医疗纠纷对剖宫产率的影响

目的探讨医疗纠纷对剖宫产率及其指征的影响.方法统计1994年至2002年我科单胎初产妇每年的剖宫产率、新生儿窒息率及剖宫产各项指征的构成比,回顾性分析各项指标的变化,尤其是1998年前后的变化.结果98年我科发生数起重大医疗纠纷,其后剖宫产率迅速攀升,一度达到82.62%,而新生儿窒息率却由98年前的3.9%升至其后的5.99%(x2=17.19,P＜0.01).以妊娠合并症及妊娠并发症、头盆不称及胎儿窘迫为主的剖宫产指征构成比自98年以后明显下降,差异有显著性;而以胎盘羊水因素及脐带因素为指征的构成比明显攀升,差异也有显著性.结论医疗纠纷严重影响剖宫产率,加强全民卫生教育、合理公正地处理此类纠纷、创造宽松的医疗环境,建立恰当的监督机制有利于减少此类纠纷,降低剖宫产率.     

妊高征患者胎盘瘦素表达与胎儿发育

瘦素是肥胖基因的编码产物，主要由白色脂肪细胞合成和分泌。但有学者发现胎盘也合成和分泌瘦素。本文旨在通过研究妊高征患者胎盘的瘦索表达及其与脐血血清瘦素水平和胎儿体重的相关性，来探讨妊高征时胎盘瘦素在胎儿宫内发育中的作用。     

瘦素与妊娠肝内胆汁淤积症、妊高征的关系

目的 :探讨瘦素与妊娠肝内胆汁淤积症 (ICP)、妊高征发病的关系。方法 :采用放射免疫法测定 2 0例ICP患者、2 0例妊高征患者和 2 0例正常妊娠妇女母血及其新生儿脐血瘦素水平。结果 :( 1)妊高征、ICP患者母血清瘦素水平分别为 ( 2 5 3 4± 6 3 )ng/mL、( 2 7 2± 6 0 )ng/mL ,高于对照组孕妇 ( 2 0 5± 5 8)ng/mL ,两组比较差异有显著性 (P <0 0 5 ,P <0 0 1)。而妊高征组与ICP组的母血清瘦素水平比较差异无显著性 (P >0 0 5 )。 3组脐血瘦素水平比较差异无显著性 (P >0 0 5 )。 ( 2 )正常妊娠时母血瘦素水平与其脐血瘦素水平无相关性 (r =0 0 3 2 ,P >0 0 5 ) ,而妊高征、ICP患者母血瘦素水平与其脐血瘦素水平存在正相关 (r =0 5 44 ,0 5 2 0 ,P <0 0 5 )。 ( 3 )妊高征、ICP、对照组脐血瘦素水平与新生儿体重呈正相关 (r =0 44 0 ,0 485 ,0 5 3 0 ,P <0 0 5 )。结论 :妊高征、ICP患者母血清瘦素水平明显高于正常妊娠 ,提示瘦素与这两种疾病的发生有关。脐血瘦素水平可以反映胎儿宫内发育情况     

踝关节扭伤的中医外治法研究概况

踝关节扭伤系骨科临床常见病,占关节韧带扭伤的首位[1].如治疗不及时或不恰当,常遗留疼痛及关节不稳,继而发生骨关节炎等.现就踝关节扭伤的中医药外治综述如下.     

慢病毒介导CCL5-siRNA对乳腺癌细胞生物学行为的影响

Objective To study the effect of lentivirus-mediated CCL5-RNAi on the biological behaviors of human breast cancer cells. Methods CCL5-specific siRNA gene was synthesized and cloned into the recombinant lentiviral vector, pGCSIL-GFP. Human high-metastatic breast cancer cells, MDA-MB-231, were infected by CCL5-siRNA recombinant lentivirus, which was set as KD group. Cells infected with CCL5-NC was as NC group, and cells cultured was as CON group. The expression of CCL5 mRNA and protein in MDA-MB-231 cells was detected by RT-PCR and western blot, respectively. Cell growth suppression and cell cycle was observed by MTT assay and fluorescence activated cell sorting (FACS). Colony formation and migration ability were determined by colony-rorming assay and Boyden chamber method. Results After infection of CCL5-siRNA recombinant lentivirus, the expression level of CCL5 mRNA and protein in MDA-MB-231 cells as well as the colony formation and migration ability decreased significantly, but cell's proliferation was not affected obviously. Compared with MDA-MB-231 (0.88± 0.15) and MDA-MB-231/CCL5-NC (1.00±0.07) cells, the expression of CCL5 mRNA in MDA-MB-231/ CCL5-siRNA decreased to 0.18±0.03, P<0.01. Compared with MDA-MB-231/CCL5-NC (1.82±0.18) cells, the expression of CCL5 protein in MDA-MB-231/CCL5-siRNA decreased to 0.33±0.13, P <0.01. Colony-forming assay and Boyden chamber method showed that the colony formation and migration ability of MDA-MB-231/CCL5-siRNA decreased markedly (P<0.05). The clone count in KD group was (0.33± 0.10), which was a significant decrease from (0.97±0.09) (NC group) and (1.04±0.07) (CON group), P<0.05. The number of cells that migrated through the chamber membrane of KD group (38± 15) was less than that of NC group (77±11, P <0.05) and CON group (69±9, P <0.05). However, MTT assay and FACS revealed that the proliferation of MDA-MB-231/CCL5-siRNA was not different from MDA-MB-231/CCL5-NC and MDA-MB-231 (P>0.05), the proliferation index (PI) of group KD, NC and CON were (0.48±0.02), (0.44±0.05) and (0.47±0.02) respectively. The difference was not statistically significant by multiple comparison (P>0.05). Conclusion CCL5-specific siRNA can specifically suppress the colony formation and migration of human high-matastatic breast cancer cells.     

