宁波市北仑区2013-2014年儿童哮喘流行病学调查

目的调查宁波市北仑区0~14岁儿童哮喘发病率、发病规律及危险因素,为制定防治措施提供参考。方法2013年1月-2014年1月,采用整群抽样法抽取北仑区19所学校0~14岁儿童为调查对象进行问卷调查,对筛查出的疑似哮喘儿童进行确诊,并对其人口学特征进行分析,采用logistic回归方程分析危险因素。结果调查收回有效问卷23 781份,共检出哮喘患儿534例,发病率为2.25%,男女发病率比例为1.92:1。其中发病较轻患儿占44.01%,中度占31.46%,重度占24.53%。发病时间以换季、冬季为主,分别占35.96%、32.02%。多因素logistic回归分析显示,呼吸道感染、药物过敏史、家族过敏史和食物过敏史是儿童哮喘发病的危险因素(P<0.05)。结论北仑区儿童哮喘发病率较高,具有性别和季节发病差异,应加大对患病危险因素的宣传,规范标准化治疗方案,减少儿童哮喘疾病的发生。     

Reactive oxygen species and human spermatozoa: physiology and pathology

The role of reactive oxygen species (ROS) in the pathophysiology of human sperm function has been emphasized in recent years. ROS production in semen has been associated with loss of sperm motility, decreased capacity for sperm–oocyte fusion and loss of fertility. There is a current presumption that the most prolific source of ROS in sperm suspensions is an NADPH oxidase located in leukocytes or in spermatozoa which produces superoxide which is further converted to peroxide by the action of superoxide dismutase. Hydrogen peroxide has been recognized as the most toxic oxidizing species for human spermatozoa, which are very sensitive to lipid peroxidation owing to the high content of polyunsaturated fatty acids in their plasma membrane, though this is not the sole mechanism by which sperm function might be impaired by ROS. Although the excessive production of ROS is detrimental to human spermatozoa, there is a growing body of evidence which suggests that ROS are also involved in the physiological control of some sperm functions. This review focuses on the nature and source of the ROS generated by human spermataozoa as well as their operational mechanisms and their effects, which may be detrimental or beneficial.     

Altered excitatory and inhibitory amino acid receptor binding in hippocampus of patients with temporal lobe epilepsy.

We examined binding to excitatory amino acid and inhibitory amino acid receptors in frozen hippocampal sections prepared from surgical specimens resected from 8 individuals with medically refractory temporal lobe epilepsy. The excitatory receptors studied included N-methyl-D-aspartate (NMDA), strychnine-insensitive glycine, phencyclidine, and quisqualate. The inhibitory receptors studied were gamma-aminobutyric acid type A (GABAA) and benzodiazepine. Excitatory and inhibitory amino acid receptor binding were differentially altered in the patients with temporal lobe epilepsy in comparison to 8 age-comparable autopsy control subjects, and changes in receptor binding were regionally selective in four areas. Binding to phencyclidine receptors associated with the NMDA channel was reduced by 35 to 70% in all regions in the hippocampi of the patients. In contrast, binding to the NMDA recognition site and its associated glycine modulatory site was elevated by 20 to 110% in the cornu ammonis (CA) 1 area and dentate gyrus of the hippocampus of the patients. Binding to these sites was unaffected in area CA4. Binding to the quisqualate-type excitatory amino acid receptor was unchanged in all regions except the stratum lacunosum moleculare CA1, where it was increased by 63%. GABAA and benzodiazepine receptor binding was reduced by 20 to 60% in CA1 and CA4, but unchanged in dentate gyrus. The data indicate that excitatory and inhibitory amino acid receptors are altered in the hippocampus of patients with temporal lobe epilepsy.     

Cephalad Movement of Morphine and Fentanyl in Humans after Intrathecal Injection

Background: Despite decades of use, controversy remains regarding the extent and time course of cephalad spread of opioids in cerebrospinal fluid (CSF) after intrathecal injection. The purpose of this study was to examine differences between two often used opioids, morphine and fentanyl, in distribution in the CSF after intrathecal injection.

