婴幼儿感染猪霍乱沙门菌耐药基因特点及同源性分析

目的研究致婴幼儿败血症猪霍乱沙门菌的耐药基因特点及同源性。方法16株猪霍乱沙门菌．采用K—B纸片扩散法检测抗菌药物的耐药性,同时用PCR法及DNA测序法对其进行β-内酰胺酶类耐药基因检测;PFGE法测定同源性。结果对氨苄西林耐药的13株猪霍乱沙门菌经PCR扩增后并测序为bl岫。16株猪霍乱沙门菌经PFGE分型,可分为5个PFGE型,其中A型是最主要的克隆（12／16）。13株blTEM-1．基因阳性菌株分别为A型11株,B型1株,D型1株。结论产TEM-1割β-内酰胺酶是本地区猪霍乱沙门菌对氨苄西林耐药的主要机制,PFGE分型方法对猪霍乱沙门菌分型能力较好。克隆性传播为猪霍乱沙门菌的主要传播途径．同一PFGE型菌株的耐药谱非常接近。     

牙胚细胞的分离培养

目的：分离培养牙胚细胞。方法：选择出生后（PN）8天的SD大鼠,从第一磨牙牙胚上撕脱牙囊和成釉器组织,切取牙胚颈部组织,剁离牙乳头组织,分别进行细胞培养,通过差速消化法分离符种牙胚细胞。结果：牙囊、牙乳头、成釉器和上皮根鞘细胞被分离纯化出来。结论：利用差速消化法可同时分离培养4种主要的牙胍细胞。     

非疫区33例布鲁菌病误诊分析

目的探讨降低布鲁菌病误诊率的临床措施。方法对兰陵县人民医院2010年1月至2013年12月中33例布鲁菌病误诊患者临床资料进行回顾性分析。结果 33例布鲁菌病被误诊为败血症8例、伤寒8例、睾丸炎7例、风湿性关节炎5例、肺炎2例、肾综合征出血热（HFRS）2例、肺结核1例,确诊后经规范治疗均治愈出院。结论布鲁菌病容易被误诊,临床医生要拓宽思路,熟练掌握有相似症状、体征的发热性疾病,综合分析,降低误诊率。     

Effect of aging on glucuronidation of valproic acid in human liver microsomes and the role of UDP-glucuronosyltransferase UGT1A4, UGT1A8, and UGT1A10

Valproic acid (VPA) is a widely used anticonvulsant that is also approved for mood disorders, bipolar depression, and migraine. In vivo, valproate is metabolized oxidatively by cytochromes P450 and beta-oxidation, as well as conjugatively via glucuronidation. The acyl glucuronide conjugate (valproate-glucuronide or VPAG) is the major urinary metabolite (30-50% of the dose). It has been hypothesized that glucuronidation of antiepileptic drugs is spared over age, despite a known decrease in liver mass. The formation rates of VPAG in a bank of elderly (65 years onward) human liver microsomes (HLMs) were measured by liquid chromatography/tandem mass spectrometry and compared with those in a younger (2-56 years) HLM bank. In vitro kinetic studies with recombinant UDP-glucuronosyltransferases (UGTs) were completed. A 5- to 8-fold variation for the formation of VPAG was observed within the microsomal bank obtained from elderly and younger donors. VPAG formation ranged from 6.0 to 53.4 nmol/min/mg protein at 1 mM substrate concentration (n=36). The average velocities at 0.25, 0.5, and 1 mM VPA were 7.0, 13.4, and 25.4 nmol/min/mg protein, respectively, in the elderly HLM bank. Rates of VPAG formation were not significantly different in the HLM bank obtained from younger subjects. Intrinsic clearances (V(max)/K(m)) for several cloned, expressed UGTs were determined. UGT1A4, UGT1A8, and UGT1A10 also were found to catalyze the formation of VPAG in vitro. This is the first reported activity of these UGTs toward VPA glucuronidation. UGT2B7 had the highest intrinsic clearance, whereas UGT1A1 demonstrated no activity. In conclusion, our investigation revealed no differences in VPAG formation in younger versus elderly HMLs and revealed three other UGTs that form VPAG in vitro.     