慢病毒介导CCL5-siRNA对乳腺癌细胞生物学行为的影响

Objective To study the effect of lentivirus-mediated CCL5-RNAi on the biological behaviors of human breast cancer cells. Methods CCL5-specific siRNA gene was synthesized and cloned into the recombinant lentiviral vector, pGCSIL-GFP. Human high-metastatic breast cancer cells, MDA-MB-231, were infected by CCL5-siRNA recombinant lentivirus, which was set as KD group. Cells infected with CCL5-NC was as NC group, and cells cultured was as CON group. The expression of CCL5 mRNA and protein in MDA-MB-231 cells was detected by RT-PCR and western blot, respectively. Cell growth suppression and cell cycle was observed by MTT assay and fluorescence activated cell sorting (FACS). Colony formation and migration ability were determined by colony-rorming assay and Boyden chamber method. Results After infection of CCL5-siRNA recombinant lentivirus, the expression level of CCL5 mRNA and protein in MDA-MB-231 cells as well as the colony formation and migration ability decreased significantly, but cell's proliferation was not affected obviously. Compared with MDA-MB-231 (0.88± 0.15) and MDA-MB-231/CCL5-NC (1.00±0.07) cells, the expression of CCL5 mRNA in MDA-MB-231/ CCL5-siRNA decreased to 0.18±0.03, P<0.01. Compared with MDA-MB-231/CCL5-NC (1.82±0.18) cells, the expression of CCL5 protein in MDA-MB-231/CCL5-siRNA decreased to 0.33±0.13, P <0.01. Colony-forming assay and Boyden chamber method showed that the colony formation and migration ability of MDA-MB-231/CCL5-siRNA decreased markedly (P<0.05). The clone count in KD group was (0.33± 0.10), which was a significant decrease from (0.97±0.09) (NC group) and (1.04±0.07) (CON group), P<0.05. The number of cells that migrated through the chamber membrane of KD group (38± 15) was less than that of NC group (77±11, P <0.05) and CON group (69±9, P <0.05). However, MTT assay and FACS revealed that the proliferation of MDA-MB-231/CCL5-siRNA was not different from MDA-MB-231/CCL5-NC and MDA-MB-231 (P>0.05), the proliferation index (PI) of group KD, NC and CON were (0.48±0.02), (0.44±0.05) and (0.47±0.02) respectively. The difference was not statistically significant by multiple comparison (P>0.05). Conclusion CCL5-specific siRNA can specifically suppress the colony formation and migration of human high-matastatic breast cancer cells.     

阴道穹隆脱垂病人手术方式的选择

目的探讨适宜于阴道穹隆脱垂病人的手术方式。方法回顾性分析2008年7月至2010年12月本院26例阴道穹窿脱垂病人的一般资料、盆腔器官脱垂（POP）．Q分期、发病时间、需再次手术治疗时间、围手术期和随访情况。结果26例患者中因非女性盆底功能障碍（FPFD）行子宫全切术后穹隆脱垂者10例,其前次手术至此次发病时间（115．2±51．67）个月,距再次手术时间（142．8±59．04）个月;因FPFD行传统修复手术后穹隆脱垂者16例,其前次手术至此次发病时间（24．38±13．43）个月,距再次手术时间（62．13±44．51）个月;两组年龄及POP—Q分期比较差异无统计学意义（P〉0．05）,后者较前者复发时间（t=6．75,P〈0．01）和需要再次手术治疗时间（t=3．97,P〈0．01）均明显提前。所有患者均由同一术者成功行Prolift全盆底重建术,手术时间（60．96±7．88）min,失血量（119．23±27．53）ml,无手术副损伤;术后随访治愈率100％,无网片侵蚀裸露发生及病例复发。结论传统手术治疗POP易复发,Prolift全盆底重建术是治疗POP适宜的手术方法,尤其适用于阴道穹窿脱垂的病人,该手术安全可行,复发率低,能更好地修补缺陷、实现结构重建和组织替代,有利于病人康复。     

