高同型半胱氨酸血症与脑卒中相关性研究

目的探讨血浆同型半胱氨酸(H cy)水平对脑卒中临床亚型、复发及痴呆的影响,并研究高同型半胱氨酸血症(HH)与脑卒中传统危险因素之间的相关性。方法应用酶联免疫吸附试验(EL ISA)检测90例急性脑卒中患者血浆H cy水平。将研究对象分为不同临床亚型,脑白质损伤组与非脑白质损伤组,青年组与老年组,痴呆组与非痴呆组。对不同类型脑卒中患者血浆H cy水平进行比较,对HH脑卒中传统危险因素进行相关与回归分析。结果首次发作(FCS)组血浆H cy水平明显低于复发(RCS)组(P<0.01),HH发生率比较RCS组明显高于FCS组(P<0.05)。痴呆组血浆H cy水平与对照组有差别(P<0.01)。饮酒者血浆H cy含量明显高于不摄入酒精者(P<0.05)。结论HH是脑卒中的独立危险因素,脑卒中患者普遍存在HH,在复发性脑卒中患者中尤其明显。血浆H cy水平随年龄增加而增加,同时HH与血管性痴呆和/或变性性痴呆有关。     

Effects of acute liver injury on blood coagulation

Summary.  The mechanisms leading to the hemostatic changes of acute liver injury are poorly understood. To study these further we have assessed coagulation and immune changes in patients with acute paracetamol overdose and compared the results to patients with chronic cirrhosis and normal healthy controls. The results demonstrate that in paracetamol overdose coagulation factors (F)II, V, VII and X were reduced to a similar degree and were significantly lower than FIX and FXI (mean levels 0.28, 0.16, 0.13, 0.19, 0.51 and 0.72 IU mL⁻¹, respectively). In cirrhosis, by contrast, FII, FV, FVII, FIX and FX were equally reduced whilst FXI was lower than the other factors (mean levels 0.64, 0.69, 0.62, 0.60, 0.66 and 0.40 IU mL⁻¹, respectively). FVIII was raised in paracetamol overdose patients but normal in those with cirrhosis (mean levels 1.95 and 1.01 IU mL⁻¹, respectively). Interleukin-6 and tumor necrosis factor-α levels were raised in both patient groups, but higher levels were found in paracetamol overdose, compared to cirrhosis. Thrombin-antithrombin and soluble tissue factor levels were higher in those with acute liver injury but normal in cirrhosis. Antithrombin levels were reduced in both acute liver injury and cirrhosis. From these data we put forward a novel mechanism for the coagulation changes in acute paracetamol induced liver injury. We propose that immune activation leads to tissue factor-initiated consumption of FII, FV, FVII and FX, but that levels of FIX and FXI are better preserved because antithrombin inhibits the thrombin induced positive feedback loop that activates these latter factors.     

Proximal load transfer with a stemless uncemented femoral implant

Bone stock preservation is crucial when performing total hip replacement in young patients. The aim is to save good bone stock for a possible revision procedure. Furthermore, there is an increasing demand from young and active patients to receive a new joint which allows a normal or nearly normal life style. With this in mind, we began, in 1993, to develop a new femoral implant. The purpose of this ultra-short stem was a physiologic strain distribution on the proximal femur with a proximal load transfer from the implant to the femoral bone. Main features were an almost complete absence of the diaphyseal portion of the stem, a well defined lateral flare with load transfer on the lateral column of the femur, and a very high femoral neck cut. These innovations resulted in a conservative implant on both the bone stock and the soft tissues. This implant, in the first years, was recommended only for young and active patients. Over the last thirteen years, this project has undergone several modifications but the basic principles of the implant have remained the same. In the present review, we present the rationale, the surgical technique and the clinical and experimental results so far obtained with this implant.     

