运动负荷对不稳定性心绞痛患者纤溶活性影响的研究

对20例健康受试者和25例不稳定性心绞痛患者进行运动负荷前、后组织型纤溶酶原激活剂(t-PA)、纤溶酶原激活剂抑制剂(PAI-1)活性的测定.结果发现运动前静息时,两组t-PA活性无显著差异,而PAI-1活性不稳定性心绞痛组明显高于对照组;运动后,不稳定性心绞痛组t-PA活性显著低于对照组(0.96±0.45IU/ml对1.89±0.68IU/ml,P<0.01),PAI-1活性下降幅度小于对照组(12.0%对31.9%),使其PAI-1活性仍显著高于对照组(8.20±2.28AU/ml对4.21±0.68AU/ml,P<0.01).提示不稳定性心绞痛患者不论是静息,还是在运动负荷激发后,均存在着纤溶活性的下降.     

老年冠心病患者纤溶酶原激活抑制剂的变化

目的探讨老年人冠心病与纤溶酶原激活抑制剂（PAI）的关系。方法测定了93例老年冠心病患者的PAI和组织型纤溶酶原激活剂（t-PA）活性、胆固醇和甘油三酯的血浆水平,并与健康对照组比较。结果冠心病组的PAI活性〔（810±360）AU/L〕明显高于健康对照组〔（640±300）AU/L,P＜0.01〕;冠心病组的t-PA活性〔（390±140）IU/L〕明显低于对照组的水平〔（490±240）IU/L,P＜0.05〕。结论老年人PAI活性的增高和t-PA活性的降低可能参与了冠心病的发病机制。     

不稳定型心绞痛患者纤溶活性及内皮功能的变化

目的观察不稳定型心绞痛患者血浆组织型纤溶酶原激活物(t-PA)、纤溶酶原激活物抑制物-1(PAI-1)、假性血友病因子(vWF)水平的变化,进一步明确纤溶活性和内皮功能在不稳定型心绞痛中的作用,并探讨其临床意义。方法选择40例不稳定型心绞痛患者和30例健康志愿者,均取早晨空腹静脉血,用发色底物法测定血浆t-PA和PAI-1的活性,用酶联免疫吸附双抗体夹心法测其血浆中vWF的含量。结果(1)不稳定型心绞痛组的t-PA活性明显低于对照组(0.2±0.11IU/ml∶0.4±0.09IU/ml,P<0.05),而PAI-1活性则较对照组增高(0.9±0.32AU/ml∶0.53±0.30AU/ml,P<0.05),vWF含量较对照组明显增高［(565±80.5)%∶(80±55.6)%,P<0.001］;(2)PAI-1活性与vWF的含量呈正相关;(3)PAI-1活性、vWF含量均与甘油三酯水平呈正相关。结论纤溶活性降低、血管内皮受损使不稳定型心绞痛患者易发生冠状动脉痉挛及血栓形成。     

急性脑梗死患者凝血象改变

目的探讨急性脑梗死患者凝血象变化,为预防本病提供依据. 方法采用ACL 200型全自动凝血分析仪检测凝血及纤溶有关指标.用血浆纤维蛋白原(Fg)功能自动化仪检测Fg浓度及其分子的功能,用发色底物法检测组织型纤溶酶原激活物(t-PA)、纤溶酶原激活物抑制物(PAI-1). 结果急性脑梗死患者血浆Fg浓度(3.38±1.3)g*L-1,其分子功能4.33±0.58,与对照组相比,P<0.05;抗凝血酶Ⅲ(AT-Ⅲ)活性(72.2±13.2)%,t-PA活性(0.89±0.16)IU*ml-1、PAI-1活性(8.27±1.34)IU*ml-1,与正常组相比,P<0.05. 结论血浆Fg浓度升高及其分子功能增强,AT-Ⅲ活性降低、t-PA活性降低及PAI-1活性增强是急性脑梗死的主要凝血象变化.检测凝血及纤溶有利于本病预防及治疗.     

