体外心脏震波治疗前后外周血内皮祖细胞数量的变化

背景：体外心脏震波治疗对冠状动脉粥样硬化性心脏病患者外周血内皮祖细胞影响的机制,目前尚不清楚。 目的：观察体外心脏震波治疗对冠状动脉粥样硬化性心脏病患者外周血内皮祖细胞增殖、分化的影响。 方法：选择行体外心脏震波治疗冠状动脉粥样硬化性心脏病患者25例。以未行心脏震波治疗冠状动脉粥样硬化性心脏病患者10例作为对照组,从外周血获取单个核细胞,将其在EGM-2-MV培养基培养,并分析细胞形态和形成集落的数量,7 d后贴壁细胞进行细胞分析和计数。用激光共聚焦显微镜鉴定分化的内皮祖细胞。 结果与结论：震波治疗组患者外周血内皮祖细胞数量、形成细胞集落数较对照组明显增多(P < 0. 05),提示体外心脏震波治疗对冠状动脉粥样硬化性心脏病患者外周血内皮祖细胞增殖及向内皮细胞系分化有显著促进作用。     

辛伐他汀对体外培养人脐静脉血内皮祖细胞扩增及黏附能力的影响

背景：他汀类药物可促进急性缺血后的血管新生、加速球囊损伤血管的再内皮化并减少新内膜下组织的增生，且这两个作用均与血管内皮祖细胞密切相关。 目的：通过体外培养人脐静脉血血管内皮祖细胞，观察辛伐他汀对血管内皮祖细胞扩增及黏附能力的影响。 设计、时间及地点：以细胞为观察对象，分组对比实验，于2006-02/10在吉林大学基础医学院病理生理教研室完成。 材料：人脐静脉血采集来源于吉林大学第二临床医学院妇产科6名正常足月顺产健康产妇。 方法：密度梯度离心法分离培养人脐静脉血血管内皮祖细胞。通过免疫荧光法观察内皮细胞吸收乙酰化低密度脂蛋白和荆豆凝血素Ⅰ情况，流式细胞仪定量检测血管内皮祖细胞表面CD133、CD34和KDR抗原表达阳性率来鉴定血管内皮祖细胞。倒置显微镜下观察血管内皮祖细胞形态学变化，计数细胞并绘制生长曲线。实验按M199培养基含辛伐他汀纯品浓度不同分5组，分别为0， 0.01，0.1，1，10 μmol/L 辛伐他汀组，其中0 μmol/L作对照。四甲基偶氮唑盐比色法观察血管内皮祖细胞增殖情况，计数贴壁细胞数法评价血管内皮祖细胞的黏附程度。 主要观察指标：原代培养血管内皮祖细胞形态变化；各组细胞增殖及黏附能力。 结果：①培养细胞呈长梭形，接种2~4 d 梭形形态细胞较少，为细胞生长的潜伏期；6~10 d 贴壁梭形细胞逐渐增多，为对数增殖期；10~14 d 细胞融合呈集落样生长，梭形细胞明显增多，进入生长平台期。②激光共聚焦显微镜鉴定乙酰化低密度脂蛋白、荆豆凝血素Ⅰ双染阳性的细胞为正在分化的血管内皮祖细胞。③流式细胞仪检测细胞表达CD133、CD34和KDR抗原的阳性率分别为（7.30±2.71）%、（42.00±6.42）%，（89.30±10.45）%。④四甲基偶氮唑盐比色结果表明各浓度组血管内皮祖细胞增殖活力、贴壁的血管内皮祖细胞数均较对照组增强（P < 0.05）；但以1 μmol/L 浓度下血管内皮祖细胞增殖活力最强。 结论：辛伐他汀能增强体外培养血管内皮祖细胞的扩增及黏附能力。     

