HBV表面抗原大蛋白与人胰腺突触角蛋白6之间的相互作用

目的 验证HBV表面抗原大蛋白(LHBs)与人胰腺突触角蛋白6 (STX6)在细胞内是否存在相互作用,为进一步研究HBV影响糖、脂代谢机制奠定研究基础.方法 构建真核表达质粒pACT-STX6,采用哺乳动物双杂交技术验证LHBs与STX6之间的相互作用.结果 实验组和各阴性对照组相对荧光素酶活性值均存在差异,且均具有显著统计学意义(P＜ 0.01).结论 LHBs与人胰腺STX6在胰腺细胞内存在相互作用.     

Prognostic value of diffusion tensor imaging parameters in severe traumatic brain injury

Diffusion tensor imaging (DTI) has recently emerged as a useful tool for assessing traumatic brain injury (TBI). In this study, the prognostic value of the relationship between DTI measures and the clinical status of severe TBI patients, both at the time of magnetic resonance imaging (MRI), and their discharge to acute TBI rehabilitation, was assessed. Patients (n=59) admitted to the trauma center with severe closed head injuries were retrospectively evaluated after approval from the institution's institutional review board, to determine the prognostic value of DTI measures. The relationship of DTI measures, including apparent diffusion coefficient (ADC), fractional anisotropy (FA), axial (λ‖) and radial diffusivity (λ⊥) from the whole brain white matter, internal capsule, genu, splenium, and body of the corpus callosum, were compared with neurological status at MRI and at discharge to acute TBI rehabilitation. Whole brain white matter averages of ADC, λ‖, and λ⊥, and their coefficient of variation (CV) were significantly correlated with the Glasgow Coma Scale (GCS) score on the day of MRI. The average λ‖ was significantly correlated with GCS scores on the day of MRI in all measured brain regions. Outcomes were associated with whole brain white matter averages of ADC and λ‖, and the CVs of FA, ADC, λ‖, and λ⊥; and the averages and CVs of FA and λ‖ in all corpus callosum regions. The inclusion of regional and global DTI measures improved the accuracy of prognostic models, when adjusted for admission GCS score and age (p<0.05). Whole brain white matter and regional DTI measures are sensitive markers of TBI, and correlate with neurological status both at MRI and discharge to rehabilitation. The addition of DTI measures adjusted for age, gender, and admission GCS score significantly improved prognostic models.     

急进不同海拔地区健康成人动脉血气变化研究

目的：通过对急进不同高海拔地区健康成年人动脉血气变化的研究,探讨高原地区血气变化规律及机体调节习服机制。方法：对急进到海拔2260m和4600m地区共计56名身体健康成年人进行随机抽样分组,分急进后的第1天、7天和15天3个时间段检测血气各项指标,使用SPSS12.0进行统计学分析。结果：①急进高原后1天、7天、15天各血气指标对比PaO2在第1天和第15天存在差异,其它各项指标均无差异性。各时间段均存在着轻度的低氧血症。多数急进者存在着轻度的碱血症;②急进海拔2260m与急进海拔4600m15天后进行血气分析对比,pH、PaO2、AB有差异,PaCO2有显著性差异,而SaO2无差异;④急进海拔2260m15天与海平面地区进行血气分析对比,pH无差异、PaO2有差异,而AB、PaCO2、SaO2、BEB均有显著性差异。急进海拔4600m15天与海平面地区进行血气分析对比,pH、PaO2、AB、PaCO2、BEB均有显著性差异,而SaO2有差异;⑤急进海拔4600m组和当地正常人群组相比,除了SaO2无差异性,其它各血气指标均存在差异和显著性差异。急进组pH、PaCO2、PaO2、AB、BE均略高于当地组。结论：①急进高原后,人体动脉血气在短时间内迅速通过肺功能的应激性调节、血液各缓冲系统的作用等机制达到一个新的平衡,在血气变化方面有着一定的＂高原调节储备＂;②急进高原健康人和当地久居或移居者之间的血气调节机制和＂调节储备＂都是不同的;③SaO2在筛选急性高原反应易感人群时,可能具有一定的价值。     

T管拔除后胆漏的预防

目的　探讨拔T管后出现胆漏并发症的预防。方法　胆总管探查、T管引流术的连续病例 2 4 3例。A组 114例术后 3周拔T管 ,若出现有症状胆漏和 /或胆汁性腹膜炎 ,立即用红橡皮导尿管置入窦道作引流 1～ 6d(平均 3.5d)。B组 12 9例术后 2周拔T管后常规立即用红橡皮导尿管置入窦道作引流 1～ 4d(平均 1.5d)。结果　A组拔T管后发生胆漏 9例 ,B组无胆漏发生。所有病例均获治愈出院。两组胆漏发生率有显著性差异 (χ2 =8.4 9,P <0 .0 0 5 )。结论　拔管后再引流法可有效预防拔T管后胆漏的发生。对已发生的局限性胆汁性腹膜炎 ,及时用导尿管置入窦道作引流 ,亦是有效的处理方法     

纳晶微针的促渗透作用及安全性实验研究

目的探讨纳晶针作用于皮肤后,可在皮肤表面形成开放给药通道,从而促进外用药物经皮渗透和吸收的价值及安全性。方法 (1)扫描电镜观察纳晶针作用后在皮肤表面形成针孔的存在和闭合;(2)以0.125%荧光素钠为模型药物,在荧光显微镜下对比观察纳晶针+荧光素钠和单纯外用荧光素钠后,荧光在大鼠皮肤的分布情况。结果 (1)纳晶针可在皮肤表层形成给药通道,该通道在20 min左右即可闭合;(2)经过纳晶针处理过的大鼠皮肤可见耀眼的荧光(+++);而未经纳晶针处理的大鼠皮肤仅在角质层可见明确的线状荧光(+),其他部位可见微弱荧光(-)。结论纳晶针对外用药物有明显的促进渗透作用,且安全简便。     

