Inner ear changes in fetal asphyxia

Deafness following complications of pregnancy and obstetrics occurs frequently. The temporal bones of stillborn or neonates who died several days after delivery have often been examined, and haemorrhage and serous labyrinthitis have been found in infections, diabetes and trauma. In this study, pathological findings in the temporal bones of foetuses who died of chronic asphyxia in utero are described. 7 out of 15 cases had no labyrinthine pathology. Four had haemorrhage into the tissue or into perilymphatic or endolymphatic spaces. Likewise, four had developed eosinophilic precipitates in the liquid spaces of the inner ear. If the foetus survives such phases of hypoxia in utero, this might be the morphological correlate of developing deafness. Similar findings in infections such as rubella or cytomegalovirus infection are discussed.     

胎儿骨髓间充质干细胞复合PLGA支架的形态学观察

目的 探讨胎儿骨髓间充质干细胞(fetal bone marrow mesenehymal stem cells，fBMSCs)与低热高压法制作的聚丙交酯-乙交酯(PLGA)支架材料复合培养。构建组织工程化骨的可行性。方法 预制PLGA支架材料，取5月胎儿肱骨和股骨骨髓，用单核细胞分离液分离fBMSCs，含双抗的低糖DMEM原代和传代培养，倒置显微镜下观察细胞生物学特性，用F1TC标记的抗CDl05、CD44和用PE标记的抗CD34、CD29对第4代细胞进行流式细胞鉴定，并与PLGA支架材料复合培养l周后行扫描电镜观察。结果原代及传代培养的fBMSCs增殖较迅速，第4代CD105阳性细胞占84．08％，CD29阳性细胞占88．77％，CD44阳性细胞占89．53％。复合PLGA支架材料细胞生长状态良好。结论 骨髓间充质干细胞(bone mesenchymal stem cells，BMSCs)是骨组织工程适宜的种子细胞，与低热高压制作的PLGA支架材料复合可体外构建组织工程骨。     

Central and regional vascular hemodynamics following intravenous milrinone in the conscious rat: comparison with dobutamine

This study examined the hemodynamic and regional vascular profile of intravenous (i.v.) milrinone during increasing doses (3, 6, 12 micrograms/kg/min, n = 8) and by intraindividual comparison of milrinone and dobutamine (n = 10) in normal conscious rats. At 3 micrograms/kg/min, Milrinone increased coronary and cerebral blood flow (radioactive microspheres 15 +/- 5 microns) (7.7-9.8 and 1.05-1.27 ml/min/g respectively, both p less than 0.05) without significant changes in systemic hemodynamics. At 6 micrograms/kg/min milrinone increased skeletal muscle blood flow (0.19-0.24 ml/min/g, p less than 0.05) along with increases in cardiac output, stroke volume, and stroke work (all p less than 0.05), while systemic vascular resistance decreased (-51%, p less than 0.05). When compared with dobutamine, milrinone caused a greater increase in cardiac output (+26% vs. +17%) and a greater reduction in systemic vascular resistance. Milrinone and dobutamine increased renal, intestinal, cerebral, and coronary flow to a similar extent, but only milrinone enhanced hepatic arterial blood flow (+26%, p less than 0.05) and tended to increase flow to skeletal muscle (+35%, p = 0.07). We conclude that milrinone exerts significant regional vasodilating effects in a conscious rat model, being most prominent in the coronary and cerebral circulations at a dosage that does not alter central hemodynamics. At higher doses, milrinone causes a balanced increase in regional blood flow including enhanced flow to skeletal muscle. The hemodynamic (particularly as compared with dobutamine) and regional vascular profile of milrinone suggests a predominant vasodilating effect in the rat. Given a similar limited response of rat and diseased human myocardium to milrinone, these findings may have important clinical implications.     

