连续性血液滤过在治疗以第三间隙液体潴留为主的腹腔高压中的应用

目的：探讨连续性血液滤过（CBP）治疗以第三间隙液体潴留为主的腹腔高压及腹腔间隙综合征（ACS）的疗效。方法37例诊断为以第三间隙液体潴留为主的腹腔高压或腹腔间隙综合征的患者按是否进行血液滤过分为治疗组（21例）和对照组（16例）,对照组采用胃肠减压、镇痛等常规治疗,治疗组采用在常规治疗基础上给予连续性血液滤过治疗,1次·d^-1,5次。记录比较治疗前后腹内压、氧合指数、平均动脉压、APACHEⅡ评分、生化指标以及 TNF-α、IL-6,和 C-反应蛋白（CRP）的水平。观察治疗前、治疗后患者一般情况及生化指标、炎症介质的变化,计算死亡率。结果治疗组14例腹腔高压好转,3例死亡,4例自动出院,好转率66．6％;对照组腹腔高压好转3例,死亡9例,自动出院4例,好转率18．7％。治疗组肾功能指标、乳酸、HCO-3、肌钙蛋白 I（cTnI）及炎症介质CRP、TNF-α、IL-6改善明显优于对照组,病死率明显低于对照组（P ＜0．05）。结论CBP 可明显改善以第三间隙液体潴留为主的腹腔高压或腹腔间隙综合征的症状,降低腹内压,改善预后,降低死亡率。     

阻塞性睡眠呼吸暂停综合征合并高血压与红细胞分布宽度的关系

目的：探讨阻塞性睡眠呼吸暂停综合征（OSAS）合并高血压与红细胞分布宽度（RDW）的关系。方法选择2011年1月至2013年8月在中国人民解放军第九四医院呼吸内科门诊及住院的 OSAS 合并高血压患者（OSAS合并高血压组）44例和体检中心体检的原发性高血压患者（高血压组）57例、健康体检者（正常对照组）52例。各组清晨空腹抽取肘静脉血2 mL,用全自动五分类血细胞分析仪检测红细胞（RBC）计数、血红蛋白（Hb）、RDW 及白细胞（WBC）计数,比较各组 RDW 的差异,并进行相关性分析。结果高血压组 RBC 计数、Hb、RDW 和 WBC 计数与正常对照组比较差异均无统计学意义（均 P ＞0．05）;OSAS 合并高血压组 BMI、DBP、RBC 计数、Hb 和 RDW 均明显高于正常对照组、高血压组,SBP 明显高于正常对照组、明显低于高血压组（均 P ＜0．05）;高血压组 SBP、DBP均明显高于正常对照组（均 P ＜0．05）。相关性分析结果显示,OSAS 合并高血压组 RDW 与睡眠呼吸暂停低通气指数（AHI）呈正相关（r＝0．426,P ＜0．05）,与最低氧饱和度呈负相关（r＝－0．509,P ＜0．05）。结论高血压患者RDW 无明显改变,RDW 增高可能是 OSAS 合并高血压患者心脑血管事件的标志物。     

猪繁殖与呼吸综合征弱毒疫苗的安全性及新型疫苗的研究进展

猪繁殖与呼吸综合征(Porcine reproductive and respiratory syndrome,PRRS)是影响养猪业的重大传染病,应用PRRS弱毒疫苗免疫是主要的预防措施。尽管各种PRRS弱毒疫苗已在我国使用,但PRRS仍持续流行,每年均有不同程度的暴发,且造成巨大的经济损失。最新研究提示,基因缺失疫苗能有效提升猪对PRRS的特异性免疫力。本文就PRRS弱毒疫苗在使用过程中可能存在的安全隐患及新型疫苗的研究进展作一综述。     

抗猪呼吸与生殖综合征病毒Nsp9蛋白单克隆抗体的制备及初步鉴定

目的制备抗猪呼吸与生殖综合征病毒(Porcine reproductive and respiratory syndrome virus,PRRSV)Nsp9蛋白单克隆抗体,并进行初步鉴定。方法用纯化的重组Nsp9蛋白免疫BALB/c小鼠,采用杂交瘤技术制备抗PRRSV Nsp9蛋白单克隆抗体,采用Western blot和间接免疫荧光试验分析单抗的特异性;使用免疫球蛋白标准亚类鉴定试剂盒鉴定单抗的亚类;将杂交瘤细胞分别保存1、2、3、4个月后复苏,采用间接ELISA法检测细胞分泌抗体的能力。结果共获得3株可稳定分泌特异性单抗的杂交瘤细胞株,分别命名为2D6、3C11和4E6,其细胞培养上清的ELISA效价分别为1∶6 400、1∶3 200和1∶1 600,腹水的ELISA效价分别为1∶640 000、1∶512 000和1∶256 000。3株单抗均可与Nsp9蛋白和PRRSV特异性结合;2D6和3C11株单抗的Ig亚型为IgG1,4E6株单抗为IgM亚类抗体;3株杂交瘤细胞保存4个月均能稳定分泌单抗。结论已制备抗PRRSVNsp9蛋白单克隆抗体,其特异性高,稳定性良好,为建立鉴别自然感染与注射疫苗感染PRRSV的诊断方法提供了材料。     

Egg Consumption Modulates HDL Lipid Composition and Increases the Cholesterol-Accepting Capacity of Serum in Metabolic Syndrome

