一氧化氮对犬下食管括约肌压力的作用

目的 :应用苄基二甲基十四烷氯化铵 (benzyldim ethyltetradecyl amm onium chloride,BAC)建立犬下食管括约肌(L ES)无神经动物模型 ,研究一氧化氮 (NO)对 L ES压力的作用。方法 :将 BAC环周注入犬 L ES,对照组注入等量生理盐水 ,均于注射前及注射后 6周测定 L ES压力 ;并观察 L -精氨酸、D -精氨酸、硝普钠及一氧化氮合酶 (NOS)抑制剂 N-硝基 - L -精氨酸 (L - NNA)对 L ES压力的影响 ;此外还测定了两组犬 L ES中 NO含量和 NOS活性。结果 :BAC处理组 L ES压力 [(4 2 .43±4.19) m m Hg,1m m Hg=0 .133 k Pa]显著高于对照组 [(2 2 .71± 5 .19) mm Hg]。 L -精氨酸可使对照组 L ES压力降低 ;L - NNA使其增高 ,但对 BAC处理组 L ES压力均无影响。硝普钠可降低两组犬 L ES压力。对照组 L ES中 NO为 (6 .0 5 8± 2 .0 6 7)μm ol/g,NOS为 (1.45 8± 0 .146 ) U /mg;而 BAC处理组 NO为 (1.797± 0 .873)μmol/g,NOS为 (0 .46 3± 0 .0 39) U /m g,均较对照组显著降低 (P<0 .0 1)。 结论 :BAC可使犬 L ES压力增高 ,其机制可能与 L ES局部 NO减少有关。     

Development a nomogram to predict fertilisation rate of infertile males with borderline semen by using semen parameters combined with AMH and INHB

The sperm quality of some males is in a critical state, making it hard for clinicians to choose the suitable fertilisation methods. This study aimed to develop an intelligent nomogram for predicting fertilisation rate of infertile males with borderline semen. 160 males underwent in vitro fertilisation (IVF), 58 of whom received rescue ICSI (R-ICSI) due to fertilisation failure (fertilisation rate of IVF ≤30%). A least absolute shrinkage and selection operator (LASSO) regression analysis identified sperm concentration, progressively motile spermatozoa (PMS), seminal plasma anti-Müllerian hormone (spAMH), seminal plasma inhibin (spINHB), serum AMH (serAMH) and serum INHB (serINHB) as significant predictors. The nomogram was plotted by multivariable logistic regression. This nomogram-illustrated model showed good discrimination, calibration and clinical value. The area under the receiver operating characteristic curve (AUC) of the nomogram was 0.762 (p < .001). Calibration curve and Hosmer–Lemeshow test (p = .5261) showed good consistency between the predictions of the nomogram and the actual observations, and decision curve analysis showed that the nomogram was clinically useful. This nomogram may be useful in predicting fertilisation rate, mainly focused on new biomarkers, INHB and AMH. It could assist clinicians and laboratory technicians select appropriate fertilisation methods (IVF or ICSI) for male patients with borderline semen.     

卡氏乳香中1个新的降二萜

目的 研究卡氏乳香Boswellia carterii中的化学成分及其抗骨质疏松活性。方法 运用硅胶柱色谱、ODS柱色谱和制备高效液相色谱等方法进行化学成分分离,通过波谱数据及文献对比对其进行结构解析。结果 卡氏乳香的95%乙醇提取物中分离得到11个化合物,分别鉴定为 (1R,2E,8S,9R)-1,9-环氧-8-乙酰氧基-4,5-二氧代降西松烷型-2-烯（1）、rel(1S,3R,7E,11S,12R)-1,12-epoxy-4-methylenecembr-7-ene-3,11-diol（2）、boscartin F（3）、boscartene K（4）、fidmansumbin-13(17)-en-3,16-diene（5）、3α-acetoxyl-7-oxo-tirucalla-8,24-dien-21-oic acid（6）、boscartene N（7）、3β-hydroxy-tirucallic acid（8）、α-boswellic acid（9）、boscarterol O（10）、boscarterol F（11）。结论 化合物1是新化合物,命名为卡氏乳香素,化合物5为首次从乳香中分离得到,化合物2和10首次从该属植物中分离得到。对11个化合物进行抗骨质疏松活性筛选,发现化合物1、3、6和10具有良好的抑制破骨细胞活性。     

柴胡桂枝干姜汤联合耳穴压豆治疗胃肠功能紊乱临床研究

目的：观察柴胡桂枝干姜汤联合耳穴压豆治疗胃肠功能紊乱的临床疗效。方法：选取胃肠功能紊乱患者110例,按单双数随机分为2组各55例。对照组予西药奥美拉唑肠溶胶囊治疗,观察组予柴胡桂枝干姜汤联合耳穴压豆治疗。观察比较2组胃肠功能指标改善情况及临床疗效。结果：观察组胃肠功能指标嗳气减少、腹胀减轻、腹部隐痛消失时间均短于对照组,差异均有统计学意义（P<0.05）。临床疗效总有效率观察组96.36%,对照组72.73%,2组临床疗效总有效率比较,差异有统计学意义（P<0.05）。结论：柴胡桂枝干姜汤联合耳穴压豆治疗胃肠功能紊乱患者,相较于单纯使用奥美拉唑肠溶胶囊治疗,可明显缩短改善嗳气、腹胀、腹部隐痛的时间,提高临床疗效。     

Comparison of the anxiety,depression and their relationship to quality of life among adult acute leukemia patients and their family caregivers: a cross-sectional study in China

Quality of Life Research - To compare the anxiety, depression and explore their relationship to quality of life (QoL) among adult acute leukemia (AL) patients and family caregivers (FCs) in China....     

