海口市公立与私立学校中学生主观生存质量及心理健康状况调查

有关中学生的主观生存质量因素的影响如何，心理健康状况如何，如何提高学生的心理健康水平和指导学生正确处理心理矛盾、心理障碍等等这些问题都是值得医务工作者深入探讨的问题。为此文章对海口市公立与私立学校中学生主观生存质量及心理健康学生进行了抽样调查。１对象与方法１．１对象海南省海口市两所公立和两所私立中学的２０００名在校的学生。回收１９１２份调查表，回收率为９５．６％。其中公立学校学生１０００名（５２．３％），高中学生５０９人，初中学生４９１名。私立学校学生９１２名（４７．７％），高中学生４２０名，初…     

脑梗死后伴发睡眠障碍的相关因素分析

目的探讨脑梗死(CI)后伴发睡眠障碍的相关影响因素,为CI后伴发睡眠障碍的防治提供临床依据。方法选择2014年6月至2017年12月因CI在海南省人民医院神经内科住院治疗的患者291例作为研究对象。采用匹兹堡睡眠质量指数量表(Pittsburgh Sleep Quality Index, PSQI)对291例患者的睡眠质量进行评价,PSQI评分≥7分视为罹患睡眠障碍,纳入研究组;PSQI评分<7分视为睡眠正常,纳入对照组。将两组患者的相关暴露因素作为研究变量进行单因素分析与Logistic回归分析。结果 PSQI评分结果表明,291例CI患者中有143例罹患睡眠障碍,发病率为49.14%。Logistic回归分析显示,从事脑力劳动、经济收入2000元/月以下、CI分期为痉挛期及部位位于丘脑或脑干是CI后伴发睡眠障碍的独立危险因素。结论 CI后伴发睡眠障碍的发病率较高,影响其发病的因素较多,应针对性的加强防治。     

RNA干扰技术阻断α-synuclein过表达诱导的细胞凋亡

BACKGROUND： Overexpression of α-synuclein can induce cell apoptosis. RNA interference （RNAi） may block specific gene function and cause gene silencing. OBJECTIVE： To construct a specific and effective RNAi plasmid for the α-synuclein gene and investigate if RNAi can block apoptosis in HEK293 cells, induced by overexpression of wild-type α-synuclein.
DESIGN, TIME AND SETTING： A contrast experiment based on genetically engineered cytobiology was performed at the State Key Lab of Medical Genetics of China, Xiangya Medical College of Central South University, between October 2004 and October 2008.
MATERIALS： HEK293 cells and pBSHH1 plasmid were provided by the State Key Lab of Medical Genetics of China; OligDNA sequence by Sagon Bioengineering Company, Shanghai; Lipofectamine 2000 by Invitrogen, USA; α-synuclein monoclonal antibody, Hoechst 33258, and MTT by Sigma, USA; Horseradish peroxidase-coupled goat anti-rat IgG by KPL, USA; FACSan flow cytometry by BD, USA.
METHODS： Four target sites were used to construct hairpin RNA pBSHH1 vectors - pSYNi-1, pSYNi-2, pSYNi-3 and pSYNi-4 - which were cloned in the pBSHH1 plasmid. HEK293 cells were transfected using Lipofectamine 2000. In addition, a non-transfect group and a negative plasmid transfect group were established. The cultured HEK293 cells were processed as follows： transfection of blank plasmid （blank control group）, transfection of α-synuclein-pEGFP and RNAi negative vector （negative control group）, and transfection of α-synuclein-pEGFP and pSYNi-1 （transfection group）. Cells in all groups were transfected with Lipofectamine 2000 for 48 hours.
MAIN OUTCOME MEASURES： Expression of α-synuclein mRNA and protein were detected by RT-PCR and Western blot. Cell morphology was observed under an inverted fluorescence microscope; cell viability was measured using MTT method; and cell apoptosis was determined with Annexin V-PE flow cytometry.
RESULTS： α-synuclein mRNA and protein expressions were significantly decreased in the pSYNi-1 group when compared with the non-transfect and negative plasmid transfect groups （P 〈 0.05）. The expressions were partially decreased in the pSYNi-2 group, but there was no significant difference in the pSYNi-3 and pSYNi-4 groups. Hoechst staining indicated that cell nuclei were enlarged in the negative control group, coloring was not uniform, and chromatin was accumulated and appeared spot-like. The nucleus coloring was uniform in the transfection group compared to negative control group. Cell viability in the negative control group was significantly lower than blank control group with cell apoptosis being significantly increased （P 〈 0.05）. In comparison with negative control group, cell viability was significantly increased in the transfection group and cell apoptosis was significantly decreased （P 〈 0.05）.
CONCLUSION： pSYNi-1 can inhibit α-synuclein gene expression and block apoptosis of HEK293 cells induced by overexpression of wild-type α-synuclein.     