无症状性脑梗死患者血清炎性因子和纤溶及抗纤溶活性的变化

目的观察无症状性脑梗死(silent cerebral infarction,SCI)患者血清炎性因子和纤溶及抗纤溶活性的变化。方法选择SCI患者53例(SCI组)和健康体检者55例(对照组),分别检测血清高敏C反应蛋白(hs-CRP)、血浆纤溶酶原活性(PLG:A)、纤溶酶活性(PLM:A)、组织型纤溶酶原激活物(t-PA)活性、D-二聚体(D-D)含量、_2α-纤溶酶抑制剂(α_2-PI)和纤溶酶原激活物抑制剂(PAI)活性。结果 SCI组hs-CRP水平明显高于对照组[(15.36±4.30)mg/L vs (10.26±2.61)mg/L,P<0.01],SCI组PLM:A、t-PA和D-D含量均明显低于对照组[(35.84±10.23)% vs (68.74±18.41)%,(0.11±0.01)U/ml vs (0.49±0.12)U/mL(0.36±0.14)mg/L vs (0.68±0.16)mg/L,P<0.01)],SCI组PLG:A与对照组比较差异无统计学意义(P>0.05),SCI组α_2-PI活性和PAI活性明显高于对照组[(128.46±23.75)% vs (96.36±19.34)%,(0.86±0.22)AU/ml vs (0.48±0.10)AU/ml.P<0.01]。结论炎症过程和纤溶及抗纤溶系统的功能失调与SCl的形成有关。     

急性冠脉综合征患者纤溶活性与脂蛋白（a）的关系探讨

目的 通过测定急性冠脉综合征(ACS)患者血浆中组织型纤溶酶原激活剂(t-PA)、纤溶酶原激活剂抑制物(PAI-1)抗原含量及脂蛋白(a)[Lp(a)]的水平,探讨纤溶活性与Lp(a)对冠脉血栓形成的影响及相互关系.方法 选取54例发病1 h～8 h以内的ACS患者作为病例组,并据病情分为不稳定型心绞痛(UAP)组及急性心肌梗死(AMI)组;42名健康体检者作为对照组.用ELISA法检测研究对象血浆t-PA、PAI-1抗原含量,用免疫透射比浊法检测Lp(a)的浓度,比较两组中各指标的变化.结果 UAP组及AMI组血浆t-PA、 PAI-1含量较对照组明显升高(P<0.05或P<0.01),t-PA在UAP组与AMI患者之间无统计学意义,而AMI组PAI-1含量较UAP组明显增高.UAP组及AMI组血浆Lp(a)浓度较对照组明显升高,AMI组又较UAP组明显升高.血浆Lp(a)水平与PAI-1含量存在着显著的正相关,而与t-PA含量之间无显著的相关关系.结论 冠脉血栓疾病发生时,血浆纤溶活性下降,t-PA、PAI-1抗原含量增加,以PAI-1增加为明显;血浆Lp(a)水平增高.Lp(a)促进PAI-1的分泌,抑制t-PA的分泌,减弱t-PA活性,打破了t-PA与PAI-1的动态平衡.     

血管紧张素Ⅱ对脐静脉内皮细胞分泌t-PA和PAI-1的影响

目的:观察血管紧张素Ⅱ(AngⅡ)对内皮细胞(EC)纤溶活性的影响。方法:用ELISA法测定人脐静脉内皮细胞(HUVEC)培养上清液中的组织型纤溶酶原激活剂(t-PA)及1型纤溶酶原抑制剂(PAI-1)抗原,观察不同浓度AngⅡ对EC分泌t-PA,PAI-1抗原的影响。结果:不同浓度AngⅡ(0、10-10、10-9、10-8、10-7和10-6mol／L)与EC共孵育4 h,培养上清液中PAI-1抗原含量分别为(94.00±18.62)、(136.10±19.20)、(164.22±25.60)、(188.00±22.36)、(140.50±25.31)和(124.48±24.20)ng／3×105EC,t-PA抗原含量无明显变化;10-8mol／L AngⅡ与EC共孵育1-24 h,从2 h开始培养上清液中PAI-1抗原含量明显高于同时点的对照组,4 h组升幅最大(3.5倍)。结论:一定浓度的AngⅡ可刺激HUVEC分泌PAI-1抗原。     

脑梗死急性期患者凝血与纤溶指标的改变及降纤酶的疗效

目的 :研究脑梗死急性期患者纤溶、凝血指标的变化及降纤酶的疗效。方法 :测定 38例脑梗死急性期 (<3天 )患者降纤酶治疗前、后的血浆纤维蛋白原 (Fbg)、α2 抗纤溶酶 (α2 - PI)、血浆组织型纤溶酶原激活物 (t- PA)及其抑制物 (PAI- 1)和 D-二聚体 (D- D)的变化。结果 :脑梗死急性期患者血浆 Fbg、α2 - PI、 PAI- 1、 D- D水平分别为 4.32± 1.7g/ L、 (15 4.39± 34 .86 ) %、 0 .2 6± 0 .1IU/ m l、 1.12± 0 .32 AU/ ml和 1.34± 1.18mg/ L,明显升高 ,较正常对照组有显著差异 P<0 .0 1) ,t- PA水平下降非常显著 (P<0 .0 0 1)。降纤酶治疗后 Fbg、α2 - PI、 PAI- 1、 D- D水平显著下降 (P<0 .0 5～ P<0 .0 0 1) ,t- PA水平升高非常显著 (P<0 .0 0 1)。结论 :降纤酶有良好降纤、溶纤作用 ,对脑梗死急性期患者有显著疗效。     

