血瘀证患者血浆组织型纤溶酶原激活物及其抑制物的变化

为探讨纤溶系统活性与血瘀证的关系,对６２例血瘀证患者和６０名健康者进行了血浆组织型纤溶酶原激活物（ｔ ＰＡ）及其抑制物（ＰＡＩ）的活性测定,结果表明：血瘀证患者ｔ ＰＡ活性为（０．２７±０．０９）Ｕ／ｍｌ,显著低于对照组的（０．４７±０．１０）Ｕ／ｍｌ（Ｐ＜０．０１）,而ＰＡＩ的活性为（０．７１±０．１６）Ｕ／ｍｌ,显著高于对照组的（０．５７±０．１４）Ｕ／ｍｌ（Ｐ＜０．０１）,且二者均存在性别间的差异（Ｐ＜０．０１）;ｔ ＰＡ的阳性率为７９０％,ＰＡＩ的阳性率为４８４％,从而提示,血瘀证的发生与体内纤溶系统失衡有关,ｔ ＰＡ、ＰＡＩ的检测,对血瘀证的诊断、药物疗效观察均具有一定的临床实用价值。     

高原老年人右心室舒张功能的脉冲多普勒超声研究

海拔２２６０ｍ老年１３例（Ａ组），海拔３５００～４２００ｍ老年１２例（Ｂ组），年龄６０～７４岁。ＥＣＧ、ＵＣＧ、心三位片和肺功能无右室肥大和器质性心脏病及慢阻肺。脉冲多普勤测定三尖瓣口Ｅ＿ｖ、Ａ＿ｖ、Ｅ＿Ｉ、Ａ＿Ｉ、Ａ＿ｖ／Ｅ＿Ｉ、ＥＤＴ、ＡＴ。结果发现Ｂ组的Ａ＿ｖ／Ｅ＿ｖ增大（Ｐ＜０．００１）；ＥＤＴ及ＡＴ缩短（分别Ｐ＜０．００１）；ＡＴ与ＥＤＴ呈高度正相关（ｒ＝０．９３５、Ｐ＜０．０１）；ＡＴ与Ａ＿ｖ／Ｅ＿ｖ呈高度负相关（ｒ＝－０．９１６、Ｐ＜０．０１）；且ＥＤＴ与Ａ＿ｖ／Ｅ＿ｖ亦呈高度负相关（ｒ＝－０．９０７、Ｐ＜０．０１）；表明尚无高原心脏病的海拔３５００ｍ以上高原老年人，右室舒张功能减低，右室后负荷已有一定程度增加，两者间呈高度正相关关系。     

特技飞行对血清胰岛素、皮质醇、血管紧张素Ⅱ和胃泌素的影响

为观察特技飞行对胰岛素、皮质醇、血管紧张素Ⅱ和胃泌素等激素的影响。２０名健康男性飞行员（年龄２４～３０岁），复杂特技飞行时最大加速度为＋６．０Ｇｚ，分别在飞行前２ｈ，飞行后即刻、６ｈ及飞行后２４ｈ采血。用放射免疫法测定上述激素。结果发现，飞行后即刻血清胰岛素含量（２６．４±３．６８μＩＵ／ｍｌ）较飞行前（１３．１±０．４８μＩＵ／ｍｌ）有明显升高（Ｐ＜０．０１），飞行后２４ｈ胰岛素含量（１７．２±１．３７μＩＵ／ｍｌ）明显下降，与飞行后即刻比较有显著性差异（Ｐ＜０．０５），但与飞行前比较，无显著性差异（Ｐ＞０．０５）。飞行后即刻６ｈ血清胃泌素明显升高（９６．４±２２．０，１１０．７±２８。７ｐｇ／ｍｌ）与飞行前（３５．３±１５，０ｐｇ／ｍｌ比较，有显著差异（Ｐ＜０．０５）。飞行后２４ｈ血清胃泌素明显下降，与飞行后即刻比较有显著差异（Ｐ＜０．０５）。飞行前后血清皮质醇和血管紧张素Ⅱ均无显著性变化（Ｐ＞０．０５）。飞行后即刻胰岛素及胃泌素含量均明显高于飞行后２４ｈ，二者同为上午１０时抽取的标本，说明其升高不是正常日节律所致，与饮食亦无明显关系。有研究发现，特技飞行后即刻血液中胃动素含量明显升高，胃动素能促进胰岛     

