Nd∶YAG激光组织间照射血管瘤后即刻 瘤腔内血液学变化

目的　研究Nd∶YAG激光组织间照射血管瘤后即刻瘤腔内血液学的变化。方法　收集适合Nd∶YAG激光组织间照射治疗且照射前后可自瘤腔内各抽取10ml血液的血管瘤病人6例,以Nd∶YAG激光行血管瘤组织间照射,照射功率密度为531×103Wcm2,能量密度为797×104Jcm2。激光照射前及照射后即刻取血进行血液细胞学、生化学、酶学、免疫学、流变学等共24项指标检测。结果　激光照射后即刻瘤腔内血液红细胞、白细胞、血小板数及血红蛋白含量下降(均P<005),丙氨酸转氨酶、天冬氨酸转氨酶、乳酸脱氢酶、全血粘度(切变率190s、46s、575s)、血浆粘度、红细胞比积、红细胞刚性指数、红细胞聚集指数、血液还原粘度、低切变率下血液相对粘度升高(均P<005),血液生化学、免疫学各指标无明显变化。结论　激光组织间照射后血液粘滞度升高,因此要注意防止血栓的形成。     

急性心肌梗塞患者尿激酶治疗前后血浆组织型纤溶酶原激活物及抑制物活性变化的动态观察

测定了急性心肌梗塞(AMI)20例患者血浆组织型纤溶酶原激活物(t-PA)及抑制物(PAI)的活性变化,并对11例尿激酶(UK)治疗的患者进行了上述指标的动态观察。结果:心肌梗塞组与正常组比较,血浆t-PA活性无变化,PAI活性显著升高(P<0.001);UK治疗前后观察,通过方差分析,上述指标差异非常显著。结果提示:PAI在血栓形成中有重要的病理意义;UK溶栓治疗能够改善机体自身纤溶系统的稳定性。     

高原青年移居者凝血纤溶系统的研究

目的 :研究高原青年移居者血液凝血纤溶系统的状态。方法 :检测 38例青年移居者血浆组织型纤溶酶原激活物 (t -PA)、纤溶酶原激活物抑制剂 (PAI)和纤维蛋白原 (Fbg)含量 ,并与 36例健康藏族世居青年进行比较。以平原健康青年作为对照。结果 :移居者较藏族世居组及对照组t -PA活性降低 (P <0 .0 5 ) ,PAI活性增高 (P <0 .0 5 ) ,各组之间Fbg含量无显著性差别 (P >0 .0 5 )。结论 :高原青年移居者血液处于高凝状态。     

高原地区妊高征患者凝血纤溶系统的变化

目的：探讨高原妊高征患者血液纤溶系统变化;方法：选择高原地区妊高征患者36例,正常妊娠妇女23列,正常健康发性20例;采集空腹静脉血,检测受检者血浆组织纤溶酶原激活剂（t-PA)、纤溶酶原激活剂抑制物－1（PAI－1）活性及纤维蛋白原（FG）、纤溶降解产物（FDP）含量,并进行分析;结果：高原地区寻高征患者FG和FDP含量及PAI－1活性显著高于正常妊娠组及对照组,妊高征患者FG和FDP含量及PAI－1活性的变化与病情程度有关,正常妊娠组和妊高征组t-PA活性明显高于对照组,但在正常妊娠组和妊高征组之间无显著差异,结论：高原地区妊高征患者存在纤溶抑制功能亢进及凝血与纤溶系统的紊乱。     

高原移居汉族凝血纤溶系统的研究

目的　研究高原环境下移居汉族血液凝血纤溶系统的状态。方法　检测 4 8例移居汉族血浆组织型纤溶酶原激活物(t-PA)、纤溶酶原激活物抑制剂 (PAI)和纤维蛋白原 (Fbg)含量 ,并与内地健康人进行比较。 结果　与内地健康人比较 ,移居者组t-PA活性降低 (P <0 .0 5 ) ,PAI活性升高 (P <0 .0 5 ) ,Fbg含量升高 (P <0 .0 5 )。 结论　高原环境下移居汉族血液处于高凝状态     

