乌司他丁保护百草枯中毒大鼠肺免受损伤的作用

目的:探讨乌司他丁保护百草枯中毒大鼠肺免受损伤的作用及其机制。方法:Wistar大鼠108只,随机分为对照组、百草枯组和乌司他丁组。百草枯组和乌司他丁组给予百草枯灌胃染毒,对照组给予无菌生理盐水灌胃,乌司他丁组同时给予乌司他丁治疗。1、3、7、14、21、28 d测血清中的MDA、SOD、IL-6、IL-10和TNF-α水平,以及肺组织中的p38 MAPK、MMP-2和TIMP-1表达水平。结果:1、3、7 d百草枯组和乌司他丁组的SOD均较对照组下降(P0.01),乌司他丁组SOD明显高于百草枯组(P0.05)。1、3、7 d百草枯组和乌司他丁组的MDA、IL-6、IL-10及TNF-α均较对照组增高(P0.01),乌司他丁组各指标明显低于百草枯组(P0.05)。1、3、7、14、21、28d百草枯组和乌司他丁组肺组织中的p38 MAPK及TIMP-1均较对照组增高(P0.01),乌司他丁组各指标明显低于百草枯组(P0.05)。1、3、7、14、21 d百草枯组和乌司他丁组肺组织中的MMP-2均较对照组增高(P0.01),乌司他丁组MMP-2明显低于百草枯组(P0.05)。结论:乌司他丁通过抑制p38 MAPK信号通路及抗炎、抗氧化作用保护百草枯中毒大鼠肺免受损伤的作用。     

亚硒酸钠对UVB损伤人角质形成细胞的保护作用

目的:研究亚硒酸钠(Na2Se O3)对中波紫外线(UVB)损伤人角质形成细胞的保护作用。方法:培养永生化人角质形成细胞(Ha Ca T细胞),实验分为4组处理:(1)正常对照组;(2)Na2Se O3组:分别加入1 nmol/L、10 nmol/L、50 nmol/L、100 nmol/L、200 nmol/L和1μmol/L的Na2Se O3预孵育24 h;(3)UVB组:300、600和900 J/m2UVB照射;(4)Na2Se O3+UVB组:Na2Se O3预孵育24 h后进行UVB照射。采用MTT法检测细胞增殖活性,采用流式细胞仪检测300 J/m2UVB照射后细胞的凋亡率。结果:(1)UVB组与正常对照组比较,细胞增殖活性显著降低(P0.05),细胞活性与UVB照射剂量呈负相关;(2)Na2Se O3组与正常对照组比较,细胞增殖活性无明显差异;(3)不同浓度Na2Se O3+UVB组与UVB组比较,细胞增殖活性增加,差异显著(P0.05),其中100 nmol/L组促进细胞增殖作用最强;(4)300 J/m2UVB照射后,不同浓度Na2Se O3+UVB组与UVB组比较,凋亡率下降,差异显著(P0.05),其中100 nmol/L组抑制凋亡作用最强。结论:UVB对角质形成细胞有损伤作用,且与照射剂量呈正相关;Na2Se O3具有光保护性能,可减轻UVB辐射损伤人角质形成细胞。     

3种银杏叶制剂治疗冠心病心绞痛的成本—效果分析

目的:比较3种银杏叶制剂治疗冠心病心绞痛的成本-效果。方法:将103例符合诊断标准的冠心病心绞痛患者按照不同的用药方案分成A组(34例)、B组(35例)、C组(34例)。A、C组分别给予生产厂商及规格不同(2mL vs.5mL)的舒血宁注射液20mL、B组给予银杏达莫注射液20mL,3组均静脉滴注,qd,治疗14d后观察疗效,并进行成本-效果分析。结果:3组心绞痛改善总有效率分别为70.59%、91.43%、73.53%。成本分别为5207.86元、3575.46元、5065.06元,成本-效果比分别为7377.62、3910.60、6888.43。结论:与A、C组比较,B组治疗方案成本-效果比更优。     

药师在输液用药安全中的责任

目的:为药师明确其在保证输液用药安全中的责任提供参考。方法:结合笔者自身的工作经历,从保证处方的合理性、指导护士准确执行医嘱和正确给药、指导患者用药、选择输液器材质等几方面进行分析。结果与结论:药师应运用药学知识对静脉药物治疗中的不合理用药进行有效干预,与医师、护士共同配合,以保证患者输液用药的安全。     

