丹酚酸B和高氧液对兔肢体缺血再灌注损伤代谢酶的影响

目的探讨高氧液和丹酚酸B对肢体缺血再灌注损伤的影响。方法选用健康新西兰家兔24只,随机分为4组,在缺血前从耳缘静脉推注等量的生理盐水(A组)、高氧液(B组)、丹酚酸B(C组)或高氧液加丹酚酸B(D组),夹阻股动静脉,建立肢体缺血再灌注损伤模型,在缺血前和再灌注4h抽血检测LDH、CK,取腓肠肌作LDH酶组织化学染色。结果再灌注4h,血清肌酸激酶活性较前明显升高,高氧液和丹酚酸B可以抑制其升高(P0.01),两者有协同作用(P=0.05);血清乳酸脱氢酶活性较前明显升高,高氧液和丹酚酸B可以抑制其升高(P0.01),两者有协同作用(P0.01)。LDH酶组织化学显色见:相对于对照组其他组组织织LDH酶活性较低,以联合用药组最低。结论高氧液和丹酚酸B对缺血再灌注损伤起预防作用,而且两者有协同作用。     

三金片辅助治疗慢性前列腺炎的疗效观察

目的 了解三金片在辅助治疗慢性前列腺炎的临床疗效.方法 将120例前列腺炎患者随机分为4组:三金片组30例,给予三金片口服治疗;舍尼通组30例,给予舍尼通治疗;联合治疗组30例,给予三金片及舍尼通联合治疗;对照组30例,给予前列康及氟哌酸治疗,比较分析四组症状缓解情况.结果 三金片组总有效率70.00%,联合治疗组总有效率86.67%,对照组总有效率40.00%.单独使用或联合运用三金片组与对照组、舍尼通组相比,总有效率明显升高,差异有统计学意义(x2=4.27,p＜o.05;x2=6.53,p＜0.01).结论 三金片辅助治疗慢性前列腺炎有助于改善患者的症状.     

Teriparatide vs. calcitonin in the treatment of Asian postmenopausal women with established osteoporosis

This study compared the clinical efficacy, safety, and tolerability of daily subcutaneous injections of teriparatide and salmon calcitonin in the treatment of postmenopausal women with established osteoporosis in Taiwan. This 6-month, multicenter, randomized, controlled study enrolled 63 women with established osteoporosis. They were randomized to receive either teriparatide 20 μg or calcitonin 100 IU daily in an open-label fashion. Lumber spine, femoral neck, total hip bone mineral density (BMD), and biochemical markers of bone turnover were measured, and adverse events and tolerability were recorded. The results at 6 months showed that patients using teriparatide had larger mean increases in spinal BMD than those who used calcitonin (4.5% vs. 0.1%), but the BMD changes in these two groups at the femoral neck and the total hip were not significant. There were also larger mean increases in bone markers in the teriparatide group than in the calcitonin group (bone specific alkaline phosphatase 142% vs. 37%; osteocalcin 154% vs. 23%). We conclude that teriparatide has more positive effects on bone formation than salmon calcitonin, as shown by the larger increments of lumbar spine BMD and bone formation markers, and caused only mild adverse events and no significant change in liver, kidney or hematological parameters. Compared with the published global results, teriparatide seems to be equally effective and safe to use in this Asian population.     

狼疮性肾炎患者透析模式与死亡率相关性研究的Meta分析

目的 采用Meta分析评价狼疮性肾炎患者透析模式与病死率的相关性,指导临床选择最佳透析方式.方法 通过计算机检索Medline数据库、EMbase数据库、Cochrane图书馆、万方数据库及CNKI数据库,由2名评价员独立对纳入的文献进行质量评价和数据提取,应用Stata12.0进行Meta分析.结果 共纳入5篇队列研究,共计4 223例患者,Meta分析结果显示腹膜透析与血液透析比较,在全因病死率方面差异无统计学意义(OR=0.85,95％CI:0.56～1.29,P=0.442);在心血管病死率方面差异无统计学意义(OR=1.02,95％CI:0.81～1.29,P=0.879);腹膜透析的感染死亡率低于血液透析(OR=0.72,95％CI:0.53～0.99,P=0.042).结论 狼疮性肾炎患者腹膜透析与血液透析的全因及心血管病死率无明显差异,但腹膜透析感染病死率低于血液透析.     

