色甘酸钠混悬气雾剂与茶碱缓释胶囊治疗中度哮喘的比较

８４例中度哮喘病人分成２组。色甘酸钠组（男性２３例，女性２０例，年龄２６±ｓ８ａ）吸入色甘酸钠混悬气雾剂１０．５ｍｇ，ｔｉｄ。茶碱缓释胶囊组（男性２２例，女性１９例，年龄２７±８ａ）口服０．２５ｇ。ｂｉｄ。２组均连续观察３ｍｏ。结果：色甘酸钠在减轻病人慢性症状、改善肺功能和降低气道高反应性等方面优于茶碱缓释胶囊，（Ｐ＜０．０１）。而后药仅可缓解近期症状。     

Increased carbon monoxide levels in the nasal airways of subjects with a history of seasonal allergic rhinitis and in patients with upper respiratory tract infection

BACKGROUND: Carbon monoxide (CO) has emerged as an endogenously produced gaseous mediator known to be involved in bronchial smooth muscle regulation. Increased amounts of CO have been found in exhaled air during asthma and lower airway inflammation. Recently CO has been shown to be produced in the nasal airways, but there are no reports of altered CO levels in nasal airways during inflammation. OBJECTIVE: This study was designed to investigate if CO levels increase in the human nasal airways during inflammatory conditions, such as allergy and upper airway respiratory tract infection (URTI). METHODS: CO was sampled separately from the upper and lower airways of 13 healthy control subjects, six patients with a history of allergic rhinitis and six patients with URTI. RESULTS: Nasal CO levels were increased in subjects with allergic rhinitis, compared to healthy controls (2.07 +/- 0.15 ppm, n = 6 and 1.62 +/- 0.08 ppm, n = 13, respectively, P < 0.01). CO levels were also increased in patients with URTI, compared to the same controls (1.92 +/- 0.09 ppm, n = 6, P < 0.05). Normal levels of CO were found in air from the lower airways among subjects with allergic rhinitis, whereas corresponding levels in the URTI patients were increased. CONCLUSION: The present data demonstrates that upper airway CO levels increase in parallel with different inflammatory stimuli, such as allergy and infection, suggesting a role for CO as marker or mediator of nasal inflammation.     

男性不育症患者中YRRM2基因缺陷的研究

YRRM基因是控制精子生成与成熟的一个重要因素，一旦该基因缺陷，将会造成无精或少精。本研究对340例无精与少精患者的外周血标本进行了PCR基因扩增筛查，结果发现7例为该基因缺陷，占2％。证明YRRM2的缺陷也是造成中国人群男性不育的一个原因，从而可作为指导医生采用适当治疗方法的一个可靠指标。在实验过程中，采用直接加热白细胞提取基因组DNA，并以此作为模板对YRRM2基因进行扩增，既节省时间和经费，又保持良好的扩增效果，使之可用于临床医院作为常规检查。     

压力调节容量控制通气对肺损伤犬血流动力学、呼吸力学和呼吸功能的影响

目的 探讨压力调节容量控制(PRVC)通气模式对健康及急性肺损伤(ALI)模型犬的血流动力学、呼吸力学和呼吸功能的影响。方法 PRVC和间歇正压通气(IPPV)两种通气模式在呼气末压为0、0．5、1．0和1．5kPa时，分别测定健康犬及油酸诱发ALI犬的血流动力学、呼吸力学及血气参数。结果 健康犬PRVC较IPPV模式下除了在PEEP为0．5kPa时，气道峰压(PIP)、肺动态顺应性(Cdyn)和肺血管阻力(PVR)的影响差异有显著性，对血流动力学、呼吸力学及呼吸功能的影响差异均无显著性。ALI犬PRVC较IPPV模式下各PEEP水平的PIP、平均气道压(mPaw)、Cdyn、动脉血氧分压[pa(O2)]和氧耗(VO2)的影响均有显著意义，但两种通气模式对血流动力学的影响差异无显著性。结论 与IPPV相比，PRVC通气模式能降低PIP，增加Cdyn和提高pa(O2)，两模式对血流动力学的影响差异无显著性，PRVC更适用于ALI／ARDS的治疗。     

急性传染性非典型肺炎的影像表现

目的探讨急性传染性非典型肺炎(SARS)的X线表现及变化规律.方法回顾性分析临床诊断SARS的61例患者,对发病后的一系列胸片和CT影像进行统计分析.结果患者以发热为最早起病症状,88.5%患者在起病1周内肺部出现肺局灶性斑片状模糊影,并迅速扩大.2周内病变达高峰,有57.4%患者两肺大部分肺野受累,病情重.83.6%患者在5周内肺部阴影逐渐消散.在恢复期16例CT扫描中,有13例显示肺部遗留纤维化病灶.有6例患者合并感染,病期延长,4例死亡.结论SARS早期出现肺部炎性改变,发展迅速,大部分两肺受累,重症比例高,易致肺纤维化.     

