高致病性禽流感病人救治管理探讨

2005年至2006年间，在皖南休宁县和屯溪区农村集中网报并纳入特殊疾病救治的有3个病人，其中确诊为人感染高致病性禽流感（H5N1）2例，救治成功1例。对前后3例的救治情况比较研究，认为人感染高致病性禽流感病人救治管理的核心环节有三：一是提高居民的择医意识，及时到专科诊治是救治成功的前提；二是提高基层医生专业知识水平，及时发现及时转医是核心环节；三是提高医院专科的救治能力，制订切实可行的应急预案，优化救治队伍，做出快速的反应，做到有效施治是救治成功的保证。     

超长方案促性腺激素释放激素激动剂降调节对子宫内膜异位症体外受精-胚胎移植结局的影响

本中心对129例经腹腔镜证实为美国生殖医学会(ASRM)II-IV期子宫内膜异位症(内异症)合并其他不育因素而行体外受精-胚胎移植(IVF-ET)治疗的病例,进行了回顾性统计和分析。一、资料和方法1.临床资料:从2005年4月至2007年3月,在本中心接受IVF-ET治疗经腹腔镜证实为ASRMII-IV期内异症合并其他不育因素的129个周期病例;对照组为输卵管性不育的1,543个周期。内异症组根据有无促性腺激素释放激素激动剂(GnRH-a)药物降调节分为A、B两组进行分析,A组:中重度内异症在手术后接受长效GnRH-a(3.75 mg/支,每28 d一支,共2~6支)抑制治疗的39个…     

Fabrication of porous hollow silica nanoparticles and their applications in drug release control.

Preparation and characterization of porous hollow silica nanoparticles (PHSN) for controlled release applications were investigated. Through orthogonally designed experiments, the optimal synthesis conditions for the preparation of PHSN were obtained and the produced PHSN were characterized by BET, SEM, TEM and IR. Scanning and transmission electron microscopy images revealed their hollow shell-core structure and also demonstrated that the size and shape of PHSN are determined by the templating CaCO3 nanoparticles. The produced PHSN were applied as a carrier to study the controlled release behaviors of Brilliant Blue F (BB), which was used as a model drug. Being loaded into the inner core and on the surfaces of the nanoparticles, BB was released slowly into a bulk solution for about 1140 min as compared to only 10 min for the normal SiO2 nanoparticles, thus exhibited a typical sustained release pattern without any burst effect. In addition, higher BET of the carriers, lower pH value and lower temperature prolonged BB release from PHSN, while stirring speed showed little influence on the release behavior. It showed that PHSN have a promising future in controlled drug delivery applications.     

体重指数、腰围、腰臀比与血压、血糖、血脂关系的探讨

目的 探讨体重指数(BMI)、腰围(WC)、腰臀比(WHR)与代谢性因素的关系.方法 对镇江市居民基线资料的1108例对象按BMI、WC、WHR分组.在正常体重、超重、肥胖;腰围正常、腰围过大;腰臀比正常、腰臀比过大各组中,比较收缩压(SBP)、舒张压(DBP)、血糖(FBG)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)的水平.结果 不论男性女性组,超重肥胖、腰围过大组,血压、血糖、血脂水平与正常组比较均明显升高;腰臀比过大组与正常组比较,男性组TG、FBG明显升高;HDL-C明显降低;女性组TG、FBG、SBP明显升高,HDL-C明显降低.结论 BMI、WC、WHR指标与代谢性因素密切相关;BMI、WC在提示肥胖程度方面优于WHR指标.     

食管癌三维适形后程加速超分割放射治疗的疗效分析

目的评价三维适形后程加速超分割放射治疗食管癌的疗效及放疗反应、并发症。方法2002年2月至2004年5月,71例食管鳞癌随机分成两组,三维适形后程加速超分割组36例,食管病变上下外约4cm,前后、左右外约0.5~1cm作为PTV1,每次2GY,每周5次,DT40GY后,病变上下外约2cm,前后、左右外约0.5~1cm作为PTV2,每日2次,每次1.5GY,间隔4~6小时,总疗程6周,总剂量67GY/38次。非三维适形后程加速超分割组35例,时间、剂量、分割方式同适形组。所有病例均采用8MV-X外照射。结果1、2、3年的生存率和原发肿瘤的局控率,与非适形后程加速超分割比较,适形组明显提高,分别为88.9%、75%、63.9%比68.6%、51.4%、40%和86.1%、72.2%、58.3%比65.7%、48.5%、34.3%。适形组的急性放射反应明显低于非适形后程加速超分割组,两组有显著差别。结论本研究的初步结果表明食管癌适形后程加速超分割放射治疗的疗效优于非适形后程加速超分割组。     

