目的 观察HB13对SD大鼠的一般生殖毒性。方法 SD大鼠,雌雄各100只,分为低、中、高剂量组(20、40和80 mg/(kg·d))和对照组(0.5%羧甲基纤维素钠溶液),每组25只。雄鼠于交配前28 d给药,雌鼠于交配前14天给药,给药至妊娠第7天。雄鼠交配后处死,孕鼠于妊娠第14天颈椎脱臼处死,观察HB13对雌雄鼠一般情况、生育力和胚胎发育的影响。结果 与对照组相比,HB13高、中剂量组雄鼠给药期体重减轻,睾丸系数及附睾系数增大,异常精子率升高;高剂量组还使雄鼠生育力降低。给予高、中剂量HB13的雌鼠妊娠后体重较对照组减轻,着床后丢失率增高,吸收胎数增加,活胎数减少,连胎子宫重降低;高剂量组HB13还使雌鼠生育率及着床数降低,着床前丢失率升高。结论 HB13低剂量对雌、雄性大鼠无一般生殖毒性;中剂量对孕鼠早期胚胎发育有明显干扰作用;高剂量对雌、雄大鼠生育力有显著降低作用并且对早期胚胎发育有明显干扰作用。

Objective To study the general reproductive toxicity of HB13 in SD rats. Methods SD rats, 100 females and 100 males, were divided into low, medium and high dose groups 20, 40 and 80 mg/(kg·d) and the control group (0.5% CMC-Na), The rats were given HB13 for 28 days in male rats and 14 days in female rats respectively before mating, and then mated. The HB13 treatment continued until the 7th day of pregnancy. When the female rats were confirmed pregnant, the male rats were executed and the female rats were executed on the 14th day of pregnancy. Then we can observe the effect of HB13 on fertility and embryonic development in rats. Results Compared with the control group, the body weight of medium, high dose group reduced significantly, the coefficient of testicular and epididymis, abnormal sperm rate increased significantly. High dose group of HB13 also made the fertilityof male rats decline; The body weight, live births uterus weight (including the fetus) of pregnant rats in high and medium group decreased significantly. At the same time, the rate of lost oosperm and absorbed embryo increased. The high dose group of HB13 can also reduce the fertility of female rats. Conclusion The low dose group of HB13 didn't have general reproductive toxicity in rats, the medium dose group impaired early embryonic development, but the high dose group can significantly reduce the fertility of both male and female rats, and can impair the development of embryonic.

目的 探讨年轻恶性肿瘤化疗女性的发病情况及保留生育功能和卵巢功能的意义。方法 回顾性分析和总结在我院行化疗的17～40岁年轻恶性肿瘤女性患者的年龄、肿瘤类别、构成等临床资料。结果 5年间在我院化疗的1261例女性恶性肿瘤患者中,年龄15～40岁者共786例(占62.3％),其中乳腺癌355例、大肠癌89例、白血病80例、宫颈癌67例、卵巢癌46例、恶性淋巴瘤39例,胃癌38例,肺癌30例,肝癌18例。15～25岁年龄段的女性恶性肿瘤化疗以白血病和卵巢癌为主。随年龄增长,大部分女性恶性肿瘤化疗的发生率增高。结论 15～40岁年轻恶性肿瘤化疗女性中乳腺癌占首位,其次为大肠癌、白血病和宫颈癌。保留年轻患者卵巢功能和生育功能的保守治疗具有重要意义。

Objective To analyze the clinical characteristics of malignant tumor in young women receiving chemotherapy aged from 15 to 40 and investigate the role of conservative treatment. Methods The clinical data of female aged from15 to 40 years old who were received chemotherapy in our hospital between 2010 and 2014 were retrospectively analyzed. Results 786 cases were identified from 1261 cases of malignant tumor receiving chemotherapy. Including 355 cases of breast cancer,89 cases of colorectal cancer,80 cases of leukemia,67 cases of cervical carcinoma,46 cases of ovarian cancer,39 cases of lymphoma,38 cases of gastric cancer,30 cases of lung cancer and 18 cases of liver cancer. Leukemia and ovarian cancer is the most common malignant tumor in young female between 15 to 25 years old. The cases of malignant tumor receiving chemotherapy increased with increasing age. Conclusion Breast cancer is the most common malignant tumor in young female receiving chemotherapy, followed by colorectal cancer, leukemia, and cervical carcinoma. It is very important to conserve young women's ovary function and fertility function.

