不同麻醉方式对腹腔镜子宫次切术围术期GRO-1、IP-10的影响

目的观察不同麻醉方式围术期对血浆趋化因子GRO-1、IP-10的变化,研究不同麻醉方式围术期对腹腔镜下子宫次切术患者免疫功能和肿瘤转移的影响。方法选择ASAⅠ～Ⅱ级腹腔镜下子宫次切术患者60例,随机分为3组:全凭静脉麻醉组(A组),静吸复合麻醉组(B组),全麻联合硬膜外阻滞组(C组),每组各20例。在麻醉前(T0)、术毕(T1)、术后24h(T2)、术后48h(T3)和出院前2h(T4)观察各时点MAP、HR、RR、SpO2,采集外周静脉血测定趋化因子GRO-1、IP-10浓度。结果患者血浆GRO-1、IP-10浓度术后均有不同程度的降低,其中B组T1时较A、C组降低更加明显;3组各时点间差异均无显著性意义。结论不同麻醉方式对围术期腹腔镜下子宫次切术患者免疫功能和肿瘤转移的影响无显著性差异,均可安全应用于腹腔镜下子宫次切术患者的麻醉。     

远程实时传输12导联心电图对老年AMI患者院前诊断价值

目的研究远程实时传输12导联心电图对老年急性心肌梗死(AMI)患者的院前诊断价值。方法将2012年4月~2014年5月在我院就诊的70例老年急性心肌梗死患者和70例健康志愿者纳入研究对象,进行远程实时传输12导联心电图和常规心电图检查,测量波幅和时间;检测血清中心肌酶谱指标。结果远程心电图和常规心电图的P波、PR波、QRS波、T波、QT波时间均无差异,Ⅱ导联、aVF导联、V1导联、V3导联、V5导联的P波、QRS波、T波时间均无差异;心肌梗死患者V1导联的QRS波和T波的振幅大于健康者[(1.352±0.185 vs 0.258±0.042,0.792±0.089 vs 0.108±0.014)mV](P<0.05),CK-MB、hs-cTnT含量高于健康者[(34.22±4.84 vs 11.44±1.63)U/L,(25.28±3.25 vs 4.94±0.60)ng/L](P<0.05);V1导联的QRS波和T波振幅与CK-MB、hs-cTnT含量呈正相关。结论远程实时传输12导联心电图可以取得与常规心电图相当的时间分辨率和空间分辨率,且振幅与心肌酶谱相关,可用于老年急性心肌梗死患者院前诊断。     

Ecotoxicological effects of hexahydro-1,3,5-trinitro-1,3,5-triazine on soil microbial activities

Although hexahydro-1,3,5-trinitro-1,3,5-triazine (also called RDX or hexogen) is a potentially toxic explosive compound that persists in soil, its ecotoxicological effects on soil organisms have rarely been assessed. In this study, two uncontaminated garden soils were spiked with 10 to 12,500 mg RDX/kg dry soil. Soil microbial activities, i.e., potential nitrification, nitrogen fixation, dehydrogenase, basal respiration, and substrate-induced respiration were chosen as bioindicators and were determined after 1-, 4-, and 12-weeks of exposure. Experimental results indicate that RDX showed significant inhibition (up to 36% of control) on indigenous soil microbial communities over the period of this study. All five bioindicators responded similarly to the RDX challenge. The length of exposure also affected the microbial toxicity of RDX, with 12-week exposure exerting more significant effects than the shorter exposure periods, suggesting that soil microorganisms might become more vulnerable to RDX when exposure is extended. The estimated lowest observable adverse effect concentration of RDX was 1,235 mg/kg. No biodegradation products of RDX were detected at all three sampling times. Compared with 2,4,6-trinitrotoluene (TNT), RDX is less toxic to microbes, probably because of its resistance to biodegradation under aerobic conditions, which precludes metabolic activation of nitro groups.     

Alterations of Fc gamma receptor I and Toll-like receptor 4 mediate the antiinflammatory actions of microglia and astrocytes after adrenaline-induced blood-brain barrier opening in rats

