外照射急性放射病合并感染的防治

外照射急性放射病的主要致死原因之一是严重感染,预防和控制感染是救治急性放射病的关键。本文从外照射急性放射病合并感染的防治方面介绍其发病机制、临床表现、预防和救治措施以及其预后转归的研究现状。     

我国急性放射病防治研究进展

急性放射病的防治一直是放射卫生领域的研究热点和难题,本文介绍了近年来我国急性放射病防治研究工作的进展情况,包括辐射损伤防治药物及急性放射病防治的辐射防护手段,分析了当前急性放射病研究存在的问题,讨论了其研究可能的发展方向。     

Spontaneous retroperitoneal hemorrhage due to acquired cystic kidney disease

A patient with end-stage renal disease on maintenance hemodialysis developed sudden severe abdominal pain and distension. He suffered a decline in his hematocrit and subsequent abdominal imaging revealed a large left-sided retroperitoneal hemorrhage in the setting of atrophic, severely cystic kidneys. He underwent selective left renal artery angiography and embolization due to continued hemorrhage with stabilization in his condition. However, he became paraparetic within hours of the embolization procedure due to spinal cord infarct. Acquired cystic kidney disease is a very common entity in patients with chronic kidney disease. Complications include cystic hemorrhage or infection, erythrocytosis, and renal cell carcinoma. Screening of patients for cystic disease and malignant transformation remains a controversial topic; however, most advocate abdominal imaging after 3 to 5 years on dialysis.     

姜黄素对脓毒症小鼠急性肺损伤的保护作用及对细胞间黏附分子-1和肿瘤坏死因子-α表达的影响

目的 研究姜黄素对脓毒症小鼠急性肺损伤(Acute lung injury,ALI)的保护作用及对细胞间黏附分子-1(Intercel-lular adhesion molecule-1,ICAM-1)和肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)表达的影响。方法将SD小鼠随机分为假手术组(Sham组)、脓毒症组(Sep组)、二甲基亚砜组(DMSO组)和姜黄素组(Cur组)。采用盲肠结扎穿刺术(Cecal ligation andpuncture,CLP)复制脓毒症相关性ALI模型,造模24 h后,Cur组给予200 mg/(kg.d)姜黄素,Sham和Sep组给予等量生理盐水,DMSO组给予等量DMSO,均经腹腔注射给药。HE染色观察小鼠肺组织病理形态学变化;ELISA法检测小鼠血浆中ICAM-1和TNF-α含量的变化;Western blot分析小鼠肺组织中ICAM-1和TNF-α蛋白的表达。结果 Cur组小鼠在给药后12 h肺组织病理变化与Sep组相比有所减轻,48 h姜黄素作用达最强,且各种病理改变明显减轻,部分肺组织已恢复到正常形态;Cur组小鼠血浆中lCAM-1的含量在给药后6、12、24和48 h均明显低于Sep组(P<0.05),Cur组小鼠血浆中TNF-α的含量在给药后24 h明显低于Sep组(P<0.05);给药后24 h,Cur组小鼠肺组织中ICAM-1和TNF-α蛋白的表达水平与Sep组相比明显降低(P<0.05);DMSO组与Sep组各项指标差异均无统计学意义(P>0.05)。结论姜黄素能够有效减轻脓毒症所致ALI,这一作用与抑制ICAM-1和TNF-α的过度表达有关。     

Survival to discharge among patients treated with continuous renal replacement therapy

