~(99)Tc~m-MIBI评价缺血预适应心肌的实验研究

目的　研究99Tcm 甲氧基异丁基异腈 (MIBI)评价缺血预适应心肌的可行性。方法　将离体灌注大鼠心脏随机分为正常组 (N)、缺血组 (IS)和缺血预适应组 (IP)。监测99Tcm MIBI摄取相和洗脱相心肌放射性变化 ,同时测定心肌乳酸脱氢酶 (LDH)和碱性磷酸酶 (ALP)渗漏 ,离体灌注结束测定单位质量心肌99Tcm MIBI滞留率 ,采用三苯硝基四唑蓝 (TTC)染色法判断心肌梗死面积。结果　N、IS、IP组心肌99Tcm MIBI摄取率 (min-1)分别为 (388± 40 )、(186± 33)和 (32 5± 44 ) ;30min内心肌洗脱率分别为 (5 .13± 0 .88) %、(8.88± 0 .95 ) %和 (6 .6 7± 0 .87) % ;单位质量心肌99Tcm MIBI滞留率 (10 3·min-1)分别为 (344± 17)、(15 8± 2 3)和 (2 77± 5 0 ) ,IS和IP间差异有显著性 (P <0 .0 1)。IP组心肌梗死面积小于IS组 [分别为 (10 .7± 3.7) %和 (2 3 .8± 8.6 ) % ,P <0 .0 0 1],LDH渗漏量IP组低于IS组 [分别为 (6 4.6± 2 6 .0 )和 (10 1.8± 32 .0 )U/L ,P <0 .0 0 1],ALP渗漏量IP组亦低于IS组 [分别为 (14.4± 6 .0 )和 (2 4.5± 10 .0 )U/L ,P <0 .0 5 ]。结论　IP可缩小心肌梗死面积 ,减少细胞酶渗漏 ;心肌99Tcm MIBI的动力学参数可作为评价心肌缺血预适应的有效指标。     

心梗部位对超声多普勒左室舒张功能测定的影响

目的 :观察心梗患者缺血部位不同对常规超声多普勒左室舒张功能检测指标的影响。资料与方法 :以核素心肌扫描显像为定位标准 ,将 84例急性、陈旧性心肌梗塞患者按缺血部位不同分成 :(1)前壁心梗 ,(2 )间壁心梗 ,(3 )下 (后 )壁心梗 ,(4 )侧壁心梗 ,(5 )广泛前壁 ,(6)前壁伴下壁及侧壁心梗 ,(7)心尖部室壁瘤形成 7组 ;观察了描述左室舒张功能的超声多普勒二尖瓣口血流速度指标 E/A比值和核素心血池造影左室峰值充盈率 LVPFR在各分组中的变化。结果 :缺血范围较局限的左室前壁、间壁及侧壁心梗组之间的 L VPFR测值无明显差别 ,分别为 (1.82± 0 .48)、(2 .0 7± 0 .79)、(2 .18± 0 .90 ) EDV/S,但多明显高于下 (后 )壁、广泛前壁、室壁瘤及左室壁多个部位缺血组 ,其 LVPFR分别为 (1.63± 0 .3 3 )、(1.2 2± 0 .68)、(1.45± 0 .43 )、(1.15± 0 .3 8) EDV/S,而后 4组之间的 L VPFR测值差别不显著 ;单有左室前壁、间壁缺血的心梗组的 E/A比值也高于左室下 (后 )壁、广泛前壁、多部位心肌缺血的心梗组 ,其 E/A比值分别为 1.17± 0 .3 1、1.0 9±0 .2 6、0 .78± 0 .2 8、0 .80± 0 .5 1、0 .81± 0 .3 1;除下 (后 )壁心梗组外 ,其它各组的 E/A比值与室壁瘤形成组差别不显著 ,后者的 E/A比值为 1.0 2± 0 .     

