妊娠期口服葡萄糖负荷试验合理血糖界值的探讨

目的 探讨目前适合我国卫生经济条件的妊娠期葡萄糖负荷试验(GCT)的筛查界值.方法 资料来源于2006年4月1日至2006年9月30日在全国18个城市25家医院保健并进行首次50 g GCT的16 286例孕妇,对其GCT结果进行统计和分析.结果 以NDDG标准诊断妊娠期糖尿病(GDM),50 g GCT的界值选取7.2 mmol/L时的敏感度和特异度分别为98.2%和59.0%,选取7.8 mmol/L时分别为96.0%和73.0%,选取8.3 mmol/L时分别为90.2%和81.5%;以ADA标准诊断GDM,选取GCT界值为7.2 mmol/L时敏感度为97.9%,特异度为60.4%;选取7.8 mmol/L时分别为96.2%和74.7%;而选取8.3 mmol/L则分别为87.0%和83.1%.以NDDG标准诊断妊娠期糖代谢异常(包括GDM及妊娠期糖耐量受损),选取7.2 mmol/L时敏感度和特异度分别为97.7%和61.4%,选取7.8 mmol/L时分别为95.4%和75.8%,选取8.3 mmol/L时分别为84.9%和84.1%.结论 据我国目前的卫生经济情况,以7.8 mmol/L作为50 g GCT的界值是合理的.     

奥利司他对肥胖IGT人群糖尿病预防效果

目的 探讨奥利司他(Orlistat,赛尼可)对肥胖糖耐量低减(IGT)患者的干预效果。方法 患者随机分两组奥利司他治疗组(50例)和对照组(51例),治疗为期1年,于治疗前后测量血脂、口服糖耐量试验(OGTT)、体重、身高等指标。结果1年后,治疗组上述指标明显改善(P<0.01),其恶化为糖尿病的发病率明显低于对照组(P<0.01)。结论 在肥胖IGT干预治疗中,奥利司他加饮食和运动治疗后可使体重减轻,改善糖耐量,明显减少糖尿病的发生。     

黄杆菌属医院感染耐药性分析

目的探讨本院5年中黄杆菌属医院感染的分布及其耐药现况. 方法黄杆菌属的分离和鉴定用全自动微生物分析系统VITEK-AMS 60及配套革兰阴性杆菌鉴定卡(GIN)和药敏卡(GNS). 结果发现感染者多为脑外科、ICU和呼吸科病房患者;均有吸氧、吸痰史,有行气管插管、机械通气史,对亚胺培南>95%耐药,头孢噻肟、头孢曲松、氨曲南、庆大霉素、阿米卡星各>90%耐药,对头孢哌酮/舒巴坦、环丙沙星、左氧氟沙星、复方新诺明、哌拉西林、哌拉西林/他唑巴坦耐药率均<60%. 结论黄杆菌属医院感染有逐年增多趋势,且对多种抗生素耐药性高,头孢哌酮/舒巴坦、哌拉西林/他唑巴坦是该菌治疗的首选药物,提示与老年、有基础病及并发症、广谱抗生素及激素应用、呼吸道侵袭性操作、呼吸器具及空气消毒不严格有关.     

2型糖尿病糖耐量实验与胰岛素释放实验关系的探讨

目的 探讨2型糖尿病血糖与胰岛素释放的关系,以及血糖水平对血糖刺激的胰岛素释放的影响.方法 对50例2型糖尿病患者停用口服药24 h后,口服75 g葡萄糖行葡萄糖耐量实验(OGTT)及胰岛素释放实验(IRT).血糖采用cobas Integra 400 plus全自动生化分析仪测定,胰岛素采用美国Becoman Coulter Access2化学发光仪测定.结果 50例2型糖尿病患者按血糖水平与胰岛素释放的变化方向可分为4组:①A组:血糖水平与胰岛素水平曲线平行,均于1 h达峰值16例.②B组:胰岛素水平峰值延迟9例.③C组:血糖水平与胰岛素水平均于2 h达峰值,峰值延迟19例.④D组:血糖峰值延迟6例.结论 血糖水平与血清胰岛素水平呈负相关,但由于胰岛B细胞的个体差异很大,可以出现不同的分离现象,体现了糖尿病发病的异质性或个体差异性.     

