重组人促红细胞生成素治疗结肠和直肠癌化疗相关贫血

目的 :观察重组人促红细胞生成素 (rhEPO)治疗结、直肠癌化疗相关贫血的疗效。方法 :选择 6 2例结、直肠癌采用以奥沙利铂为主联合方案化疗所致贫血患者 ,随机分为两组 :rhEPO治疗组 34例 ,给予皮下注射rhEPO 4 0 0 0 0U/周。对照组 2 8例 ,不给予rhEPO治疗 ,仅给予五参芪口服液。结果 :治疗后 4周起治疗组患者血红蛋白 (Hb) ,红细胞压积 (HCT)、红细胞总数 (RBC)均明显上升 ,与对照组相比差异有统计学意义 (P <0 .0 1)。rhEPO治疗组总有效率为 79.4 % ,对照组为 2 1.7% ,差异有统计学意义 (P <0 .0 1)。结论 :rhEPO 4 0 0 0 0U/周对晚期结、直肠癌联合方案化疗相关贫血有肯定的疗效     

Optical properties of human normal small intestine tissue determined by Kubelka-Munk method in vitro

AIM: To study the optical properties of human normal small intestine tissue at 476.5 nm, 488 nm, 496.5 nm, 514.5 nm, 532 nm, 808 nm wavelengths of laser irradiation. METHODS: A double-integrating-sphere system, the basic principle of measuring technology of light radiation, and an optical model of biological tissues were used in the study. RESULTS: The results of measurement showed that there were no significant differences in the absorption coefficients of human normal small intestine tissue at 476.5 nm, 488 nm, 496.5 nm laser in the Kubelka-Munk two-flux model (P>0.05). The absorption coefficients of the tissue at 514.5 nm, 532 nm, 808 nm laser irradiation were obviously increased with the decrease of these wavelengths. The scattering coefficients of the tissue at 476.5 nm, 488 nm, 496.5 nm laser irradiation were increased with the decrease of these wavelengths. The scattering coefficients at 496.5 nm, 514.5 nm, 532 nm laser irradiation were obviously increased with the increase of these wavelengths. The scattering coefficient of the tissue at 532 nm laser irradiation was bigger than that at 808 nm. There were no significant differences in the total attenuation coefficient of the tissue at 476.5 nm and 488 nm laser irradiation (P>0.05). The total attenuation coefficient of the tissue at 488 nm, 496.5 nm, 514.5 nm, 532 nm, 808 nm laser irradiation was obviously increased with the decrease of these wavelengths, and their effective attenuation coefficient revealed the same trend. There were no significant differences among the forward scattered photon fluxe, backward scattered photon fluxe, and total scattered photon fluxe of the tissue at 476.5 nm, 488 nm, 496.5 nm laser irradiation. They were all obviously increased with attenuation of tissue thickness. The attenuations of forward and backward scattered photon fluxes, and the total scattered photon fluxe of the tissue at 514.5 nm laser irradiation were slower than those at 476.5 nm, 488 nm, 496.5 nm laser irradiation respectively. The attenuations of forward and backward scattered photon fluxes, and total scattered photon fluxes at 532 nm laser irradiation were obviously slower than those at 476.5 nm, 488 nm, 496.5 nm, 514.5 nm laser irradiation. The attenuations of forward and backward scattered photon fluxes, and total scattered photon fluxe at 808 nm laser irradiation were all obviously slower than those at 476.5 nm, 488 nm, 496.5 nm, 514.5 nm, 532 nm laser irradiation respectively. CONCLUSION: There are significant differences in optical parameters of human normal small intestine tissue in the Kubelka-Munk two-flux model at six different wavelengths of laser radiation. The results would provide a new method of information analysis for clinical diagnosis.     

