神经内科老年患者医院获得性肺炎高危因素分析

目的为前瞻性医院感染控制提供依据。方法对2004~2005年,神经内科住院患者发生医院获得性肺炎(HAP)的病历资料进行回顾性的分析。结果两年期间住院患者发生医院感染109例,医院感染145例次;医院HAP感染77例次,其中呼吸机相关性肺炎(VAP)感染32例次,感染率为22.1%。结论神经内科HAP感染可由多方面的因素所致,但在治疗原发病的基础上,及时的进行医院感染前瞻性监测,实施有效的预防医院感染的措施,是控制HAP的关键。     

C-反应蛋白测定用于医院获得性肺炎诊疗与预后的评价

目的测定C-反应蛋白(CRP)水平并与体温、白细胞计数进行比较,观察其用于医院获得性肺炎(HAP)诊疗及预后的价值。方法每天测定患者的体温、白细胞计数和CRP浓度,择日进行继发器官衰竭评分(SOFA);观察患者治愈、病情稳定转出重症监护病房(ICU)或死亡;根据预后分为存活组和死亡组进行回顾性分析。结果抗菌治疗后CRP比率有4种反应模式:快反应、慢反应、无反应、双相反应;快反应和大部分慢反应的患者存活,无反应和双相反应的患者全部死亡;差异有统计学意义。结论CRP比率的变化与HAP病情的变化相关,CRP比率快速下降预示病情改善;CRP比率无反应或双相反应时,提示预后不良。     

烧伤科成人院内获得性肺炎危险因素的研究

目的了解烧伤科成人院内获得性肺炎的危险因素,为临床治疗提供参考资料。方法对2001年1月～2010年12月于本院烧伤科患者中诊断为院内获得性肺炎者运用统计学方法进行回顾性分析。结果老年患者比年轻患者院内获得性肺炎感染率高,差异有统计学意义(χ2=28.3,P<0.05);重度及特重烧伤患者较轻中度烧伤患者院内获得性肺炎感染率高,差异有统计学意义(χ2=123.1,P<0.05);有吸入性损伤者较无吸入性损伤者院内获得性肺炎感染率高,差异有统计学意义(χ2=116.6,P<0.05);气管切开及机械通气者较未行气管切开者院内获得性肺炎感染率高,差异有统计学意义(χ2=51.2,P<0.05);女性较男性院内获得性肺炎感染率低,但差异无统计学意义(χ2=0.43,P>0.05)。痰培养显示,院内获得性肺炎主要有2种或2种以上细菌混合感染引起,革兰阴性杆菌是主要的致病菌。创面细菌迁移和胃肠-肺感染途径是院内获得性肺炎的重要感染途径。结论烧伤科感染院内获得性肺炎危险因素有年龄、烧伤程度、吸入性损伤、气管切开,与性别无关。对胃肠道反流和创面处理上需要引起足够的重视,并尽量避免交叉感染。     

Regulation of intracellular HAP1 trafficking

A number of proteins are known to interact with huntingtin (htt), the Huntington's disease (HD) protein. Understanding the function of these htt-associated proteins could help elucidate the pathogenesis of HD and the role that htt plays in the disease process. The present review focuses on one such protein, huntingtin-associated protein 1 (HAP1), which has proved to be involved in intracellular trafficking. Unlike huntingtin, which is expressed ubiquitously throughout the brain and body, HAP1 is enriched in neurons, suggesting that its dysfunction could contribute to the selective neuropathology in HD. HAP1 binds microtubule-dependent transporters that engage anterograde or retrograde transport and also associates with a variety of organelles and membrane receptors. This raises the interesting issue of how the HAP1 trafficking function is regulated. We discuss recent evidence for the involvement of HAP1 in intracellular trafficking as well as potential mechanisms that may regulate its trafficking.     

Measurement of hydroxyapatite density and Knoop hardness in sound human enamel and a correlational analysis between them

Objective

The aim of this study was to measure the hydroxyapatite (HAP) density and Knoop hardness (KHN) of enamel slabs and to analyse the relationship between them.

Design

Twenty enamel slabs (10 lingual sides and 10 buccal sides) were prepared and scanned with micro-CT. Tomographic images of each slab from dental cusp to dentinoenamel junction (DEJ) were reconstructed. On these three-dimensional (3D) images, regions of interest (ROIs) were defined at an interval of 50 μm, and the HAP density for each ROI was calculated. Then the polished surfaces were indented from cusp to DEJ at intervals of 50 μm with a Knoop indenter. Finally, the data were analysed with one-way ANOVA, Student's t-test, and linear regression analysis.

Results

The HAP density and KHN decreased from the dental cusp to DEJ. Both HAP density and KHN in the outer-layer enamel were significantly higher than those in the middle- or inner-layer enamel (P < 0.05). The HAP density showed no significant difference between the buccal and lingual sides for enamel in the outer, middle and inner layers, respectively (P > 0.05). The KHN in the outer-layer enamel of the lingual sides was significantly lower than that of the buccal sides (P < 0.05); there was no significant difference between the lingual and buccal sides in the middle or inner layer. Linear regression analysis revealed a linear relationship between the mean KHN and the mean HAP density (r = 0.87).

