急性缺血性脑血管病血小板膜P-选择素表达的临床观察

目的　探讨急性缺血性脑血管病血小板膜P -选择素 (CD6 2P)的表达及其与临床类型和病程的关系。方法　用流式细胞术测定 16 4例急性缺血性脑血管病患者血小板膜CD6 2P的表达。结果　脑梗塞、腔隙性脑梗塞、TIA各组患者CD6 2P的表达分别为 (8 5 8± 8 76 ) %、(7 2 6± 5 70 ) %、(4 2 6± 1 5 4 ) % ,与对照组 (2 2 6± 0 85 ) %比较 ,有显著性差异 (P <0 0 5和P <0 0 1)。脑梗塞、腔隙性脑梗塞、TIA各组间比较无显著性差异 (P >0 0 5 )。脑梗塞、腔隙性脑梗塞、TIA各组患者在发病 4 8小时内CD6 2P的表达分别为 (7 6 8± 11 16 ) %、(6 4 7± 3 5 6 ) %、(4 2 0± 1 5 2 ) % ,与发病 2～ 14天时检测 (10 5 7±9 13) %、(9 2 6± 8 97) %、(4 4 6± 1 73) %比较无显著性差异 (P >0 0 5 )。结论　血小板膜CD6 2P在各型急性缺血性脑血管病患者中均可有显著表达 ,但与急性期内病程早、晚无明显关系。     

急性脑梗死患者血小板膜糖蛋白CD62P表达量的检测及临床意义

目的 :探讨急性脑梗死 (CI)患者血浆P选择素 (CD6 2P)的表达量及其临床意义。方法 :用流式细胞术 ,以单克隆抗体为分子探针 ,对 4 2例急性脑梗死患者和 2 0例健康对照者外周血血小板膜糖蛋白 (MGP)CD6 2P的表达量进行检测 (以平均荧光强度MFI来表示 ) ,观察急性脑梗死患者 72h内和第 7天的CD6 2PMFI,并与健康人作对照。结果 :病人组 72h内CD6 2P的表达量高于正常对照组 (P <0 .0 5) ;脑梗死患者第 7天CD6 2P的表达量较第 3天为低 (P <0 .0 5) ,与正常对照组比较无差别 (P >0 .0 5)。神经功能缺损程度严重者 ,CD6 2P表达量多 (r =0 .35,P <0 .0 5)。结论 :急性脑梗死患者发病时 ,血小板被激活 ,血小板膜糖蛋白CD6 2P的表达上调 ,可作为CI发生的预测指标 ;CD6 2P的表达量与CI的严重程度相关     

伴脑梗死颈动脉粥样硬化与血小板激活的关系

目的　探讨伴脑梗死颈动脉粥样硬化 (CAS)与血小板激活的关系。方法　采用流式细胞仪测定4 0例伴脑梗死CAS患者 (A组 )和 31例不伴脑梗死CAS患者 (B组 )外周血血小板膜糖蛋白Ⅱb Ⅲa复合物α亚单位 (CD4 1)、P 选择素 (CD6 2p)和溶酶体膜蛋白 5 3(CD6 3)的表达以及血小板与淋巴、单核和中性粒细胞的凝集性。结果　与B组相比 ,A组CD6 2p、CD6 3阳性百分率和血小板 单核细胞的凝集性升高 (P <0 .0 5 ) ;Spearman相关分析发现 ,A组CD6 2 p和B组CD4 1、CD6 2 p阳性百分率与CAS程度呈显著正相关 (P <0 .0 5 ) ;Logistic回归分析证实 ,血小板 单核细胞凝集性和CD6 2 p是CAS患者产生脑梗死的独立危险因素 (P <0 .0 5 )。 结论　血小板活性增高的CAS患者易发生缺血性脑血管病。     

老年脑梗死患者急性期血小板活化功能定量检测

目的 :探讨老年脑梗死患者外周血中血小板膜糖蛋白变化的临床意义。　方法 :应用流式细胞术检测了 6 8例急性期老年脑梗死患者外周血血小板活化分子标记物CD4 1、CD6 2p和CD6 3的含量水平 ,与 4 2例正常老年人对照 ;并对脑梗死组病灶大小、梗死部位、病情分级等与血小板活化分子表达的变化进行分析 ,应用统计学进行处理。　结果 :急性期脑梗死患者血小板粘附分子CD4 1、CD6 2 p和CD6 3的表达水平显著高于正常对照组 (P <0 .0 1) ,且与梗死灶大小及病情分级密切相关 ,与梗死部位无关。　结论 :老年脑梗死患者急性期外周血血小板活化功能明显增强 ,为早期应用抗血小板聚集药物的治疗提供了实验依据     