MSCT后处理技术在肘关节严重创伤中的应用研究

目的：评价64层螺旋CT（MSCT）后处理技术在肘关节严重创伤中的临床应用价值。方法26例肘关节严重创伤患者行CT检查,运用多平面重建（MPR）、表面遮盖显示（SSD）和容积再现（VR）重建,分析肘关节骨折及脱位情况。结果26例肘关节严重创伤患者轴位影像结合后处理技术共发现53处骨折,7例伴有脱位。其中肱骨外侧髁骨折13处,肱骨内侧髁9处,髁间骨折6处,尺骨鹰嘴骨折12处,尺骨冠状突骨折8处,桡骨小头骨折5处。结论 MSCT运用各种后处理技术结合轴位影像,可以发现各种细小骨折及显示骨折内部情况,能够直观、立体、多方位、多角度显示骨折部位、骨碎片移位、关节面损伤、关节脱位等,有利于临床医生选择合适的治疗方案,提高诊疗水平。     

老年帕金森病患者血尿酸水平及其与认知功能的关系

目的 探讨老年帕金森病(PD)患者血尿酸水平与认知功能的关系,并对相关因素进行分析.方法 回顾性分析60例老年PD患者的病历资料,选择性别、年龄相匹配的60例健康体检者作为对照,记录性别、年龄、病程、Hoehn&Yahr分期(H-Y分期)、尿酸、简易智能量表(MMSE)评分,并进行比较和相关性分析.结果 老年PD组血浆尿酸水平[(262±53)μmol/L]明显低于对照组[(332±45)μmol/L],差异有统计学意义(t=-6.724,P＜0.001).PD组男性血浆尿酸水平[(271±48)μmol/L]均值略高于女性水平[(254±39)μmol/L],但差异无统计学意义(t=3.282,P=0.058).PD组男性血浆尿酸水平明显低于对照组男性尿酸水平[(353±62)μmol/L],差异有统计学意义(t=-5.625,P＜0.001).PD组女性血浆尿酸水平低于对照组女性尿酸水平[(294±59)/μmol/L],差异有统计学意义(t=-4.721,P=0.012).老年PD各亚组间血尿酸水平无显著差异,但与对照组比较差异均有统计学意义(F=22,039,P＜0,01).老年PD组血尿酸水平与病程长短无明显相关性(r=0.961,P＞0,05).老年PD患者存在认知功能障碍,其MMSE评分与H-Y分期(r=-0.577,P=0.019)、年龄(r=-0.333,P=0.034)呈负相关,与血尿酸水平呈正相关(r=0.789,P=0.000),与病程(r=-0.333,P=0.027)、体质指数(BMI)(t=-0.410,P=0.115)无相关性.结论 老年PD患者血尿酸水平降低,低尿酸水平可能与老年PD患者的认知功能障碍有关.

Abstract：

Objective To explore the relationship between uric acid (UA) level and cognitive function in elderly patients with Parkinson,s disease (PD) and analyze the cognition related factors.Methods The clinical data of 60 elderly PD cases in our hospital from 2001 to 2009 were retrospectively analyzed. The 60 healthy people receiving medical examination in our hospital and matched by gender and age, were as control group. The information including gender, age, illness duration, Hoehn & Yahr stage (H-Y stage), serum UA level and Mini-Mental State Examination (MMSE) scale were recorded. Results The serum UA level was significantly lower in PD group than in control group [(262±53) μmol/L vs. (332±45) μmol/L, t=-6.724, P＜0.001]. In PD group, the serum UA level was slightly higher in males than in females [(271 ±48) μmol/L vs.(254±39) μmol/L, t=3. 282, P=0. 058]. The serum UA level was significantly lower in male PD patients than in male controls [(353± 62) μmol/L, t=- 5. 625, P＜0. 001], and was lower in female PD patients than in female controls [( 294 ± 59) μmol/L, t = - 4. 721, P = 0. 012]. There were no significant differences in serum UA level among different H-Y stage subgroups (P＞0. 05), but the serum UA level was lower in different H-Y stage subgroups than in control group (F=22. 039, P＜0. 01 ). There was no correlation between the UA level and the illness duration (r=0. 961, P＞0.05).The MMSE score had significant difference between elderly PD group and control group (t= -3. 168,P＜0. 001). In PD patients, the MMSE score was positively correlated with serum UA level (r=0. 789, P= 0. 000), and was negatively correlated with H-Y stage (r= - 0. 577, P = 0. 019 ), age (r= -0. 333, P=0. 034), but was not correlated with illness duration (r= -0. 333, P=0. 207) and BMI (t=- 0. 410, P= 0. 115). Conclusions The level of serum UA is lower in elderly patients with PD than in normal controls. There is correlation between the serum UA level and cognitive impairment. Lower serum UA level predicts worse cognitive scores.     