维拉帕米对梭曼兔的毒代动力学及小鼠脑与膈肌分布的影响

目的 :考察维拉帕米对梭曼兔的毒代动力学及小鼠脑与膈肌分布的影响 ,探索维拉帕米对梭曼代谢解毒作用机制。方法 :大进样量气相色谱仪及手性毛细管柱氮磷检测器测定兔静脉染毒后血中及小鼠皮下染毒后脑与膈肌中游离C(± )P(_)梭曼。结果 :维拉帕米 (10mg kgim ,预给药 0 .5h) ,在中毒后 15 ,6 0 ,90 ,12 0 ,180及 2 4 0s可明显降低血液中游离C(± )P(_)梭曼浓度。维拉帕米使C(± )P(_)梭曼的CL由 (2 0 .8± 1.5 )ml (kg·s)显著增加到 (4 4 .3±7.0 )ml (kg·s) ;使AUC由 (2 .0 8± 0 .15 )mg·s L显著下降到 (0 .996± 0 .172 )mg·s L。维拉帕米预给药在小鼠皮下梭曼染毒后 30 ,90及 12 0s时 ,能使膈肌中游离C(± )P(_)梭曼的浓度由 74 .7,70 .5 ,88.7ng g降低到 4 1.1,39.0 ,4 9.3ng g。但在以上时间点对脑中游离C(± )P(_)梭曼的浓度却没有显著的影响。结论 :维拉帕米能促进血中游离C(± )P(_)梭曼的消除 ,并降低靶器官膈肌中的分布 ,从而促进了梭曼的代谢解毒。     

2型糖尿病血脂正常组与异常组血脂浓度比较

目的 :研究 2型糖尿病血脂异常的临床特点。方法 :分别对血脂异常组和正常组病人于入院次日行空腹血糖、血脂、生化等检查 ,比较两组血脂浓度。结果 :血脂正常组TC 4 4 8± 0 86mmol/L ,TG 1 4 6± 0 4 6mmol/L ,HDL C 1 2 0± 0 2 5mmol/L ,LDL C 2 4 0± 0 75mmol/L ,载脂蛋白B 0 87± 0 2 3g/L ;血脂异常组分别为 4 86± 1 2 8、2 5 5± 1 2 8、1 0 0± 0 2 8、2 98± 1 19mmol/L和 1 0 3± 0 2 8g/L。两组比较差异显著 (P <0 0 5 )或非常显著 (P <0 0 1)。结论 :2型糖尿病血脂异常很常见 ,应积极防治     

缺血性脑卒中早期脑血清酶及MR T_2 WI动态改变的实验研究

目的　通过建立兔缺血性脑卒中模型研究早期脑缺血后脑血清肌酸磷酸激酶 (CPK)、乳酸脱氢酶 (LDH)、门冬氨酸转氨酶(AST)活性与MRT2 WI动态改变及其相关性。材料与方法　 5 2只兔分 3组 :缺血组 ( 3 8只 ) ,对照组 ( 6只 ) ,病理观察组 ( 8只 )。通过建立改进的自体血凝块栓塞法兔缺血模型 ,分别测定不同时间点脑血清CPK、LDH、AST的活性改变以及MRT2 WI信号强度改变 ,计算结果并进行统计学处理。结果　缺血组脑血清CPK于缺血后 2h即开始升高 ,而LDH、AST则在缺血后 4h开始升高 ,并均于2 4h达到高峰 ,分别为 5 2 98.0± 810 .0IU/L、3 2 8.7± 5 7.4IU/L、5 9.7± 10 .6IU/L ,48、72h后逐渐下降 ,但仍较正常高 (P <0 .0 1)。MRT2 WI则在 4h时可清楚显示缺血区高信号改变 ,其SI增强百分比为 16.8± 2 .72 % ,较栓塞前 ( 10 .2 6± 3 .84% )及对照组 ( 10 .68±2 .5 7% )为高 (P <0 .0 1) ,且在 2 4h时达到高峰。在 48、72hSI信号强度百分比较 2 4h已有下降 ,但仍呈高信号改变。缺血区SI增强百分比与脑血清CPK、LDH、AST动态改变呈明显正相关 (r为 0 .90、0 .93、0 .94)。结论　研究脑血清CPK、LDH、AST酶活性的动态改变及MRT2 WI缺血灶SI信号改变有助于缺血性脑卒中的早期诊断 ,为今后判断溶栓治疗及脑保     