脑梗死患者血浆Hcy浓度与其临床亚型及疾病严重程度的关系研究

目的 :检测脑血栓形成患者血浆同型半胱氨酸 (HCY)浓度 ,探讨其与患者脑梗死临床亚型及疾病严重程度的关系。方法 :应用Waters公司Baseline 810型高效液相色谱仪 ,HPLC -FD法测定 87例急性脑血栓形成患者和 80例对照者血浆HCY浓度 ,入院 3d内病情稳定后完成脑血栓形成患者临床神经功能缺损程度评分和按OCSP(OxfordCommunityStrokeProject)完成脑梗死临床分型。结果 :病例组空腹血浆HCY浓度 (15 .2 8± 4 .33umol/L)较对照组 (11.32± 3.86umol/L)高 (P <0 .0 0 1) ,两组中血浆HCY升高者分别为 31% (2 7/ 87)和 6 .3% (5 / 80 ) (P <0 .0 0 1) ;病例组 87例 ,按 0CSP脑梗死临床分型法分为TACⅠ 10例、PACI 5 6例、POCI 9例和LACI 12例 ,血浆HCY浓度各为 13.39± 2 .0 9、15 .16± 4 .5 6、16 .16± 3.86和 16 .77± 4 .6 4umol/L(F =1.2 6 3,P =0 .2 93) ;按改良爱丁堡 -斯堪的那维亚神经功能缺损程度评分标准将病例组患者分为轻型 4 3例、中型 36例和重型 8例 ,血浆HCY浓度各为 15 .6 3± 4 .4 8、14 .90± 4 .33和 15 .11± 3.76umol/L(F =0 .2 77,P=0 .75 8)。结论 :高HCY血症是脑血栓形成的独立危险因素 ,研究未显示血浆Hcy浓度与脑梗死临床分型和神经功能缺损程度有关。     

粘附分子P-选择素在糖尿病肾病中表达的临床意义

目的　探讨 2型糖尿病患者粘附分子P -选择素 (CD6 2 p)表达及其与肾脏微血管并发症的关系。 方法　用流式细胞仪分别测定有、无并发肾脏微血管病变的 48例 2型糖尿病患者粘附分子CD6 2 p的表达 ,同时测定血小板常规参数 ,分别同正常对照组比较。结果　有、无并发肾病组糖尿病患者CD6 2 p的表达分别为 7.6 3± 2 .3、3.31± 2 .1,均显著高于正常对照组 (P <0 .0 1,<0 .0 5 ) ,并发肾病组又高于无并发肾病组 (P <0 .0 5 )。而各组间血小板的常规指标比较无明显差异 (P >0 .0 5 )。结论　 2型糖尿病患者粘附分子CD6 2p的表达与肾脏微血管病变的发生有密切关系。     

弗斯兰治疗缺血性脑血管病30例临床观察

目的 :评价弗斯兰 (盐酸丁咯地尔 )治疗急性脑梗死的疗效。方法 :随机选择颈内动脉系统急性脑梗死患者 30例治疗组 ,静滴弗斯兰 2 0 0 mg/d;30例对照组静滴丹参40 ml/d,持续 2周。治疗前后患者做神经功能缺损程度评分、生活能力评价、血液流变学检查。结果 :弗斯兰组神经功能缺损评分治疗后 ( 5 .41± 5 .37)较治疗前 ( 1 6.30± 5 .76)有显著性差异 ,神经功能缺损评分的改善治疗组 ( 1 0 .89± 2 .0 6)与对照组 ( 6.5 5± 2 .1 3)相比有显著性差异 ,生活能力等级的提高较前有显著性差异 ,弗斯兰治疗后血液粘度及血小板聚集率下降。结论 :弗斯兰是治疗急性脑梗死的一种安全有效的药物     

