新生儿败血症继发血小板减少症(附26例报道)

本文对26例败血症继发血小板减少症的观察、治疗结果表明,血小板减少症在新生儿败血症中的发生率高,是导致新生儿败血症死亡的重要因素之一.动态观察血小板计数,对败血症的诊断、治疗效果的判断以及预后估计均有帮助。根据临床表现,我们分别给予静脉滴注新鲜血、血浆、低分子右旋糖酐、激素等治疗,均获得较为满意效果。     

131Ⅰ治疗分化型甲状腺癌的单病种临床路径优化

目的探讨^131I治疗分化型甲状腺癌的临床诊疗程序,优化单病种临床路径。方法使用放射性核素^131I治疗14例分化型甲状腺癌患者,观察患者的治疗反应及对症处理,优化临床路径。结果对分化型甲状腺癌^131I治疗的术前准备、常规医嘱、临床观察、疗效评估、护理、治疗注意事项等方面进行优化。结论^131I治疗分化型甲状腺癌疗效肯定,在满足条件的医院,可广泛开展。     

眼表面郎格罕细胞对单纯疱疹病毒感染的反应

对豚鼠眼表面 LC 在实验性 HSV-1(F 株)角膜划痕接种后的反应进行了形态学和定量研究。接种后4 d,可见角膜缘及角膜内 LC 的数量明显增加。角膜缘者,至第6d 达到高峰值(390±94/mm~2),为对照组的2.8倍;角膜者至第8 d 达到高峰值(366±34/mm~2),60倍于对照组。接种后第11d,两处 LC 数量开始减少,但直至种毒后第51d,仍高于正常水平。对于局部 LC 密度的改变在机体免疫反应中的意义其及与角膜炎发展的关系进行了讨论。     

胰岛素壳聚糖纳米粒的制备

 目的制备胰岛素壳聚糖纳米粒。方法采用酶水解和超滤膜分离技术，得到不同相对分子质量的壳聚糖，由凝胶渗透色谱法测定其相对分子质量；采用溶剂扩散法制备纳米粒，研究纳米粒的空间结构，测定其粒径、表面电位(zeta电位)、模型药物胰岛素包封率及体外释放。结果通过控制酶水解条件，经超滤分离得到3种不同相对分子质量的壳聚糖，凝胶渗透色谱法测得的重均相对分子质量(MW)分别为10 289，41500和101 870。经溶剂扩散法制备得到的壳聚糖纳米粒，呈类圆形球体，粒径分布较窄，且随制备工艺中乙醇加入量的增加、分散用超声次数的增多，以及壳聚糖分子量的降低，粒径变小。壳聚糖纳米粒带正电荷，zeta电位值大于+30 mV。放射免疫法测得的药物包封率为72.66%。在壳聚糖酶存在条件下，前1 h体外释放药物较快，1 h后趋于平稳，并能持续释放6 h。结论选用合适相对分子质量壳聚糖制备胰岛素壳聚糖纳米粒，方法简便，药物包封率高，并有一定的缓释作用。     

Un tratamiento nuevo para una enfermedad antigua: tratamiento de la hipertensión arterial resistente mediante denervación simpática renal percutánea

Hypertension is a major contributor to cardiovascular events, such as stroke and myocardial infarction, with accelerated sympathetic nerve activity implicated in its pathogenesis. However, hypertension in many patients is not adequately controlled, despite the availability of numerous medication classes. Novel procedure—as well as device-based strategies, such as percutaneous renal sympathetic nerve denervation therapy—have been developed to improve blood pressure in these refractory patients. Renal sympathetic denervation delivers not only a decrease in blood pressure levels but also renal as well as systemic sympathetic nerve activity. The reduction in blood pressure appears to be sustained over 3 years after the procedure, which implies no counterregulatory mechanism or re-innervation of afferent renal sympathetic nerve so far. Renal sympathetic denervation is expected to be a promising treatment for patients with hypertension, congestive heart failure, chronic kidney disease, and metabolic syndrome implicated in the pathogenesis of potentiated sympathetic nerve activity. This review will focus on the current devices and procedures, their outcomes and prospects in the treatment of hypertension.     

