目的 观察葛根素对新西兰白兔视网膜缺血/再灌注损伤组织中细胞凋亡的保护作用。方法 新西兰白兔30只随机分为缺血再灌注对照组和葛根素治疗实验组,各组右眼应用前房灌注加压法建立视网膜缺血再灌注模型,分别于再灌注后第12、24、72 h处死动物,摘除眼球,制作石蜡切片,用TUNEL法检测细胞凋亡,计算凋亡指数。结果 对照组缺血再灌注12 h在神经节细胞层和内核层可见凋亡细胞;24 h神经节细胞层细胞数有所减少,视网膜神经节细胞层、内核层及外核层均见凋亡细胞明显增多;72 h神经节细胞层细胞数明显减少,神经节细胞层、内核层及外核层仍见凋亡细胞,但较24 h有所减少。葛根素治疗视网膜的凋亡细胞在各个时间段的表达规律与对照组相似,但凋亡细胞计数在12 h,24 h,72 h均较对照组明显减少,两组间差异有统计学意义。结论 葛根素能减轻缺血-再灌注损伤的视网膜细胞凋亡,对视网膜有保护作用。

Objective To observe the protective effects of Puerarin on apoptosis of ischemic injury in rabbit retina. Methods Retinal ischemia was induced in rabbits by increasing intraocular pressure to 120 mmHg for 60 minutes. TdT-mediated biotin-dUTP nick end labelling(TUNEL) staining technique was used to examine the apoptosis of retinal ganglion cells in the control group and the puerarin treatment group. Results The number of apoptotic cells in 12, 24 and 72h after reperfusion in the puerarin treatment group was obvious lower than that in the control group(P<0.05). Conclusion Puerarin has protective effects in protecting against apoptosis in ischemia reperfusion injury of rabbit retina.

目的 探讨心肌细胞RyR2和L型钙通道的基因变异与室性心律失常和心源性猝死的相关性。方法 回顾分析2010年1月—2012年12月在我院就诊的慢性心力衰竭患者622例的临床资料,并选取同一时期体检中心体检的健康人群516例作为对照组,门诊或者电话随访记录慢性心力衰竭患者的死亡为终点,通过候选基因分析可能具有相关功能的4个基因变异,rs41315858(G1885E)、rs3766871(G1886S)、rs790896(G>A)和rs723672(T>C),采用Logestic、Cox回归分析对4个候选基因变异进行相关性研究。结果 入选622例慢性心力衰竭患者和516例对照组,基因分析结果显示RyR2上的基因变异rs376687lA等位基因携带可以增加慢性心力衰竭患者发生室性心律失常的风险性;校正可能与该疾病相关的危险因素后,rs376687lA等位基因携带会增加心源性死亡和心源性猝死的风险,RyR2上的基因变异rs790896A等位基因携带可以降低心源性猝死风险。结论 RyR2上的基因变异rs376687lA是室性心律失常和心源性猝死的遗传学预测因子,而rs790896A等位基因是慢性心力衰竭患者的保护因子,可降低室性心律失常和心源性猝死的风险。

Objective To investigate the myocardial cells RyR2 and L-type calcium channel gene variants with ventricular arrhythmias and sudden cardiac death correlation. Methods Retrospective analysis of patients with chronic heart failure from January 2010 to December 2012 in our hospital including 622 cases of clinical data, and to select 516 cases of healthy people in medical examination center during the same period as a control group.Clinic or telephone follow-up recorded chronic patients with heart failure and sudden death acting as end. We analyzed possible candidate genes, according to four gene variants related functions, rs41315858 (G1885E), rs3766871 (G1886S), rs790896 (G> A) and rs723672 (T> C), by using Logestic, Cox regression analysis of four candidate gene variants for related research. Results 622 cases of chronic heart failure patients were enrolled and 516 patients in the control group. Genetic analysis showed that the gene variant alleles carried rs376687lA RyR2 may increase in patients with chronic heart failure ventricular arrhythmia risk; correction may be associated with the disease after risk factors, rs376687lA allele carries an increased risk of cardiogenic death and sudden cardiac death, and gene mutation alleles carried on rs790896A RyR2 can reduce the risk of sudden cardiac death. Conclusion Gene mutation rs376687lA RyR2 on genetics is predictor of ventricular arrhythmias and sudden cardiac death, and rs790896A allele is protective factor in patients with chronic heart failure which can be reduced ventricular arrhythmias and sudden cardiac death in risk.

