原发性高血压患者血清可溶性E选择素水平与肥胖及性别的关系

目的　探讨原发性高血压患者血清可溶性E 选择素 (sE selectin)浓度与肥胖、性别、血糖、胰岛素等的关系。方法 :酶联免疫吸附法测定 179例原发性高血压患者 (正常体重组 4 3例 ,超重组 10 4例 ,肥胖组 32例 ;男 6 7例 ,女 112例 )的空腹血清sE selectin浓度 ,口服葡萄糖耐量试验和胰岛素释放试验 ,测定血浆葡萄糖浓度和血清胰岛素浓度 ,计算葡萄糖曲线下面积 (AUCG)和胰岛素曲线下面积(AUCIN) ,测定收缩压 (SBP)、舒张压 (DBP)和体重指数 (BMI)。分析血清sE selectin浓度与其它各项参数的相关性。结果 :血清sE selectin浓度肥胖组 (5 6 .4± 2 1.2 ) μg L高于超重组组 (4 3.5± 16 .6 ) μg L(P <0 .0 0 1)和正常组 (37.8± 12 .9) μg L(P <0 .0 0 1) ,男性组 (5 0 .0± 17.8) (g L高于女性组 (4 1.2± 16 .9) μg L(P <0 .0 1)。血清sE selectin浓度男性组与BMI相关 ,女性组与BMI、空腹胰岛素、AUCIN相关。结论 :合并肥胖的后发性高血压患者和男性有较高的血清sE selectin浓度 ,肥胖程度与血清sE selectin浓度直接相关 ,提示肥胖患者和男性有较高的血管内皮细胞活化程度     

血清抵抗素浓度与血压的相关性研究

为探讨血清抵抗素浓度与血压的关系 ,以酶免疫测定法检测 17例正常血压者和 44例高血压病患者的空腹血清抵抗素水平。结果显示 ,2级高血压组血清抵抗素浓度 ( 3 0 5±11 0 μg/L)显著高于 1级高血压组 ( 2 4 3± 10 5 μg/L)和正常组 ( 2 1 5± 6 1μg/L) ,但经协方差分析校正年龄和体内脂肪含量百分比 (BF % )后 ,3组间差异不再有显著性意义 ;血清抵抗素浓度与收缩压 (SBP)、年龄、BF %、空腹血糖 (FPG)呈显著正相关 ;逐步回归分析显示 ,年龄、BF %、FPG为抵抗素的独立预测因素 ,而SBP不是抵抗素的独立预测因素。研究表明 ,血清抵抗素浓度与血压无直接相关关系 ,而与衰老、肥胖及糖代谢密切相关     

黄芪抗肝纤维化的作用与转化生长因子β_1及干扰素γ的关系

目的　探讨黄芪抗肝纤维化的作用与转化生长因子 β1(TGFβ1)及干扰素γ(IFN γ)的关系。方法　分别测定慢性肝炎黄芪治疗前后血清TGFβ1,透明质酸 (HA)及外周血单个核细胞 (PBMC)产生IFN γ的变化。结果　慢性乙型肝炎血清TGFβ1,HA ,PBMC产生IFN γ的含量分别为 (4 2 8.85± 117.5 3)mg/L ,(35 6 .77± 78.43) μg/L ,(12 .3± 5 .7) μg/L ,黄芪治疗后分别为 (2 2 2 .6 9± 85 .73)mg/L(P <0 .0 5 ) ,(179.2 3± 5 8.43) μg/L(P <0 .0 1) ,(2 2 .6± 8.7) μg/L(P <0 .0 5 ) ,治疗前后TGFβ1,HA均高于对照组 ,治疗前PBMC产生IFN γ含量低于对照组 (P <0 .0 5 )。结论　黄芪具有抗肝纤维化作用 ,其机制可能与调节患者TGFβ1,IFN γ含量有关。     

