手臂振动对中枢神经系统功能的影响及振动负荷试验意义的研究

目的 了解手臂振动及振动负荷试验对中枢神经系统功能的影响。方法 对振动性白指患者（白指组）、振动作业工人（接振组）进行振动负荷前后脑干听觉诱发电位的变化,并同对照组进行比较。结果振动负荷前后白指组脑干听觉诱发电位的Ⅰ、Ⅲ、Ⅴ波潜伏期及各峰间期和接振组Ｉ波潜伏期均较对照组明显延长（Ｐ〈０．０５,Ｐ〈０．０１）;白指组脑干听觉诱发电位的Ⅰ、Ⅲ、Ⅴ波、各峰间期及接振组Ⅰ、Ⅴ波潜伏期在振动负荷后较振动负荷     

阳性与阴性精神分裂症患者的诱发电位比较

目的:探讨阳性与阴性精神分裂症在感觉诱发电位检查中异同。方法:收集37例阳性、26例阴性精神分裂症及64名正常对照,应用脑诱发电位仪(美国)完成视觉诱发电位(VEP)、听觉诱发电位(AEP)和体感诱发电位(SEP)检查。结果:阳性、阴性及正常对照组在VEP、AEP潜伏期,VEP、AEP、SEP波幅上差异有显著性(P<0.05或P<0.01)。与正常对照组相比,阳性组VEP、AEP潜伏期前移,AEP潜伏期延迟,VEP、AEP、SEP波幅降低;与正常对照组相比,阴性组AEP潜伏期延迟,VEP、AEP、SEP波幅降低更甚;阳性与阴性组比较,VEP、AEP潜伏期及VEP、AEP波幅差异有显著性。结论:阳性与阴性精神分裂症诱发电位潜伏期和波幅变化有其特点,值得进一步随访观察。     

凿岩振动作业对工人神经传导功能的影响

目的　探讨金矿凿岩作业对工人外周神经传导功能的影响。方法　应用丹麦产DANTICNeuromatic 2 0 0 0C型或DANTICKeypoint神经肌电图仪 ,进行左侧手臂体感诱发电位及正中神经感觉、运动传导速度的测定。结果　白指组与接振组相比 ,感觉神经体感诱发电位N2 0 、P2 5波均有延长的趋势 ,且较对照组有显著性差异 (P <0 .0 1) ,P15波未见显著性差异 ;白指组与接振组的感觉传导速度较对照组明显减慢 (P <0 .0 1) ,潜伏时未见显著性差异 ;运动神经传导速度、远端潜伏时较对照组出现明显改变化 (P <0 .0 1)。结论　凿岩作业对工人神经的损害主要表现在外周末梢神经系统方面。     

脑干及体感诱发电位对慢性酒精中毒患者脑功能评定的研究

目的评价应用体表感觉诱发电位（SEP）、脑干诱发电位（BAEP）作为诊断慢性酒精中毒的辅助定量指标。方法收集36名男性慢性酒精中毒患者,以及30名男性正常人,使用日本仪器利用脉冲电流刺激下肢以及短声（Click）刺激为诱发事件,完成SEP和BAEP检测。结果36例患者体表感觉诱发电位各波潜伏期均延长,且与对照组有显著性差异（P〈0.01）;BAEP的Ⅰ波、Ⅲ波、V波潜伏期及Ⅰ～Ⅲ波、Ⅲ～V波的峰间潜伏期均延长,其间差异具有显著意义（P〈0.01）。结论BAEP和SEP指标的检查对慢性酒精中毒患者的诊断具有重要意义,可作为其有效的评价方法。     

脑干听觉诱发电位和闪光视觉诱发电位检测在新生儿缺氧缺血性脑病中的应用价值

目的探讨脑干听觉诱发电位(BAEP)和闪光视觉诱发电位(FVEP)检测在新生儿缺氧缺血性脑病(HIE)中的应用价值。方法选择2016年5月至2017年6月新乡市中心医院收治的确诊为缺氧缺血性脑病的新生儿40例为HIE组,另选择同期正常足月新生儿20例作为对照组,分别于出生后20 d对2组新生儿进行BAEP和FVEP检测,并测定Ⅴ波阈值。结果 HIE组新生儿BAEP中Ⅰ、Ⅲ、Ⅴ波的潜伏期及Ⅰ~Ⅲ、Ⅲ~Ⅴ、Ⅰ~Ⅴ峰间期显著长于对照组(P<0.05),HIE组新生儿BAEP中Ⅰ、Ⅲ、Ⅴ波的波幅显著低于对照组(P<0.05),HIE组新生儿BAEP中Ⅴ波阈值显著高于对照组(P<0.05),HIE组新生儿FVEP主波潜伏期显著长于对照组(P<0.05)。结论 BAEP和FVEP联合检测可以早期准确评估HIE新生儿脑损伤及听力损伤程度,对新生儿HIE的早期诊断、病情评估及指导治疗具有重要意义。     

