脑梗塞患者脑脊液中亮氨酸—脑啡肽含量变化的观察

测定20例动脉粥样硬化性脑梗塞患者脑脊液中亮氨酸—脑啡肽(LEK)的含量,高于对照组,差别有极显著性意义(P<0.001)。在患者发病后的20d中,以第2～7d为最高,第8～19d次之。     

脑梗死患者合并低钠血症分析

目的:208例脑梗死患者中,对合并有低钠血症患者的临床特点及其预后的分析。方法:对208例脑梗死患者的血清钠进行测定,将发病后0～3 d、4～7 d、8～14 d的低钠血症发生率进行对比,并观察与合并低钠血症及对预后的影响。结果:脑梗死患者并发低钠血症占31.2%。其中0～3 d、4～7 d、8～14 d发生率分别为10.1%、17.3%及7.5%,在4～7 d脑梗死患者中,合并有低钠血症发生率明显高于0～3 d和8～14 d(P<0.05),低钠血症能够增加患者病死率。结论:急性期脑梗死患者出现低钠血症与梗死预后有关。     

脑梗塞患者血清中β淀粉样蛋白的含量及其临床意义

目的:探讨脑梗塞(CI)患者血清β淀粉样蛋白(Aβ)水平及其在脑梗塞发生、发展中的关系。方法:采用放射免疫分析法测定30例急性脑梗塞患者(CI组)3～5d、10～14d以及30例正常人(对照组)血清Aβ水平,并测定CI组脑梗塞的体积及患者肢体残损程度。结果:CI组患者发病3～5d血清Aβ水平显著高于发病后10～14d眼(1.2460±0.2517)ng/mlvs(1.1103±0.1825)ng/ml,P<0.05演;10～14d血清Aβ水平明显高于正常对照组眼(1.1103±0.1825)ng/mlvs(0.9885±0.2253)ng/ml,P<0.05演。血清Aβ水平与患者脑梗塞灶的体积及神经功能缺损程度呈正相关(r=0.406,P<0.01)。结论:Aβ参与CI的发生与发展。干扰Aβ的产生,下调其表达,可减轻缺血性脑梗塞及所致的躯体神经功能缺损程度。     

血浆纤维蛋白原与血小板在急性脑血管病中的动态变化（附600例分析）

目的观察急性脑血管病患者血浆纤维蛋白原（fibrinogen,Fbg）和全血血小板（platelet,PLT）计数的动态变化。方法随机挑选2006年8月至2008年3月在我院神经内科收治的500例急性脑梗死患者和100例脑出血患者,分别于发病后第1、3、7、14、21d同步测定血浆Fbg含量及全血PLT计数,并与50例健康对照组进行比较。结果急性脑梗死组第1、3、7、14、21dFbg均明显高于对照组（P〈0．01）;脑出血组第1、3、7dFbg均明显高于对照组（P〈0．01）,第14、21d接近正常水平;急性脑血管病组PLT计数与对照组无明显变化（P〉0．05）。结论血浆Fbg含量升高是急性脑血管病的重要危险因素,观察Fbg的变化对脑血管病的临床诊断和治疗具有重要的指导意义;急性脑血管病并不引起外周血PLT数量变化     

急性一氧化碳中毒患者血浆溶血磷脂酸含量变化

目的:检测急性一氧化碳(CO)中毒后血浆溶血磷脂酸(LPA)含量的动态变化,了解CO中毒后血小板活化状态的改变.方法:急性CO中毒患者50例(观察组),根据临床症状及碳氧血红蛋白(HbCO)的浓度将患者分为轻、中、重度中毒(12例出现继发脑病),所有患者于发病后入院当时、入院后3 d、7 d、10 d、14 d、21 d检测血浆LPA含量变化.另选50例健康体检者为对照组.结果:急性CO中毒患者血浆LPA含量发病3～14 d高于对照组(P＜0.05);重度中毒者在3 d、10 d、14 d较轻、中毒者LPA含量高(P＜0.05);中度中毒者发病7～10 d时血浆LPA水平高于轻度中毒者(P＜0.05),轻度中毒者仅在发病3 d时升高,很快下降;继发脑病患者10～14 d时血浆LPA水平较无继发脑病者明显升高(P＜0.05),且持续时间长.结论:CO中毒后血小板活化明显,中、重度中毒者血小板活化更明显,血小板活化可能是继发脑病发生的原因之一,提示可据LPA水平采取不同的抗血小板活化治疗.     

