实时心肌造影结合斑点追踪技术评价不同顿抑状态犬心肌微循环与收缩功能变化

目的:应用实时心肌造影技术(RT-MCE)和斑点追踪技术(STI),研究不同顿抑状态心肌的收缩功能和微循环的变化及相互关系,从影像可视化角度探讨顿抑心肌的生物学特征.方法:制作冠状动脉左前降支阻断后再灌注犬心肌顿抑模型,分为短顿抑组(阻断15 min)、长顿抑组(阻断45 min)和假手术组(不阻断),分别于阻断前、再灌注即刻、再灌注10、30、60、90、120 min进行MCE和STI检查.实验结束后,心肌标本行透射电镜检查.结果:再灌注即刻,长顿抑组和短顿抑组缺血心肌的径向应变和A·β均低于基础状态及假手术组,差异具有统计学意义(P＜0.01);随再灌注时间的延长,长顿抑组和短顿抑组缺血心肌A·β值较再灌注即刻时增高;至再灌注后30 min,径向应变峰值进一步降低,再灌注60、90、120 min,径向应变峰值有所恢复.再灌注120 min时缺血心肌A·β值和径向应变峰值仍低于基础状态和假手术组.缺血心肌血流量(Y)与径向应变(X)呈线性关系,可拟合直线方程,其回归方程与相关系数为Y=0.443+49.64X,r=0.80,R2=0.64,P=0.031(长顿抑组);Y=-2.184+65.88X,r=0.78,R2 =0.60,P=0.039(短顿抑组).结论:STI能够反映心肌微循环血流情况.STI结合MCE能反映顿抑心肌生物学特征的动态变化     

实时三维超声心动图评价扩张型心肌病左室收缩同步性的有效性研究

目的 探讨应用实时三维超声心动图(RT-3DE)评价扩张型心肌病(DCM)患者左室收缩同步性的可行性.方法 将24例扩张型心肌病患者和20例正常人行RT-3DE检查.应用QLAB定量分析软件对三维数据库进行评价,即左室16节段、6个基底段和6个中间段、6个基底段达收缩末最小容积时间的标准差(TmsvSD-16,12,6),达到最小收缩末容积的时间的最大差值(Tmsv-16,12,6Dif),经心率校正后值Tmsv-SD％和Tmsv-Dif％.结果 心肌病组的TmsvSD-16、Tmsv-16Dif及TmsvSD-16％Tmsv-16Dif％值均较正常对照组增加(P＜0.05).结论 RT-3DE能客观的评价扩张型心肌病患者左心室收缩同步性,TmsvSD-16％、Tmsv-16Dif％可作为评价左室收缩同步性的有效指标.     

Comparison of Cepheid® Xpert Flu and Roche RealTime Ready Influenza A/H1N1 Detection Set for detection of influenza A/H1N1

Objective

To compare two influenza polymerase chain reaction (PCR) methods.

Mechanism of adrenocortical toxicity induced by quinocetone and its bidesoxy-quinocetone metabolite in porcine adrenocortical cells in vitro

Quinocetone (QCT) is a new feeding antibacterial agent in the QdNOs family. The mechanism of its adrenal toxicity is far from clear. This study was conducted to estimate the adrenal cell damage induced by QCT and its bidesoxy-quinocetone (B-QCT) metabolite and to further investigate their mechanisms. Following doses of QCT increasing from 5 to 50 μM, cell apoptosis and necrosis, mitochondrial dysfunction and redox imbalance were observed in porcine adrenocortical cells. The mRNA levels of the six components of intermediary enzymes and the adrenal renin-angiotensin-aldosterone system (RAAS) displayed a dysregulation induced by QCT, indicating that QCT might influence aldosterone secretion not only through the upstream of the production but also through the downstream of the adrenal RAAS pathway. In contrast, B-QCT had few toxic effects on the cell apoptosis, mitochondrial dysfunction and redox imbalance. Moreover, LCMS-IT-TOF analysis showed that no desoxy metabolites of QCT were found in either cell lysate or supernatant samples. In conclusion, we reported on the cytotoxicity in porcine adrenocortical cells exposed to QCT via oxidative stress, which raised awareness that its toxic effects resulted from N→O groups, and its toxic mechanism might involve the interference of the steroid hormone biosynthesis pathway.     

医院感染管理中信息化管理的应用和效果分析

目的：探讨信息化管理应用于医院感染管理中的效果,为临床工作者提供参考。方法在医院信息化管理的基础上,将医院感染管理平台、医院信息平台和临床实验室信息系统等相连接。实时监测传染性疾病、抗生素使用情况、消毒灭菌情况、病原菌和药敏信息,网上直报和反馈各项信息。结果信息化管理开展了感染管理相关的前瞻性监测,简化了程序,节省了时间,对医院感染做到了早发现、早报告、早控制。该院采用了医院感染管理信息化管理后,抗菌药物的应用更合理,环境卫生更优,医院感染发生率和感染管理漏报率显著下降(P<0.05),并形成了全面的监测报表。结论信息化管理应用于医院感染管理中,提高了医院感染管理水平,实现了医疗信息共享,有效防控感染流行爆发。     

