腹腔镜手术治疗异位妊娠78例临床分析

异位妊娠是妇科常见的急腹症之一,近年来异位妊娠发病率呈上升趋势,而其中输卵管妊娠所占比率最高,达90％以上^[1],是孕产妇死亡的主要原因之一。本病治疗以手术为主。随着腹腔镜手术在妇科领域的广泛应用,腹腔镜手术治疗异位妊娠有取代开腹手术的趋势。我院2004年1月至2006年5月应用腹腔镜手术治疗异位妊娠78例,现将结果报道如下。     

沙门菌PCR检测技术应用进展

沙门菌是引起食物中毒的主要致病菌之一,其传统检测方法包括选择性培养、生化鉴定等步骤,耗时长、灵敏性差,很难满足快速检测要求。聚合酶链反应（PCR）技术是近年来广泛应用于食品中沙门菌快速检测的方法之一,其检测目的基因多种多样,主要包括属特异性引物基因、血清群特异性引物基因与血清型特异性引物基因。本文主要概述PCR技术应用于沙门菌检测的各种目的基因,并简要介绍常规PCR、多重PCR及实时定量PCR等技术的应用。     

GLOBAL TESTS FOR COMBINATION DRUG STUDIES IN FACTORIAL TRIALS

To test the hypothesis that there are some studied dose combinations more effective in treating a disease than their respective component doses of two drugs, Hung, Chi and Lipicky proposed two α-level tests for normally distributed data. This paper extends the utilities of these tests to the outcome variable that has variance as a function of its mean, such as with a binomially distributed outcome, and to incomplete factorial design settings where some cells are not studied. I explore the impacts of excluding cells from study on the power performances of these tests.     

痔组织弹性纤维退变和血管生成的机制及其意义

目的研究痔组织弹性纤维的病理变化及微血管密度(MVD)和血管生成相关蛋白的表达与痔形成的关系。方法利用免疫组织化学染色技术(SP法),对比研究24例Ⅲ度痔患者的正常肛垫和痔两种组织内弹性纤维和MVD的变化,并检测一氧化氮合酶(NOS)的3种亚型、血管内皮生长因子(VEGF)和金属基质蛋白酶(MMP)2、MMP9在两种组织中表达的差异。结果痔组织存在显著的新生血管形成,痔组织与相对正常肛垫组织间的MVD计数、VEGF、MMP9表达差异存在统计学意义(P<0.05)。痔组织中iNOS明显增高,但与正常肛垫组织比较,不具备统计学意义;痔组织弹性纤维出现断裂、扭曲、变形、玻璃样变等异常,而正常肛垫组织中弹性纤维形态较规则、密集,断裂和变形少见。结论新生血管形成可能是痔的发病机制之一;MMP9对肛垫纤维支持结构的直接降解作用可能是痔形成和加重的一个重要机制;痔组织中iNOS表达增高还提示炎症因素和一氧化氮可能参与了痔的病理过程。     

A Prospective,Randomized Comparison of Modified Pulmonary Vein Isolation Versus Conventional Pulmonary Vein Isolation in Patients with Paroxysmal Atrial Fibrillation

Modified Pulmonary Vein Isolation in AF Ablation. Introduction: Pulmonary vein isolation (PVI) is the primary ablation therapy in patients with atrial fibrillation (AF). We hypothesized that high dominant frequency (DF) sites (AF nests during sinus rhythm [SR]) adjacent to the PV ostia are associated with the atrial substrate that maintains AF, and PVI incorporating the high‐frequency AF nests may have a higher efficacy. Methods and Results: In a prospective and randomized comparison, 126 symptomatic paroxysmal AF patients that underwent PVI were enrolled. We compared the efficacy of a modified PVI (ablation line: 1.0–1.5 cm from the PV ostium with encircling the AF nests [spectral analysis with DF >70 Hz during SR, Group II]) versus the anatomy‐guided conventional PVI (Group I). In Group II, the DF value along the PV ostium was lower than 70 Hz after the PVI. The primary endpoint was the freedom from symptomatic atrial arrhythmias after a single procedure. We also followed the autonomic function by a time‐domain analysis of the heart rate variability. In both groups, AF nests were observed and electric isolation was successfully obtained in all patients. With a mean duration of 16 ± 6.1 months of follow‐up, Group II had a higher single procedure efficacy without drugs (78.7% vs 66.1%, log‐rank test: P = 0.02), and fewer repeat procedures (6.6% vs 23%; P = 0.04), as compared to Group I. Conclusion: PVI incorporating the high frequency AF nests adjacent to the PV ostia had a better single procedure efficacy. (J Cardiovasc Electrophysiol, Vol. 23, pp. 1155–1162, November 2012)     

