DIAGNOSIS AND TREATMENT OF INSIDIOUS RECURRENT SMALL INTESTINAL HEMORRHAGE

Objective. To improve the localized diagnosis of insidious recurrent small intestinal hemorrhage. Methods. This retrospective analysis include 64 cases of such diseases, which were admitted from 1988 to 1998 toour hospital. Result. Ultrasonography, CT, small bowel pneumobariunlgraphy, diluted barium enema, isetopic examination, DSA and intraoperafive small-bowel endoscopy were used for diagnosis of hemonrrhagic site, and 37 cases got a defirfite location before operation, while 10 cases were confirmed the diagnosis during the operation. Forty-seven cases were treated surgically, while the other 17 cases had non-surgical treatment. Of the 47 cases,39 cases underwent partial en-terectomy, 5 cases had suture and ligature of vascular deformity, 2 cases had Whipple‘s operation, and one patient had ectomy of the end of ileum and right colon. Conclusion. DSA, Isotopic examination and intraoperafive enteroscopy are of considerable importance for the lo-cation judgement of recurrent small intestinal hemorrhage.     

力调控糖蛋白Ibα与细丝蛋白相互作用的分子动力学模拟

静息血小板中细丝蛋白a的17号结构域(FLNa17)可组成型结合到血小板膜糖蛋白Ibα(GPIbα)的胞质尾部(GPIbα-CT),抑制下游信号活化,而配体的结合和血流剪切力可激活血小板。为模拟来自GPIbα胞外配体向胞内传递的正向拉力及血小板细胞骨架形变传递的侧向张力,本文在GPIbα-CT/FLNa17复合物上施加两种受力模式,采用分子动力学模拟方法探究机械力对该复合物亲和力及力学稳定性的调控。本研究首先识别出GPIbα-CT与FLNa17接触面上的9对关键氢键是维持复合物结构稳定的基础。其次,发现仅正向拉力作用下,这些氢键作用网络才会发生断裂,并导致复合物的最终解离;而侧向张力下,FLNa17两端的二级结构会解折叠以保护复合物接触面不受机械力破坏。在0～40 pN范围内,正向拉力的增加促使GPIbα-CT氨基酸序列中第563位的苯丙氨酸的氮原子(PHE⁵⁶³-N)的外旋和复合物解离概率的提高。本研究首次在原子层面揭示胞外配体传递的正向拉力可更有效解除FLNa17对GPIbα下游信号的抑制,为深入理解力调控的血小板胞内信号通路提供参考。     

舰艇用防火漆热解气急性吸入毒性试验

目的 :观察舰艇用防火漆热解气小鼠急性吸入毒性。方法 :急性试验用鼠 6 0只 ,随机分为 6组 ,每组 10只 ,各组试验浓度呈等比级数 ,染毒柜为六面体的玻璃柜。启动热解气循环系统后 ,用煤气火焰烧烤干漆膜试样 ,直到全部炭化 ,小鼠在染毒柜内静式吸入 2h ,观察小鼠在染毒期间的活动情况 ,存活小鼠饲养观察 2周 ,解剖作病理检查。结果 :染毒后急性死亡小鼠以肺的急性损害为主要特征。存活小鼠镜下所见各脏器与正常对照组无明显差异。结论 :通过防火漆热解气小鼠急性吸入毒性试验 ,求得LC50 为 5 7.72mg/L ,舰艇用防火漆属低毒类。     

肺癌侵犯左心房的MRI诊断价值探讨

作者将肺癌侵犯左心房的ＭＲＩ征象归纳为左心房的异常,左房周围脂肪异常和肺静脉干异常三点,并以此为诊断标准判断有无左房受侵,通过对３０例肺癌患者术前ＭＲＩ征象分析与术后结果对照研究,结果显示：ＭＲＩ诊断的敏感性、特异性、准确性分别为９３３％、８６７％、９００％。本文结合文献探讨了ＭＲＩ对该病的诊断价值     

热休克蛋白70抑制大鼠感染性脑水肿炎症因子的研究

为了探讨热休克蛋白７０（ＨＳＰ７０）对大鼠感染性脑水肿的保护作用,该文采用百日咳菌液所致的大鼠感染性脑水肿模型及将大鼠进行热休克处理,观察脑组织中白细胞介素１－β（ＩＬ－１β）、肿瘤坏死因子－α（ＴＮＦ－α）及一氧化氮（ＮＯ）水平的变化,并应用Ｗｅｓｔｅｒｎ印迹分析检测大鼠脑组织的ＨＳＰ７０表达。结果发现感染性脑水肿脑组织ＩＬ－１β、ＴＮＦ－α及ＮＯ浓度均增高,热休克处理可降低以上三者的浓度,Ｗｅ     

酸枣、山楂、葡萄的体外抗氧化作用研究

采用Ｆｅ２＋－半胱氨酸诱发大鼠肝微粒体生成丙二醛（ＭＤＡ）和用过氧化叔丁醇（ｔｅｒｔ－ｂｕｔｙｌｈｙ－ｄｒｏｐｅｒｏｘｉｄｅ）损伤大鼠红细胞生成ＭＤＡ两种损伤体系,分别观察酸枣、山楂、葡萄３种果汁的体外抗脂质过氧化作用。结果表明,在２．５～３．３ｍｇ／ｍｌ浓度下,葡萄、山楂和酸枣３种果汁对Ｆｅ２＋－半胱氨酸诱发大鼠肝微粒体ＭＤＡ生成的抑制率分别达到４６．２％、９８．３％和９９．１％,这３种果汁对过氧化叔丁醇所致大鼠红细胞生成ＭＤＡ的抑制率分别为葡萄汁（５５．６ｍｇ／ｍｌ）５８．５％、山楂汁（１３．９ｍｇ／ｍｌ）３８．７％和酸枣汁（８．３ｍｇ／ｍｌ）３８．７％。采用ＥＳＲ测定３种果汁对Ｏ－２和ＯＨ自由基的清除作用。结果表明高浓度时,葡萄汁（１３４ｍｇ／ｍｌ）、山楂汁（５０ｍｇ／ｍｌ）和酸枣汁（５０ｍｇ／ｍｌ）对Ｏ－２的清除率分别为７４．７％、８５．８％和８４．０％,对ＯＨ自由基的清除率分别为８６．３％、９７．８％和９６．７％。上述结果表明,这３种果汁具有较强的抗氧化作用。     