大鼠下肢缺血再灌注对心、肺组织功能损伤研究

目的：研究大鼠下肢缺血再灌注后对心、肺组织和功能的损伤作用。方法：ＳＤ大鼠２０只随机分成２组,组 Ⅰ（ｎ＝１０）为实验组,行肾动脉水平远端腹主动脉阻断 １２０ ｍｉｎ后再灌注 １２０ ｍｉｎ,组Ⅱ （ｎ＝１０）为假手术对照组,不行腹主动脉阻断。观察２组术后心肺组织病理变化以及心肌ＡＴＰ酶,心肌凋亡率,平均动脉压（ＭＡＰ）变化,肺丙二醛（ＭＤＡ）,伊文氏兰（Ｅｖａｎ＇ｓ ｂｌｕｅ）含量,肺糖皮质激素受体（ＧＲ）的 ｍＲＮＡ水平变化。结果：组Ⅰ大鼠心肺组织可见炎性细胞浸润,心肌变性,肺渗出增加。与组Ⅱ比较,平均动脉压下降［（６１±１４）ｍｍＨｇ）］与（８６±１２）ｍｍＨｇ相比,Ｐ＜０．０５］,心肌ＡＴＰ酶活力下降［Ｎａ＋Ｋ＋ＡＴＰａｓｅ（８．０５±０．３５）Ｕ／ｍｇ与（９．０４±０．８１）Ｕ／ｍｇ相比较,ｐ＜０．０５;Ｃａ２＋ＡＴＰａｓｅ（４．９９±０．２３）Ｕ／ｍｇ与（５．６９±０．７５）Ｕ／ｍｇ相比较,ｐ＜０．０５;Ｍｇ２＋ＡＴＰａｓｅ（４．４０±０．２６）Ｕ／ｍｇ与（５．３０±０．６２）Ｕ／ｍｇ相比较,ｐ＜０．０５］,心肌凋亡率增加［（５．８５±２．４０）％与（０．８７±０．２６）％相比较,ｐ＜０．０５］,肺ＭＤ     

糖皮质激素在成人呼吸窘迫综合征救治中的合理应用

采用放射配体结合法测定２８例成人呼吸窘迫综合征（ＡＲＤＳ）病人外周血白细胞糖皮质激素受体（ＧＣＲ），结果（１０１８．３±８２５．２）位点／细胞，显著低于正常人（４６３４．１±４３６．５）位点／细胞（Ｐ＜０．０１）。而其血浆皮质醇浓度为（２８９±１５１）ｕｇ／Ｌ，高于正常人（１２４±４７）ｕｇ／Ｌ（Ｐ＜０．０５）。结合病人ＡＰＡＣＨＥⅡ评分，并根据ＧＣＲ指导地塞米松的用法，使ＡＲＤＳ的病死率由８８．３％下降至３６。４％。     

L-精氨酸对缺氧性肺动脉高压大鼠内皮素释放的影响

为了探讨Ｌ—精氨酸（Ｌ－Ａｒｇ）对缺氧性肺动脉高压（ＨＰＨ）大鼠血浆内皮素释放的影响。本文建立了ＨＰＨ大鼠模型,将Ｗｉｓｔａｒ大鼠４０只分为;对照组、缺氧组、缺氧＋Ｎ－硝基Ｌ精氨酸甲脂（ＬＮＡＭＥ）组和缺氧ＬＡｒｇ组四组进行研究,结果显示：缺氧组的肺动脉平均压（ｍＰＡＰ）显著高于对照组（Ｐ＜００５）,缺氧组＋Ｌ－Ａｒｇ组的ＭＰＡＰ显著低于缺氧组（Ｐ＜００５）及缺氧＋Ｌ－ＮＡＭＥ组（Ｐ＜００１）,缺氧组的ＲＶ／（ＬＶ＋Ｓ）比值显著高于对照组（Ｐ＜００１）,缺氧＋ＬＮＡＭＥ组的ＰＶ…     

