哮喘患者诱导痰嗜酸粒细胞测定的意义

目的：监测哮喘患者诱导痰嗜酸粒细胞数,分析其与临床和糖皮质激素治疗的关系。方法：采集29例哮喘患者糖皮质激素治疗3个月前、后的诱导痰液,检测痰液细胞分类计数和肺功能并记录症状。22例健康非吸烟者为对照。结果：急性发作期哮喘患者痰液嗜酸粒细胞百分数（E%）明显高于非急性发作期和对照组（P均〈0.05）,糖皮质激素治疗后痰液E%较前明显减低（P〈0.01）。急性发作期哮喘患者痰液E%和一秒用力呼气量（FEV1）百分数预计值、FEV1/用力肺活量（FVC）均呈显著负相关（r=-0.743、-0.652,P均〈0.05）,与峰呼气流速变异率（PEF%）呈显著正相关（r=0.806,P〈0.01）。结论：哮喘患者诱导痰中嗜酸性粒细胞水平增高,与临床病情、肺功能和糖皮质激素治疗密切相关。     

Investigation of UCH-L1 levels in ischemic stroke,intracranial hemorrhage and metabolic disorder induced impaired consciousness

Objective

We aimed to determine the levels of ubiquitin C-terminal hydrolase-L1 (UCH-L1) in patients admitted to the emergency department with impaired consciousness due to metabolic or neurological reasons.

银杏内酯B对神经干细胞分化的影响及其机制研究

目的观察银杏内酯B对体外培养的神经干细胞（NSCs）分化的影响。方法用含不同浓度银杏内酯B（20mg／L、40mg／L、60mg／L）的分化培养基培养NSCs 3d和7d，测量细胞突起长度和胞体面积，用免疫荧光检测神经丝蛋白-200（NF-200）、胶质纤维酸性蛋白（GFAP）及少突胶质细胞特异性蛋白（CC-1）、细胞因子信号抑制因子2（SOCS2）、DNA结合抑制因子2（Id2）的表达。结果银杏内酯B组细胞突起增长，胞体增大；NF阳性神经元样细胞百分率增加，GFAP阳性星形胶质样细胞百分率随银杏内酯B浓度增加而增加；SOCS2阳性细胞百分率（35．46％）较对照组（22．17％）明显增加（P〈0．01），银杏内酯B组Id2阳性细胞百分率（51．52％）较对照组（66．24％）明显减少（P〈0．01）。结论银杏内酯B可促进分化细胞成熟，促进NSCs向神经元分化；星形胶质细胞百分率的增高与银杏内酯B呈剂量依赖关系。     

未婚先孕者实施人工流产术情况调查分析及避孕指导

目的 通过对未婚先孕行人工流产术者状况的调查分析，探讨避孕相关知识指导的必要性及方法。方法 采用自行设计的调查问卷对2005年1月-2006年9月3187例实施人工流产术者进行调查。结果 未婚先孕行人工流产术者1823例，占同期人流总数的57．20％，其中17～20岁占23．69％，大学文化程度者占34．00％，初次行人工流产术者占65．99％，2次或以上行人流术者占34．01％；初次行人流术者不了解人流并发症的占92．10％，2次或以上行人流术者不了解人流并发症的占93．87％；初次行人流术者不懂避孕知识的占75．39％，2次以上行人流术者不懂避孕知识的占35．16％。结论 未婚先孕行人流术者日益低龄化且职业分布呈多元化，人员文化程度较以往提高，但是严重缺乏生殖健康常识和避孕知识。建议：加强中学生及大学生在校期间生殖健康知识的教育，把人流的危害性及必要的避孕常识作为必修内容，同时医务人员也要抓住时机对未婚先孕行人工流产术者进行有效的避孕指导。     

