从脂毒及毒损肾络探讨糖尿病肾病病理机制简

脂代谢紊乱对糖尿病并发症的发生有重要影响。根据中医理论特点,脂毒可以归为＂毒＂邪概念。该文试着从脂毒及毒损肾络角度出发,探讨糖尿病肾病的发病机制,旨在为临床治疗糖尿病肾病提供新的思路和方法。     

IGF-I对子宫切除所致大鼠卵巢颗粒细胞凋亡的抑制作用

目的 探讨IGF-I对子宫切除所致大鼠卵巢颗粒细胞凋亡的抑制作用。方法 采用子宫切除术方法建立子宫切除Sprague-Dawley大鼠模型(保留卵巢)。向体外培养的子宫切除大鼠卵巢颗粒细胞施加60ng刖浓度外源性IGF-I。应用流式细胞仪检测细胞凋亡率。应用荧光显微镜观察细胞凋亡形态学特征。结果 模型组(子宫切除)较正常组(子宫未切除)凋亡增加;IGF-I组(子宫切除 IGF-I)能减缓子宫切除引起的凋亡升高。结论 外源性IGF-I抑制子宫切除大鼠卵巢颗粒细胞凋亡。     

茅台酒与乙醇影响二乙基亚硝胺引发小鼠肝细胞癌的比较

目的：观察茅台酒与乙醇在协同二乙基亚硝胺（DEN）引发小鼠肝细胞癌（HCC）的差异。方法：74只雄性C57BL／6J小鼠随机分为正常对照组、茅台酒组、乙醇组、DEN组、茅台酒干预组及乙醇干预组,实验35周末检测各组小鼠血清谷氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）与肝组织匀浆中丙二醛（MDA）水平,观察肝组织病理学变化和HCC相关磷脂酰肌醇蛋白聚糖3（GPC3）表达。结果：肝功能检测发现,茅台酒干预组与正常对照组比较,ALT和MDA差异无统计学意义（P〉0．05）,而AST高于正常对照组,差异有统计学意义（P〈0．05）;乙醇干预组ALT、AST与ADM高于正常对照组、茅台酒组、乙醇组、DEN组、茅台酒干预组,均P〈0．05;病理组织学检查发现乙醇干预组小鼠肝纤维化程度和GPC3表达明显高于其他各组,P〈0．05。茅台干预组肝脏细胞学检查未见癌前病变及HCC,仅在汇管区有少量PGC3表达。结论：乙醇可以协同DEN诱发小鼠HCC,茅台酒没有这种协同作用。     

急性心肌梗死伴右束支传导阻滞的临床意义

目的探讨急性心肌梗死(AMI)患者伴发右束支传导阻滞(RBBB)的临床意义及预后。方法将我院近5年来收治的AMI患者共240例分为AMI伴RBBB组和不伴RBBB组。根据RBBB发生的时间、持续间期以及是否合并左束支分支阻滞将前者分为新发生RBBB、陈旧性RBBB、持续性RBBB、短暂性RBBB、双束支阻滞和单纯性RBBB 6个亚组,观察各组的临床经过和住院病死率。结果240例AMI伴发RBBB 26例,占10.8% ,与不伴RBBB比较,其磷酸肌酸激酶(CK)峰值、恶性室性心律失常发生率、心功能不全发生率、住院病死率均显著增高(P < 0.01)。RBBB组高发的心功能不全发生率和住院病死率并非源自陈旧性RBBB和单纯性RBBB,而是来源于新发生RBBB和双束支阻滞。新发生的持续性RBBB住院病死率最高,为50%, 短暂性RBBB为11.1% , 而持续性RBBB的再灌注治疗率较短暂性RBBB明显降低(25% vs 88.9%, P < 0.05)。结论AMI患者伴发RBBB提示预后不良。再灌注治疗可改善预后。     

实验性颅内压增高对垂体－靶腺轴激素的影响

雄性麻醉犬９只，硬脑膜外置套囊注盐水，阶梯升高７只犬的颅内压（ＩＣＰ）至６．７，１３．３和２０．０ｋＰ３，观察每次升高ＩＣＰ稳定１０ｍｉｎ后的血液动力学和垂体－靶腺轴激素及其组织结构的变化．结果表明随着ＩＣＰ的阶梯性增高，血压也升高，心输出量增加，心率减慢；但当ＩＣＰ升至２０ｋＰａ，心率反而变快，颅内灌注压明显降低．ＩＣＰ升至各阶梯水平，Ｔ３均降低，皮质醇增高显著（Ｐ＜０．０５），Ｔ４和ＬＨ基本不变，ＴＳＨ均＜１　μｇ／Ｌ．光镜观察脑垂体、甲状腺和肾上腺结构基本正常．     

