非X线透视下用DHS内固定在治疗股骨转子间骨折的体会

文章阐述了在非X线透视下用DHS内固定治疗股骨转子间骨折67例的临床体会，即充分利用DHS钉在设计上所具有的生物力学性能及其仿生学形态特点，在没有X线透视下行内固定术。在讨论中重点提出了在手术中应注意的问题及其解决办法。     

Comparison of the expression profile of apoptosis-associated genes in rheumatoid arthritis and osteoarthritis

The purpose of this study was to employ microarray analysis to evaluate differential gene expression in synovial tissue samples obtained from patients with rheumatoid arthritis (RA) or osteoarthritis (OA) to study the expression profile of apoptosis-associated genes in these tissues. Four samples were obtained from RA-affected patients and three from osteoarthritis patients. After total RNA was extracted from synovial tissue, the RNA was processed using two-cycle target labeling, followed by hybridization and scanning procedure. The GeneChip Human Genome U133 Plus 2.0 containing 900471 gene loci was used and eight genes associated with apoptosis were identified with a selected p value <0.05 and a twofold change in expression in rheumatoid samples compared to osteoarthritis tissues. Anti-apoptotic genes were generally upregulated whereas apoptotic genes were downregulated suggesting that these genes may play a role in the pathogenesis of RA. Furthermore, these genes may serve as novel therapeutic targets for the treatment of RA.     

上海市杨浦区市东医院2008-2010年临床分离菌菌群分布及其耐药性

目的:调查上海市杨浦区市东医院2008-2010年常见临床分离菌的菌群分布和耐药性。方法:收集本院2008-2010年临床送检标本中非重复菌株的药敏试验资料,用WHONET5.5软件进行数据分析。结果:共分离病原菌9852株,鲍曼不动杆菌、金黄色葡萄球菌和屎肠球菌的检出率明显上升(P<0.01)。56.9%的大肠杆菌和17.1%的肺炎克雷伯菌产超广谱β-内酰胺酶(ESBLs)。鲍曼不动杆菌耐药形势日趋严重,2010年该菌对美罗培南的耐药率为39.2%,对亚胺培南的耐药率为30.7%。葡萄球菌对苯唑西林的耐药率高达78.1%～93.6%。屎肠球菌的耐药率高于粪肠球菌。2010年检出2株耐万古霉素和利奈唑胺的溶血葡萄球菌,以及2株耐万古霉素的屎肠球菌。结论:本院临床分离菌耐药情况日趋严重,并于2010年出现多耐药菌株和泛耐药菌株,增加了临床抗菌治疗的难度。     

琦云安乐片与劳拉西泮治疗广泛性焦虑症临床对照研究

目的 验证安乐片与劳拉西泮治疗广泛性焦虑症的临床疗效及副反应.方法 采用随机分组的方法,将符合CCMD-3诊断标准的60例广泛性焦虑症分为安乐片组（30例）、劳拉西泮（30例）,疗程4周,用焦虑自评量表（SAS）,Hamilton焦虑量表（HAMA）和副反应量表（TESS）评定疗效和副反应.结果 安乐片与劳拉西泮疗效相当（P＞0.05）.治疗第4周两组SAS、HAMA及HAMA因子分的减分比较有非常显著性差异（P＜0.01）,两者副反应相当,均较轻微,不影响治疗效果.结论 琦云安乐片治疗广泛性焦虑症有效,副反应轻微.     

Design and in vivo evaluation of an indapamide transdermal patch

The aim of the present study was to develop and evaluate a novel drug-in-adhesive transdermal patch system for indapamide. Initial in vitro experiments were conducted to optimize formulation parameters prior to transdermal delivery in rats. The effects of the type of adhesive and the content of permeation enhancers on indapamide transport across excised rat skin were evaluated. The results indicated that DURO-TAK^® adhesive 87-2852 is a suitable and compatible polymer for the development of transdermal drug delivery systems for indapamide. The final formulation contained 4% N-dodecylazepan-2-one, 6% l-menthol and 3% isopropyl myristate. For in vivo studies patch systems were administered transdermally to rats while orally administered indapamide in suspension was used as a control. The PK parameters, such as the maximum blood concentration (C_max), time to reach the peak blood concentration (T_max), mean residence time (MRT), area under the curve (AUC_0–t) and terminal elimination half-life (T_1/2) were significantly (p < 0.05) different following transdermal administration compared with oral administration. In contrast to oral delivery, a sustained activity was observed over a period of 48 h after transdermal administration. This sustained activity was due to the controlled release of drug into the systemic circulation following transdermal administration.     