氧化修饰低密度脂蛋白及内皮素-1水平与消化性溃疡

为探讨低密度脂蛋白的氧化修饰程度及内皮素分泌情况在胃及十二指肠溃疡发病中的作用及其机理，用单克隆抗体酶联免疫吸附法和放射免疫分析均相竞争法分别测定了血浆中氧化修饰低密度脂蛋白和内皮素－１的含量。结果：胃及十二指肠溃疡患者血浆中的氧化修饰低密度脂蛋白水平分别为（０．５２±０．０９）ｍｇ／Ｌ和（０．６７±０．０９）ｍｇ／Ｌ，均较正常人（０．３２±０．０７）ｍｇ／Ｌ呈显著升高（Ｐ＜０．０１），内皮素－１水平在胃及十二指肠溃疡时分别为（１０．２±２．３）ｎｇ／Ｌ和（１３．１±２．８）ｎｇ／Ｌ，也较正常人（６．０±１．３）ｎｇ／Ｌ明显地增高（Ｐ＜０．０１）；两项指标在胃溃疡患者均明显地低于十二指肠溃疡患者（Ｐ＜０．０５）；且两指标的总体水平均与溃疡直径呈明显正相关（Ｐ＜０．０５）。提示氧化修饰低密度脂蛋白和内皮素－１可能参与了溃疡的形成过程，并有可能是造成溃疡的重要因素。     

HAPC患者红细胞2,3—二磷酸甘油酸的变化和红细胞ATP酶的活性

目的：了解红细胞２，３－二磷酸甘油酸、红细胞膜ＡＴＰ酶在高原红细胞增多症（ＨＡＰＣ）的变化及二者关系。方法：ＨＡＰＣ患者２４例，正常对照１９例，分别测定红细胞２，３－二磷酸甘油酸，红细胞膜ＡＴＰ酶（Ｎａ＋－Ｋ＋－ＡＴＰ酶，Ｃａ２＋－Ｍｇ２＋－ＡＴＰ酶活性。结果：ＨＡＰＣ组及对照组红细胞２，３－二磷酸甘油分别为：３．２１ｍｍｏｌ／Ｌ±０．１３ｍｍｏｌ／Ｌ，４．８７ｍｍｏｌ／Ｌ±０．０７ｍｍｏｌ／Ｌ，（Ｐ＜０．０５）；Ｎａ＋－Ｋ＋－ＡＴＰ酶活性分别为：４．１±０．０１３λΒ／μｍｏｌ·ｈ－１·ｇ－１，７．４±０．１９λΒ／μｍｏｌ·ｈ－１·ｇ－１（Ｐ＜０．０１）；Ｃａ２＋－Ｍｇ２＋－ＡＴＰ酶活性分别为１５．１±１．７０λΒ／μｍｏｌ·ｈ－１·ｇ－１，２５．３±２．３１λΒμｍｏｌ·ｈ－１·ｇ－１（Ｐ＜０．０１）；相关分析显示：２，３－二磷酸甘油酸与Ｎａ＋－Ｋ＋－ＡＴＰ酶呈正相关（ｒ＋０．４８１７，Ｐ＜０．０１）与Ｃａ２＋－Ｍｇ２＋－ＡＴＰ酶呈正相关（ｒ＝０．４７８３，Ｐ＜０．０１）。结论：ＨＡＰＣ患者红细胞２，３－二磷酸甘油酸的减少，红细胞膜ＡＴＰ酶活力降低，反映机体缺氧状况，体细胞代谢异常     