快速脱敏疗法对真菌致敏性哮喘的疗效及IgE,ECP的影响

目的　对真菌致敏性哮喘进行快速脱敏治疗 ,观察其疗效 ,对比治疗前后血清总IgE ,ECP的变化。 方法　对洛阳农村地区 14 0例真菌哮喘患者随机分为两组 ,A组 70例 ,B组 70例。A组采用常规治疗。B组病人在常规治疗基础上采用北京协和医院提供的多价霉菌浸出液做快速脱敏治疗 ,注射浓度从 1:10 5(W /V)开始 ,以 0 .1,0 .2 ,0 .4,0 .8ml剂量递增 ,上午及下午各 1次皮下注射 ,尔后以 1:10 4 ,1:10 3,1:10 2浓度递增 ,8d即可达维持量 ,从第 9日开始进行维持治疗 ,用 1:10 2 浓度每周 1次 0 .5ml皮下注射 ,1年后全部结束。治疗前 1周及 1年疗程结束后 1周抽 2ml静脉血测定治疗前后总IgE ,ECP ,并进行疗效判断。结果　血清总IgE(KU/L)A组治疗前为 (165 .5 0± 41.0 2 )KU/L ,治疗后为 (160 .3 0± 2 5 .3 2 )KU/L ,前后对比无明显差异 (P >0 .0 5 ) ;B组治疗前为 (170 .65± 40 .2 0 )KU/L ,治疗后为 (75 .3 0± 2 0 .48)KU/L ,前后对比差异显著 (P <0 .0 1)。血清ECPA组治疗前为 (19.2 4± 3 .18) μg/L ,治疗后为 (17.2 5± 3 .98) μg/L ,前后对比无明显差异 (P >0 .0 1) ;B组治疗前为 (18.2 4± 4.0 8) μg/L ,治疗后为 (10 .3 3± 2 .67) μg/L ,前后对比差异显著 (P <0 .0 1)。疗效判断A组临床控制 2 2例     

静脉用药后人眼房水中头孢曲松浓度的测定

目的　测定静脉用头孢曲松 1g后不同时间点人眼房水中的药物浓度。方法　将 75例白内障患者依给药后取房水时间点不同随机分为 30min、6 0min、12 0min、180min组及空白对照组 ,每组 15例。每例按所确定的时间点于术中眼内操作前取房水 2 0 0～ 30 0 μl,用高压液相色谱法测定房水中头孢曲松的浓度。结果　静脉注射头孢曲松后 30min、6 0min、12 0min、180min组的房水药物浓度分别为0 2 35± 0 12 1mg/L、0 4 74± 0 2 2 4mg/L、0 4 5 3± 0 16 2mg/L、0 5 34± 0 2 0 2mg/L。30min组的房水药物浓度低于其他组 (P <0 0 1) ,6 0min、12 0min、180min组的房水药物浓度无明显差别 (P >0 0 5 ) ,后 3组的房水药物浓度高于大部分常见致病菌的最低抑菌度 (MIC50 )。结论　头孢曲松可用于由敏感菌引起的眼内炎的治疗 ,也可作为内眼手术前的预防用药。     

慢性心衰病人肿瘤坏死因子受体Ⅱ的变化

目的 :观察慢性心衰病人血清可溶性肿瘤坏死因子受体Ⅱ (sTNFRⅡ )的改变及其临床意义。方法 :sTNFRⅡ采用酶联免疫双抗体夹心法测定。结果 :对照组sTNFRⅡ为 (2 5 9± 0 5 8) μg/L ,观察组sTNFRⅡ为 (8 6 2± 5 32 ) μg/L ,两组间差异非常显著 (P <0 0 1)。观察组中轻度组sTNFRⅡ为 (5 31±1 5 4 ) μg/L ,重度组sTNFRⅡ为 (10 87± 5 78)ug/L ,两组间差异非常显著 (P <0 0 1)。 结论 :心力衰竭病人血清sTNFRⅡ值升高 ,并与心力衰竭的严重程度相关。sTNFRⅡ可以作为判断心力衰竭严重程度的指标之一。     

冠心病合并糖尿病患者血同型半胱氨酸、铜水平的相关性研究

目的　探讨冠心病合并糖尿病患者血同型半胱氨酸、铜的水平及两者的相关性。方法　以 31例冠心病合并 2型糖尿病患者为研究对象 (糖尿病组 ) ,以同期不合并糖尿病的冠心病患者 36例为对照组 (非糖尿病组 ) ,另选择健康对照组 30例 ,测定外周血同型半胱氨酸、铜浓度、体重指数和血脂。结果　糖尿病组血Hcy、Cu ,分别为 (18.8± 3.5 ) μmol L、(2 1.1± 3.8) μmol L ,高于健康对照组 ,分别为(10 .7± 2 .3)、(16 .8± 2 .7) μmol L(P <0 .0 1)和非糖尿病组 ,分别为 (15 .6± 1.9)、(14 .8± 2 .2 ) μmol L(P <0 .0 5 ) ;非糖尿病组Hcy高于健康对照组 (P <0 .0 1) ,而Cu水平与对照组差异无显著性 (P >0 .0 5 )。冠心病合并糖尿病组患者血Hcy与Cu呈正相关 (P <0 .0 1)。结论　高Hcy致糖尿病患者发生冠状动脉硬化可能与Cu的协同作用有关     

