住院患者抗生素临床应用现状

目的：通过分析某市立医院住院患者抗生素使用情况，探讨抗生素临床应用的合理性。方法：统计2003年7月20日全院住院患者处方590张中抗生素总药量、总用药天数、联合用药情况以及2003年7月1～31日为期1个月全院临床科室所用抗生素的给药途径、用药总量。结果：住院患者抗生素的使用量很大．但由DUI值可见日剂量基本正常。联合用药比例大，两联及两联以上占使用抗生素处方的95．6％。头孢呋辛钠、头孢曲松钠、头孢唑林钠的总DDD数远大于其他各种抗生素占据前3位。结论：不规范的联合用药导致抗生素重复用药，用量过大，抗生素滥用明显。     

Antitumor effects of a monoclonal antibody that binds anionic phospholipids on the surface of tumor blood vessels in mice.

PURPOSE: We recently reported that anionic phospholipids, principally phosphatidylserine, become exposed on the external surface of viable vascular endothelial cells in tumors, possibly in response to oxidative stresses present in the tumor microenvironment. In the present study, we tested the hypothesis that a monoclonal antibody directed against anionic phospholipids might exert antitumor effects by causing vascular damage in tumors. EXPERIMENTAL DESIGN: A new mouse immunoglobulin G3 monoclonal antibody, 3G4, was raised that binds anionic phospholipids in the presence of serum or beta2-glycoprotein I. The antibody was tested for its ability to localize to tumor vessels and exert antitumor effects in mice. RESULTS: 3G4 recognized anionic phospholipids on the external membrane of H(2)O(2)-treated endothelial cells and in vitro. It localized specifically to tumor vascular endothelium and to necrotic tumor cells after injection into severe combined immunodeficient mice bearing orthotopic MDA-MB-435 tumors. Treatment with 3G4 retarded the growth of four different tumors in mice. It reduced the growth of established orthotopic MDA-MB-231 and MDA-MB-435 human breast tumors in mice by 75% and 65% respectively, large L540 human Hodgkin's tumors by 50%, and small syngeneic Meth A fibrosarcomas by 90%. Histologic examination revealed vascular damage, a reduction in vascular density, and a reduction in tumor plasma volume. Treatment with 3G4 induced the binding of monocytes to tumor endothelium and infiltration of macrophages into MDA-MB-435 and MDA-MB-231 tumors. No toxicity to the mice was observed. CONCLUSIONS: 3G4 localizes specifically to complexes of anionic phospholipids and serum proteins on the surface of vascular endothelial cells in tumors in mice. This results in damage to tumor vasculature and suppression of tumor growth.     

冠心病患者介入治疗失败后行急诊冠状动脉旁路移植术的预后

目的 探讨冠心病患者经皮冠状动脉介入治疗失败后行急诊冠状动脉旁路移植术(CABG)的预后.方法回顾性分析2002年1月至2010年12月阜外心血管病医院11例经皮冠状动脉介入治疗失败后行急诊CABG患者的临床资料,并进行随访.院内随访内容包括心脏性死亡、Q波心肌梗死、肾功能不全、神经系统事件;院外随访的研究终点为主要心血管不良事件,包括死亡、心肌梗死和靶病变血管重建.结果 患者年龄(61±5)岁.冠状动脉造影显示三支病变患者5例(45.5％).在介入治疗的靶血管病变中,9例(81.8％)位于左前降支,中、重度钙化、慢性完全闭塞及弥漫性长病变分别为3例(27.3％)、4例(36.4％)和4例(36.4％).11例患者均有行急诊CABG的指征,其中冠状动脉夹层5例(45.5％)、冠状动脉穿孔 3例(27.3％)、病变无法充分扩张1例(9.1％)、血管急性闭塞1例(9.1％)和支架脱载1例(9.1％).CABG术后随访(47±33)个月.院内随访期间,发生心脏性死亡1例(9.1％),Q波心肌梗死2例(18.2％).院外随访期间,1例(9.1％)患者死于肾功能衰竭,无因心原性事件再次住院的患者.结论经皮冠状动脉介入治疗失败后行急诊CABG多见于复杂冠状动脉病变,术后患者的长期预后良好.     

Analysis of glioma cell lines for amplification and overexpression of MDM2

Recently, amplification of the gene encoding a p53 binding protein, MDM2, was determined in 8% of the cases constituting a large series of glioblastomas. Here we have utilized Southern blot analysis to examine 30 cell lines established from such tumors, and our investigation has revealed large increases in MDM2 gene dosage in two cases, one of which showed coamplification of the CDK4 gene that resides in close proximity to MDM2 in chromosomal region 12q13–14. Northern analysis demonstrated overexpression of MDM2 mRNA in the two cell lines with gene amplification, and overexpression of MDM2 protein was evident in each of these by immunohistochemical and Western blot analysis. Analysis of TP53 cDNAs revealed normal TP53 sequences in the cell lines with MDM2 amplification; these results are consistent with those of previous studies suggesting that MDM2 amplification occurs only in tumors expressing wild-type p53. In total, these data suggest that MDM2 amplification in glioblastoma cell lines occurs at a frequency (6.7%) comparable to that determined in primary tumors; occurs in cell lines expressing wild-type p53; and can involve the coamplification of additional genes.     

