补肾中药对肾虚骨质疏松症大鼠红细胞膜PKC、 Ca2+-Mg2+- ATP酶活性影响的实验研究

本实验研究切除卵巢造成肾虚骨质疏松症大鼠模型。通过观测红细胞膜蛋白激酶Ｃ（ＰＫＣ）和Ｃａ２＋－Ｍｇ２＿－ＡＴＰ酶的活性，探讨肾虎骨质疏松症病理机制中肌醇脂质系统的变化，并结合全身和脊柱骨密度（ＢＭＤ）指标观察了补肾中药（密骨灵）的疗效，与正常对照组、模型空白组和阳性药（骨疏康颗粒剂）对照组进行对照，探讨补肾法的防治机理。结果表明；模型空白组大鼠红细胞膜ＰＫＣ和Ｃａ２＋－Ｍｇ２＋－ＡＴＰ酶、Ｍｇ２＋－ＡＴＰ酶的活性明显低于正常组（ｐ均＜０．０５）；密骨灵组与骨疏康组大鼠全身、脊柱ＢＭＤ和红细胞膜ＰＫＣ、Ｃａ２＋－Ｍｇ２＋－ＡＴＰ酶的活性均明显高于模型空白组（ｐ均＜０．０５），并且与正常组大鼠无明显差别（ｐ均＞０．０５）；密骨灵组大鼠红细胞膜Ｍｇ２＋－ＡＴＰ酶活性高于模型空白组和骨疏康组（ｐ＜０．０５），并且与正常组无显著性差异（ｐ＞０．０５）；密骨灵组大鼠红细胞膜ＰＫＣ活性高于骨疏康组（Ｐ＜０．０５）。结论：肾虎骨质疏松症具有红细胞膜ＰＫＣ和Ｃａ２＋－Ｍｇ２＋－ＡＴＰ酶、Ｍｇ２＋－ＡＴＰ酶活性的改变；密骨灵可以恢复肾虎骨质疏松症大鼠全身骨量，达到防治目的；补肾中药可以恢复红细胞膜ＰＫＣ活性和钙镁泵的活性，是补     

1993年云南省瑞丽等地吸毒者艾滋病病毒感染定群研究

１９９３年３月对已建立一年的吸毒者定群研究现场──云南省德宏州瑞丽市、陇川县及潞西县再次进行调查。本次调查７５５例吸毒者及１０２例配偶。从１９９２年进入定群研究ＨＩＶ阴性的８９例静脉吸毒者中，１９９３年又采到血样有５４例，其中９例血清转阳。瑞丽市、陇川县及潞西县１９９２年和１９９３年静注者血清阳转率（／百观察人年）分别为４３．２％及４０．０％，１２．２％及１２．２％，０％及０％。１９９３年新进入定群研究的１１６例静注者中，采集到血样的有１０４例，发现ＨＩＶ阳性３８例。上述三市县１９９２年及１９９３年入定群研究的静注者的ＨＩＶ感染率分别为８１．８％及８５．７％，４４．６％及４０．０％，５．１％及０％。可以看出血清阳转率的高低与ＨＩＶ感染率高低相吻合。ＨＩＶ阳性者的配偶１９９０、１９９２及１９９３年的ＨＩＶ感染率分别为３．１％、９．８％和７．４％，有上升趋势。潞西县ＨＩＶ阳性者少，静脉注射出现时间晚，但近年来静脉吸毒者比例上升快，值得注意。     

Occluding the pulmonary artery to improve detection of patent foramen ovale during ventricular assist device placement

Unrecognized patent foramen ovale (PFO) in patients after left ventricular assist device (VAD) placement could cause significant hypoxemia and paradoxical embolism. We aim to improve the techniques for PFO detection in this patient population before left ventricular device initiation. We evaluated the effects of main pulmonary artery occlusion on patients' hemodynamic and detection of PFO by transesophageal echocardiography (TEE). We compared between the standard and pulmonary artery occlusion technique. Sixty-two patients with ASA physical status class IV were studied. They presented with end-stage heart failure for left VAD placement. All patients received both Valsava maneuver and occlusion of their pulmonary arteries to assess their influence on detection of PFO. Occlusion of the main pulmonary artery consistently increased right atrial to left atrial pressure gradient. The PFO detection rate using TEE was significantly improved from 0% to 10% by this maneuver compared with the Valsava maneuver. Occlusion of the main pulmonary artery is a simple and effective method to improve PFO detection by TEE before left VAD initiation.     

Hyperactive Transforming Growth Factor‐β1 Signaling Potentiates Skeletal Defects in a Neurofibromatosis Type 1 Mouse Model

