手术治疗慢性鼻窦炎对控制支气管哮喘发作疗效的初步观察

目的探讨慢性鼻窦炎合并支气管哮喘患者在手术治疗慢性鼻窦炎后支气管哮喘的发作情况。方法选取2001～2007年我院收治的慢性鼻窦炎且合并支气管哮喘的手术患者40例行鼻内镜下手术,术后平均随访(5.4±2.0)年,观察鼻窦炎术后哮喘发作情况。结果术后1年随访结果显示,支气管哮喘治愈6例(15.0%),好转18例(45.0%);术后3年随访结果显示,支气管哮喘治愈18例(45.0%),好转14例(35.0%)。结论多数慢性鼻窦炎合并支气管哮喘患者经鼻内镜手术治疗后支气管哮喘症状明显改善,部分患者甚至可以治愈。     

齐墩果酸通过MAPK/ERK信号传导通路对U87 MG细胞增殖及凋亡的体外实验研究

目的 探讨齐墩果酸(0A)对神经胶质母细胞瘤U87MG细胞增殖及细胞凋亡的影响.方法 以U87MG细胞为研究对象,使用25、50、80、100、150和200μg/ml的OA处理24、48和72h后,采用MTT实验检测OA对体外培养U87MG细胞增殖抑制作用,计算其抑制率;采用划痕法检测OA对U87MG细胞迁移能力的影响;用流式细胞仪分析OA对U87MG细胞周期与凋亡的影响;通过Western blot检测OA对MAPK/ERK信号传导通路活性的影响.结果 50μg/ml以上浓度的OA处理48h后,U87MG细胞的形态发生不同程度的变化,大量细胞脱落.150μg/ml和200μg/ml的OA处理U87MG细胞72h后,生长抑制率可达100％,与对照组相比差异有统计学意义(P＜0.01).25μg/ml的OA处理48 h后,迁移至划痕区的细胞数量相比于对照组明显减少.经50μg/mlOA作用48h后,处于Go/G1期的细胞从64.23％上升至75.03％,说明发生Go/G1期阻滞.同一浓度下,细胞凋亡率达到18.77％.U87MG细胞中MEK和ERK蛋白的磷酸化水平受到明显的抑制.结论 OA可显著抑制U87 MG细胞的生长增殖,呈一定的量效关系;OA可明显抑制U87MG细胞的迁移,并能抑制MAPK/ERK信号传导通路的激活.OA通过抑制MAPK/ERK信号传导通路的激活,可以抑制神经胶质母细胞瘤细胞的增殖生长.     

Socio-economic achievements of individuals born very preterm at the age of 27 to 29 years: a nationwide cohort study

Aim  To describe the socio economic achievement of individuals born very preterm (VPT) at the age of 27 to 29 years.
Method  Demographic and social data were extracted from national registers for all individuals born between 1974 and 1976 in Denmark ( n =208 656). Of these, 203 283 individuals were alive in 2006. We compared VPT individuals (gestational age <33wks, n =1422; 51.8% males, n =736) with individuals born at term (>36wks, n =192 223; 51.1% males, n =98 240), of whom 4.08% ( n =58) of the VPT and 0.19% ( n =373) of the term individuals had a diagnosis of cerebral palsy (CP).
Results  Overall results in the two groups were similar, but significant differences appeared. The VPT group had a lower educational level than the term group: 23.9% versus 16.3% had a basic education (corresponding to attendance at basic school for 9y or less; odds ratio [OR] =1.61, 95% confidence interval [CI] 1.42–1.82). Similarly, 31.9% versus 37.6% had a tertiary education (corresponding to different levels of professional education; OR=0.77, CI 0.69–0.86). Net income was 11% lower in the VPT group and 10.8% versus 5.3% were receiving welfare support (OR=2.14, CI 1.81–2.55). In the VPT group 59% versus 52% did not have children ( p <0.001) and there were more individuals living alone without children (28.8% vs 21.8%; OR=1.45, CI 1.29–1.63).
Interpretation  VPT birth in the 1970s in Denmark is associated with a highly statistically significant educational and social disadvantage persisting into young adulthood. CP increased the relative risk of social disadvantage in VPT individuals. However, the majority of the survivors are well integrated in society.     

病原菌耐药性检测结果在下呼吸道感染治疗中价值的评价

目的 评价病原菌耐药性检测结果在下呼吸道感染治疗中的价值.方法 统计下呼吸道感染住院患者痰标本的培养结果,了解病原菌菌种分布及其耐药状况;回顾调查近期该类患者的临床资料及培养送检率、阳性率、抗菌药物使用情况.结果 下呼吸道感染住院患者痰液培养的送检率为67.8%,病原菌阳性率为55.9%;菌种分布以革兰阴性菌为主,占82.39%,革兰阳性菌占14.18%;不同病原菌对常用抗菌药物呈现不同程度的耐药,肠杆菌科细菌、非发酵菌对氟喹诺酮类抗菌药物环丙沙星的耐药率分别为47.8%、34.8%,对哌拉西林/他唑巴坦的耐药率分别为31.5%、44.7%;金黄色葡萄球菌对氟喹诺酮类抗菌药物左氧氟沙星的耐药率为63.9%.结论 下呼吸道感染病原菌对常用抗菌药物耐药率较高,临床治疗仍以经验用药为主,对下呼吸道感染治疗中抗菌药物选择的作用不明显.     

