P47phox基因C923T多态性与脑梗死的相关性研究及其对血脂的影响

目的探讨P47^phox基因第10外显子C923T（Ala308Val）多态性与脑梗死的关系及其对血脂的影响。方法采用PCR-单链构象多态技术和DNA直接测序法检测110例脑梗死患者、10个脑梗死家系成员和100名健康对照者的P47^phox基因第10外显子C923T多态性;酶法测定总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）,免疫比浊法测定apoA-I及apoB100,酶联免疫吸附法测定脂蛋白a血清水平。结果P47^phox基因第10外显子C923T多态存在CC、CT、TF三种基因型,脑梗死组及其各亚组C923T多态基因频率分布与对照组比较差异无统计学意义（P〉0．05）;脑梗死组和对照组CT基因型血清11G水平均明显高于CC基因型（P〈0．05）。结论P47^phox基因C923T多态性可能与脑梗死的易患性无关,但与血脂代谢有一定相关。     

Critical Amino Acid Residues for Nicotine 5＇ -Hydroxylation in Human CYP2A Enzymes

Objective： We have continued previous work in which we demonstrated that #117 and #372 amino acids contributed to the high activities of human CYP2A13 in catalyzing 4-methylnitrosamino-1-（3-pyridyl）-1-butanone（NNK） and aflatoxin BI（AFB1） carcinogenic activation. The present study was designed to identify other potential amino acid residues that contribute to the different catalytic characteristics of two CYP2A enzymes, CYP2A6 and CYP2A13, in nicotine metabolism and provide insights of the substrate and related amino acid residues interactions. Methods： A series of reciprocally substituted mutants of CYP2A6lle^300→ Phe, CYP2A6Gly^301aAla, CYP2A6Ser^369 → Gly, CYP2A13Phe^300→ Ile, CYP2A13Ala^301 → Gly and CYP2A13Gly^369 → Set were generated by site-directed mutagenesis/baculovirus-Sf9 insect cells expression. Comparative kinetic analysis of nicotine 5＇hydroxylatin by wild type and mutant CYP2A proteins was performed. Results：All amino acid residue substitutions at 300, 301 and 369 caused significant kinetic property changes in nicotine metabolism. While CYP2A6Ile^300→ Phe and CYP2A6Gly^301→Ala mutations had notable catalytic efficiency increases compared to that for the wild type CYP2A6, CYP2A13Phe^300→Ile and CYP2A13Ala^301→Gly replacement introduced remarkable catalytic efficiency decreases. In addition, all these catalytic efficiency alterations were caused by Vmax variations rather than Km changes. Substitution of #369 residue significantly affected both Km and Vmax values. CYP2A6Ser^369 → Gly increase the catalytic efficiency via a significant Km decrease versus Vmax enhancement, while the opposite effects were seen with CYP2A13Gly^369 → Ser. Conclusion：#300, #301 and #369 residues in human CYP2A6/13 play important roles in nicotine 5＇ -oxidation. Switching #300 or #301 residues did not affect the CYP2A protein affinities toward nicotine, although these amino acids are located in the active center. Set369 to Gly substitution indirectly affected nicotine binding by     

整体护理干预应用于血栓性血小板减少性紫癜患者实施血浆置换期间的临床研究

目的：探讨整体护理干预应用于血栓性血小板减少性紫癜（TTP）患者实施血浆置换期间的临床效果。方法选择收治的 TTP 患者58例作为研究对象,将2009年5月—2011年4月实施常规护理的27例患者作为对照组,将2011年5月—2014年4月实施整体护理的31例患者作为观察组,比较二组患者护理前后的汉密尔顿焦虑量表（HAMA）和焦虑自评量表（SAS）评分、不良反应发生率及患者满意度。结果观察组出院前1d HAMA 、SAS 评分为（14．19±1．39）分和（35．27±8．57）分,均低于对照组,差异有统计学意义（P＜0．05）;观察组护理质量、护理满意度评分为（9．48±0．34）分和（9．56±0．28）分,均高于对照组,差异有统计学意义（ P ＜0．05）;观察组不良反应发生率显著低于对照组,差异有统计学意义（ P ＜0．05）。结论 TTP 患者实施血浆置换期间应用整体护理干预显著缓解焦虑情绪,提高了患者满意度,值得临床重视。     