国产辛伐他汀调脂疗效的多中心随机对照临床试验

目的　了解国产辛伐他汀 ( SS)的调脂疗效。方法　以默沙东生产的舒降之为对照 ,进行多中心随机对照临床观察。将 16 0例高脂血症患者随机分为试验组 (国产 SS,A组 )、对照组 (进口 SS,舒降之 ,B组 )和开放组 (国产 SS,C组 ) ,其中 A、B组为单盲。每例受试者均于每日晚餐后口服 SS10 mg,疗程 8周 ,且保持受试前的饮食和生活习惯不变。分别于受试后的 4周和 8周随访。结果　完成试验 15 5例 ,脱落 5例 (均因病员不合作 )。疗程4周时 ,A、B、C三组的血总胆固醇 ( TC)分别下降 16 .88%、19.2 3%和 14.10 % ,血甘油三酯 ( TG)分别下降19.2 7%、15 .6 6 %和 17.96 % ,HDL- C分别升高 7.6 9%、7.46 %和 6 .6 9% ,L DL- C分别下降 2 3.0 %、2 7.84%和2 4.43% ,三组间比较无显著性差异 ( P>0 .0 5 )。疗程 8周时 ,A、B、C三组的 TC分别下降 2 5 .0 3%、2 6 .5 3%和2 5 .2 2 % ,TG分别下降 2 3.85 %、2 4.74%和 2 4.75 % ;HDL- C分别升高 9.2 3%、8.95 %和 8.89% ,L DL- C分别下降33.72 %、35 .5 0 %和 30 .99% ,三组间比较也无显著性差异 ( P>0 .0 5 )。不良反应主要为消化道症状 ,其发生率 A、B、C三组分别为 2 0 .34 %、2 2 .81%和 17.95 % ,三组间无显著性差异 ( P>0 .0 5 )。 4周与 8周时比较 ,8周的疗效呈     

枸杞对辐射损伤小鼠造血功能恢复的影响

目的：观察枸杞对辐射损伤小鼠造血功能恢复的影响。方法：用１００％枸杞浸出液给小白鼠灌胃５ｄ后,用＾６０钴照射３０ｓ,剂量为３０ｃＧｙ,每日１次,共５次。检测骨髓细胞增殖反应、白细胞介素－１（ＩＬ－１）和白细胞（ＷＢＣ）。结果：枸杞组骨髓细胞增殖反应增强,ＷＢＣ明显升高,与照射组相比有非常显著性差异（Ｐ〈０．０１）。结论：枸杞对辐射损伤小鼠有促进骨髓细胞增殖及ＷＢＣ升高的作用。     

DNA repair synthesis following irradiation with 254-nm and 312-nm ultraviolet light is not diminished in fibroblasts from patients with dysplastic nevus syndrome

The DNA excision repair capacity of 23 primary fibroblast lines from patients with dysplastic nevus syndrome was investigated and DNA repair synthesis (unscheduled DNA synthesis) was determined after UV exposure. Seventeen fibroblast lines from normal donors served as controls. The dose/response experiments included up to ten dose levels and two wavelength ranges: UV-C (using a low-pressure mercury lamp emitting predominantly 254-nm light) and UV-B (artificial sunlamp radiation centering around 312-nm light). For each dose level, silver grains over fibroblast nuclei were counted by visual inspection. Twelve cell lines were also evaluated for both UV wavelength ranges using a new semi-automatic image analyzing system. This system included components for rapid sequential identification of both fibroblast nuclei and silver grains sited above them. Silver grains over 100 nuclei were determined for each UV dose level. Dose/response curves were established and analyzed by linear regression. As a quantitative term for assessing DNA excision repair capacity of a cell line we calculated the linear increase (G ₀) in the number of grains per nucleus, when the UV dose was multiplied by the factor e (i.e. 2.72). The sensitivity of grain detection and resolution ofoverlapping grains was approximately threefold better in visual than in automatic counting, especially when there were more than 70 grains over nuclei. The time recired for visual conting, however, was tenfold that of automatic counting. The varianceweighted meanG ₀ ^v,w of all fibroblast lines from patients with dysplastic nevus syndrome was found to be 79.1 (±1.8-grains/nucleus, that of fibroblast lines from normal donors was 74.2 (±1.7) grains/nucleus. This difference revealed a slightly better repair capability for cell lines from patients but was at the borderline of detection and, therefore, should not be overinterpreted. From the experimental accuracy achieved by determination of the varianceweighted means of the two groups, we would have been able to detect a difference of 7 and more grains [> 2 x (_normal + _patients)]. The variance-weighted meanG _o ^v,w of all fibroblast lines from patients with dysplastic nevus syndrome was found to be 76.4 (±1.4) grains/nucleus, whereas that of fibroblast lines from normal donors was only 66.6 (±1.8) grains/nucleus. This difference was statistically significant and, contrary to expectation, revealed better, not worse post-UV DNA repair capability in cell lines from patients that in those from normal donors. From the experimental accuracy achieved by determination of the variance-weighted means of the two groups, we would have been able to detect a difference of 6.4 or more grains [> 2 x (_normal + _patients)]. Variation between cell lines belonging to the same group was expressed by the standard deviation. On average, the standard deviation was in the range 18.2–21.1 grains/nucleus. This variation did not reflect experimental inaccuracy but different responses of individual cell lines to UV irradiation. On the basis of our data, we consider the hypothesis that patients with dysplastic nevus syndrome are prone to melanoma development because of a general defect in post-UV DNA repair to be improbable.This work was supported by the Deutsche Forschungsgemeinschaft, SFB 136     

