中医肺康复法治疗慢性阻塞性肺疾病稳定期患者的疗效分析

目的：探讨与分析中医肺康复法治疗慢性阻塞性肺疾病稳定期患者的临床效果。方法将2010年9月~2013年9月于我院接受治疗的100例慢性阻塞性肺疾病稳定期患者作为研究对象,按照入院顺序随机将其分为对照组与观察组各50例,对对照组患者选用口服多索茶碱片治疗,对观察组则给予中医肺康复法治疗,对比观察两组患者的治疗效果。结果观察组患者在接受治疗后,中医症候评分显著低于对照组患者,且治疗后其生存质量的评分提高情况明显高于对照组患者,<0.05。结论选用中医肺康复法能够显著提高COPD稳定期患者的治疗效果,改善其肺部组织功能,延长其生存时间,并提高患者的生活质量。     

Associations of visit-to-visit fasting glucose with risk of mortality: A retrospective cohort study of 48,077 people with type 2 diabetes

AimTo investigate the association between mean fasting glucose (FG) and variability in visit-to-visit FG and risk of mortality in people with type 2 diabetes (T2D).MethodsThis retrospective cohort study included 48,077 Chinese men and women with T2D. The yearly mean and coefficient of variation for fasting glucose (mean-FG and FG-CV, respectively) were based on at least two measurements taken each year over a mean duration of 4.5 years. Deaths and their causes were identified using the Shanghai Vital Statistics registry. Mean-FG and FG-CV served as time-dependent variables in Cox models to estimate their associations with risk of mortality; hazard ratios (HRs) were adjusted for baseline risk factors. Potential non-linear associations were examined by restricted cubic splines.ResultsDuring an average 4.5 years of follow-up, 2095 men and 1923 women died. Men with low mean-FG and women with low or high FG were at greater risk of death. Mean-FG was not associated with either cardiovascular disease (CVD) or cancer-specific mortality, whereas higher yearly FG-CV was associated with all-cause and CVD-/cancer-specific mortality in both genders. Compared with a yearly FG-CV of 1.76 (5th percentile), men and women with an FG-CV of 14.14 (75th percentile) had HRs (95% CI) of 1.41 (1.24–1.61) and 1.44 (1.26–1.65), respectively, for all-cause mortality.ConclusionVariability of visit-to-visit FG may be a more sensitive predictor of risk of death than mean-FG in people with T2D.     

Anatomic Variants on Computed Tomography in Congenital Aural Atresia and Stenosis

Objectives

To quantitatively analyzing the anatomic variants on temporal computed tomography (CT) in congenital external auditory canal stenosis (EACS), congenital aural atresia (CAA), and normal ear structure.

Methods

Through a retrospective study, we analyzed 142 temporal high-resolution CT studies performed in 71 microtia patients. The following 6 parameters were compared among the three groups: Marx classification, medial canal diameter, vertical facial nerve (VFN) anterior displacement, tegmen mastoideum position, tympanic cavity volume, and malleus-incus joint or malleus-incus complex (MIC) area.

Results

The results showed that the microtia distributions in the Marx classification in these three groups were significantly different, as 86% (31 of 35) of ears with major microtia (third-degree dysplasia) had an atresia, and in 54.8% (23 of 42) of the minor microtic (first-degree or second-degree) ears, the bony or cartilaginous part of the external auditory canal was stenotic. Measurement data also showed that the potential medial canal diameter of the atresia group was obviously shorter than that of the stenosis group. The VFN anterior displacement and temporomandibular joint backward-shift together lead to medial canal diameters in ears with atresic canals that is smaller than those with stenotic canals. The tegmen mastoideum position was not significantly different between the three groups.

Conclusion

The mal-development of the external auditory canal is significantly associated with auricle and middle ear developmental anomalies. Compared with CAA ears, EACS have better development of the auricle, canal, tympanic cavity and MIC and relatively safer surgical operation except for the position of the tegmen mastoideum and the VFN.     

Inhibiting HIV-1 infection in human T cells by lentiviral-mediated delivery of small interfering RNA against CCR5

Double-stranded RNAs approximately 21 nucleotides long [small interfering RNA (siRNA)] are recognized as powerful reagents to reduce the expression of specific genes. To use them as reagents to protect cells against viral infection, effective methods for introducing siRNAs into primary cells are required. Here, we describe success in constructing a lentivirus-based vector to introduce siRNAs against the HIV-1 coreceptor, CCR5, into human peripheral blood T lymphocytes. With high-titer vector stocks, >40% of the peripheral blood T lymphocytes could be transduced, and the expression of a potent CCR5-siRNA resulted in up to 10-fold inhibition of CCR5 expression on the cell surface over a period of 2 weeks in the absence of selection. In contrast, the expression of another major HIV-1 coreceptor, CXCR4, was not affected. Importantly, blocking CCR5 expression by siRNAs provided a substantial protection for the lymphocyte populations from CCR5-tropic HIV-1 virus infection, dropping infected cells by 3- to 7-fold; only a minimal effect on infection by a CXCR4-tropic virus was observed. Thus, our studies demonstrate the feasibility and potential of lentiviral vector-mediated delivery of siRNAs as a general means of intracellular immunization for the treatment of HIV-1 and other viral diseases.     