多系统萎缩患者的诱发电位分析

目的:分析多系统萎缩(multiple system atrophy,MSA)患者脑干听觉诱发电位(brainstem auditory evoked potential,BAEP)、下肢体感诱发电位(somatosensory evoked potential ,SSEP)、视觉诱发电位(visual evoked potential ,VEP)的变化及诊断价值.方法:对28例MSA患者行BAEP检测,20例MSA患者行SSEP检测,10例MSA患者行VEP检测,并将检测结果与电生理检查正常值对照.结果:BAEP异常16例(57%),其中Ⅴ波缺失2例,Ⅴ波潜伏期(potential latency,PL)延长6例,Ⅲ波PL延长3例,Ⅰ波PL延长2例,Ⅰ-Ⅲ、Ⅲ-Ⅴ、Ⅰ-Ⅴ峰间潜伏期(interpeak potential latency,IPL)延长8例,Ⅲ-Ⅴ/Ⅰ-Ⅲ IPL比值>1者11例,Ⅴ波波幅低,波幅Ⅴ/Ⅰ<0.5者8例;SSEP异常7例(35%),其中未引出肯定波形1例,P40 波PL延长4例,P40波PL左右侧间差>2 ms 4例;VEP异常2例(20%),为P100波PL延长.结论:诱发电位的检测,尤其是BAEP对MSA的早期辅助诊断有较大帮助.     

肝硬化患者诱发电位检查的临床意义

检查了25例肝硬化患者脑干听觉、视觉及体感诱发电位(BAEP、VEP、SEP).结果显示B、C级肝硬化及肝昏迷患者BAEP的Ⅲ,Ⅴ波潜伏期及Ⅰ—Ⅲ、Ⅰ—Ⅴ波间潜伏期,VEP的P_(100)波潜伏期,SEP的P_(40)、N_(50)、P_(60)及N_(75)波潜伏期延长,且随病情加重而渐延长,P_(10c)波潜伏期表现最明显。A级肝硬化患者已存在VEP及SEP的异常。表明肝硬化患者在发生临床肝昏迷之前已存在脑电活动异常,VEP可反映肝硬化的严重程度.SEP则是一较敏感的指标。     

轻度认知损害和阿尔茨海默病的听觉诱发电位与P300检查的性别差异

目的:比较性别对阿尔茨海默病(AD)、轻度认知损害(MCI)的脑干听觉诱发电位(BAEP)、事件相关电位(ERP)P300的影响.方法:对38例MCI、26例AD患者、20例健康老年人(HC)进行BAEP和P300检查,根据性别的不同,进行组间和组内的比较.结果:组内BAEP比较,MCI组在左侧Ⅲ、Ⅴ波潜伏期差异有显著性(P<0.01);HC组在左侧Ⅳ、Ⅴ波潜伏期差异有显著性(P<0.01);AD组组内比较,差异无显著性;P300比较,MCI潜伏期女性比男性延长,差异有显著性(P<0.01);AD和HC组差异无显著性.组间BAEP比较,AD与MCI仅男性左侧Ⅰ、Ⅱ差异有显著性.AD与HC比较,男性在左侧Ⅰ、Ⅲ～Ⅴ和右侧Ⅳ波,女性在左右两侧Ⅰ～Ⅴ差异有显著性.MCI与HC比较,男性在左侧Ⅲ、Ⅴ和右侧Ⅰ、Ⅳ、Ⅴ波,女性在右侧Ⅰ、Ⅱ、Ⅴ波差异有显著性.P300检查发现,男性AD的潜伏期比MCI显著延长.AD和HC比较,无论男女在潜伏期的Fz、Cz、Pz点差异有显著性.MCI与HC比较,女性在潜伏期的Fz、Cz、Pz点,差异有显著性.结论:性别对MCI的BAEP和P300检查均有影响,而对AD检查未显示明显的影响.相同性别的AD、MCI和HC的BAEP和P300的表现也有不同,可能对三者的鉴别有意义.     

正常成年人脑诱发电位研究

本文报告了正常成年人体感、听觉脑干及视觉诱发电位的检查结果,3项诱发电位均各测定50人,体感诱发电位(SEP)出现P_1、N_1、P_2、N_2、P_3、N_3波,听觉脑干诱发电位(ABR)出现Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ波,视觉诱发电位(VEP)出现N_1、P_2、N_2波,各波的形态基本一致,波峰潜伏期均数值呈正态分布。发现男性SEP双侧P_1、N_1波峰潜伏期较女性延长(P<0.01),男女ABR右耳Ⅱ波峰潜伏期均较左耳延长(P<0.001)。     

后循环缺血患者高压氧治疗对脑干诱发电位的影响

目的探讨高压氧治疗在后循环缺血患者治疗中对脑干诱发电位的影响。方法将40例后循环缺血住院患者随机分为两组:高压氧组和对照组,各20例。两组患者均采用统一的常规治疗,高压氧组在此基础上加用高压氧治疗。观察两组患者脑干听觉诱发电位(BAEP)图形的各波潜伏期(PL)和波峰间潜伏期(IPL)。结果治疗前高压氧组与对照组BAEP异常率间差异无统计学意义(P>0.05),治疗后差异有统计学意义(P<0.05)。高压氧组与对照组治疗前各波PL及IPL间差异无统计学意义(P>0.05),治疗后两组PL、IPL间差异有统计学意义(P<0.01)。结论高压氧治疗能改善后循环缺血患者的脑干诱发电位。     

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.