基于IgG抗A（B）效价梯度及动态差值探讨ABO-HDN病情相关性

目的探讨动态监测IgG抗A(B)效价梯度与ABO-HDN病情严重程度临床指标的相关性。方法选取2017年1~5月间47例ABO溶血病患儿临床资料进行统计分析,记录患儿出生后32 h的血清总胆红素(serum total bilirubin,STB_(32h))、血红蛋白(hemoglobin,Hb)、网织红细胞百分比(the percentage of reticulocyte,Ret%)及孕妇第16和37周IgG抗A(B)效价梯度。比较各组新生儿临床指标和lgG抗A(B)效价的相关性。结果 STB_(32h)与37周IgG抗A(B)效价梯度、IgG抗A(B)_(37-16)梯度差呈正相关(P0.001);Hb与第37周IgG抗A(B)效价梯度呈负相关(r~2=0.2074,P=0.0013);Hb与IgG抗A(B)_(37-16)梯度差值呈负相关(r~2=0.1831;P=0.0027);Ret%与37周IgG抗A(B)效价梯度、IgG抗A(B)_(37-16)梯度差值呈正相关(P0.001)。结论产前37周IgG抗A(B)效价梯度、IgG抗A(B)_(37-16)效价梯度差值与新生儿ABO-HDN的病情严重程度具有一定相关性。     

Effects of the bone morphogenetic protein binding protein spp24 (secreted phosphoprotein 24 kD) on the growth of human lung cancer cells

Bone morphogenetic proteins (BMPs) and transforming growth factor‐beta (TGF‐β) contribute to the growth of some skeletal metastases through autocrine stimulation. Secreted phosphoprotein 24 kDa (spp24) has been shown to bind to both BMP‐2 and TGF‐β and to markedly inhibit the osteogenic properties of rhBMP‐2. We hypothesized that the addition of spp24 would sequester autocrine growth factors (especially BMP‐2) and reduce tumor growth in a system (A549 human non‐small cell lung cancer cell line) where autocrine stimulation by BMP‐2 is known to be important. A549 cells were injected into two sites (subcutaneous and intraosseus) in SCID mice with and without the co‐injection of BMP‐2 and spp24. Tumor growth after 8 weeks was assessed through gross examination, radiological imaging, and histological analysis. Spp24 attenuated the tumor growth enhancing effects of rhBMP‐2 and reduced the tumor growth when added to tumor cells that were not treated with BMP‐2. We conclude that spp24 can reduce A549 cell tumor growth in both soft tissue and intraosseus environments. We hypothesize that the mechanism for this inhibition is interruption of autocrine stimulation through the sequestration of BMP‐2. Spp24 can be developed into a therapeutic agent that can be employed in clinical situations where the inhibitions of BMPs and related proteins is advantageous. © 2011 Orthopaedic Research Society Published by Wiley Periodicals, Inc. J Orthop Res 29:1712–1718, 2011     

聚丙烯补片预防游离腹直肌皮瓣术后切口疝的作用

目的 探讨聚丙烯补片（Prolene)预防游离腹直肌皮瓣术后切口疝发生的作用。方法 1999年11月9日-2000年10月22日对26例患者行游离腹直肌皮瓣移植术时,采用聚丙烯补片作腹直肌前鞘修补,分析聚丙烯补片植入后的组织反应及创口愈合情况,以及切口疝发生的情况。结果 25例患者腹部创口均Ⅰ期愈合,1例术后腹部创口出现局部积液,经保守治疗好转,未出现排异和感染等并发症,术后随访1-12个月,全部患者聚丙烯补片愈合良好,无排出或取出,腹部不适,切口疝及腹壁膨隆。结论 聚丙烯补片具有较好的生物相容性,其植入体内后不会发生排异和增加创口感染的机会,用于腹直肌前鞘的修补安全可靠,能有效预防游离腹直肌皮瓣术后切口疝的发生,值得进一步观察和应用。     

术后24h开始经口进食对直肠癌患者术后恢复的影响

为探讨术后24h开始经口进食对直肠癌患者术后恢复的影响,选择2013年12月至2014年2月于我科择期行直肠癌根治术的60例患者进行研究,随机分为观察组和对照组,各30例,观察组术后接受快速康复治疗（术后24h开始进食）,对照组术后接受传统治疗（肠功能恢复后开始进食）。对比两组患者术后住院时间、首次排气时间和首次排便时间。结果显示,观察组患者术后住院时间、首次排气时间、首次排便时间均明显短于对照组,P〈0．05。结果表明,直肠癌患者术后24h开始经口进食安全、可行,术后肠道功能恢复快,住院时间短。     

24小时多通道腔内阻抗-pH监测在胃食管反流病中的应用价值研究

目的 评价24 h多通道腔内阻抗-pH监测(24 h MII-pH)在胃食管反流病(GERD)诊断中的应用价值。方法 选取2016年1月—2018年6月在某院就诊的326例GERD患者作为观察组,并选取同时期健康志愿者75例作为对照组,均行24 h MII-pH监测,并记录GERD相关参数。比较MII-pH监测与单独pH监测对GERD的诊断情况。结果 ①24 h pH监测结果显示,观察组各监测指标均显著高于对照组(P<0.05);②24 h MII-pH监测结果显示,除弱碱反流次数两组无明显差异(P＞0.05)外,在其他指标比较中,观察组均显著高于对照组(P<0.05);③24 h MII-pH监测GERD的阳性诊断率为87.42%,与单纯食管pH监测的44.78%比较,差异有统计学意义(P<0.05)。结论 24 h MII-pH可识别反流物的运动方向、酸碱性和成分,提高GERD的检出率,具有重要的临床价值。     

