起搏治疗遗传性长QT间期综合征23例

目的:评价VVI起搏治疗遗传性长QT综合征的疗效. 方法:对23例有尖端扭转性室速发作,且经正规药物治疗无效或无法耐受的遗传性长QT综合征患者,植入了VVI起搏器.随访这23例患者术后心电图及心脏事件发生率. 结果:QT间期平均值由术前(638.0±55.7)ms缩短至术后的(471.3±48.9)ms,QTc平均值为由0.627±0.07缩短至0.519±0.06.心脏事件的发生率由术前的(0.353±0.46)次/年降至术后(0.111±0.24)次/年,(P=0.039).其中77.5%的患者随访期间无晕厥或猝死等心脏事件发生.90.91%患者存活.2例患者因尖端扭转性室速恶化为室颤抢救无效死亡. 结论:VVI起搏治疗可以有效地减少长QT综合征患者恶性心律失常的发生,是治疗长QT综合征的重要方法之一.     

nm23基因在前列腺癌中的表达与癌转移的关系

应用ＬＳＡＢ免疫组织化学染色方法，研究转移抑制基因ｎｍ２３表达产物二磷酸核苷激酶（ＮＤＰＫ）在前列腺癌中的表达及其意义。结果表明，ＮＤＰＫ／ｎｍ２３在前列腺癌中有较高的表达，阳性率为５００％（２０／４０）。无前列腺癌转移者其阳性率为６６７％（１２／１８），有前列腺癌转移者其阳性率为３６４％（８／２２），两者比较差异有显著性（Ｐ＜００５），并与前列腺癌分化程度和临床分期有显著相关。因此，ｎｍ２３基因可能在前列腺癌形成及转移过程中起不同的调节作用，其表达程度与前列腺癌转移呈负相关，有可能成为评价前列腺癌病人预后的一项新指标。     

彩色多普勒血流显像对小孔室间隔缺损的诊断价值

目的　评价彩色多普勒血流显像 (CDFI)对小孔室间隔缺损 (VSD)的诊断价值。方法　对经CDFI诊断的 43例小孔VSD患者与手术治疗结果进行对照分析。结果　CDFI诊断阳性预测值为 95 % ,误、漏诊各 1例 ;整体定位阳性预测值为 88% ;40例彩色穿隔血流束宽测值与手术结果建立的回归方程式为Y =0 5 47+0 616X ,r =0 815 ,P <0 0 0 1;术前估测肺动脉收缩压 (PASP)为 ( 4 76± 1 93 )kPa。结论　CDFI诊断小孔VSD具有很高的特异性和准确性 ,并可估测患者术前的PASP。     

Inhibin B regulating follicle-stimulating hormone secretion during testicular recrudescence in the male golden hamster

In the present study, to clarify whether inhibin affects follicle-stimulating hormone (FSH) secretion in the recrudescence of the male golden hamster, we used a recently developed specific enzyme-linked immunosorbent assay (ELISA) in order to measure 2 forms of inhibin molecules: inhibin B and inhibin pro-alphaC. In addition, we used the radioimmunoassay (RIA) to measure immunoreactive (ir-)inhibin, FSH, luteinizing hormone (LH), and testosterone. And finally, we used the proliferating cell nuclear antigen (PCNA) and computer-assisted sperm motion analysis (CASA) methods to ascertain how well spermatogenesis and sperm motility recover from the photoinhibition caused by exposure to a short-day (SD; 10-hour light: 14-hour dark) photoperiod. Animals were exposed to SD for 15 weeks, and then their testes were checked carefully and found to be completely regressed. Thereafter, those animals were transported to a long-day (LD; 14-hour light: 10-hour dark) photoperiod. Sampling was carried out at weeks 0 (exposed SD 15 weeks), 1, 2, 4, 6, 8, and 10. Plasma FSH rapidly increased and reached peak levels 2 weeks after transferral to the LD photoperiod and then declined to normal LD levels at week 6. Circulating ir-inhibin, inhibin B, and inhibin pro-alphaC rose to normal LD levels by week 4. A highly significant inverse correlation was observed between plasma FSH and inhibin B but not between FSH and either ir-inhibin or inhibin pro-alphaC. Plasma testosterone recovered to normal LD levels within 1 week. Sperm motility parameters were low until week 2 and recovered to normal LD levels from weeks 4 to 10. PCNA-labeled cells were confined to the spermatogenic cells of the seminiferous tubules, though Leydig and Sertoli cell nuclei were never stained for PCNA during the period studied. The number of pachytene spermatocytes and the diameter of seminiferous tubules increased in a time-dependent manner after transferral from SD to LD. In conclusion, these results suggest that 1) secretion of inhibin B may be stimulated by an early rise in FSH; 2) inhibin B suppresses FSH secretion from weeks 2 to 10, after transferral to the LD photoperiod; and 3) testes recrudescence is based on the increase in the number of sperm cells instead of the increase in the number of Sertoli and Leydig cells of the male golden hamster.     