脂质沉积性肌病诊断及随访分析

自1973年Engel和Angelini首次报道脂质沉积性肌病(Lipid storage myopathy,LSM)以来,关于该病的散发报道日渐增多,我们总结了7例LSM患者临床及随访资料并复习文献,以加深对此病的认识。     

124例贲门癌术前诊断和外科治疗分析

目的：提高贲门癌术前诊断与外科治疗的认识。方法：对１９８６－１９９６年外科治疗１２４例贲门癌进行回顾怀调查分析。结果：手术切除８２例，姑息手术６例，单纯探查３６例，术后发生吻合瘘３例，腹腔内出血１例，术后７－８个月发生吻合口狭窄４例。除吻合瘘１例发生全身衰竭死亡外，。其余均痊愈出院。结论：内镜检查是诊断贲让癌主要手段。根据各种不同情况采用不同手术进路。使用吻合器可简便手术操作，缩短时间、减少并发症     

小泛素样修饰蛋白对α-突触核蛋白线粒体亚细胞定位及α-突触核蛋白经泛素系统降解的影响

目的 探讨α-突触核蛋白(α-synuclein)的小泛素样修饰蛋白1(small ubiquitin-like modifier1,SUMO-1)化修饰对α-synuclein蛋白亚细胞线粒体定位及α-synuelein蛋白经泛素系统降解的影响.方法 构建野生型、A53T突变型和缺失SUMO-1互作氨基酸的K96R突变型α-synuclein真核表达质粒.将野生型、A53T突变型和K96R突变型α-synuclein真核表达质粒分别转染HEK293细胞;在转染后48 h通过应用线粒体染色剂和激光共聚焦技术,观察野生型、A53T突变型及缺失SUMO-1修饰的α-synuclein蛋白的亚细胞线粒体定位和蛋白聚集情况.在转染后48 h应用anti-ubiquitin抗体进行Western印迹分析,明确野生型、A53T突变型及缺失SUMO-1修饰的α-synuclein蛋白泛素化程度有无差别.结果 将构建所得EGFP-α-synuclein-WT、EGFP-α-synuclein-A53T、EGFP-α-synuclein-K96R真核表达质粒经双酶切鉴定及DNA测序证实;激光共聚焦结果显示野生型、A53T突变型、K96R突变型α-synuclein蛋白均广泛分布于细胞质和细胞核中,以细胞质为主,野生型、A53T型细胞可见绿色荧光物质在胞质积聚,形成强荧光斑块,K96R型胞质内绿色荧光物质聚集少;野生型、A53T突变型、K96R突变型α-synuclein均与线粒体存在共定位,A53T突变型、K96R突变型α-synuclein在SUMO-1修饰或缺失的情况下对α-synuclein蛋白的线粒体亚细胞定位无明显影响.Western印迹结果显示转染缺失SUMO-1互作氨基酸的K96R突变型α-synuclein真核表达质粒组的细胞泛素蛋白的含量与转染空质粒组相比无明显变化,转染野生型、A53T突变型α-synuclein真核表达质粒组HEK293细胞中泛素蛋白的含量减少.结论 α-synuclein基因过度表达及致病突变A53T对α-synuclein蛋白的线粒体亚细胞定位无明显影响;SUMO-1修饰对α-synuclein蛋白的线粒体亚细胞定位也无明显影响;SUMO-1对a-αsynuclein基因过度表达及A53T突变型α-synuclein细胞内泛素化蛋白数量产生影响.     

全脑DSA在脑血管病变诊断中的价值

目的 收集行介入检查的42例全脑数字减影血管造影(DSA)完整资料,分析其影像检查的选择及在临床方面的应用价值.方法 经CT和/或MRI检查发现或临床高度怀疑脑血管疾病的病例,行全脑DSA检查.结果 行DSA前,CT和/或MRI阳性发现21例,行DSA后阳性发现42例.结论 DSA不但能对动脉瘤、动静脉畸形、烟雾病、脑静脉畸形等定性定位诊断,而且对病变的范围及严重程度亦可清楚地了解,为手术提供较可靠的客观依据,对于脑出血、蛛网膜下腔出血,可进一步查明导致出血的病因,不失为一种行之有效的诊断方法.