带血供溃变神经游离移植后肌电图及组织学变化

目的:从神经血供和溃变两方面对自体神经的移植效果进行分析,观察神经游离移植后的电生理及组织学变化。方法:实验于2001-01/2002-06在白求恩国际和平医院动物实验室完成。①实验分组及方法:选用Wistar大鼠120只,按随机数字表法分为7组,正常对照组12只;其余108只根据移植神经的溃变时间分为3组,分别为健康(未溃变)、溃变1,4周组,每组再根据是否存在尺神经血供分为带和不带血供神经移植组。以双上肢为观察对象,以尺神经桥接正中神经缺损。②实验评估:各组分别于术后第4,8,12周在移植尺神经的中段和正中神经远端距吻合口3mm处,分别取材进行显微解剖观察和光镜观察,测量移植尺神经及正中神经远端横截面轴突的数目,并计算出有髓神经轴突的再生率;于术后第12周测定神经传导速度、诱发电位波幅及潜伏期;术后第12周切取正中神经行电镜观察。结果:120只大鼠全部进入结果分析。①神经外观各组间无明显差异,健康神经移植组移植术后神经与周围组织间粘连最轻。②移植术后第8,12周,相同溃变时间带血供组的神经轴突再生率高于不带血供组(P<0.05);健康神经组高于溃变神经组(P<0.05)。健康神经组与溃变1周组神经纤维生长情况差异无显著性意义(P>0.05)。③移植术后12周,相同溃变时间带血供组的尺神经及正中神经传导速度、诱发电位波幅均高于不带血供组(P<0.05),潜伏期短于不带血供组(P<0.05),而带血供组组间以及不带血供组差异均无显著性意义(P>0.05)。④带血供溃变1周神经轴突生长最好。结论:带血供溃变神经移植优于不带血供的溃变神经,带血供的短期溃变神经可以用来代替健康神经移植。     

Multicenter surveillance of antimicrobial resistance of Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis in Taiwan during the 1998-1999 respiratory season

A susceptibility surveillance study of 276 isolates of Streptococcus pneumoniae, 301 of Haemophilus influenzae, and 110 of Moraxella catarrhalis was carried out from November 1998 to May 1999 in Taiwan. High rates of nonsusceptibility to penicillin (76%), extended-spectrum cephalosporins (56%), azithromycin (94%), clarithromycin (95%), and trimethoprim-sulfamethoxazole (TMP-SMX) (65%) for S. pneumoniae isolates and high rates of nonsusceptibility to amoxicillin (58%) and TMP-SMX (52%) for H. influenzae isolates were found. Higher percentages of S. pneumoniae isolates nonsusceptible to aminopenicillins, extended-spectrum cephalosporins, macrolides, and TMP-SMX were observed among penicillin-intermediate and -resistant isolates. All quinolones tested were active in vitro against these three organisms.     

缺血再灌注后心肌细胞缝隙连接通讯改变与其凋亡及坏死的关系

目的:了解不同缺血再灌注时间心肌细胞缝隙连接通讯改变情况,分析心肌细胞缝隙连接通讯与心肌细胞坏死、凋亡的关系以及卡维地洛、庚醇的干预作用。方法:实验于2004-10/2005-03在中日友好医院临床研究所完成。取培育7d心肌细胞缺氧30min后换用正常含糖的DMEM培养基培养1,2,3,6h,造成再给氧损伤。给药方案:分为三组;未用药组,庚醇组,卡维地洛组。庚醇用DMEM(含5%的小牛血清)配成1,2mmol/L的浓度,卡维地洛配成0.001g/L的浓度,分别加入药物于受试细胞,培养细胞30min后再做相关实验。未用药组不加药。采用细胞划痕技术,在倒置荧光显微镜下直观地观察不同组别、缺氧再灌注不同时间罗氏黄经过缝隙连接流通情况。利用流式细胞仪观察缺氧再灌注不同时间细胞凋亡情况。结果:①在缺氧30min时心肌缝隙连接通讯明显下降,荧光仅传至划痕附近第二列细胞,正常细胞荧光则传至四列以外的细胞。再供氧1h时恢复到第三列,以后逐步恢复到正常。运用庚醇后传导明显减慢荧光仅传至第二列细胞,缺氧和再供氧时传导也无明显变化。运用卡维地洛后传导改变不明显。②正常和缺血30min时凋亡指数差异无显著性(P>0.05),再供氧1h凋亡指数为27.4%,与正常相比差异显著(P<0.01)。坏死的心肌细胞在再供氧2h后差异有显著性(P<0.01)。运用卡维地洛、庚醇后凋亡指数在再灌注1h时分别较未用药组减少了55.11%,21.53%。③培养7d的心肌细胞搏动频率为(120±18)次/min,缺氧30min时,搏动减弱,次数为(56±16)次/min,再供氧1h时,搏动次数为(118±22)次/min,两者差异显著(P<0.01)。加入浓度为2mmol/L的庚醇后,心肌细胞搏动明显减弱,约为(64±20)次/min,差异显著(P<0.001)。加入0.001g/L卡维地洛搏动次数也有不同程度的减低(P<0.05)。在缺氧再灌注过程中,两个干预组搏动次数变化不大。结论:心肌细胞在缺氧时缝隙连接通透性减低,庚醇、卡维地洛也有不同程度的降低缝隙连接通讯的作用。庚醇、卡维地洛通过改变缝隙连接通讯以及其他方面的作用来减少心肌细胞的死亡和凋亡。     

