利多卡因对脓毒症大鼠肺组织高迁移率族蛋白B1mRNA表达的影响

目的 探讨利多卡因对脓毒症大鼠肺组织高迁移率族蛋白B1( HMGB1) mRNA表达的影响.方法 雄性Wistar大鼠50只,体重200 ～ 250 g,采用随机数字表法,将其随机分为5组(n＝10):假手术组(S组)、脓毒症组(L组)、低、中和高剂量利多卡因组(LL1组、LL2组和LL3组).除S组外,其他4组采用盲肠结扎穿孔术制备大鼠脓毒症诱发急性肺损伤模型.LL1组、LL2组和LL3组分别于术毕、术后1、2h时腹腔注射利多卡因5、10、20 mg/kg,S组和L组给予等容量生理盐水.分别于术后24、48 h时处死5只大鼠,取肺组织,测定HMGB1 mRNA表达、髓过氧化物酶(MPO)活性和NF-κB活性,光镜下观察肺组织病理学结果.结果 与S组比较,其他4组肺组织HMGB1 mRNA表达上调,MPO活性升高(P<0.05);与L组比较,LL1组、LL2组和LL3组肺组织HMGB1 mRNA表达下调,MPO活性降低(P<0.01);LL1组、LL2组和LL3组肺组织HMGB1 mRNA表达依次下调,MPO活性依次降低(P<0.05).LL1组、屿LL2和LL3组肺组织NF-κB活性逐渐降低,肺组织损伤程度逐渐减轻.结论 利多卡因减轻脓毒症大鼠急性肺损伤的机制与下调肺组织HMGB1基因表达有关,其下调HMGB1基因表达的机制与抑制NF-κB活化有关.     

The impact of the bundle on lab services

The rule states that CMS will implement a quality incentive program (QIP) for Medicare outpatient end-stage renal disease (ESRD) dialysis providers and facilities with payment consequences beginning January 1, 2012. This is in accordance with section 1881(h) of the Act (added on July 15, 2008 by section 153(c) of the Medicare Improvements for Patients and Providers Act (MIPPA)). Under the ESRD QIP, ESRD payments made to dialysis providers and facilities under section 1881(b)(14) of the Social Security Act will be reduced by up to 2% if the providers/facilities fail to meet or exceed a total performance score for standards related to certain specified performance measures.     

血清前白蛋白和总胆汁酸联合检测在肝病中的临床价值

目的探讨血清前白蛋白（PAB）和总胆汁酸（TBA）在肝病中的临床价值。方法分别检测急性肝炎、慢性肝炎、肝硬化、肝癌患者及正常对照组的血清PAB和TBA,并进行统计学分析。结果血清前白蛋白在各肝病中均显著低于对照组（P〈0.01）,而血清TBA则明显高于对照组（P〈0.01）。结论可见联合检测血清PAB和TBA,有助于肝病的诊断、疗效的观察以及预后的判断。     

Association of serum uric acid levels with the progression of Parkinson’s disease in Chinese patients

Background  Uric acid (UA) is suspected to play a neuro-protective role in Parkinson’s disease (PD). This study aimed to evaluate whether the serum UA level was associated with the disease progression of PD in a relatively large population of Chinese patients.

Methods  Serum UA levels were measured from 411 Chinese PD patients and 396 age-matched controls; following the uric acid colorimetric method, the serum creatinine (Scr) levels were also measured to reduce the bias caused by possible differences in renal excretion function. The disease progression was scored by Hoehn and Yahr (H&Y) scales and disease durations; PD group was divided into 3 subgroups according to H&Y scales. Independent-samples t test was performed to analyze the differences between PD group and control group. Multiple analysis of covariance was performed to analyze the differences between PD subgroups. Spearman rank-correlation was performed to evaluate the associations between serum UA or Scr level and disease progression.

Results  PD patients were found to have significantly lower levels of serum UA than controls ((243.38±78.91) vs. (282.97±90.80) µmol/L, P <0.01). As the disease progression, the serum UA levels were gradually reduced. There was a significantly inverse correlation of UA levels with H&Y scales (Rs= –0.429, P <0.01) and disease duration (Rs= –0.284, P <0.01) in PD patients of both females and males. No significant difference of the Scr level between PD patients and controls was found ((70.01±14.70) vs. (69.84±16.46) µmol/L), and the Scr level was not involved in disease progression.

Conclusion  Lower serum UA levels may possess a higher risk of PD, which may be a potential useful biomarker to indicate the progression of PD.

     

斑点追踪显像技术评价生理性和病理性左室心肌肥厚的左心室功能

目的应用二维斑点追踪显像（2DSTI）技术评价生理性和病理性左心室心肌肥厚的左心室功能。方法高心组（50例）,运动员组（25例）和对照组（25例）。应用STI技术测定左心室各壁基底段、中间段和心尖段收缩期峰值应变（Ss）和收缩期峰值应变率（SRs）,并对结果进行分析。结果与对照组和运动员组比较,高心组Ss和SRs均显著降低（均P〈0.05）,对照组和运动员组比较无显著性差异（P〉0.05）。结论 STI技术可实时、准确地反映心肌收缩功能状况,并可对生理性肥厚心肌和高血压左心室肥厚进行鉴别。     

多烯紫杉醇联合奈达铂或顺铂治疗晚期非小细胞肺癌的疗效观察

目的对比观察多烯紫杉醇联合奈达铂或顺铂治疗晚期非小细胞肺癌（NSCLC）的疗效和不良反应。方法选取107例晚期NSCLC患者,分为奈达铂联合多烯紫杉醇治疗组（DN组）53例和顺铂联合多烯紫杉醇治疗组（DP组）54例,观察其疗效及不良反应。结果DN组有效率（41．51％,22／53）和DP组有效率（42．59％,23／54）之间差异无统计学意义（χ＾2=0．013,P〉0．05）。DN组恶心呕吐发生率（20．75％,11／53）低于DP组（62．96％,34／54）,差异有显著统计学意义（χ＾2=19．554,P〈0．01）,但DN组血小板下降发生率（49．06％,26／53）高于DP组（22．22％,12／54）,差异有显著统计学意义（χ＾2=8．410,P〈0．01）。结论晚期NSCLC治疗中DN方案和DP方案疗效相当,但DN方案的胃肠道毒性明显轻于DP方案。