囊性肾癌的影像学诊断分析

目的 认识囊性肾癌的影像学特征，提高对囊性肾癌的早期诊治水平。方法 回顾性分析1998年6月～2006年6月收治的21例囊性肾癌患者的影像学及临床资料。21例患者均经手术．和病理证实。结果 常规超声联合彩色多普勒超声的诊断准确率为86％；增强CT的诊断准确率为81％；二者联合诊断准确率为100％。结论 囊性肾癌影像学表现复杂多变，常规超声联合彩色多普勒超声和增强CT对囊性肾癌的诊断有重要价值。根治性肾切除术是囊性肾癌的首选治疗方法。     

Role of beta blockers in congestive heart failure

Prolonged activation of the adrenergic nervous system has adverse consequences on the cardiovascular system in patients with congestive heart failure. Beta adrenergic receptor-blocker therapy modifies these deleterious effects. Beta blockers have been shown to improve myocardial function and survival when used in conjunction with conventional treatment with diuretics, angiotensin-converting enzyme inhibitors, and digoxin. Beta blocker therapy in mild-to-moderate heart failure should not be delayed because it causes some reversal of both neurohormonal compensatory mechanisms and the deleterious myocardial remodeling process. This paper reviews the beneficial effects of beta adrenergic receptor-blocker therapy on the pathophysiology, symptoms, left ventricular function, morbidity, and mortality in patients with congestive heart failure. (c)2000 by CHF, Inc.     

氯化镍染毒对小鼠外周血网织红细胞微核形成的影响

目的研究氯化镍(NiCl2)诱导小鼠外周血网织红细胞微核形成的作用.方法将30只健康的成年雄性NIH小鼠随机分为6组,设生理盐水对照组、秋水仙素阳性对照组(剂量为0.75 mg/kg)、环磷酰胺阳性对照组(剂量为40.0mg/kg)和NiCl2染毒组(剂量分别为5.0、10.0、20.0 mg/kg),分2次腹腔注射染毒,间隔24 h,每次按0.1 ml/10 g体重腹腔注射.采用转铁蛋白受体荧光抗体和碘化丙碇染色,以疟原虫感染小鼠外周血红细胞为微核生物模型,调校流式细胞仪,检测秋水仙素、环磷酰胺和0、5.0、10.0、20.0 mg/kg NiCl2染毒后小鼠外周血含微核网织红细胞率的变化.结果秋水仙素和环磷酰胺染毒小鼠的外周血含微核网织红细胞率均明显高于对照组小鼠(P＜0.01),但不同剂量NiCl2染毒小鼠外周血含微核网织红细胞率均未见明显升高(P＞0.05).结论该研究条件下未观察到氯化镍有明显的诱导小鼠外周血网织红细胞微核形成的作用.     

Sulindac-induced immune hemolytic anemia

BACKGROUND: Sulindac, a nonsteroidal, anti-inflammatory, indene-derived drug, caused life-threatening immune hemolytic anemia in an individual with back pain. CASE REPORT: A patient was admitted to the hospital with immune hemolytic anemia and kidney and liver failure after several days ingestion of sulindac. The direct antiglobulin test was positive with polyspecific and monospecific anti-IgG but not with anti-C3. The eluate did not react in routine tests but reacted strongly after the addition of sulindac. The serum contained a sulindac-dependent antibody reacting to a titer of 32. The sulindac-dependent antibody was of both IgG and IgM classes and had no apparent blood group specificity. The antibody agglutinated red cells from humans and chimpanzees but not from chickens, rabbits, or sheep, which implied that a specific component on human and chimpanzee red cells was needed for reactivity. The antibody reacted with red cells treated with trypsin, papain, pronase, dithiothreitol, and sialidase. With aggressive medical care, the patient's condition improved. CONCLUSION: These findings appear compatible with the so-called immune complex mechanism for drug-induced immune hemolytic anemia. Physicians are alerted to the severe nature of this syndrome.     

NIPPV在AECOPD合并重度二氧化碳潴留患者中的应用效果分析

目的探讨无创正压通气(NIPPV)在急性加重期慢性阻塞性肺疾病(AECOPD)合并重度二氧化碳潴留患者中的应用效果。方法选取2010年4月至2014年9月凉山州第一人民医院收治的AECOPD合并重度二氧化碳潴留患者138例作为研究对象,在常规治疗的基础上采用NIPPV治疗,分析治疗前后患者心率(HR)、呼吸(R)、氢离子浓度指数(pH)、血氧饱和度(SaO2)、氧分压(PaO2)和二氧化碳分压(PaCO2)改善情况。结果本次研究中气管插管率为21.01%(29/138),病死率为5.80%(8/138),NIPPV有效率为81.88%(113/138)。HR和R在治疗2h后虽有一定下降,但与治疗前比较差异无统计学意义(P0.05)。治疗24h后HR和R均有较大幅度下降,与治疗前及治疗后2h比较,差异有统计学意义(P0.05)。SaO2、pH和PaO2在治疗2h后及24h后增高均较为明显,而PaCO2在治疗2h后及24h后下降均较明显,不同时点间的比较差异均有统计学意义(P0.05)。结论 NIPPV对合并重度二氧化碳潴留的AECOPD患者有良好的治疗效果,血气指标能够得到迅速改善。