Methods: Eight healthy volunteers received intrathecal injection of morphine (50 [mu]g) plus fentanyl (50 [mu]g) at a lower lumbar interspace. CSF was sampled through a needle in an upper lumbar interspace for 60-120 min. At the end of this time, a sample was taken from the lower lumbar needle, and both needles were withdrawn. CSF volume was determined by magnetic resonance imaging. Pharmacokinetic modeling was performed with NONMEM.

Results: Morphine and fentanyl peaked in CSF at the cephalad needle at similar times (41 +/- 13 min for fentanyl, 57 +/- 12 min for morphine). The ratio of morphine to fentanyl in CSF at the cephalad needle increased with time, surpassing 2:1 by 36 min and 4:1 by 103 min. CSF concentrations did not correlate with weight, height, or lumbosacral CSF volume. The concentrations of morphine and fentanyl at both sampling sites were well described by a simple pharmacokinetic model. The individual model parameters did not correlate with the distance between the needles, CSF volume, patient height, or patient weight.     

大肠癌术后早期肠梗阻的临床特点和治疗

目的：探讨大肠癌术后早期肠梗阻的诊断与治疗。方法：回顾分析在肠癌手术412例术后早期肠梗阻29例的临床资料。结果：20例经手术探查发现以机械性梗阻占多数（18/20)，手术治愈18例；死亡2例，死亡原因均为延误手术时机造成；非手术治愈9例。结论：大肠癌术后早期肠梗阻虽有梗阻症状，但由于术后诸多因素的影响，大多缺乏典型机械性肠梗阻的临床表现。处理中先进行适当时间的非手术治疗，无缓解者再手术。     

The A-wave of the human electroretinogram and rod receptor function

The amplitude of the leading edge of the a-wave of the human electroretinogram (ERG) was compared with predictions from a computational model of the light-induced responses of rod mammalian receptors. According to this model, a linear process describes the amplitude and time course of the response to relatively low flash intensities and at brief times after the onset of the flash. At higher flash intensities, a nonlinear process, described by the Naka-Rushton function or a saturating exponential, is involved. The primary focus here is on intensity-response data recorded with a clinical ganzfeld apparatus. The leading edge of the rod a-wave recorded from normal observers and patients with congenital stationary night blindness (CSNB) was described by a linear process for flash intensities up to the maximum available flash intensity, 2.0 log scot td-sec. This finding is consistent with the model of the rod's response. It suggests, however, that when ERGs are recorded with clinical systems limited to 2.0 log scot td-sec, these data cannot be used to distinguish between changes in the parameters (eg, semisaturation intensity versus maximum response) of the human rod receptors. Responses to flash intensities up to 3.4 log scot td-sec were recorded using a custom, high-intensity ganzfeld system. Both the linear and nonlinear components of the model were needed to fit the ERGs recorded with this system. This suggests that changes in different receptor parameters can be distinguished with higher intensity flashes.     

Induction of vitellogenin in primary monolayer cultures of cockerel hepatocytes.

A primary monolayer culture system from cockerel hepatocytes was established. The cultures synthesize and secrete proteins that comigrate with authentic serum proteins on polyacrylamide gels and are found in the same relative abundance. Addition of estradiol increased the synthesis of apoprotein B, found in very low density lipoprotein, under all culture conditions. Vitellogenin synthesis could not be induced directly by estradiol. However, when serum was obtained from cockerels injected with estradiol 4 days before blood collection and included in the culture medium, the cultures secreted a protein identified immunologically as vitellogenin by affinity chromatography. Furthermore, addition of growth hormone or prolactin to cultured cockerel hepatocyte monolayers resulted in the synthesis and secretion of a polypeptide that comigrates with authentic vitellogenin on polyacrylamide gels.