肾移植术后普通环孢素A与环孢素A微乳剂对移植肾功能影响的系统评价

目的评价肾移植术后普通环孢素A与环孢素A微乳剂对受者移植肾功能影响的差异。方法遵循Cochrane肾脏协作组随机对照试验检索策略，检索MEDLINE（1994—2006．3）、EMBASE（1994～2006．3）、中国生物医学文献数据库CBM（1994—2006．3）、Cochrane图书馆（2005年第4期）与肾移植相关的8种中文杂志。采用Revman4．2．7进行Meta分析。结果共有5个随机对照试验纳入研究，包括1671例同种异体尸体肾移植患者。结论肾移植术后使用普通环孢素A与环孢素A微乳剂相比受者移植肾功能无明显差异，但环孢素A微乳剂肾毒性发生率较高。     

计算机辅助精液分析男性不育患者精子运动参数与精子活力的相关性

目的探讨计算机辅助精液分析精子运动参数在评价男性不育患者精子活力中的价值。方法按《WHO人类精液及精子-宫颈黏液相互作用实验检验手册》标准,采用国产WLJY-9000伟力彩色精子质量检测系统对276例男性不育患者的精液进行平均直线运动速度、平均曲线运动速度、运动的前向性、运动的直线性、运动的摆动性、平均路径速度、精子活力及分级等进行检测并分析其相关性。结果276名男性不育患者的平均精子活力为（48.93±19.10）%,分级为A级（32.11±17.25）%、B级（17.03±8.91）%、C级（10.14±5.99）%。平均直线运动速度、平均曲线运动速度、运动的前向性、运动的直线性、运动的摆动性、平均路径速度与精子活力的相关系数分别为0.60（P〈0.01）、0.59（P〈0.01）、0.51（P〈0.01）、0.55（P〈0.01）、0.52（P〈0.01）、0.67（P〈0.01）。结论计算机辅助精液分析精子运动参数平均直线运动速度、平均曲线运动速度、平均路径速度是反映精子活力的有效指标,精子运动参数对男性不育的诊断和生育能力的评估具有实用意义。     

Novel IgE peptide-based vaccine prevents the increase of IgE and down-regulates elevated IgE in rodents

BACKGROUND: Immunotherapy with anti-IgE antibodies for treatment of allergy is promising but a short half-life and extremely high cost limit its application. OBJECTIVE: We sought to develop IgE vaccines that induce longer-lasting auto-antibodies to neutralize self-IgE as an alternative therapy. METHODS: The vaccine was made by conjugating three synthetic peptides corresponding to human IgE receptor-binding sites to a carrier, hepatitis B surface antigen. To test the immunogenicity of the vaccine, rats were immunized with the vaccine or hepatitis B surface antigen as control. Serum IgG titres to human IgE and the IgE of other species were measured. The inhibition by rat antisera of the binding of human IgE to its receptor was assessed by ELISA, flow cytometry analysis, and passive cutaneous anaphylaxis (PCA), and its ability to recognize receptor-bound IgE was examined. The in vivo effect of the vaccine was evaluated in trichosanthin-sensitized mice and rats. In the preventative study, vaccination started before sensitization commenced, while in the treatment study, vaccination started after sensitization. Sensitized mice and rats receiving injections of the carrier served as controls. Trichosanthin-specific IgE was measured using PCA. RESULTS: Sera from vaccine-immunized rats contained high titre antibodies that reacted with soluble and plate-bound but not with receptor-bound human IgE; they also reacted with mouse, rat, and dog IgE. Furthermore, the sera inhibited the binding of human IgE to its receptor in a dose-dependent manner. In preventative and treatment studies, serum trichosanthin-specific IgE levels were significantly reduced in vaccinated groups compared with controls. CONCLUSION: Antibodies against self-IgE can be induced by IgE peptide-based vaccines, which are effective in preventing the increase of IgE and in down-regulating IgE in sensitized animals.     

Effect of low-level clenching and subsequent muscle pain on exteroceptive suppression and resting muscle activity in human jaw muscles.

OBJECTIVE: To investigate the effects of muscle fatigue induced by low-level isometric jaw-clenching and subsequent glutamate-evoked muscle pain on the exteroceptive suppression (ES) response and resting electromyographic (EMG) activities in human jaw muscles. METHODS: The resting EMG activity and the ESs were recorded before (baseline), after low-level jaw-clenching (Post1), after subsequent glutamate or isotonic saline injections into the left masseter (Post2), and 60 min after the clenching (Post3) in 23 healthy volunteers. RESULTS: The late ES (ES2) showed more inhibition at Post1 compared with baseline (P<0.05). It was less inhibited after both types of injections (Post2), and increased at Post3 again (P<0.05) with no significant difference between the glutamate and isotonic saline sessions. The resting EMG activity increased at Post1 and Post2 (P<0.05). The glutamate injection further increased the resting EMG activity in the injected muscle (P<0.01). CONCLUSIONS: Muscle fatigue influences inhibitory reflex pathways in jaw-closing muscles and subsequent acute muscle pain potentiates the local increase in the resting EMG activity of the painful muscle. SIGNIFICANCE: Muscle fatigue which can be observed in patients with oral dysfunctions may interact with nociceptive regulation and influence the clinical presentation of jaw symptoms and function.     