针刺控制人工流产反应的效果研究

将妊娠时间在 40～ 70天之间孕妇 70例 ,随机分为针刺组、安慰针 1组、安慰针 2组、空白组及栓剂组。针刺及安慰针组采用单盲法。结果显示针刺组的疗效最好 ,对手术中临床表现、下腹疼痛及揪拽酸坠感的疗效 ,针刺组明显优于空白组和安慰针组 ;安慰针 1组和安慰针 2组术中下腹部揪拽酸坠感均明显轻于空白组。表明针刺合谷、三阴交两穴具有镇痛、减少人工流产反应的作用 ,在针刺的临床研究中设立安慰针作为对照是必要的。     

健脾补肾法治疗重症肌无力3O2例

目的：探讨健脾补肾法治疗重症肌无力的疗效。方法：选符合纳入标准的重症肌无力患者426例，随机分为两组。治疗组予健脾补肾中药，对照组予肾上腺皮质激素或免疫抑制剂。两组均治疗6个月观察疗效。结果：治疗组痊愈59例，显效93例，有效116例，无效34例，总有效率为88．7％(95％CI=85．1％～92．3％)；对照组痊愈21例，显效29例，有效40例，无效34例，总有效率为72.6％(95％CI=64．7％～80．5％)；两组综合疗效比较，有明显差异(u=2．6438，P=0．0091)。结论：健脾补肾法治疗重症肌无力疗效优于甲基强的松龙或环磷酰胺，其收益为OR=0．34(95％CI=0．20～0．57)，NNT=6(95％CI=4．20～11．76）。     

人类男性Y染色体变异对男性生育力影响的临床分析

目的:探讨Y染色体异常对男性生育能力的影响。方法:对因不育而就诊的4 238例男性患者进行G显带核型分析。结果:共检出Y染色体异常核型550例,占全部被检者12．98％,其中大Y 染色体异常497例;小Y染色体21例;倒位染色体13例;缺失Y染色体12例;47,XYY 4例;45,XO／ 46,XY嵌合体3例;48,XXYY 1例;环状Y染色体1例;Y染色体的平衡易位46,X,t(Y;17)(q12; q25)1例、46,X,t(Y;3)(q11;p11)1例、46,X,t(Y;14)(q12;q22)1例和1例46,X,t(Y;15) (p11;q13)。结论:Y染色体数目与形态结构的异常对男性生育能力有重要影响。     

贵州省1996~2004年出生缺陷抽样调查分析

目的:探讨贵州省出生缺陷发生特点。方法:采用分层整群随机抽样方法在全省范围抽取17所(2003年起扩大为30所)县级以上医院为出生缺陷监测点,1996~2004年于监测点监测118091例围产儿,确诊出生缺陷儿1472例。应用《妇幼卫生监测数据管理系统》录入原始数据,建立数据库,采用SPSS11.5版软件包进行统计学处理。资料采用描述性分析及因素分析。结果:出生缺陷发生率随年度呈上升趋势,2004年达最高水平(137·92/万)。出生缺陷总发生率男性高于女性,差异有显著统计学意义(x2=6·852,P<0·05);乡村发生率高于城镇,差异有显著统计学意义(x2=49·109,P<0·05)。9年出生缺陷总发生率居前5位依次为:唇裂合并腭裂(13·89/万)、多指(趾)(13·63/万)、神经管畸形(12·62/万)、先天性脑积水(8·21/万)、先天性心脏病(7·96/万)。结论:提高产前诊断技术,重视产前咨询和围产期保健,落实各种预防措施,尤其是做好病因学预防是降低出生缺陷发生率的关键。