高压氧治疗重型颅脑损伤后临床、脑电地形图、血浆内皮素、经颅多普勒超声的研究

目的研究高压氧（ＨＢＯ）治疗重型颅脑损伤（ＳＥＩ）的疗效及机制。方法治疗组３５例,对照组２０例,观察ＨＢＯ前后脑电地形图（ＢＥＡＭ）血浆内皮素（ＥＴ）及经颅多普勒超声（ＴＣＤ）查大脑中动脉收缩期流速,平均流速及搏动指数（ＭＣＡ－Ｖｓ,Ｖｍ,ＰＩ）等７项参数。结果治疗组的临床（ＧＣＳ）,ＢＥＡＭ,预后（ＧＯＳ）均明显迅速改善,与对照组有显著性差异。治疗组在ＨＢＯ１疗程后的ＥＴ值从（９１．２４±１２．１８）ｎｇ／Ｌ降到（６８．８８±１４．３７）ｎｇ／Ｌ（Ｐ＜０．０１）,与对照组相应时相比较,ＥＴ降至（８３．１２±１２．２２）ｎｇ／Ｌ,也有显著性差异（Ｐ＜０．０５）。相应的ＴＣＤ的ＭＣＡ－Ｖｍ从（６４．２±４．８）ｃｍ／ｓ降至（５１．６±４．２）ｃｍ／ｓ（Ｐ＜０．０１）,ＭＣＡ－Ｖｓ,ＰＩ的下降同样有极显著性差异（Ｐ＜０．０１）。结论ＨＢＯ能迅速改善重型颅脑损伤者的意识状态、ＢＥＡＭ异常率及生存质量。研究表明与急性期血浆ＥＴ下降和ＭＣＡ血管痉挛缓解有关,表现在ＭＣＡ血流速度和血管阻力的改善,从而减轻脑缺血缺氧,降低颅压,这是ＨＢＯ改善预后的重要机制之一。     

21天头低位(-6°)卧床前后下体负压和头高位倾斜暴露时的心血管反应

目的探讨２１天头低位（ＨＤＴ）卧床对人体立位应激下心血管反应的影响,以及比较下体负压（ＬＢＮＰ）和头高位倾斜（ＨＵＴ）两种立位应激下心血管反应的差异。方法６名受试者在２１天ＨＤＴ前、后分别进行ＬＢＮＰ（－４．００ｋＰａ／３ｍｉｎ、－６．６７ｋＰａ／３ｍｉｎ及－９．３３ｋＰａ／３ｍｉｎ）和ＨＵＴ试验（３０°／３ｍｉｎ、４５°／３ｍｉｎ、６０°／３ｍｉｎ及７５°／３ｍｉｎ）,以比较两种检测方法的血压（ＢＰ）和心率（ＨＲ）的变化情况。结果与ＬＢＮＰ（或ＨＵＴ）前相比：①ＬＢＮＰ（ＨＵＴ）时ＨＲ显著增加（Ｐ＜０．０１）,ＳＢＰ显著降低（Ｐ＜０．０５）;卧床后相应的变化量增加。②ＬＢＮＰ时ＤＢＰ降低（卧床后达显著,Ｐ＜０．０５）;而ＨＵＴ时ＤＢＰ增加（卧床后达显著,Ｐ＜０．０５）。③ＬＢＮＰ时ＭＡＰ均显著降低（Ｐ＜０．０５）;而ＨＵＴ时在卧床前无变化（Ｐ＞０．０５）,在卧床后显著增加（Ｐ＜０．０５）。结论ＬＢＮＰ和ＨＵＴ引起的ＣＶＳ反应并不相同。笔者认为,ＨＵＴ更能促进心血管系统对立位应激的调节作用。     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

Developmental validation of the PowerPlex(®) ESI 16 and PowerPlex(®) ESI 17 Systems: STR multiplexes for the new European standard