包裹天然骨架CpG ODN和HBsAg的非磷脂脂质体疫苗的免疫效果

非磷脂脂质体NovasomeR○(Np )是由Brij5 2、胆固醇和油酸组成 ,可作为同时传递佐剂和抗原的载体。我们将HBsAg与天然骨架CpGODN (phosphodiesterCpGODN ,pdCpGODN )包裹于Np后免疫BALB/c小鼠 ,检测其免疫效果。结果显示 ,包裹pdCpGODN和HBsAg的Np在小鼠中诱导了很高滴度的抗 HBs抗体产生并诱生了HBsAgS2 8 3 9特异性的CTL ,而铝佐剂组和仅包裹HBsAg的Np组诱生的抗体滴度较低 ,未检测到CTL活力。抗体亚类分析结果表明包裹pdCpGODN和HBsAg的Np诱生的免疫应答类型与pdCpGODN剂量有关 ,较低剂量 (2 4 μgpdCpGODN )诱生的为IgG2a为主的Th1型应答 ,而较高剂量(4 7μgpdCpGODN )诱生的是Th1/Th2混合型应答。铝佐剂和仅包裹HBsAg的Np组诱生的是以IgG1为主的Th2型应答。此外 ,包裹pdCpGODN和HBsAg的Np免疫小鼠脾淋巴细胞在体外HBsAg刺激培养后特异性增殖并分泌高水平的IFN γ。这些结果表明包裹pdCpGODN和HBsAg的Np能增强HBsAg的免疫原性 ,诱生体液 /细胞免疫均衡应答 ,有可能发展为慢性乙肝的治疗性疫苗     

GK型机械瓣空化可视化研究

对国产GK27型机械二尖瓣进行了单次关闭方式的离体空化实验，采用数码相机拍摄了空泡照片。机械瓣阻塞体关闭后，云状空泡出现在挡座周围，呈放射状向外运动，空化原因是机械瓣关闭时阻塞体与挡座的撞击形成的局部挤压射流，挤压缝隙出口射流速度高达9m/s，局部低压造成空化，在机理上，这是附壁射流引起的旋涡空化。关闭速度是衡量机械瓣空化趋势的重要指标之一。空化历时随心室载荷率的增加而增加，在载荷率为2750mmHg/s时，最大空化历时达440μs。机械瓣空化临界载荷率为420mmHg/s，这比动物实验所得的正常生理条件750mmHg/s低，因此在人体正常生理条件下，机械二尖瓣存在空化的可能。     

Clinicopathologic features and survival of patients with colorectal mucinous, signet-ring cell or non-mucinous adenocarcinoma:experience at an institution in southern China

Background Previous studies have shown conflicting results on the relation between clinicopathologic features and prognosis of patients with colorectal mucinous, signet-ring cell, or non-mucinous adenocarcinoma; only few such studies have been performed in China. This retrospective study analyzed data from our department to investigate clinicopathologic characteristics, prognosis and possible correlations of three histologic types -- colorectal mucinous,signet-ring cell, and non-mucinous adenocarcinoma, to clarity the bases for observed differences which may lead to development of targeted therapies Methods Of 2079 patients diagnosed with colorectal cancer between 1994 and 2007, 144 had mucinous, 25 had signet-ring cell, and 1837 had non-mucinous adenocarcinoma. Their clinicopathologic parameters and survival were analyzed using established statistical methodologies.Results Mucinous and signet-ring cell adenocarcinomas were common in younger patients (P <0.001). Location, size and disease stage differed significantly among the three types. Signet-ring cell tumors were more commonly found in the rectum than mucinous and non-mucinous adenocarcinoma (P <0.001). Mucinous and signet-ring cell tumors presented in a later stage in life more often than non-mucinous adenocarcinoma, with lymph node involvement, serosal infiltration, peritoneal dissemination, and adjacent organ invasion (P <0.01). The rate of radical resection, hepatic metastasis and local recurrence did not differ among types (P ＞0.05). Compared with patients with non-mucinous adenocarcinoma, patients with mucinous and signet-ring cell tumors who underwent potentially curative resections or stage Ⅱ/Ⅲ disease had poorer long-term overall survival. Survival did not differ by type for patients with either stage Ⅰor Ⅳ disease (P ＞0.05). Conclusions Mucinous and signet-ring cell adenocarcinoma have unique carcinogenesis and similar biologic behavior.Our study confirms that both histologic types, especially signet-ring cell tumors, are independent, negative prognostic factors for patients with colorectal cancer. Type does not appear to have a significant effect on survival when disease is either stage Ⅰ or Ⅳ at presentation.     

Early operation for fulminant acute pancreatitis: a possible way to decrease mortality

Background Although the indication and the timing for surgery in fulminant acute pancreatitis (FAP) are still controversial, our experience of surgical treatment for fulminant acute pancreaUtis may help improve the outcome for patients.Methods The clinical data of twenty-six patients with FAP from January 1, 2001 to October 1,2005 were analyzed. The diagnostic criteria fitted the 2007 Guidelines for the Management of Severe Acute Pancreatitis by the Chinese Medical Association.Results Twenty-six patients with FAP received surgical debridement, with a mortality rate of 42.3% (11/26). The postoperative mortalities in the ＞72 hour operation group and the <72 hour operation group were highly significantly different (7/8 vs 22.2% (4/18), respectively).Conclusions Early surgery may reduce the intraabdominal pressure and prevent the deterioration of FAP. An operation within 72 hours from the onset of symptoms might decrease the mortality of the disease.