颈内动脉粥样硬化性脑梗死患者外周血内皮祖细胞的变化趋势

目的 观察急性颈内动脉粥样硬化性脑梗死患者外周血内皮祖细胞数目的 变化趋势.方法 分别于发病24 h,以及第4、7、14 和21 天时提取30 例成年急性脑梗死患者外周血单个核细胞,流式细胞术检测CD34和CD133表达水平,计数内皮祖细胞数目.结果 不同处理组患者各观察时间点外周血内皮祖细胞数目比较,差异均有统计学意义(P = 0.000).脑梗死后24 h,脑梗死组和颈动脉硬化组患者外周血内皮祖细胞数目均低于对照组(P = 0.000);脑梗死后第7 天,外周血内皮祖细胞数目减少至最低水平(P = 0.001),至第21 天外周血内皮祖细胞数目接近颈动脉硬化组水平(P = 0.901),但仍低于正常值范围(P = 0.000).内皮祖细胞数目的 变化与血小板计数之间不具有相关性(R2 = 0.852,P = 0.895).结论 颈内动脉系统粥样硬化所致脑梗死患者外周血内皮祖细胞数目低于正常值范围,且于急性期可能存在骨髓动员抑制,同时需要消耗大量内皮祖细胞以进行损伤内皮的修复,使得患者在急性期出现短暂性内皮祖细胞数目减少.     

依达拉奉治疗急性脑梗死后脑水肿的MRI动态观察

目的通过MRI各项指标观察依达拉奉钠对急性脑梗死后脑水肿影响。方法将60例急性脑梗死患者随机分成对照组30例和治疗组30例,对照组予以脑梗死常规治疗,治疗组在常规治疗基础上加用依达拉奉,在脑梗死后1,5,14d行MRI扫描,扫描后工作站后处理合成ADC图,测量、计算脑梗死体积、水肿吸收率（△V）、各序列的信号强度比（SIR）、信号强度比相对变化率（ASIR）、相对ADC（rADC）。结果脑梗死后14d,治疗组的脑梗死体积明显小于对照组,差异具有统计学意义（P〈0．01）;治疗组的△V明显高于对照组,差异具有统计学意义（P〈0．05）。脑梗死后5d和14d,治疗组T1wI的sIR均明显高于对照组,差异具有统计学意义（P〈0．01）,T2WI、FLAIR序列的ASIR均明显低于对照组,差异具有统计学意义（P〈0．05）。脑梗死后5d,治疗组DwI序列的SIR明显低于对照组,差异具有统计学意义（P〈0．01）。治疗组T1wI、T2wI、FLAIR序列的△sIR均明显高于对照组,差异具有统计学意义（P〈0．05）。梗死后5d,治疗组梗死区rADC明显高于对照组,差异具有统计学意义（P〈0．01）。结论依达拉奉对缺血性脑水肿有明显的抑制作用。     

急性脑梗死患者血液流变学及血细胞成分临床观察

目的：探讨急性脑梗死患者血液流变学及血细胞成分的变化。方法：对62例急性脑梗死患者进行血液流变学及血细胞成分检测并与对照组相比较。结果：患者组血液流变学指标及红细胞（RBC）计数显著高于对照组（P＜0．05~0．001）,血红蛋白（HGB）、平均红细胞体积（MCV）、平均血红蛋白含量（MCH）和平均红细胞血红蛋白浓度（＊C＊c）显著低于对照组（P＜0.01~0．001）,与对照组比较男性患者白细胞（WBC）计数无显著性差异（P＞0．05）,女性患者差异具有显著性（P＜0．05）。结论：血液流变学及血细胞参数异常可能与急性脑梗死发生有关。     

早期康复治疗对急性脑梗死患者运动、肌痉挛及生活活动能力的影响

目的：应用Fugl-Meyer量表、改良Ashworth量表和简化巴氏指数量表（BI）分别进行评定,探讨早期康复治疗对急性脑梗死偏瘫患者运动功能、肌痉挛及日常生活活动能力（ADL）的影响。方法：选择急性脑梗死偏瘫患者90例,随机分为康复治疗组和对照组。康复治疗组在临床药物治疗的同时进行规范的康复训练,对照组给予临床药物治疗及未经指导的自我锻炼,在患者入组时和30d后分别进行有关的功能评定,评价两组的疗效。结果：治疗前两组的一般资料、运动功能、肌痉挛与ADL的评定差异无统计学意义（P〉0．05）,经30d治疗后,运动能力和BI均有一定程度的改善,改善幅度康复治疗组明显优于对照组（P〈0．05）,肌痉挛评分康复治疗组也明显优于对照组（P〈0．05）。结论：早期康复治疗有助于改善急性脑梗死偏瘫患者的运动、肌痉挛及生活活动能力。     

