善宁治疗急性胰腺炎临床疗效观察

目的:观察人工合成的生长抑素类似物(善宁)治疗急性胰腺炎(AP)的临床疗效.方法:对我院1999～2008年收治的156例AP患者分为治疗组与对照组各78例,对照组采用一般常规治疗方法,治疗组在一般常规治疗的基础上加用善宁0.1 mg,缓慢静脉推注后,继以25μg/h的速度持续静脉滴注,连用7～14天.观察两组腹痛缓解时间;实验室检查:白细胞计数、血淀粉酶、血钙与血糖恢复正常时间,多器官功能障碍(MODS)发生情况,恢复进食的时间.结果:善宁治疗组比对照组明显降低血淀粉酶,减少腹痛缓解时间,降低MODS的发生.结论:善宁能有效改善AP的临床症状,减少并发症.     

社交焦虑障碍患者父母的人格特征和心理健康状况调查

目的探索社交焦虑障碍(SAD)患者父母的人格特征和心理健康状况。方法设研究组(SAD患者的父母)和对照组。入组时按要求进行艾森克人格问卷(EPQ)和症状自评量表(SCL-90)评定。结果SAD患者的父母在EPQ量表测验中的内外向因子标准分低于对照组;SAD患者的父母SCL-90各项因子除强迫和敌对因子,标准分低于对照组。结论SAD患者的父母的人格特征倾向内向,易安静、内省、离群、不喜欢接触人;SAD患者的父母更容易表现出躯体化症状、人际交往的困惑、抑郁、焦虑、恐怖和偏执。     

利用外国政府贷款医疗项目操作程序及需要注意的问题

综合了申请利用外国政府贷款医疗项目所涉及的部门、政策规定、申请程序、工作要求等,并按照实际工作中的大体操作顺序作了较为具体的介绍。     

丘脑底核电刺激治疗帕金森病术后程控问题分析

目的 总结丘脑底核电刺激治疗帕金森病术后程控经验，提高术后程控水平，改善疗效。方法 对32例丘脑底核电刺激术后的帕金森病患者进行程控，其中单侧植入者6例，双侧26例；年龄40～73岁，在不同刺激器植入中心接受手术，程控时间术后3周至4年之间。程控前均停药10h以上，程控参数调整主要为刺激电极触点、电压、频率、脉宽四项，程控过程中密切观察病员肌张力和震颤等症状改变以及副反应发生情况，作好详细记录，并分别评估患者程控前后药物“关期”和“开期”症状改善情况，部分行UPDRS评分。结果 31例（97％）患者术后症状得到不同程度改善。刺激电极触点选择中，共29例患者采用单极模式，3例因出现持续、无法耐受的副反应采用双极模式。除1位患者使用循环模式外，其他患者均使用持续刺激模式。刺激电压2．0-4．0V，主要集中于2．8～3-3V，是主要的程控调整参数，电压的高低与病人UPDRS运动评分不具有相关性（P〉0．05）。刺激脉宽60～120μs，刺激频率130～185Hz。药物“关”期，患者UPDRS运动评分，在刺激器打开时，平均18．7分；刺激器关闭时平均47．9分。在刺激器打开情况下，药物“开”期患者症状仍然有进一步缓解．主要表现为步态、全身协调动作方面。合并异动患者6例中，3例适当降低刺激电量，1例提高电压后，异动缓解。结论 丘脑底核电刺激术是有效的帕金森病症状控制手段。准确植入刺激电极是术后获得良好症状控制的前提条件，而术后程控是脑深部刺激器置入术后的关键环节．精确的参数调整能够满意控制病人症状。     

APP17肽对APP转基因小鼠学习记忆能力和海马神经细胞凋亡的影响

目的观察APP(-βamyloid precursop protein,APP)17肽(APP695中319-335肽段)对APP转基因小鼠(APP695V717I)学习、记忆能力及海马神经细胞凋亡的影响。方法3月龄的APP695转基因小鼠随机分为模型组和APP17肽治疗组,正常对照组采用月龄和性别与之相匹配的C57BL/6J小鼠。APP17肽治疗组给予皮下注射APP17肽,每只每次0.34μg,每周3次;模型组和正常对照组给予等体积NS。应用水迷宫试验观察小鼠学习、记忆功能的变化,以流式细胞技术分析海马神经细胞凋亡率和线粒体膜电位的变化。结果(1)水迷宫试验结果显示,模型组小鼠存在明显学习和记忆功能障碍,其第3、4、5天游完全程的时间[(93.22±16.35)、(86.73±20.26)、(77.13±29.35)s]和错误反应次数[(6.63±2.16)、(5.81±2.13)、(5.33±1.41)次]均较正常对照组[分别为(70.89±20.19)、(61.25±21.88)、(54.63±16.92)s和(5.01±1.93)、(2.97±0.96)、(2.31±1.01)次]增多(P<0.05);APP17肽治疗组小鼠的行为学障碍明显轻于模型组(P<0.05),其上述水迷宫检测结果与正常对照组比较差异无统计学意义。(2)与正常对照组小鼠海马神经细胞凋亡发生率[(3.13±1.19)%]和线粒体膜电位[(176.39±13.88)mV]比较,模型组凋亡发生率[(8.06±2.31)%]显著增加(P<0.01)而线粒体膜电位[(97.51±15.73)mV]明显降低(P<0.01);APP17肽治疗组检测结果与正常对照组接近,海马神经细胞凋亡发生率[(4.38±1.26)%]低于模型组(P<0.01),线粒体膜电位[(168.35±19.29)mV]高于模型组(P<0.01)。结论APP695转基因小鼠存在学习和记忆功能障碍,且其海马神经细胞凋亡率增加,线粒体膜电位降低;APP17肽能够明显改善该转基因小鼠的学习和记忆能力,其作用机制可能是通过稳定线粒体膜电位及抑制凋亡发生而实现。     

