经尿道切除综合征的实验研究

本文通过经尿道切除综合征(TURS)的实验研究发现:①冲洗液吸收完时,血钠下降最为明显,而它的恢复与血浆甘露醇的消除在时相上并不一致。低钠的影响大且持续的时间长。②冲洗液吸收后,血钾逐渐升高。高钾血症是实验动物死亡的主要原因之一。③等渗的甘露醇冲洗液吸收,血浆渗透压不发生改变。④死亡兔肺重量明显增加,呈肺水肿表现。无脑水肿存在。④根据动物实验推算,经尿道前列腺切除的患者,术中短时间內吸收38ml/kg以上的冲洗液,有发生TURS的可能。上述结果对TURS病理生理改变的认识及其防治提供了实验依据。     

卵巢上次性肿瘤ER、TNF表达及相互关系

用肿瘤坏死因子（TNF）、雌激素受体（ER）的单克隆抗体对46例卵巢上皮肿瘤及10例正常卵巢新鲜组织的冰冻切片，进行TNF、ER免疫组化ABC法测定。结果：卵巢囊腺癌TNF及ER表达的阳性率高于卵巢囊腺瘤；临床分期越晚，TNF及ER表达强度越高。表明卵巢上皮性肿瘤TNF及ER表达与其组织学类型及临床分期有关。提示TNF在卵巢癌中的表达可预测预后，ER的表达可指导卵巢肿瘤内分泌治疗。     

脑出血致多脏器功能失常综合征的多因素相关分析

探讨多脏器功能失常综合征（Multipleorgandysfunctionsyndrome，MODS）的病因及高危因素。对229例老年脑出血患者进行了回顾性调查，其中MODS患者97例，与132例无MODS的脑出血患者的临床资料比较，结果表明：原发病的危重程度和全身炎症反应综合征（Systemicinflammatoryresponsesyndrome，SIRS）与MODS的发生密切相关（P＜0．01）。MODS的高危因素的单因素分析均有统计意义（P＜0．05）。作者认为除了脑出血本身的严重程度外，治疗不当、老年患者并存躯体疾病也是激发SIRS和MODS的重要因素。     

Viewpoints of adults with and without Autism Spectrum Disorders on public transport

BackgroundPublic transport is low cost, allows for independence, and facilitates engagement and participation for non-drivers. However, the viewpoints of individuals with cognitive disabilities are rarely considered. In Australia, the prevalence of Autism Spectrum Disorders (ASD) is approximately 1% and increasing. Many individuals with ASD do not possess a driver’s licence, indicating that access to public transport is crucial for their independence. However, at present, there is no research on the opinions of adults with ASD on public transport.AimTo identify the viewpoints of adults with ASD regarding the barriers and facilitators of public transport usage and their transportation preferences, and to contrast these against the viewpoints of neurotypical adults.MethodsQ method was used to identify the viewpoints of both participant groups on public transport. Participants consisted of 55 adults with a diagnosis of ASD and a contrast group of 57 neurotypical adults. Both groups completed a Q sort task which took place in either Perth or Melbourne, Australia.ResultsThe most prominent viewpoint indicated that both groups preferred to use public transport over driving and believed that it supported their independence. This viewpoint also indicated that both groups preferred to use electronic ticketing when using public transport. Interestingly, the second most prominent viewpoint indicated that both groups preferred to drive themselves by private car rather than use public transport.DiscussionIt appears that the viewpoints of adults with and without ASD regarding public transportation were largely similar. However, questions arose about whether the preference for public transport in the ASD group may be more a result of difficulties obtaining a driving licence than a deliberate choice. The only barrier specified by adults with ASD related to crowding on public transport. Safety and convenience in relation to location and timing of services were barriers reported by neurotypical adults.     