We recently demonstrated that daily whole egg consumption during moderate carbohydrate restriction leads to greater increases in plasma HDL-cholesterol (HDL-C) and improvements in HDL profiles in metabolic syndrome (MetS) when compared to intake of a yolk-free egg substitute. We further investigated the effects of this intervention on HDL composition and function, hypothesizing that the phospholipid species present in egg yolk modulate HDL lipid composition to increase the cholesterol-accepting capacity of subject serum. Men and women classified with MetS were randomly assigned to consume either three whole eggs (EGG, n = 20) per day or the equivalent amount of egg substitute (SUB, n = 17) throughout a 12-week moderate carbohydrate-restricted (25–30 % of energy) diet. Relative to other HDL lipids, HDL-cholesteryl ester content increased in all subjects, with greater increases in the SUB group. Further, HDL-triacylglycerol content was reduced in EGG group subjects with normal baseline plasma HDL-C, resulting in increases in HDL-CE/TAG ratios in both groups. Phospholipid analysis by mass spectrometry revealed that HDL became enriched in phosphatidylethanolamine in the EGG group, and that EGG group HDL better reflected sphingomyelin species present in the whole egg product at week 12 compared to baseline. Further, macrophage cholesterol efflux to EGG subject serum increased from baseline to week 12, whereas no changes were observed in the SUB group. Together, these findings suggest that daily egg consumption promotes favorable shifts in HDL lipid composition and function beyond increasing plasma HDL-C in MetS.     

基于基因打靶技术的中医脏腑辨证分型算法

受生物学基因打靶技术的启发和通过对中医脏腑证型分类标准的研究,提出了一种新颖的中医智能脏腑辨证算法,称之为中医脏腑辨证分型算法。主要思想是把中医脏腑证型的主要症状和次要症状,以及舌象、脉象信息设计为脏腑证型模靶;临床病例病症信息作为脏腑病症基因组,并进行模靶射击式的辨证分型操作。通过对慢性胃炎疾病的辨证分型计算结果的分析,说明中医脏腑辨证分型算法的有效性,为中医辨证信息处理的客观化、可计算化提供了一种新的研究方法,同时具有一定的临床诊断应用价值。     

半导体激光联合电针、中频电治疗及护理颞下颌关节紊乱综合症的疗效观察

目的:观察半导体激光联合电针及中频电治疗颞下颌关节紊乱综合征的效果。方法:将56例符合诊断标准的颞下颌关节紊乱综合征患者分为观察组和对照组,各28例,对照组使用中频电治疗,观察组在对照组治疗的基础上加用半导体激光和电针治疗,两组采用相同护理措施,10d后进行疗效比较。结果:对照组治愈10例,显效3例,好转7例,无效8例,总有效率71.4%;观察组治愈19例,显效5例,好转2例,无效2例,总有效率92.9%;观察组临床疗效明显优于对照组(P0.05)。结论:半导体激光联合电针、中频电治疗及护理颞颌关节紊乱综合征临床疗效显著,具有消炎,止痛,改善颞颌关节和恢复咀嚼肌功能的作用,且优于单纯中频电治疗。     

老年男性阻塞性睡眠呼吸暂停程度与代谢综合征的相关性研究

目的：研究老年男性阻塞性睡眠呼吸暂停综合征（obstructive sleep apnea syndrome ,OSAS）严重程度与代谢综合征的相关性。方法：随机选择我院收治的663例老年患者,根据呼吸暂停及低通气指数,将其分为非OSAS 组和轻、中、重度OSAS 组。比较各组患者颈围、体质指数（BMI）、腰臀比、血压、血脂、空腹血糖等,分析OSAS严重程度与代谢综合征及其组分发病率之间的相关性。结果 OSAS患者的颈围、BMI、腰臀比、收缩压、舒张压、空腹血糖等显著高于非OSAS组患者。OSAS严重程度与颈围、BMI、甘油三酯等存在显著正相关,且随着OSAS严重程度的增加,代谢综合征及其组分的发生率呈逐渐递增趋势。结论：老年男性阻塞性睡眠呼吸暂停程度与代谢综合征发病率密切相关,这可能是阻塞性睡眠呼吸暂停综合征增加心血管疾病发生率和死亡率的主要原因。     

Planning globally,protesting locally: Patterns in community perceptions towards the installation of wind farms

The evidence is compelling that extended use and production of energy are globally responsible for the serious deterioration of physical environment and climate change. The further penetration of renewable energy sources (RES) emerges as a crucial factor contributing to the mitigation of global warming. Within this framework wind energy is expected to have a leading role for Greece's compliance with the EU environmental targets of 2020. However, the installation of wind parks in specific regions with high wind potential is seriously constrained by the reaction of local communities. Using a survey the present research dissects public acceptance for existing and proposed wind farms in the region of Southern Evia, Greece. Results indicate an overall support for wind energy and confirm the growing inconvenience with NIMBYism, especially in areas with existing wind parks in operation, as a theoretical framework explaining resistance to planned wind energy investments. By contrasting self-reported ex ante- and ex post-perceptions of impacts and benefits we highlight the role of experience in community acceptance of wind energy installations. Our statistical models prescribe the profile of those most probably in favour of existing installations, new installations in other parts of Evia or new installations elsewhere in Greece. Finally, we introduce the ‘Not-In-My-Front-Yard’ (NIMFY) syndrome suggesting that the impact of visibility on public acceptance is far from being a simple concept as it is linked to both a physical landscape context and socio-economic parameters.