双器械吻合联合全直肠系膜切除Dixon保肛手术治疗直肠癌的临床效果观察

目的  探讨双器械吻合联合全直肠系膜切除Dixon保肛手术治疗直肠癌的临床治疗效果。方法  选取2013年4月-2015年4月张家港市第一人民医院诊治的80例直肠癌患者资料进行分析,采用随机数字方法将患者分为对照组和实验组,两组均应用全直肠系膜切除Dixon保肛手术治疗,对照组联合单器械吻合予以治疗,实验组联合双器械吻合进行治疗,比较两组患者的临床疗效。结果  实验组患者手术过程中出血量少,住院时间短,肠道功能恢复较早,患者尿管留置时间短,与对照组患者比较差异有统计学意义（P <0.05）;患者治疗后实验组并发症发生率显著低于对照组（P <0.05）;实验组患者肛门功能良好率为87.5%,显著高于对照组（67.5%）（P <0.05）。结论  应用双器械吻合联合全直肠系膜切除Dixon保肛手术治疗直肠癌疗效显著,患者肛门功能恢复程度好,值得临床上推广应用。

     

Cervical Infection of Oncogenic Human Papillomavirus (HPV) Types in Beijing,China

ObjectiveThis study was designed to determine the prevalence of oncogenic human papillomavirus (HPV) in cervical infections in Beijing, China, and to investigate the odds ratio (OR) of HPV single and multiple infections in abnormal cytology. MethodsA total of 19,018 specimens from outpatients in thedepartment ofobstetric andgynecology were collected. They were detected usinghigh-risk HPV genotyping real-time polymerase chain reaction (PCR) kit and analyzed by ThinPrep cytology test for cervical pathological diagnosis. HPV prevalence, age-specific prevalence, andOR of each type of HPV in abnormal cytology were analyzed. ResultsOverall, 19.1% (3,623/19,018) of the individuals were positive for HPV infection, 14.9%(2,833/19,018) were positive for a single HPV type, and 4.2% (790/19,018) were positive for multiple types. Among the 3,623 HPV-positive individuals, the most predominant HPV types were HPV52 (4.4%, 834/19,018), HPV16 (3.7%, 710/19,018), and HPV58 (3.4%, 644/19,018). TheOR of multiple infections and single infection differed significantly among disease severities. TheOR of dual infection was higher than that of each of the two single infection types, respectively. ConclusionHPV prevalence in the outpatients was 19.1%, and the most predominant HPV types in the study were HPV52, HPV16, and HPV58. Women with multiple infectionswere more likely to have abnormal cytology.     

小儿麻醉医师迈向围术期医师理念的培养

随着现代医学的飞速发展,麻醉学正向围术期医学转变。培养小儿麻醉医师向围术期医师转变的理念,需要在了解儿童病理生理特点的前提下,重点培训小儿麻醉术前访视、术中麻醉相关技能、术后访视、围术期疼痛相关管理及心理创伤的预防与治疗。让患儿安全舒适地度过围术期、减少术后并发症及死亡率、改善远期预后,是每位小儿围术期医师的责任。     

