Hipertensión arterial y anovulatorios transdérmicos

Cardiovascular complications are one of the risks of hormonal contraception use (a two-fold risk of stroke and ischemic infarct and a four-fold risk of thromboembolic complications). Although the development of hypertension is infrequent, cases of accelerated hypertension accompanied by renal failure have been described. This adverse effect has been reported in relation to oral contraceptives but there are no references in the literature to the use of transdermal contraceptives, despite differences in the pharmacodynamics between the two routes of administration.     

Opciones terapéuticas en el embarazo intersticial

Cornual pregnancy is very rare, with an incidence of 2-4% of ectopic pregnancies. As with tubal pregnancy, treatment options include surgery, medical therapy or a combination of both. Currently, there are also other treatment options that are effective. We report a case of cornual pregnancy treated with hysteroscopic resection followed by laparoscopic review, which can be an effective treatment option.     

新生儿重症监护室医院感染现患率调查

目的 了解新生儿重症监护室医院感染现况，以采取相应的控制措施。方法 调查2002年8月1～31日期间新生儿重症监护室所有住院患儿的医院感染情况。结果 应查人数162人，实查人数162人，实查率为100％。医院感染19人，医院感染现患率为11．73％。感染部位以皮肤感染居第一位，占63．16％。结论 降低新生儿医院感染率，必须加强新生儿皮肤护理及其他有效的护理措施。     

全国医院感染监控网医院呼吸道、泌尿道、胃肠道感染病原学及其变迁

目的 了解全国医院感染监控网医院报告的医院内呼吸道、泌尿道、胃肠道感染的病原学及其变迁。方法 收集全国医院感染监控网医院1999年7月～2001年12月报告的呼吸道、泌尿道、胃肠道感染的病原学资料。结果 在不同部位感染中，排前5位的病原体分别是：下呼吸道为铜绿假单胞菌、白色念珠菌、克雷伯菌属、不动杆菌属、金黄色葡萄球菌；泌尿道为大肠埃希菌、白色念珠菌、肠球菌属、克雷伯菌属、肠杆菌属；胃肠道以真菌为主。结论 医院内下呼吸道和泌尿道感染以革兰阴性杆菌为主，胃肠道感染以真菌为主。1999～2001年，呼吸道、泌尿道、胃肠道感染的部分病原体构成发生明显变化。     

中国特发性无精子症和少精子症患者雄激素受体基因CAG重复多态性研究

目的分析中国特发性无精子症和少精子症患者雄激素受体(AR)基因(CAG)n微卫星多态性并探讨该多态性与精子生成障碍发生的关系。方法应用PCR和变性聚丙烯酰胺凝胶电泳分析技术对52例少精子症患者和31例无精子症患者的外周血标本进行CAG重复数测定,分析该微卫星多态性和精子生成障碍发生的关系。结果少精子症患者组和无精子症患者组CAG重复数均数分别为22.19和22.13,CAG重复数≥28的百分率分别为1.9%和3.2%,比例逐渐升高。结论AR基因(CAG)n微卫星的CAG重复数在中国男性不育患者中呈现多态性,与精子生成障碍发生的关系有待进一步研究。     

老年住院病人的医院感染

对1195份60岁以上病人的病历作了回顾性调查与分析。结果发现发生医院感染者共99例(8.3%),致死亡者7例(7%)。感染部位以下呼吸道占首位(54.4%),其次为尿路(17.4%)和消化道(16.5%)。共分离病原菌235株,以 G(一)杆菌为主,克雷白菌属、绿脓杆菌和肠杆菌属共占培养菌株的73.5%,G(+)球菌占7.7%。这些病原菌对常用的抗生素耐药情况严重。老年病人发生医院感染与增龄导致免疫功能减退,病人同时存在多种慢性疾病,经常困各种感染而应用抗生素和住院时间较长等因素有关。提出控制老年病人医院感染的对策为改善住院环境,严格消毒隔离制度,积极治疗基础疾病,改善病人自身免疫功能及合理应用抗生素。     

Extremely fast hydrogen exchange of ribonuclease-(1–118) as compared with native RNase A and its implication for the conformational energy state

RNase-(1–118) containing native disulfide bonds is similar in fold to native RNase A but not of lowest Gibbs energy as compared with the isomers containing non-native disulfide bonds. The present n.m.r. studies have indicated a dramatic increase in the exchange rate of all of the ‘protected’ amide protons of RNase-(1–118) over RNase A. A calculation shows a large increase in the rate of ‘opening’ of the structure. The exchange rate of the protected amide protons of RNase-(1–120) is slower than RNase-(1–118) but much faster than RNase A. Binding with a synthetic complementing fragment (114–124) markedly reduces the exchange rate of 20 to 25 amide protons of RNase-(1–118). It has previously been shown that binding with a complementing fragment of RNase-(1–118) generates a lowest Gibbs energy state. Thus, using available thermodynamic information for interpretation, we suggest that a) removal of six carboxy terminal residues of RNase A would disrupt coupling between these residues and those distant in the structure (loss of extra stabilizing energy), b) this would, in turn, alter the enthalpy-entropy compensation in such a way that the magnitude of Gibbs energy change favoring folding is significantly reduced without a large change of fold and c) in this activated state the molecule would be highly motile.     

医院获得性嗜麦芽窄食单胞菌肺炎的耐药及临床特点

目的探讨医院获得性嗜麦芽窄食单胞菌肺炎的临床特点及药物敏感性。方法对医院获得性嗜麦芽窄食单胞菌肺炎57例患者的临床资料及危险因素进行分析。结果57例患者均有基础疾病,以各种恶性肿瘤最常见,其次为呼吸系统疾病;使用广谱抗生素、ICU内停留的时间、气管插管时间的长短、免疫抑制剂的使用、低蛋白血症等与嗜麦芽窄食单胞菌肺炎的发生有明显关系;该菌对常用抗生素广泛耐药。结论针对医院获得性嗜麦芽窄食单胞菌肺炎的易患因素,采取相应防范措施,治疗可选用复方新诺明、环丙沙星。