Continuous renal replacement therapy (CRRT) is widely used in critically ill patients with acute renal failure (ARF). The survival of patients who require CRRT and the factors predicting their outcomes are not well defined. We sought to identify clinical features to predict survival in patients treated with CRRT. We reviewed the charts of all patients who received CRRT at the Toronto General Hospital during the year 2002. Our cohort (n=85) represented 97% of patients treated with this modality in 3 critical care units. We identified demographic variables, underlying diagnoses, transplantation status, location (medical-surgical, coronary, or cardiovascular surgery intensive care units), CRRT duration, baseline estimated glomerular filtration rate (eGFR), and presence of oliguria (<400 mL/day) on the day of CRRT initiation. The principal outcome was survival to hospital discharge. Among those alive at discharge, we assessed whether there was an ongoing need for renal replacement therapy. Greater than one-third (38%, 32/85) of patients survived to hospital discharge. Three (9%) survivors remained dialysis-dependent at the time of discharge. Survivors were younger than nonsurvivors (mean age 56 vs. 60 years), were on CRRT for a shorter duration (7 vs. 13 days), and had a higher baseline eGFR (74 vs. 62 mL/min/m(2)). Patient survival varied among different critical care units (medical surgical 33%, coronary 38%, and cardiovascular surgery 45%). Multivariable logistic regression revealed that shorter duration of CRRT, nonoliguria, and baseline eGFR >60 mL/min/m(2) were independently associated with survival to hospital discharge (p<0.05). Critically ill patients with ARF who require CRRT continue to have high in-hospital mortality. A shorter period of CRRT dependence, nonoliguria and higher baseline renal function may predict a more favorable prognosis. The majority of CRRT patients who survive their critical illness are independent of dialysis at the time of hospital discharge.     

苯扎氯铵消毒液的急性毒性和致突变实验研究

目的：研究以苯扎氯铵为主要有效成分消毒液的急性毒性和致突变性,为其应用安全性进行毒理学评价提供依据。方法：依据消毒技术规范（2002年版）[1]进行小鼠急性经口毒性试验、骨髓细胞微核试验、精子畸形试验。结果]：急性经口毒性试验：雄性小鼠LD50为3.16（2.71-5.01）g/kgBW、雌性小鼠LD50为3.69（2.71-5.01）g/kgBW,属低毒;小鼠骨髓嗜多染红细胞微核试验结果为阴性;小鼠精子畸形试验结果为阴性,未见有致突变性。结论：该浓度苯扎氯铵消毒液要注明使用条件。     

喷气织机织物下机缩率的分析研究

纤维，纱线和织物受到应力作用时会产生三种变形，一种是与作用时间无关的急弹性变形。另外二种与作用时间和应力大小有关的变形。即缓弹性变形与塑性变形，或称之为初级时而变和次级蠕变。     

P792: a rapid clearance blood pool agent for magnetic resonance imaging: preliminary results

An original MRI contrast agent, called P792, is described. P792 is a gadolinium macrocyclic compound based on a Gd-DOTA structure substituted by hydrophilic arms. The chemical structure of P792 has been optimized in order to provide (1) a high r₁ relaxivity in the clinical field for MRI: 29 mM⁻¹ x s⁻¹ at 60 MHz. (2) a high biocompatibility profile and (3) a high molecular volume: the apparent hydrodynamic volume of P792 is 125 times greater than that of Gd-DOTA. As a result of this high molecular volume, P792 presents an unusual pharmacokinetic profile, as it is a Rapid Clearance Blood Pool Agent (RCBPA) characterized by limited diffusion across the normal endothelium. The original pharmacokinetic properties of this RCBPA are expected to be well suited to MR coronary angiography, angiography, perfusion imaging (stress and rest), and permeability imaging (detection of ischemia and tumor grading). Further experimental imaging studies are ongoing to define the clinical value of this compound.     

人心肌肌钙蛋白I的分离纯化

目的制备抗人cTnI单克隆抗体,以便进一步制备AMI诊断制剂。方法用兔骨骼肌Tnc(sT-nC)制备ThC-Sepharose-4B亲和柱,直接从心肌组织中分离提纯人cTnI。结果所提纯的cTnI经SDS-PAGE分析已达电泳纯,其相对分子质量和氨基酸组成与文献报道相符。结论为建立AMI早期诊断试剂奠定了基础。