施行负压吸引快速羊水减量术孕妇的围术期护理

目的探讨负压吸引快速羊水减量术治疗羊水过多孕妇的围术期护理方法。方法回顾性分析并总结2010年5月至2012年12月在同济大学附属第一妇婴保健院施行快速负压吸引羊水减量术的57例孕妇的临床资料。结果 57例孕妇行羊水减量术75次,平均抽取羊水量为(2640±1208)ml,手术过程均顺利;1例孕妇当日发生胎膜早破流产,无胎盘早剥及宫腔感染发生。结论精心细致的围术期护理有利于缓解负压吸引快速羊水减量术孕妇的紧张心理,减少术后并发症的发生,改善妊娠结局。     

Partial sequencing of 5' noncoding region of 7 HGV strains isolated from different areas of China

INTRODUCTIONAlthoughsensitivetestsfordetectionofknownhepatitisvirusesareavailable,theeti0logy0fl0%-l5%post-transfusionandc0mmunity-acquiredhepatitiscaseshasremainedundefined.Itsuggeststheexistenceofunknowncausativeagentsass0ciatedwiththedisease.GBV-CandHGVwerenewlydiscoveredasputativen0n-AtoEhepatitisvirusesreportedbySi.o.s[l]andLinnenL2]independently.However,thesequencehom0logyanalysisofthetwostrainsrevealedthattheyaredifferentisolatesofthesamevirus.HGVisapositive-strandRNAviruswi…     

减少肝炎复发,提高肝移植存活率

自１９６３年Ｔｈｏｍａｓ开展第１例人类肝移植以来，至今已有６０多个国家开展此项手术，每年肝移植病例约１００００余例。随着肝移植手术和器官保存方法的不断改进及免疫学研究的进展，肝移植手术后存活率大大提高。据美国器官共享联网组织（Ｕｎｉｔｅｄ　　Ｎｅｔｗｏｒｋ　　ｏｎＯｒｇａｎ　Ｓｈａｒｉｎｇ，ＵＮＯＳ）统计，目前美国肝移植手术后１年和３年存活率分别为８７０％和７７．４％、被移植的肝脏存活率分别为７９．１％和６６．４％，１０年存活率达６０％以上。同时，肝移植的适应证也逐渐扩大，要求肝移植的患者越来越…     

起搏器预防阵发性心房颤动的随访

心房颤动（房颤）是最常见的具临床意义的也是仍然、没有最后解决的持续性心律失常，房颤患者有超过正常人5～17倍的中风危险性，房颤的治疗困难，已成为2l世纪研究的“难点”和“热点”。多年以来恢复和维持窦性心律是患者和医生的共同愿望。阵发性房颤如不加以干预可以转变为持续性房颤，人们对阵发性房颤的触发因素进行统计分析，认为大多数的房颤是可以通过起搏程序预防的。我们对病态窦房结伴阵发性房颤的患者植入了有预防房颤功能的起搏器并进行长期随访。资料和方法     

乙型肝炎不同白介素细胞因子的检测及其意义

目的探讨血清IL-10、IL-13、IL-15水平在乙型肝炎发生发展中的意义。方法采用双抗体夹心ELISA法检测2002年5月至2004年9月泉州市第一医院感染科109例乙型肝炎患者血清中IL-10、IL-13、IL-15水平。结果慢性肝炎中度患者血清IL-10、IL-13显著高于慢性重型肝炎、慢性肝炎重度、急性肝炎及正常对照组(P<0.01)。IL-15值比较,急性肝炎、慢性肝炎中度、慢性肝炎重度、慢性重型肝炎明显高于正常对照组(P<0.01)。IL-15/IL-10、IL-15/IL-13比值,慢性重型肝炎、慢性肝炎重度、急性肝炎明显高于慢性肝炎中度及正常对照组(P均<0.01)。慢性重型肝炎死亡组IL-15值及IL-15/IL-10、IL-15/IL-13比值明显高于治疗好转组(P<0.01)。结论乙型肝炎患者存在异常的细胞免疫应答,通过联合检测血清IL-10、IL-13、IL-15值及IL-15/IL-10、IL-15/IL-13比值,能较好地反映乙型肝炎患者Th1/Th2细胞激活状态,有助于不同临床类型的乙型肝炎患者的预后判断及指导治疗。     

Regulation of von willebrand factor of human endothelial cells exposed to laminar flows: an in vitro study

The effect of laminar flow on the regulation of von Willebrand Factor (vWF) of cultured human umbilical vein endothelial cells (HUVECs) was studied. Confluent endothelial monolayers were exposed to shear stresses (0.2 and 1.0 Pa) from 2 to 24 h. vWF was labelled with indirect immunofluorescence method and observed with 3D fluorescence microscopy. The distribution of vWF and the cytoskeleton organization were observed simultaneously by double fluorescence labelling. More actin stress fibers and an increased release of vWF appeared in the cells exposed to flow at the same time. The qualitative and quantitative results showed that there was not only a shear-dependent regulation but also a time-dependent modification. For a short-time shear stimulation, both 0.2 Pa and 1.0 Pa shear stresses induced a release of vWF from the endothelial cells. In contrast, after 24 h exposure to 1.0 Pa shear flow, vWFs were much more in the cells than that in the cells exposed to 0.2 Pa for 24 h (p < 0.01) or that in the control cells (p < 0.05). TNF-alpha caused a decrease of vWF and Weibel-Palade bodies in the cells.     