目的 探讨彩色多普勒超声在无精子症患者睾丸穿刺活检中的应用价值。方法 回顾性分析2012年11月—2015年2月在我科诊断为无精子症的53例患者的病例资料。所有患者进行常规阴囊超声检查,采用频谱多普勒检测睾丸动脉(TA)、睾丸内动脉(ITA)的收缩期最大速度(PSV)、舒张末期速度(EDV)和阻力指数(RI)。采用彩色多普勒超声观察睾丸内的血管分布及其数目,并进行半定量评分。所有患者进行睾丸穿刺活检并进行Johnsen评分。结果 47例患者诊断为梗阻性无精子症(OA),6例患者诊断为非梗阻性无精子症(NOA)。0A组睾丸的平均体积(15.3±3.6) mL,NOA组睾丸的平均体积(7.1±2.8) mL,差异有统计学意义(P＜0.01);OA组与NOA组患者睾丸的血流参数(PSV、EDV、RI) 结果有统计学意义(P＜0.05);OA组与NOA组睾丸内血管半定量分级有的差异,其差异有统计学意义(P＜0.01)。结论 彩色多普勒超声检查对睾丸生精功能有很好的预测作用,可作为鉴别OA患者和NOA患者的指标。

Objective To explore the application value of color Doppler ultrasound in patients with azoospermia who underwent testicular needle biopsy. Methods Retrospective analysed the clinical data of 53 cases patients with azoospermia from 2012 November to 2015 February in our department.All patients underwent routine scrotal ultrasonography, to detecte the peak systolic velocity (PSV), end diastolic velocity (EDV) and resistance index (RI) of testicular artery (TA)and intratesticular artery (ITA)with spectral Doppler ultrasound. Color Doppler ultrasound was used to observe the distribution and the number of blood vessels in the testicle, and semi quantitative score. All patients underwent testicular biopsy and Johnsen score. Results 47 patients were diagnosed as obstructive azoospermia(OA), 6 patients were diagnosed as non obstructive azoospermia(NOA). The average volume of testis was (15.3±3.6)mL in 0A group. The average volume of testis was (7.1±2.8) mL in N0A group.There was significant difference (P<0.01). The blood flow parameters(PSV, EDV, RI) results between OA group and NOA group have obvious difference,the difference was statistically significant (P<0.05). The semi quantitative classification of testicular vessels between OA group and NOA group have obvious difference,the difference was statistically significant (P< 0.01). Conclusion Color Doppler ultrasound is a good predictor of testicular spermatogenic function, can be used as the identification index of patients with OA and patients with NOA.

目的 探讨脑钠肽(BNP)在协助判断肺结核合并呼吸衰竭疗效及预后的价值。方法 2013年1月—2014年12月我院收治初治菌阳肺结核合并呼衰共81例,分别在抗结核、呼衰治疗前及2 周末行BNP、动脉血气分析及胸部X线检查;按住院号对应随机数字表随机抽取我院同期初治菌阳肺结核无合并呼衰104例作为对照组,采集两组数据进行回顾性病例对照研究。结果 肺结核合并呼衰BNP高于单纯肺结核11.4倍(1115.11 pg/mL比97.60 pg/mL),全肺结核高于非全肺结核3.4倍(1549.82 pg/mL比449.47 pg/mL)。治疗前BNP与PaO₂、SaO₂和pH值呈负相关,与PaCO₂呈正相关,治疗后两者无相关性。2周末 BNP是治疗前0.57倍(632.41 pg/mL比1115.11 pg/mL),死亡组高于存活组8.7倍(3119.63 pg/mL比359.84 pg/mL)。结论 肺结核合并呼衰BNP升高,治疗后随病情好转持续下降,有可能成为协助判断疗效及估测预后的指标之一。