低强度半导体激光口咽部照射对急性缺血性脑血管病患者血液流？…

目的 研究无创性激光疗法对急性缺血性脑血管病（ＩＣＶＤ）患者血液流变学和纤溶功能的影响。方法 ６０例ＩＣＶＤ患者随机分为３组,每组２０例,均予通脉液５００ｍｌ、川芎嗪１００ｍｇ静脉滴注,每天１次,共１０天,其中２组分别另行低强度半导体激光口咽部照射（无创组）或Ｈｅ－Ｎｅ激光血管内照射（ＩＬＬＬＬＩ组）,前者功率９ＭＷ,照射３０ｍｉｎ,后者功率１．５～２．０ＭＷ,照射６０ｍｉｎ,每天１次,工１０天。     

高压氧对血管内皮细胞损伤大鼠纤溶系统和血小板的影响

目的：通过观察高压氧（HBO）对血管内皮损伤大鼠纤溶系统以及血小板的数量（PLT）及另2项参数的影响，以证实HBO对血栓的发生，发展过程有否抑制作用。方法：将44只大鼠随机分成6个组，正常组（N组，n=6)、模型对照组（M组，n=10)、模型制作后HBO治疗5天组（T1组，n=7)和10天组（T2组，n=7)以及高压空气治疗5天组（T3组，n=7)和10天组（T4组，n=7)。血管内皮细胞（VEC）损伤动物模型均以皮下注射大剂量肾上腺素制成。测定其血浆中纤溶酶原激活物抑制物（PAI）和组织型纤溶酶原激活物（tPA)的活性以及PLT和另2项参数。结果：T1组和T2组比M组PAI活性明显较低，tPA活性和PLT显著较高（P＜0．05，P＜0．01）；T3组和T4组较M组PAI、tPA活性及PLT变化不明显（P＞0．05）。结论：HBO可以促进血管内皮损伤大鼠纤溶活性的恢复，减少血小板的聚集，促进内皮细胞损伤的修复，有效地抑制血栓前状态，从而预防血栓的形成。     

血管内低强度激光照射对急性心肌梗死后病人致血栓标志物的影响

目的　比较血管内低强度HeNe 激光照射(ILLLI) 与口服阿司匹林对急性心肌梗死(AMI) 后病人血浆中致血栓标志物浓度的影响。方法　42 例AMI后的病人随机分成两组,一组(24 例) 进行ILLLI治疗,每天1 次,每次60 min ,共10 天;另一组(18 例) 每天顿服肠溶阿司匹林150 mg ,共10 天。观察两组治疗前后血浆中致血栓和纤溶指标内皮素(ET)1 、血小板α颗粒膜蛋白140(GMP140) 、凝血酶活性片段(FⅡa) 及D二聚体的变化。结果　ILLLI组病人治疗后,血浆GMP140 和FⅡa 浓度下降( P< 0-01) ,而阿司匹林组病人只有GMP140 浓度下降,且下降程度不如ILLLI组。结论　研究结果提示ILLLI治疗AMI后病人对上述指标的有利影响可能强于阿司匹林,但需要进一步进行病例数更多、设计更严密、观察时间更长的对照试验。     

健康青年急进高原后凝血纤溶系统改变的研究

目的探讨高原环境下,急进高原人群不同时相凝血及纤溶系统变化的基本规律.方法对从平原地区急进3 650 m高原前、急进高原后第3 d、第7 d第15 d及第30 d的30名健康青年血浆凝血酶时间(PT)、活化部分凝血活酶时间(APTT)、组织纤溶酶原激活物(t-PA)、纤溶酶原激活抑制物活性(PAI)、纤溶酶原(PLG)、D-二聚体含量(DD)进行检测,并与30名世居者作对照.结果健康青年急进高原3 d后其PT、APTT出现延长,t-PA活性增高,而PAI、Fg含量降低,与平原组相比有显著差异(P＜0.05).急进高原后7～30 d,其PT、APTT随移居时间延长而逐渐缩短,t-PA活性则逐渐降低,PAI、Fg逐渐增高,血液处于高凝状态.且急进高原30 d后,与平原人及世居组比较均有显著差异(P＜0.05).结论 高原环境下,急进高原青年凝血系统出现紊乱,表现为早期凝血与纤溶被激活,而后出现继发性纤溶受抑,凝血及纤溶的平衡被破坏,而使血液呈现高凝和继发纤溶状态.     