In response to the ENFSI and EDNAP groups’ call for new STR multiplexes for Europe, Promega^® developed a suite of four new DNA profiling kits. This paper describes the developmental validation study performed on the PowerPlex^® ESI 16 (European Standard Investigator 16) and the PowerPlex^® ESI 17 Systems. The PowerPlex^® ESI 16 System combines the 11 loci compatible with the UK National DNA Database^®, contained within the AmpFlSTR^® SGM Plus^® PCR Amplification Kit, with five additional loci: D2S441, D10S1248, D22S1045, D1S1656 and D12S391. The multiplex was designed to reduce the amplicon size of the loci found in the AmpFlSTR^® SGM Plus^® kit. This design facilitates increased robustness and amplification success for the loci used in the national DNA databases created in many countries, when analyzing degraded DNA samples. The PowerPlex^® ESI 17 System amplifies the same loci as the PowerPlex^® ESI 16 System, but with the addition of a primer pair for the SE33 locus. Tests were designed to address the developmental validation guidelines issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), and those of the DNA Advisory Board (DAB). Samples processed include DNA mixtures, PCR reactions spiked with inhibitors, a sensitivity series, and 306 United Kingdom donor samples to determine concordance with data generated with the AmpFlSTR^® SGM Plus^® kit. Allele frequencies from 242 white Caucasian samples collected in the United Kingdom are also presented. The PowerPlex^® ESI 16 and ESI 17 Systems are robust and sensitive tools, suitable for the analysis of forensic DNA samples. Full profiles were routinely observed with 62.5 pg of a fully heterozygous single source DNA template. This high level of sensitivity was found to impact on mixture analyses, where 54–86% of unique minor contributor alleles were routinely observed in a 1:19 mixture ratio. Improved sensitivity combined with the robustness afforded by smaller amplicons has substantially improved the quantity of data obtained from degraded samples, and the improved chemistry confers exceptional tolerance to high levels of laboratory prepared inhibitors.     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

Bronchial stump fistula :treatment with covered retrievable hinged metallic stents-preliminary clinical experience

Objective To evaluate the preliminaily clinical efficacy and retrievability of a retrievable hinged covered metallic stent in the treatment of the bronchial stump fistula （BSF）. Methods Between April 2003 and March 2005, 8 patients with bronchial stump fistula after pneumonectomy or lobectomy were treated with two types （A and B） of retrievable hinged covered metallic stents. Type A stent was placed in 6 patients and type B in 2 under fluoroscopic guidance. The stent was removed with a retrieval set when BSF was healed or complications occurred. Results Stent placement in the bronchial tree was technically successful in all patients, without procedure-related complications. Immediate closure of the BSF was achieved in all patients after the procedure. Stents were removed from all patients but one. Removal of the stents was difficult in two patients due to tissue hyperplasia. Patients were followed up for 6 - 21 months. Placement of the stents remained stable in all patients except one due to severe cough. Permanent closure of BSF was achieved in 7 （87.5%） of 8 patients. Conclusion Use of a retrievable hinged covered expandable metallic stent is a simple, safe, and effective procedure for closure of the BSF. Retrieval of the stent seems to be feasible. （J Intervent Radiol, 2007, 16： 253-257）     

Die rechtsmedizinische Identifizierung — Bedeutung und Beweiswert —

Zusammenfassung Bei der rechtsmedizinischen Identifizierung kann die Identität im strengen Sinn allenfalls bei lebenden Personen festgestellt werden; sonst läßt sich nur von Teilen auf das Ganze (vom Untersuchungsobjekt auf die Person) schließen, wobei die verschiedenen Merkmale des Untersuchungsobjektes entsprechend der Hdufigkeit ihres Vorkommens eine unterschiedliche Beweiskraft haben. Bei der Schädelidentifizierung mit Hilfe moderner photographischer oder elektronischer Superprojektionsverfahren ergeben sich unter Berücksichtigung der Weichteildicken so viele (fiktive) Vergleichspunkte, daß bei geeignetem Vergleichsmaterial (Photographien) Identität wegen der Vielzahl übereinstimmender Bezugspunkte in den meisten Fällen evident ist.     

Imaging of abdominal nodal spread in malignant disease

This is a review of the role of imaging procedures for the assessment of abdominal and pelvic lymph nodes. The diagnosis of malignant lymphatic spread is rarely the sole purpose of imaging, because it is usually part of a general abdominal examination, most frequently with CT or US, or increasingly with MRI. These studies are often requested in order to obtain information about the situation to be encountered during surgery, or to alert the surgeon to irresectability or to unexpected metastases outside the initially planned area of exploration. In most surgically treated tumours the role of imaging for preoperative staging is limited, due either to its insufficient sensitivity or because the initial treatment is independent of the lymph node stage. Imaging is commonly used to verify treatment response to chemo- or radiotherapy and for follow-up.Correspondence to: S. Delorme