彩色多普勒超声诊断镜像右位心并矫正型大动脉转位1例

患者男，32岁。因劳动或喝酒时出现右侧胸部不适反复发作而就诊。查体：心率78次／min、律齐，心尖搏动点位于右锁骨中线第五肋间外约1．0cm处，心尖部可闻及2／6级收缩期吹风样杂音，较柔和。超声检查示腹部脏器全部反位，肝胆位于上腹部、脾脏位于右上腹部。彩色多普勒超声心动图显示：心脏位于右侧胸腔，与左位心呈“镜像”位显示，收集4根肺静脉血的左心房位于右侧，与三尖瓣及右心室相通（图1），     

基层医改依然有挑战

医改和医院管理是两个概念。医院管理是提高医院管理能力,搞好医疗质量,转变服务模式,加强医院内部的监督与管理,最终目的是为老百姓提供好的医疗服务,让老百姓满意。但它不能称之为医疗改革。真正的改革是要从政策、法规、制度、体制上进行改革。     

模拟7500m高空飞行血浆TXB2、6-K-PGF1α、VWF含量和心电图变化

<正> 作者对30名轰炸机飞行员进行模拟7500m 高空飞行前后血浆血栓素 B₂（TXB₂）、6-酮前列腺素 F_1α(6-K-PGF_1α)、假性血友病因子（VWF）含量和心电图变化的研究,结果发现 TXB₂含量从飞行前平均0.4 6±0.10nmol/L 上升至飞行后的0.52±Q.12nmol/L,相差显著（P<0.05）。心率从73.04次/min 加快至105.11次/min,Q—T 间期从0.357缩短至0.309,分别具有显著差异（P<0.05,P<0.05）。但前一项和后两项变化无明显相关。心脏对缺氧甚为敏感,本组观察飞行员     

肝癌患者乙型肝炎病毒基因变异的检测

目的了解肝癌患者HBV基因变异、机体免疫功能异常及肿瘤抑制基因P16蛋白失活的情况。方法运用基因芯片和核苷酸序列分析技术，对114份我院住院患者血清中HBVDNA（前C区1814、1896、BCP区1762、1764位）进行分析，流式细胞荧光染色检测患者外周血WBC中P16蛋白，流式细胞仪检测T淋巴细胞亚群，ELISA法检测IFN-γ、IL-4水平。结果慢性乙型肝炎组（41份）、乙型肝炎肝硬化组（37份）、肝癌组（36份）血清中的HBV总突变率为58．5％、75．6％和88．8％，肝组织中肝硬化、肝癌分别为75．0％和100％；慢性乙型肝炎、乙型肝炎肝硬化、肝癌组患者外周血WBC中P16蛋白阳性率分别为（43．09±8．08）％、（30．54±10．61）％和（16．29±6．86）％，正常人为（76．57±6．07）％；肝癌患者CD3^＋、CD4^＋、CD8^＋T淋巴细胞绝对数均明显低于健康对照组（t＇1=8．83、t＇2=6．59、t＇3=9．84，P〈0．05）；肝癌患者IFN-γ、IL-4水平明显低于健康者（t＇1=6．67、t＇2=3．82，P〈0．05）。结论肝癌患者中HBV基因变异普遍存在，机体免疫功能低下，外周血WBC中P16蛋白表达明显低。     

表里经配穴法对脑缺血再灌注损伤大鼠海马细胞凋亡及JNK信号通路的影响

【目的】观察表里经配穴法对脑缺血再灌注损伤大鼠海马细胞凋亡及c－jun氨基末端激酶（JNK）信号通路的影响,探讨其对脑缺血再灌注损伤保护作用的可能机制。【方法】将120只SD大鼠随机分为假手术组、模型组、表里经配穴电针组、抑制剂组;参照Longa法复制局灶脑缺血再灌注模型,表里经配穴电针组取表里经配穴的足三里、三阴交和尺泽、合谷行电针治疗,每日1次。采用神经行为学评定各组大鼠不同时段神经行为, TUNEL法检测海马细胞凋亡指数,免疫组织化学法检测p－JNK表达。【结果】表里经配穴电针组、抑制剂组神经功能缺损评分均显著低于模型组（P＜0．05）;模型组凋亡指数显著高于假手术组（P＜0．01）,表里经配穴电针组和抑制剂组凋亡指数均显著低于模型组（P＜0．05）;模型组各时段p－JNK表达较假手术组显著增加（P＜0．01）,表里经配穴电针组、抑制剂组p－JNK表达较模型组显著降低（P＜0．05）。【结论】表里经配穴法可不同程度地减轻缺血再灌注后大鼠的神经功能缺损,减少细胞凋亡,其机制可能与抑制JNK信号通路有关。     