Objective Discussion about value of brain natriuretic peptide (BNP) in helping to determine the efficacy and prognostic of pulmonary tuberculosis combine with respiratory failure. Methods 81 cases were admitted from January 2013 to December 2014 in our hospital of early treatment sputum positive pulmonary tuberculosis with respiratory failure. And the cases were carried out BNP, arterial blood gas analysis and chest X-ray before treatment and after two weeks respectively.104 cases of earlier sputum positive pulmonary tuberculosis accompanied with respiratory failure were randomly drawn according to the corresponding random number of hospitalization as a control group. Two sets of data were collected to conduct retrospective case-control study. Results BNP of pulmonary tuberculosis combine with respiratory failure is 11.4 times higher than that of tuberculosis alone (1115.11 pg/mL compare 97.60 pg/mL), the whole TB is 3.4 times higher than non-full-tuberculosis (1549.82 pg/mL t compare 449.47 pg/mL). Before treatment, BNP was negatively correlated to PaO₂, SaO₂ and pH BNP was positively correlated with PaCO₂. There was no correlation after treatment between BNP and PaCO₂.After two weeks BNP is 0.57 times of the pre-treatment (632.41 pg/mL compared 1115.11 pg/mL). The group of death is 8.7 times higher than the survival group (3119.63 pg/mL compared 359.84 pg/mL). Conclusion BNP was significantly increased in patient accompanied tuberculosis with respiratory failure .The condition is continued to decline after treatment. There is likely to be one of the indicators of helping to determine the efficacy and estimate prognosis.

目的 探索内源性神经干细胞在大鼠海马可溶性因子中的体外发育归宿及分化鉴定。方法 显微镜下分离Wistar大鼠海马组织放置于低温DMEM/12培养基,低温振荡2小时后高速离心(15000 g),获取实验所用海马组织可溶性因子。取材出生1天的Wistar乳鼠海马中的内源性神经干细胞(endogenous neural stem cells, ENSCs),将ENSCs分别于含海马可溶性因子终浓度为0(对照组)、50、100、200、400 μl/mL的无血清DMEM/F12培养基中培养6天并每日观察,使用免疫细胞化学、Western Blot印记技术比较各组ENSCs中Nestin、CD133的表达量;同时计量并比较各组ENSCs成球个数,以探索在模拟颅内微环境情况下,ENSCs发育、归宿及分化。进一步于最适宜的海马可溶性因子终浓度中分化神经球,对分化的细胞行神经元特异性蛋白入(如:β-tubullin III、MAP2)及胶质细胞特异性蛋白(如:GFAP、S100及p75 NGFR)免疫细胞化学检测。结果 大鼠ENSCs在培养基中呈单细胞漂浮生长,球形; ENSCs于海马可溶性因子各实验分组中培养第2天呈细胞球状态,对照组中无细胞球形成(与100 μl/mL组比较,P₁=0.00),100 μl/mL组与对照组比较有统计学意义(P₁=0.00<0.05);至第6天,在100 μl/mL组中的细胞球数量明显多于其余各组(P₁'=P₂'=P₃'=P₄'=0.00)。在免疫细胞化学检测中,100 μl/mL组中细胞球表达干细胞高亲和蛋白Nestin、CD133阳性,Western Blot免疫印迹检测其中Nestin、CD133蛋白高于对照组。进一步分化试验中,细胞球呈贴壁生长的单细胞状态、有突起伸出、长梭形,免疫细胞化学检测分化的细胞表达胶质细胞特异性蛋白GFAP、S100、p75NGFR阳性,但不表达神经元特异性蛋白β-tubullin III与MAP2。结论 大鼠ENSCs在终浓度为100 μl/mL的HSF作用下,可促进 ENSCs的增殖分裂;ENSCs在同样浓度下的HSF中可进一步分化为表达GFAP、S100、p75NGFR阳性的胶质样细胞;100 μl/mL的HSFS是ENSCs的一种生理性诱导剂或参与促进ENSCs增殖、分化及通过细胞替代或因子分泌等机制修复神经损伤。

Objective The aim of this study was to explore induction and differentiation of endogenous neural stem cells(ENSCs) in the hippocampus soluble factors(HSF) from the hippocampus of adult Wistar rats by mimicking an intracranial microenvironment. Methods After Wistar rats sacrificed, the hippocampus tissue was obtained in cold DMEM/F12. After centrigued and filtered, the HSF was stored at -20℃. The ENSCs was obtained from the hippocampus tissue of a neonate Wistar rat. Collected the tissue, digested and obtained the ENSCs. After we observed the morphology, the ENSCs were cultured in different concentration (0、50、100、200、400 μl/mL) of HSF for 6 days, and compared the expression of Nestin and CD133 by immunocytochemistry. Meanwhile,we compared the Nestin and CD133 protein by western blot. And then we explored the optimal concentration of HSF by the numbers of all groups on the second and sixth day. Furthermore, we did the differentiated experiment using the same concentration of HSF. Results The number of neurospheres in the 100 μg/mL group was significantly higher than those in the other groups on the 6th day. Immunofluorescence revealed that the neurospheres from ENSCs in the 100 μg/mL group more highly expressed nestin and CD133 than control. This result was confirmed by western blot analysis. The neurospheres can differentiate into glia-like cells in 100 μg/mL HSF and 1% FBS expressing GFAP, S100 and P75 NGFR by immunofluorescence. Conclusion These data indicated that HSF alone, mimicking a destination of ENSCs in vitro, could induce and differentiate neurospheres from ENSCs, as a new method to get NSCs and glia-like cells differentiated from ENCs to repair the diseases of center nervous system.

