卡介菌多糖核酸对尖锐湿疣患者外周血T细胞受体表达的影响

目的：研究卡介菌多糖核酸(BCG PSN)对尖锐湿疣患者外周血T细胞受体(TCR)表达的影响，探讨BCG PSN对尖锐湿疣可能的免疫调节机制。方法：尖锐湿疣患者18例给予BCG PSN 0.5 mg，im，隔天1次，36 d为1个疗程。治疗前后采用双色荧光抗体染色技术经流式细胞仪检测外周血CD＋3及TCRαβ＋T细胞、TCRγδ＋T细胞百分率。结果：在BCG PSN治疗前，尖锐湿疣患者CD＋3 T细胞百分率明显低于正常对照组(P＜0.01)，TCRγδ＋T细胞百分率较正常对照组明显下降(P＜0.01)，TCRαβ＋T细胞百分率与正常对照组差异无显著性(P＞0.05)；而治疗后尖锐湿疣患者CD＋3T细胞百分率高于治疗前(P＜0.01)；TCRαβ＋T细胞、TCRγδ＋T细胞百分率较治疗前升高(P＜0.01)。结论：BCG PSN可能通过调节尖锐湿疣患者外周血TCR的表达，起到治疗尖锐湿疣的作用。     

椎弓根内固定在下腰椎失稳伴椎管狭窄手术中的应用

目的：探讨下腰椎失稳伴椎管狭窄的手术要点及椎弓根内固定在手术中的作用和意义。方法：总结2001年5月～2004年6月采用后路椎管减压、椎弓根内固定及椎间关节融合、横突间植骨治疗的32例下腰椎失稳伴椎管狭窄病例的临床资料。结果：32例随访6个月-40个月，平均19．5个月，术后跛行改善者32例（100％），下肢肌力障碍恢复22例（68．7％），肌萎缩14例均有所恢复；28例感觉障碍者，完全恢复18例（64．3％），部分恢复6例（21．4％）。无明显恢复2例（7．1％）。结论：下腰椎失稳伴椎管狭窄可分别表现为结构性和动力性腰椎滑脱，椎弓根内固定对病人可起到使滑脱椎体复位、相邻椎体间稳定及椎间融合的作用，并可使摘除椎间盘后的相关间隙高度得到维持。充分解除神经受压症状。     

复吸预防的综合干预措施对吸毒患者焦虑症状的疗效评价

目的:促进吸毒者戒毒后的身心康复,减缓吸毒者的焦虑症状,提高操守率、延长操守时间.方法:对干预组实施一个月的综合干预,内容包括:讲授与讨论毒品的有关知识、成功防复吸的要素、自我暗示和自我激励、心理脱敏和集体讨论等.干预前后分别对干预组和对照组进行焦虑症状调查.结果:干预前后干预组SAS平均得分差值明显高于对照组(P=0.0220,＜0.05).结论:该综合干预方案能够有效降低吸毒者的焦虑症状,加速脱毒病人的身心康复,对预防脱毒后复吸有一定的意义.     

Lidocaine intoxication in newborn following maternal pudendal anesthesia: report of three cases

Pudendal nerve block may be indicated during instrumental delivery in situations where peridural anesthesia is unavailable. We report three cases of neonatal lidocaine intoxication following maternal pudendal block during delivery. Clinical features were hypotonia, pupillary mydriasis fixed to light, apnea, cyanosis and seizures. Two neonates required mechanical ventilation. Lidocaine was found in the serum of two babies. In all three cases, recovery was complete. The pharmacokinetics of lidocaine in a highly vascularized perineum during labor increase the risk of neonatal intoxication. A possible intoxication by local anesthetics should be considered in neonates presenting an acute distress in the delivery room.     

Polycystic ovary syndrome (PCOS)

Polycystic ovaries syndrome (PCOS) is one of the most common female hormonal disorders. Its multiple components--reproductive, metabolic, neoplasic and cardiovascular--have a major impact on the public health. Androgen excess and resistance to insulin, probably from genetic origin, are responsible for most of the clinical symptomatology. Resistance to insulin seems to be accompanied by a greater risk of glucose intolerance, type 2 diabetes, lipidic anomalies and can involve the development of cardiovascular diseases. In addition, sleep apnea syndrome is more progressively described in PCOS. Infertility, menses disorders and hirsutism often push these patients to consult their physician. A better understanding of the physiopathological mechanisms led to the emergence of new therapeutic options increasing the sensitivity to insulin. Besides the pregnancy wishes, cares aim to attenuate the marks of the hyper-androgenism (hormonal treatment and cosmetic) and to correct cardiovascular, respiratory and gynaecological risk factors. In case of infertility by anovulation, cares must be performed by trained experts to minimize the risk of ovarian hyper-stimulation syndrome and multiple pregnancies. A gradation from loose weight to clomiphene citrate ovulation induction, ovarian drilling, low dose gonadotropin, in vitro fertilisation, or in vitro maturation of oocytes should bring back good reproduction potential.     

黄褐毛忍冬化学成分及先导物的糖基化研究

目的研究黄褐毛忍冬的化学成分及其先导物衍生物的制备。方法提取和纯化黄褐毛忍冬中的化学成分及先导物,采用酰化和甲基化方法制备衍生物,通过光谱分析鉴定化合物的结构。结果用石油醚从黄褐毛忍冬分离得到两个化合物,分别为三十烷醇（Ⅰ）和岩白菜素（Ⅱ）,制备了先导物常春藤皂苷元以及两个衍生物,经光谱确证结构。结论以天然化合物制备先导物产率高,有利于进一步的糖基化修饰。     

Starch digestibility modulation significantly improves glycemic variability in type 2 diabetic subjects: A pilot study

Background and aimsIn type 2 diabetes (T2D) patients, the reduction of glycemic variability and postprandial glucose excursions is essential to limit diabetes complications, beyond HbA1c level. This study aimed at determining whether increasing the content of Slowly Digestible Starch (SDS) in T2D patients’ diet could reduce postprandial hyperglycemia and glycemic variability compared with a conventional low-SDS diet.Methods and resultsFor this randomized cross-over pilot study, 8 subjects with T2D consumed a controlled diet for one week, containing starchy products high or low in SDS. Glycemic variability parameters were evaluated using a Continuous Glucose Monitoring System.Glycemic variability was significantly lower during High-SDS diet compared to Low-SDS diet for MAGE (Mean Amplitude of Glycemic Excursions, p < 0.01), SD (Standard Deviation, p < 0.05), and CV (Coefficient of Variation, p < 0.01). The TIR (Time In Range) [140–180 mg/dL[ was significantly higher during High-SDS diet (p < 0.0001) whereas TIRs ≥180 mg/dL were significantly lower during High-SDS diet. Post-meals tAUC (total Area Under the Curve) were significantly lower during High-SDS diet.ConclusionOne week of High-SDS Diet in T2D patients significantly improves glycemic variability and reduces postprandial glycemic excursions. Modulation of starch digestibility in the diet could be used as a simple nutritional tool in T2D patients to improve daily glycemic control.Registration numberin clinicaltrials.gov: NCT 03289494.