人心肌肌钙蛋白I第2和第4个密码子同义突变对其在大肠埃希菌中表达的影响

目的 对人心肌肌钙蛋白I（cTnI）基因实行定点突变并进行原核表达，观察此突变对cTnI表达量的影响。方法 利用RT-PCR方法从人心肌细胞的总RNA中克隆出编码人心肌肌钙蛋白I的cDNA片段，设计引物将其第2和第4个密码子突变后插入原核表达载体形成重组体，并导人宿主菌BL21（DE3）中，经IPTG诱导表达，Ni-NTA树脂纯化后行Western blot鉴定，观察突变对cTnI表达的影响。结果 突变后的cTnI基因与对照组相比在大肠埃希菌中得到高效表达，经纯化可获得电泳单点纯的cTnI蛋白。结论 成功克隆了cTnI基因，所设计的同义突变可促进cTnI在大肠埃希菌中的高效表达。     

经直肠超声下的前列腺低回声区及其临床意义

目的评估经直肠超声下的前列腺低回声区及其临床意义。方法1999年8月～2004年8月，共438例患者接受了经直肠超声引导前列腺系统穿刺活检术。活检点数为6～13点。如果经直肠超声检查发现前列腺的低回声区，亦加取该区部位的活检。将低回声区、等回声区的活榆结果进行比较。结果总的癌检出率为25．6％（112／438）。112例前列腺癌患者中，有低回声区者75例，占67％，无低回声区者37例，占33％。本组总共取得3504个活检点，取自低回声区者636个。636个低回声区中癌区163个，占25．6％，非癌区473个，占74．4％。腺体中有或无低回声区检出前列腺癌的可能性相当，为25．2％（75／298）和26．4％（37／140），差异无统计学意义（P〉0．05）。结论多数前列腺癌可发现低回声区，但多数低回声区并非前列腺癌。腺体中有无低同声区对前列腺癌的检出率相当。     

肌肉注射与静脉输注哌替啶术后止痛效果的比较

[目的]通过观察两种不同给药方式的止痛效果,探讨骨科病人术后应用哌替啶止痛的良好途径。[方法]采用视觉模拟评分法判断病人持续缓慢静脉输注哌替啶与肌肉注射哌替啶的术后疼痛情况,并进行比较。[结果]静脉输注哌替啶疼痛程度比肌肉注射哌替啶疼痛程度明显降低,用药总量减少近1倍,且静脉输注哌替啶避免了术后剧烈疼痛的发生以及血管吻合术因疼痛而产生的血管危象,提高了病人休息的质量。[结论]骨科手术后采用持续缓慢静脉输注哌替啶预防性用药是一种有效、适用的止痛方法。     

Colonization with methicillin-resistant Staphylococcus aureus after liver transplantation.

Methicillin-resistant Staphylococcus aureus (MRSA) is a frequent cause of infection after orthotopic liver transplantation (OLT). Colonization with MRSA is associated with a higher risk of infection. Previous studies have shown a high prevalence of MRSA colonization among OLT candidates. However, the risk of colonization with MRSA after OLT is still unclear. The objective of this study was to estimate the incidence and the factors associated with colonization with MRSA after OLT. This was a prospective cohort study including patients submitted to OLT between the years 2000 and 2002. Surveillance cultures of nasal swab specimens were performed within the 1st 72 hours of hospital admission and, subsequently, on weeks 2, 6, 13, and 26. Patients whose baseline cultures revealed nasal carriage of MRSA were excluded. A total of 60 patients were included in the study. The median follow-up was 72 days. A total of 9 patients (15%) became colonized. In multiple logistic regression analyses, the use of a urinary catheter for > or =5 days (P = .006), postoperative bleeding at the surgical site (P = .009), and preoperative use of fluoroquinolones (P = .08) were associated with a higher risk of colonization. Patients without any of these risk factors did not become colonized. In conclusion, nasal carriage of MRSA is frequently acquired after OLT. Periodic postoperative screening for MRSA carriage should be an integral component in programs designed to reduce nosocomial MRSA transmission in these patients. Further studies are needed to set up and validate a predictive model that could allow targeting postoperative screening to high-risk OLT recipients.     