肌钙蛋白T基因单核苷酸多态性与运动性横纹肌溶解症的关联研究

 目的：分析慢肌型肌钙蛋白T（sTnT）基因第7内含子C7761T位点与快肌型肌钙蛋白T（fTnT）基因第8内含子T7955C位点单核苷酸多态性与大强度训练后血清肌酸激酶（CK）活性之间的关系,探索运动性横纹肌溶解症（ERM）的可能遗传机制。方法：85名武警战士进行一次大强度负重训练造成亚临床ERM,检测血清CK活性的时程变化;PCR-RFLP法测定sTnT（C7761T）和fTnT（T7955C）基因多态性;分析基因多态性与安静CK（CK rest）、峰值CK（CK peak）以及CK最大变化值（ΔCK max）之间的关系。结果：sTnT和fTnT基因型分布频率均符合哈-温平衡定律。sTnT基因：C/T和C/C基因型组CK rest均高于T/T基因型组（均P<0.01）,CK peak和ΔCK max在各组间无显著差异（均P>0.05）,（T/T+C/T）组CK rest低于CC基因型组（P<0.05）。fTnT基因：T/C基因型组和C/C基因型组CK rest均低于T/T基因型组（分别为P<0.05和P<0.01）,C/C基因型组CK peak和ΔCK max均低于T/T基因型组和T/C基因型组（均P<0.01）,（T/T+T/C）组CK peak和ΔCK max均高于C/C基因型组（均P<0.01）。结论：fTnT基因第8内含子T7955C位点单核苷酸多态性可作为ERM易感性的分子遗传学标记,T等位基因携带者是患ERM的高危人群。     

健康青年定量平衡分析及其影响因素

目的 对健康青年进行平衡功能定量测试,获得静态/动态姿势图参数的正常值范围,探讨受试者个体因素对参数的影响.方法 利用Synapsys(SPS)静动态平衡仪对50名健康青年进行稳定极限试验、睁眼/闭眼静态平衡试验、睁眼/闭眼前后向动态平衡试验、睁眼/闭眼左右向动态平衡试验.结果 得到了健康青年静态/动态姿势图各参数、稳定极限范围、Romberg商数、感觉结构组成等参数的95%参考值范围;受试者身高、体重差异对一些平衡测试参数有一定影响,特别是与极限稳定范围呈高度正相关;性别差异会影响稳定极限范围、动态平衡参数、感觉结构组成等测试结果.结论 静动态平衡仪测试可定量评测人体平衡功能,临床中应根据不同个体特征参照正常值范围.     

Radionuclide Angiocardiography in Post-myocardial Infarction Patients

ABSTRACT One hundred and one representative post-myocardial infarction (MI) patients were investigated with radionuclide angiocardiography (RNA) and exercise test within 1 month of the MI and after 6 and 12 months. From the RNA were calculated the left ventricular ejection fraction (LVEF) and a quantified phase image, the phase standard deviation (phase-SD), representing the timing of the left ventricular contraction. The mean phase-SD was significantly higher among these patients (18°, 19° and 18°, respectively, at the three investigations) compared to phase-SD in normals (6°), indicating an impaired timing of the left ventricular (LV) contraction. At all three investigations a significant correlation was found between the phase-SD and the LVEF (r=0.58, r=-0.74 and r=-0.75, respectively) and the corrected QT interval (r=0.27, r=0.44 and r=0.39, respectively). Maximal serum ASAT in patients with their first MI correlated significantly to phase-SD. Low exercise capacity or unfavourable NYHA classification was associated with high phase-SD. Phase-SD higher than mean was also associated with significantly increased mortality during the follow-up year (P=0.0057). In conclusion, phase-SD, reflecting the timing of the LV contraction wave, is easily accessible and clinically relevant. It merits further investigation as a prognostic factor after an MI.     

Staging of Idiopathic Myelofibrosis: Significance of Haemoglobin Value and Reticulocyte Count

ABSTRACT. A retrospective analysis of 18 patients with idiopathic myelofibrosis (IMF) suggested that IMF is adequately staged by combining haemoglobin value and reticulocyte count. Four stages were recognized. All deaths occurred in late stage. The stages appeared to reflect a sequential course of the disease. The present staging system adequately identified patients at high risk. However, the rate of disease progress varied greatly. It is therefore suggested that the rate of disease progress should also be considered when an individual patient is evaluated.