肝癌患者外周血白细胞中p16蛋白的表达及其意义

目的了解肝癌患者外周血白细胞中P16蛋白的表达及其意义。方法对20例正常献血员,32例慢性乙型肝炎,28例肝硬化,35例肝癌患者外周血白细胞进行P16蛋白的流式细胞荧光染色检查。结果P16蛋白在正常献血员,慢性乙型肝炎,肝硬化,肝癌中阳性率分别为(76.57±6.07)%、(43.09±8.08)%、(30.54±10.61)%、(16.29±6.86)%,正常献血员中的阳性率明显高于后三者(P<0.05),慢性乙型肝炎阳性率明显高于肝硬化和肝癌(P<0.05)。结论肝细胞癌的发生可能与P16表达减少有关。     

善良 丰富 高贵

如果我是一个从前的哲人,来到今天的世界,我会最怀念什么？一定是这六个字：善良,丰富,高贵。看到医院拒收付不起昂贵医疗费的穷人,听凭危急病人死去,看到商人出售假药和伪劣食品,制造急性和慢性的死亡,看到矿难频繁,矿主用工人的生命换取高额利润,看到每天发生的许多凶杀案,往往为了很少的一点钱或一个很小的缘由夺走一条命,我为人心的冷漠感到震惊,于是我怀念善良。     

周国平:如何打造属于你的健康人生

人怎样活着才是健康的?用什么标准来衡量呢?我觉得这是一个问题,不管你是肢体健全的人也好,还是器官有残疾的人也好,都会面临这个问题。当然我们都希望活在这个世界上都是健康的。但这种健康是你自己左右不了的,不管是天生的原因还是后天的原因,每一个人都有可能成为残疾人,好好的发生地     

不同年龄脑出血大鼠海马齿状回神经干细胞增殖与分化差异的比较

BACKGROUND:Cerebral hemorrhage can activate the proliferation and differentiation of neural stem cells in the dentate gyrus of the hippocampus. Through continuous differentiation and proliferation, endogenous neural stem cells can gradually replace aging and damaged neurons, thus protecting the brain structure. OBJECTIVE:To compare the difference of the proliferation and differentiation of neural stem cells in the dentate gyrus of the hippocampus of rats with different ages. METHODS:Ninety-six adult rats and 96 aged rats were randomly divided into normal group (n=18 per group), sham operation group (n=12 per group) and cerebral hemorrhage group (model group, n=66 per group), respectively. Cerebral hemorrhage models were made in the two model groups in which, the rats were subjected to cerebral hemorrhage for 6, 24, 48, 72 hours and 7 days, respectively. Then, brain tissues were collected to measure brain water content. BrdU/NeuN and BrdU/GFAP double staining were performed at 3, 7, 14, 21, 28 days after surgery to calculate the number of positive cells. RESULTS AND CONCLUSION:For both adult and aged rats, the brain water content was significantly higher than that in the normal group and sham operation group (P < 0.05), while in the normal and sham operation groups, the brain water content was significantly lower in the aged rats than the adult rats (P  < 0.05). The number of bilateral BrdU-positive cells in the adult and aged model groups was significantly higher than that in the corresponding normal and sham operation groups (P  < 0.05), and moreover, the positive cell number at the hemorrhage side was significantly higher than that at the opposite side (P < 0.05). In addition, the number of BrdU-positive cells at the hemorrhage side in the adult rats was significantly higher than that in the aged rats at different time after cerebral hemorrhage (P  < 0.05). Results from immunohistochemical double staining showed that the BrdU/NeuN and BrdU/GFAP expression in the hippocampal dentate gyrus of adult rats with cerebral hemorrhage was significantly higher than that of normal adult rats. All these experimental results show that there are a few neural stem cells proliferating in the hippocampal dentate gyrus of normal rats, and the proliferation ability is stronger in the adult rats than the aged rats. Cerebral hemorrhage can significantly strengthen the proliferation of neural stem cells in the dentate gyrus in the adult rats compared with the aged rats.