老年脑中风相关因素对比研究

为探索脑中风的相关因素及其分布规律，本研究采取WHO统一调查方法与质控要求，从中风低发区云南景洪市与中风高发区上海市闸北区两地5万人口中随机抽取60岁以上11234人作为调查样本，并用中风危险因素积分法，选择974人积分高者作为中风高危人群进行中风危险因素对比研究。结果表明，景洪脑中风的危险因素高血压、身体质量指数、总胆固醇、LDL—CH、载脂蛋白-I、ApoB、C肽、血糖及血清胰岛素等各项指标均明显低于闸北（P〈0．05或P〈0.01）.     

口腔、食管脱落细胞微核检测法对食管癌早期诊断初探

1982年Stich首次报道口腔粘膜脱落细胞的微核检测法,发现口腔癌高发区人群的微核细胞率明显增高。本文采用该法对河南高发区(15例)、低发区(13例)     

RUNX3基因364位点C→T突变与胃癌关系的研究

目的：研究RUNX3基因C364T突变在我国胃癌高、低发区普通人群和胃癌患者中的分布，H.pylori感染者胃粘膜的RUNX3基因C364T突变率，探讨此突变与我国胃癌发生的关系。 方法： 采用PCR-限制性片段长度多态性（RFLP）分析法检测胃癌高发区169名普通人、86例胃癌患者和胃癌低发区192名普通人和92例胃癌患者的RUNX3基因多态性。同时比较胃癌低发区普通人胃粘膜H.pylori阳性和阴性者的RUNX3突变率。 结果： 在胃癌高、低发区，胃癌患者RUNX3基因C364T突变频率与普通人群无显著差异（χ2=0.57和0.16，P>0.05）。与肿瘤类型也无明显关系。低发区H.pylori阳性者粘膜中，RUNX3基因突变率也无显著增高。 结论： RUNX3基因C364T突变可能不是我国胃癌高、低发区胃癌的遗传易感因素。而且H.pylori感染导致胃癌形成可能不由RUNX3基因C364T突变参与。     

急性缺血性脑血管疾病的近代治疗

急性脑血管疾病是人类三大死因之一，而缺血性中风又占所有中风病人的半数以上。随着世界人口老龄化现象日趋严重，中风发病人数也逐年增多。因此国内外学者针对急性缺血性中风进行了大量的研究；积累了丰富的经验，现总结如下。1、血液稀释疗法（HD）[1]HD是根据血液流变学原理，采用降低红细胞压积（Hct）来降低血液的粘稠度，从而改善血流速度，增加脑血流量和组织供氧，达到治疗缺血性中风的目的。1．1、理想的Hct水平Hct与血液粘稠度呈负相关。Hct为0．30～0．33时红细胞携氧能力最大。Hot为0．50时的血液粘稠度为0．40时的一倍。…     

交链孢酚对体外培养的人胎儿食管上皮的作用

河南林县是我国食管癌高发区之一。流行病学调查证明,林县粮食中互隔交链孢霉的污染率高于低发区。该霉菌的乙醚、乙醇提取物均有明显的诱变性,将提取物进一步分离纯化,确定了数种有效成分,其中之一为交链孢酚(alternariol, AOH)。实验证明,     

中风患者病情轻重程度与脑电节律相对功率的相关性分析

目的:观察中风患者病情轻重程度与脑电节律相对功率谱之间的相关性,以期为中风病情评估提供电生理依据。方法:将80名纳入标准的中风恢复期患者进行脑电检测,并根据《中风病诊断与疗效评定标准》中的病类诊断标准对患者病情进行评价,采用Pearson相关性分析观察脑电信号与病情轻重的相关性。结果:中风患者病情轻重程度与脑电相对功率具有显著相关性,α节律与病情呈负相关,病情越重,α节律相对功率越低且主要体现在前额区、中央区及顶区;θ节律与病情呈正相关,病情越重,θ节律相对功率越高,且体现在顶区、枕区。结论:中风患者病情轻重程度与脑电相对功率有显著的相关性,以α、θ节律为主,可以用于评估中风患者的病情。     