丙型肝炎5''''非编码区末端快速基因扩增方法的建立及应用

目的 建立快速获得丙型肝炎（HCV）基因组5’非编码区（5’uTR）真末端序列的分子生物学方法。方法 逆转录后利用末端聚合酶（TOT）进行加尾反应，再利用套式聚合酶链反应（PCR）扩增出目的末端基因的cDNA片段，A-T克隆，用限制性内切酶片段长度多态性分析（RVLP）与PCR鉴定重组子，全自动序列分析仪测定插入子序列。结果 cDNA末端快速扩增技术（RACE）获得5株HCV5’UTR克隆，包括3株全长克隆和2株缺失克隆。2株缺失克隆，一条在5’末端缺失53个碱基，另一条缺失144个碱基。结论 RACE技术快速、有效、实用，可有效获得丙型肝炎病毒基因组的5’非编码区末端序列。     

泛昔洛韦和拉米夫定治疗慢性乙肝的短期疗效对比研究

比较和评价泛昔洛韦和拉米夫定短期治疗慢性乙肝的疗效.将101例慢性乙肝患者,随机分为泛昔洛韦组(A组)1500mg/日分三次(4个月)、拉米夫定组(B组)100mg/日和对照组(C组).结果显示,治疗4个月时①A、B和C组ALT的复常率分别为74.0%、82.5%和63.3%.②A和B组HBV DNA的阴转率为64.5%和90.0%均显著高于C组(16.5%),P＜0.001;B组明显高于A组,P=0.017.③A和B组HBeAg血清转化率达27.3%和25.8%,高于C组(13.0%),但P＞0.05.④A组HBV DNA阴转的20例患者,在停药后2、4和6月时其持续应答率分别为65.0%、45.0%和25.0%.表明泛昔洛韦和拉米夫定对慢性乙肝均有治疗效果,拉米夫定的抗病毒作用和疗效明显优于泛昔洛韦.     

性激素及人前列腺生长因子对人前列腺间质成纤维细胞增殖的影响

从人胎儿前列腺组织中分离培养了间质成纤维细胞,观察雄激素(DHT)、雌激素(E_2)及部分纯化的人前列腺生长因子(hPGF)对该细胞增殖的影响。结果发现:(1)DHT及hPGF对体外培养的人前列腺间质成纤维细胞均具有明显的促增殖作用,但前者表现为延迟反应,后者为即时效应;(2)雌激素对该细胞无刺激增殖作用;(3)E_2与DHT联合应用对该细胞增殖刺激作用也无明显影响。实验结果提示:DHT对人前列腺间质成纤维细胞具有间接的刺激增殖作用,可能通过刺激前列腺细胞自分泌或旁分泌作用而调节前列腺生长。     

Do race and gender influence the use of invasive procedures?

OBJECTIVE: To assess the influence of race and gender influence on the use of invasive procedures in patients with acute myocardial infarction (AMI) in community hospitals. DESIGN: Prospective, observational. SETTING: Five mid-Michigan community hospitals. PATIENTS: All patients (838) identified with AMI between January 1994 and April 1995 in 1 of these hospitals. MEASUREMENTS AND MAIN RESULTS: After adjusting for age, hospital of admission, insurance type, severity of AMI, and comorbidity, using white men as the reference group, the rate of being offered cardiac catheterization (CC) was 0.88 (95% confidence interval [95% CI], 0.60 to 1.29) for white women; 0.79 (95% CI, 0.41 to 1.50) for black men; and 1.14 (95% CI, 0.53 to 2.45)for black women. Among patients who underwent CC, after also adjusting for coronary artery anatomy, the rate of being offered angioplasty, using white men as the reference group, was 1.22 (95% CI, 0.75 to 1.98) for white women; 0.61 (5% CI, 0.29 to 1.28, P =.192) for black men; and 0.40 (95% CI, 0.14 to 1.13) for black women The adjusted rate of being offered bypass surgery was 0.47 (95% CI, 0.24 to 0.89) for white women; 0.36 (95% CI, 0.12 to 1.06) for black men; and 0.37 (95% CI, 0.11 to 1.28)for black women. CONCLUSIONS: Our study shows that white women are less likely than white men to be offered bypass surgery after AMI. Although black men and women with AMI are less likely than white men to be offered percutaneous transluminal coronary angioplasty or coronary artery bypass grafting in both unadjusted and adjusted analyses, these findings did not reach statistical significance. Our study is limited in power due to the small number of blacks in the sample.