麦滋林-S对氧氟沙星的血浆浓度的影响

目的　因氧氟沙星口服对胃黏膜有刺激作用 ,因此在治疗中往往造成药物性胃炎。本文寻找一种既不影响氧氟沙星疗效 ,又能对抗氧氟沙星破坏胃黏膜作用的理想配伍药物。方法　选择麦滋林 -S(Marzulene -S)及硫糖铝 2种抗溃疡药分别与氧氟沙星配伍使用。结果　麦滋林组的病例与氧氟沙星单独用药组血药浓度相似 (P >0 .0 5 ) ,而硫糖铝组血中氧氟沙星浓度明显低于上述 2组 (P >0 .0 5 )。结论　证明麦滋林 -S颗粒对氧氟沙星血药浓度没有影响 ,且有效保护了胃黏膜免受氧氟沙星的破坏 ;而硫糖铝中所含金属铝离子与喹诺酮类药物形成络合物 ,影响其吸收 ,因而降低了氧氟沙星的疗效     

全静脉营养加谷氨酰胺对危重症患者血浆内毒素、肿瘤坏死因子-a水平及预后的影响

目的观察全静脉营养加谷氨酰胺（Gln）对危重症患者血浆内毒素（LPS）、肿瘤坏死因子-a（TNF-a）水平及预后的影响。方法将120例危重症患者随机分为观察组和对照组,每组60例。对照组给予常规全静脉营养支持,观察组在对照组全静脉营养支持基础上给予Gln。比较两组患者血浆Gln、LPS和TNF-a水平的变化,以及肠外营养支持治疗时间、住院天数和预后情况。结果观察组血浆Gln水平逐渐升高,与治疗前比较,差异有统计学意义（P〈0．01）。观察组血浆LPS和TNF-a水平逐渐降低,对照组逐渐升高,与治疗前比较,差异均有统计学意义（P〈0．05或P〈0．01）;治疗第3天及第7天两组之间Gln、LPS及TNF—a水平比较,差异均有统计学意义（P〈0．01）。观察组患者肠外营养支持治疗时间和住院天数均显著短于对照组（P〈0．01）,感染发生率亦显著低于对照组（P〈0．05）。结论全静脉营养加Gln在危重症患者治疗中可有效改善胃肠道功能,降低血浆LPS和TNF—d水平,改善预后。     

稽留流产组织中VEGF与PAPP-A的表达及关系

目的:探讨稽留流产组织中血管内皮生长因子(VEGF)的表达与血清中妊娠相关血浆蛋白-A(PAPP-A)的关系。方法:选择60例在我院就诊的稽留流产患者为观察组,并选取60例因早孕要求人工流产的健康孕妇为对照组,检测两组患者血清中PAPP-A水平,流产后留取两组患者的绒毛组织及蜕膜组织并行免疫组化测定VEGF的表达,比较分析两组患者VEGF及PAPPA表达的水平及关系。结果:两组患者血清中PAPP-A水平比较发现,观察组患者血清中PAPP-A水平明显低于对照组(P<0.05);两组患者绒毛膜及蜕膜组织VEGF表达比较,正常流产患者绒毛膜及蜕膜组织中VEGF蛋白的阳性表达率及表达强度明显高于稽留流产患者(P<0.05)。结论:稽留流产孕妇的血清VEGF与PAPP-A水平明显低于正常孕妇,有助于诊断稽留流产,临床工作中可作为检测指标。     