Transient Macular Edema after Laser In-Situ Keratomileusis

Purpose: To investigate the macular changes induced by laser in situ keratomileusisc(LASIK) procedure.Methods: Optical Coherence Tomography (OCT) was used to examine 27 eyes of 15LASIK patients before surgery, and 1 day, 1 week, 1 month after surgery.Results: The mean thick iness of neuroepithelial layer of macula was (195 ±24)microns, (178± 16) microns 1 day and 1 month after surgery, respectively, while thebaseline was (174 ± 12) microns. The increase in macular neuroepithelial thickness wascorrelated with the degree of myopia, but not with the duration of suction or thepostoperative BCVA.Conclusion: Mild macular edema is common in the first month following LASIK,especially in high myopia. However, no association with loss of BCVA has beenestablished. Eye Science 2003; 19: 20 - 24.     

普南扑灵滴眼剂在视网膜脱离手术中的应用

目的　探讨普南扑灵滴眼剂在减轻玻璃体视网膜术 (VRS)和巩膜扣带术 (SBS)后炎症反应的作用。方法　将 82例 (82只眼 )随机分为研究组和对照组 ,研究组 41例 (41只眼 ) ,选用 0 .1%普南扑灵滴眼剂点眼 ,对照组 41例 (41只眼 ) ,选用 0 .0 2 5 %地塞米松滴眼剂点眼。观察指标为眼部疼痛、充血、前房闪辉、角膜炎症、虹膜后粘连。结果　选用 0 .1%普南扑灵滴眼剂的研究组在缓解术后眼部疼痛方面及减轻玻璃体切割术后前房闪辉、虹膜后粘连方面优于对照组 ,差异有显著性 (P <0 .0 5～ 0 .0 1)。结论　普南扑灵能显著的减轻 VRS及 SBS后炎症反应。     

Access编制数据库在白内障病例管理中的应用

目的 应用微机对白内障病例进行管理，实现病例管理自动化。方法 根据患者姓名、晶状体等各项临床信息，在Windows98及以上版本的操作平台上，应用Access2000建立患者信息病例库。结果 建立Access病例库管理白内障病例，病例存储量大，查询方便快捷，数据处理方便。结论 Access2000编写的数据库在临床病例的管理中值得广泛应用及推广。     

Glucocorticoid receptor enhancement of pregnane X receptor-mediated CYP2B6 regulation in primary human hepatocytes.

Although the glucocorticoid receptor (GR) facilitates the xenobiotic-induced expression of CYP2B in rodents, its role in the regulation of human CYP2B6 is unclear. In this report, the role of human GR in the regulation of CYP2B6 was evaluated using primary human hepatocytes and transfection assays with Huh7 cells. CYP2B6 expression was not induced in primary hepatocytes treated with dexamethasone (DEX) concentrations (0.01-1 microM) known to activate GR. In contrast, treatment with 0.1 microM DEX enhanced CYP2B6 induction by different pregnane X receptor (PXR) activators, including rifampin, phenytoin, clotrimazole, and phenobarbital. In Huh7 cells, cotransfection of human (h)GR and hPXR with CYP2B6-phenobarbital-responsive enhancer module (PBREM) reporter constructs revealed that all hPXR ligands induce CYP2B6 reporter gene activity, and this ligand-dependent activation is greatly enhanced by activated hGR. CYP2B6 reporter gene expression was not induced in the presence of hPXR ligands when hGR alone was cotransfected with CYP2B6 reporter construct. In hGR and human constitutive androstane receptor (hCAR) cotransfection assays, activated hGR increased the constitutive activation of PBREM reporter constructs by hCAR in the absence of inducers. In the presence of activated hGR and known inducers of CYP2B6, only PB treatment caused a further 2-fold activation of hCAR compared with control. These studies show that hGR is involved synergistically in the xenobiotic-responsive regulation of human CYP2B6 by hPXR and hCAR. Moreover, the results suggest that the GR-enhanced expression of CYP2B6 is mediated through an indirect mechanism that does not require increased expression of nuclear receptor.     

新生儿脐炎85例脐部分泌物细菌学分析

目的：了解新生儿脐部感染细菌学状况，为临床提供预防及治疗参考。方法：调查我院1997年1月－2002年6月收治的有完善细菌学资料的新生儿脐炎85例，对所获得的98例致病菌的种类及药敏状况进行分析。结果：社会获得性感染主要致病菌为G^ 球菌（70．5％），金黄色葡萄球菌占比例较高。医院感染主要致病菌为C^-杆菌（51．4％），以大肠埃希菌占比例较高。两类感染所分离的细菌均具有多重耐药性，但对氨基糖苷类及喹诺酮类耐药率较低，其次是第三代头孢菌素类抗生素。结论：临床对新生儿脐部感染，特别是有严重感染中毒症状时，应首先考虑使用第三代头孢菌素类抗生素。     

对耳轮过度前突畸形的整复

对耳轮过度前突为对耳轮的角度过锐，致使耳轮的位置相应后移，表现为与招风耳完全相反的畸形。畸形虽不十分明显，但影响美观。自１９９２年４月开始应用患侧耳廓软骨和耳后皮瓣对５例患者８只外耳进行治疗得到满意效果。认为文中所述方法是矫正对耳轮过度前突畸形的良好方法。