脑梗塞患者血清叶酸维生素B12浓度与同型半胱氨酸及血脂水平的研究

目的探讨本地区脑梗塞患者的血清叶酸、维生素B12（VitB12）与同型半胱氨酸（Hcy）水平及血脂水平的关系。方法应用全自动化学发光免疫法测定115例脑梗塞患者血清叶酸、维生素B12水平,采用荧光定量分析法测定血清同型半胱氨酸水平,采用免疫比浊法测定血脂水平。结果脑梗塞患者血清叶酸水平明显低于对照组（P〈0．001）,血清Hcy及甘油三酯（TG）水平明显高于对照组（P〈0．01）,而维生素B12及其余所测血脂指标与健康对照组无显著差异（P〉0．05）。结论即时监测血清叶酸、Hcy及TG水平,适当补充叶酸,可早期预防和及时治疗脑血管疾病,降低脑梗塞的发生率及复发率。     

高原汽车兵血清Hcy、叶酸和维生素B12的测定及相关性研究

目的 了解高原汽车兵血清同型半胱氨酸(Hcy)水平和营养状况,为合理补充营养提供依据.方法 采用S-腺苷酶法和酶促间接化学发光法,对36名在海拔3700 m以上高原生活9个月的汽车兵和40名在海拔1500 m平原生活的汽车兵进行了血清Hcy、叶酸和维生素B12含量的测定.结果 高原组血清Hcy含量明显高于平原组(P＜0.05),而血清叶酸和维生素B12的含量明显低于平原组(P＜0.05).结论 高原汽车兵血清Hcy明显偏高,营养不够合理,有必要进行营养干预.     

叶酸联合维生素B12对慢性心力衰竭患者血清同型半胱氨酸、N端脑钠肽水平及左心功能的影响

目的 观察叶酸联合维生素B12(VitaminB12)对慢性心力衰竭(chronic heart fa-ilure,CHF)患者血清同型半胱氨酸(Homocysteine,Hcy)及B型脑钠肽前体N端片段(N-terminal brain natriuretic peptide,NT-proB-NP)水平及左心功能的影响.方法 将符合入选标准120例CHF患者,按入选顺序随机分为治疗组58例和对照组62例,两组均予CHF常规治疗,治疗组在常规治疗基础上加用叶酸5 mg(1次/d)及维生素B120.5 mg(1次/d),疗程均为6个月;比较治疗前后血清Hcy及NT-proBNP水平,左室舒张末期内径(LVEDD)、左室射血分数(LVEF)、左室舒张早期心室充盈峰值(E峰)与舒张晚期心室充盈峰值(A峰)比值的变化.结果 治疗后两组Hcy、NT-proBNP均明显下降(P≤0.05),E/A值明显提高(P≤0.05),与对照组相比,治疗组改变更加明显(P≤0.05).LVEDD、LVEF无明显改变(P>0.05).结论 叶酸联合维生素B12能明显降低CHF患者血清Hcy及NT-proBNP水平,改善左心舒张功能,减轻CHF患者的临床症状.     

心脏超声对心力衰竭心功能指标与血清Hcy的关系研究

目的探讨射血分数保留的心衰(HF-PEF)患者血浆同型半胱氨酸(Hcy)与患者心功能、心肌重构的关系。方法选取本院(2015年6月~2016年12月)确诊的60例HF-PEF患者(HF-PEF组)、另选取60例非HF-PEF患者作为对照组,检测两组血浆Hcy,采用彩色超声心动图检测两组患者的心功能及心肌重构指标,并探讨Hcy与HF-PEF患者心功能、心肌重构的关系。结果 HF-PEF组患者的血浆Hcy水平显著的高于对照组,差异具有统计学意义(P0.05);HF-PEF组患者的室间隔厚度、左室后壁厚度、左房内径、E/A值显著的高于对照组,差异具有统计学意义(P0.05);HF-PEF组患者的左室舒张末期内径、LVEF%测定值与对照组比较差异无统计学意义(P0.05);HF-PEF组患者的室间隔厚度、左室后壁厚度、左房内径、E/A值与血浆Hcy呈显著的正相关关系(r=0.517、r=0.443、r=0.426、r=0.584,P0.05);HF-PEF组患者的血浆Hcy水平与患者左室舒张末期内径测定值相关性不显著(r=0.098,P0.05);HF-PEF组患者的血浆Hcy水平与LVEF%呈显著的负相关性(r=-0.382,P0.05)。结论 HF-PEF患者血浆Hcy水平较非HF-PEF患者显著的升高,且与患者的心功能及心肌重构关系密切。     