帕罗西汀并认知行为疗法治疗惊恐障碍临床对照研究

①目的评价帕罗西汀并认知行为疗法治疗惊恐障碍的临床效果及帕罗西汀副作用。②方法将符合CCMD-3诊断标准的60例惊恐障碍病人随机分成研究组和对照组,两组均应用帕罗西汀20mg／d,研究组同时行认知行为治疗,连续治疗6个月,采用焦虑自评量表（SAS）、汉密尔顿焦虑量表（HAMA）和副作用量表（TESS）评定疗效和药物副作用。③结果帕罗西汀并认知行为治疗后病人SAS、HAMA评分及其因子分和减分率与单用帕罗西汀比较均有统计学意义（t=2．12～7．45,P〈0．05）;帕罗西汀副作用轻微。④结论帕罗西汀并认知行为疗法治疗惊恐障碍安全有效。     

原发性肝癌患者血清中庚型肝炎病毒核酸的检测分析

为了解庚型肝炎病毒（ＨＧＶ）在原发性肝癌患者中的感染状况，本文对１４５例原发性肝癌患者血清进行了分析。应用逆转录多聚酶链反应（ＲＴ－ＰＣＲ）技术扩增庚型肝炎病毒基因，采用蛋白酶Ｋ裂解法提取血清中ＨＧＶ－ＲＮＡ，逆转录为ｃＤＮＡ后进行巢式扩增，获得２３８ｂｐ的特异性片段。用此方法对１４５例原发性肝癌（ＨＣＣ）患者血清标本进行检测，结果发现２１例ＨＧＶ－ＲＮＡ阳性（１４．５％），均为男性患者。     

十二指肠球后溃疡穿孔的处理

目的探讨十二指肠球后溃疡穿孔临床上正确的围手术期处理办法。方法回顾性分析我院1998年5月至2004年11月6例十二指肠球后溃疡穿孔的临床症状、穿孔部位、手术方式、治疗结果和随访情况。结果6例患者均为溃疡穿孔，分别行急诊手术，术后1例死亡，1例转院，4例完全治愈。结论术中根据患者条件选择合理的手术方式，重视术后引流，早期肠内营养是改善患者预后的关键。     

胰岛素抵抗与陈旧性心肌梗死患者血脂浓度的关系

目的探讨胰岛素抵抗与冠心病患者血脂浓度间关系。方法收集55例陈旧性心肌梗死患者及47例对照组。用血浆空腹血糖浓度（FPG）×血浆空腹胰岛素浓度（FPI）÷22．5计算胰岛素抵抗（IR）。用常规方法测定血脂浓度。结果陈旧性心肌梗死患者FPI、IR水平较对照组无显著统计学差异（P＞0．05）。且IR与血浆总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL－C）及甘油三酯（TG）浓度均无显著统计学相关（P＞0．05）。结论胰岛素抵抗与血脂改变及冠心病可能无联系。     

他汀类药物对冠心病患者影响的对比分析

目的研究冠心病患者对他汀类药物治疗依从性和对预后的影响。方法206例住院冠心病患者，均行冠状动脉造影术（冠脉造影），分为他汀组（包括行PTCA＋支架术及未行血运重建治疗但LDL-C〉2．6mmol／L的患者）和非他汀组（血管狭窄为50％～70％且LDL-C〈2．6mol／L的患者）。结果平均随访1．2年后他汀组患者出院后服药率占62％，至少进行1次血脂复查者占60％，LDL-C达标率为32．4％，未用他汀组患者出院后以上指标分别为24．5％、41．6％、40．8％。二者对心血管事件影响差异无显著性。结论院内予以他汀类药物治疗可提高患者的依从性，服用他汀类药物影响高危冠心病患者的心血管事件。