IgA肾病肾血管纤溶酶原激活物抑制物-1和基质金属蛋白酶-9的表达及其意义

为探讨免疫球蛋白A肾病(IgA肾病)患者肾血管壁纤溶酶原激活物抑制物1(PAI1)、基质金属蛋白酶9(MMP9)、金属蛋白酶组织抑制物1(TIMP1)和α平滑肌肌动蛋白(αSMA)的表达及意义,采用免疫组织化学技术检测38例IgA肾病肾组织血管壁的PAI1、MMP9、αSMA和TIMP1的蛋白表达。结果显示,αSMA主要表达于平滑肌细胞;PAI1表达与αSMA类似;MMP9在平滑肌细胞和内皮细胞均表达;TIMP1仅在血管壁内膜的内皮细胞微弱表达。在IgA肾病LeeⅣ～Ⅴ级组,肾血管壁的PAI1、MMP9和αSMA表达显著高于LeeⅠ～Ⅲ级组(P<001)。直线相关分析显示,肾血管的PAI1、MMP9和αSMA表达与肾小管间质的纤维化和炎细胞浸润呈正相关(P<001)。提示PAI1可能参与介导了IgA肾病肾血管壁细胞外基质的积聚过程,MMP9则可能促进血管的平滑肌细胞迁移和内膜增生。     

急诊室连续竖脊肌平面阻滞对胸部创伤患者疼痛控制及不良反应的影响

目的评价在急诊室实施超声引导下连续竖脊肌平面阻滞对胸部创伤患者围术期疼痛控制及不良反应的影响。方法前瞻性分析2017年12月-2018年11月联勤保障部队第九O九医院心胸外科收治的68例胸创伤急诊患者,男性44例,女性24例;年龄19~73岁,平均45. 8岁;ASA分级Ⅱ~Ⅲ级,AIS评分3~4分;致伤机制:冲击伤49例,挤压伤14例,爆震伤5例。按照随机数字法分为连续竖脊肌平面阻滞复合静脉自控镇痛组(E组,n=34)和静脉自控镇痛组(P组,n=34),记录两组患者注药前(T0)、注药后30min(T1)、麻醉前(T2)、术后12h(T3)、术后24h(T4)、术后48h(T5) VAS评分及围术期不良反应、阿片类药物追加率和使用总量、住院天数、术后慢性疼痛(CPSP)的发生率。结果 E组T1~T5时间点VAS评分显著低于P组(P <0. 05),E组住院期间肺部感染(8. 8%)、肺不张(8. 8%)、恶心呕吐(5. 8%)、术后CPSP发生率分别为20. 5%,显著低于P组(17. 6%、26. 4%、35. 2%、38. 2%,P <0. 05)。E组哌替啶使用率(17. 6%)、使用总量(550mg)与平均住院天数(6. 8±2. 4) d显著低于P组[76. 4%、2350mg、(10. 5±1. 1) d,P <0. 05]。结论急诊室超声引导下连续竖脊肌平面阻滞可以明显缓解胸部创伤患者的疼痛,缩短患者住院时间,降低不良反应发生率。     

物理方法治疗不同时期面神经炎

目的　探讨物理因子治疗不同时期面神经炎的最佳方法。方法　 1 6 0例患者随机分成综合理疗组 (治疗组 ) 80例 ;针刺组 (对照组 ) 80例。全部患者均在发病 3周测定强度———时间曲线 (I/t) ,以检查神经支配情况。结果　治疗组痊愈 6 9例占 86 2 5 % ,显效 1 0例占 1 2 5 % ,好转 1例占 1 2 5 %。治愈率与对照组对比 ,P <0 0 0 1 ,有非常显著性。而且无任何副作用。结论　在面神经炎不同时期慎重选择理疗方法 ,早期针刺及电刺激无益而有害。     

