稳定型与不稳定型心绞痛患者冠状动脉内皮功能的比较

目的：比较不稳定型心绞痛与稳定型心绞痛患者冠状动脉内皮功能状况，探讨内皮功能不全在不同类型心绞痛发病机制中的作用。方法：对20例冠心病不稳定型心绞痛患者和17例稳定型心绞痛患者行冠状动脉造影，并向冠脉内依次以递增剂量注入乙酰胆碱。以定量冠脉造影分析软件测量狭窄病变段最小腔径、邻近病变的造影正常段和正常冠状动脉支注入乙酰胆碱前后的内径，比较两组在上述检测部位的内径变化率。结果：两组在注入乙酰胆碱后各检测部位的内径均较基础值显著缩小；在狭窄病变段和邻近病变的造影正常段，不稳定型心绞痛患者的内径变化率显著大于稳定型心绞痛患者；在正常冠状动脉支，不稳定型心绞痛组的内径变化率亦呈现出大于稳定型心绞痛组的趋势，但未达到显著意义。结论：稳定型与不稳定型心绞痛均存在弥漫性冠状动脉内皮功能不全，但不稳定型心绞痛冠脉内皮功能损伤程度大于稳定型心绞痛，内皮功能障碍的恶化可能是促发不稳定型心绞痛的重要机制。     

氯吡格雷治疗不稳定型心绞痛临床观察

不稳定型心绞痛(UAP)是介于稳定型心绞痛与急性心肌梗死之间的一种不稳定性的心肌缺血综合征,常有较严重的冠状动脉粥样硬化病变,病理上常有冠状动脉器质性狭窄、粥样斑块破裂、出血、血小板聚集,而血小板聚集则是血栓形成的源头,氯吡格雷有效地抑制ADP诱导的血小板聚集,广泛用于防治血小板活化及高集状态的心血管疾病,本文就我院两年来患者应用氯吡格雷抗血小板治疗的效果进行研究,现报告如下:     

C-反应蛋白对冠心病的临床预测价值

目的 观察C-反应蛋白（C—RP）对冠心病及其严重程度的预测价值。方法 冠心病（CHD）组83人，其中急性心肌梗死（AMI）30例，不稳定型心绞痛（UA）组23例，稳定型心绞痛（SA）组30例。对照组60例，C—RP含量测定采用免疫比浊法。结果 AMI组、UA组、SA组C—RP显著高于对照组；AMI组、UA组显著高于SA组。结论 C—RP是预测冠心病的一个敏感指标，同时对预测冠心病的严重程度有一定的预测价值。     

CD40-CD40L与急性冠状动脉综合征的研究进展

急性冠状动脉综合征（Acute Coronary Syndrome，ACS）是心肌急性缺血的一组临床表现，包括不稳定心绞痛，无ST段抬高的急性心肌梗死和有ST段抬高的急性心肌梗死，也包括猝死性冠心病。目前认为ACS的病理生理机制是粥样硬化斑块不稳定，发生溃破、出血，随后血栓形成，引起冠状动脉不同程度堵塞，造成心肌血和氧供应急剧减少。免疫和炎症反应在ACS的发生发展过程中起着重要作用，CIM0-CD40L作为免疫和炎症反应中的重要信号转导系统，在动脉粥样硬化（Atherosclerosis，AS）炎症调节中的作用已日益明确，它几乎贯穿AS发生发展乃至斑块破裂的全过程。Yan等最近报道，ACS患者血小板表面CD40、CD40L显著升高，且不稳定型心绞痛病人的CD40、CD40L水平显著高于稳定型心绞痛病人；Wu等在兔AS模型中发现CD40、CD40L也显著升高，且与斑块中基质金属蛋白酶（Matrix Metalloproteinases，MMPs）成线性相关；Schonbeck证实CD40共刺激信号在AS鼠的血管内皮及斑块中大量表达，且抑制CD40信号系统，限制AS的进展。故认为CD40、CD40L对斑块不稳定性及ACS的发展起一定作用。     

GMP-140 RIA及其临床初步观察

活化血小板是血栓的主要组份之一，通过对体内活化血小板表面或血浆内的α颗粒膜蛋白(GMP-140)的检测，对临床有关血栓性疾病的早期诊断和预后将有很大帮助。也可作为代谢性疾病、自身免疫性疾病等体内血小板活化程度的特异性指标。本文对69例健康人和142例不同病人进行了全血中血小板表面GMP-140测定，观察其临床意义。     

血小板颗粒膜蛋白-140研究进展（文献综述）

血小板α-颗粒膜蛋白(α-granule membrane protein．GMP-140)是血小板活化脱颗粒反应中α-颗粒释放后的遗留产物。测定GMP-140可直接了解血小板的活化程度，可作为血栓性疾病的体外诊断指标，也可作为代谢性疾病．自身免疫性疾病等体内血小板活化程度的特异性指标。     

不稳定型心绞痛发病机制及治疗进展

不稳定型心绞痛(UnstableAngina,UA)是介于稳定型心绞痛和急性心肌梗死(AMI)之间的一种状态,易演变为急性心梗或猝死,因此具有重要的临床意义。目前仍沿用1979年WHO的诊断标准,将初发劳累型心绞痛、恶化劳累型心绞痛及自发型心绞痛(包括变异型心绞痛)称为UA。近年来国内外学者对UA进行了广泛深入的研究,认为UA很大程度上是冠状动脉粥样斑块破裂,血栓形成,冠脉痉挛及侧支循环状况的共同参与决定了UA的发生。治疗目标是控制心肌缺血症状,有效的抗血栓和抗血小板药物,阻止动脉粥样硬化的发展,避免AMI和猝死。本文就此UA的发病机制和…     

不稳定型心绞痛可溶性白介素-2受体改变的研究

中国图书分类号Ｒ５４１．４不稳定型心绞痛发生机制尚不清楚，近来研究发现不稳定型心绞痛患者循环中有淋巴细胞依赖性的单核细胞被激活、细胞因子增高［１］，这表明细胞介导的炎症反应可能参与了此过程。本研究通过测定不稳定型心绞痛患者血清中可溶性白介素２受体（...     