急性脑梗死患者血清血管内皮生长因子和肿瘤坏死因子-a水平的动态变化研究

目的：探讨血管内皮生长因子（VEGF）和肿瘤坏死因子-a（TNF-a）对急性脑梗死患者病情的判断和对神经功能恢复的预测价值。方法：采用ELISA方法测定脑梗死组和对照组的VEGF和TNF-a含量。结果：急性脑梗死患者血清VEGF和TNF-a含量在发病3、7、14d明显高于对照组。血清VEGF含量和梗死灶大小呈正相关，而TNF-a的峰值和梗死灶大小及神经功能缺损评分无显著相关。结论：组织的损伤、缺氧和VEGF的表达增加明显相关。TNF-a仅在发病后7d达峰值，并与梗死面积及神经功能评分无明显相关，与外周血白细胞无关。     

食管癌患者手术前后外周血角蛋白19片段浓度变化分析

目的分析食管癌患者手术前后外周血角蛋白19片段（Cyfra21-1）浓度变化。方法连续选择接受手术治疗的食管癌患者49例（食管癌组）、同期住院非肿瘤患者（对照组）35例,两组对象分别多次进行外周血Cyfra21-1浓度测定,食管癌组3次采样时间分别是术前1d、术后1d和7d,对照组在入选后第1d、3d和10d。结果食管癌组各次外周血Cyfra21-1浓度值均明显高于对照组,前者术后1d和7d血清Cyfra21-1明显低于手术前检测值（P均〈0.05～0.01）。结论食管癌患者外周血Cyfra21-1浓度明显增加,手术切除病灶后可显著降低其血清Cyfra21-1水平。     

急性脑梗死外周血中NOX2、SOD水平变化的临床意义

目的探讨外周血NOX2、SOD水平与急性脑梗死的关系。方法收集98例急性脑梗死患者,采用ELISA法以及WST-1还原法分别测定急性脑梗死患者患病后24h、3d、7d、14d以及对照组SOD、NOX2在外周血的水平,并与91例健康者进行比较。结果脑梗死组外周血SOD值表达于发病后24h内降低显著多于对照组(P<0.01),至3~7d达到高峰(P<0.01),然后在发病后14d逐渐升高,水平仍低于对照组,但差异无统计学意义(P>0.05);脑梗死组NOX2在发病后24h即明显升高(P<0.01),至3~7d达到最高值(P<0.01),之后又缓慢下降,至发病后14d接近正常。进一步将脑梗死分为轻、中、重三组,发现发病7d时重度、中度脑梗死组NOX2、SOD的水平与轻度脑梗死组、对照组比较,差异均有统计学意义(P<0.05)。结论急性脑梗死患者外周血NOX2与SOD水平存在着动态变化,与脑梗死的严重程度有关,其浓度水平对急性脑梗死的病情变化及治疗具有重要的价值。     

脑梗塞患者外周血白细胞数的变化

脑梗塞是一种内科常见病、多发病,具有较高的致死率及致残率。近年来的研究发现,脑卒中急性期外周血白细胞（WBC）数明显增高,对脑卒中急性期的发病及预后具有重要意义。本文对3年来我科收治的损例急性脑梗塞患者的临床资料进行了分析,旨在探讨急性脑梗塞患者外周血WBC总数变化的规律,现将结果报告如下。l资料与方法l、l临床资料4患者6例,男28例,女18例,平均468岁（33～周岁）。所有患者均在发病后3天内入院。同时设立正常对照组周例,男16例,女14例,平均年龄M6岁（35～64岁）。均为同期在我科查体的健康人。12诊断标准根据198…     

中药敷贴对哮喘豚鼠外周血白三烯B4、D4的影响

目的:观察中药敷贴对哮喘豚鼠外周血白三烯B4(LTB4)、白三烯D4(LTD4)含量的影响,探讨其治疗哮喘的作用机制。方法:以卵蛋白致敏复制哮喘豚鼠模型,用酶联免疫吸附法(ELISA)测定各组豚鼠血清中LTB4、LTD4的含量。结果:哮喘豚鼠血清LTB4、LTD4含量较正常对照组显著升高。中药敷贴后,能显著降低哮喘豚鼠血清中LTB4、LTD4的含量,与氨茶碱、生理盐水、地塞米松各组比较均具有显著性差异(P<0.05)。结论:中药敷贴对哮喘有治疗作用,明显降低哮喘豚鼠血清中LTB4、LTD4的含量可能为其作用机制之一。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.