目的 评价实时荧光定量PCR分析低氧性肺动脉高压大鼠肺动脉平滑肌基因表达时12个候选内参基因表达的稳定性,获得最适合的内参基因。方法 以低氧性肺动脉高压大鼠肺动脉平滑肌为研究对象,选择文献报道的常用12种内参基因为候选内参基因,利用geNorm和NormFinder程序分析实时荧光定量PCR数据,筛选出最适内参基因。结果 12个候选内参基因在低氧性肺动脉高压大鼠肺动脉平滑肌表达稳定性由强到弱顺序为:TBP>B2M>HPRT1>HMBS>RPL13a>18sRNA>PPIA>ACTB>GUSB>TFRC>GAPDH>PGK1,平均表达稳定度(M值)均<0.5,geNorm和NormFinder评估后推荐使用TBP和B2M一起作为该研究时的内参基因。结论 同时使用TBP和B2M是实时荧光定量PCR分析低氧性肺动脉高压大鼠肺动脉平滑肌基因表达的最适合内参基因,为低氧性肺动脉高压相关基因研究提供最优内参基因。

Objective To compare and select the suitable reference genes in real-time quantitative PCR analysis of rat pulmonary artery smooth muscle cells mRNA expression level of pulmonary hypertension. Methods To choose appropriate reference gene, the expression of twelve commonly use housekeeping genes were examined in rat pulmonary artery smooth muscle cells of hypoxia-induced pulmonary hypertension by using geNorm and NormFinder programs. Results The expression consistency of 12 genes was (from high to low): TBP>B2M>HPRT1>HMBS>RPL13a>18sRNA>PPIA>ACTB>GUSB>TFRC>GAPDH>PGK1. The average expression stability(M) values of them were low than 0.5. TBP and B2M reference genes were recommended to use in the same condition. Conclusion TBP and B2M reference genes were the most suitable combination of the reference genes for real-time quantitative PCR analysis in rat pulmonary artery smooth muscle cells of hypoxia-induced pulmonary hypertension.

目的 探讨个体化术前访视在手术室临床护理路径的作用。方法 将167例进入手术室临床护理路径的子宫肌瘤截石位阴式全子宫切除手术患者随机分为实验组和对照组,分别予以或不予个体化术前访视,其他手术室临床护理路径相同,比较两组的护理效果。结果 两组均未出现手术体位并发症,实验组的术中心理应激变化小于对照组,实验组术后首次肛门排气时间、下床活动时间均早于对照组,实验组患者满意度高于对照组(P均<0.05)。结论 手术室临床护理路径应从个体化术前访视开始。

KOA是临床上最常见,发病起源于关节软骨的慢性退行性关节疾病。近年来,应用黄芪治疗KOA的报道不断增多,并且开展了大量的机制研究。本文综述了黄芪在KOA治疗中的应用现状及研究进展,同时指出从PPAR-γ信号通路探索黄芪干预KOA的具体分子机制具有积极的理论和实践意义。

目的 探讨赛肤润与局部氧疗对新生儿臀红皮肤的疗效,总结防治新生儿臀红的护理方法。方法 选择66例患有臀红的新生儿随机分成对照组和实验组,对照组给予臀部清洁并吸干水分,对潮红及尿液刺激处皮肤涂搽赛肤润处理;实验组在给予臀部清洁,吸干水分,对臀红皮肤行吹氧气治疗5分钟后给潮红及尿液刺激处范围的皮肤涂搽赛肤润,并加强护婴者婴儿臀部护理知识宣教。结果 实验组新生儿臀红处皮肤红斑消退时间比对照组短;实验组新生儿臀红和皮肤红疹发生率比对照组减少18.33%;实验组新生儿臀部皮肤红疹治愈率比对照组高22.61%(P<0.05)。结论 加强臀部护理知识宣教,赛肤润与局部氧疗联合干预在降低新生儿臀红发生率,缩短新生儿臀红消退时间、提高新生儿臀红治愈率比单纯赛肤润治疗效果明显,值得临床推广应用。