目的 通过观察隔姜灸神厥穴并同时口服黄芪汤治疗脓毒症急性肾损伤患者的效果分析,初步探讨该方法能否改善患者的APACHEⅡ评分,入住重症监护病房的时间有没有缩短,14天内死亡率有否差异。方法 以2014年1月—2015年8月于我院确诊的脓毒症急性肾损伤患者为研究对象,观察常规治疗(对照组)及常规治疗基础上给予隔姜灸神厥穴同时口服黄芪汤治疗(治疗组)对脓毒症急性肾损伤患者危重情况的影响。结果 治疗组患者的危重指标(APACHEⅡ评分)明显改善,患者治疗5天后组间比较差异有统计学意义(P<0.05);两组患者入住重症监护病房的时间比较,患者治疗第四周χ²=4.5241,P=0.0334,差异有统计学意义(P<0.05);14天死亡率差异无统计学意义(P>0.05)。结论 隔姜灸神厥穴同时口服黄芪汤治疗能有效改善脓毒症急性肾损伤患者的APACHEⅡ评分,入住重症监护病房的时间减少。

目的 探讨分娩前后母体血浆D-二聚体的变化及其在预测和预防静脉血栓栓塞症的临床意义。方法 回顾性分析2015年5月在东莞市长安医院分娩的、产前与产后均进行了D-二聚体检测,产前与产后均未使用抗凝药物并产后随访6周的102例产妇的临床资料。结果 分娩后48~72小时,75.5%的产妇血浆D-二聚体水平下降,24.5%的产妇血浆D-二聚体水平升高。血浆D-二聚体水平升高的产妇60%存在发生VTE的高危因素,经积极预防,无静脉血栓栓塞症病例发生。结论 比较分娩前后母体血浆D-二聚体水平是有临床意义的。对分娩后母体血浆D-二聚体水平升高者,尤其是存在血栓高危因素者应高度重视,积极预防静脉血栓栓塞症。

目的 评估SCORTEN评分与我国SJS/TEN患者疾病严重程度的一致性,比较单用糖皮质激素(TCS)和糖皮质激素—丙种球蛋白冲击(TCS-IVIG)联合治疗SJS/TEN的临床效果。方法 收集我院2005年6月—2015年5月住院的SJS/TEN患者,计算每例患者的SCORTEN评分,采用Hosmer-Lemeshow检验评估SCORTEN模型的预期死亡率和实际死亡率的拟合度;比较单用TCS和TCS-IVIG联合治疗的患者在疾病严重程度、住院天数、疾病控制时间和死亡率方面的差异。结果 SCORTEN模型的预期死亡率和实际死亡率之间的拟合度良好(各组P值均大于0.5);二组患者在住院天数、疾病控制时间和死亡率方面的差异没有统计学意义(P分别为0.105,0.910,0.701),但TCS-IVIG组患者的疾病严重程度显著高于TCS组(P=0.017)。结论 SCORTEN评分可以用于评估国内SJS/TEN患者的病情严重程度,并预测患者预后;与单用TCS相比,联合IVIG有助于提高重症SJS/TEN患者的救治效果。

Objectivs To evaluate the performance of SCORTEN in severity of SJS/TEN in China, and to compare the efficacy of corticosteroid therapy (TCS) and intravenous immunoglobulin combined therapy (TCS-IVIG). Methods Collected retrospectively the data of the SJS/TEN patients from June 2005 to May 2015 in our hospital. Hosmer-Lemeshow statistic were used to assess SCORTEN model calibration. And the differences between TCS group and TCS-IVIG group were compared in severity-of-illness, length of hospitalization, disease control time and mortality. Results A good calibration were found in all groups (all P＞0.5). Although the severity-of-illness in the TCS-IVIG group was significantly higher than that in the TCS group (P=0.017), there was no statistical significance between the two groups in length of hospitalization, disease control time and mortality (P=0.105, 0.910, 0.701, respectively). Conclusion SCORTEN can be used to assess the severity-of-illness in Chinese patients with SJS/TEN and to predict the prognosis. Compared with single TCS, It could improve the clinical outcomes of patients with severe SJS/TEN combined with IVIG.