Triptolide inhibits T cell activation and proliferation via multiple pathways

Triptolide is potent immunosuppressive has been reported to inhibit autoimmunity, compound isolated from Chinese herbal medicine. Triptolide allograft attributed to the suppression of T cells via NF - kB rejection and GVHD, and its efficacy was previously pathway and apoptosis. In the present study, we detailedly analyzed Triptolide＇ s function on murine primary T cell. We found that Triptolide could inhibit T cell activation and proliferation by dramatically down - regulating cell division and cell cycle. Triptolide inhibited T cell activation in a dose- dependent manner, and the inhibition was mediated by both NF- kB pathway and AP - 1 pathway.     

早期应用无创性通气治疗老年Ⅱ型呼吸衰竭的护理

目的　探讨应用无创性通气治疗老年Ⅱ型呼吸衰竭的护理。方法　在常规治疗的同时 ,实验组与对照组分别应用无创通气和呼吸兴奋剂治疗 ,观察 2组患者治疗前、后、治疗间歇期动脉血气变化及康复例数。结果　实验组患者治疗后血气明显改善 (P <0 .0 1) ,康复例数明显多于对照组 (P <0 .0 1)。结论　应用无创通气可促进呼吸衰竭患者的康复 ,护士要加强对患者的心理支持 ,严密监测生命体征 ,保持呼吸道通畅 ,熟练掌握无创通气呼吸机的性能、使用方法 ,防止并发症     

胰岛素强化治疗对严重创伤患者炎性反应及预后的影响

Objective To investigate the effects of intensive insulin therapy on inflammatory re-sponse and prognosis of patients with severe trauma. Methods Eighty severely injured patients were di-vided into intensive insulin therapy group (n = 40, IT) and routine therapy group (n = 40, RT) in random pair. At the time of admission, a continuous infusion of insulin (2 -4 U/h) was pumped into the patients of IT group to maintain blood glucose level at 6 -8 mmol/L. Patients in RT group were given routine treatment without administration of insulin. Fever, organ injury, and mortality of patients in 2 groups were recorded. Venous blood was drawn from patients of 2 groups on the morning of post treatment day (PTD) 1, 3, 5, and 7. Values of TNF-α, C-reactive protein (CRP), IL-2, and IL-10 in plasma were assayed. Results High fever appeared in 9 patients in IT group, and WBC exceeded 10.0×109 for more than 3 days in 17 patients in this group, versus 20 and 29 patients respectively in RT group. Dysfunction of 1 organ appeared in 31 pa-tients in IT group and 30 patients in RT group. Dysfunction of 3 organs appeared in 10 patients in IT group and 19 patients in RT group. Dysfunction of 4 organs appeared in 7 patients in IT group and 12 patients in RT group. In IT group, 4 patients died within 3 post-injury day (PID), and 1 patient died after PID 3 (total case fatality: 12.5% ). In RT group, 5 patients died within 3 PID, and 4 patient died after PID 3 (total case fatality: 22.5%). Plasma levels of TNF-α and CRP of patients in IT group were significantly lower than those of patients in RT group on PID 3 - 7 ( P<0.05 or P<0.01 ), while levels of IL-2 and IL-10 of patients in IT group were significantly higher than those of patients in RT group ( P<0.05 or P<0.01 ). Plasma levels of TNF-α ( 1.3±0.6 μg/L) and CRP (55±16 mg/L) of patients in IT group on PTD 7 were lowered to the trough level, and they were significantly lower than those of patients in RT group (3.0±0.8μg/L, 89±20 mg/L, respectively, P <0.01 ). Conclusions Intensive insulin therapy can mitigate systemic inflammatory response and improve prognosis of patients with severe trauma.     

深静脉血栓形成患者凝血因子ⅩⅢ Val34Leu基因多态性检测

目的:探讨凝血因子ⅩⅢ(FⅩⅢ)Val34Leu基因多态性与中国人群深静脉血栓形成(DVT)发病的相关性.方法:利用聚合酶链反应和限制性片段长度多态性(PCR-RFLP)方法,检测了103例DVT患者与106例正常对照的FⅩⅢVal34Leu基因多态,并加以对照分析.结果:103例DVT患者FⅩⅢVa134Leu基因型均为野生型V/V,未见突变类型;106例对照组中发现1例突变杂合子V/L.2组基因型频率、等位基因频率相互比较,差异均无统计学意义(P＞0.05).结论:FⅩⅢVal34Leu对中国人群DVT有保护作用的可能性极小.