复方磺胺甲恶唑对肾移植后卡氏肺孢子虫肺炎的预防作用

背景：卡氏肺孢子虫肺炎是由卡氏肺孢子虫寄生于肺部引起的一种严重的致命性肺炎。复方磺胺甲恶唑是目前用于治疗卡氏肺孢子虫肺炎的一线药物,治疗量往往有明显的不良反应,小剂量预防用药临床疗效及毒副作用尚不清楚。目的：观察复方磺胺甲恶唑对肾移植后卡氏肺孢子虫肺炎的预防效果。方法：选择肾移植后1个月且无复方磺胺甲恶唑过敏者。肾移植后1个月至半年或1年常规服用复方磺胺甲恶唑（0.48g/d）。观察移植肝肾功能,感染情况,药物不良反应。结果与结论：2006年起,随访125例肾移植术后早期患者,73例术后1个月起常规服用复方磺胺甲恶唑（0.48g/d）至术后半年者,1例停药4个月后感染卡氏肺孢子虫肺炎死亡,47例服用复方磺胺甲恶唑（0.48g/d）至术后1年者,无感染卡氏肺孢子虫肺炎者,5例因复方磺胺甲恶唑过敏或医从性差未服用复方磺胺甲恶唑者,2例分别在术后4,5个月感染卡氏肺孢子虫肺炎,1例死亡。结果提示,肾移植术后1个月至1年常规服用复方磺胺甲恶唑（0.48g/d）,可有效预防卡氏肺孢子虫肺炎,临床无明显不良反应。     

淫羊藿降压有效部位中活性成分淫羊藿甙含量的RP-HPLC分析

建立了淫羊藿Epimediumgrandiflorum降压有效部位中降压活性成分淫羊藿甙（icariin）含量的RP－HPLC分析方法。并对由不同产地的淫羊藿药材制备的淫羊藿降压有效部位中淫羊藿甙的含量进行了分析。这为淫羊藿降压有效部位质量标准的制定奠定了基础。     

4种少见脑膜瘤的临床病理观察

报告４种少见的脑膜瘤亚型：分泌型、微囊型、脂肪瘤和黄色瘤型。临床表现主要有头痛、恶心、轻度呕吐、眼底水肿和肢体功能障碍。形态学：分泌型脑膜瘤以散在多个嗜酸性近圆形包含体为特征，包含体对ＣＥＡ、ＥＭＡ呈特异性表达；微囊性脑膜瘤含微小囊腔状如海绵，囊内含粉染浆液，囊壁由疏松和涡漩状排列之瘤细胞组成；脂肪瘤和黄色瘤型脑膜瘤分别在其瘤组织中含有大量脂肪细胞或泡沫细胞为特征。文中讨论了肿瘤形成机制及鉴别要点。     

尿液中PCA3mRNA和融合基因TMPRSS2：ERGmRNA的检测在前列腺癌早期临床诊断中的应用

目的研究前列腺按摩后尿液中PCA3mRNA联合融合基因TMPRSS2：ERG亚型T1E4mRNA的定量检测在早期前列腺癌临床诊断中的应用价值。方法收集前列腺癌（PCa）患者53例和前列腺增生（BPH）患者37例,收集前列腺按摩后尿液,离心取细胞沉淀物,提取总RNA,用实时荧光定量RT—PCR的方法检测PSAmRNA、PCA3mRNA和T1E4mRNA的含量,以PSAmRNA来校正尿液中的前列腺癌细胞。以PCA3mRNA／PSAmRNA表示PCA3mRNA的含量,以T1E4mRNA／PSAmRNA表示融合基因T1E4mRNA的含量。用ROC曲线对T1E4mRNA及PCA3mRNA诊断PCa的性能进行分析。结果尿T1E4mR．NA／PSAmRNA比值诊断PCa的ROC曲线下面积（AUC）为0．802（95％CI：0．709～0．895）,以0．007为截断值时,其诊断前列腺癌的敏感度和特异度分别为56．6％和94．6％。尿PCA3mRNA／PSAmRNA比值诊断PCa的ROC曲线下面积（AUC）为0．646（95％CI：0．533—0．758）,以0．001为截断值时,其诊断前列腺癌的敏感度和特异度为47．2％和73．0％。PCa组PCA3mRNA（P=0．009）及T1E4mRNA（P=0．000）的含量均高于BPH组,T1E4mRNA联合PCA3mRNA定量检测的敏感度为81．1％,比单独应用PCA3mRNA和T1E4mRNA检测的敏感度分别提高了33．9％和24．5％。结论前列腺癌按摩后尿沉渣中可以检测到TMPRSS2：ERG亚型T1E4mRNA,联合PCA3mRNA和T1E4mRNA两个指标定量检测,可以显著提高检出前列腺癌的敏感度。此联合检测方法可以用于早期的前列腺癌诊断。     

傅里叶变换红外光谱结合偏最小二乘模式识别方法应用于藏药麻花秦艽真伪鉴别的研究

目的:采用傅里叶变换红外光谱技术,结合化学模式识别方法,对麻花秦艽及其伪品进行鉴别分析,为麻花秦艽的质量控制提供一种新的方法。方法:采集560个来自5个不同产地的麻花秦艽及其伪品黑秦艽、甘肃丹参的原始红外光谱图,并经过多元散射校正(MSC)和二阶导数(SD)处理后,用偏最小二乘判别分析对其进行整体指纹信息判别。结果:采用的PLSDA判别分析方法,能准确成功地识别麻花秦艽及其伪品黑秦艽、甘肃丹参。结论:该法快速、准确,为客观评价中药材的真伪、产地归属、质量类别等提供了一种新的方法和手段,在中药材质量控制领域具有广阔的应用前景。     

