基因活化材料的构建及在骨与软骨损伤中的应用

组织工程技术为关节软骨的再生带来希望，适当浓度的生长因子、合适的微环境无疑会利于这种技术的实施。近年来，生物可降解材料作为基因传送载体转染体细胞的研究正逐渐受到重视，可以利用生物材料的降解特性以及化学构成特点构建具有可控制性、安全性、靶向性的转染系统，通过靶细胞表达转移后的基因片段，可以在局部持续获得治疗性的生长因子。     

获得性纯红再障患者外周血T细胞亚群分析

目的　本研究通过分析获得性纯红再障患者外周血T细胞亚群 ,进一步探讨该病的细胞免疫发病机制。方法　用抗人CD3、CD4、CD8、IFN γ及IL 4单抗结合人外周血单个核细胞 ,流式细胞术分析单个核细胞中CD3 +、CD4+、CD8+细胞数Th1、Th2、Tc1、Tc2细胞数以及CD4+/CD8+、Th1/Th2、Tc1/Tc2比值。结果　贫血组患者 ,外周血CD3 +细胞和CD8+细胞明显增加 (P <0 .0 1) ,CD4+/CD8+比例倒置 (P <0 .0 5 ) ;Tc2细胞明显增加 (P <0 .0 5 ) ,Tc1/Tc2比值降低(P <0 .0 5 ) ,治疗后血象恢复的患者各增高的亚群细胞均有所恢复 ,接近正常。结论　在获得性纯红再障患者T细胞明显增高 ,其中主要是CD8+细胞 ,而在CD8+细胞中 ,是Tc2细胞发挥了重要作用。经治疗有效的患者 ,其增高的T细胞亚群降低 ,提示以纠正病人细胞免疫异常为主的治疗方案有益于获得性纯红再障的治疗。     

rhTPO在大肠杆菌中的表达、纯化及生物活性分析

目的：探讨人促血小板生成素(human thromlbopoietin，hTPO)在大肠杆菌中表达、分离纯化及生物学活性初步鉴定。方法：利用RT-PCR法从人胎肝细胞中扩增目的基因片段，将其定向插入pQE30表达质粒T5启动子下游的多克隆区，转化大肠杆菌M15，得到pQE30-TPO的工程菌，诱导目的蛋白表达、纯化。将表达产物给血小板减少模型小鼠尾静脉注射，观察注射后不同时间血小板量的改变。结果：经异丙基硫代-β-D-半乳糖苷(isopropylthio-β-D-galactoside IPTG)诱导培养，该工程菌可以产生单一特异性的高表达蛋白条带。将纯化后的表达蛋白注射小鼠，结果显示对实验性小鼠血小板减少症具有一定的治疗作用。结论：在大肠杆菌中成功地高效表达了重组hTPO，该产物具有促血小板生成的活性。     

互联网与中医学教育

随着网络技术的飞速发展，互联网对中医学教育产生深远的影响。传统的中医学教育模式正面临着网络技术带来的冲击，文章提出了中医学教育应逐渐把以课堂教授为主的方式转向以网络互动式自学方式的观点。     

利用cDNA微阵列技术筛选成年期与胚胎期睾丸差异表达基因——钙联接蛋白基因

目的 :用cDNA微阵列技术克隆和筛选成年期与胚胎期睾丸差异表达基因 ,以进行睾丸发育及精子发生的调控研究。　方法 :构建人睾丸cDNA芯片 ,分别用正常成人及胚胎睾丸的mRNA探针进行杂交 ,对成人和胚胎睾丸中差异表达的基因进行高流量的比较。　结果 :发现 1条成人睾丸高表达、胚胎低表达的基因———钙联接蛋白 (CLGN)基因。　结论 :运用cDNA微阵列方法可筛选到成年期与胚胎期睾丸差异表达基因     

Influence of blood supply of the esophageal and gastric stumps on anastomotic healing after esophagogastrostomy in rabbits]

OBJECTIVE: To study how blood supply of the esophageal and gastric stumps influences the anastomotic healing after esophagogastrostomy in rabbits. METHODS: Twenty-seven New Zealand rabbits were randomly divided into 3 groups to receive esophagogastrostomy, followed by different procedures. Except for those in group I, all the rabbits were subjected to procedures of reducing the blood supply either of the esophageal or the gastric stump (group II and group III, respectively), followed by single-layer esophagogastric anastomoses using interrupted 5-0 polypropylene sutures. Ten days after operation, all the rats were killed and the anastomotic sites excised for measurement of the inner diameter, tensile strength, and hydroxyproline concentration. RESULTS: Healing of the esophagograstric anastomosis was obtained in all the rabbits but one with anastomotic leakage in group I and one with perforation of the gastric fundus in group III. The anastomotic inner diameters were similar in all the three groups, whereas the tensile strength and hydroxyproline concentration at the anastomoses decreased in group III in comparison with the other two groups (P<0.05) that had similar measurements (P>0.05). CONCLUSIONS: Extended length of the free esophageal stump does not significantly affect anastomotic healing as decrease of blood supply in the gastric stump.     