Infant feeding, solid foods and hospitalisation in the first 8 months after birth

Most infants in the UK start solids before the recommended age of 6 months. We assessed the independent effects of solids and breast feeding on the risk of hospitalisation for infection in term, singleton infants in the Millennium Cohort Study (n = 15,980). For both diarrhoea and lower respiratory tract infection (LRTI), the monthly risk of hospitalisation was significantly lower in those receiving breast milk compared with those receiving formula. The monthly risk of hospitalisation was not significantly higher in those who had received solids compared with those not on solids (for diarrhoea, adjusted odds ratio 1.39, 95% CI 0.75 to 2.59; for LRTI, adjusted odds ratio 1.14, 95% CI 0.76 to 1.70), and the risk did not vary significantly according to the age of starting solids.     

Aicardi–Goutières syndrome presenting with haematemesis in infancy

Aicardi–Goutières syndrome is a genetic childhood encephalopathy characterized by basal ganglia calcification, chronic cerebrospinal lymphocytosis and elevated cerebrospinal fluid interferon-alpha, mimicking acquired congenital viral infections. As more is discovered about the pathogenesis of Aicardi–Goutières, it is becoming evident that a dysfunction of the immune system is likely to be responsible for the disease phenotype. We describe a previously healthy 2-month-old female infant who presented with haematemesis and seizures and was subsequently diagnosed with Aicardi–Goutières syndrome. To our knowledge, this is the first documented case of Aicardi–Goutières syndrome presenting with haematemesis. The gastrointestinal tract is an area of high cell loss, revealing early signs of systemic inflammation and we postulate that a systemic proinflammatory milieu occurs in Aicardi–Goutières syndrome.
Conclusion: Aicardi–Goutières syndrome can present with haematemesis, adding to the growing evidence that the Aicardi–Goutières syndrome spectrum encompasses an immune-mediated multisystem involvement. Gastrointestinal inflammation should also be considered in these patients and treated appropriately.     

海南黎族跳娘舞的健身价值

目的:评价跳娘舞者运动负荷程度,分析其健身价值。方法:①2003-03/07对海南省五指山市、陵水县、保亭县3个黎族市县的乡镇跳娘舞者120人,其中男80人,女40人,年龄20～40岁。均身体健康,且对检测项目知情同意。②跳娘舞共有8个表演程序基本动作:跳步,跳踢步,三步摆胯,二步摆胯,甩手拭汗,摊掌跳摆,甩手祈福,甩手闪臂,拍手跳。③以主观心理感觉等级表等级作为运动时心理负荷的标志,该表按自我感觉分为6～20级,级数越高,则表明被试感觉越累,运动强度越大。运动处方的适宜强度应为11～14级(心率110～140次/min)。④用芬兰产的Polar遥测心率仪对跳娘舞者心率进行测定。结果:跳娘舞者97人(81%)心率为110～140次/min,是适宜的运动负荷程度。结论:大多数跳娘舞者运动负荷程度适宜,是健身效果较好的运动。     

《数字化卒中单元管理系统》数据库网络版的研究与开发

目的:充分利用现有的计算机网络资源,研究和开发卒中单元计算机管理软件。方法:客户端利用MicrosoftVisualBasic6.0作为计算机语言编写系统前台软件,即《数字化卒中单元管理系统》,给用户提供了人机对话界面。服务器端采用甲骨文公司ORACLE数据库作为系统数据库。通过《数字化卒中单元管理系统》调用后台服务器ORACLE数据库中的数据。结果:成功编写完成了《数字化卒中单元管理系统》软件,是一套网络化、高效、方便快捷、统一有序的卒中单元计算机管理软件。结论:《数字化卒中单元管理系统》为卒中单元的临床和研究积累数据,为组织化卒中医疗提供网络化管理,是建立和运作卒中单元的数字化临床路径,简化和方便了卒中单元的推广和运作。     

人食管上皮酸反流损伤的早期超微结构改变

学改变.本研究的目的是确定此种改变是否也是人食管酸反流损伤的一种早期表现.方法用透射电镜检查10例正常对照组,12例胃食管反流病(GERD)患者(经24 h pH监测和压力测定诊断为GERD)的内镜活检标本(标本均取自食管下端5 cm内、内镜下无异常的粘膜),用图象分析仪测量每例标本透射电镜照片的细胞间隙.结果胃食管反流病患者组的细胞间隙(1.27±0.77)μm大于正常对照组细胞间隙(0.49±0.08)μm,P＜0.01,前者有9例有细胞间隙≥2.5 μm,而正常对照组无一例有细胞间隙≥2.5μm.结论细胞间隙增大是人食管酸反流损伤的一种早期表现.