柿叶多糖对糖尿病小鼠降血糖作用及其机制研究

目的:研究柿叶多糖对链脲佐菌素糖尿病小鼠的降血糖作用及其作用机制。方法:将实验小鼠随机分成5组:正常对照组、模型组、格列本脲组(25 mg.kg-1.d-1),柿叶多糖低、高剂量组(150,600 mg.kg-1.d-1)。ig给于药物15 d,并在相应时间采血测定空腹血糖(FBG)、空腹胰岛素(FINS)、胰岛素敏感指数(ISI)、丙二醛(MDA)、超氧化歧化酶(SOD)等指标。结果:高剂量的柿叶多糖能较明显的改善糖尿病小鼠的葡萄糖耐量(P<0.01),低、高剂量组均能显著降低糖尿病小鼠的血糖水平(P<0.05),有效降低肝组织MDA值,相应增高SOD活力,并能显著增加胰岛素敏感指数(ISI),改善胰岛素抵抗状态。结论:柿叶多糖具有较强的降血糖作用,可能与其能提高小鼠肝脏抗氧化酶活性、改善胰岛素抵抗等有关。     

Montelukast decreased exhaled nitric oxide in children with perennial allergic rhinitis

BACKGROUND: Measurement of exhaled nitric oxide (eNO) is a simple and noninvasive method for assessment of inflammatory airway diseases. eNO is elevated in adolescent patients with perennial allergic rhinitis and related to bronchial hyperresponsiveness. The aim of this study was to investigate whether oral loratadine, montelukast, nasal budesonide or nasal sodium cromoglycate could reduce airway inflammation as indicated by decrease of eNO in children with perennial allergic rhinitis as demonstrated by eNO levels. METHODS: A randomized and investigator-blinded study was conducted in a hospital-based outpatient clinic. Children with perennial allergic rhinitis were divided into four groups and treated by loratadine, loratadine with nasal sodium cromoglycate, loratadine with oral montelukast, and loratadine with nasal budesonide, respectively. Allergic rhinitis scores, eNO and peak expiratory flow were measured before and 2, 4, 6 and 8 weeks after treatment. RESULTS: Results showed that eNO in children with perennial allergic rhinitis was reduced by nasal budesonide and oral montelukast within 2 weeks (24.56 +/- 14.42 vs 18.42 +/- 12.48, P < 0.001, in budesonide group; 27.81 +/- 13.4 vs 19.09 +/- 10.45, P < 0.001, in montelukast group), but not in the loratadine and cromoglycate groups. In contrast, loratadine or sodium cromoglycate also did not decrease eNO levels although they could decrease the symptom scores. CONCLUSIONS: It was concluded that four common treatment modalities could effectively release symptom scores, but decrease of airway inflammation as determined by decrease of eNO might be only achieved by nasal budesonide and montelukast, but not nasal sodium cromoglycate and loratadine. Children with perennial allergic rhinitis with high eNO levels may require oral montelukast or nasal budesonide treatment to prevent airway hyperresponsiveness.     

利用人支气管上皮细胞系分离和培养人博卡病毒

目的 研究人博卡病毒(HBoV)在呼吸道感染中致病性及机理.方法 利用人支气管上皮细胞系进行HBoV分离及培养,通过电镜对培养细胞中HBoV的形态及感染细胞进行研究,并采用逆转录PCR(RT-PCR)方法,检测HBoV在细胞中转录产物mRNA,同时对扩增产物进行测序及分析.结果 将含有HBoV阳性痰液标本无菌接种人支气管上皮细胞系,出现2例致使细胞发生明显的病变(CPE).电镜观察在细胞质中散在六角形或圆形的病毒粒子,大小18～26 nm之间,大部分是20nm.RT-PCR扩增产物经电泳检测与预期结果相符是295 bp,扩增产物测序结果与GenBank中HBoV序列比较,核苷酸同缘性99%,氨基酸同缘性100%.结论 HBoV感染人支气管上皮细胞后能够在该细胞内增殖,并产生特征性生物学改变.本研究为今后HBoV致病性及免疫应答谱研究奠定基础.