Comparison of mortality risk associated with bacteremia due to methicillin-resistant and methicillin-susceptible Staphylococcus aureus.

OBJECTIVE: To quantify the clinical impact of methicillin-resistance in Staphylococcus aureus causing infection complicated by bacteremia in adult patients, while controlling for the severity of patients' underlying illnesses. DESIGN: Retrospective cohort study from October 1, 1995, through December 31, 2003. PATIENTS AND SETTING: A total of 438 patients with S. aureus infection complicated by bacteremia from a single Veterans Affairs healthcare system. RESULTS: We found that 193 (44%) of the 438 patients had methicillin-resistant S. aureus (MRSA) infection and 114 (26%) died of causes attributable to S. aureus infection within 90 days after the infection was identified. Patients with MRSA infection had a higher mortality risk, compared with patients with methicillin-susceptible S. aureus (MSSA) infections (relative risk, 1.7 [95% confidence interval, 1.3-2.4]; P<.01), except for patients with pneumonia (relative risk, 0.7 [95% confidence interval, 0.4-1.3]). Patients with MRSA infections were significantly older (P<.01), had more underlying diseases (P=.02), and were more likely to have severe sepsis in response to their infection (P<.01) compared with patients with MSSA bacteremia. Patients who died within 90 days after S. aureus infection was identified were significantly older (P<.01) and more likely to have severe sepsis (P<.01) and pneumonia (P=.01), compared with patients who survived. After adjusting for age as a confounder, comorbidities, and pneumonia as an effect modifier, S. aureus infection-related mortality remained significantly higher in patients with MRSA infection than in those with MSSA infection, among those without pneumonia (hazard ratio, 1.8 [95% confidence interval, 1.2-3.0]); P<.01. CONCLUSIONS: The results of this study suggest that patients with MRSA infections other than pneumonia have a higher mortality risk than patients with MSSA infections other than pneumonia, independent of the severity of patients' underlying illnesses.     

呼吸机在ICU应用的质量管理

现代通气技术的快速发展,使呼吸机在临床得到广泛应用,医护人员在重视使用技术的同时,还应做好使用前后及使用过程中的安全维护和管理,才能使其安全地发挥出最大效益.     

Type II pneumocytes modulate surfactant production in response to cigarette smoke constituents: Restoration by vitamins A and E

This study was to evaluate the effects of cigarette smoke constituents upon type II pneumocyte surfactant production in vitro, and how vitamins A and E may alter the response. Freshly isolated type II pneumocytes from Sprague–Dawley rats were incubated 20 h in medium with fetal bovine serum that was or was not treated with cigarette smoke. The number of adherent cells was inversely related to the dose of smoke or benzo(a)pyrene. Despite the decreased number of treated cells, the total amount of surfactant per culture well was unchanged, whereas surfactant production per cell was significantly increased (P < 0.05). Vitamin A concentration was significantly (P < 0.05) lower in the smoke-treated serum compared with untreated serum. When vitamin A or E was added to the cigarette smoke-treated serum, cell adherence and surfactant production returned to control values. In conclusion, cigarette smoke constituents or benzo(a)pyrene alone decreased the number of adherent type II pneumocytes, but did not alter surfactant amounts because of an increased production of surfactant per cell. Type II pneumocytes seem to adjust surfactant production dependent upon the number of type II pneumocytes to produce it and vitamin A or E enhance cell attachment in the presence of the smoke toxins.     

同种肾组织移植治疗慢性肾功能衰竭性贫血的实验研究

以Ｗｉｓｔａｒ雄性大鼠为受体，建立慢性肾功能衰竭动物模型，将鼠婴肾组织声多点植入受体双侧后肢皮下和筋膜下。结果表明，３０天后移植物的体积由１ｍｍ＾３增至４ｍｍ＾３大小，表面血管网丰富；光镜下见肾小球、肾小管结构正常。促红细胞生成素（ＥＰＯ）着色颗粒主要分布在肾小球区，移植组着色程度明显增高。血红蛋白和４促红细胞生成素随移植的时间延长而逐渐升高，实验结果提示，此方法有可能为治疗慢性肾功能衰竭性贫血提