番鸭性别控制的研究

本试验在福建农业大学种番鸭场进行。用了 3种处理方法 :①以外源激素分别用浸泡、涂种和喷雾的方法处理番鸭受精蛋 ;②用精氨酸溶液 ( 5.0、2 .5mg/L) ,睾丸组织匀浆及芳香化酶抑制剂 ( 5.0、2 .5mg/L)作为性控液分别灌注母鸭产道和稀释公鸭精液 ;③用芳香化酶抑制剂 ( 5.0、2 .5mg/L)涂抹种蛋。结果表明 :性激素处理法可使胚胎性别分化发生倾向性改变 ,其中已烯雌酚处理组明显提高雌性比例 (P<0 .0 5) ,3种处理方法的雌性百分比分别为 ( 75.8± 3.5) %、( 79.3± 3.5) %和 ( 75.5± 1 .8) % ;其他几种激素处理效果不明显 (P >0 .0 5)。用性控液灌注母鸭产道和稀释精液 ,其中精氨酸组雄性百分比略有提高 ,分别为 ( 58. 2± 1 .5) %和 ( 59.2±1 .l) % ;而睾丸组织匀浆组却使雌雏增多 ,雌性百分比分别为 ( 56 .7± 2 .l) %和 ( 56 .3± 3.8) % ,但二者与对照组均无明显差异 (P >0 .0 5) ;芳香化酶抑制剂处理组极显著提高雄性比例 (P <0 .0 1 ) ,各处理组雄性百分比分别为 ( 75.4± 7.4) %和 ( 84.4±1 .5) % ,比对照组 ( 49.7± 3.5) %分别提高 2 5.7%和 34.7% ,也明显高于芳香化酶抑制剂涂抹胚胎蛋处理组 ( 6 1 .7± 0 .4) % ,且对种蛋受精率和孵化率无不良影响     

急性冠脉综合证患者C反应蛋白与冠脉病变的相关研究

目的 :探讨血浆C反应蛋白 (CRP)与急性冠脉综合证 (ACS)冠脉病变之间的关系。方法 :测定正常人 (n =5 2 )及不稳定心绞痛 (USA ,n =83)和急性心肌梗死 (AMI,n =4 2 )患者血浆CRP浓度 ,分析冠状动脉病变程度、病变支数及病变类型与相应CRP浓度的关系。结果 :CRP浓度在正常组、USA及AMI组依次增高 ,分别为 ( 3 11±1 82 )mg/L ,( 12 2 0± 5 86 )mg/L和 ( 18 90± 8 96 )mg/L ,P <0 0 1。在ACS组中 ,轻度狭窄、中度狭窄及重度狭窄 ,其CRP浓度也依次增高 ,分别为 ( 6 0 2± 2 18)mg/L ,( 10 0 4± 2 87)mg/L和 ( 18 2 2± 7 6 ) 1mg/L ,P <0 0 1;单支病变、双支病变以及三支病变 ,其CRP浓度依次增高 ,分别为 ( 11 75± 5 33)mg/L ,( 16 86± 5 6 0 0 )mg/L和 ( 2 2 4 1±10 2 5 )mg/L ,P <0 0 1;A型病变、B型病变和C型病变 ,其CRP浓度依次增高 ,分别为 ( 8 2 4± 3 78)mg/L ,( 14 2 1± 4 30 )mg/L和 2 2 4 0± 8 32mg/L ,P <0 0 1。结论 :CRP浓度与冠脉病变程度关联密切。     

纳米级雄黄粉体药代动力学研究

目的　制备纳米级雄黄粉体 ,比较传统雄黄与纳米级雄黄的药代动力学行为。方法　两组家兔分别单剂量口服5 0mg ,比较纳米级雄黄粉体和传统雄黄在兔体内的药代动力学参数。结果　传统雄黄组家兔的药动学参数为 :A =0 .0 96 2±0 .0 0 93mg·L-1,Ke =0 .0 70 2± 0 .0 0 74l/h ,Ka =0 .4 72 3± 0 .0 712l/h ,Lagtime=0 .0 30 0± 0 .0 0 0 0H ,T1/ 2　 (Ka) =0 .15 1± 0 .2 38H ,T1/ 2　 (Ke) =10 .0 5 6± 0 .895H ,T(peak)　　 =4 .80 6± 0 .4 0 1H ,C(max)　 =0 .0 6 0± 0 .0 0 0mg·L-1,AUC =1.16 8± 0 .0 84 (mg·L-1)h ,CL/F(s) =4 3.0 78± 3.4 95L/h ,V/F(c) =6 2 0 .6 96± 2 9.6 4 9L ;纳米雄黄组家兔的药动学参数为 :A =0 .2 4 4 3± 0 .0 0 5 2mg·L-1,Ke =0 .0 2 2 7±0 .0 0 5 2l/h ,Ka =0 .92 2 5± 0 .0 5 93l/h ,Lagtime =0 .0 30 0± 0 .0 0 0 0H ,T1/ 2　 (Ka) =0 .75 4± 0 .0 4 9H ,T1/ 2　 (Ke) =2 8.74 6± 1.0 0 7H ,T(peak)　 =4 .0 6 6± 0 .174H ,C(max)　 =0 .2 16± 0 .0 0 5mg·L-1,AUC =9.82 2± 0 .394 (mg·L-1)h ,CL/F(s) =5 .10 8± 0 .2 0 8L/h ,V/F(c) =2 11.5 6 6± 3.2 97L。结论　纳米级雄黄粉体与传统雄黄比较 ,其药代动力学发生显著变化 ,吸收相增大而消     

