心肌肌钙蛋白Ⅰ,肌红蛋白在急性心肌梗塞早期诊断中的价值

目的 探讨心肌肌钙蛋白Ｉ（ｃＴｎＩ）、肌红蛋白（Ｍｂ）在急性心肌梗塞早期诊断中的价值。方法 对胸痛发作后４－６ｈ的２例急性心肌梗塞（ＡＭＩ）患者，２５例健康者，２８例非急性心肌梗塞患者的血清心肌肌钙蛋白Ｉ（ｃＴｎＩ）和肌红蛋白（Ｍｂ）进行测定。结果 ＡＭ 血清ｃＴｎＩ值明显高于健康组及其它对照组差异有显著性ＡＭＩ组Ｍｂ值显著高于正常值，除骨骼肌损伤且Ｍｂ有明显开高外，其它对照组测定值均在正常范围内     

急性心肌梗塞和不稳定性心绞痛GMP—140和TXB2的动态变化

为了解急性心肌梗塞（ＡＭＩ）和不稳定性心绞痛（ＵＡ）患者体内血小板活化程度，用放射免疫分析法测定２０例ＡＭＩ、３０例ＵＡ病人和２０例健康人血小板α颗粒膜蛋白（ＧＭＰ１４０）与血浆血栓素Ｂ２（ＴＸＢ２）的浓度。结果：①ＡＭＩ患者起病１２小时ＧＭＰ１４０和ＴＸＢ２浓度即明显高于对照组（Ｐ＜００１），第４８小时达高峰（Ｐ＜０００１），ＧＭＰ１４０在第５天降至正常，ＴＸＢ２第７天时仍高于对照组（Ｐ＜００５）；②ＵＡ患者在心绞痛发作时ＧＭＰ１４０、ＴＸＢ２明显高于对照组（Ｐ＜００１），心绞痛缓解后３０分钟降至正常，其ＧＭＰ１４０、ＴＸＢ２的升高幅度和持续时间均小于ＡＭＩ患者。表明ＡＭＩ和ＵＡ患者体内血小板高度激活，ＡＭＩ较ＵＡ患者冠状动脉内有更强的促凝因素。     

急性心肌梗塞TXB_2变化与~（99m）Tc－MIBI心肌显像缺损区范围的关系

探讨了急性心肌梗塞（ＡＭＩ）病人的血浆ＴＸＢ２变化与９９ｍＴｃ－甲氧基异丁基异腈（ＭＩＢＩ）心肌显像缺损区范围的关系，发现ＡＭＩ患者发病后２４小时内血浆ＴＸＢ２明显升高。并与放射性缺损区范围呈高度相关，ｒ＝０．８５，Ｐ＜０．０１．这对于估测心肌梗塞预后的价值有待进一步探讨．     

大鼠感染性脑水肿时NMDA受体的变化

测定百日咳菌液（ＢＰ）所致大鼠感染性脑水肿（ＩＢＥ）对３ＨＭＫ８０１与大脑皮层神经细胞特异结合的影响。从大鼠左颈总动脉注入ＢＰ，制备ＩＢＥ模型。雄性ＳＤ大鼠随机分３组：①对照组（ＮＳ，ｎ＝１１）；②ＩＢＥ组（ＢＰ，ｎ＝１２）；③ＭＫ８０１＋ＢＰ预处理组（ＭＫ８０１，ｎ＝４）。０２ｍｌ／ｋｇ体重生理盐水或ＢＰ注入左颈总动脉作为ＮＳ或ＢＰ组；每天腹腔注射０５ｍｇＭＫ８０１／ｋｇ体重，共２天，然后注入ＢＰ为ＭＫ８０１组。注射ＢＰ２４小时后断头取脑。Ｎ甲基Ｄ天冬氨酸（ＮＭＤＡ）受体与３ＨＭＫ８０１的特异结合用放射配体结合分析法测定，Ｓｃａｔｃｈａｒｄ作图。结果，ＮＳ及ＢＰ组的Ｂｍａｘ分别为０６２３±００８２和０６０６±００８７ｐｍｏｌ／ｍｇ蛋白质（ｔ＝０４８，Ｐ＞００５），Ｋｄ分别为４３１±４２和３０５±３０μｍｏｌ／Ｌ（ｔ＝７８，Ｐ＜００５）。ＭＫ８０１预处理减少ＮＭＤＡ受体的特异结合。表明在此脑水肿模型中ＮＭＤＡ受体总数未发生变化，但亲和力明显增高，其增高能被预先腹腔注入的ＭＫ８０１抑制。     