输尿管镜气压弹道碎石治疗输尿管结石110例

目的总结输尿管镜气压弹道碎石治疗输尿管结石的临床效果。方法采用F8/9.8 Wolf硬性输尿管镜、JUN—AIR气压弹道碎石机治疗110例输尿管结石。结果输尿管镜直视下一次碎石成功105例，成功率95．5％（105／110），1～6周内结石全部排净。2例因置镜失败改开放手术，3例输尿管上段结石上移至肾脏行ESWL2例，口服排石药物治疗1例。术后泌尿系感染5例，轻度肉眼血尿1～3d。结论输尿管镜气压弹道碎石是治疗输尿管中、下段结石的有效方法之一，具有碎石率高、安全、并发症少、操作简单的优点。     

The influence of ureteral stent on renal pelvic pressure in vivo

The objective of this study was to explore the influence of ureteral stent on renal pelvic pressure by urodynamic study. 41 patients (with unilateral renal and/or ureteral calculi) after minimally invasive percutaneous nephrolithotomy (MPCNL) were placed a 4.7-Fr ureteral stent and 16-Fr nephrostomy tube. Renal pelvic pressure of these patients was measured by urodynamic study at the 5–7 days after MPCNL. Renal pelvic pressure (RPP), intraabdominal pressure (IAP), and vesical pressure (VP) during the filling and voiding phases were detected by urodynamic study with intravesical perfusion. At the baseline, intraabdominal pressure (IAP₀) was 27.52 ± 7.03 cmH₂O, renal pelvic pressure (RPP₀) was 33.07 ± 7.04 cmH₂O; at the maximum cystometric bladder capacity (MCBC) during the filling phase, vesical pressure (VP_vol) was 41.61 ± 10.34 cmH₂O, renal pelvic pressure (RPP_vol) was 39.44 ± 7.33 cmH₂O; at the maximum vesical pressure during the voiding phase, vesical pressure (VP_max) was 74.95 ± 12.79 cmH₂O, renal pelvic pressure (RPP_max) was 65.68 ± 17.03 cmH₂O. (1) There was a strong relationship between RPP₀ and IAP₀ (P = 0.0001); (2) There was statistical significance among RPP₀, RPP_vol and RPP_max (P = 0.0001); (3) RPP was higher than 40 cmH₂O during the voiding phase, and it was obviously relevant to the VP (P = 0.0001) but not to the MCBC (P = 0.2696). RPP increased mildly during the filling phase and dramatically during the voiding phase after stenting. RPP increased higher than the level required for a backflow (40 cmH₂O) during the voiding phase. So it was encouraged to remove the stent at earlier stage or decrease using the ureteral stent if possible.     

Metabolic syndrome does not always play a critical role in decreased GFR

Background There is a paucity of literature available as to the relationship between different levels of each metabolic syndrome (MetS) component and decreased GFR. In the present study, we aimed to demonstrate whether MetS always plays a critical role in decreased GFR. Methods A cross-sectional study was conducted between February 2010 and September 2012, with 75,468 adults enrolled undergoing measurements of blood pressure as well as tests of blood and urine samples. Univariate and multivariable logistic regression analyses were performed to estimate the odds ratio (OR) with 95% confidence intervals (CI), and the chi-square test was used for categorical variables and described as a percentage. Results Of the 75,468 participants, 350 (0.5%) subjects met criteria for the decreased GFR, with a mean age of 48.79?±?13.76?years. After adjustment for age, diastolic blood pressure and high-density lipoprotein were inversely related to decreased estimated glomerular filtration rate (eGFR) in multivariable analyses, with an OR (95% CI) of 0.57 (0.39–0.84) and 0.41 (0.24–0.72), respectively. The prevalence rate of CKD in critical group was 0.73% (154 of 21,127) and 0% (0 of 370) in noncritical group. In analysis stratified by the type of MetS components, the differences in noncritical group and the reference group were not statistically significant (χ^2?=^?1.349, p?>?0.05). Conclusions MetS does not always play a critical role in decreased GFR, with different levels of individual components of MetS exerting idiosyncratic effects in decreased eGFR. In fact, patients with abnormal body mass index, high triglycerides, and elevated fasting plasma glucose would not have impact on decreased GFR.     

Complex cervical spondylotic myelopathy: a report of two cases and literature review

Study Design

A report of two cases with complex cervical spondylotic myelopathy (CSM) and review of the literature.

Objective

To describe two unique patients with complex CSM due to simultaneous anomalies as anteroposterior compressions of the spinal cord in both upper and lower cervical spine, caused by hypertrophic transverse ligament of atlas (TLA), dysplasia of the posterior arch of atlas, disc herniation, hypertrophic ligamentum flavum and osteophytes.

Methods

We present such two cases with clinical, imageological presentations, and describe the surgical procedure, to which both patients responded favorably.

Results

The neurological functions of both patients gradually improved according to the JOA scores and VAS scores in preoperative clumsiness and gait disturbance during the mean follow-up period lasted for 18 months. The latest plain radiographs and computed tomography (CT) revealed good fusion without instrumental failure and magnetic resonance imaging (MRI) showed good decompression of C1–7 spinal cord of both patients. Both patients are progressively followed-up.

Conclusion

Posterior surgical approach as C1–7 laminectomy with fixations or occipital-cervical fusions may obtain better reconstructions of the cervical spine and good neurological recovery for the patients with complex CSM we present. However, the incidence and ethnic predisposition for the patients with complex CSM are still unclear.