G3PD的修饰蛋白对庆大霉素所致急性肾功能衰竭大鼠的保护作用

目的 :观察 3 磷酸甘油醛脱氢酶 (G3PD)的修饰蛋白 (modifierprotein ,MP)对庆大霉素所致急性肾功能衰竭 (acuterenalfailure ,ARF)大鼠的保护作用。方法 :利用庆大霉素致ARF的动物模型 ,将大鼠随机分成正常对照组、模型组和MP组 ,在实验第 7天和第 14天 ,分别测定各组血清及肾皮质匀浆丙二醛 (malondialdehyde ,MDA)和超氧化物歧化酶 (superoxidedismutase ,SOD) ,光镜、电镜观察肾组织学改变 ,免疫组化染色标记细胞间粘附分子 1(in tercellularadhesionmolecule 1,ICAM 1) ,同时测定血肌酐 (serumcreatine ,SCr)。结果 :MP组血清及肾皮质匀浆MDA明显下降 ,SOD明显上升 (P<0 .0 1) ;光镜、电镜示MP组肾脏病理比模型组减轻 ,同时SCr下降 (P<0 .0 1) ;免疫组化显示MP组ICAM 1表达下调 ,灰度值升高 ,与模型组相比差异非常显著 (P <0 .0 1)。结论 :MP可以缓解氧自由基损伤 ,降低ICAM 1表达 ,减少炎性细胞浸润 ,减轻ARF大鼠肾脏病理状况 ,改善肾功能     

胶原性关节炎大鼠滑膜组织细胞因子基质金属蛋白酶3和组织金属蛋白酶抑制剂1表达的变化

目的:观察Ⅱ型胶原诱导的实验性关节炎动物模型组织细胞因子基质金属蛋白酶3和组织金属蛋白酶抑制剂1表达的变化,探讨基质金属蛋白酶3和组织金属蛋白酶抑制剂1在类风湿关节炎发病机制中的作用。方法:实验于2005-09/2006-11在白求恩国际和平医院中心实验室完成。①实验分组:健康雄性Wistar大鼠60只,体质量(100±20)g,随机选出50只以备造模,另外10只作为对照组。在造模成功的大鼠中再随机选出10只作为模型组。②实验方法:采用10mg牛Ⅱ型胶原与100mg弗氏不完全佐剂和60mg卡介苗充分研磨后,以每支每点0.1～0.2mL(1g/L)从大鼠背部尾根部多点皮下注射,于10d后按上述方法和剂量再次重复免疫和制作大鼠胶原性关节炎模型。③实验评估:初次免疫后7周,剥离膝关节滑膜,进行苏木精-伊红染色光镜下观察;切除另侧膝关节滑膜,免疫组织化学染色后,用Metamorph图像分析系统进行检测,计算每个视野基质金属蛋白酶3和组织金属蛋白酶抑制剂1的阳性面积比,以其作为阳性反应细胞密度。结果:纳入大鼠60只,20只进入结果分析。模型组大鼠关节组织中的基质金属蛋白酶3阳性密度为0.75±0.19,明显高于对照组,差异有显著性意义(P<0.01);组织金属蛋白酶抑制剂1的表达阳性密度为0.48±0.17,与对照组0.78±0.21比较明显降低,差异有显著性意义(P<0.01)。结论:细胞因子基质金属蛋白酶3和组织金属蛋白酶抑制剂1表达的变化与胶原性关节炎大鼠的发病相关。     

工程化视知觉感知学习系统治疗儿童弱视的效果评价

目的:传统治疗弱视的方法(如遮盖治疗,精细训练等)起效慢,疗效欠佳;视知觉感知学习系统作为一种针对性很强的儿童弱视治疗方法,其疗效需进一步观察。方法:①收集2006-09/2007-02于广西壮族自治区人民医院视光中心就诊的弱视儿童125例250眼,女73例,男52例,年龄(6±2)岁。患儿家长知情同意并签署知情同意书;实验经医院伦理委员会批准。②根据视功能检查结果,采用视知觉感知学习系统对弱视患儿进行针对性的治疗,如双眼视力相差两行以上,辅助遮盖优势眼治疗。1个月为1个疗程,每天训练2次,每次2个训练内容(程序),每个训练内容10min,40min/d,训练内容之间要求有10min左右的休息间隙。训练需在安静和黯淡环境下进行。每月定期复查双眼视力及其各项视功能的恢复情况,并根据复查结果继续原程序治疗或调整治疗程序。结果:弱视患儿125例均进入结果分析。①视力:视知觉感知学习系统治疗儿童弱视的总有效率为75.2%,视力提高行数从治疗第3个月起有大幅增加(P<0.05),最佳矫正视力由治疗前的0.60±0.23提高至治疗后的0.86±0.26,差异有显著性意义(P<0.05)。②治疗时间与疗效:疗效达到进步的平均时间为(2.82±1.30)个月,达到基本治愈为(2.87±1.40)个月。治疗3个月的患者视力疗效达进步率最高[98%(39/40)],治疗1个月的患者视力进步率最低[55%(31/56),P<0.05]。基本治愈率随治疗时间的增加递增,治疗4个月组基本治愈率最高[67%(31/46),P<0.05]。结论:视知觉感知学习系统治疗儿童弱视疗效快,达到有效的时间为治疗两三个月。     

Copeptin,a novel prognostic biomarker in ventilator-associated pneumonia

Background  

The present study sought to investigate the correlation of copeptin with the severity of septic status in patients with ventilator-associated pneumonia (VAP), and to analyze the usefulness of copeptin as a predictor of mortality in VAP.     

