The optimal mode of delivery for the haemophilia carrier expecting an affected infant is caesarean delivery

Summary. While a majority of affected infants of haemophilia carriers who deliver vaginally do not suffer a head bleed, the outcome of labour cannot be predicted. A planned vaginal delivery puts a woman at risk of an abnormal labour and operative vaginal delivery, both of which predispose to intracranial haemorrhage. Furthermore, vaginal delivery does not eliminate the risk to the haemophilia carrier herself. Overall, maternal morbidity and mortality from planned vaginal delivery are not significantly different from those from planned caesarean delivery. Caesarean delivery is recommended or elected now in conditions other than haemophilia carriage, where the potential benefits are not nearly as great. Additionally, vaginal delivery of the haemophilia carrier poses medical/legal risks if the infant is born with cephalohaematoma or intracranial haemorrhage. Caesarean delivery allows for a planned, controlled delivery. Caesarean delivery reduces the risk of intracranial haemorrhage by an estimated 85% and the risk can be nearly eliminated by performing elective caesarean delivery before labour. Therefore, after a discussion of the maternal and foetal risks with planned vaginal delivery versus planned caesarean delivery, haemophilia carriers should be offered the option of an elective caesarean delivery.     

黏蛋白1基因磁转染树突状细胞诱导细胞毒性T细胞抗膀胱肿瘤免疫效应的研究

目的：探讨黏蛋白1（mucins 1,MUC1）基因磁转染体外人树突状细胞（dendritic cell,DC）的可行性,观察其诱导的特异性抗MUC1膀胱癌CTL的免疫效应。方法：以葡聚糖磁性纳米颗粒（DMN）作为载体,在多聚赖氨酸（PLL）的辅助下,通过静电作用结合MUC1基因的真核表达载体pEGFP-C1-MUC1,在钕-铁-硼稀土强磁块的磁场作用下转染DC,荧光显微镜下观察及流式细胞术检测转染效率,并用RT-PCR法检测转基因DC中MUC1基因的表达;再将转染MUC1基因的DC与自体T细胞共培养,并分别用乳酸脱氢酶释放法检测所致敏的细胞毒性T淋巴细胞（cytotoxic lymphocyte,CTL）对MUC1特异性抗膀胱癌（膀胱肿瘤BIU87细胞系）的杀伤活性,用透射电镜观察CTL诱导靶细胞凋亡情况;ELISA法测定MUC1基因修饰后的DC刺激自体T细胞分泌IFN-γ的能力。结果：pEGFP-C1-MUC1转染效率为10%左右,荧光显微镜下可观察到明显绿色荧光蛋白的表达,RT-PCR法可检测到MUC1条带,转染MUC1基因的DC与自体T细胞混合培养后能诱导出MUC1特异性的CTL,对BIU87细胞的杀伤实验表明T-DC-MUC1的杀伤活性显著高于对照组T-DC-pEGFP-C1和T-DC诱导的CTL（P均〈0.05）;在透射电镜下也可观察到部分BIU87膀胱肿瘤细胞出现了细胞核核仁消失,染色质浓集于核膜周围等早期凋亡表现;基因修饰后的DC能刺激自体T细胞分泌高水平的IFN-γ,明显高于未转染的DC（P〈0.05）。结论：葡聚糖磁性纳米颗粒在固定磁场的作用下成功将MUC1基因转入DC,并可有效诱导出特异性抗MUC1膀胱癌的细胞毒性T细胞。     

溶质运载蛋白16A家族成员10(SLC16A10)对胶质瘤干细胞增殖及自我更新能力的影响

目的 探索溶质运载蛋白16A家族成员10(SLC16A10)在胶质瘤干细胞(GSC)中的功能,为针对GSC的脑胶质瘤治疗提供新的潜在靶点.方法 387GSC培养于含10％胎牛血清的DMEM培养基中7 d,分化为387非干性肿瘤细胞(387NSTC),RT-qPCR检测387GSC和387NSTC中SLC16A10、性别...     