99m Tc－M IBI心肌灌注断层显像对实验性心肌梗塞的评价

目的：评价９９ｍ锝一甲氧基异丁基异腈（９９ｍＴｃ－ＭＩＢＩ）ＳＰＥＣＴ显像对心肌梗塞范围的估测及硝酸甘油介入后对存活心肌检测的价值。材料和方法：７条杂种犬通过结扎冠状动脉造成心肌梗塞模型，分别在实验第一天及实验第七天行９９ｍＴｃ－ＭＩＢＩＳＰＥＣＴ静息显像及硝酸甘油介入９９ｍＴｃ－ＭＩＢＩ心肌显像。用圆周剖面法定量分析短轴６个断面心肌缺损面积大小。结果：末次显像缺损面积与病理梗塞面积有良好相关性（ｒ＝０．８６和ｒ＝０．８７分别为硝酸甘油介入前后心肌缺损面积与病理梗塞面积的相关系数），末次显像与首次显像相比缺损面积明显缩小（Ｐ＜０．０５），硝酸甘油介入后心肌显像的平均缺损面积在首次和末次显像均明显减小（Ｐ＜０．０１），且缺损区的平均计数在硝酸甘油介入后均明显增高（Ｐ＜０．０５）。结论：９９ｍＴｃ－ＭＩＢＩ心肌断层显像是了解急性心肌梗塞范围的较好手段及硝酸甘油介入９９ｍＴｃ－ＭＩＢＩＳＰＥＣＴ显像可以提高检测低灌注区残存的存活心肌。     

硝酸甘油酯介入~(99m)Tc-MIBI心肌断层显像与多巴酚丁胺负荷超声心动图判定存活心肌的比较

为比较硝酸甘油酯（ＮＴＧ）介入９９ｍＴｃ甲氧基异丁基异腈（ＭＩＢＩ）心肌断层显像与小剂量多巴酚丁胺负荷超声心动图（ＤＳＥ）在判断急性心肌梗塞（ＡＭＩ）后病人存活心肌中的一致性，对３６例ＡＭＩ病人分别进行了ＮＴＧ介入９９ｍＴｃＭＩＢＩ心肌断层显像和小剂量（＜１０μｇ·ｋｇ－１·ｍｉｎ－１）的ＤＳＥ检查，所有检查均在病人入院后２～３周内完成。结果：在心肌静态显像示梗塞的１０９个节段中，ＮＴＧ显像４３个为存活节段，存活心肌检出率为３９％；在基础状态下超声心动图示梗塞的９４个节段中，ＤＳＥ检查３５个为存活节段，其存活心肌检出率为３７％，两者间差异无显著性（χ２＝０１０５，Ｐ＞００５）。在两法共同检出的９２个梗塞节段中，均存活的节段为２９个，均未存活的节段为４９个，两法的一致性为８４８％（７８／９２，Κ＝０６８）。因此，ＮＴＧ介入９９ｍＴｃＭＩＢＩ心肌断层显像与ＤＳＥ检查均为判断ＡＭＩ后病人存活心肌的安全、可靠的方法，两法具有良好的一致性。     

急性心肌梗塞TXB2变化与99mTc—MIBI心肌显像缺损区范围的关系

探讨了急性心肌梗塞（ＡＭＩ）病人的血浆ＴＸＢ２变化与＾９９ｍＴｃ－甲氧基异丁基异腈（ＭＩＢＩ）心肌显像缺损区范围的关系，发现ＡＭＩ患者发病后２４小时内血浆ＴＸＢ２明显升高，并与放射性缺损区范围呈高度相关，ｒ＝０．８５，Ｐ〈０．０１。这对于估测心肌梗塞预后的价值有待进一步探讨．     

^99mTc—MIBI心肌断层显像对急性心肌梗塞早期静脉溶栓的疗效观察

为观察急性心肌梗塞（ＡＭＩ）早期静脉溶栓的疗效，应用静态９９ｍＴｃ甲氧基异丁基异腈心肌断层显像，对２２例ＡＭＩ病人进行了观察。结果显示，９例溶栓再通病人由溶栓前平均９１±３３分降至３７±２２分（ｔ＝４０８５，Ｐ＜００１）。溶栓后２０个缺损节段中６个恢复正常，１０个明显改善。而这些节段为ＥＣＧ检查所示的梗塞部位。未溶栓组２次心肌显像变化不大。因此，静息心肌显像可观察ＡＭＩ病人溶栓前后心肌缺血有无改善，也可为判断冠状动脉再通提供影像学基础，具有一定的应用前景。     

进驻高原不同海拔高度不同时间健康青年血清心肌酶活性的变化

为探讨进驻高原不同海拔高度和不同居住时间健康青年血清心肌酶活性的变化,对从平原（海拔１４００ｍ）进驻海拔３７００ｍ和５３８０ｍ高度第７天及半年的８４名青年,进行血清ＡＳＴ、ＣＫ、ＬＤＨ．ａ－ＨＢＤＨ检测,并与平原健康青年作对照。结果表明,进驻高原ＡＳＴ、ＣＫ、ＬＤＨ及ａ—ＨＢＤＨ均显著高于平原（Ｐ＜００５或Ｐ＜００１）。进驻海拔达３７００ｍ,第七天较居住半年时ＬＤＨ显著增高（Ｐ＜００５）,ＡＳＴ、ＣＫ、ａ—ＨＢＤＨ虽然增高但无统计学差异（Ｐ＜００５）,进驻５３８０ｍ第７天较居住半年时的Ａ…     