食管癌高发区人胚胎发育过程中食管上皮组织P16、PCNA蛋白的表达及其与形态学变化关系

目的初步探讨食管癌高发区人胎儿食管上皮组织抑癌基因p16和增殖细胞核抗原(proliferation cell nuclear antigen,PCNA)与人胚胎发育过程中食管上皮细胞增殖特性的关系。方法采用免疫组化ABC法检测3～10月份胎儿食管上皮组织中p16和PCNA的表达状况。结果在26例食管癌高发区人胎儿食管上皮组织中,p16蛋白总阳性率61.5%(16/26),p16蛋白阳性率在低月龄组中明显低于高月龄组(P<0.05),PCNA单位面积平均阳性细胞数为(450±156)/mm2,PCNA单位面积阳性细胞数在低月龄组中明显高于高月龄组(P<0.05)。结论食管癌高发区人胎儿食管上皮组织中p16基因的表达和PCNA单位面积阳性细胞数与胎龄密切相关,可以客观反映食管癌高发区人胎儿食管上皮的组织分化状态。     

MIF-173位点单核苷酸多态性与我国胃癌关系的研究

目的：研究巨噬细胞移动抑制因子(MIF)基因-173 G/C位点单核苷酸多态性在中国胃癌高发区和低发区普通人群和胃癌患者中的分布，并探讨其基因多态性与我国胃癌的关系。 方法： 用聚合酶链反应-限制性片段长度多态性(PCR－RFLP)检测年龄和性别匹配的广东省104例普通人及104例胃癌患者和陕西省普通人和胃癌患者各102例的MIF-173位点单核苷酸多态性。 结果： 在胃癌高发区，胃癌患者携带MIF-173 C/C的频率明显高于普通人群(28.8% vs 15.4%, χ2=5.47, P<0.05, OR=2.23, 95% CI=1.13-4.41)，MIF-172 C/C 基因型增加Hp感染后胃癌发生的危险性(χ2=5.27, P<0.05, OR=8.0，95% CI=1.27-19.72)。在胃癌低发区，胃癌患者MIF-173 C/C基因型的频率与正常对照组无明显差异(31.4% vs 27.5%, χ2=0.38, P>0.05)。 结论： MIF-173 C等位基因可能与我国汉族人群胃癌发生有关。     

动脉平滑肌细胞结蛋白与波形蛋白的免疫组化研究

平滑肌细胞(SMC)在动脉粥样硬化(AS)发病机理中起决定性作用。SMC表型改变是其增生的先决条件,而SMC的骨架成分能较好地反映SMC的表型特征。AS高发区欧美国家的资料表明,SMC骨架成分的改变与AS的发生与发展有着密切的关系。目前尚缺乏AS低发区的报道。南宁是我国AS发病率最低的地区之一。我们的资料能     

食管癌高、低发区人群681例胃活检病理分析

本文对食管癌、低发区681例胃粘膜活检作了病理观察。材料来自1983年12月及1989年11月食管癌低发区河南省范县濮城镇(食管癌年死亡率男性26.54/10万,女     

Lowering of blood pressure by increasing hematocrit with non nitric oxide scavenging red blood cells