足月儿母乳淀粉酶活性动态变化

为了解我国足月儿母乳淀粉酶活性的动态变化规律,测定40例足月顺产儿乳母不同泌乳期及一次喂奶时前、中、后段乳及母血中淀粉酶的活性。结果显示初乳中淀粉酶活性为(9772.37±1.70)IU/L;随着泌乳期的延长,淀粉酶活性逐渐下降;一次喂奶前、中、后段乳中淀粉酶的活性差异无显著性意义;母乳淀粉酶98％为唾液型淀粉酶;母乳中淀粉酶活性高于母血100倍;产妇年龄与母乳淀粉酶活性无显著性相关。提示母乳中含有丰富的淀粉酶,对母乳喂养儿的淀粉消化和潜在的抗感染作用具有积极意义,应向广大群众大力提倡母乳喂养。     

危重患儿血糖与胰岛素水平的临床分析

Objective To analyse the changes of blood glucose and insulin levels in children with critical illness,and to investigate the mechanism of hyperglycemia in critical illness.Methods Blood glucose and insulin levels were detected among 51 critically ill children hospitalized in our PICU from January to December,2007,which were compared with those of 15 healthy children.Results (1) All the patients had hyperglycemia after admission within 2Ah,septic shock patients showed the highest level with the maximum value of 27.30 mmol/L The dally mean blood glucose levels of the first 5 days after admission peaked on the admission day.(2) Within 24 h after admission,the blood insulin levels of patients with pulmonary infection,intracranial infection,septic shock and congenital heart disease were(17.65±16.85) mU/L,(13.45±7.33) mU/L,(16.24±12.41) mU/L,(6.75±3.22) mU/L respectively.The blood insulin levels of all the patients within the first 5 days after admission wrere higher than that of healthy children[(8.70±6.57) mU/L].According to blood glucose level on admission day,the patients were divided into normoglycemia and hyperglycemia group,and the blood insulin levels of the former and the letter were(5.44 ± 3.38) mU/L and (14.22±12.29) mU/L respectively.(3) The mean of PIM Ⅱscore of the patients averaged 12.96±16.82,and the mortality rate was 15.6%.The blood glucose level and the insulin level within 24 h after admission were(10.97±5.76) mmol/L and(49.46±90.35) mU/L in dead cases and(8.73±2.58) mmol/L and(11.91±11.24) mU/L for the survivals,and both the blood glucose level and insulin level had significant difference between the dead cases and survivals(P ＜0.05).(4) The scatter graphic analysis did not show significant linear relation between blood glucose and insulin,nor did it show significant linear relation between PIM Ⅱ and insulin levei,or blood glucose.Condusion Hyperglycemia and hyperinsulinemia are common in critical illness,which reflects indirectly the severity and prognosis of the disease.Hyperglycemia may be related to relative insulin insufficiency or insulin resistance;however,the definite relationship can not be confirmed until more reliable clinical data were available in the future.     

PPAR-γ的激动剂抑制肺癌细胞生长的实验研究

目的　研究肺癌细胞上过氧化物酶体增生物激活受体γ(PPAR γ)的表达及其经配体 (激动剂 )活化后抑制肺癌细胞生长的机制。方法　以RT PCR和Westernblot检测肺癌细胞上PPAR γ的表达 ,并通过MTT和细胞计数检测经PPAR γ的激动剂作用后的细胞增殖情况 ,以TUNEL检测细胞的凋亡情况。结果　两种细胞上均有PPAR γ的表达 ;PPAR γ的配体作用后明显抑制细胞生长 ,且与时间和剂量有关 ;经配体活化的PPAR γ能诱导细胞凋亡 ,使其增殖受抑。结论　作为肺癌治疗的新靶点———PPAR γ在肺癌细胞上表达 ,且经配体活化后能通过诱导凋亡而抑制肺癌细胞的生长 ,从而为未来肺癌的治疗提供了新的途径     

鼻内镜手术用微波止血及清除病灶的疗效观察

目的 探讨有效减少内镜鼻窦手术中出血及彻底清除病灶的微波处理方式。方法 选择临床Ⅱ、Ⅲ型慢性鼻窦炎鼻息肉88例,随机分为:A组48例,采用内镜手术配合微波治疗;B组40例,行单纯鼻内镜手术。术后统计分析两组的出血量、手术时间及微波组10周内上皮化与常规组的比较。结果 两组治疗后平均出血量和手术时间分别是:A组为(91.25±72.55)ml和(57.95±9.70)min;B组为(115.89±59.48)ml和(73.59±20.77)min。治愈率A组为83.3％,B组为70.0％。10周内术腔上皮化A组为70.8％,B组为40.O％。结论 鼻窦炎鼻息肉在施行鼻内镜手术时,配合微波处理术中出血及清除病灶,能明显减少出血量,缩短手术时间,提高治愈率,缩短疗程。