C反应蛋白与动脉粥样硬化性心脑血管病

在动脉粥样硬化形成的炎症机制中 ,C反应蛋白 (CRP)起着重要作用。超敏CRP检测可用于评价动脉粥样硬化性心脑血管病的危险性。通过监测CRP指导抗炎治疗 ,可能会在心脑血管病的一、二级预防中发挥重要作用。     

不同病理类型原发性甲状旁腺功能亢进症临床表现的比较分析

目的分析不同病理类型甲状旁腺功能亢进(PHPT)的临床表现特点。方法回顾性分析1958—2005年北京协和医院收治经手术病理证实的280例PHPT患者的临床资料。按病理类型分为甲状旁腺腺瘤组208例,甲状旁腺增生组52例及甲状旁腺腺癌组20例。结果腺癌组中男性高于另外2组(P<0.05)。增生及腺癌组中骨畸形、骨软化比例较低,增生组骨吸收、病理性骨折比例低于腺瘤组;胃肠道症状、多饮多尿及泌尿系统病变在腺癌组中高于另外2组(P均<0.05)。血总钙(TCa)、血游离钙离子(ICa)及24h尿Ca在腺癌组显著高于腺瘤组及增生组(P均<0.01),在腺瘤组与增生组间差异无统计学意义(P>0.05)。出现高钙危象的比例在腺癌组显著高于另外2组(P<0.01)。腺癌组病灶重量高于增生组,腺瘤组病灶直径小于增生组(P均<0.05)。结论在本组病例中,腺癌组男性比例较高,泌尿系统病变更为多见,出现高钙危象的比例显著增高,术后复发的比例较高。增生组骨骼系统病变相对较轻,其病变甲状旁腺重量低于腺癌与腺瘤组。     

不同培养方法骨髓破骨细胞样细胞分化及活性的实验观察

目的研究不同骨髓细胞培养方法对大鼠破骨细胞样细胞(OLC)诱导分化及活性的影响。方法大鼠骨髓细胞以巨噬细胞集落刺激因子(M-CSF)作用后与核因子!B受体活化因子配体(RANKL)协同诱导OLC分化,采用全骨髓细胞(A组)及密度梯度离心后骨髓单个核细胞(B组)两种培养方法,通过倒置相差显微镜及细胞染色观察两组OLC分化数量的差异,通过骨吸收陷窝分析及OLC膜表面整合素#3(CD61)表达量比较两组OLC活性的差异。结果B组培养5、7d抗酒石酸酸性磷酸酶(TRAP)染色阳性多核OLC数量及TRAP活性均高于A组,骨吸收陷窝计数亦较A组为多,差异均有统计学意义(P<0.01,P<0.05);陷窝面积比培养早期两组比较差异无统计学意义,7d时B组大于A组,差异有统计学意义(P<0.01);OLC膜表面CD61表达量及平均荧光强度0及3d时B组均较A组明显增高,随培养时间延长组间比较差异无统计学意义。结论低转速、短时间密度梯度离心后骨髓细胞培养诱导OLC分化获得的细胞数量较多且不影响其活性,是一种简便有效的OLC培养方法。     

原位心脏移植的初步体会

目的总结9例原位心脏移植经验,探讨该方法的近、远期疗效。方法心脏移植病人9例,均患终末期扩张型心肌病,术前射血分数(ejection fraction,EF)为0．10-0．29(0．21±0．03),均有频发室性期前收缩。用标准法处理5例,用双腔静脉法4例。供心热缺血时间2．6-6．7(4．2±1．0)min,冷缺血时间110- 175(141±16)min。抗排斥反应采用环孢素、麦考酚酸酯和甲泼尼龙三联方案,以环孢素为主。维持其血药浓度200μg／L;综合临床表现、超声心动图和心电图观察排斥反应,必要时行心内膜活检。结果手术全部成功,病人均在术后1-3月内出院,出院时心功能均恢复到0-Ⅰ级。随访4-42(27±20)个月,除1例病人在8个月时自行停服免疫抑制药因排斥反应死亡外,其余8例病人健康状况良好,6例病人已恢复工作。结论原位心脏移植是治疗终末期心脏病的有效手段。术前认真选择供体和受体,并造好血液配型及组织配型,移植过程中尽量缩短热、冷缺血时间和良好吻合是手术成功的关键。术后应用免疫抑制药和密切观察排斥反应是取得远期疗效的重点。     