Dysregulated transforming growth factor beta (TGF‐β) signaling is associated with a spectrum of osseous defects as seen in Loeys‐Dietz syndrome, Marfan syndrome, and Camurati‐Engelmann disease. Intriguingly, neurofibromatosis type 1 (NF1) patients exhibit many of these characteristic skeletal features, including kyphoscoliosis, osteoporosis, tibial dysplasia, and pseudarthrosis; however, the molecular mechanisms mediating these phenotypes remain unclear. Here, we provide genetic and pharmacologic evidence that hyperactive TGF‐β1 signaling pivotally underpins osseous defects in Nf1^flox/?;Col2.3Cre mice, a model which closely recapitulates the skeletal abnormalities found in the human disease. Compared to controls, we show that serum TGF‐β1 levels are fivefold to sixfold increased both in Nf1^flox/?;Col2.3Cre mice and in a cohort of NF1 patients. Nf1‐deficient osteoblasts, the principal source of TGF‐β1 in bone, overexpress TGF‐β1 in a gene dosage–dependent fashion. Moreover, Nf1‐deficient osteoblasts and osteoclasts are hyperresponsive to TGF‐β1 stimulation, potentiating osteoclast bone resorptive activity while inhibiting osteoblast differentiation. These cellular phenotypes are further accompanied by p21‐Ras–dependent hyperactivation of the canonical TGF‐β1–Smad pathway. Reexpression of the human, full‐length neurofibromin guanosine triphosphatase (GTPase)‐activating protein (GAP)‐related domain (NF1 GRD) in primary Nf1‐deficient osteoblast progenitors, attenuated TGF‐β1 expression levels and reduced Smad phosphorylation in response to TGF‐β1 stimulation. As an in vivo proof of principle, we demonstrate that administration of the TGF‐β receptor 1 (TβRI) kinase inhibitor, SD‐208, can rescue bone mass deficits and prevent tibial fracture nonunion in Nf1^flox/?;Col2.3Cre mice. In sum, these data demonstrate a pivotal role for hyperactive TGF‐β1 signaling in the pathogenesis of NF1‐associated osteoporosis and pseudarthrosis, thus implicating the TGF‐β signaling pathway as a potential therapeutic target in the treatment of NF1 osseous defects that are refractory to current therapies. © 2013 American Society for Bone and Mineral Research.     

雷帕霉素对胰腺癌生长的抑制作用及其与基质细胞 衍生因子1α的关系

目的:探讨雷帕霉素对胰腺癌体内生长的抑制作用及其对基质细胞衍生因子1α(SDF-1α)的影响。方法:20只裸鼠胰腺注射胰腺癌SW1990细胞悬液后,随机均分为实验组与对照组,实验组裸鼠每日雷帕霉素(1.5mg/kg)腹腔注射,对照组以同样的方式给予等体积溶剂。3周后取移植瘤,比较两组肿瘤的生长情况,免疫组化法检测肿瘤组织单核-巨噬细胞、肿瘤相关巨噬细胞(TAM)浸润情况及p-m TOR、HIF-1α、SDF-1α蛋白的表达;Westonblot及q RT-PCR法检测肿瘤组织p-m TOR、HIF-1α、SDF-1α的蛋白与m RNA表达。结果:与对照组比较,实验组的肿瘤重量(0.3340g vs.1.7790g)与体积(0.2375mm3 vs.1.2662mm~3)均明显减小(均P0.05)。免疫组化结果显示,与对照组比较,实验组肿瘤组织浸润的单核-巨噬细胞、TAM计数均明显少(均P0.05);p-m TOR、HIF-1α、SDF-1α蛋白表达率均明显降低(均P0.05);肿瘤组织SDF-1α表达评分与TAM计数呈正相关(r=0.52,P0.05)。Westonblot与q RT-PCR结果显示,实验组肿瘤组织p-m TOR、HIF-1α、SDF-1α的蛋白与m RNA表达均低于对照组,除HIF-1αm RNA外(P0.05),其余差异均有统计学意义(均P0.05)。结论:雷帕霉素能抑制胰腺癌的体内生长,其机制可能与抑制m TOR通路活性而下调SDF-1α蛋白表达,进而减少肿瘤微环境中的TAM有关。     

Comparison of Intravenous versus Topical Tranexamic Acid in Total Knee Arthroplasty: A Prospective Randomized Study

The purpose of this study was to compare the efficacy of topical Tranexamic Acid (TXA) versus Intravenous (IV) Tranexamic Acid for reduction of blood loss following primary total knee arthroplasty (TKA). This prospective randomized study involved 89 patients comparing topical administration of 2.0 g TXA, versus IV administration of 10 mg/kg. There were no differences between the two groups with regard to patient demographics or perioperative function. The primary outcome measure, perioperative change in hemoglobin level, showed a decrease of 3.06 ± 1.02 in the IV group and 3.42 ± 1.07 in the topical group (P = 0.108). There were no statistical differences between the groups in preoperative hemoglobin level, lowest postoperative hemoglobin level, or total drain output. One patient in the topical group required blood transfusion (P = 0.342). Based on our study, topical Tranexamic Acid has similar efficacy to IV Tranexamic Acid for TKA patients.     

鼻出血患者100例治疗结果分析

目的总结鼻出血的治疗经验,分析治疗中可能存在的问题,探讨各种治疗措施在处理鼻出血中的意义。方法对2006年5月～12月来住院治疗的鼻出血患者100例进行回顾性分析与研究。结果100例均治愈,治疗手段包括前后鼻孔填塞、内镜下电凝、微波、药物烧灼手术等。结论治疗鼻出血的关键是找准出血部位及明确出血原因,再根据患者的实际情况采取有效止血措施。     

加强院前急救的有效护理是基层急救的有效途径

目的总结院前急救的有效护理措施。方法对100例急救患者进行出诊前、出诊时、途中监护的精心护理。结果100例急救患者确保了生命安全，提高了救治率。结论科学有效的院前急救护理是为患者赢得生命有效的途径。