体外治疗性超声对大鼠纤溶系统的影响

目的　研究体外治疗性超声对大鼠血浆组织型纤溶酶原激活因子 (t-PA)、纤溶酶原激活物抑制因子 -1(PAI -1)的影响。方法　采用酶联免疫吸附法测定超声治疗前后大鼠血浆t-PA、PAI -1的改变。结果　超声治疗后ETUS组t-PA(0 .5 4± 0 .19)IU/ml,PAI -1(0 .44± 0 .18)AU/ml,对照组t -PA(0 .5 1± 0 .2 5 )IU/ml,PAI -1(0 .43± 0 .19)AU/ml,二者比较无明显差异 (P >0 .0 5 )。结论　治疗剂量超声对大鼠纤溶系统没有影响     

急性脑梗死患者血浆t-PA、PAI-1水平及血液流变学指标变化的相关性分析

目的研究急性脑梗死患者治疗前后血浆中组织型纤溶酶原激活物(t-PA)和纤溶酶原激活物抑制剂-1(PAI-1)的水平及血液流变学指标变化的意义。方法应用酶联免疫吸附试验(ELISA)测定急性脑梗死患者血浆t-PA和PAI-1的水平,常规方法测定血液流变学指标。结果①脑梗死患者急性期血浆t-PA含量明显低于对照组(P<0.01),而PAI-1含量则明显高于对照组(P<0.01),恢复期PAI-1水平趋于正常,而t-PA水平与对照组比较仍存在一定差异(P<0.05)。②t-PA和PAI-1的水平与多项血液流变指标相关。结论急性脑梗死患者存在不同程度的凝血纤溶系统失衡,并与血液流变学指标异常密切相关。     

Research and Evaluation of the Influence of the Construction of the Gate and the Influence of the Piston Velocity on the Distribution of Gases into the Volume of the Casting

Distribution of gasses to the cast volume and volume of pores can be maintained within the acceptable limits by means of correct setting of technological parameters of casting and by selection of suitable structure and gating system arrangement. The main idea of this paper solves the issue of suitability of die casting adjustment—i.e., change of technological parameters or change of structural solution of the gating system—with regards to inner soundness of casts produced in die casting process. Parameters which were compared included height of a gate and velocity of a piston. The melt velocity in the gate was used as a correlating factor between the gate height and piston velocity. The evaluated parameter was gas entrapment in the cast at the end of the filling phase of die casting cycle and at the same time percentage of porosity in the samples taken from the main runner. On the basis of the performed experiments it was proved that the change of technological parameters, particularly of pressing velocity of the piston, directly influences distribution of gasses to the cast volume.     

Weighing the QT Intervals with the Slope or the Amplitude of the T Wave

Objective: The reproducibility of QT interval measurements is low, even for the mean QT interval based on the standard ECG. In this study we analyzed whether the reproducibility of the mean weighed QT interval was better than the simple mean QT interval. The weighing was based on the amplitude of the T wave or the slope of the steepest tangent on the terminal part of the T wave. Material and methods: 12‐lead ECGs of 130 postmyocardial infarction patients were obtained. The QT intervals were measured by the tangent‐method on two occasions by the same observer Mismatch QT intervals were defined as QT intervals that were measured at only one occasion. Sixteen ECGs were rejected. The data were split into 34 and 80 ECGs for optimization and validation of the weighing, respectively. The weighed QT dispersion was calculated as the weighed mean of the three longest minus the weighed mean of the three shortest QT intervals. Results: Weighing with the slope increased the reproducibility by 41% (P = 3 10^‐6), but weighing with the amplitude reduced it by 20% (P = 0.02). However, if measurements with errors above 75 ms were rejected, weighing with the slope or the amplitude increased the reproducibility with 26% and 20% (P = 0.02), respectively. Weighing did not change the reproducibility of the weighed QT dispersion. Conclusion: Weighing with the slope improved the reproducibility of the mean weighed QT interval. However, if measurements with errors above 75 ms were rejected, weighing with the amplitude also increased the reproducibility. Weighing did not change the reproducibility of the weighed QT dispersion. Weighing is particularly efficient at reducing the negative impact of mismatch QT intervals on the reproducibility. A.N.E. 2002;7(1):4–9     