血清同型半胱氨酸、纤维蛋白原与阻塞性睡眠呼吸暂停综合征关联性分析

目的:对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者按呼吸暂停严重程度分组,对不同程度OSAHS患者的血清同型半胱氨酸(Hcy)、纤维蛋白原(Fbg)与睡眠呼吸参数指标关联性进行分析.方法:选取2011年3月至2013年12月在兵团医院睡眠监测室行多导睡眠图(PSG)检查的患者中确诊OSAHS患者133例,根据监测结果分成3组:轻度组(50例)、中度组(46例)、重度组(37例);另选取同期经PSG监测AHI＜5次/h的50名健康体检者为对照组.所有受试者均记录睡眠呼吸监测相关指标,并测定Hcy、Fbg数值.结果1、OSAHS各组与对照组比较Hcy、Fbg水平均存在差异,差异有统计学意义(均P＜0.001).2、各组受试者整体血清Hcy水平与LSa02％呈高度负相关(r=-0.455,P=0.000),与Fbg呈高度正相关(r =0.338,P=0.000).结论:睡眠低氧血症可引起血清Hcy、Fbg水平异常,OSAHS患者体内存在氧化应激损伤.     

高同型半胱氨酸血症对高海拔地区阿尔茨海默病影响的观察

目的：探讨高同型半胱氨酸（Hey）水平对高原地区阿尔茨海默病（AD）的影响以及干预治疗。方法：选取30例高海拔地区（西宁海拔2260m）AD患者,28例同龄同一地区健康老年人为对照组。测定血清Hcy、叶酸、维生素B12水平,并对AD患者进行了12周叶酸5mg及维生素B12 500μg干预治疗。主要疗效指标为神经量表MMSE、ADAS—cog和ADL。结果：AD患者血清Hcy水平高于对照组（P〈0．01）,血清叶酸水平低于对照组（P〈0．05）,VitB12在2组间变化不大。AD组有18例（60．0％）患者有高同型半胱氨酸血症,而对照组6例（21．0％）,P〈0．01。治疗12周后AD患者MMSE、ADAS—00g和ADL差别有统计学意义（P〈0．01和P〈0．05）,血清Hcy水平较治疗前明显下降（P〈0．01）。结论：高海拔AD患者血清Hcy水平明显增高,而高Hcy与高海拔AD患者饮食中叶酸摄入不足有密切关系。经干预治疗可降低AD患者血清Hcy水平,有效地改善AD患者认知功能、社会活动以及日常生活能力。     