肠易激综合征模型大鼠的大脑和消化道中5-HT的表达与病理作用

目的检测腹泻型肠易激综合征(D-IBS)和便秘型肠易激综合征(C-IBS)模型大鼠大脑及肠道组织中的5-HT分泌表达的差异,探索5-HT在IBS发病中的作用。方法采用冰醋酸加束缚应激的方法造成D-IBS动物模型,冰水灌胃法造成C-IBS动物模型,并鉴定模型。用免疫组化方法检测各组大鼠海马、下丘脑、空肠、回肠、近端结肠、远端结肠组织中5-HT阳性细胞并进行分析。结果IBS模型经鉴定符合其病理特征。结肠组织分析显示各组大鼠均无明显炎性表现。D-IBS组海马、下丘脑、空肠、回肠、近端结肠、远端结肠5-HT阳性细胞数显著多于对照组(P<0.05),并且空肠、回肠阳性细胞数也多于C-IBS组(P<0.05);C-IBS组海马、下丘脑、回肠、近端结肠、远端结肠阳性细胞显著多于对照组(P<0.05)。结论IBS模型大鼠大脑及肠道中5-HT的增加与IBS发病相关,5-HT在IBS不同亚型发病机制中的作用可能与其不同受体在大脑和消化道的表达分布差异有一定的关系。     

血液净化对肾综合征出血热炎症介质的清除作用

目的　通过观察连续性肾替代治疗 (CRRT)对肾病综合征出血热 (HFRS)患者肿瘤坏死因子α(TNF α)、白介素 6(IL 6 )及内皮素 1(ET 1)的清除作用 ,探讨炎症介质在HFRS中的作用。方法　将诊断为HFRS的中型及以上类型患者 4 0例随机分为两组 :CVVH组 2 0例行CVVH ,HD组 2 0例行HD。用ELISA法检测TNF α和IL 6浓度 ,放射免疫法测定ET 1浓度。结果　①CVVH组及HD组少尿天数 (3.0± 2 .1,6 .0± 3.4 )、并发症发生率 (2 5 % ,4 0 % )及病死率 (15 % ,2 5 % )差异均有显著性 (P <0 .0 1)。②两组治疗前后血肌酐和尿素氮下降有显著性差异 (P <0 .0 1)。③CVVH组治疗后血中TNF α、IL 6和ET 1均较治疗前明显降低 ,差异均有显著性意义 (P均 <0 .0 1) ;HD组治疗前后血中TNF α、IL 6和ET 1无显著性差异 (P >0 .0 5 )。④CVVH组滤出液中可持续检测到IL 6及ET 1,未检测到TNF α。透出液中未检测到上述炎症介质。结论　连续性血液净化治疗可清除炎症介质 ,改善HFRS的病理生理过程 ,改善肾功能和预后 ,减少并发症 ,降低病死率 ,是治疗HFRS的最佳方法     

Fas相关磷酸酯酶-1在卵巢癌中的表达及意义

目的　探讨Fas相关磷酸酯酶 1(FAP 1)在卵巢癌发病中的作用。方法　采用免疫组化链霉菌抗生物素蛋白 过氧化物酶染色法 (SP法 )检测 5 2例卵巢癌及 15例卵巢良性肿瘤组织标本中FAP 1蛋白的表达水平 ,设正常卵巢组织为对照组 (10例 )。结果　FAP 1蛋白在正常卵巢中未见表达 ,良性肿瘤中的表达率为 2 6 % ,而在交界性肿瘤与恶性肿瘤中的阳性表达率分别为 6 9%和 77% ,与前两者相比差异有显著性 (P <0 .0 1) ,而后两组间无显著性差异 (P >0 .0 5 )。FAP 1的表达与卵巢癌的临床分期、病理分级相关 (FIGOⅢ～Ⅳ期高于Ⅰ～Ⅱ期 ,病理分级Ⅱ～Ⅲ级高于Ⅰ级 ,P <0 .0 5 ) ,而与组织学类型和转移性无明显相关性。结论　FAP 1在卵巢癌组织中有广泛表达 ,且在临床分期晚和病理分级高的组织中表达增高 ,可能对于卵巢癌的发病机制及恶变程度具有重要意义     