丁咯地尔治疗脑梗死98例

1　对象和方法1.1　对象　急性脑梗死患者 196例 ,均经头部 CT证实 ,符合 1995年全国第四届脑血管病学术会议通过的脑梗死诊断标准 [1 ] ,按会议通过的“脑卒中临床神经功能缺损程度评分标准”[2 ]分为轻、中、重三型 ,轻型 0～ 15分、中型 16～ 30分、重型 31～ 45分 .随机分为治疗组 98(男 6 2 ,女 36 )例 ,年龄 43～91(平均 6 2± 13)岁 ,轻型 31例 ,中型 5 4例 ,重型 13例 ,神经功能缺损评分 15± 10分 .对照组 98(男 5 8,女 40 )例 ,年龄 46～ 88(平均 6 3± 11)岁 ,轻型 34例 ,中型 5 3例 ,重型 11例 ,神经功能缺损评分 16± 10分 .…     

脑梗死患者血小板活化状态及血小板参数的研究

目的:探讨脑梗死患者血小板膜糖蛋白P选择素(CD62P)、溶酶体蛋白(CD63)以及血小板3项参数即血小板计数(PLT)、血小板平均体积(MPV)和血小板最大聚集率(MAR)的变化及意义。方法:采用流式细胞术测定168例脑梗死患者血小板活化指标CD62P、CD63的表达,同时对其进行血小板3项参数PLT、MPV和MAR的测定,并与对照组比较。结果:(1)脑梗死患者急性期CD62P、CD63、MPV及MAR较健康对照组以及恢复期患者显著升高,而且恢复期患者上述指标仍高于健康对照组(均为P<0.01),而PLT在脑梗死急性期、恢复期及健康对照组之间均无显著性差异(均为P>0.05)。(2)CD62P、CD63、MPV及MAR与神经功能缺损程度评分呈显著直线正相关(r=0.84、0.817、0.684和0.698,均为P<0.01),而PLT与神经功能缺损程度评分间无相关性(r=0.32,P>0.05)。结论:脑梗死患者血小板大量活化及其体积和最大聚集率的升高参与了脑梗死的病理过程,MPV和MAR较PLT更能反映脑梗死的严重程度。     

心脑血管疾病患者血小板活化分子检测的临床意义

目的　探讨心脑血管疾病患者血小板的活化状态及其临床意义。方法　利用流式细胞仪检测了 10 1例心脑血管病患者及 4 5例正常人外周血小板的膜糖蛋白CD6 2 p、CD6 3、CD4 1、CD6 1的表达。 结果　冠心病组、高血压组、脑梗死组患者的CD6 2 p、CD6 3表达与正常人组比较均显著增高 (P <0 0 5 ) ,各组的CD4 1、CD6 1表达与正常人组比较没有显著差异 (P >0 0 5 )。结论　心脑血管疾病患者的血小板活化均增高 ,因此检测活化血小板的特异膜糖蛋白在这些疾病中有重要的临床意义。     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

Analysis of CK-19,PDX-1,Nestin,Ngn3 in different donor islet purity in rats

Objective: To investigate if there are the CK-19, PDX-1, Nestin, Ngn3 positive cells in the donor islets of different purity in rats. Methods: Thirty male adult SD rats were randomly divided into 3 groups. Islets were isolated using digestion by ductal injection of collagenase. Group Ⅰ (n=10): Separating cell preparations were not purified, Group Ⅱ(n=10): Islet sediment was purified with 25% Ficoll400 ,Group Ⅲ (n=10): Islet sediment was purified with 25% and 11% Ficoll-400. The levels of protein of CK-19, PDX-1, Nestin and Ngn3 were detected by immunohistochemistry and the mRNA of CK-19, PDX-1, Nestin, Ngn3 was amplified by RT-PCR. Results: After two different purification methods applied, three islet preparations of different purities were obtained. The difference of islet purity was significant among various groups (P＜0.05). Compared with group Ⅱ and group Ⅲ,the protein and mRNA of CK-19, PDX-1, Nestin,Ngn3 were both higher in group Ⅰ; group Ⅲ was poorly expressed. Conclusions: The three different islet purity donor islet have different CK-19, PDX-1, Nestin, Ngn3 positive cells within them, indicating that there are some islet stem cells in the purified donor islet.     

Dr.Zhang Ren''''s Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

Luo Lingjie''''s Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.