新型双道阻抗血流图仪

本文提出的新型双道血流图可用于检测两道独立的心,脑,肢体等阻抗血流数据并给出分析报告,可对心,脑,肝,肾及肢体等器官进行血流分析,打印相应的报告,临床试验表明,该仪器在心功能健康普查,心脏血管疾病的辅助诊断方面给出较为客观,可比性好的评价指标,可报告特征点数值,因此还可用于临床研究。     

补肾纳气活血冲剂治疗慢性阻塞性肺病的临床观察

慢性阻塞性肺疾病(chronic obstructive lung disease, COPD)是以气流限制不完全可逆为特征的呼吸系统疾病[1].2002～2004年,我们在常规治疗的同时,结合中药补肾纳气活血冲剂治疗COPD患者,取得了满意的疗效,现报道如下.     

血必净注射液对重症脓毒症患者Toll样受体4及下游细胞因子的影响

目的:探讨血必净注射液对重症脓毒症患者Toll样受体4(TLR4)及下游细胞因子的影响。方法:将40例严重脓毒症患者随机分为常规治疗组(20例)和血必净治疗组(20例);以同期20例健康志愿者作为健康对照组。常规治疗组按严重脓毒症治疗指南进行治疗;血必净治疗组在常规治疗组的基础上加用血必净注射液100mL静脉滴注,q12h,连续7天。健康对照组于清晨取血一次。常规治疗组与血必净治疗组于治疗前、治疗后第1、3、7天清晨取血。采用酶联免疫吸附法(ELISA)测定血清白细胞介素6(IL-6)、肿瘤坏死因子-α(TNF-α),流式细胞仪检测单核细胞膜表面TLR4蛋白表达,半定量逆转录-聚合酶链式反应法(RT-PCR)检测单核细胞TLR4 mRNA表达。结果两组患者之间治疗前IL-6、TNF-a、TLR4蛋白和TLR4mRNA的表达水平比较,差异无统计学意义(P>0.05),但均明显高于健康对照组,差异有统计学意义(P<0.01)。两组患者治疗后IL-6、TNF-a、TLR4蛋白和TLR4mRNA的表达水平与本组治疗前比较均明显下降,差异有统计学意义(P<0.05或P<0.01),且血必净治疗组下降幅度大于常规治疗组,差异有统计学意义(P<0.05或P<0.01)。结论:重症脓毒症患者IL-6、TNF-a、TLR4蛋白和TLR4mRNA的表达水平均升高;血必净可能通过下调TRL4蛋白及TRL4mRNA水平抑制下游细胞因子的释放。     

Retinoic acid retards fetal and hindlimb skeletal development asymmetrically in a retinoic acid-induced clubfoot model

Retinoic acid (RA) has been shown to induce congenital clubfoot in animal models, but it is unknown whether the effect of RA on the formation of clubfoot in vivo results from generalized growth retardation or from the specific effects of hindlimb skeletal development. Our experimental research was based on a clubfoot model treated by maternal administration of RA (120, 130 or 140 mg/kg body weight) as an intragastric dose on embryonic day 10 (E10), and a control group was administered with an equivalent dose of solvent. Prenatal RA exposure reduced fetal body weight, length and skeletal ossification of the hindlimb compared with the control fetuses in a dose-dependent manner. The normal development curves indicated that the RA-exposed fetuses showed delayed increase in body weight and skeletal ossification development. However, there was no uniform effect on the skeletons of the hindlimb, not least retardation in ossification and induction malformation on the talus and calcaneus. Our results demonstrated that prenatal RA exposure had retardation effects on the developing hindlimb skeleton that was independent of those on the overall fetal growth. The normal skeletal ossification showed that the talus and calcaneus were poorly ossified and they were delayed by almost one day in the RA 120 mg/kg group. Therefore, during the susceptible stages, different regions of the limb bud responded differently to the teratogenic effects of RA.     