Multiscale Analogue Modelling of Clinching Process to Investigate Thickness Tolerance and Tool Misalignment

NEED—The effect of dimensional variability of sheet thickness (tolerance) and tool misalignment is poorly understood for the clinching process. Finite element analysis (FEA) is valuable but requires a lot of and is difficult to verify in this situation due to the asymmetrical geometry and nonlinear plasticity. OBJECTIVE—The objective of this work was to determine the effect of thickness tolerance, tool misalignment and sheet placement (top vs. bottom) in the clinching process, by use of analogue modelling with plasticine. METHOD—Experiments used a scaled-up punch and die, with plasticine as the analogue. Thickness tolerances were represented by sheet thicknesses of 11 and 7 mm, 12 and 8 mm, 8 and 12 mm and 13 and 9 mm for upper and lower sheets, respectively. Two types of lubricant were tested between sheets: glycerine and silicone oil. Angular variability was also introduced. Measured parameters were interlock (also called undercut) and neck thickness. Analogue results for deformation were compared with microscopy of metal clinching. FINDINGS—The results reveal that the multiscale analogue model is an efficient tool for studying the effect of dimensional deviation on a clinch joint. Thickness tolerance showed a critical relationship with interlock, namely a reduction to about half that of the nominal, for both maximum and least material conditions. Increased angular misalignment also reduced the interlock. Compared with glycerine, silicone oil tests showed reduced interlock, possibly the result of a lower coefficient of friction. ORIGINALITY—This work demonstrates the usefulness of analogue modelling for exploring process variability in clinching. The results also show that significant effects for sheet placement are ductility, lubricant (friction), thickness of samples and tool misalignment.     

妊娠早期阻断协同刺激分子诱导自然流产模型孕鼠脾脏细胞母-胎免疫耐受的研究

目的　探讨阻断协同刺激分子———CD80 和CD86对自然流产模型孕鼠妊娠结局及孕鼠脾脏免疫细胞对父系抗原免疫耐受状态的影响。方法　将雌性小鼠 (CBA/J)分别与BALB/c及DBA/2两种雄性小鼠合笼交配 ,分别建立正常妊娠模型CBA/J×BALB/c( 2 0只 ,对照组 )和自然流产模型CBA/J×DBA/2 ( 2 0只 ,研究组 )。CBA/J小鼠于妊娠第 4天 (着床期 )腹腔分别注射大鼠同型IgG 0 2mg( 10只 ) ,或大鼠抗小鼠CD80 和CD86单克隆抗体 ( 10只 )。妊娠第 9天 ,采用单向混合淋巴细胞反应 ,分析孕鼠脾脏免疫细胞对父系抗原的增殖能力 ,并测定细胞培养上清液中白细胞介素 2(IL 2 )水平 ,以研究脾脏细胞母 胎免疫耐受状态 ;妊娠第 14天观察两组的胚胎吸收率。结果　 ( 1)研究组中 ,腹腔注射大鼠IgG的孕鼠胚胎吸收率为 2 4 3% ,而注射大鼠抗小鼠CD80 和CD86单克隆抗体的孕鼠胚胎吸收率为 9 8% ,两者比较 ,差异有显著性 (P <0 0 5 )。 ( 2 )应用大鼠抗小鼠CD80 和CD86单克隆抗体 ,使妊娠 9d的孕鼠脾脏免疫细胞对父系抗原的增殖能力及IL 2水平显著下降(P <0 0 5 )。结论　孕早期阻断协同刺激分子 ,可诱导产生孕鼠脾脏免疫细胞对父系抗原的免疫耐受 ,从而使自然流产模型孕鼠的妊娠结局达到正常妊娠水平。     