Isovolemic exchange transfusion of 40% of the blood volume in awake hamsters was used to replace native red blood cells (RBCs) with RBCs whose hemoglobin (Hb) was oxidized to methemoglobin (MetHb), MetRBCs. The exchange maintained constant blood volume and produced different final hematocrits (Hcts), varying from 48 to 62% Hct. Mean arterial pressure (MAP) did not change after exchange transfusion, in which 40% of the native RBCs were replaced with MetRBCs, without increasing Hct. Increasing Hct with MetRBCs lowered MAP by 12 mm Hg when Hct was increased 12% above baseline. Further increases of Hct with MetRBCs progressively returned MAP to baseline, which occurred at 62% Hct, a 30% increase in Hct from baseline. These observations show a parabolic "U" shaped distribution of MAP against the change in Hct. Cardiac index, cardiac output divided by body weight, increased between 2 and 17% above baseline for the range of Hcts tested. Peripheral vascular resistance (VR) was decreased 18% from baseline when Hct was increased 12% from baseline. VR and MAP were above baseline for increases in Hct higher than 30%. However, vascular hindrance, VR normalized by blood viscosity (which reflects the contribution of vascular geometry), was lower than baseline for all the increases in Hct tested with MetRBC, indicating prevalence of vasodilation. These suggest that acute increases in Hct with MetRBCs increase endothelium shear stress and stimulate the production of vasoactive factors (e.g., nitric oxide [NO]). When MetRBCs were compared with functional RBCs, vasodilation was augmented for MetRBCs probably due to the lower NO scavenging of MetHb. Consequently, MetRBCs increased the viscosity related hypotension range compared with functional RBCs as NO shear stress vasodilation mediated responses are greater.     

Hematocrit and blood osmolality in developing chicken embryos (Gallus gallus): in vivo and in vitro regulation

Hematocrit (Hct) regulation is a complex process involving potentially many factors. How such regulation develops in vertebrate embryos is still poorly understood. Thus, we investigated the role of blood pH in the regulation of Hct across developmental time in chicken embryos. We hypothesized that blood pH alterations in vitro (i.e., in a test tube) would affect Hct far more than in vivo because of in vivo compensatory regulatory processes for Hct. Large changes in Hct (through mean corpuscular volume (MCV)) and blood osmolality (Osm) occur when the blood was exposed to varying ambient temperatures (T(a)'s) and P(CO2) in vitro alongside an experimentally induced blood pH change from ~7.3 to 8.2. However, homeostatic regulatory mechanisms apparently limited these alterations in vivo. Changes in blood pH in vitro were accompanied by hydration or dehydration of red blood cells depending on embryonic age, resulting in changes in Hct that also were specific to developmental stage, due likely to initial blood gas and [HCO(3)(-)](v) values. Significant linear relationships between Hct and pH (Hct/ΔpH=-21.4%/(pH unit)), Hct and [HCO(3)(-)] (ΔHct/Δ[HCO(3)(-)]=1.6%/(mEq L(-1))) and the mean buffer value (Δ[HCO(3)(-)]/ΔpH=-13.4 (mEq L(-1))/(pH unit)) demonstrate that both pH and [HCO(3)(-)] likely play a role in the regulation of Hct through MCV at least in vitro. Low T(a) (24°C) resulted in relatively large changes in pH with small changes in Hct and Osm in vitro with increased T(a) (42°C) conversely resulting in larger changes in both Hct and Osm. In vivo exposure to altered T(a) caused age-dependent changes in Hct, demonstrating a trend towards increased Hct at higher T(a). Further, exposing embryos to a gas mixture where P(CO2) = 5.1 kPa for >4 h period at T(a) of 37 or 42°C also did not elicit a change in Hct or Osm. Presumably, homeostatic mechanisms ensured that in vivo Hct was stable during a 4-6 h temperature and/or hypercapnic stress. Thus, although blood pH decreases (induced by acute T(a) increase and exposure to CO(2)) increase MCV and, consequently, Hct in vitro, homeostatic mechanisms operating in vivo are adequate to ensure that such environmental perturbations have little effect in vivo.     

Hematocrit of the fetal rabbit placenta.