大黄煎剂对多发伤并严重感染患者血中内毒素、白细胞介素-6和一氧化氮的影响

目的　观察多发伤并严重感染患者血中内毒素 (LPS)、一氧化氮 (NO)、白细胞介素 -6 (IL - 6 )变化及探讨大黄煎剂的治疗作用。　方法　 75例多发伤并严重感染患者随机分为治疗组和对照组 :对照组 (38例 )应用常规治疗 ;治疗组 (37例 )在常规治疗的基础上 ,自第 4天起应用大黄煎剂 (10 0ml,口服 ,2次 d)治疗。观察两种方法治疗后LPS、NO、IL - 6的变化。　结果　 (1)两组患者血中 3项指标均明显升高 ,对照组LPS为 (15 .2 6± 4 .0 1)～ (40 .2 4± 4 .4 7)ng L、NO为 (5 5 5 .91± 12 4 .70 )～ (72 1.5 9± 2 5 5 .33)mg L、IL - 6为 (0 .10± 0 .0 2 )～ (5 4 3.2 3± 319.75 )ng L ;治疗组LPS为(15 .74± 3.81)～ (41.35± 4 .16 )ng L、NO为 (5 4 2 .70± 139.2 1)～ (74 9.37± 2 91.80 )mg L、IL - 6为(0 .11± 0 .0 2 )～ (5 79.18± 4 0 5 .4 3)ng L ,两组间比较差异无显著性意义 (P >0 .0 5 )。 (2 )治疗组应用大黄煎剂后 ,3项指标均逐渐下降 ,LPS为 (2 1.0 7± 3.6 5 )～ (17.0 4± 5 .91)ng L、NO为 (6 0 4 .35±2 13.72 )～ (5 91.15± 136 .31)mg L、IL - 6为 (2 15 .5 4± 110 .6 5 )～ (10 0 .6 8± 95 .4 4 )ng L ,而对照组 3项指标有继续增高趋势 ,两组比较差异有非常显著性意义或显著     

雌二醇屈螺酮片对绝经期女性骨密度和骨代谢影响64例临床观察

ObjectiveTo investigate the effects of estradiol and drospirenone tablets (E2/DRSP) on bone mineral density and bone turnover markers. MethodsThis was a prospective, self controlled cohort study. Postmenopausal women who were treated with E2/DRSP for at least 6 months from March 2012 to June 2013 and at the age of 45—60 (52.5±3.4) years were enrolled. Comparisons were made by bone mineral density and bone turnover markers (bone alkaline phosphatase and tartrate resistant acid phosphatase) between pre and post treatment. ResultsA total of 64 women were enrolled. Symptoms of menopausal syndrome alleviated significantly. Bone mineral densities of the lumber spine [(1.016 7±0.104 6) g/cm2 vs (1.025 0±0.019 1) g/cm2] and the hip [(0.455 5±0.089 9) g/cm2 vs (0.484 7±0.138 0) g/cm2] were significantly improved after 6 months of treatment (P<005). Levels of bone alkaline phosphatase [(65.82±14.75) U/L at baseline vs (61.14±12.38) U/L, (58.77±11.35) U/L at 3rd and 6th month, respectively, P<0.05] and tartrate resistant acid phosphatase [(6.15±3.02) U/L at baseline vs (5.99±2.98) U/L, (4.90±2.90) U/L at 3rd and 6th month, respectively, P<0.05)] were significantly decreased after treatment of E2/DRSP. ConclusionE2/DRSP can alleviate symptoms of menopausal syndrome effectively, and also has benefits for bone mineral density and bone metabolism.     

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.