目的 探讨微泡增强的超声空化对荷瘤兔乳腺癌的治疗效果。方法 建立兔VX2乳腺癌模型,肿瘤兔随机分成两组,超声微泡组及单纯超声组,各组于治疗前及治疗后分别行超声造影,分析造影前后肿瘤灌注情况。结果 超声微泡组治疗前后造影灰阶值改变明显,造影灰阶值从治疗前的(20.26±2.59)降至(3.71±1.61)(P<0.01);而单纯超声组肿瘤造影灰阶值无明显统计学差异(P>0.05)。结论 微泡增强的超声空化对荷瘤兔乳腺癌有一定的治疗效果。

Objective To investigate the treatment effect of microbubbles-enhanced ultrasound cavitation on VX2 breast tumor in rabbits. Methods The rabbit model of VX2 breast tumor were established. The rabbits were randomly divided into two groups, microbubbles-enhanced ultrasound (US+MBs) group and standard ultrasound (US) group. The VX2 breast tumor perfusion were imaged and assessed using contrast enhanced ultrasonography (CUES) before and after treatment. Results The contrast enhanced grayscale value (GSV) of VX2 breast tumors decreased significantly in the US+MBs group, from 20.26±0.59(before treatment) to 3.71±.761 (after treatment)(P<0.01). While there was no significance of GSV before and after treatment (P>0.05) in the US group. Conclusion Microbubble-enhancement ultrasound cavitation has a certain therapeutic effect on the VX2 breast tumor in rabbits.

目的 分析ITP患者血清中IgG型抗体糖基化的特异性,初步探讨其特异性与临床症状的相关性。方法 选取健康献血员30例、ITP患者13例及健康怀孕妇女23例,纯化血清中的IgG型抗体,应用nano-LC-MS法分析糖基化种类及水平,对比分析ITP患者血清中IgG型抗体的糖基化特异性。结果 ① ITP 患者血清中IgG型抗体的半乳糖糖基化水平为47.08±2.69,低于健康怀孕妇女(50.93±2.21),高于健康献血员(42.88±2.00)(P<0.05);② ITP 患者岩藻糖基化水平为81.16±2.49低于健康献血员(82.60±2.56)(P>0.05),同时低于健康怀孕妇女(86.17±2.23)(P<0.05);③ITP 患者唾液酸化水平为3.93±1.20,高于健康献血员(3.69±1.19),低于健康怀孕妇女(4.28±0.88)(P>0.05)。④ITP 患者乙酰葡糖氨基化水平为10.53±1.41,低于健康献血员(11.54±1.76),高于健康怀孕妇女(10.13±1.45)(P>0.05)。结论 ITP患者血清中的IgG型抗体的岩藻糖基化、半乳糖糖基化水平的特异性可能是其产生有别于健康怀孕妇女的临床症状的的分子基础。

Objective To investigate the glycosylation specificity of the IgG antibody in ITP. Methods Choose 30 healthy donors, 23 healthy pregnants and 13 ITP patients, purified the IgG antibody from serum, analysied the level of all kinds of glycosylation. Compared with healthy donor and healthy pregnants to find the specificity of the IgG antibody in ITP patients. Results ① The galacosylation of IgG antibody in ITP patients was 47.08±7.24,lower than healthy pregnants (50.93±4.91), higher than healthy donor (42.88±4.01), and the healthy pregnants were higher than healthy donor (P<0.05). ② The fucosylation in ITP patients was 81.16±6.2, lower than healthy donors (82.60±2.56) (P>0.05), higher than healthy pregnants(86.17±2.23)(P<0.05); ③The sialylation in ITP patients was 3.93±1.20, higher than healthy donors (3.69±1.19), lower than healthy pregnants (4.28±0.88)(P>0.05); ④The GlcNAc in ITP patients was 10.53±1.41, lower than healthy donors (11.54±1.76), higher than healthy pregnants (10.13±1.45)(P>0.05). Conclusion The specificity of IgG antibody in ITP patients in galacosylation and fucosylation may be the molecule base of ITP's clinic symptom.