目的 观察以湿敷为主的早期综合干预疗法治疗婴幼儿湿疹的效果。方法 按照随机的原则对118例患有湿疹的婴幼儿分为观察组(60例)和对照组(58例)。观察组采取以湿敷为主的早期综合治疗,对照组采取一般家庭干预,两组均跟踪随访,观察湿疹的好转情况,并统计湿疹复发率。结果 观察组60例患者中痊愈38例,占 63.3%;显效20例,占 33.3%;有效2例,占3.3%;无效0例;总有效率100%。痊愈的38例中,随访8周后重新出现湿疹的病例为8例,复发率为21%。对照组58例患者中痊愈20例,占 34.48%;显效14例,占24.14%;有效16例,占27.59%;无效8例,占13.79%;总有效率86.21%。观察组痊愈的38例中,随访8周后重新出现湿疹的病例为8例,复发率为21%。对照组痊愈20例中复发6例,复发率为30%。结论 以湿敷为主的早期综合干预疗法能有效减轻湿疹的症状,可以作为社区治疗婴幼儿湿疹的参考。

Objective To observe the effects of wet compress based early comprehensive intervention therapy in the treatment of infant eczema. Methods 118 cases of infantile eczema within the jurisdiction were randomly divided into observati on group (60 cases)and control group (58 cases). The observation group was given early comprehensive therapy based on wet compress while the control group took general family intervention.Follow-up observations were adopted for both groups to examine the curing of eczema and to collect data for eczema recurrence. Results In the observation group of 60 cases, 38 were cured, accounting for 63.3%; 20 markedly improved (33.3%),2 effective(3.3%) and 0 ineffective; with the total effective rate of 100%.of the 38 cases cured, eczema reappeared in 8 cases after eight weeks of follow-up observation, with the recurrence rate of 21%. In the control group of 58 cases, 20 were cured, accounting for 34.48%; 14markedly improved (24.14%), 16 effective (27.59%),and 8 ineffective (13.79%),with the total effective rate of 86.21%. In the observation group, eczema recurred in 8 of the 38 cured cases after eight weeks of follow-up observation, with the recurrence rate of 21% while in the control group, eczema recurred in 6 cases, with the recurrence rate of 30%. Conclusion Wet compress based early comprehensive intervention therapy can effectively relieve the symptoms of eczema, so it can be effectively used in community treatment of infantile eczema.

目的 探讨光棒引导与传统喉镜气管插管在不稳定型颈椎骨折患者中的应用效果。方法 不稳定型颈椎骨折患者80例,按照随机数字表法随机分成光棒引导组和传统喉镜组各40例,记录两组患者的插管时间、插管总成功率,入室安静后(T0)、诱导后插管前(T1)、气管插管后即刻(T2)、气管插管后3 min(T3)时的收缩压(SBP)、舒张压(DBP)、心率(HR)、血浆去甲肾上腺素(NE)、肾上腺素(E) 和血管紧张素Ⅱ(ATⅡ)的变化和插管时气道并发症。结果 两组间插管时间(光棒组29.63±11.04s vs.喉镜组62.41±19.49 s)有统计学意义(P<0.001)。两组插管总成功率无统计学意义(P=0.305)。光棒组T2、T3时刻SBP、DBP、HR 、NE、E和ATⅡ均低于喉镜组(P<0.001)。光棒组气道并发症低于喉镜组无统计学意义(P>0.05)。结论 光棒引导气管插管较传统喉镜气管内插管插管时间短,对血流动力学和应激激素水平影响较轻。

目的 分析耳石症手法复位治疗后残余症状的特点及其相关危险因素。方法 收集2014年2月—2015年2月石景山医院神经内科诊治的198例耳石症患者,分析其临床表现,经手法复位治疗后,部分患者痊愈,部分患者残留不同类型及不同程度症状,随访3个月,观察残余症状特点、持续时间,分析其相关因素。结果 198例患者中,男78例(39.4%),女120例(60.6%),平均年龄(59.2±11.5)岁,病程3小时~10年,中位数4.8天。其中121例(61.2%)患者有后遗症状,如头部昏沉感、紧箍感、走路不稳,持续数天至数月。其中,155例患者完成随访3个月,残余头晕组平均年龄大于无头晕组,在残余头晕组中,女性多于男性。对残余头晕患者危险因素进行Logistic回归分析,治疗前病程长短是残余头晕症状的独立危险因素(OR=2.876,95%,CI 1.532~5.331,P=0.000);结论 耳石症手法复位后一半以上患者均可遗留头晕、头部昏沉感、紧箍感、走路不稳感,多在1~2个月左右逐渐改善,治疗前病程长短是治疗后残余症状的独立危险因素。