Gleason’s Grading of Prostatic Adenocarcinoma: Inter-Observer Variation Among Seven Pathologists at a Tertiary Care Center in Oman

Prostatic adenocarcinoma is the commonest solid malignancy seen in Omani elderly males 60-80 years of age. The Gleason grade is the most widely used grading system for prostatic carcinoma and is recommended by the World Health Organization. A peer review was carried out at the Pathology Department of Sultan Qaboos University Hospital (SQUH), Oman, to assess the quality of reporting at the center. The aim of this study was to determine inter-observer variation among 7 pathologists working at a tertiary care center in Oman. A total of 47 consecutive prostatic biopsies were interdependently reviewed by seven pathologists and the results obtained were compared with each other and the original diagnosis. This peer review indicated a fair inter-observer agreement (0.482) among 7 pathologists in the department, with fair to moderate agreement when the results were compared to the reported diagnosis, comparable to the published literature. Dual and sub-specialty reporting are being instituted to improve the performance in this vital aspect of pathology.     

Tuberculous otitis media in a renal transplant recipient

Tuberculous otitis media is a rare cause of chronic suppurative infection of the middle ear and a very uncommon form of extrapulmonary tuberculosis. Although there have been several case reports in the nonimmunosuppressive population of tuberculous otitis media, it has never been reported in an immunosuppressed allograft recipient. We present a case of diagnosed tuberculous otitis media after recurrent chronic otitis media treated several times with empiric antibiotic treatment. After the patient developed postauricular fistula and underwent surgical removal of granulation tissue, the diagnosis was made on the basis of histopathology and growth in culture of Ziehl-Neelsen. Clinical response promptly followed institution of antituberculous treatment including isoniazid, rifampicin, ethambutol, and pyrazinamide.     

Lactational and postnatal exposure to polychlorinated biphenyls induces sex-specific anxiolytic behavior and cognitive deficit in mice offspring

The central nervous system is affected by polychlorinated biphenyls (PCBs). Previous studies have indicated that developmental exposure to PCBs impairs behavioral performance and alters cognitive abilities. This study assessed the effects of lactational and postnatal exposure to a commercial PCBs mixture, Aroclor 1254 (A1254), on mice performing several neurobehavioral tasks including the open field test, novel object test, elevated plus maze test, Y‐maze test, and tail suspension test. In the open field test, PCBs treatment (6 and 18 mg/kg/day) was associated with increased movement, time duration, and frequency in the central zone in female but not male mice. PCBs‐treated female mice (6 and 18 mg/kg/day) also showed decreased novel object recognition, indicating impairment in recognition memory. Finally, we performed autoradiographic receptor binding assays for dopamine (DA) D₁ and D₂ receptors, dopamine transporter (DAT), and the N‐methyl‐D ‐aspartic acid (NMDA) receptor after behavioral tests to examine whether alterations occurred in the dopaminergic and NMDAergic systems of the brain. Our results showed that PCBs treatment did not change D₁ and D₂ receptors or DAT binding in the dorsal striatum of female mice. However, PCBs treatment significantly decreased NMDA receptor binding in the dorsal striatum, frontal cortex, cingulate cortex, and motor cortex, and CA3 and dentate gyrus (DG) of the hippocampus in female mice. Collectively, our results suggest that long‐term PCBs exposure can induce anxiolytic behavior, cognitive deficits, and changes of NMDA receptors. Synapse, 2011. © 2011 Wiley©Liss, Inc.     

建立评分系统预测胸中下段食管鳞癌颈部淋巴结转移风险

目的 建立评分系统精确预测胸中下段食管鳞癌颈部淋巴结转移的风险,探讨其颈部淋巴结的治疗策略。 方法 回顾性分析219例食管鳞癌切除术患者的临床及病理资料,通过单因素和多因素分析胸中下段食管鳞癌颈部淋巴结转移的独立危险因素,综合独立危险因素,建立临床模型,权衡临床模型的贝塔系数,建立评分系统。应用评分系统对219例患者进行评分,并分为低、中、高3个危险组,探讨颈部淋巴结转移合适的治疗策略。 结果 颈部淋巴结转移发生率为30.59%(67/219)。单因素及多因素分析结果显示,胸中下段食管鳞癌颈部淋巴结转移的独立危险因素为肿瘤位置、肿瘤长度(>5.25 cm)、肿瘤分化。建立临床模型,权衡临床模型贝塔系数建立评分系统:胸中段3分(2.66),肿瘤长度>5.25 cm(1.20)和肿瘤低分化2分(1.55),肿瘤中分化1分(0.35)。依患者的得分情况分为3组:低危组(0～2)、中危组(3～4)及高危组(>4),3组颈部淋巴结转移发生率分别为3.03%,26.19%和55.00%(P<0.05)。 结论 建立的评分系统可以在术前精确预测胸中下段食管鳞癌颈部淋巴结转移的风险,为术中淋巴结清扫临床决策提供参考,低危组推荐不行颈部淋巴结清扫,高危组推荐行颈部淋巴清扫或术后放疗。     