低流量携氧液低温机器灌注保存供肝的研究

目的 观察低温机器灌注氟碳携氧液保存供肝过程中低流量因素与再灌注损伤之间的关系,为供肝低温机器灌注保存流量的设定寻找依据。方法 应用离体大鼠肝脏保存再灌注模型,随机以0.4 ml/（min• g）、0.2 ml/（min• g）和0.1 ml/（min•g）不同流量氟碳携氧液低温机器灌注保存供肝18小时。测定供肝再灌注流出液中丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）和内皮素(ET) 的含量,光镜和电镜下观察肝细胞及肝窦内皮细胞的形态学改变。另设灌注保存0小时组为正常组。经与正常组上述指标的对照,了解低流量因素对低温机器灌注保存供肝损伤程度的影响。结果 与正常组比较,对照组0.4 ml/（min•g）组、试验组0.2 ml/（min•g）和0.1 ml/（min•g）组再灌注流出液中ALT、AST和ET 的含量均明显增高（P<0.05）,但 0.1 ml/（min•g）组增高更明显。与0.4 ml/（min•g）组比较,0.2 ml/（min•g）组上述指标无明显差异(p>0.05),0.1 ml/（min•g）组上述指标差异显著（P<0.05）。供肝组织病理改变0.4 ml/（min•g）和 0.2 ml/（min•g）组明显轻于0.1 ml /（min•g）组。结论 氟碳携氧液低温机器灌注保存离体大鼠肝脏过程中,当灌注液流量降至0.1 ml /（min•g）时肝细胞及肝窦内皮细胞受损严重以致于再灌注时损伤严重。     

住院早产儿10年间医院感染139例的病原菌分布及耐药性的变迁

目的探讨住院早产儿医院感染的病原体分布和耐药现状及耐药变迁的情况,指导临床合理使用抗生素。方法回顾性分析2000年1月至2009年4月安徽医科大学第一附属医院儿科住院的1023例早产儿,对其中139例医院感染患儿标本培养的病原菌及药敏试验结果进行分析。结果院内感染后5年比前5年病原菌谱有所改变,真菌耐药性变迁不大。革兰阳性细菌（G＋菌）对青霉素、苯唑西林、头孢西丁耐药性高,革兰染色阴性细菌（G-菌）对头孢唑啉、氨苄青霉素、喹诺酮类耐药性高,对3代头孢耐药率明显上升,对碳氢霉烯类最敏感。结论院内感染的发生率逐年增加,病原菌谱不断改变,对亚胺培南的耐药率呈上升趋势。     

呼吸内科下呼吸道感染的病原菌谱及耐药性研究

目的探讨和分析呼吸内科下呼吸道感染患者的病原菌分布及其耐药性。方法回顾性分析2010年8月~2012年8月在我院呼吸内科住院的下呼吸道感染的患者合格痰标本进行细菌培养,然后进行细菌菌株的鉴定和药物敏感性检测。结果共分离出480株致病菌,其中,革兰阴性菌410株,占85．42％,依次为铜绿假单胞菌138株（占28．75％）,鲍曼不动杆菌75株（占15．63％）,肺炎克雷伯菌40株（占8．33％）,大肠埃希菌37株（占7．71％）,嗜麦芽窄食单胞菌29株（占6．04％）,真菌91株（占18．96％）,主要以白色假丝酵母菌为主;革兰阳性菌70株（占14．58％）。结论呼吸内科下呼吸道感染以革兰阴性杆菌为主,真菌感染率呈增加趋势,不同病原菌对抗生素的敏感性和耐药性差异较大。     

Long-circulating poly(ethylene glycol)-coated poly(lactid-co-glycolid) microcapsules as potential carriers for intravenously administered drugs

