兔眼玻切及 C3 F8填充术后房水 bFGF含量与白内障形成的实验研究

目的：研究玻璃体切除联合全氟丙烷（C3 F8）填充术后形成白内障的兔房水碱性成纤维细胞生长因子（bFGF）含量变化与白内障形成之间的关系。方法18只成年纯系新西兰白兔（雌雄不限）的36只眼，随机平均分为3组：正常组，不做手术；对照组，行单纯玻璃体切除术及眼前房灌注液（BSS ）填充；实验组，行玻璃体切除联合C3 F8填充术。术后第1，3，8，35及45天观察各组白内障的形成情况，并抽取房水用ELISA法检测房水中bFGF的含量。结果正常组与对照组均未出现晶体混浊，实验组均出现晶体混浊。术后不同时期，实验组与对照组的bFGF含量均明显高于正常组。术后第1，3，8天，实验组的bFGF含量明显高于对照组，有显著性差异（P＜0．05）。结论 C3 F8填充引起房水中bFGF的升高与引发一过性白内障的形成有关。     

Role of N-acetylcysteine in the management of COPD

The importance of the underlying local and systemic oxidative stress and inflammation in chronic obstructive pulmonary disease (COPD) has long been established. In view of the lack of therapy that might inhibit the progress of the disease, there is an urgent need for a successful therapeutic approach that, through affecting the pathological processes, will influence the subsequent issues in COPD management such as lung function, airway clearance, dyspnoea, exacerbation, and quality of life. N-acetylcysteine (NAC) is a mucolytic and antioxidant drug that may also influence several inflammatory pathways. It provides the sulfhydryl groups and acts both as a precursor of reduced glutathione and as a direct reactive oxygen species (ROS) scavenger, hence regulating the redox status in the cells. The changed redox status may, in turn, influence the inflammation-controlling pathways. Moreover, as a mucolytic drug, it may, by means of decreasing viscosity of the sputum, clean the bronchi leading to a decrease in dyspnoea and improved lung function. Nevertheless, as successful as it is in the in vitro studies and in vivo studies with high dosage, its actions at the dosages used in COPD management are debatable. It seems to influence exacerbation rate and limit the number of hospitalization days, however, with little or no influence on the lung function parameters. Despite these considerations and in view of the present lack of effective therapies to inhibit disease progression in COPD, NAC and its derivatives with their multiple molecular modes of action remain promising medication once doses and route of administration are optimized.     

Human lymphotoxin has at least equal antitumor activity in comparison to human tumor necrosis factor but is less toxic in mice

Because of the severe toxicity of systemically applied tumor necrosis factor (TNF) in cancer patients, considerable efforts have been made to construct mutant TNF molecules, which retain antitumor activity, but display less toxicity. We compared tumor suppression in relation to the toxic effects of human TNF and human lymphotoxin (LT) in mice. The genes for these two cytokines were expressed in Chinese hamster ovary (CHO) cells. Intraperitoneal injection of parental and gene modified CHO cell lines producing similar amounts of biologically active TNF or LT, respectively, into nude mice showed that CHO-TNF cells killed the mice more rapidly than parental cells, but that CHO-LT tumor bearing mice lived significantly longer than mice injected with parental cells. Injection of the cells subcutaneously into severe combined immunodeficiency (SCID) mice allowed direct comparison of tumor suppression and toxic effects of the two cytokines. Both TNF and LT produced by the tumor effectively suppressed tumor growth by an indirect mechanism, LT being at least as effective as TNF. However, mice bearing CHO-TNF cells either died rapidly or developed cachexia, as shown by weight loss. In contrast, mice injected with CHO-LT cells never rapidly died and became cachectic much later than CHO-TNF cell injected animals, though serum levels of LT were higher than those of TNF. Analysis of soluble forms of TNF receptors (TNF-R1 and TNF-R2) in sera of tumor bearing mice showed that soluble TNF-R1 was downregulated in both CHO-TNF and CHO-LT, in comparison with CHO-neo cell injected mice and to normal SCID mice. The soluble form of TNF-R2 was induced by CHO cell lines. In CHO-TNF cell injected SCID mice, serum levels were significantly increased, whereas in mice injected with CHO-LT cells, serum levels of soluble TNF-R2 were decreased. Together, our results show a higher therapeutic index of LT compared with TNF.     

结直肠高级别上皮内瘤变的处理策略

[目的]研究结直肠高级别上皮内瘤变的临床及病理特征,探讨外科治疗原则和策略。[方法]45例结直肠肿瘤患者术前经内镜病理活检均诊断为高级别上皮内瘤变者,其中1例行腹腔镜探查,2例扩肛肿瘤局部切除,1例扩肛局部切除后补充行Miles术,2例行姑息性肿瘤手术,余39例行根治性结直肠癌手术,并将手术标本与术前病理作比较。[结果]术后病理活检示45例中有3例仍为高级别上皮内瘤变;42例证实为腺癌,其中1例伴有肝转移,24例有淋巴结转移,17例无淋巴结转移。[结论]术前病理活检确诊的结直肠高级别上皮内瘤变的肿瘤与术后病理活检结果一致性较差,对于这类患者应予积极的外科处理。     