51Cr-labeled erythrocytes and [125I]RISA were used simultaneously to measure the fetal rabbit whole-body and placental hematocrits (Hct) and to find the ratio of placental transit times of erythrocytes and plasma. The levels were injected into the heart of 21 fetal rabbits of 26--28 days gestation, and about 60 s mixing time, the placenta and a fetal blood sample were assayed with a gamma well-type scintillation counter. Erythrocyte and plasma activity per milliliter were determined from a standard dilution of the isotopes. Large-vessel Hct was measured as the corrected packed erythrocyte percentage in capillary tubes. Large-vessel Hct was 37.3 (+/- 3.7 SD) %, whole-body Hct was 31.3 (+/- 3.5) %, and the placental Hct was 25.3 (+/- 4.0) %. The placental/large-vessel Hct ratio was 0.676. The ratio may be estimated as 0.765 when corrected for the loss of albumin in time. The transit time of erythrocytes in the placenta was calculated to be 0.682 of that for plasma. The shorter erythrocyte transit time implies that there is less time for O2 and CO2 exchange than previously thought.     

深圳市南山区2008—2010年脑卒中住院病例分析

目的通过对脑卒中住院病例进行分析,了解深圳市南山区脑卒中患者发病特征。方法对南山区2008—2010年收治的3989例脑卒中患者进行年龄、性别、分类、危险因素等分析。结果脑卒中患者男女性别比为1．52：1;脑卒中病例随年龄的增长而增加,主要集中在60—79岁之间,占49．79％,其次为40—59岁占34．07％;脑卒中分类中以脑梗塞最高占77．34％,依次为脑出血18．20％、蛛网膜下腔出血3．88％、未分类卒中0．58％。除〈30岁组外,其余年龄组均以脑梗塞发病为最常见,并随年龄的增加所占比例也增加;〈30岁组以脑出血多见（50％）;脑卒中危险因素以高血压最重要占59．61％。结论南山区脑卒中以脑梗塞为最多见,最重要的危险因素为高血压。     

热应激蛋白70及其抗体在中暑病人血浆中水平改变的观察研究

探讨中暑发生的病理过程中热应激蛋白７０（ＨＳＰ７０）水平及其抗体滴度水平的变化和相互关系。应用Ｗｅｓｔｅｒｎ Ｂｌｏｔ法测定血浆ＨＳＰ７０水平；应用免包被的酶联免疫吸附分析法经倍比稀释测定血浆ＨＳＰ７０抗体滴度。     

Plasma bioactive erythropoietin in mice with dietary Iron deficiency anaemia: Enhanced reticulocytosis and recombinant erythropoietin administration

Plasma erythropoietin (EPO) activity was determined by an erythroid colony-forming microassay during the development of and recovery from iron deficiency anaemia (IDA) in mice. Growing mice were made iron deficient by feeding a low-iron diet. During the development of IDA, the plasma EPO level increased as the haematocrit (Hct) value decreased in the time-dependent fashion. Likewise, reticulocytosis was enhanced depending on the severity of anaemia or the plasma EPO level. After 9 weeks of the feeding, the development of IDA was confirmed by blood analyses. During the recovery from IDA after switching to an iron-rich diet and/or parenteral iron administration, the plasma EPO levels rapidly declined to normal level, while the Hct values increased and completely returned to normal on day 6. Administration of recombinant human EPO (rHuEPO) in addition to the iron-rich diet and iron brought about the supranormal levels of Hct after day 6. Thus, rHuEPO had no therapeutic role in IDA. The plasma EPO titres were inversely correlated with the Hct values during the progression and reversal of IDA. This result supports a generally accepted concept that the EPO production in anaemia is primarily regulated by Hct feedback control mechanism.     