痛经的临床因素分析

目的:痛经的发病率逐年增高,重新分析痛经患者的临床因素,提出新的认识。方法:将1 158例痛经患者的临床资料及超声检查结果进行统计学分析。结果:人工流产史与痛经的发生有密切相关性(P<0.001)。结论:人工流产手术是引起痛经的主要原因。该手术所产生的副作用可对女性生理健康造成严重伤害,必须引起全社会的高度关注。     

体外培养骨髓单个核细胞分泌促血管生长因子的实验研究

目的分析体外培养的骨髓单个核细胞持续分泌促血管生长因子的能力。方法从大鼠胫骨及股骨采集骨髓,密度梯度离心法分离出骨髓单个核细胞进行体外培养,并连续收集4周培养上清液。酶联免疫吸附实验(ELISA)法测定培养上清液中碱性成纤维细胞生长因子(bFGF)、血管内皮细胞生长因子(VEGF)和白介素-1β(IL-1β)等因子水平。结果第1、2、3、4周骨髓单个核细胞体外培养上清液中VEGF分别为(24.40±7.99)pg/m、l(89.28±5.13)pg/m、l(115.24±10.08)pg/m、l(157.00±15.64)pg/m l;bFGF含量分别为(52.72±2.13)pg/m、l(48.10±6.41)pg/m、l(44.71±3.21)pg/m、l(25.61±2.42)pg/m l;IL-1β含量分别为:(31.28±5.44)pg/m、l(71.87±3.01)pg/m、l(55.77±11.94)pg/m、l(41.75±9.14)pg/m。l结论体外培养骨髓单个核细胞可持续分泌VEGF、bFGF、IL-1β等多种促血管生长因子。     

Evaluation of Training Course Effects on Integrated Sexual and Reproductive Health Counseling

Since the International Conference on Population and Development held in Cairo in 1994, and the Fourth World Conference on Women held in Beijing in 1995, the international organizations and public health communities have paid more attention to reproductiv…     

阿尔茨海默病与血管性因素的关系探讨

目的探讨阿尔茨海默病（AD）与血管性因素之间的关系。方法选取解放军总医院临床诊断可能的AD患者91例，以性别、职业和受教育程度相匹配的认知功能正常老年人155例为对照，以Logistic回归模型分析各种血管性因素与AD的关系。结果单因素分析显示，起搏器心律、贫血、冠心病、慢性阻塞性肺疾病、脑卒中、心律失常、短暂性脑缺血发作、心脏传导阻滞、高脂血症、糖尿病史、婚姻状况及年龄与AD有关，OR值范围为12．83～1．18。多因素分析校正了年龄和婚姻状况的影响后，证实贫血、冠心病和脑卒中史与AD有关，OR值（95％可信区间）依次为4．87（2．12～11．22）、2．94（1．38～6．27）、2．44（1．28～4．64）。结论AD与血管性因素有关，贫血、冠心病和脑卒中史可能是AD的独立危险因素。     

脑卒中后抑郁症相关心理社会因素的对照研究

目的 探讨脑卒中后抑郁症相关的心理社会因素,以指导心理干预,提高生活质量。方法 30例卒中后抑郁患者为研究组,42例卒中后无抑郁患者为对照组。以医学应对问卷、社会支持评定量表(SSRS)和Barthel指数(BI)为评定工具,对两组患者分别进行评定。结果研究组面对量表分显著低于对照组(P<0.05),而屈服量表分显著高于对照组(P<0.01)。研究组SSRS评分显著低于对照组(P<0.01)。两组BI评分差异无显著性(P>0.05)。结论 有针对性的心理教育性干预并加强社会支持可能对防治卒中后抑郁起重要作用。     

不同促细胞分裂因子对人神经干细胞定向分化的影响

目的观察不同促细胞分裂因子对人神经干细胞(NSCs)增殖及定向分化的影响。方法对人NSCs用无血清DMEM培养基行原代培养的同时,分别加入表皮生长因子(EGF)、碱性成纤维生长因子(bFGF)、神经生长因子(NGF)、维甲酸(RA)等因子,观察其对NSCs定向分化的作用。结果EGF培养的NSCs,克隆球形成慢且较松散,经血清诱导分化后,主要为星形胶质细胞,仅有少数神经元。而bFGF培养的NSCs则生长良好。在加血清诱导分化后,不同浓度bFGF培养的NSCs分化的细胞不同。bFGF与EGF共同培养的NSCs,其生长及神经球形成良好。在加血清诱导分化后,分化的神经细胞比例更接近脑内神经细胞的组分。NGF对神经球的形成无明显影响,但可促使其向神经元分化。RA使神经克隆球形成,可使NSCs直接分化为神经元细胞的比例明显增加。结论不同促细胞分裂因子对人NSCs的增殖及定向分化均有一定影响。