多囊卵巢综合征患者肾素-血管紧张素与子宫卵巢血流动力学的相关性

目的　探讨多囊卵巢综合征 (PCOS)患者肾素 血管紧张素系统 (RAS)与子宫及卵巢血流动力学的相关性。方法　选择多囊卵巢综合征患者和正常对照组各 4 0例 ,采用彩色多普勒超声仪 ,经阴道测定子宫动脉和卵巢基质血流阻力指数 (RI)和搏动指数 (PI) ,放射免疫法测定血浆肾素活性 (PRA)、血管紧张素Ⅱ (AngⅡ )以及血清性激素浓度。结果　黄体生成素、睾酮、PRA和AngⅡ浓度、子宫阻力指数和子宫搏动指数、子宫内膜厚度、卵泡数目、卵巢容积、卵巢髓质容积显示 :PCOS组大于对照组 (P <0 .0 5 ) ;卵巢阻力指数以及卵巢搏动指数 ,PCOS组小于对照组 (P <0 .0 5 ) ;PCOS组AngⅡ与睾酮、子宫内膜厚度、卵泡数目、子宫阻力指数和子宫搏动指数呈正相关 (r =0 .4 2、0 .34、0 .2 7、0 .4 5、0 .4 5 ,P <0 .0 5 ) ,AngⅡ与卵巢阻力指数和卵巢搏动指数呈负相关 (r =- 0 .32、- 0 .34,P <0 .0 5 )。结论　①PCOS患者存在肾素 血管紧张素 雄激素级联亢进现象 ;②RAS亢进可能参与PCOS生殖器官血流动力学变化和生育障碍的发生。     

The clinical role of increase of serum matrix metalloproteinase-8 concentration in patients with acute coronary syndrome

Objective To study the clinical role of the variation of serum matrix metalloproteinase-8 (MMP-8)concentration in patients with acute coronary syndrome (ACS). Methods ELISA method was adopted to detect serum MMP-8 concentration and to observe concentration's differences and features among 80 selected ACS cases (43 acute myocardial infarction and 37 unstable angina pectoris), 43 stable angina pectoris (SAP) cases and 37 control cases.And meanwhile the atherosclerosis risk factors of each case, such as age, sex, hypertension, body mass index, smoking,family history, diabetes, and hyperlipidemia were collected and analyzed as a whole. Results First, serum MMP-8 concentration reached the highest point in ACS, and there was significant difference between SAP and control groups (P<0.01). Second, sermn MMP-8 in AMI was much higher than that in UAP with significant difference (P<0.01). There was no difference between UAP and SAP groups (P>0.05). Third, Logistic regression analysis revealed that serum MMP-8 concentration might be the indicator of ACS (B=4.493, P=0.000), particularly, that of AMI (B=9.961,P=0.000). Fourth, linear correlation and linear regression analysis found that only neutrophil was likely to influence serum MMP-8 concentration (r=0.274, P=0.001). Fifth, in the diagnosis of ACS, the area under ROC curve of MMP-8 was 0.785, the sensitivity and specificity were 68.6% and 76.5%, respectively. Conclusion ① Serum MMP-8 concentration has close relationship with the occurrence of ACS, particularly with AMI;② Serum MMP-8 concentration may be one of the predicting indicators of ACS and particularly of AMI;③ Neutrophil may be correlated with serum MMP-8 concentration;④ MMP-8 is of somewhat valuable in diagnosing ACS.     

来曲唑与克罗米酚在诱导多囊卵巢综合征患者排卵中的作用

目的探讨来曲唑(LE)与克罗米酚(CC)在诱导多囊卵巢综合征(PCOS)患者排卵中的作用。方法选择在我院就诊的PCOS排卵障碍患者46例(58个周期),随机分为LE组和CC组,分别用LE、CC进行促排卵治疗,比较两组发育及成熟卵泡数、排卵数、平均卵泡直径、子宫内膜厚度及形态、排卵率、黄体化卵泡未破裂(LUF)的发生率及妊娠率。结果CC组发育和成熟卵泡数、注射绒毛膜促性腺激素(hCG)日及排卵后1周血清雌二醇浓度、LUF发生率较LE组显著升高(P<0.05),而注射hCG日子宫内膜厚度、子宫内膜三线征阳性率(A型%)显著低于LE组(P<0.05);两组血清孕酮浓度、排卵率及妊娠率无显著性差异。结论LE适合PCOS患者的诱导排卵治疗,有望作为PCOS患者的一线促排卵药物。