新型IKKβ激酶抑制剂的体外抗胃癌活性

目的：探究新型EF24类IKKβ激酶抑制剂H18的体外抗胃癌活性。方法：利用分子对接模拟H18与IKKβ的结合模式;利用MTT实验检测H18对胃癌细胞BGC-823抑制生长的作用;集落克隆实验检测H18对BGC-823增殖的影响;利用DAPI染色检测细胞凋亡情况;利用Western blot实验分析H18对胃癌细胞BGC-823的NF-κB信号通路的影响。结果：H18可与IKKβ的变构位点结合;H18对BGC-823细胞72 h IC50为（1.7±0.3）μmol/L;与IKK抑制剂BMS-345541相比,H18明显抑制细胞的增殖,而对凋亡无明显影响;H18可对胃癌细胞NF-κB信号通路产生明显抑制作用。结论：H18具有良好的体外抗胃癌活性,是一种具有研发前景的IKKβ抑制剂。     

Long-term results of irrigated radiofrequency modified maze procedure in 200 patients with concomitant cardiac surgery: six years experience

BACKGROUND: The Cox maze procedure is considered an effective surgical treatment of atrial fibrillation in patients with and without organic heart disease. Radiofrequency energy offers an alternative to the complex surgical maze procedure. We used the radiofrequency modified maze III procedure in patients with atrial fibrillation undergoing elective concomitant cardiac surgery. This study evaluated the long-term results of the irrigated radiofrequency ablation to create linear lines of conduction block endocardially. METHODS: Between November 1995 and June 2001, 200 patients with mainly structural heart disease and chronic atrial fibrillation underwent intraoperative radiofrequency linear ablation in both atria with concomitant cardiac surgery. RESULTS: The in-hospital mortality rate was 3.5% (7 patients) and during the mean follow-up of 40 months (range, 12 to 80) 27 patients (13.5%) died. Eight patients (4%) were lost from follow-up and complete data were available in 158 survivors. Sinus or atrial rhythm was present in 116 patients (73.4%) and an atrial driven rhythm in 10 patients (6.3%) with an atrioventricular pacemaker. Atrial fibrillation or flutter was documented in 32 patients (20.3%). Antiarrhythmic drugs were used in 49% of survivors who were free of atrial fibrillation or flutter. CONCLUSIONS: Intraoperative radiofrequency endocardial ablation is an effective technique to eliminate atrial fibrillation with promising long-term results.     

Verlaufsformen und Mikrobiologie der bakteriellen Osteomyelitis

Zusammenfassung Wegen der vielfältigen klinischen Präsentation der Osteomyelitis werden diese Patienten von Ärzten verschiedenster Fachrichtungen gesehen. Verschiedene Klassifikationen spiegeln die Konzepte zur Diagnostik und Therapie der Osteomyelitis wider. Ursprünglich wurde die Osteomyelitis nur in eine akute und eine chronische eingeteilt. Die klassische Einteilung nach Waldvogel berücksichtigt die Pathogenese. Nach Wagner wird beim diabetischen Fuß der fließende Übergang von der Weichteilinfektion zur Osteomyelitis und zur Gangrän beschrieben. Die Einteilung nach Cierny-Mader nützt v. a. der Therapie durch den Traumatologen/Orthopäden. Das Erregerspektrum ist abhängig von Art der Osteomyelitis, geographischer Epidemiologie, Patientenalter, Komorbidität, mikrobiologischer Technik und Infektionsdauer. S. aureus spielt bei jeder Form die wichtigste Rolle. Bei Bildung von Biofilm und small-colony variants neigt der Keim zu Persistenz und Rezidiv. Die Antibiotikaresistenz nimmt seit 20 Jahren zu. Nicht nur die In-vitro-Resistenz, sondern auch die Wirkung der Antibiotika auf nichtwachsende und adhärierende Keime bei Implantatinfektionen sind wichtig. Zur optimalen Antibiotikatherapie sollte immer der Keimnachweis versucht werden.     

Acute effect of propranolol on splanchnic circulation in normal and portal hypertensive rats

Propranolol decreases portal venous pressure in patients with cirrhosis but no method is available in man to study the effect of this beta-blocker on splanchnic organ blood flow. Because in rats, the microsphere method allows evaluation of regional blood flow, the acute effect of propranolol on both splanchnic and systemic circulations was studied in normal rats and in rats with portal hypertension due to portal vein stenosis. Portal venous pressure significantly decreased during propranolol administration in normal (5.6 +/- 1.0-4.7 +/- 1.1 mm Hg; mean +/- SD) as well as in portal hypertensive rats (11.7 +/- 2.3-10.3 +/- 1.8 mm Hg). Propranolol slightly decreased cardiac output and arterial pressure in all rats. Portal tributary blood flow was significantly reduced by propranolol in normal rats (17.4 +/- 3.0-11.3 +/- 2.2 ml/min) and in portal hypertensive rats (23.7 +/- 5.0-16.6 +/- 3.3 ml/min). Accordingly vascular resistance of the different organs in the portal venous territory increased in these rats receiving propranolol. The percentage of the decrease in portal tributary blood flow was significantly more marked than the percentage of reduction in cardiac output in portal hypertensive rats but, in normal rats, these percentages were parallel. Hepatic arterial blood flow did not change or slightly increased and, consequently, hepatic arterial vascular resistance decreased. These findings further clarify the marked effects of propranolol on splanchnic circulation.