细胞增殖抑制基因、p21WAF1蛋白在非小细胞肺癌组织中的表达及其意义

目的 探讨细胞增殖抑制基因(HSG/Mfn2)、p21WAF1蛋白在非小细胞肺癌中的表达及相关性.方法 采用免疫组化SP法检测92例非小细胞肺癌中HSG/Mfn2、p21WAF1蛋白的表达.结果 HSG/Mfn2在肺鳞癌、腺癌、非癌肺组织中吸光度值分别为15.06±2.73、12、21±2.96、10.36±3.60,差异有统计学意义(P<0.05),并与肺癌分化程度有关.p21WAF1蛋白在肺鳞癌、腺癌、非癌肺组织中吸光度值分别为3.16±0.98、3.44±0.22、0.06±0.32,肺鳞癌和腺癌组织与非癌组织比较差异均有统计学意义(均P<0.05),与分化程度、淋巴结转移有关.结论 HSG/Mfn2,p21WAF1蛋白与肺癌发生、发展密切相关.二者在肺癌组织中的表达呈正相关.     

The imprecision in heart rate correction may lead to artificial observations of drug induced QT interval changes

Because of the known limitations of the Bazett and other heart rate correction formulas, it has been proposed that studies of drug induced QT interval changes should use several different heart rate correction formulas and that the consistency of findings by a majority of such formulas should be considered as valid. The aim of this article was to show that such an approach is inappropriate. Using the database of the EMIAT trial, data of QT and RR intervals were taken from electrocardiograms of the first postrandomization visit of 1,402 patients. Of these, 309 were on amiodarone and beta-blockers, 395 on amiodarone and off beta-blockers, 318 on beta-blockers and off amiodarone, and 380 off amiodarone and off beta-blockers. An investigation of drug induced QT interval changes was modeled by evaluating the corrected QT (QTc) interval differences between patients on and off amiodarone, and on and off beta-blockers. A set of 31 previously published heart rate correction formulas was used. In addition to calculating the QTc difference between on and off drug for each formula, the success of heart rate correction was judged by computing correlation coefficients between QTc and RR intervals (ideally corrected QTc values should be independent of heart rate). The difference between on and off drug QT intervals was also evaluated by logarithmic regression models between uncorrected QT and RR intervals in data taken from patients on and off treatment. The QTc interval prolongation on amiodarone was confirmed by all heart rate correction formulas but the extent of the prolongation differed from formula to formula and ranged from 13.6 to 30.9 ms. Of the 31 formulas, 3 reported QTc interval shortening on beta-blockers (up to -11.8 ms) and 28 reported QTc interval prolongation (up to +16.8 ms). The distribution of the results provided by the different formulas suggested that beta-blocker treatment led to a QTc interval prolongation by approximately 7 ms (e.g., +7.4 ms by the Fridericia formula, P = 0.002). The on treatment QTc changes obtained by different formulas were closely correlated to their correction success. Formulas that provided QTc intervals almost independent of the RR intervals estimated approximately 20 ms QTc prolongation on amiodarone and no QTc change on beta-blockers. QT/RR regression analysis confirmed that while amiodarone led to substantial QT prolongation, there was no change of QT interval on beta-blockers beyond the change in heart rate. The study showed that the concept of "majority voting" by different heart rate correction formulas is inappropriate and may lead to erroneous conclusions.     

氯离子通道阻断剂对肺血管内皮细胞氧化损伤的保护作用

目的:研究氯离子通道阻断剂在肺血管内皮细胞氧化损伤中的作用。方法:以肉联厂检疫合格的健康小牛为研究对象,过氧化氢(H2O2)诱导体外培养的牛肺动脉内皮细胞损伤,观察Cl-通道阻断剂对受损细胞细胞活力、乳酸脱氢酶(LDH)释放量、三磷酸腺苷(ATP)含量、细胞内钙离子浓度犤Ca2+犦i和DNA降解程度的影响。结果:Cl-通道阻断剂可使受损细胞的细胞活力得到提高,NPPB组和NFA组分别恢复到0.449±0.015和0.535±0.023;LDH释放量下降,分别为(12.4±0.4)%,(6.4±0.6)%。ATP含量分别回升为18.22nmol/mg蛋白质和21.96nmol/mg蛋白质,犤Ca2+犦i下降和DNA降解程度减轻。结论:Cl-通道参与了氧化剂对肺血管内皮细胞损伤的病理过程,Cl-通道阻断剂对肺血管内皮细胞的损伤具有保护作用。     