细粒棘球绦虫TaqMan实时荧光定量PCR检测方法的建立及应用

目的 为建立高效、特异的细粒棘球绦虫(Echinococcus granulosus,Eg)检测方法。方法 本研究设计了一组基于Eg线粒体基因的特异性引物和TaqMan探针,通过反应体系及条件的优化,建立了Eg荧光定量PCR检测方法。结果 该方法线性关系好,灵敏度高,在10⁹~10²拷贝/μL相关系数达0.998,灵敏度达10²拷贝/L;在特异性试验中,与其他病原虫株无交叉反应,特异性较好;重复性试验变异系数均低于3%。应用该方法对50份临床样品进行检测,发现6份为Eg感染阳性。结论 由此可见,建立的荧光定量PCR方法可快速、灵敏、特异地检测细粒棘球绦虫,具有一定的实际应用价值。     

联合应用激光微切和实时定量RT-PCR检测单个胰岛的基因表达

在显微镜下用紫外激光微切机将单个胰岛从胰腺切片中切下，提取RNA后逆转录成cDNA并在实时定量RY—PCR中得到有效的扩增，其表达量与细胞数量成正比。     

Real-time perfusion adenosine stress echocardiography in the coronary care unit: a feasible bedside tool for predicting coronary artery stenosis in patients with acute coronary syndrome.

Myocardial contrast echocardiography using power modulation real-time perfusion (RTP) is an appealing method for bedside risk stratification of patients with acute coronary syndrome. In this study, we aimed to evaluate the accuracy in predicting significant coronary stenosis of a bedside RTP adenosine stress protocol in patients with acute coronary syndrome. METHODS: Prior to coronary angiography, 36 consecutive in-patients with acute coronary syndrome underwent a bedside adenosine stress echocardiography with RTP in the coronary care unit. Visual assessment of both perfusion and wall motion was made, comparing rest and hyperaemia images. Each segment was attributed to one of the three main coronary vessel areas. RESULTS: The sensitivity of predicting significant stenosis was 87, 83 and 81% for left anterior descending, circumflex and right posterior descending areas, respectively. Specificity was 69, 67 and 60%, respectively. The positive predictive values were 83, 79 and 74%, respectively. CONCLUSIONS: RTP using adenosine is a feasible bedside tool in predicting the area of significant coronary stenosis and could be helpful as a bedside decision-making tool in the clinical setting. More studies are required to assess the clinical value of RTP adenosine stress echocardiography.     

白介素-6对人冠脉平滑肌细胞表达妊娠相关血浆蛋白-A的影响

目的探讨炎症因子白介素-6(IL-6)对人冠脉平滑肌细胞表达妊娠相关血浆蛋白A的影响。方法实验于2005年5月至2006年8月在解放军305医院老年病中心实验室完成。人冠脉平滑肌细胞37℃、5%CO2条件下常规培养。实验用5~7代的细胞,按2.5×105/mL密度接种于25cm2的培养瓶中,24h后换液,生长接近80%融合时进行如下处理:(1)应用质量浓度为10ng.mL-1的IL-6刺激人冠脉平滑肌细胞,分别在共同培养0,2,4,8,24,36h后收集细胞。(2)应用不同质量浓度的IL-6(0,5,10,50ng.mL-1)刺激人冠脉平滑肌细胞,共同培养6h后收集细胞。应用实时荧光定量聚合酶链反应的方法检测细胞内妊娠相关血浆蛋白A基因的表达量。应用SPSS10.0软件进行统计学描述与分析,所得数据用x-±s表示,多组间比较用onewayANOVA检验,两两比较应用SNK法检验,并进行pearson相关分析,P<0.05为差异有显著性意义。结果同剂量白介素-6刺激下,妊娠相关血浆蛋白A的表达量在2h时就开始发生上调,8h达高峰,而后开始下降;在不同剂量白介素-6刺激下,妊娠相关血浆蛋白A的表达量在实验剂量范围内随着白介素-6的剂量加大呈上升趋势。除5ng.mL-1和10ng.mL-1组之间差异无显著性意义(P=0.065),其余组间差异均有显著性意义(P<0.05)。结论炎症因子白介素-6能促进冠脉平滑肌细胞中斑块稳定相关标志物妊娠相关血浆蛋白A的表达,可能是炎症在急性冠脉综合征的发生发展中起重要作用的机制之一。     

Quantitative Monitoring of Circulating Epstein-Barr Virus DNA for Predicting the Development of Posttransplantation Lymphoproliferative Disease

Epstein-Barr virus (EBV)-DNA was quantitatively measured to assess posttransplantation virus reactivation by real-time polymerase chain reaction (PCR). In the first retrospective analysis of a 7-year-old boy with lymphoproliferative disease (LPD) after an unrelated cord blood transplantation, serum EBV-DNA progressively increased to 4 x 10(5) copies/mL. EBV load was then prospectively monitored in peripheral blood from posttransplantation patients. The second case was an 8 year-old boy with aplastic anemia who received a CD34+ cell transplantation. This patient died of LPD with the progression of pulmonary nodules. EBV-DNA increased to 4 x 10(4) copies/mL after the control of cytomegalovirus reactivation. On the other hand, EBV-DNA was undetectable (<200 copies/mL) in the series of all 58 samples from 10 patients who did not develop LPD after hematopoietic stem cell transplantation. Sequential monitoring of circulating EBV-DNA by quantitative PCR may be a useful indicator for predicting the development of posttransplantation LPD.