receptor agonist R-phenylisopropyl-adenosine (R-PIA) or the opioid morphine has anti-allodynic effects in a model of presumed chronic central pain after photochemically induced spinal cord injury in rats. In the present study, we set out to investigate the possible interaction between i.t. R-PIA and morphine in spinally injured rats. METHODS: Sprague-Dawley rats displaying allodynia-like behaviors to mechanical and cold stimuli after photochemically induced spinal cord injury with minor motor deficits were used. R-PIA and morphine, either alone or in combination, were administered i.t. through an implanted catheter to lumbar spinal cord. RESULTS: Cumulative doses of R-PIA or morphine dose-dependently reduced the mechanical allodynia-like behavior, with a threshold of 1 nmol and 1.5 nmol, respectively. When co-administrated, R-PIA and morphine produced marked suppression of mechanical allodynia at doses of 5 pmol and 7.5 pmol, respectively. The effect of i.t. co-administration of R-PIA and morphine on cold allodynia was comparable to i.t. R-PIA alone. The combination of R-PIA and morphine did not increase adverse effects such as motor deficits in comparison to either drug alone. CONCLUSION: These results demonstrate a supra-additive interaction between the adenosine A1-receptor agonist R-PIA and morphine to reduce mechanical allodynia-like behavior in rats with chronic spinal cord injury. The combination of R-PIA and morphine administered spinally may be superior to R-PIA or morphine alone for treating such pain.     

The effects of ropivacaine on sodium currents in dorsal horn neurons of neonatal rats

We used a whole cell patch clamp technique to study the effects of ropivacaine on rat dorsal horn neurons. Under voltage clamp, ropivacaine (10-400 microM) produced a dose-dependent inhibition of sodium current. From a holding potential (V(h)) of -80 mV, sodium currents evoked by test pulses to 0 mV were inhibited by ropivacaine with a mean drug concentration required to produce 50% current inhibition (IC(50)) value of 117.3 microM, which was more than the value of the bupivacaine (IC(50) 53.7 microM). The inhibition effect of ropivacaine was also voltage-dependent. Current evoked from a V(h) of -60 mV was inhibited by ropivacaine with a mean IC(50) value of 74.3 microM, which was less than that obtained at the V(h) of -80 mV. The inhibition effect of ropivacaine on sodium current was use dependent. Repeated activation by a train of depolarizing pulses (5 Hz, 20 ms) increased the inhibitory effects of ropivacaine. The ratio amplitudes of the 20th to the first pulse were 91.2% and 71.1%, respectively, in the absence and presence of ropivacaine (50 microM). Ropivacaine also produced a significant hyperpolarizing shift of 11 mV in the steady-state inactivation curve of sodium current. The inhibition of ropivacaine on the sodium channel may contribute to the mechanism of action of local anesthetics during epidural and spinal anesthesia.     

水中嗜肺军团菌分布规律研究

目的　探讨水环境中嗜肺军团菌分布规律及分型特征。方法　采集自然环境及生活环境中各主要水体样品 ,浓缩后经常规细菌培养后的疑似菌株 ,用血清学鉴定与 1 6SrRNA半套式PCR技术双重鉴定进行军团菌和嗜肺军团菌的分型。结果　全部 1 2 6个监测点水样有 2 8个出现军团菌阳性 (其中嗜肺军团菌 2 1个 ) ;自然环境及生活环境监测点军团菌阳性率分别为 32 1 %、2 2 2 % (其中嗜肺军团菌阳性率分别为2 1 4 %、1 6 7% ) ;全年 4 30份水样有 36份军团菌阳性 (其中 2 3份为嗜肺军团菌 ) ,夏、秋季检出率较高 ,春、冬季也有检出 ;空调冷却塔水、淋浴喷头水、公园湖水检出率较高。结论　嗜肺军团菌在自然环境及生活环境各水体中分布广泛。环境温度是军团菌污染的重要因素 ,夏、秋季是军团菌污染和军团病传播的高发季节 ,春、冬季也可发生。公园娱乐水体、空调冷却水、淋浴喷头水等与人群密切接触水体是军团菌污染和军团病传播的高危水体。应尽快采取预防与控制措施以保护广大人群身体健康     

镉诱导LLC-PK_1细胞凋亡与bcl-2、p53蛋白表达关系的研究

目的　探讨镉诱导LLC PK1 细胞凋亡及与bcl 2、p5 3(mtp5 3)蛋白表达的相互关系。方法　采用透射电镜观察凋亡小体、流式细胞仪分析凋亡率、琼脂糖凝胶DNA电泳方法确定镉对LLC PK1 细胞诱导的凋亡作用 ,以及流式细胞仪分别测定bcl 2和p5 3基因表达产物bcl 2蛋白、mtp5 3蛋白。结果　透射电镜观察发现 4 0 μmol LCdCl2 作用LLC PK1 细胞 12h后 ,出现典型的凋亡小体 ;流式细胞仪分析其凋亡率为 32 6 1% ,并高于对照组 (1 0 8% ) (P <0 0 1) ;琼脂糖凝胶DNA电泳呈明显梯形条带。 0、10、2 0、4 0 μmol LCdCl2 作用LLC PK1 细胞 4h、8h ,8h后 ,bcl 2基因表达逐渐下降 ,并呈良好的剂量 -反应关系 (r=- 0 910 ,P <0 0 5 ) ;作用 4h、8h后mtp5 3蛋白表达均明显下降 ,并有剂量 -反应关系 (r值分别为 - 0 716、- 0 972 ,P值均 <0 0 5 )。结论　镉诱导LLC PK1 细胞凋亡可能与镉抑制bcl 2、mtp5 3蛋白表达有关     

氯沙坦和非洛地平治疗中老年高血压合并高尿酸血症的疗效观察

[目的 ]　比较氯沙坦和非洛地平对中老年高血压合并高尿酸血症的疗效。　 [方法 ]　 60例中老年高血压合并高尿酸血症患者随机分成两组 ,分别服用氯沙坦 (氯沙坦组 ,n =3 0例 )和非洛地平 (非洛地平组 ,n =3 0例 ) ,分别测定两组患者治疗前后的血压、2 4h动态血压、血尿酸、空服血糖、血脂和肝肾功能。　 [结果 ]　氯沙坦和非洛地平均有明显的降压效果 (P <0 .0 1) ,两组的降压效果相似 (P <0 .0 5 ) ,但氯沙坦降低血尿酸的效果优于非洛地平 (P <0 .0 0 1) ,对血糖、肝肾功能、血脂均无明显作用 ,未发生明显不良反应。　 [结论 ]　氯沙坦治疗中老年高血压安全、有效 ,与非洛地平相似 ,并且有降低高血尿酸作用