HPLC-DAD法测定洋葱中黄酮类含量

目的：建立高效液相色谱（HPLC‐DAD）方法,对鲜洋葱中的主要黄酮类化合物进行含量测定。方法采用色谱柱Shimadzu VP‐ODS （250mm ×4．6 mm ,5μm）,以乙腈－水为流动相,梯度洗脱,柱温30℃,流速1．0 ml／min ,检测波长350 nm。首先根据紫外光谱图,确定黄酮类化学成分。而后以芦丁为对照品建立标准曲线,对洋葱中黄酮类化学成分进行定量研究。结果建立的高效液相色谱分析方法能够满足洋葱中主要黄酮类化学成分准确测定的要求,芦丁在5．0～502．5μg／ml范围内有良好的线性关系（r＝0．9995）,重复性（RSD＜4.1％）,日内精密度和日间精密度（RSD＜3．3 ％）,加样回收率（95．1％～103．2 ％）,检出限（0．3μg／ml）和定量限（1．0μg／ml）。含量测定表明洋葱中主要黄酮类化学成分的含量为2．8 mg／g。结论该方法简便可行,测定结果准确,能够满足洋葱中主要黄酮类化学成分准确测定的需要。     

不同麻醉方式对老年下肢骨折患者临床预后的影响

目的探究硬膜外麻醉与联合麻醉(腰麻加硬膜外麻醉)对老年下肢骨折患者临床预后的影响。方法选取2012~2014年扬州友好医院接受下肢手术的94例老年患者为研究对象,根据手术时麻醉方式不同,分为观察组和对照组各47例,观察组采取联合麻醉法,对照组采取硬膜外麻醉法。观察两组患者在手术时麻醉起效时间以及麻醉效果等指标。结果观察组患者麻醉指标,手术时用药物情况,麻醉效果以及Bromage评分均明显优于对照组,差异有统计学意义(P0.05)。结论联合麻醉法对老年下肢骨折患者有较好的麻醉效果,且起效时间快,不良反应少,预后好,值得临床推广应用。     

丙型肝炎病原学不同检测方法的临床应用价值对比分析

目的探讨抗体、抗原及核酸检测在丙型肝炎诊断中的应用价值。方法收集2012年1月到2013年12月珠海市香洲区人民医院筛查抗-HCV抗体阳性标本48份。用3种抗体试剂、2种抗原试剂及HCV-RNA复核检测结果。结果复核阳性丽珠37份,科华36份,新创36份,莱博21份,康润18份,HCV-RNA 28份。3种抗体试剂复核均阴性的10份标本中检出HCV-RNA阳性1份,莱博抗原阳性3份,康润抗原阳性1份。3种抗体灵敏度均为96.4%,阳性预测值为72.9%~75.0%;2种抗原试剂灵敏度分别为40.0%和83.3%,阳性预测值分别为57.0%和83.3%。结论丙型肝炎病毒抗体检测具有较高的诊断灵敏度,但诊断特异性较低,对抗-HCV抗体阳性标本采用抗体加抗原模式进行复核对丙型肝炎诊断具有重要的价值,对有疑问的标本再用HCV-RNA进行确证,可预防误诊、漏诊。     

接种卡介苗与新生儿病理性黄疸发生及严重程度的相关性

目的探讨接种卡介苗与新生儿病理性黄疸发生及严重程度的相关性。方法选择2011年1月至2013年12月出生的200例新生儿,其中剖宫产85例,顺产115例。剖宫产新生儿分娩后48h接种者40例作为A组,剖宫产新生儿分娩后5d接种者45例作为B组,顺产新生儿分娩后12h接种者50例作为C组,顺产新生儿分娩后3d接种者65例作为D组。观察各组新生儿病理性黄疸发生率与胆红素峰值。结果 (1)C组新生儿病理性黄疸发生率为68.00%,明显高于A、B、D组的35.00%、31.11%、30.76%,差异有统计学意义(χ21=7.256、χ22=7.998、χ23=8.115,P0.05);(2)C组新生儿血清胆红素峰值为(14.98±4.86)mg/dL,高于A、B、D组的(14.33±3.55)、(13.91±3.08)、(14.02±3.09)mg/dL,差异有统计学意义(t1=6.221、t2=7.018、t3=6.582,P0.05);(3)A、B、C、D 4组病理性黄疸患儿血清胆红素峰值分别为(14.98±1.76)、(14.61±1.56)、(15.76±2.05)L、(15.76±2.05)mg/dL,比较差异有统计学意义(F=10.223,P0.05)。结论接种卡介苗时机越早与新生儿病理性黄疸发生率及严重程度越高。     

酶联免疫吸附试验中影响全自动加样系统加样准确性的因素分析

目的探讨酶联免疫吸附试验(ELISA)中使用不同容量加样针和分液高度,对全自动加样系统加样准确度和精密度的影响。方法选取10μL和100μL两种加样量,每种加样量分4个小组进行实验,分别使用不同容量(400μL和800μL)的加样针和不同分液高度(浸润和未浸润)加样,计算每组的最终加样量、均值相对误差(E)和变异系数(CV),与实际工作标准进行比较。结果10μL加样E在-37.9%~-2.8%,CV在3.29%~14.49%;100μL加样E在-1.9%~0.8%,CV在0.44%~0.95%。结论不同容量加样针和分液高度对10μL加样影响较为明显,对100μL加样影响较小,在使用全自动加样系统进行ELISA时,应当选择适当容量的加样针和分液高度。