现代医学200词——147、社区康复

所谓社区康复的“社区”一词尚没有明确的定义。其范围是小的群体、大城市、县，也有以国为单位的。另方面，关于康复历史上虽提出了很多概念，但现在暂时一致采用1982年“联合国残疾人世界行动计划”的定义，即康复是尽可能使躯体和心理达到社会的最适机能水平，旨在提供改变个体人生的手段，且限定在一定时间的过程。但与康复的4个方面，即依据医学、社会、职业、教育的专门领域的概念相异，统一还相当困难。     

国产长效皮下埋植避孕剂的临床应用

1992年我院用国产长效皮下埋植避孕剂(左旋18-甲基炔诺酮),对600例育龄妇女进行皮下埋植,经1年随访,结果显示:国产长效皮下埋植剂的避孕效果达100％。600例中10例因出现月经异常而终止使用,其持续使用率为98.33％,获得了与进口长效皮下埋植避孕剂相同的效果。     

人脑桥内部的动脉供应和毛细血管构筑

采用血管灌注和透明切片,在立体解剖显微镜下对30例脑桥内部动脉的分群,经行分支和供应范围进行了观察。并应用图像分析系统测算了脑桥内部主要神经核团和纤维束的毛细血管密度。脑桥内部前正中群有三组长动脉,分别由脚间窝下端,基底沟中部和盲孔处穿入,这些动脉在向脑桥被盖部经行和分布的过程中,可形成多级直角分支,使之呈“垂柳状”外观。脑桥内部的毛细血管构筑,在透明切片上,可显示出神经结构的轮廓。其中上橄榄核的毛细血管密度最高,小脑上脚的毛细血管密度最低。     

梭曼中毒动物中枢神经系统病变与惊厥的关系

用神经组织学方法观察了兔、猫、狗、猴梭曼中毒急救治疗后CNS的病理变化.结果表明,CNS病变程度随着惊厥持续时间的延长而加重,抗惊剂可以保护CNS免受损伤.不同种动物梭曼引起的CNS病变基本相似,均为神经细胞的缺血性改变.主要病变包括大脑皮质、丘脑、海马、小脑和脊髓的神经细胞尼氏体溶解、核浓缩和细胞表面结痂.由于CNS病变与惊厥有密切关系,因此梭曼中毒后必须应用抗惊剂.     

Evaluation of hypothesis testing for comparing two populations using NONMEM analysis

In a simulation study of inference on population pharmacokinetic parameters, two methods of performing tests of hypotheses comparing two populations using NONMEM were evaluated. These two methods are the test based upon 95% confidence intervals and the likelihood ratio test. Data were simulated according to a monoexponential model and, in that context, power curves for each test were generated for (i)the ratio of mean clearance and (ii)the ratio of the population standard deviations of clearance. To generate the power curves, a range of these parameters was employed; other pharmacokinetic parameters were selected to reflect the variability typically present in a Phase II clinical trial. For tests comparing the means, the confidence interval tests had approximately the same power as the likelihood ratio tests and were consistently more faithful to the nominal level of significance. For comparison of the standard deviations, and when the volume of information available was relatively small, however, the likelihood ratio test was more able to detect differences between the two groups. These results were then compared to results on parameter estimation in order to gain insight into the question of power. As an example, the nonnormality of estimates of the ratio of standard deviations plays an important role in explaining the low power for the confidence interval tests. We conclude that, except for the situation of modeling standard deviations with only sparse information, NONMEM produces tests of significance that are effective at detecting clinically significant differences between two populations.Partial support from the Upjohn Company, NIH-BRSG SO RR 07066, and the Burroughs Wellcome Foundation.     

离子对提取比色法测定复方制剂中氨基比林的含量

复方制剂中氨基比林与溴甲酚绿形成稳定的离于对，用氯仿萃取后在４１６．８ｎｍ处测定吸收度．回收率为９９．８０％，相对标准偏差为０．９２％（ｎ＝５）。方法简便快速，结果准确可靠。