The intrinsic advantages of microcapsules with regard to nanocapsules as intravenous drug carrier systems are still not fully exploited. Especially, in clinical situations where a long-term drug release within the vascular system is desired, if large amounts of drug have to be administered or if capillary leakage occurs, long-circulating microparticles may display a superior alternative to nanoparticles. Here, microcapsules were synthesised and parameters such as in vitro tendency of agglomeration, protein adsorption and in vivo performance were investigated. Biocompatible poly(ethylene glycol) (PEG)-coated poly(DL-lactide-co-glycolide) (PLGA) as wall material, solid and perfluorodecalin (PFD)-filled PEG–PLGA microcapsules (1.5?µm diameter) were manufactured by using a modified solvent evaporation method with either 1% poly(vinyl alcohol) (PVA) or 1.5% cholate as emulsifying agents. Compared to microcapsules manufactured with cholate, the protein adsorption (albumin and IgG) was clearly decreased and agglomeration of capsules was prevented, when PVA was used. The intravenous administration of these microcapsules, both solid and PFD-filled, in rats was successful and exhibited a circulatory half-life of about 1?h. Our data clearly demonstrate that PEG–PLGA microcapsules, manufactured by using PVA, are suitable biocompatible, long-circulating drug carriers, applicable for intravenous administration.     

Application of the combined use of ultrasonic homogenization and electro-spraying in the formation of nano carrier systems

Chitosan-coated nano-liposomes containing etofenprox were prepared by ultrasonic homogenization (UH) and a combined use of UH and electro-spraying. The physicochemical properties of the resulting samples were examined and compared. The two methods yielded similar values and tendencies, except for encapsulation efficiency that differed by an average of 15%. In the coating process, as the chitosan concentration increased (0.1–0.5%, w/v) and the degree of deacetylation increased (chitosans A, B and C), the surface charge of the nano carrier likewise increased and carrier size distribution was altered. The encapsulation efficiency as measured by gas chromatography decreased slightly with the increasing chitosan concentration (0.1–0.5%, w/v). The results indicate that diverse preparation conditions could affect the physicochemical properties of the resulting nano carrier systems.     

The Interaction of Fatty Acid Amide Hydrolase (FAAH) Inhibitors with an Anandamide Carrier Protein Using 19 F-NMR

It has been reported that the endocannabinoid anandamide (AEA) binds to a class of fatty acid-binding proteins and serum albumin which can serve as carrier proteins and potentiate the cellular uptake of AEA and its intracellular translocation. Here, we employed ¹⁹F nuclear magnetic resonance spectroscopy to study the interactions of serum albumin with two inhibitors of fatty acid amide hydrolase (FAAH), the enzyme involved in the deactivation of anandamide. We found that, for both inhibitors AM5206 and AM5207, the primary binding site on serum albumin is drug site 1 located at subdomain IIA. Neither inhibitor binds to drug site 2. While AM5207 binds exclusively to drug site 1, AM5206 also interacts with other fatty acid-binding sites on serum albumin. Additionally, AM5206 has an affinity for serum albumin approximately one order of magnitude higher than that of AM5207. The data suggest that interactions of FAAH inhibitors with albumin may provide added advantages for their ability to modulate endocannabinoid levels for a range of applications including analgesia, antiemesis, and neuroprotection.     

幼女阴道感染的病原学分析

目的研究引起幼女阴道感染的病原体种类及感染频率。为临床治疗提供参考。方法选取0.5-7岁阴道炎患儿137例,收集阴道分泌物,涂片观察检查念珠菌、滴虫、线索细胞;并进行培养后检查淋球菌、解脲支原体、人型支原体、衣原体;做普通细菌培养检查大肠埃希菌、金黄葡萄球菌、肺炎链球菌、流感杆菌、变形杆菌、绿脓杆菌等。根据病原体感染情况针对性治疗或对症治疗。结果病原体检出率为37.9％,其中以大肠埃希菌感染最多,占检出病原体的25.0％;其他依次为加德纳菌感染占17.3％,淋球菌感染占11.5％,金黄葡萄球菌感染占9.6％。其他病原体有少量检出。结论幼女阴道感染以非特异性感染为主,在病原体导致的感染中,以大肠埃希菌最多,其次为加德纳菌。根据发病原因针对性治疗是理想的治疗方案。