尿激酶对椎-基底动脉供血不足血液学部分指标的影响

目的　观察尿激酶 (UK)治疗椎 -基底动脉供血不足 (VBI)对血液学部分指标的影响及临床疗效。方法　治疗组 3 1例 ,UK5× 1 0 5U加入 0 .9%盐水 2 5 0 ml中静脉滴注 ,1次 /d,共 7d;对照组 3 0例 ,治疗以血管扩张剂和钙离子拮抗剂为主。两组以治疗 7d为统计界限。两组治疗前后对全血粘度、血浆粘度、PAd T、PAg T、纤维蛋白原、PLG、PLT计数、BT及BCT等血液学参数进行检测。结果　静脉滴注 UK后病人全血粘度、血浆粘度、PAd T、PAg T、纤维蛋白原及 PLG比治疗前明显改善 (P<0 .0 5或 0 .0 1 ) ,对 PLT计数、BT及 BCT影响不显著 (P>0 .0 5 ) ;对照组对上述参数均改善不明显 (P>0 .0 5 ) ;治疗组临床疗效显著高于对照组 (P<0 .0 5 )。结论　 UK通过改善血液学部分参数达到提高 VBI病人临床疗效的目的     

Blood flow after contraction and cuff occlusion is reduced in subjects with muscle soreness after eccentric exercise

Delayed onset muscle soreness (DOMS) occurs within 1‐2 days after eccentric exercise, but the mechanism mediating hypersensitivity is unclear. This study hypothesized that eccentric exercise reduces the blood flow response following muscle contractions and cuff occlusion, which may result in accumulated algesic substances being a part of the sensitization in DOMS. Twelve healthy subjects (five women) performed dorsiflexion exercise (five sets of 10 repeated eccentric contractions) in one leg, while the contralateral leg was the control. The maximal voluntary contraction (MVC) of the tibialis anterior muscle was recorded. Blood flow was assessed by ultrasound Doppler on the anterior tibialis artery (ATA) and within the anterior tibialis muscle tissue before and immediately after 1‐second MVC, 5‐seconds MVC, and 5‐minutes thigh cuff occlusion. Pressure pain thresholds (PPTs) were recorded on the tibialis anterior muscle. All measures were done bilaterally at day 0 (pre‐exercise), day 2, and day 6 (post‐exercise). Subjects scored the muscle soreness on a Likert scale for 6 days. Eccentric exercise increased Likert scores at day 1 and day 2 compared with day 0 (P <.001). Compared with pre‐exercise (day 0), reduced PPT (~25%, P <.002), MVC (~22%, P <.002), ATA diameter (~8%, P <.002), ATA post‐contraction/occlusion blood flow (~16%, P <.04), and intramuscular peak blood flow (~23%, P <.03) were found in the DOMS leg on day 2 but not in the control leg. These results showed that eccentric contractions decreased vessel diameter, impaired the blood flow response, and promoted hyperalgesia. Thus, the results suggest that the blood flow reduction may be involved in the increased pain response after eccentric exercise.     

Optimal central trapping (OPCETRA) vena caval filter: results of experimental studies.

The authors present the in vitro and in vivo results of use of a new vena caval filter, the optimal central trapping (OPCETRA) filter. The in vitro study was designed to compare the clot-trapping effectiveness of three filters: the OPCETRA, the stainless steel Greenfield, and the original Vena Tech-LGM. Standardized 3-mm, 5-mm, and 7-mm clots were captured in 66%, 100%, and 100% of cases, respectively, with the OPCETRA filter; in 34%, 82%, and 100% of cases with the Greenfield filter; and in 50%, 100%, and 100% of cases with the LGM filter. When filters were tilted 15 degrees, 100% of the 5-mm clots were trapped with the OPCETRA filter versus 50% with the Greenfield (P < 1.04 x 10(-9)) and 70% with the LGM (P < 1.78 x 10(-5)) filters. The in vivo animal study was designed to confirm ease of placement, tolerance, and effectiveness of the OPCETRA filter in sheep. Animals were separated into two groups: Group 1 underwent embolization through the femoral vein 40 days after filter implantation and were killed immediately; group 2 underwent embolization at 90 days and were killed 8 days later. In all cases pathologic analysis on the vena cava wall was performed after resection. The in vivo study demonstrated no tilting or migration with the OPCETRA filter. These encouraging results can be explained by the filter's hourglass shape, the number of arms, and the slow release of the filter at insertion.(ABSTRACT TRUNCATED AT 250 WORDS)     

MRI relaxation fluctuations in acute reperfused hemorrhagic infarction.