Clinical value of acanthocyturia in differential diagnosis of diabetic nephropathy and nondiabetic renal disease

目的 探讨棘形红细胞尿对糖尿病肾病(DN)与非糖尿病肾病(NDRD)鉴别诊断的临床意义以期指导临床.方法 对在我科及肾内科住院诊治的22例合并有血尿的DN患者与33例合并有血尿的NDRD患者的尿棘形红细胞进行相差显微镜观察计数,并进行对比研究;所有病例均行肾穿刺活检术提供病理学依据.结果 NDRD组及DN组的棘形红细胞尿的检出率分别为:69.5%和4.5%,两者相比具有统计学意义.结论 合并血尿的DM患者出现肾功能损害时,若发现棘形红细胞尿则考虑可能合并NDRD,需要尽快行肾穿刺活检术以明确其病理类型,以便指导临床治疗.     

表观遗传学在无创性产前诊断中的应用进展

孕妇血浆中胎儿表观遗传学标志物可作为一个定性标志物用于检查实验结果是否存在假阴性的指标,也可作为一个定量标志,用于筛查妊娠相关性疾病;其中的染色体特异性标记物,可用于胎儿三倍体的检测。目前已有较多胎儿表观遗传学标志被发现,部分已用于临床相关疾病的筛查。但孕妇血浆中胎儿表观遗传学标志物的广泛应用,仍需要大量的临床试验来验证。作者拟就表观遗传学在无创性产前诊断中的应用进展,综述如下。     

Expression of core?binding factor alpha 1 and collagen Ⅱ in patients with chronic kidney disease stage 5

Objective To study the relationship between the medial artery calcification and expression of core?binding factor alpha 1 (Cbfα?1) and collagen Ⅱ (ColⅡ) in chronic kidney disease(CKD) stage 5 patients. Methods Pieces of radial arteries were taken from 40 patients with CKD stage 5 during internal arteriovenous fistula operation. Ten patients with subtotal gastrectomy and normal renal function were chosen as control. The vessels were examined for calcification by von Kossa stain and for the presence of Cbfα?1 and ColⅡ by immunohistochemistry. According to von Kossa stain, CKD stage 5 patients were divided into no calcification group, mild?moderate calcification group and severe calcification group. Other related factors including serum calcium,phosphate, intact parathyroid hormone (iPTH), C?reactive protein (CRP), triglyceride(TG), cholesterol(TC) and low?density lipoproteins(LDL) were also detected. Results Seventeen (42.5%) of CKD Stage 5 patients showed vascular calcification, while calcification was not found in controls. Most calcification occurred in medial layer．Positive immunohistochemical staining of core?binding factor and ColⅡ was found in the smooth muscular cell plasma of medial layer in the vessels with calcification. However, above positive staining was also observed in 78.3% of no calcification group. But there was little staining in control group. Positive staining score of Cbfα?1 and ColⅡ in severe calcification group was significantly higher than that in no calcification group. Same findings were obtained in mild?moderate calcification group, but the difference between them was not statistically significant. CRP and Ca×P were positively correlated with staining score of Cbfα?1 and ColⅡ. Serum phosphate was positively correlated with Cbfα?1 (r=0.786, P<0.01) and ColⅡ (r=0.785, P<0.01) respectively． Conclusions 42.5% of CKD stage 5 patients in our group shows vascular calcification, which occurrs mainly in medial layer. High expression of Cbfα?1 and ColⅡ can be observed in vascular calcification of radial arteries, which is earlier than vascular histological changes. Cbfα?1 and ColⅡ may be involved in the development of vascular calcification.     

RasDL与IRAS远程访问系统对比分析

针对大连医科大学图书馆安装试用的两种远程访问系统(RasDL和IRAS),以调查问卷及网络问答等途径收集反馈信息,从用户反馈和管理员管理两个方面对两种访问系统进行比较分析,希望能对高校图书馆开展远程访问服务提供一定参考。     

蛇莓和马鞭草在跟骨骨折术后感染中的应用研究

目的 探讨蛇莓和马鞭草在跟骨骨折术后感染中的应用价值.方法 选取2018年6月至2020年9月在本院住院治疗的跟骨骨折术后感染患者60例,根据不同的治疗方式分为实验组和对照组,各30例.实验组患者伤口分泌物标本进行培养、分离和传代,对常见的感染菌株进行流行病学分析.将蛇莓和马鞭草的提取物用不同的比例进行分装并进行浓度递...