PegIFN-α2a for the treatment of chronic hepatitis B and C: a 10-year history

Chronic HBV and HCV are progressive diseases leading to cirrhosis and liver transplantation. Persistent viral eradication or suppression can positively affect the natural course of the infection, by preventing disease progression. Since its introduction more than 30 years ago, IFN-α has represented the foundation of HBV and, lately, anti-HCV treatment. Pegylation of the IFN-α molecule (PegIFN-α2a) has provided improvements in both efficacy and administration schedule, thus becoming part of the standard-of-care regimen for HCV and HBV therapy in the last 10 years. Currently, treatment of finite duration with PegIFN-α2a may achieve a sustained virological response off-treatment and HBsAg seroconversion. PegIFN-α2a will most likely remain the backbone of HCV treatment for the next few years, despite the availability of direct-acting antivirals that are expected to improve cure rates. However, many efforts are concentrated on developing new compounds, with the goal of administrating all oral regimens and eliminating PegIFN from anti-HCV treatment.     

烧伤创面铜绿假单胞菌的分离和耐药谱分析

目的　探讨烧伤创面铜绿假单胞菌耐药谱的变迁及诱导型 β 内酰胺酶的产生。 方法对笔者医院 1996年 6月～ 2 0 0 0年 6月鉴定的 4 5 2株烧伤创面铜绿假单胞菌 ,用VITEK AMS全自动细菌鉴定及药敏系统、E test浓度梯度法做药敏试验 ,以K B法为基础作诱导酶的检测。　结果　 4年中临床常用的头孢菌素及亚胺培南的耐药率均有提高 ;其中以头孢哌酮 /舒巴坦的耐药率最低 ,但 4年中耐药率的变化差异也有显著性意义 (P <0 .0 5 ) ,亚胺培南的耐药率在 2 0 %～ 4 0 %之间。 12 0株野生型铜绿假单胞菌中 ,以亚胺培南为诱导剂 ,检出产生诱导酶者为 72 .5 %。　结论　烧伤创面铜绿假单胞菌耐药谱的分析和诱导酶的检测 ,可以及时监控和调整抗生素的使用 ,对避免铜绿假单胞菌在医院内流行具有重要意义     

Depression of NMDA-receptor-mediated segmental transmission by ketamine and ketoprofen, but not L-NAME, on the in vitro neonatal rat spinal cord preparation

Activation of spinal N-methyl-D-aspartate (NMDA) receptors and then the nitric oxide and the arachidonic acid pathways is important in pain transmission. This study assessed the effects of the NMDA receptor channel blocker ketamine, the nitric oxide synthase inhibitor L-NAME, and the cyclooxygenase inhibitor ketoprofen in nociceptive transmission using an in vitro neonatal rat spinal cord preparation. Supramaximal electrical stimulation of the dorsal root evoked the A-fibre- and C-fibre-mediated high intensity excitatory postsynaptic potential (EPSP) in the ipsilateral ventral root. Low intensity stimulation evoked the A-fibre-mediated monosynaptic compound action potential (MSR) superimposed on the low intensity EPSP. Both the low intensity EPSP and the high intensity EPSP contain NMDA-receptor-mediated components. Only ketamine and ketoprofen depressed the synaptic responses. Ketamine depressed all three spinal reflexes with IC(50) values (with 95% CI) of 10.80 microM (5.97 to 19.54 microM) for the MSR, 8.29 microM (4.53 to 14.17 microM) for the low intensity EPSP, and 5.35 microM (3.05 to 9.40 microM) for the high intensity EPSP. Ketoprofen depressed the low intensity EPSP and the high intensity EPSP only; IC(50) values (with 95% CI) were 354.5 microM (217.5 to 576.8 microM) and 302.7 microM (174.0 to 526.7 microM), respectively. Reflexes recovered after drug washout. These data demonstrated that ketamine and ketoprofen, but not L-NAME, depressed NMDA-mediated nociceptive transmission in spinal cord preparations from neonatal rats.     

两种方法腭向移动上颌第二磨牙效果比较

目的：研究安氏Ⅰ类错患者中,分别采用微型种植体作支抗与口内支抗腭向移动上颌第二磨牙进行比较,以评价两种方法各自的特点。方法：将20例成人患者随机分成两组,分别采用两种方法腭向移动上颌磨牙。测量上颌第二磨牙在移动速度和颊舌向、垂直方向的位置变化,以衡量磨牙的位置改变。结果：种植体作支抗组上颌第二磨牙平均腭向移动3.8mm,疗程4.4个月,平均移动速度0.86mm/月,磨牙垂直向压低0.45mm。对照组上颌第二磨牙平均腭向移动4.0mm,疗程6.2个月,平均移动速度0.65mm/月,磨牙垂直向伸长1.86mm。结论：两种方法比较,种植体的支抗更强,磨牙移动速度更快。二者磨牙的移动方式有所区别。