通心络对颈动脉粥样硬化斑块患者内皮祖细胞增殖能力的影响

目的探讨通心络胶囊对颈动脉粥样硬化斑块患者内皮祖细胞（endothelial progenitor cells,EPCs）功能的影响。方法选择颈动脉粥样硬化斑块（软斑和/或混合斑）患者20例,分别于通心络治疗前和治疗后1个月诱导分化其外周血来源的EPCs,培养第7天测定EPCs的增殖能力、细胞和集落计数并进行对比。结果通心络治疗前EPCs增殖能力为（0.193&#177;0.037）,细胞计数为（60.24&#177;11.36）,集落计数为（2.50&#177;0.41）;治疗后EPCs增殖能力为（0.260&#177;0.044）,细胞计数为（80.16&#177;14.01）,集落计数为（4.22&#177;0.79）,治疗前后相比差异具有统计学意义（P〈0.05）。结论通心络可以增强颈动脉粥样硬化斑块患者EPCs的增殖能力,增加EPCs集落和细胞数目。     

不同TOAST分型维汉急性脑梗死患者的血清胆红素、γ－谷氨酰转移酶水平比较

目的：探讨新疆维吾尔族与汉族急性脑梗死患者的危险因素,以及 TOAST 不同分型与胆红素、γ－谷氨酰转移酶（GG T ）的相关性。方法选取急性脑梗死汉族患者323例与维族尔族患者144例,检测血清胆红素、GGT水平,了解TOAST分型构成比。比较不同分型维汉患者的血清胆红素、GGT水平。结果维族患者吸烟、饮酒比例明显低于汉族患者,差异有统计学意义（P ＜0．01）汉族组血清总胆红素（TBIL）、直接胆红素（DBIL）、间接胆红素（TBIL）、GGT水平高于维族组,差异有统计学意义（P＜0．05）。TOAST分型中,维族与汉族ACI各亚型构成比比较,差异无统计学意义（χ2＝0．824,P＞0．05）。LAA型患者中,维族患者TBIL、DBIL、GGT水平低于汉族患者,差异有统计学意义（P ＜0．05）;CE型患者中,两组各项比较差异均无统计学意义;SAO型患者中,维族患者 TBIL、IBIL水平低于汉族患者,差异有统计学意义（P ＜0．05）。结论维族与汉族ACI患者不同TOAST 病因分型血清胆红素、GG T水平可能亦不同,其饮酒、吸烟的发生有差异,为不同民族脑梗死疾病的预防和病情评估可能提供一定的临床依据。     

青年脑梗死患者血浆同型半胱氨酸水平及影响因素研究

目的分析青年脑梗死患者血浆同型半胱氨酸（homocysteine，Hcy）的水平特点，并探讨其相关因素。方法采用高效液相色谱法检测55例青年脑梗死患者、316例老年脑梗死患者和40名健康青年对照者血浆Hcy水平，对青年脑梗死患者血浆Hcy的分布特征及相关因素进行统计学分析。结果青年脑梗死组血浆Hcy水平（几何均数17．35μmol/L）高于健康青年对照组（几何均数11．88μmol／L），差异有统计学意义（P〈0．01）；与老年脑梗死组（几何均数17．60μmol／L）比较差异无统计学意义（P〉0．05）；青年脑梗死患者Hcy水平与叶酸水平以及性别相关，回归系数分别为～0．513（P〈0．01）和-0．242（P〈O．05）。结论青年脑梗死患者血浆Hcy水平显著增高，男性高于女性，Hcy水平与叶酸水平呈负相关。     

三七总皂苷对急性脑梗死患者血清sICAM-1的影响

目的观察不同的药物治疗对急性脑梗死患者血清可溶性细胞间黏附分子-1（sICAM-1）的影响。方法84例患者分为治疗组44例和对照组40例，治疗组应用三七总皂苷，对照组应用维脑路通，采用双抗体酶联免疫吸附法（ELISA）分析。结果2组患者治疗后血清sICAM-1含量均降低，治疗组下降更显著。结论三七总皂苷对急性脑梗死患者血清中异常升高的sICAM-1有明显降低作用，其疗效优于对照组，差异有统计学意义（P〈0．05）。     