The effect of supplementation with fish oil during pregnancy on breast milk immunoglobulin A, soluble CD14, cytokine levels and fatty acid composition

BACKGROUND: Breast milk contains many immunomodulatory factors (soluble CD14 (sCD14), IgA and cytokines) with the potential to influence infant immune development. OBJECTIVE: To determine if changes in breast milk omega-3 polyunsaturated fatty acid (n-3 PUFA) composition as a result of maternal dietary fish oil supplementation during pregnancy can modify levels of these immunological parameters in breast milk. METHOD: In a randomized controlled trial, 83 atopic women received either 4 g fish oil capsules (containing 3.7 g n-3 PUFA) (n = 40) or 4 g olive oil capsules (n = 43) from 20 weeks gestation until delivery. Breast milk was collected 3 days post-partum and fatty acids were analysed by gas liquid chromatography and IgA, sCD14 and cytokines (IL-5, IL-6, IL-10, TNF-alpha and IFN-gamma) were quantitated by ELISA or time resolved fluorescence (TRF). RESULTS: Omega-3 docosahexaenoic acid (DHA; 22:6n-3) and eicosapentaenoic acid (EPA; 20:5n-3) levels were significantly higher (P < 0.001) in breast milk from women supplemented with fish oil (n = 33, DHA mean 1.15%, SD 0.47% and EPA mean 0.16%, SD 0.07%) than in samples from the control group (n = 40, DHA mean 0.50%, SD 0.17% and EPA mean 0.05%, SD 0.02%). Breast milk arachidonic acid (AA; 20:4n-6) levels were significantly lower (P = 0.045) in the fish oil group (mean 0.55%, SD 0.12%) compared with the control group (mean 0.61%, SD 0.14%). Breast milk IgA was positively correlated with DHA (P = 0.046) and 22:5n-3 (P = 0.003), but inversely correlated with linoleic acid (LA; 18:2n-6) (P=0.034). Levels of sCD14 were also positively correlated with 22:5n-3 (P=0.009). Cytokines involved in IgA synthesis (IL-10 and IL-6) were also significantly correlated with both IgA and n-3 PUFA levels, although there were no differences in the levels of breast milk IgA, sCD14 or cytokines between study groups. CONCLUSION: Supplementation with fish oil during pregnancy significantly alters early post-partum breast milk fatty acid composition. omega-3 PUFA levels were positively associated with IgA and sCD14 levels, suggesting a relationship between fatty acid status and mucosal immune function.     

某医院传染性非典型肺炎疫情分析

目的：分析某医院SARS疫情的发生、发展及控制过程，为疫情控制提供一定的参考依据。方法：依照卫生部推荐的统一个案调查表和临床诊断标准，描述疫情的三间分布以及发放防护用品的数量与病例数的关系。结果：某医院疫情暴发曲线由3个暴发高峰组成，前两个峰较大，后一个峰较小，呈散发。提示病例传染共形成“三代”流行。结论：采用严密的综合防护措施，能够彻底控制SARS疫情在医院的暴发。     

人源化抗体构建过程中假链的产生及应对策略

目的在人源化抗体构建过程中，采用方便、快捷的分子克隆手段。消除SP2／0内源性畸形轻链转录本以获得正确的轻链cDNA。方法在mRNA抽提时，不用常规的TRIZOL法抽提总RNA，而采用经腹腔培养。生长状态良好的杂交瘤细胞。用QIAGEN公司Oligotex Direct mRNA Purification Kit，将polyA^＋的mRNA富集。可有效减少畸变转录本的含量，提高功能型mRNA的丰度。利用polyA^＋RNA。采用RT-PCR，我们成功地克隆到了轻链可变区序列，序列分析证实读码框完全正确，属于轻链可变区基因。结果NCBI数据库BLAST显示。克隆的基因序列符合小鼠lg可变区特征，具有正确的CDR和FR功能区及VJ连接区。结论采用polyA^＋ mRNA富集技术，成功克隆获得阻断型抗人CD154 mAb（4F1）单克隆抗体的轻链、重链可变区基因，成功地消除了SP2／0内源性畸形转录本对免疫球蛋白功能性轻链基因的影响。     

山莨菪碱和无创面罩正压通气治疗急性呼吸窘迫综合征的临床观察

目的比较山莨菪碱联合无创正压面罩通气（654-2＋NIPPV）和传统机械通气（CMV）治疗急性呼吸窘迫综合征（ARDS）的临床效果，评估山莨菪碱联合无创正压通气在ARDS治疗中的作用。方法将各种原因所致ARDS患者42例随机分为654-2＋NIPPV组（21例）和CMV组（21例），在给予病因治疗同时分别实施654-2＋NIPPV和CMV。观察分析两组患者在治疗过程中动脉血气变化、并发症的发生率及治疗效果。结果654-2＋NIPPV组有8例（38．1％）治疗失败转为气管插管实行CMV，其中6例（28．6％）死亡。CMV组死亡7例（33．3％），两组病死率无显著差异（P〉0.05）。两组治疗有效的患者在分别接受654-2＋NIPPV和CMV治疗后1h和6h动脉血气有相似的显著改善。654-2＋NIPPV组患者机械通气时间和住院时间短于CMV组（P〈0.05）。654-2＋NIPPV组的并发症发生率低于CMV组（P〈0.05）。结论在经过选择的ARDS患者中，应用654-2＋NIPPV治疗的临床效果与CMV相似。实施654-2＋NIPPV可缩短机械通气和住院时间，减少并发症。654-2＋NIPPV可作为经过选择的ARDS患者首选的通气支持治疗手段。