慢病毒介导CCL5-siRNA对乳腺癌细胞生物学行为的影响

Objective To study the effect of lentivirus-mediated CCL5-RNAi on the biological behaviors of human breast cancer cells. Methods CCL5-specific siRNA gene was synthesized and cloned into the recombinant lentiviral vector, pGCSIL-GFP. Human high-metastatic breast cancer cells, MDA-MB-231, were infected by CCL5-siRNA recombinant lentivirus, which was set as KD group. Cells infected with CCL5-NC was as NC group, and cells cultured was as CON group. The expression of CCL5 mRNA and protein in MDA-MB-231 cells was detected by RT-PCR and western blot, respectively. Cell growth suppression and cell cycle was observed by MTT assay and fluorescence activated cell sorting (FACS). Colony formation and migration ability were determined by colony-rorming assay and Boyden chamber method. Results After infection of CCL5-siRNA recombinant lentivirus, the expression level of CCL5 mRNA and protein in MDA-MB-231 cells as well as the colony formation and migration ability decreased significantly, but cell's proliferation was not affected obviously. Compared with MDA-MB-231 (0.88± 0.15) and MDA-MB-231/CCL5-NC (1.00±0.07) cells, the expression of CCL5 mRNA in MDA-MB-231/ CCL5-siRNA decreased to 0.18±0.03, P<0.01. Compared with MDA-MB-231/CCL5-NC (1.82±0.18) cells, the expression of CCL5 protein in MDA-MB-231/CCL5-siRNA decreased to 0.33±0.13, P <0.01. Colony-forming assay and Boyden chamber method showed that the colony formation and migration ability of MDA-MB-231/CCL5-siRNA decreased markedly (P<0.05). The clone count in KD group was (0.33± 0.10), which was a significant decrease from (0.97±0.09) (NC group) and (1.04±0.07) (CON group), P<0.05. The number of cells that migrated through the chamber membrane of KD group (38± 15) was less than that of NC group (77±11, P <0.05) and CON group (69±9, P <0.05). However, MTT assay and FACS revealed that the proliferation of MDA-MB-231/CCL5-siRNA was not different from MDA-MB-231/CCL5-NC and MDA-MB-231 (P>0.05), the proliferation index (PI) of group KD, NC and CON were (0.48±0.02), (0.44±0.05) and (0.47±0.02) respectively. The difference was not statistically significant by multiple comparison (P>0.05). Conclusion CCL5-specific siRNA can specifically suppress the colony formation and migration of human high-matastatic breast cancer cells.     

碱性成纤维细胞生长因子及宫颈红外线凝结法治疗宫颈糜烂疗效分析

目的　对比分析碱性成纤维细胞生长因子 (bFGF)及宫颈红外线凝结法对宫颈糜烂的治疗效果。方法　 2 0 0 2年 4～ 8月 ,对 72例患者按宫颈糜烂类型的不同分为 3大组 ,每组又再按患者入选序号随机分为治疗组及对照组 ,前者直接使用bFGF ,后者使用宫颈红外线凝结法治疗宫颈糜烂。 1个月后复查 ,观察糜烂面愈合及治疗后阴道出血情况。结果　两种方法治疗单纯型、颗粒型及轻、中度宫颈糜烂 ,疗效差异无显著性意义 (P >0 0 5 ) ;对于乳突型及重度宫颈糜烂 ,红外线凝结法优于bFGF ,疗效差异有显著性意义 (P <0 0 5 )。治疗组无一例发生阴道出血 ,而对照组术后均有不同程度的阴道出血。结论　bFGF治疗单纯型、颗粒型及轻、中度宫颈糜烂与传统的宫颈红外线凝结法比较 ,疗效差异无显著性意义 ,且无发生阴道出血的可能 ;而对于乳突型或重度宫颈糜烂 ,后者仍然占有明显优势     

人CCL5基因RNA干扰慢病毒载体的构建

目的 构建人CCL5基因RNA干扰(RNAi)慢病毒载体.方法 根据人CCL5基因信息,构建4个携带RNAi序列的pGCSIL-GFP质粒,与pHelper 1.0、Helper 2.0质粒一起利用293T细胞进行慢病毒包装.用CCL5 RNAi慢病毒载体感染人宫颈癌细胞(Hela),使用RT-PCR方法验证其干扰效率.结果 4个靶点中有3个靶点(a1、a2、a3)在Hela细胞上对CCL5基因的表达都有非常显著的敲减效果,敲减效率均达到95%以上.结论 构建的CCL5 RNAi慢病毒载体在Hela细胞中有较高的敲减效率,提示RNAi技术能够使细胞CCL5基因沉默.