Conclusion

Both HAP density and KHN decrease simultaneously from dental cusp to DEJ, and the two properties are highly correlated.     

HAP/TZP复合材料的凝胶注模成型研究

多相材料凝胶注模成型时的关键问题是制备出混合均匀的稳定悬浮液，本实验主要研究了pH值、分散剂加入量对于悬浮液稳定性的影响，初步探索了羟基磷灰石（HAP）／氧化锆（TZP）复相陶瓷的凝胶注模成型条件。结果显示：TZP在复合材料中分散均匀，并对基体起到一定的增强作用；其增韧机制主要是纳米颗粒细化晶粒增韧和相变增韧。     

HAP1基因对人乳腺癌MDA-MB-231细胞裸鼠移植瘤放射敏感性的影响

[目的]研究HAP1基因对人乳腺癌MDA-MB-231细胞裸鼠移植瘤放射敏感性的影响及作用机制.[方法]取对数生长期已构建好的MDA-MB-23 1/HAP1和MDA-MB-231/Pb稳转细胞株(5×106),接种于5周龄BALB/C雄性裸鼠左腹股沟部皮下,建立人乳腺癌裸鼠移植瘤模型,21d裸鼠皮下肿瘤长径到达0.6～0.9cm时,分为4组(n=5):MDA-MB-231/Pb组,MDA-MB-231/HAP1组,MDA-MB-231/Pb+放射组和MDA-MB-231/HAP1+放射组.放射组在第21d给予5Gy X线照射一次后继续饲养3周左右.期间每隔4d测量1次肿瘤的长径及短径,计算肿瘤体积.第6周时处死各组裸鼠统计瘤重.免疫组织化学方法分析Cleaved-caspase-3和Cleaved-caspase-9表达,TUNEL分析细胞凋亡.[结果]MDA-MB-231/HAP1+放射组裸鼠肿瘤生长明显迟缓,平均体积小于其他3组(P均＜0.01),MDA-MB-231/HAP1+放射组平均瘤重明显小于其他3组(P均＜0.01).TUNEL凋亡实验结果表明,MDA-MB-231/Pb组细胞平均凋亡率为3.27％ ±1.51％,MDA-MB-231/HAP1组为36.77％ ±3.78％,MDA-MB-231/Pb+放射组为46.27％±2.98％,MDA-MB-231/HAP1+放射组为83.07％±0.21％,MDA-MB-231/HAP1+放射组凋亡率明显高于其他3组(P＜0.05).免疫组织化学染色评分结果显示,MDA-MB-231/Pb组,MDA-MB-23 1/HAP1组,MDA-MB-231/Pb+放射组,MDA-MB-231/HAP1+放射组中凋亡蛋白Cleaved-caspase-3平均积分分别为1.67±0.47,6.00±1.63,7.00±1.41和14.67±1.89,凋亡蛋白Cleaved-caspase-9平均积分分别为2.00±0.82,4.67±0.94,5.33±0.94和11.00±1.41;Cleavedcaspase 3和cleaved-caspase 9在MDA-MB-231/HAP11+放射组中的水平明显高于其他3组(P＜0.05).[结论] HAP1基因可能通过调控肿瘤细胞的凋亡来增强人乳腺癌细胞对放射治疗的敏感性.     

急性胰腺炎床旁严重度指数和无害性胰腺炎评分对急性胰腺炎预后的评估价值

目的 评价急性胰腺炎床旁严重度指数(BISAP)与无害性胰腺炎评分(HAPS)评估急性胰腺炎(AP)预后的价值.方法 回顾性分析2003年1月至2010年12月中山大学附属第一医院收治的442例AP患者资料,计算BISAP和HAP评分,绘制受试者工作特征(ROC)曲线并计算曲线下面积(AUC),分析它们对AP严重度、局部并发症、器官功能不全、预后的评估价值,并与传统的Ranson评分进行比较.结果 442例AP患者中,73例(16.5％)为重症急性胰腺炎(SAP).BISAP评分预测SAP、局部并发症、器官功能不全、病死结局的AUC分别是0.90(95％ CI:0.86～ 0.93)、0.82(95％ CI:0.76～0.89)、0.93(95％ CI:0.89 ～0.96)、0.93(95％ CI:0.87 ～0.98).BISAP评分和Ranson评分上述4项指标的AUC差异无统计学意义.HAP评分预测轻症急性胰腺炎(MAP)的特异性为85％,阳性预测值95％,AUC为0.73(95％CI:0.67 ～ 0.79).将BISAP和HAP评分相结合,2种评分均异常的患者发生不良结局的风险逐渐升高.结论 BISAP评分对AP预后的评估价值与Ranson评分相当,但更为简便.HAP评分能简单且准确地预测MAP的预后,BISAP和HAP评分相结合有助于更好地判断AP患者的预后.     

The inhibitory effects of ATP,ADP, and AMP on the rate of dissolution of calcium hydroxyapatite

Summary ATP is as effective as inorganic pyrophosphate in retarding the rate of dissolution of calcium hydroxyapatite at pH 7, ADP is less effective, and AMP is without effect. The inhibition is due to the adsorption of ATP and ADP units on the crystal surface.