13-甲基十四烷酸对大鼠局灶性缺血脑组织的保护作用

目的 探讨13-甲基十四烷酸(13-MTD)对局灶性脑缺血损伤的保护作用。 方法 线栓法制备大鼠右侧大脑中动脉缺血6,12及24 h模型。雄性SD大鼠随机分为假手术组、溶媒对照组及13-MTD 40(M40),80(M80),120 mg/kg(M120)干预组。采用Longa法进行神经功能缺失评分; 采用2,3,5-氯化三苯基四氮唑(TTC)染色法观察脑梗死体积; 采用Auto CAD图像分析软件计算脑水肿程度; 采用伊文思蓝(EB)检测血脑屏障(BBB)通透性。 结果 与溶媒对照组比较,13-MTD 40,80,120 mg/kg干预组均可明显改善不同脑缺血时限神经功能缺失症状,使脑梗死体积明显缩小,亦可使脑含水量和脑水肿程度减轻,EB渗出减少,且在缺血6 h时,M80组的效果最佳,并有量效差异。 结论 各剂量的13-MTD对不同时间大鼠局灶性脑缺血所致的脑损伤均有保护作用,在缺血6 h时,80 mg/kg的13-MTD疗效较为显著。     

塑化剂对慢性肾衰大鼠模型和腹膜透析患者腹膜纤维化调控因子TGF-β1/Smads表达的影响

目的 研究塑化剂对慢性肾衰大鼠模型和腹膜透析患者腹膜纤维化调控因子——转化生长因子-β1(TGF-β1)/Smad蛋白家族(Smads)表达的影响。 方法 紫外分光光度法测定腹膜透析液中邻苯二甲酸二(2-乙基)己酯(DEHP)的含量。30只雄性SD大鼠随机平均分为正常对照组、模型对照组、低浓度DEHP组、中浓度DEHP组、高浓度DEHP组。模型对照组和DEHP组采用5/6肾切除法制备大鼠肾衰模型,建模成功后每日向大鼠腹腔注射含不同浓度DEHP的“腹透液”连续28 d。苏木精-伊红染色法(H-E)、蛋白质印迹法(Western-blot)及反转录PCR(RT-PCR)技术观察大鼠腹膜组织病理、TGF-β1/Smads通路关键因子及基因的表达,免疫荧光法检测大鼠腹膜组织α平滑肌肌动蛋白(α-SMA)的表达。16例腹膜透析患者随机分为2组,分别给予聚氯乙烯(PVC)包装腹透液和非PVC包装腹透液,3月后测量2组腹膜平衡试验、尿素清除指数(KT/V)、肌酐清除率(Ccr)和腹透液中TGF-β1含量。 结果 DEHP组表现出腹膜纤维化趋势。与对照组比较,DEHP组TGF-β1/Smads关键因子及其mRNA的表达水平有明显上调(P<0.05); DEHP组间各蛋白及mRNA的表达比较,差别无统计学意义(P>0.05)。DEHP组Smad7 mRNA和蛋白表达水平较对照组下调(P<0.05),DEHP各组间比较,差别无统计学意义(P>0.05)。2组腹膜透析患者KT/V,Ccr及腹膜平衡试验结果比较,差别无统计学意义(P>0.05); 非PVC组腹透液中TGF-β1浓度较PVC组明显降低(P<0.05)。 结论 DEHP可引起慢性肾衰模型大鼠腹膜纤维化的发生,机制为致经典纤维化通路TGF-β1/Smads激活,激活程度与DEHP浓度无关。PVC包装腹膜透析液能上调腹膜TGF-β1的表达,可能导致腹膜纤维化进展。