直肠癌根治会阴部造口术后二期股薄肌移植肛门成形

目的　回顾性总结32例直肠癌根治会阴部造口术后二期股薄肌移植肛门成形术的治疗效果。方法　采用Williams 5级评分法对重建前后肛门功能进行评价。结果　二期股薄肌移植肛门成形术前,32例患者肛门功能均在4级以上[4级28.4%(9/32),5级71.6%(23/32)],二期股薄肌移植肛门成形术后肛门功能明显好转。结论　二期股薄肌移植肛门成形术是直肠癌根治会阴部造口术后有效的肛门重建手段。     

绝经后阴道出血的相关因素分析

目的探讨绝经后阴道出血的病因及相关因素。方法对129例绝经后阴道出血患者的临床资料进行回顾性分析。结果因良性疾病引起的出血占51.16%,非器质性疾病占25.58%,恶性肿瘤占23.26%,患者出血时年龄大,绝经年限长恶性肿瘤发生率高。结论绝经后阴道出血的主要原因是良性疾病和非器质性病变,但恶性肿瘤仍占一定比例。因此对绝经后阴道出血患者应采取综合的检查手段,明确病因,对因治疗。     

Electrophysiological study on differentiation of rat bone marrow stromal stem cells into neuron-like cells in vitro by edaravone

To explore the electrophysiological proper-ties of differentiation of rat bone marrow-derived stromal stem cells (rBMSCs) to neuron-like cells in vitro by edaravone, a new type of free radical scavenger. Methods: Stromal stem cells were separated from rat bone marrow with Ficoll-Paque reagent and expanded in different culture medium in vitro, rBMSCs were induced by edaravone containing serum-free L-DMEM. Morphologic observation and Western blot analysis including the ex-pression of Nav1.6, Kv1.2, Kv1.3, Cav1.2 were performed, and whole patch-clamp technique was used. Results: Cyton contraction and long processes were shown in differentiated stromal stem cells. Nav1.6, Kv1.2, Kv1.3 and Cav1.2 were expressed in both differentiated and undifferentiated cells. However, the expression of channel proteins in differentiated cells was up-regulated. Consistently, their resting potential and outward currents were also enhanced in the differentiated cells, which was especially significant in the outward rectifier potassium current. Conclusion: In vitro, neuron-like cells derived from rBMSCs, induced by edaravone, possess electrophysiologi-cal properties of neurons.     

血管紧张素(1-7)和依那普利拉对烧伤血清离体灌注大鼠心脏功能的影响

Objective To investigate effects of angiotcnsin ( 1-7 ) [ Ang( 1-7 ) ] and enalaprilat on function of isolated rat heart perfused by burn serum. Methods Eighty SD rats were used to prepare burn serum. Hearts of another 24 SD rats were isolated to reproduce Langendorff perfusion model. The rat hearts were divided into different groups with different perfusion fluids as K-H buffer group, K-H buffer containing 20% burn serum group ( burn serum group) , K-H buffer containing 20% burn serum and 2 μg/mL enala-prilat group (enalaprilat group), and K-H buffer containing 20% burn serum and 1 nmol/mL Ang(1-7) group [ Ang(1-7) group]. The rat hearts were perfused for 30 mins with each of above-mentioned fluids in different groups. Then left ventrieular systolic pressure (LVSP) , left ventricular end diastolic pressure ( LV-EDP) , ± dp/dt max, coronary flow(CF) , level of creatine kinase (CK) and lactate dehydrogenase (LDH) in respective coronary effluent were determined. Results Compared with LVSP ( 11.2 ± 1.0 kPa, 1 kPa = 7.5 mm Hg), +dp/dt max (642±53 kPa/s), -dp/dt max (380±61 kPa/s) and CF level in K-H buffer group, CF, LVSP(5.9±0.8, 8.0±1.1, 8.9±1.3 kPa, respectively), +dp/dt max(275±37, 454±48, 479±63 kPa/s, respectively), - dp/dt max ( 135±35, 219±47, 277±58 kPa/s, respectively ) of burn serum group, those levels in Ang(1-7) group, and enalaprilat group were decreased obviously(P<0.05 or P <0.01 ), but LVEDP, level of CK and LDH in coronary effluent were increased. Compared with those parameters in burn serum group, CF, LVSP, ±dp/dt max of Ang(1-7) group and enalaprilat group were increased obviously(P<0.05 or P<0.01), and LVEDP, level of CK and LDH in coronary effluent were decreased obviously(P<0.01). Conclusions Ang(1-7) and enalaprilat can effectively improve left ventricular function of isolated rat heart perfused by burn serum and mitigate myocardial injury.     

c-Met及HGF在胃癌及其肝转移灶中的表达

目的:探讨胃癌肝细胞生长因子受体(c-Met)及肝细胞生长因子(HGF)表达与胃癌肝转移间的相关性。方法:晚期胃癌标本59例,其中11例同时有取自左肝外叶的肝转移标本,应用免疫组化方法对上述组织石蜡标本进行检测。结果:59例胃癌中,c-Met阳性率55.8%(33/59),HGF阳性率28.8%(17/59);在29例发生了同时或异时性肝转移的胃癌标本中,c-Met表达率为75.9%(22/29),HGF阳性率为37.9%(11/29),其中c-Met表达率在有和无肝转移组间有显著差异(P<0.05);在11例胃癌肝转移灶中,9例c-Met阳性表达率为81.8%,3例HGF阳性表达率为27.3%。结论:胃癌组织c-Met表达可能与胃癌肝转移行为相关。