县级以下综合医疗机构医务人员对现代结控知识的认识现状调查

目的本文旨在了解医务人员现代结控知识掌握的现状及培训效果?方法于培训前后进行问卷调查,内容包括:病例发现?结核病诊断及化疗?结果培训前疫情报告和转诊,回答正确者占75.2%?71.7%;对临床表现?查痰和诊断依据,回答正确者占83.5%?42.5%?40.8%;抗痨药物?用药方法?化疗原则?短化方案?短化疗程?治愈标准六项,回答正确者占58%?14.4%?20.8%?9.2%?17%?24.3%?培训后再次调查发现,90%以上医务人员对现代结控基本知识已掌握?结论各级医务人员现代结控知识是很贫乏的,因此,对其进行系统培训是极为必要的,此项工作省时?省力?投入少,可收到事半功倍的效果。     

大骨节病病区水,粮实验对动物的骨和软骨中化学元素组成的影响

用质子激发 X 线荧光分析方法(PIXE)测定了大骨节病病区和非病区的水、粮以及用该水粮喂养的大白鼠的肋软骨和硬骨中22种化学元素的含量。结果发现水粮中存在差异的元素反应在用该水粮喂养的大白鼠的骨、软骨中也存在差异,含量都低的元素有 P、Mn、Cu、As、Zn。都高的有铅。其中锌低在水、粮、硬骨和软骨中都完全一致呈非常显著性差异(p<0.01)。提示病区水、粮中化学元素对骨质的影响不是单一元素缺乏或过多所致,而是多种元素的复合因素。     

Assessment of the Soft-Tissue Seal at the Interface between the Base of the Fixed Denture Pontic and the Oral Mucosa

Fixed dentures (bridges) are often selected as a treatment option for a defective prosthesis. In this study, we assess the contact condition between the base of the pontic and oral mucosa, and examine the effect of prosthetic preparation and material biocompatibility. The molars were removed and replaced with experimental implants with a free-end type bridge superstructure after one week. In Experiment 1, we assessed different types of prosthetic pre-treatment: (1) the untreated control group (Con: mucosa recovering from the tooth extraction); (2) the laser irradiation group (Las: mucosa recovering after the damage caused by a CO₂ laser); and (3) the tooth extraction group (Ext: mucosa recovering immediately after the teeth extraction). In Experiment 2, five materials (titanium, zirconia, porcelain, gold-platinum alloy, and self-curing resin) were placed at the base of the bridge pontic. Four weeks after the placement of the bridge, the mucosa adjacent to the pontic base was histologically analyzed. In Experiment 1, the Con and Las groups exhibited no formation of an epithelial sealing structure on the pontic base. In the Ext group, adherent epithelium was observed. In Experiment 2, the sealing properties at the pontic interface were superior for titanium and the zirconia compared with those made of porcelain or gold-platinum alloy. In the resin group, a clear delay in epithelial healing was observed.     

高胆红素血症对肿瘤标志物测定的影响探讨

目的探讨高胆红素血症对Ca19-9、Ca24-2和CEA检测的影响.方法对320例胆管、胆囊良恶性疾病病人,15例胆囊炎病人的胆汁和血清以及10例肝硬化、10例黄疸肝炎病人进行Ca19-9、Ca24-2和CEA检测.结果在良性胆管、胆囊疾病中,Ca19-9的假阳性最高;在胆红素增高的良性疾病中,Ca19-9假阳性率达46.7%;15例胆汁和血清以及10例肝硬化和10例黄疸肝炎病人中,Ca19-9的假阳性率分别为93%、20%、80%和80%.结论高胆红素血症对Ca19-9检测影响最明显,胆囊、胆管良恶性疾病鉴别时,以Ca24-2和CEA检测为佳.     

Echocardiography in the Emergency Department: From the Perspective of the Emergency Physician and the Cardiologist

Echocardiography performed in the emergency department must adapt to this new setting for noninvasive diagnostic testing. Emergency physicians require echocardiography to provide rapid diagnosis in life-threatening emergencies. New initiatives are being proposed by emergency physicians in the delivery of this test. Cardiologists now use echocardiography in the emergency-department to make the diagnosis of heart disease earlier and with greater accuracy.