CRISPR/Cas9-Mediated Gene Correction in Newborn Rabbits with Hereditary Tyrosinemia Type I

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MicroRNA profiles in five pairs of early gastric cancer tissues and adjacent non-cancerous tissues

Approximately half of the world''s gastric cancer cases and deaths occur in China. In addition, the incidence and mortality rates of gastric cancer in Gansu province in China are much higher than the average nationwide levels. The present study investigated microRNA (miRNA/miR) profiles in early gastric cancer (EGC) without specific symptoms. miRNA expression levels in five pairs of EGC tissues and adjacent non-cancerous mucosa tissues of patients from Gansu province in China were analyzed using a miRNA microarray. A total of 47 differentially expressed miRNAs (DEMs) were identified. Subsequently, mRNA expression profiles of three pairs of cancer tissues and adjacent non-cancerous tissues from 3 Asian patients with stage I or stage II gastric cancer (stage I/II; American Joint Committee on Cancer classification, Eighth Edition) were obtained from The Cancer Genome Atlas database, and differentially expressed genes (DEGs) were identified. The target genes of DEMs were filtered from the DEGs using the miRDB database and a miRNA-gene network was constructed. The functions of DEMs were evaluated using the tool for annotations of human miRNAs database, and via Gene Ontology analysis, Kyoto Encyclopedia of Genes and Genomes analysis and Gene Set Enrichment Analysis of the target genes. Finally, survival analyses of DEMs, which were in the miRNA-gene network, was performed. The results suggested that a number of miRNAs, including hsa-let-7a-5p, hsa-miR-27a-3p, hsa-miR-126-5p and hsa-miR-424-5p, may serve critical roles in EGC. The present study could provide a basis for the identification of EGC screening biomarkers. Furthermore, the present study may provide a basis for the exploration of the cause of the high incidence of gastric cancer in Gansu province from the perspective of miRNAs.     

Primary aldosteronism and impaired natriuresis in mice underexpressing TGFβ1

To uncover the potential cardiovascular effects of human polymorphisms influencing transforming growth factor β1 (TGFβ1) expression, we generated mice with Tgfb1 mRNA expression graded in five steps from 10% to 300% normal. Adrenal expression of the genes for mineralocorticoid-producing enzymes ranged from 50% normal in the hypermorphs at age 12 wk to 400% normal in the hypomorphs accompanied with proportionate changes in plasma aldosterone levels, whereas plasma volumes ranged from 50% to 150% normal accompanied by marked compensatory changes in plasma angiotensin II and renin levels. The aldosterone/renin ratio ranged from 0.3 times normal in the 300% hypermorphs to six times in the 10% hypomorphs, which have elevated blood pressure. Urinary output of water and electrolytes are markedly decreased in the 10% hypomorphs without significant change in the glomerular filtration rate. Renal activities for the Na⁺, K⁺-ATPase, and epithelial sodium channel are markedly increased in the 10% hypomorphs. The hypertension in the 10% hypomorphs is corrected by spironolactone or amiloride at doses that do not change blood pressure in wild-type mice. Thus, changes in Tgfb1 expression cause marked progressive changes in multiple systems that regulate blood pressure and fluid homeostasis, with the major effects being mediated by changes in adrenocortical function.     

提高病案质量 防范医疗风险

<正>加强病案管理,提高病案质量,是我们日常医疗、教学、科研、甚至司法等的需要。《医疗事故处理条例》(以下称条例)出台实施后,病案又是解决医疗纠纷时起原始证据作用和判断法律责任的法律依据。所以加强病案管理,提高病案质量,是贯彻落实条例,防范医疗风险的需要。