Influence of arterial occlusion on hematocrit and plasma protein concentration of femoral venous blood in rabbit

The changes of venous outflow (Qv), hematocrit (Hct), total plasma protein (Tp), electrolytes, crystalloid osmolality, PO2, PCO2, and pH were simultaneously measured in hindlimb preparation of anesthetized rabbits during 5 min occlusion of the femoral artery and the abdominal aorta and during the reactive hyperemia. During the occlusion of the femoral artery, Qv decreased to 66.4% at the end of the occlusion. Hct and Tp decreased slightly and then tended to progressively increase. PO2 showed an increasing trend following an initial decrease. During the occlusion of the aorta, Qv showed a continuous drop to 38.0%, while Hct and Tp declined to 95.4 and 93.8%, respectively. Qv, Hct, and Tp showed increase after the release of the occlusion of the femoral artery and the aorta. Crystalloid osmolality and K+ were observed to rise slightly. From these results it was suggested (1) that the increase of Hct and Tp which represents the hemoconcentration occurred during the reactive hyperemia and during the occlusion of the femoral artery, while the hemodilution occurred during the aortic occlusion, and (2) that the gradual increase of Hct and Tp during the occlusion of the femoral artery would be caused by the collateral blood flow.     

Acute regulation of hematocrit and blood acid-base balance during severe hypoxic challenges in late chicken embryos (Gallus gallus)

Acid-base and hematocrit (Hct) responses of vertebrate embryos to severe hypoxia are as yet unknown, but may reveal the maturation process of physiological regulatory mechanisms. The present study elucidated how acute, severe hypoxia (10% O(2), with and without 5% CO(2)) affects Hct and blood acid-base balance in late prenatal (days 11-19) chicken embryos. The time-course of the resulting Hct changes and blood acid-base disturbances was examined in detail in day 15 (d15) embryos to further understand the magnitude and time-components of these physiological changes. We hypothesized that Hct of developing embryos increases during severe hypoxia (10% O(2)) and hypercapnic hypoxia (5%CO(2), 10%O(2)), due to increased mean corpuscular volume (MCV) and red blood cell concentration ([RBC]). We additionally hypothesized that 10% O(2) would induce anaerobic glycolysis and the attendant increase in lactate concentration ([La(-)]) would create a severe metabolic acidosis. Hct increased in all embryos (d11-d19) during severe hypoxia (2h) but, with the exception of d19 embryos, the increase was due to increased MCV and was therefore unlikely related to O(2) transport. The time-course of the d15 embryonic Hct response to hypoxic or hypercapnic hypoxic exposure was very rapid with MCV increasing within 30min. Severe metabolic acidosis occurred in all developing embryos (d11-d19) during 2h hypoxic exposure. Additionally, respiratory acidosis was induced in d15 embryos during hypercapnic hypoxia, with acid-base status recovering within 120min in air. Throughout hypoxic exposure and recovery, changes in [HCO(3)(-)] were matched by those in [La(-)], indicating that anaerobic glycolysis is a key factor determining the metabolic alterations and overall acid-base status. Further, the blood gas and Hct values recovered in air and unchanged embryo mass suggest that the hypoxia-induced disturbances were only transient and may not affect long-term survival.     

不同方法测定红细胞压积对血液流变学部分指标的影响

目的:采用仪器法和温氏法测定红细胞压积(Hct),分析其对血液流变学部分指标的影响。方法:Hct采用血液细胞分析仪器法和温氏法分别测定。用锥板式表观粘度测定仪对150例随机选取的健康体检人员进行血液流变学指标测定,并分别按照两种方法测得的Hct进行统计分析。结果:仪器法和手工法测得的Hct低值部分有统计学差异(P<0.05),高、中值没有显著性差异(P>0.05);不同方法测得的高、中、低值Hct对部分血液流变学指标没有明显影响(P>0.05)。结论:在血流变学检查中,Hct值测定用仪器法替代手工法,不影响血液流变学有关指标的检测。     

精神分裂症患者伴发脑卒中偏瘫的早期康复护理

目的 通过对精神分裂症伴发脑卒中偏瘫患者在药物治疗的同时接受早期康复训练,探讨早期康复护理干预对患者肢体功能及生活能力的影响.方法 选择100例分裂症伴发脑卒中偏瘫的患者作为研究对象,52人为康复组,在发病72小时,生命体征平稳以后开始实施早期康复训练.另48人为对照组,行常规康复训练.比较两组患者生活能力恢复情况.结...