米索前列醇在产程中的临床应用研究

目的研究米索前列醇（米索）在产程中的应用效果。方法对足月妊娠符合引产指征者行米索前列醇或常规催产素引产，对潜伏期延长和活跃期停止的产妇行米索前列醇或催产素加强宫缩（简称催产）。统计本站分娩272例孕产妇随机分成两组，即米索组172例（引产104例，催产68例），催产素组100例（引产60例，催产40例）。米索前列醇25^ug（1／8片）q4h舌下含化，催产素0．3u＋5％GNS500ml，静脉滴注。结果米索组引产成功率73．08％，有效23．07％，无效3．85％，催产成功率73．57％，有效19．12％，无效7．35％。催产素组引产成功率为46．67％，有效35％，无效18．33％。催产成功率70％，有效22．5％，无效7．5％。剖宫产率：烛索组20．35％，催产素组30％。结论米索前列醇用于足月妊娠引产和宫缩乏力强加宫缩（催产），此方法经济、方便、完全、稳定、可靠，大大提高了病人对药物的可接受性，临床上可推广应用。     

下腰痛患者下肢或下腹牵涉痛的发生机制

目的:利用荧光素逆行双标法和免疫组化法探讨下腰痛患者下肢或下腹部牵涉痛的发病机制。方法:将14只Wistar大鼠分两组。Ⅰ组中将荧光素碘化丙啶(PI)注入背肌,双苯甲亚胺(Bb)注入膀胱壁;Ⅱ组中将荧光素快蓝(Fb)注入背肌,维生素B2(NY)注入坐骨神经。此后在有双标细胞的切片上行免疫组化检查。结果:在腰部的后根神经节(DRG)中发现荧光素双标细胞;部分荧光素双标细胞含降钙素基因相关肽(CGRP)。腰部的DRG细胞周围突有分支投射到背肌和膀胱及背肌和坐骨神经;部分有分支投射的细胞含CGRP。结论:由下腰痛引起的下肢或下腹部牵涉痛的发生机制可能与发生在DRG水平的轴突反射有关。     

In Vivo Evaluation of a Closed Loop Monitoring Strategy for Induced Paralysis

Objective. Reliable closed loop infusion systems for regulating paralysis level can be a great convenience to the anesthesiologists in automating their task. This paper describes the in vivo performance evaluation of a self-tuning controller that is designed to accommodate large varations in patient drug sensitivity, drug action delays and environmental interfering noise. Methods. The infusion system was evaluated in six adult mongrel dogs. Following the manual induction of paralysis by an anesthesiologist, the controller regulated the infusion of vecuronium to maintain a desired level of paralysis. The integrated EMG response of the hypothenar muscle to a train-of-four stimulation of the ulnar nerve quantified the depth of paralysis. The controller's robustness was tested by contaminating the sensed twitch signal with electrocautery noise and electrode disconnection. Results. The controller reached the initial level of paralysis of 100% in about 4.0 minutes and arrived at the desired level of 90% with an overshoot of 6.38% (±6.82). It maintained the desired level of paralysis with a 2.04% (±1.20) mean offset at 90% and 0.4% (±0.5) mean offset at 80% steady state level, respectively. The mean infusion rate to sustain 90% and 80% paralysis were 2.70 (±2.05) and 2.15 (±2.57) ((mg/kg)/min), respectively. Conclusions. The system adapted to a large variation in the sample subject drug sensitivity. It remained stable despite large amplitude disturbances and maintained the paralysis at the desired level following the removal of the disturbances.