血清AFP、SA、AFU及TGF-β1检测对原发性肝癌诊断价值的评价

目的探讨血清中甲胎蛋白(AFP)、唾液酸(SA)、α-L-岩藻糖苷酶(AFU)及转化生长因子β1(TGF-β1)各项标志物在肝病患者中对PHC的诊断价值及联合俭测的意义.方法检测了226例肝病患者血清中各项标志物的水平及阳性率.结果各种标志物诊断PHC的敏感性为AFU(93.2%)＞TGF-β1(80.0%)＞ AFP(72.9%)＞SA(67.8%),特异性为SA(94.6%)＞AFP(83.8%)＞TGF-β1(82.0%)＞AFU(79.0%),联合四项检测可将阳性率提高到96.6%.结论多项肿瘤标志物联合检测对PHC尤其是AFP阴性PHC的诊断具有重要价值.     

Value of QT dispersion in evaluating spatial dispersion of ventricular repolarization during acute myocardial ischemia

OBJECTIVES:

To study the value of epicardial QT interval dispersion in predicting ischemia-induced heterogeneity of ventricular repolarization.

ANIMALS AND METHODS:

Ischemia was produced by total occlusion of the obtuse branch of the circumflex coronary artery in seven open-chest sheep. A 64-channel electrocardiogram (ECG) was acquired from the epicardium before and after coronary artery occlusion. Wavelet transformation was used to determine the characteristic points of the epicardial ECGs, and to measure the QT interval and activation-recovery interval (ARI) and their dispersions.

RESULTS:

The average QT interval and ARI from the epicardial ECG were not changed by acute myocardial ischemia (P=0.07 and P=0.13, respectively). QT dispersion remained unchanged during ischemia (P=0.17), whereas ARI dispersion was significantly increased by acute ischemia (59.9±24.0 ms versus 126.3±32.1 ms, P<0.001).

CONCLUSIONS:

These findings indicate that epicardial QT dispersion is less sensitive than ARI dispersion in estimating repolarization heterogeneity induced by acute myocardial ischemia.     

针刺对缺血缺氧性脑病神经细胞和神经营养因子的影响

针刺抑制缺血缺氧性脑损伤后的神经元凋亡，促进缺血缺氧性脑损伤后内源性神经干细胞的增殖和各种神经营养因予分泌的机制。     

Experimental study of quantitative assessment of left ventricular mass with contrast enhanced real-time three-dimensional echocardiography

OBJECTIVES: To evaluate the feasibility and accuracy of measurement of left ventricular mass with intravenous contrast enhanced real-time three-dimensional (RT3D) echocardiography in the experimental setting. METHODS: RT3D echocardiography was performed in 13 open-chest mongrel dogs before and after intravenous infusion of a perfluorocarbon contrast agent. Left ventricular myocardium volume was measured according to the apical four-plane method provided by TomTec 4D cardio-View RT1.0 software, then the left ventricular mass was calculated as the myocardial volume multiplied by the relative density of myocardium. Correlative analysis and paired t-test were performed between left ventricular mass obtained from RT3D echocardiography and the anatomic measurements. RESULTS: Anatomic measurement of total left ventricular mass was 55.6 +/- 9.3 g, whereas RT3D echocardiographic calculation of left ventricular mass before and after intravenous perfluorocarbon contrast agent was 57.5 +/- 11.4 and 55.5 +/- 9.3 g, respectively. A significant correlation was observed between the RT3D echocardiographic estimates of total left ventricular mass and the corresponding anatomic measurements (r = 0.95). A strong correlation was found between RT3D echocardiographic estimates of left ventricular mass with perfluorocarbon contrast and the anatomic results (r = 0.99). Analysis of intraobserver and interobserver variability showed strong indexes of agreement in the measurement of left ventricular mass with pre and post-contrast RT3D echocardiography. CONCLUSIONS: Measurements of left ventricular mass derived from RT3D echocardiography with and without intravenous contrast showed a significant correlation with the anatomic results. Contrast enhanced RT3D echocardiography permitted better visualization of the endocardial border, which would provide a more accurate and reliable means of determining left ventricular myocardial mass in the experimental setting.