玻璃体切割术后角膜上皮病变的危险因素分析

目的:分析玻璃体切割术(PPV)后发生角膜上皮病变(CED)的危险因素。方法:回顾性分析2016-07/2018-06于我院行PPV术的患者235例235眼的临床资料,收集患者年龄、性别、相关病史资料(如眼部病变、全身疾病),记录术中眼内填充物、手术时间、术后眼压等情况,采用Logistic回归分析PPV术后发生CED的危险因素。结果:本研究纳入患者PPV术后CED发生率为16.6%(39/235),持续性角膜上皮病变发生率为1.3%(3/235)。Logistic回归分析结果显示年龄、术前合并干眼、糖尿病、术中硅油填充、术后高眼压及手术时间是导致PPV术后发生CED的危险因素(OR=1.270、5.218、18.598、4.659、10.799、1.104,均P<0.05)。结论:患者年龄、术前合并干眼、糖尿病、术中硅油填充、手术时间及术后高眼压是PPV术后发生CED的危险因素。     

Role of saliva proteinase 3 in dental caries

Salivary analysis can be used to assess the severity of caries. Of the known salivary proteins, a paucity of information exists concerning the role of proteinase 3 (PR3), a serine protease of the chymotrypsin family, in dental caries. Whole, unstimulated saliva was collected from children with varying degrees of active caries and tested using a Human Protease Array Kit and an enzyme-linked immunosorbent assay. A significantly decreased concentration of salivary PR3 was noted with increasing severity of dental caries (P<0.01); a positive correlation (r=0.87; P<0.01; Pearson''s correlation analysis) was also observed between salivary pH and PR3 concentration. In an antibacterial test, a PR3 concentration of 250 ng·mL⁻¹ or higher significantly inhibited Streptococcus mutans UA159 growth after 12 h of incubation (P<0.05). These studies indicate that PR3 is a salivary factor associated with the severity of dental caries, as suggested by the negative relationship between salivary PR3 concentration and the severity of caries as well as the susceptibility of S. mutans to PR3.     

Endobronchial Ultrasound Elastography for Diagnosing Mediastinal and Hilar Lymph Nodes

Background:

Pathophysiological processes, such as malignancy, can lead to the formation of stiffer tissue in lung cancers. Endobronchial ultrasound (EBUS) elastography is a novel technique for measuring tissue stiffness during EBUS-guided transbronchial needle aspiration (EBUS-TBNA). The current study was conducted to investigate the diagnostic value of EBUS elastography for mediastinal and hilar lymph node metastasis in lung cancers.

Methods:

From January 2014 to January 2015, 40 patients suspected of lung cancer were enrolled, and a total of 68 lymph nodes were evaluated by EBUS-TBNA. EBUS-guided elastography of lymph nodes was performed prior to EBUS-TBNA. Standard EBUS characteristics were also described. Pathological determination of malignant or benign lymph nodes was used as the gold standard for this study. If EBUS-TBNA did not result in a formal pathological diagnosis of malignancy, patients were referred for a surgical procedure. Comparisons of elastography and standard EBUS characteristics were made between benign and malignant lymph nodes.

Results:

Elastography grading scores and strain ratios showed significant differences between benign and malignant lymph nodes (P = 0.000). The elastography strain ratio was more sensitive and specific for determining malignant lymph nodes than elastography grading score or standard EBUS criteria. The receiver operating characteristic curve for the elastography strain ratio showed an area under the curve of 0.933. The best cut-off point of the strain ratio for differentiating malignant from benign lymph nodes was 32.07. The elastography strain ratio had a sensitivity of 88.1%, the specificity of 80.8%, positive predictive value of 88.1%, and negative predictive value of 80.8% for distinguishing malignant from benign nodes. The overall accuracy of elastography strain ratio was 85.3%. The strain ratio of malignant and benign lymph nodes positively correlated with the elastography grading score (r = 0.561, P = 0.000).

Conclusions:

EBUS elastography can be effectively used to predict mediastinal and hilar lymph node metastases in lung cancer. This noninvasive technique may thus complement standard EBUS and help guide EBUS-TBNA procedures.     

Determination of a new active steroid by high performance liquid chromatography with laser-induced fluorescence detection following the pre-column derivatization

A sensitive analytical method for the determination of a new active steroid, butane acid-(5-androsten-17-one-3beta-ol)-diester (A1998), was developed by high performance liquid chromatography with laser-induced fluorescence detection following the pre-column derivatization with dansylhydrazine. The calibration curve for A1998 derivatization was found linear in the dynamic range from 0.025 to 5.0 microg/ml, with the precision less than 6% (CV) and the mean extraction efficiency greater than 92%. In 200 microl of plasma samples the limit of quantitation was as low as 0.025 microg/ml with a signal-to-noise ratio of 10. This assaying was further applied to the determination of the pharmacokinetic parameters of A1998 in rats with an intravenous injection of A1998. Values for clearance for elimination, volume of distribution at steady state and terminal half life in the above case were determined as 50.3+/-1.1 ml/min kg, 1329.0+/-111.0 ml/kg and 44.0+/-2.7 min, respectively.