经皮冠状动脉介入术对不稳定型心绞痛患者QT离散度的影响

目的 探讨经皮冠状动脉介入术（PCI）治疗不稳定型心绞痛（UA）对QT离散度（QTd）的影响。方法 58例经皮冠状动脉介入术治疗不稳定型心绞痛及54例对照组在术前24h，术后6、24h和1周分别同步记录12导联心电图，测量QTd及QTcd。结果 治疗组支架置入术后QTd、QTcd早期（6h）即有明显改善，对照组冠造前后QTd、QTcd无显著改善。结论 经皮冠状动脉介入术可显著改善不稳定型心绞痛患者术后的QT离散度。     

心绞痛患者血清hsCRP、MIF及IL-10水平与临床分型研究

目的检测稳定型心绞痛患者及不稳定型心绞痛患者外周血血清高敏C反应蛋白（hsCRP）、巨噬细胞移动抑制因子（MIF）、白介素10（IL-10）水平,了解其变化与患者临床分型之间的关系。方法共收入43例稳定型心绞痛患者和50例不稳定型心绞痛患者,同时收入40例健康志愿者作为对照组,以ELISA法检测其外周血血清中hsCRP、MIF、IL-10水平并进行统计分析。结果不稳定型心绞痛患者血清hsCRP水平（12.53±2.89）mg/L高于对照组（3.46±1.02）mg/L及稳定型心绞痛患者（4.51±0.98）mg/L,差异有统计学意义;不稳定型心绞痛患者MIF水平（30.94±5.85）μg/L高于对照组（8.31±1.38）μg/L及稳定型心绞痛患者（9.85±1.44）μg/L,差异有统计学意义;稳定型心绞痛患者及对照组hsCRP及MIF水平比较差异无统计学意义。不稳定型心绞痛患者及稳定型心绞痛患者血清IL-10水平分别为（19.44±2.11）ng/L和（20.19±2.04）ng/L,与对照组（14.89±2.49）ng/L比较差异有统计学意义。结论稳定型心绞痛与不稳定型心绞痛患者的血清炎症反应与抗炎反应生物标志物存在不同的表达情况,提示心绞痛患者体内炎症反应与抗炎反应平衡与患者病情进展之间存在一定的关系。     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.     

The universal muscular chamber. A basic unit of the genitourinary, cardiovascular, gastro-intestinal, skeletal, cutaneous, respiratory and other systems, endocameral hypertension; and spasm, the key to their idiopathic diseases and arthropathies

Starting with the integument, we see many organs are contractile sacs or multiples thereof, which tubes or bags constitute the major part of the entire body. Recognition of this basic unit and its characteristics sheds new light, individually and collectively, on many disorders previously considered unrelated. Muscular tears and perforations develop in the walls of these chambers, being no way peculiar to those organs, wherein, hydrochloric acid occurs. So, it is not necessary to explain the absence of excessive acid from patients who exhibit holes in the gastric, uterine, aortic, duodenal, rectal, pulmonary, retina, and other walls. Muscle, not acid is the great common factor relating idiopathic disorders in the gastrointestinal tract to each other and to similar diseases in other systems. When the units are linked together, the lesions tend to appear as arthropathies, i.e. at the joints. Rephrasing common-place observations, frees us from conventional, conceptual cul-de-sacs. An observation is only as good as its interpretation, so all possibilities must be considered, otherwise, we will remain blinded by our misconceptions.     

Der Einfluß von Nahrungsmitteln und Rauchen auf die klinisch-chemische Diagnostik von Phäochromozytom,Neuroblastom und Karzinoid-Syndrom

Zusammenfassung Der Einfluß von verschiedenen Nahrungsmitteln auf Methoden zur Bestimmung von Adrenalin (AD), Noradrenalin (NA), Vanillinmandelsäure (VMS), Metanephrinen (MN), Homovanillinsäure (HVS) und 5-Hydroxyindolessigsäure (5-HIE) im 24 h-Harn zur Diagnose des Phäochromozytoms bzw. Karzinoid-Syndroms wurde untersucht. Die in die Untersuchung einbezogenen Nahrungsmittel waren: Tee, Kaffee, Mandeln, Ananas, Käse, Walnüsse, Vanillepudding, Bananen, Tomaten und Milchschokolade. Außerdem wurde der Einfluß des Zigarettenrauchens auf die Bestimmung von AD, NA, VMS und MN untersucht.Walnüsse führten zu einer starken Erhöhung der 5-HIE-Ausscheidung. Bananen erhöhten die Ausscheidung von AD, NA, VMS, MN und 5-HIE. Kaffee und Ananas bewirkten eine geringe Zunahme der MN-Werte. Rauchen von 20–30 Zigaretten/Tag beeinflußte keine der vier Variablen.Wenn die beschriebenen Methoden benutzt werden, sollte lediglich auf den Verzehr von Bananen und Walnüssen vor und während der Harnsammelperioden verzichtet werden, da die oberen Normgrenzen im Harn überschritten werden könnten. Ein Verzicht auf Kaffee und Ananas in normalen Mengen ist nicht erforderlich. Es besteht kein Anlaß, weiterhin die bisherigen umfangreichen Restriktionen der übrigen Nahrungsmittel beizubehalten.