卵泡发育迟缓者在体外受精中延长使用促性腺激素的临床疗效观察

目的探讨体外受精（IVF）周期中,卵泡发育迟缓者延长使用促性腺激素（Gn）的临床效果。方法将552个IVF周期按Gn用药时间、剂量和获卵数分组,观察组（69个取卵周期,66个移植周期）：Gn起始用量为75IU／d-300IU／d,用药时间≥16d,用至卵泡达到取卵标准为止,获卵数≥4个;对照组（483个取卵周期,464个移植周期）：Gn起始用量为150IU／d～300IU／d,用药时间≤15d,且总Gn用量≤3300IU,获卵数≥4个。比较两组患者的Gn用量及用药时间、获卵数、临床妊娠率、胚胎着床率及治疗结局。结果观察组和对照组的临床妊娠率分别为45．5％（30／66）和51．7％（240／464）;胚胎着床率分别为28．0％（46／164）和30．5％（385／1262）;分娩率分别为37．9％（25／66）和39．4％（183／464）;两组患者的临床妊娠率、胚胎着床率、分娩率等比较,差异均无统计学意义（P〉0．05）。观察组和对照组的多囊卵巢（PCO）和（或）多囊卵巢综合征（PCOS）患者的比例分别为55．1％（38／69）和20．1％（97／483）;基础窦卵泡数分别为（20±11）个和（15±6）个;Gn用药时间分别为（20．8±4．2）d和（10．3±1．8）d;Gn用药总量分别为（3090±1140）IU和（2302±862）IU;血清雌二醇峰值分别为（4595±5181）pmol／L和（7272±6320）pmol／L;获卵数分别为（10±6）个和（14±7）个;移植胚胎数分别为（2．5±0．6）个和（2．7±0．5）个;两组上述各指标比较,差异均有统计学意义（P〈0．01）。结论对IVF周期中卵泡发育迟缓的患者,延长使用Gn有效、方便,能获得满意的临床结局。     

Decrease and dysfunction of endothelial progenitor cells in umbilical cord blood with maternal pre-eclampsia

BACKGROUND: The pre-eclampsia is characterized by placental defective angiogenesis and maternal vascular/endothelial dysfunction. Recently, the decrease and senescence of endothelial progenitor cells (EPC) has been observed in maternal circulation with pre-eclampsia. Given the essential involvement of EPC in neovascularization and reendothelialization, we investigate whether or not the depletion of EPC is existent in placental/fetal circulation with maternal pre-eclampsia. METHODS: Samples of venous cord blood were collected during the labor of preeclamptic mothers (n = 14) and normotensive controls (n = 10). Circulating EPC were enumerated as AC133+/KDR+ cells via fluorescence-activated cell sorting (FACS) analysis. Additionally, EPC were expanded in vitro and identified by DiI-acLDL uptake and lectin staining by direct fluorescent staining under a laser scanning confocal microscope. EPC proliferation, migration and vasculogenesis activities were determined by MTT, modified Boyden chamber assay and in vitro vasculogenensis assay. RESULT: The placental/fetal circulating EPC numbers were significantly decreased in the pre-eclampsia group compared with the control (median, 200; range, 100-440 cells/mL vs 390; 270-440 cells/mL, P < 0.001), and after in vitro cultivation the numbers of EPC also decreased in pre-eclampsia group (19.5; 5.0-32.0 vs 39.5; 31.2-52.0 EPC/x200 field; P < 0.001). Both circulating EPC and cultivated EPC were inversely correlated with cord blood level of soluble fms-like tyrosine kinase 1 (sFlt-1). In addition, the EPC from patients with pre-eclampsia were significantly impaired in their proliferation, migration and vasculogenesis capacities. CONCLUSION: The present study documented the decrease and dysfunction of placental/fetal circulating EPC in patients with pre-eclampsia. The alteration is probably associated with the increased sFlt-1 levels in the umbilical cord blood.     

中医药大数据技术基础课程思政探索与实践

介绍课程思政研究现状,阐述中医药大数据技术基础课程思政建设的主要内容,包括明确总体课程思政目标、制定各章思政目标及思政元素、修改教学设计等,分析课程思政教学实践效果并提出相关建议。     

基于本体技术的高血压知识库平台构建

详细阐述基于本体技术的高血压知识库平台构建,包括本体库以及Web端界面等,指出该平台可以为高血压诊断和治疗提供依据,为其他慢病知识库平台构建提供借鉴。