同种异体骨髓移植后的中毒性表皮坏死松解症可能与超急性移植物抗宿主病有关

中毒性表皮坏死松解症(TEN)是一种严重的可危及生命的水疱性皮肤病,可发生于骨髓移植的患者。它可以是移植物抗宿主病(GVHD)的一种表现,也可由药物不良反应造成,需仔细鉴别。报告1例在骨髓移植后8天     

糖尿病并胆石症（附54例临床探讨）

糖尿病是临床常见的内分泌代谢性疾病,并发症较多,其中糖尿病并胆石症是常见并发症之一,比非糖尿病患者胆石症发病率明显升高。为进一步探讨糖尿病与胆石症的关系,本文对近2年我院住院及健康体检时发现的糖尿病患者154例,就其中合并阻石症的54例分析报道如下。     

胎儿Turner综合征合并囊性水瘤二例

例1 患者28岁,G1P0.孕16周时取静脉血2 mL,采用时间分辨免疫荧光法进行唐氏综合征筛查(试剂由美国PE公司提供),21-三体综合征风险概率1:60.B超发现胎儿颈部囊性水瘤.     

不同给药途径的腺苷预处理对大鼠缺血再灌注心肌的保护

Objective To evaluate the effect on myocardial protection of adenosine preconditioning in different route of administration through right jugular vein and left ventricle.Methods 48 SD rats were randomly divided into ischemia reperfusion group(blank control),ischemic preconditioning group(IP,positive control),adenosine venous infusion group,adenosine in ventricular group,normal saline(NS)venous infusion group(negative control I)and NS in ventricular group(negative control Ⅱ).The ischemia reperfusion rats model were established in vivo,and then changes of heart function,serum cardiac troponin T (cTnT),superoxide dismutase(SOD),malondialdehyde(MDA)and expression of nuclear factor KB(NF-kB) were observed.Results SOD in IP[(208.63±23.88)U/ml],adenosine venous infusion group [(178.27±11.56) U/ml]and adenosine in ventricular group[(191.31±28.14)U/ml]were significantly higher than that in the ischemia reperfusion group[(145.05±23.18)U/ml](P<0.05),cTnT,MDA and expression of NF-kB were lower than that in the ischemia reperfusion group (P<0.05).Heart function was significantly better than that in the ischemia reperfusion group(P<0.05);SOD in adenosine in ventricular group was significantly higher than that in adenosine venous infusion group(P<0.05).cTnT,MDA and expression of NF-kB were lower than that in adenosine venous infusion group (P<0.05).Conclusion Adenosine preconditioning may mimic protective effect of ischemic preconditioning. The effect on myocardial protection of adenosine in ventricular group was better than that of adenosine venous infusion group.     

GnRH拮抗剂在体外受精-胚胎移植中的应用

目的探讨促性腺激素释放激素（GnRH）拮抗剂方案在体外受精-胚胎移植（IVF—ET）促超排卵中的应用效果。方法回顾性比较分析本中心2006年8月～2007年8月接受ⅣF—ET助孕治疗的患者中采用GnRH拮抗剂方案的54例患者和采用GnRH激动剂长方案的135例患者，观察其临床效果。结果两组Gn用量、HCG日内膜厚度、受精率、卵裂率之间比较无显著性差异；两组患者Gn使用天数、HCG日E2值、获卵数、冷冻率、种植率、妊娠率、OHSS发生率之间比较有显著性差异。结论GnRH拮抗剂联合促性腺激素促超排卵方案缩短用药时间，减少费用，并可显著降低OHSS的发生率，但冷冻率、妊娠率较GnRH激动剂长方案偏低。     

不同给药途径的腺苷预处理对大鼠缺血再灌注心肌的保护

Objective To evaluate the effect on myocardial protection of adenosine preconditioning in different route of administration through right jugular vein and left ventricle.Methods 48 SD rats were randomly divided into ischemia reperfusion group(blank control),ischemic preconditioning group(IP,positive control),adenosine venous infusion group,adenosine in ventricular group,normal saline(NS)venous infusion group(negative control I)and NS in ventricular group(negative control Ⅱ).The ischemia reperfusion rats model were established in vivo,and then changes of heart function,serum cardiac troponin T (cTnT),superoxide dismutase(SOD),malondialdehyde(MDA)and expression of nuclear factor KB(NF-kB) were observed.Results SOD in IP[(208.63±23.88)U/ml],adenosine venous infusion group [(178.27±11.56) U/ml]and adenosine in ventricular group[(191.31±28.14)U/ml]were significantly higher than that in the ischemia reperfusion group[(145.05±23.18)U/ml](P<0.05),cTnT,MDA and expression of NF-kB were lower than that in the ischemia reperfusion group (P<0.05).Heart function was significantly better than that in the ischemia reperfusion group(P<0.05);SOD in adenosine in ventricular group was significantly higher than that in adenosine venous infusion group(P<0.05).cTnT,MDA and expression of NF-kB were lower than that in adenosine venous infusion group (P<0.05).Conclusion Adenosine preconditioning may mimic protective effect of ischemic preconditioning. The effect on myocardial protection of adenosine in ventricular group was better than that of adenosine venous infusion group.     