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     

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。     

血清Ⅳ型胶原和层粘连蛋白浓度测定在慢性肝病诊断中的临床价值

目的 :评价血清Ⅳ型胶原 (Ⅳ·C)和层粘连蛋白 (LN)浓度测定对肝纤维化诊断的价值。方法 :应用放射免疫分析法测定 83例慢性肝炎患者和 2 3例肝炎后肝硬化患者的血清LN、Ⅳ·C含量。结果 :慢性肝炎患者血清LN含量为(14 5 .1± 3 7.9) μg/l,Ⅳ·C含量为 (67.6± 2 0 ) μg/l,显著高于正常人 [LN (115 .7± 17.3 ) μg/l、Ⅳ·C (49.7± 15 ) μg/l] ;肝硬化患者血清LN (2 0 7.0± 63 .3 ) μg/l、Ⅳ·C /l(92 .9± 2 8.8) μg/l ,与慢性肝炎患者相比 ,有极显著性差异。LN和Ⅳ·C对肝硬化的敏感性分别为 82 .6%、86.9%。本文还分析了肝硬化患者LN、Ⅳ·C浓度与谷丙转氨酶 (ALT)、A/G的相关系数分别为 0 .14、0 .13、0 .14、-0 .17,均无显著意义。结论 :LN和Ⅳ·C对慢性肝病纤维化的发生、发展有重要的临床价值     

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.     

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).     

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.     

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.     

Bronchial stump fistula :treatment with covered retrievable hinged metallic stents-preliminary clinical experience

Objective To evaluate the preliminaily clinical efficacy and retrievability of a retrievable hinged covered metallic stent in the treatment of the bronchial stump fistula （BSF）. Methods Between April 2003 and March 2005, 8 patients with bronchial stump fistula after pneumonectomy or lobectomy were treated with two types （A and B） of retrievable hinged covered metallic stents. Type A stent was placed in 6 patients and type B in 2 under fluoroscopic guidance. The stent was removed with a retrieval set when BSF was healed or complications occurred. Results Stent placement in the bronchial tree was technically successful in all patients, without procedure-related complications. Immediate closure of the BSF was achieved in all patients after the procedure. Stents were removed from all patients but one. Removal of the stents was difficult in two patients due to tissue hyperplasia. Patients were followed up for 6 - 21 months. Placement of the stents remained stable in all patients except one due to severe cough. Permanent closure of BSF was achieved in 7 （87.5%） of 8 patients. Conclusion Use of a retrievable hinged covered expandable metallic stent is a simple, safe, and effective procedure for closure of the BSF. Retrieval of the stent seems to be feasible. （J Intervent Radiol, 2007, 16： 253-257）     

Prevalence and severity of hip and groin pain in sub‐elite male football: a cross‐sectional cohort study of 695 players

The purpose of this study was twofold: (a) to investigate the prevalence of hip and groin pain in sub‐elite male adult football in Denmark and (b) to explore the association between prevalence and duration of hip and groin pain in the previous season with the Copenhagen Hip and Groin Outcome Score (HAGOS) in the beginning of the new season. In total 695 respondents from 40 teams (Division 1–4) were included. Players completed in the beginning of the new season (July–Sept 2011) a self‐reported paper questionnaire on hip and/or groin pain during the previous season and HAGOS. In total 49% (95% CI: 45–52%) reported hip and/or groin pain during the previous season. Of these, 31% (95% CI: 26–36%) reported pain for >6 weeks. Players with the longest duration of pain during the previous season had the lowest HAGOS scores, when assessed at the beginning of the new season, P < 0.001. This study documents that half of sub‐elite male adult football players report pain in the hip and/or groin during a football season. The football players with the longest duration of pain in previous season displayed the lowest HAGOS scores in the beginning of the new season.