Growth and Gastrointestinal Tolerance in Healthy Term Infants Fed Milk-Based Infant Formula Supplemented with Five Human Milk Oligosaccharides (HMOs): A Randomized Multicenter Trial

Background: Five of the most abundant human milk oligosaccharides (HMOs) in human milk are 2′-fucosyllactose (2′-FL), 3-fucosyllactose (3-FL), lacto-N-tetraose (LNT), 3′-sialyllactose (3′-SL) and 6′-sialyllactose (6′-SL). Methods: A randomized, double-blind, controlled parallel feeding trial evaluated growth in healthy term infants fed a control milk-based formula (CF; n = 129), experimental milk-based formula (EF; n = 130) containing five HMOs (5.75 g/L; 2′-FL, 3-FL, LNT, 3′-SL and 6′-SL) or human milk (HM; n = 104). Results: No significant differences (all p ≥ 0.337, protocol evaluable cohort) were observed among the three groups for weight gain per day from 14 to 119 days (D) of age, irrespective of COVID-19 or combined non-COVID-19 and COVID-19 periods. There were no differences (p ≥ 0.05) among the three groups for gains in weight and length from D14 to D119. Compared to the CF group, the EF group had more stools that were soft, frequent and yellow and were similar to the HM group. Serious and non-serious adverse events were not different among groups, but more CF-fed infants were seen by health care professionals for illness from study entry to D56 (p = 0.044) and D84 (p = 0.028) compared to EF-fed infants. Conclusions: The study demonstrated that the EF containing five HMOs supported normal growth, gastrointestinal (GI) tolerance and safe use in healthy term infants.     

耐长春新碱视网膜母细胞瘤细胞株的建立

目的：研究视网膜母细胞瘤获得性多药耐药现象，探讨其产生机制。方法：利用长春新碱(vincristree，VCR)对人视网膜母细胞瘤细胞系HXO-RB₄₄细胞在体外进行浓度递增法逐步诱导实验，建立一株耐长春新碱视网膜母细胞瘤细胞亚株HXO—RB/VCR。并对其细胞生长，药物含量，药物敏感性与放射性敏感性进行检测。 结果：该耐药细胞株HXO—RB/VCR细胞对长春酰胺、丝裂霉素C、阿霉素、足叶乙甙、顺铂、卡铂等有交叉耐受，对卡氮芥、氟尿嘧啶无明显抗药性，而对氨甲喋呤的敏感性反而增加。对⁶⁰ Coγ射线有轻度耐受性。细胞内药物含量测定显示：耐药细胞内长春新碱浓度明显低于敏感细胞，钙通道阻断剂异博定可使细胞内VCR浓度增加，部分逆转其耐药性。 结论：VCR可诱导视网膜母细胞瘤产生多药耐药和轻度放射耐受，获得性多药耐药作用可被异博定逆转。 （中华眼底病杂志，1997，13：6-9）     

尿新蝶呤在112例儿童肺结核耐药性监测中的临床价值

目的探讨尿新蝶呤在儿童肺结核耐药性监测中的临床价值。方法应用纸片扩散法进行结核耐药性检测。根据耐药检测结果,将肺结核活动期患儿112例分为耐药组（n=48）和非耐药组（n=64）,健康儿童50例作为健康对照组。ELISA法检测其尿新蝶呤水平。结果结核耐药组、非耐药组、健康对照组尿新蝶呤水平差异有统计学意义,结核患儿尿新蝶呤水平显著高于健康对照组,耐药组又显著高于非耐药组。结论尿新蝶呤水平测定不仅对儿童肺结核有辅助诊断价值,而且在儿童结核耐药性监测中有重要的预警价值。尿新蝶呤测定作为一种无创、快速、简捷、敏感的结核耐药性初筛方法,值得临床推广应用。