高原低氧血清肌红蛋白及乳酸代谢的变化

目的：探讨进驻高原不同海拔高度不同居住时间健康青年血清肌红蛋白（Ｍｂ）和乳酸（ＢＬＡ）水平的变化。方法：对从平原进驻海拔３７００ｍ和５３８０ｍ高原第７天及６个月的４０名官兵进行血清Ｍｂ、ＢＬＡ检测,并与２０名平原健康青年作对照。结果：在高原,Ｍｂ和ＢＬＡ均明显高于平原（Ｐ〈０．０５或Ｐ〈０．０１）,且随海拔高度的升高而增高（Ｐ〈０．０１）,随居住时间的延长而降低（Ｐ〈０．０５或Ｐ〈０．０１）。结论：Ｍｂ和ＢＬＡ是反映高原缺氧适应能力有意义的生理指标。     

Optimization of the system of medical service of students of Cadet Schools of the Ministry of Defense of the Russian Federation

One of the factors of the successful military career guidance Cadet schools students is preserving and promoting their health. Medical support of children and adolescents aged 10-17 years should include the full range of medical and preventive measures defined for this group. The state of providing outpatient care for pupils at the Cadet School in St. Petersburg was studied. These results show that full medical care in accordance with the standards can be based only on children's health clinics. It is important that the organization of medical support pupils cadet schools should be cooperate with civilian health care.     

带状疱疹83例误诊原因分析

带状疱疹是由水痘—带状疱疾病毒引起的皮肤科常见疾病。其主要的病理损害,一是受累神经的严重炎症性浸润,继而导致受侵犯神经节内神经细胞变性、坏死;二是皮肤的水泡。迅速抑制神经节和相应的感觉神经纤维的充血、水肿和坏死,防止粘连形成,达到迅速镇痛、改善皮损,缩短病程及防止后遗症的发生是治疗的关键。因而,尽早明确诊断,     

Estimation of accumulated dose of radiation by method of ESR-spectrometry of dental enamel of mammals

ESR-spectrometry was used to investigate radiation-induced paramagnetic centers in enamel of mammals: carnivores (polar bear and fox), ungulates (reindeer, European bison, moose), and man. Values at half the microwave power saturation of the radiation signal, P_1/2, evaluated at room temperature, was found to range from 16 to 26 mW for animals and man. A new approach to discrimination of the radiation induced signal from the total ESR spectrum of reindeer enamel is proposed. ‘Dose-response’ dependencies of enamel of different species mammals were measured within the dose range from 0.48 up to 10.08 Gy. Estimations of ‘radiosensitivity’ enamel of carnivores and ungulates showed good agreement with radiosensitivity enamel of man by ESR method.     

Analysis of the results of the international comparison of activity measurements of a solution of Fe

The results of an international comparison of activity measurements of a solution of ⁵⁵Fe organized by the BIPM in 2005 are reported and analysed. This exercise, which follows the procedures of the CIPM mutual recognition arrangement to update older comparisons, is a renewal of the comparison organized by the BIPM that took place in 1978. A EUROMET comparison was organized in 1996 specifically to compare activity measurements of a ⁵⁵Fe solution by means of liquid-scintillation techniques. Results of these three comparisons are presented and discussed in this paper.

The radionuclide solution was provided by the NPL, which also distributed the samples to the participants. The activity of the ampoules was measured by 16 laboratories using 12 methods producing 25 results. Some general considerations on uncertainty assessments pertaining to the different techniques used are drawn. The outcome of four different estimators is compared from which the presence of at least one outlier can be confirmed. Further measurements should be made to try to reduce the discrepancy between the results. To date the outcome of the present comparison does not show an improvement to that of the 1996 comparison.     

Evaluation of the results of various technics of non-surgical therapy of varicocele

A new method of non-surgical treatment of varicocele syndrome is described: it consists in sclerotherapy of spermatic vein by trans-femoral percutaneous catheterization with balloon-catheters. In 8 cases venous thrombosis has been induced by direct electric clotting. The techniques and a 6 months follow-up are discussed. It is pointed out that this procedure should be considered as the method of choice for tubular lesions and sub-fertility prophylaxis in young people and in childhood.     

延迟性脾破裂误漏诊原因分析

目的探讨延迟性脾破裂误漏诊原因和预防措施.方法回顾性分析总结12例延迟性脾破裂中的诊断和误漏诊的经验与教训.结果本组延迟性脾破裂的误漏诊5例(41.66%).对多发伤与脾破裂并存可能认识不足,外伤史轻微或伤员隐瞒外伤史,缺乏腹痛-缓解-突然再腹痛的典型病史,缺乏“对冲性脾破裂”力学分析和整体化诊断思路等为其误漏诊的主要原因.结论详细的外伤史和全面系统检查,重视腹以外多发伤掩盖腹内脏器伤及延迟性脾破裂可能.确立外伤-腹内脏器伤-脾破裂整体化诊断思路.不间断地辅以B超检查脾形态学变化和腹内有无积液,腹腔穿刺确定有无血腹、X线胸腹部检查观察左侧胸肋角和膈肌运动情况、必要时CT检查以尽早发现脾包膜下血肿,降低延迟性脾破裂误漏诊率.