131Ⅰ治疗甲亢性心脏病患者尿脑钠肽水平变化的研究

目的 探讨尿液脑钠肽水平的测定在131Ⅰ治疗甲状腺功能亢进性心脏病(甲心病)中的应用价值.方法 采用化学发光法检测111例接受131Ⅰ治疗的甲状腺功能亢进症(甲亢)患者和30名健康对照者的血浆和尿液脑钠肽浓度以及血清游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)水平.将111例甲亢患者分为单纯甲亢组(51例)和甲心病组(60例),并对甲心病组患者按照纽约心脏病学会(NYHA)标准对其心功能进行分级,其中,NYHA Ⅰ ～Ⅱ级(A组)37例、NYHAⅢ～Ⅳ级(B组)23例.对正常对照组及131Ⅰ治疗前后各组患者的血浆和尿液脑钠肽水平以及FT3、FT4水平进行比较分析.结果 A、B两组甲心病患者治疗前血浆和尿液脑钠肽水平均显著高于单纯甲亢组(血浆:t=8.98、9.52,P均＜0.01;尿液:t=10.83、12.73,P均＜0.01)和正常对照组(血浆:t=8.97、9.52,P均＜0.01;尿液:t=9.21、5.64,P均＜0.01);甲心病B组131Ⅰ治疗前、治疗后6个月、12个月的血浆、尿液脑钠肽水平均明显高于甲心病A组(血浆:t=5.98、5.87、6.35,P均＜0.01;尿液:t=4.33、4.09、5.02,P均＜0.01).随着心功能不全程度的加重,尿液脑钠肽水平逐渐升高,与血浆脑钠肽水平呈正相关(r=0.829,P＜0.01);与NYHA分级呈正相关(r=0.751,P＜0.01);与FT3、FT4水平呈正相关(FT3:r=0.635; FT4:r=0.672,P均＜0.01).结论 甲心病患者尿液脑钠肽水平随着心功能严重程度的增加而升高,尿液脑钠肽可以准确评价甲亢患者的心功能,可作为临床诊断、疗效观察以及预后判断的客观指标,与血浆脑钠肽具有相同的应用价值.     

冠脉旁路移植术后血清同型半胱氨酸水平及相关因素变化的临床研究

目的 探讨冠脉旁路移植术后血清同型半胱氨酸(Hcy)水平升高的原因.方法 选择体外循环和非体外循环患者各20例,测定其术前第1天及术后第1、3、5、7天血清Hcy、铜离子、铜蓝蛋白、铁离子、叶酸、维生素B12、C反应蛋白(CRP)的水平.结果 铜蓝蛋白、铜离子和Hcy分别于术后第3、4、6天明显升高;维生素B12和铁离子均于术后第3天明显下降,此后缓慢上升;CRP于术后第3天显著升高,然后逐渐下降到正常水平;叶酸在手术前后无显著改变.上述指标两组间比较均无显著差异.结论 冠脉旁路移植术后血清Hcy上升可能与体内铜代谢变化有关,而与体外循环无关.     

脑梗死患者血清同型半胱氨酸与小而密低密度脂蛋白胆固醇的关系

目的探讨血清同型半胱氨酸(Hcy)水平升高和小而密低密度脂蛋白胆固醇(sdLDL-C)水平在脑梗死发病中的作用。方法采用全自动生化分析仪检测124例脑梗死患者血清Hcy和sdLDL-C水平,同时检测血清总胆固醇、三酰甘油、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、血糖水平。根据头颅CT和磁共振检查证实后将患者分为多发性脑梗死组与单发性脑梗死组,观察其与Hcy及sdLDL-C的关系。结果脑梗死组血清Hcy及血脂水平明显高于对照组(HDL-C低于对照组),P<0.05,Hcy与sdLDL-C水平随脑梗死病变程度增加而升高(P<0.05)。Hcy和sdLDL-C与脑梗死病变程度密切相关(r=0.259和r=0.452,P<0.001)。结论 Hcy和sdLDL-C均是脑梗死发病的独立危险因素。     

H型高血压与冠状动脉粥样硬化的关系

目的 探讨H型高血压与冠状动脉粥样硬化的关系.方法 根据患者血清同型半胱氨酸(Hcy)水平,将118例原发性高血压合并冠状动脉粥样硬化性心脏病的患者分为H型高血压组(H型组,Hcy≥10 μmol/L)和单纯高血压组(单纯组,Hcy＜10 μmol/L).所有患者均行冠状动脉造影,并对其粥样硬化程度进行Gensini评分.结果 H型组中,急性冠脉综合征的比例显著高于单纯组(P＜0.05);单纯组血清Hcy水平与Gensini评分无相关性(r=0.16,95%CI:-0.12～0.41,P＞0.05);H型组血清Hcy水平与Gensini评分呈显著正相关(r=0.47,95%CI:0.25～0.64,P＜0.01).结论 H型高血压患者冠状动脉粥样硬化病变狭窄程度与血清Hcy水平相关.     

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.     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

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.     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

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.