培本固疏方对去势大鼠骨代谢及骨生物力学的影响

目的观察培本固疏方对去卵巢骨质疏松模型大鼠骨密度、骨生物力学及骨代谢指标的影响。方法将42只SD大鼠随机分为假手术组(SHAM)、模型对照组(OVX)、中药低剂量组(D)、中药中剂量组(Z)、中药高剂量组(G)和西药组(X),通过切除大鼠双侧卵巢建立骨质疏松症模型,假手术组仅切除卵巢周围约1 g的脂肪组织。造模4周后进行药物干预,各组持续灌胃8周。计算子宫指数,测定股骨骨密度(bone mineral density,BMD)及股骨生物力学弹性载荷、极限载荷、弹性模量等指标;采用ELISA法测定血清骨代谢指标TRACP5b、sRANKL、OPG及氧化应激指标MDA、AGEs的含量。结果与SHAM组比较,OVX组子宫指数、股骨近端和股骨中段BMD、弹性载荷、弹性模量均明显降低(P0. 05),OVX组血清MDA、AGEs含量明显升高(P0. 01),血清TRACP5b含量明显升高(P0. 01),而OPG、OPG/sRANKL比值下降(P0. 01);与OVX组相比,各治疗组子宫指数、骨强度均有所改善。Z组、G组及X组BMD均明显增高(P0. 05)。Z组、G组及X组TRACP5b含量下降(P0. 05)、OPG含量升高(P0. 05)、RANKL含量降低、OPG/sRANKL比值升高(P0. 05)。Z组、G组血清MDA、AGEs含量降低(P0. 05)。结论培本固疏方可以增加骨强度,通过OPG/RANKL/RANK通路来抑制破骨细胞形成,减缓骨基质吸收,抗氧化应激机制也可能参与其中,具体机制有待探讨。     

吸烟者血浆可溶性蛋白C受体测定的临床意义及影响因素分析

目的 测定吸烟者血浆可溶性蛋白C受体(sEPCR)水平,探讨其临床意义及影响sEPCR的相关因素。方法 测定643例健康人员血浆sEPCR和蛋白C(PC)浓度和凝血因子Ⅷ和Ⅴ(FⅧ:C和FⅤ:C)以及D-二聚体(D-D)水平,并调查其年龄、吸烟和戒烟、吸烟剂量等情况,分为吸烟组和不吸烟组。结果 吸烟组sEPCR、FⅧ:C、FⅤ:C和D-D水平均显著高于不吸烟组(P均=0.000)。吸烟组sEPCR浓度与FⅧ:C、FⅤ:C和D-D水平均呈较高程度正相关(P<0.01)。在吸烟与不吸烟组、不同吸烟年限组以及不同吸烟剂量组中,sEPCR浓度均随年龄段增大而增加(P均<0.01)。不同年龄段中,吸烟组和高剂量组sEPCR浓度分别显著高于不吸烟组和低剂量组(P均<0.05)。在不同年龄段组和不同性别组中,sEPCR浓度均随吸烟年限增加而增高(P均<0.05);不同年限吸烟者中,男性组与女性组之间sEPCR浓度差异均无统计学意义(P>0.05)。结论 吸烟者血栓风险增高可能与血浆sEPCR水平升高有关,烟龄、年龄和吸烟剂量是影响吸烟者血浆sEPCR水平的重要因素。     

Effect of Streptococcus sanguinis/Porphyromonas gingivalis single and combined biofilms upon platelet aggregation

Oral Diseases (2012) 18, 586–594 Objective: To assess the effect of two oral bacteria Streptococcus sanguinis and Porphyromonas gingivalis upon platelet aggregation. Materials and Methods: Streptococcus sanguinis, P. gingivalis, S. sanguniis + P. gingivalis were added to platelet‐rich plasma and platelet aggregation measured using a platelet aggregometer. Platelets were passed through a flow chamber with S. sanguinis, P. gingivalis or a biofilm of S. sanguinis and P. gingivalis coated with saliva. Platelet adhesion to the chamber was observed under a fluorescence microscope for 15 min. The positive control was platelets treated with adrenaline; the negative control was platelets treated with phosphate‐buffered saline. Results: The mean (± s.e.) aggregation magnitude of S. sanguinis and P. gingivalis was 77.7 ± 7.4% and 79.3 ± 9.9%, respectively. The aggregation magnitude of S. sanguinis + P. gingivalis was 51.3 ± 12.9%, which was significantly lower than that for S. sanguinis/P. gingivalis (P < 0.05). In the flow chamber system, platelets adhered to S. sanguinis/P.gingivalis respectively within 3 min, and reached a plateau at 5–15 min. Under the condition of the S. sanguinis‐ and P. gingivalis‐saliva biofilm, platelet adhesion to the biofilm was significantly reduced at 5–15 min (P < 0.05). Conclusions: In the static or dynamic flow system, platelets adhered to S. sanguinis or P. gingivalis. However, if S. sanguinis was mixed with P. gingivalis, the aggregation magnitude (%) was significantly reduced.