癥瘕说略

讨论了瘕的定义,以及病位、病因、病机,并列举案例说明其辨证论治。     

基于.Net的实验室仪器设备管理系统三层架构设计与实现

结合海南医学院实际,介绍了学校实验室仪器设备管理系统的总体架构设计、系统功能设计及技术实现。测试运行显示,该系统方便了各类用户对实验室仪器设备的查询、管理与维护。     

Attribute capture in the precedence effect for long-duration noise sounds

Listeners perceptually fuse the direct wave from a sound source with its reflections off nearby surfaces into a single sound image, located at or near the sound source (the precedence effect). This study investigated how a brief gap presented in the middle of either a direct wave or simulated reflection is incorporated into the fused image. For short (<9.5 ms) delays between the direct (leading) and reflected (lagging) waves, no sound was perceived from the direction of the lagging wave. For delays between 10 and 15 ms, both sounds were perceived, but the gap was heard only on the leading side. When the gap was only in the correlated lagging sound at short delays, it also was perceived as occurring on the leading side. Moreover, gap detection thresholds were the same for gaps in the leading and lagging sounds, suggesting that the perception of the gap was not suppressed, but rather incorporated into the leading sound. Finally, scalp event-related potentials were not associated with the precedence effect until the gap occurred. This suggests that cortical mechanisms are engaged to maintain fusion when attributes in direct or reflected waves change.     

不同透析频率在尿毒症血液透析患者中的应用效果

目的：比较不同透析频率在尿毒症血液透析患者中的应用效果。方法选取2011年1月至2013年12月期间于我院进行血液透析治疗的81例尿毒症患者为研究对象,根据透析频率分为 A 组(每周透析4次,n =19)、B组(每周透析3次,n =33)、C 组(每周透析2次,n =29)。比较3组一般情况、营养状况指标、钙磷代谢状况、微炎症指标、并发症发生率和转归情况。结果开始透析时3组各临床资料比较差异均无统计学意义(P >0.05)。透析1年后,A 组血红蛋白(Hb)显著高于 B 组(P <0.05),A 组血清白蛋白(ALB)、前白蛋白(PA)、Hb 均显著高于 C 组,而血肌酐(SCr)和尿素氮(BUN)均显著低于 C 组(P <0.05),B 组的 ALB、PA 均显著高于 C 组(P <0.05)。A 组的血钙(Ca)显著高于 B 组和 C 组,而血磷(P)、甲状旁腺激素(PTH)显著低于 B 组和 C 组(P <0.05)。A 组的超敏 C 反应蛋白(hs-CRP)、白细胞介素6(IL-6)水平均显著低于 C 组(P <0.05)。A 组的感染发生率和病死率均显著低于 C组(P >0.05)。结论透析频率增加有助于改善营养状况和微炎症状态,降低感染的发生风险,从而改善尿毒症患者的预后,故推荐对每周透析3次的患者增加透析频率,在经济条件允许情况下可采用每周透析4次的高通量透析方案。     

Survival, mutagenesis, and host cell reactivation in a Chinese hamster ovary cell ERCC1 knock-out mutant

Positive selection-negative selection gene targeting was usedto disrupt the nucleotide excision repair gene ERCC1 in a Chinesehamster ovary cell line, CHO-K1. Southern and Northern analysisshowed that a cell clone isolated by this targeting approach,CHO-7-27, had an ERCC1 gene structure consistent with targeteddisruption of ERCC1 exon V, and did not express ERCC1 mRNA.CHO-7-27 was further characterized with respect to UV and mitomycinC sensitivities, and was shown to exhibit severe mutagen sensitivityphenotypes consistent with those of other CHO cell ERCC1 mutants.Mutation frequency experiments showed that CHO-7-27 was UV-hypermutableat the hypoxanthine-guanine phosphoribosyltransferase locus.Experiments assessing host cell reactivation of viral DNA synthesisfor UV-irradiated adenovirus showed that CHO7-27 exhibited aseverely deficient HCR phenotype similar to that of UV20 cells.Our results demonstrate that CHOK1 cells are hemizygous forthe ERCC1 gene, and show that the comparatively mild mutagensensitivities and lack of severely deficient HCR phenotypesof conventionally derived CHO-K1 ERCC1 mutants, in contrastto the severe phenotypes of CHO-AA8-derived mutants, are notdue to any intrinsic genetic differences between CHO-K1 andCHO-AA8 parental cell lines. ⁴To whom correspondence should be addressed