重症监护病房中呼吸机相关肺炎的病原学和耐药性特征

目的探讨重症监护病房（ICU）中呼吸机相关肺炎（VAP）的流行病学、病原菌分布、耐药性特征。方法对广州市3所三级甲等医院ICU发生VAP的53例患者进行前瞻性研究，对病原菌进行细菌鉴定和耐药性分析。结果VAP平均发病时间为机械通气后7．8d。97株病原菌中革兰阴性细菌58株（59．8％），革兰阳性细菌23株（23．7％），真菌16株（16．5％）。最常见病原菌分别为铜绿假单胞菌16株（16．5％），金黄色葡萄球菌13株（13．4％），嗜麦芽窄食单胞菌8株（8．2％），肺炎克雷伯菌8株（8．2％），白色念珠菌8株（8．2％）。耐甲氧西林金黄色葡萄球菌（MRSA）检出率为100．0％；未发现耐万古霉素金黄色葡萄球菌；VAP病原菌存在严重的多重耐药性。结论ICU中VAP的病原菌构成以革兰氏阴性杆菌为主且呈现多重耐药现象，适当的经验性抗菌治疗应以病原学和耐药性的监测结果为依据。     

不同给药途径的腺苷预处理对大鼠缺血再灌注心肌的保护

Objective To evaluate the effect on myocardial protection of adenosine preconditioning in different route of administration through right jugular vein and left ventricle.Methods 48 SD rats were randomly divided into ischemia reperfusion group(blank control),ischemic preconditioning group(IP,positive control),adenosine venous infusion group,adenosine in ventricular group,normal saline(NS)venous infusion group(negative control I)and NS in ventricular group(negative control Ⅱ).The ischemia reperfusion rats model were established in vivo,and then changes of heart function,serum cardiac troponin T (cTnT),superoxide dismutase(SOD),malondialdehyde(MDA)and expression of nuclear factor KB(NF-kB) were observed.Results SOD in IP[(208.63±23.88)U/ml],adenosine venous infusion group [(178.27±11.56) U/ml]and adenosine in ventricular group[(191.31±28.14)U/ml]were significantly higher than that in the ischemia reperfusion group[(145.05±23.18)U/ml](P<0.05),cTnT,MDA and expression of NF-kB were lower than that in the ischemia reperfusion group (P<0.05).Heart function was significantly better than that in the ischemia reperfusion group(P<0.05);SOD in adenosine in ventricular group was significantly higher than that in adenosine venous infusion group(P<0.05).cTnT,MDA and expression of NF-kB were lower than that in adenosine venous infusion group (P<0.05).Conclusion Adenosine preconditioning may mimic protective effect of ischemic preconditioning. The effect on myocardial protection of adenosine in ventricular group was better than that of adenosine venous infusion group.     

Phenotypic Knockout of HIV-1 Chemokine Coreceptor CXCR4 and CCR5 by Intrakines for Blocking HIV-1 Infection

To investigate the phenotypic knockout of HIV-1 chemokine coreceptor CXCR4 and CCR5 by intrakines and its inhibitory effect on HIV-1 infection. Primary human PBLs were transduced with the recombinant vector pLNCX-R-K-S-K(△NGFR), followed by anti-NGFR/anti-IgG-magnetic bead method selection and FCM detection. The transduced PBLs were infected with DP1 HIV-1 virus thereafter envelope-mediated syncytium formation and p24 detection were carried out to study the blockage of HIV-1 infection by co-inactivation of CCR5 and CXCR4. pLNCX-R-K-S-K (△NGFR)-transduced PBILs were isolated with an anti-NGFR/anti-IgG-magnetic bead method. After isolation, about 70% of the PBLs were positive for the NGFR marker. When the transduced PBLs were infected with DP1 HIV-1 virus, envelop-mediated syncytium formation was almost completely inhibited by pLNCX-R-K-S-K(△NGFR) transfection. Also, p24 antigen was very low in the cultures of pLNCX-R-K-S-K (△NGFR) transduced PBLs. pLNCX-R-K-S-K(△NGFR) transduction inhibited the production of DP1 p24 antigen by 15%, 43% and 19% on days 4, 7 and 10 respectively. The lymphocytes with the phenotypic knockout of CCR5 and CXCR4 could protect primary human PBLs from DP1 HIV-1 virus infection.     

网络成瘾和睡眠时长在青少年受校园欺凌与抑郁间的链式中介作用

目的 探索青少年网络成瘾和睡眠时长在受校园欺凌与抑郁关系之间的中介作用,为青少年抑郁的预防干预提供依据。 方法 使用青少年健康相关危险行为问卷及CES - D抑郁量表,采用多阶段整群抽样法抽取徐州市4 190名青少年进行问卷调查。结果 在控制人口学等变量后,受校园欺凌、网络成瘾、睡眠时长对抑郁均有预测作用（r = 0.283,P＜0.01;r = 0.331,P＜0.01;r = - 0.184,P＜0.01）。路径分析表明,网络成瘾在受校园欺凌和青少年抑郁之间起中介作用;网络成瘾和睡眠时长在受校园欺凌和青少年抑郁间起链式中介作用。结论 受校园欺凌不仅直接影响青少年抑郁,还通过网络成瘾和睡眠时长的链式中介作用间接影响青少年抑郁。可通过减少青少年网络使用和提高睡眠时长来降低受校园欺凌对青少年抑郁的影响。