显微镜下最小量手术治疗孔源性视网膜脱离21例

目的:探讨显维镜下最小量外加压手术治疗孔源性视网膜脱离的疗效。方法:孔源性视网膜脱离患者21例(21眼)均行不放液的最小量视网膜脱离手术,观察视网膜复位和视力改善情况。结果:共有19眼一次手术视网膜完全复位,成功率90.45%;视力提高19眼,提高率90.45%。结论:显维镜下最小量外加压手术治疗孔源性视网膜脱离具有简单可靠且创伤小、视网膜复位率高的优点。     

Ⅱ型糖尿病患者机体脂质过氧化及抗氧化能力研究

测定了Ⅱ型糖尿病患者及健康对照者红细胞超氧化物歧化酶、血中谷胱甘肽过氧化物酶、过氧化氢酶活力及丙二醛（ＭＤＡ）含量。结果：糖尿病患者病程从～１０年组ＳＯＤ活力开始下降，与对照组比较差异有高度显著性（Ｐ＜０．０１），与病程呈高度负相关。ＧＳＨ－Ｐｘ、ＭＤＡ与对照组比较差异均有高度显著性（Ｐ＜０．０１），并与病程呈高度正相关，ＣＡＴ仅１５年以上组与对照组比较差异有显著性（Ｐ＜０．０１），与病程相关不显著（Ｐ＞０．０５）。结果说明，Ⅱ型糖尿病患者脂质过氧化作用增强及抗氧化能力下降，对心血管系统造成氧化性损伤是心血管并发症的重要原因之一。     

Cyclooxygenase-2 mRNA expression is associated with c-fos mRNA expression and transient water ADC reduction detected with diffusion MRI during acute focal ischemia in rats

Cyclooxygenase-2 (COX-2) plays an important role in the development of injury during cerebral ischemia and inhibition of its activity can reduce infarct size. COX-2 expression during acute ischemia is caused by activation of post-synaptic glutamate receptors, which occurs during spreading depression and ischemic depolarization. Both of these phenomena cause a reduction in the apparent diffusion coefficient of water (ADC), which can be detected with diffusion-weighted magnetic resonance imaging. The reduction is believed to be caused by cellular swelling that occurs as cells depolarize. The goal of this work was to determine the spatial relationship between cyclooxygenase-2 mRNA (cox-2) expression, c-fos mRNA expression and ADC reduction during acute focal cerebral ischemia. Adult rats were subjected to either 30- or 60-min permanent occlusion of the middle cerebral artery. A 2-Tesla scanner was used to acquire diffusion-weighted echo-planar images throughout the ischemic period, which were used to calculate ADC maps. Cox-2 and c-fos mRNA were detected with (35)S in situ hybridization. The results indicate that, for rats subjected to 60-min ischemia, cox-2 was observed in superficial layers of cortex, where transient ADC reduction and c-fos expression were observed. The same was true for most rats subjected to 30-min ischemia. However, in a small number of rats of the 30-min group, cox-2 mRNA expression was observed in regions exhibiting transient and persistent ADC reduction with no c-fos expression. The results suggest that cox-2 mRNA expression during acute MCA occlusion is caused by either or both spreading depression and transient ischemic depolarization.     

Acupuncture and moxibustion reduces neuronal edema in Alzheimer’s disease rats

To examine the possible correlation of aberrant Wnt signaling and pathological changes in Alzheimer's disease, we established a rat model of Alzheimer's disease and measured axin and β-catenin expression in the hippocampus. Rats were pretreated with moxibustion or electroacu-puncture, or both, at Baihui(GV20) and Shenshu(BL23). Axin expression was lower, β-catenin expression was greater, and neuronal cytoplasmic edema was visibly prevented in the rats that had received the pretreatments. Our results suggest that the mechanism underlying the neuro-protective effect of acupuncture and moxibustion in Alzheimer's disease is associated with axin and β-catenin expression in the Wnt signal transduction pathway.     

节段性狭窄闭塞布-加综合征的介入治疗

目的　探讨布 加综合征 (BCS)下腔静脉节段性狭窄、闭塞合并肝静脉阻塞的介入治疗。方法　 2 8例节段性狭窄、节段闭塞患者 ,多数合并 1～ 3支肝静脉闭塞 ,无合并下腔静脉血栓形成。应用球囊导管或房间隔穿刺针行下腔静脉开通术 ,下腔静脉开通后用 2 .0～ 2 .3cm球囊扩张后放入金属内支架。术后抗凝治疗 2年。结果　 2 7例患者成功进行了经皮穿刺球囊破膜扩张 ,即经皮腔内血管成形术 (PTA)和血管内支架植入治疗。闭塞肝静脉多数扩张下腔静脉后同时开通。患者肝、脾缩小 ,腹水吸收。 1例穿破下腔静脉急诊手术止血。随访 2～ 36个月未见复发及消化道出血。结论　下腔静脉狭窄者注意有肝静脉闭塞 ;下腔静脉闭塞破膜后 ,2 0例肝静脉闭塞者 19例随之开放 ,无需特殊处理 ;安放支架时注意保护肝静脉入口。