骨髓瘤病人血清某些免疫学性质的研究

本文对21例多发性骨髓瘤病人(MM)和1例巨球蛋白血症(WM)血清Ig、补体C_3、溶菌酶含量及循环免疫复合物(CIC)进行了测定,观察了血清及血中单克隆Ig(M-蛋白)对正常人淋巴细胞功能的影响。本实验的结果表明MM血清功能性Ig、C_3、溶菌酶含量均明显下降;血清CIC阳性率显著高于正常人;血清及M-蛋白对正常人淋转均有抑制作用。上述结果提示,MM血清中某些免疫成分的异常可能对病人机体免疫功能产生影响。     

浆细胞性乳腺炎的钼靶X线表现

目的探讨浆细胞性乳腺炎的X线表现,提高诊断准确性。方法回顾性分析12例经手术和病理证实的浆细胞性乳腺炎X线表现及其临床、病理资料。结果团片状模糊影5例,肿块影5例,均呈等或稍高密度,大部分位于乳晕周围及乳腺中央区,边缘模糊毛糙。乳晕皮肤增厚3例。乳腺内良性钙化2例。乳晕后导管相增强2例。腋窝淋巴结肿大2例。乳头内陷1例。结论浆细胞性乳腺炎的X线表现虽无特异性,但如能掌握一些常见征象并密切结合临床及病理,可提高该病诊断及鉴别诊断的准确性。     

Investigation of Electrical Transitions in the First Steps of Spark Plasma Sintering: Effects of Pre-Oxidation and Mechanical Loading within Copper Granular Media

Spark Plasma Sintering (SPS) has become a conventional and promising sintering method for powder consolidation. This study aims to well understand the mechanisms of densification encountered during SPS treatments, especially in the early stages of sintering. The direct current (DC) electrical behavior of copper granular medium is characterized. Their properties are correlated with their microstructural evolutions through post-mortem scanning electron microscope (SEM) observations to allow a thorough understanding of the involved Branly effect that is suspected to occur in SPS. The electrical response is studied by modifying the initial thickness of the oxide layer on particles surfaces and applying various mechanical loads on the granular medium. Without load and at low current, the measured quasi-reversible behavior is connected to the formation of spots at the microcontacts between the particles. By increasing the current, the Branly transition from an insulating to a conductive state suddenly occurs. The insulating oxide layer is destroyed, and micro-bridges are created. The application of a mechanical pressure strongly modifies the DC Branly effect. Increasing low stress leads to a strong decrease in the breakdown field. For high-applied pressure, successive drops in the electric field are detected during the electrical transition. These successive drops are induced by microcracking of the insulating oxide layer.     

胶体液对肝移植围术期血浆胶体渗透压的影响

目的观察经典非转流原位肝移植术中应用4%白蛋白和6%羟乙基淀粉130/0.4氯化钠(万汶)注射液对血浆胶体渗透压的影响。方法选取术前血浆白蛋白含量正常的经典非转流原位肝移植患者20例,随机分为两组。白蛋白组(Ⅰ组)和万汶组(Ⅱ组)。分别于建立肘正中静脉通路前(T0)、开始输注30min(T1)、输注60min(T2)、输注结束后30min(T3)、输注结束后60min(T4)。取静脉血进行胶体渗透压测定,同时测定血浆白蛋白含量。结果血浆胶体渗透压Ⅰ组于T1开始下降(P<0.05),于T2恢复至术前水平,与T1比较有差别(P<0.05)。Ⅱ组于T2时明显升高(P<0.05),两组间在T1时有差别(P<0.05),T2时差别明显(P<0.01)。血浆白蛋白含量Ⅰ组在T1时升高明显(P<0.05),Ⅱ组在T2时与T1比较有降低趋势(P<0.05),与T0比较有差异(P<0.05),两组间在T1时有差异(P<0.05),到T2、T3、T4时差异更明显(P<0.01)。结论本研究术中胶体液仅输注4%白蛋白液组短期有降低血浆胶体渗透压的趋势,长时间输注可维持血浆胶体渗透压在正常水平。胶体液仅输注万汶组可提高术中血浆胶体渗透压。