Mechanism of action of tubocurarine on nicotinic cholinoreceptors of neurons of the sympathetic ganglia of rats

Tubocurarine (Tc) effect on membrane currents elicited by acetylcholine (ACh) was studied in isolated superior cervical ganglion neurons of rat using patch-clamp method in the whole-cell recording mode. The "use-dependent" block of ACh current by Tc was revealed in the experiments with ACh applications, indicating that Tc blocked the channels opened by ACh. Mean lifetime of Tc-open channel complex, tau, was found to be 9.8 +/- 0.5 s (n = 7) at -50 mV and 20-24 degrees C. tau exponentially increased with membrane hyperpolarization (e-fold change in tau corresponded to the membrane potential shift by 61 mV). Inhibition of the ACh-induced current by Tc (3-30 microM/1) was completely abolished by membrane depolarization to the level of 80-100 mV. Inhibition of ACh-induced current was augmented at increased ACh doses. It is concluded that the open channel block produced by Tc is likely to be the only mechanism for Tc action on nicotinic acetylcholine receptors in superior cervical ganglion neurons of rat.     

The effect of age of onset of PD on risk of dementia

Background Dementia occurs in the majority of patients with Parkinson’s disease (PD). Late onset of PD has been reported to be associated with a higher risk for dementia. However, age at onset (AAO) and age at baseline assessment are often correlated. The aim of this study was to explore whether AAO of PD symptoms is a risk factor for dementia independent of the general effect of age. Methods Two community-based studies of PD in New York (n = 281) and Rogaland county, Norway (n = 227) and two population-based groups of healthy elderly from New York (n = 180) and Odense, Denmark (n = 2414) were followed prospectively for 3–4 years and assessed for dementia according to DSM-IIIR. All PD and control cases underwent neurological examination and were followed with neurological and neuropsychological assessments. We used Cox proportional hazards regression based on three different time scales to explore the effect of AAO of PD on risk of dementia, adjusting for age at baseline and other demographic and clinical variables. Findings In both PD groups and in the pooled analyses, there was a significant effect of age at baseline assessment on the time to develop dementia, but there was no effect of AAO independent of age itself. Consistent with these results, there was no increased relative effect of age on the time to develop dementia in PD cases compared with controls. Interpretation This study shows that it is the general effect of age, rather than AAO that is associated with incident dementia in subjects with PD. Received in revised form: 22 December 2005     

Limits of deinstitutionalization--perspectives of relatives of psychiatric patients

After a hopeful beginning, the social process of the reintegration of those with severe mental illness has come to a standstill. I am led to wonder whether "the community" really wants to live together with people suffering from severe mental illness, and if so, how closely? As long as the medical treatment of mental illness provided by the general practitioners is fundamentally deficient, as they are not able to prescribe the necessary interventions--such as out-patient psychiatric nursing, and service providers in the out-patient sector are content with offering increasingly intensive forms of care for the less seriously ill at the cost of the Social Welfare System--the reintegration of those with serious mental illness remains an illusion--which is mainly to the benefit of providers of residential care in homes and hostels.     

Sense of coherence as a predictor of subjective state of health: results of 4 years of follow-up of adults

A number of cross-sectional population studies have shown that a strong sense of coherence (SOC) is associated with various aspects of good perceived health. The association does not seem to be entirely attributable to underlying associations of SOC with other variables, such as age or level of education. OBJECTIVE: The aim of the study reported here was to determine whether SOC predicted subjective state of health. METHODS: The study was carried out as a two-way panel mail survey of 1976 individuals with 4 years interval for two collections of data. The statistical method used was multivariate cumulative logistic modeling. Age, initial subjective state of health, initial occupational training level, and initial degree of social integration were included as potential explanatory variables. RESULTS: A strong SOC predicted good health in women and men. CONCLUSIONS: SOC can be interpreted as an autonomous internal resource contributing to a favorable development of subjective state of health. SOC data should, however, be regarded as complementary to and not a substitute for information already known to be associated with increased risk of future ill health.