己糖激酶在原代培养腹膜间皮细胞的表达

目的 :探讨大鼠腹膜间皮细胞 (peritonealmesothelialcell,PMC)的原代培养方法及其己糖激酶 (hexoki nase ,HK)的表达。方法 :胰蛋白酶 EDTA消化法进行PMC的分离、培养 ,6 磷酸葡萄糖脱氢酶 (G6PDH)偶联比色法检测其HK总活性。结果 :PMC的原代及传代细胞 5～ 8d即可达到融合 ,其HK的基础活性为 (4.80± 0 .39)U/g蛋白。结论 :改良的胰蛋白酶消化法是进行PMC原代培养的一种可靠的实验方法。PMC有较强的HK活性 ,参与了腹膜透析时对葡萄糖吸收和利用方面的调节 ,可能对透析超滤有较大的影响     

Comparison of patient-reported outcomes after elective coronary artery bypass grafting in patients aged greater than or equal to and less than 65 years.

Older patients represent a growing proportion of patients undergoing coronary artery bypass grafting (CABG). Although functional benefits after CABG have been demonstrated, most assessments of outcomes have involved patients aged less than 65 years. Therefore, little is known concerning the impact of CABG on older patients compared with that on younger ones. A number of postsurgical (6 months) health-related quality-of-life outcomes (e.g., symptoms, cardiac functional class, instrumental activities of daily living, and emotional and social functioning) reported by patients aged less than 65 (n = 169) and greater than or equal to 65 (n = 99) years who underwent elective CABG at 4 major teaching hospitals in Massachusetts and California were compared. The proportion of patients reporting cardiac-related symptoms after surgery did not vary by age, and quality-of-life outcome scores of younger and older patients did not differ even after adjustment for clinical and demographic characteristics. The exception to this was mental health status, an outcome for which older patients reported better functioning than did younger ones. On average, patients in the 2 age groups reported equivalent improvement over preadmission status in instrumental activities of daily living, and emotional and social functioning. The independent relation of clinical and sociodemographic factors to quality-of-life outcomes was also investigated. Patients who functioned better before admission, those with less severe co-morbid disease, and married patients reported better functioning after discharge. In general, older patients who underwent elective CABG reported functional benefits similar to those reported by younger ones, and the factors associated with better functioning did not vary by age group.     

促红细胞生成素对实验性肾性贫血的作用

促红细胞生成素(erythropoietin,EPO)是由肾细胞分泌的一种糖蛋白激素。从人胚肾细胞中诱导,经生物化学方法分离、提纯得到此品。本试验用5/6肾切除的方法造成大鼠慢性肾衰性(CRF)贫血,研究不同剂量EPO对CRF贫血的作用。结果表明EPO有显著的促进红细胞生成,改善CRF贫血状态,使其接近或达到正常水平,最佳剂量为1000 U/kg,并可预防实验性贫血,对正常鼠未见明显作用。     

Quality of diabetes care among cancer survivors with diabetes

BACKGROUND: Among patients with chronic medical conditions, unrelated conditions are often undertreated. OBJECTIVE: To compare the quality of diabetes care delivered to diabetic patients with and without cancer in a large regional integrated delivery system. DESIGN: Observational cohort study using propensity score methods to control for baseline differences between diabetic patients with and without a history of cancer. SUBJECTS: A total of 5773 Kaiser Northern California members with diabetes and previous cancer and 23,092 members with diabetes and no previous cancer. MEASURES:: Nine measures of diabetes technical quality and clinical outcomes in 2003. RESULTS:: Relative to diabetic patients without cancer, those with cancer had higher adjusted rates of HbA1c testing (66.3% vs. 64.4%; P = 0.02), HbA1c control (73.4% vs. 70.9%; P < 0.001), and urine microalbumin testing (59.1% vs. 55.2%; P < 0.001) but lower rates of low-density lipoprotein (LDL) cholesterol control (40.7% vs. 42.2%; P = 0.02) and statin use if LDL >100 mg/dL (76.7% vs. 80.6%; P < 0.001). The groups had similar rates of LDL cholesterol testing, dilated retinal examinations, blood pressure control, and angiotensin converting enzyme (ACE) inhibitor use for hypertension (all P >/= 0.20). CONCLUSIONS: Despite the potential for cancer-related services to compete with delivery of diabetes care, diabetic patients with cancer received care of generally similar quality relative to diabetic patients without cancer in this integrated delivery system. Nevertheless, the quality of diabetes care delivered to all patients could be improved, particularly the control of LDL cholesterol and blood pressure. Combining data from electronic disease registries has the potential for monitoring quality of care delivered to patients with more than 1 major medical illness.