Blood-brain barrier (BBB) opening occurs under many physiological and pathological conditions. BBB opening will lead to the leakage of large circulating molecules into the brain parenchyma. These invasive molecules will induce immune responses. Microglia and astrocytes are the two major cell types responsible for immune responses in the brain, and Fc gamma receptor I (FcgammaRI) and Toll-like receptor 4 (TLR4) are the two important receptors mediating these processes. Data suggest that activation of the FcgammaRI pathway mediates antiinflammatory processes, whereas activation of TLR4 pathway leads to proinflammatory activities. In the present study, we tested the hypothesis that BBB opening could lead to alterations in FcgammaRI and TLR4 pathways in microglia and astrocytes, thus limiting excessive inflammation in the brain. The transient BBB opening was induced by adrenaline injection through a caudal vein in Sprague-Dawley rats. We found that the FcgammaRI pathway was significantly activated in both microglia and astrocytes, as exhibited by the up-regulation of FcgammaRI and its key downstream molecule Syk, as well as the increased production of the effector cytokines, interleukin (IL)-10 and IL-4. Interestingly, after transient BBB opening, TLR4 expression was also increased. However, the expression of MyD88, the central adapter of the TLR4 pathway, was significantly inhibited, with decreased production of the effector cytokines IL-12a and IL-1beta. These results indicate that, after transient BBB opening, FcgammaRI-mediated antiinflammatory processes were activated, whereas TLR4-mediated proinflammatory activities were inhibited in microglia and astrocytes. This may represent an important neuroprotective mechanism of microglia and astrocytes that limits excessive inflammation after BBB opening.     

三种幽门螺杆菌致病作用的实验研究

目的 为观察３种幽门螺杆菌株在小鼠胃内集落形成能力及感染后对小鼠胃粘膜组织学影响。方法 Ｃ５７ＢＬ／Ｃ小鼠４０只,分野生型株,突变株,悉尼株及对照组４组,每组１０只鼠。野生型ＣＰＹ３４０１株（表达细胞相关基因（Ｃｙｔｐｔｏｘｉｎ－ａｓｓｏｃｉａｔｅｄｇｅｎｅＡ,ＣａｇＡ）菌株（ＣａｇＡ）与野生型ＣＰＹ３４０１株同源并去掉ＣａｇＡ的突突株（ＣａｇＡ）及悉尼株（ＣａｇＡ）分别以０．５ｍｌ（１０＾９菌落     

复方苦参结肠溶胶囊治疗湿热内蕴型溃疡性结肠炎的研究

目的评价复方苦参结肠溶胶囊治疗湿热内蕴型溃疡性结肠炎(UC)的有效性、安全性。方法采用随机、单盲、阳性药平行对照方法进行研究,并做非劣效性检验。将16例UC患者随机分为2组:试验组服用复方苦参结肠溶胶囊,对照组服用柳氮磺胺吡啶片,均连用8周,将患者临床症状、结肠镜检查结果、病理变化及粪便常规作为有效性指标进行疗效评价,根据患者血尿常规、肝肾功能及心电图的变化结合不良事件进行安全性评价。结果治疗8周后,试验组与对照组总有效率分别为88%(7/8)和75%(6/8),临床疗效试验组与对照组总有效率均为88%(7/8),中医证候疗效试验组与对照组总有效率分别为100%和88%。试验组1例发生不良反应,对照组无一例发生不良反应。结论复方苦参结肠溶胶囊能有效治疗湿热内蕴型UC,并且具有良好的安全性。     

超声对腹膜间皮瘤诊断价值探讨

目的　探讨超声对腹膜间皮瘤的诊断价值。方法　回顾性分析 7例经病理证实的腹膜间皮瘤的超声表现。结果　 7例病人自出现腹水至确诊前曾反复多次行超声检查 ,早期用 3 .5MHz探头检查 ,除腹水外无阳性发现 ,后改用高频探头可在腹膜壁层、大网膜及肠系膜探及形状各异的实质性肿块。结论　超声检查特别是用高频探头对腹膜间皮瘤的诊断有很大的实用价值     

Prevalence and genetic diversity of norovirus in outpatient children with acute diarrhea in Shanghai, China

This study aimed to investigate the epidemiology of norovirus (NoV) associated-diarrhea among pediatric outpatients in Shanghai, and characterize the genotypes of circulating NoV strain. Stool samples were collected from 910 children with non-dysenteric diarrhea between August 2008 and July 2009. One-step real-time RT-PCR was used to screen for NoV genogroup I (GI) and genogroup II (GII). Genotypes were classified by sequence analysis of partial capsid and RNA-dependent RNA polymerase (RdRp) fragments. NoV was detected year round with high activity in July, August, September, and October. Of 910 specimens, 165 (18.13%) were positive for NoV; 4 (2.42%) were GI, and 161 (97.58%) were GII. Based on capsid sequences, 8 different genotypes were identified for 114 NoV strains, including GII.4 2006b (57.89%), GII.3 (30.70%), GII.6 (4.39%), GII.12 (3.51%), GII.14, GII.2, GI.4, and GI.5 (0.88% each). Based on the RdRp sequences of 86 NoV strains, NoV was genotyped as GII.4 (62.79%), GII.12 (30.23%), GII.g (2.33%), GII.2 (1.16%), GII.6 (1.16%), GII.7 (1.16%), and GI.4 (1.16%). The RdRp genotypes of 30 strains were inconsistent with the capsid genotypes, indicating potential NoV recombinants.