MRI evaluations of intramyocardial hemorrhage in acute infarction have relied on T(2) and T(2)(*) shortening only. We propose a more comprehensive evaluation of hemorrhagic infarction based on the concept that fluctuations in T(2) and T(1) relaxation in acute reperfused infarction will reflect transient edema and hemoglobin oxidative denaturation to uncompartmentalized methemoglobin. Anteroapical infarction was created via percutaneous balloon in young swine (22-25 kg, N = 12). T(2), T(1), diastolic wall thickness (DWT), and the Gd-DTPA partition coefficient (lambda) were measured on days 0, 2, and 7. DWT was elevated at 1 hr postreperfusion (128% +/- 53%, P = 0.0001), and alleviated on days 2 and 7 (48% +/- 10%, P = 0.008; 53% +/- 24%, P = 0.003). T(2) and T(1) elevations were coincident with early edema (DeltaT(2) = 55% +/- 24%, P < 0.0001; DeltaT(1) = 27% +/- 18%, P < 0.04). T(2) and T(1) were nearly normal on day 2 (DeltaT(2) = 8% +/- 8%, P = 0.27; DeltaT(1) = 0% +/- 1%, P = 0.65). On day 7, T(2) increased while T(1) decreased (DeltaT(2) = 27% +/- 16%, P = 0.005; DeltaT(1) = -14% +/- 10%, P = 0.02). Lambda was elevated by >150% at all time points (P < or = 0.002). Histology verified hemorrhagic injury. T(1) and T(2) fluctuations are consistent with transient edema, as well as hemoglobin oxidative denaturation to decompartmentalized methemoglobin. This methodological development may broaden our understanding of hemorrhagic microvascular injury and improve its detection in clinical populations.     

小鼠急性皮肤缺损创面粒-巨噬细胞集落刺激因子表达特点及其作用机制

目的 探讨创面愈合过程中粒-巨噬细胞集落刺激因子(granulocyte-macrophage colony stimulating factor,GM-CSF)的表达变化及其在创面愈合中的作用和机制.方法采用小鼠全层皮肤缺损伤模型.肌肉麻醉后在背部中线近颈侧制作1.0 cm×1.0 cm大小皮肤缺损伤创而.50只雄性...     

Reliability of power output during intermittent high-intensity cycling.

PURPOSE: We determined the number of trials on consecutive days required to establish high reliability of an intermittent high-intensity cycling test in subjects unfamiliar with multiple-sprint exercise. We also examined the extent to which this reliability could be maintained for 6 d. METHODS: Five untrained men performed a multiple-sprint test (10 x 7 s, with each sprint separated by 30 s) on each of four consecutive days (days 1-4), then rested for 6 d, and finally performed two additional tests on consecutive days (days 11 and 12). For statistical comparisons (analyses of variance), mean power outputs during sprints 8, 9, and 10 (MP8-10) on each test day were calculated for each of the 4th, 5th, and 6th seconds of the sprints, i.e., MP8-10(4th), MP8-10(5th), and MP8-10(6th). Peak power during each sprint was also examined. RESULTS: For days 3 and 4, values for MP8-10(4th), MP8-10(5th), and MP8-10(6th) were greater than on day 1 (P < 0.05). MP8-10(6th) on day 2 was also greater than on day 1 (P < 0.05). There were no differences in MP8-10 among days 2, 3, 4, 11, and 12. Also, peak power on day 1 was lower (P < 0.05) than peak power for all other days, which were not different from one another. The coefficients of variation (CV) for MP8-10 on day 3 versus day 4 were 3.3%, 2.5%, and 2.9% for MP8-10(4th), MP8-10(5th), and MP8-10(6th), respectively. The CV for MP8-10(4th), MP8-10(5th), and MP8-10(6th) on days 4, 11, and 12 ranged from 2.1 to 3.9%, with an overall mean of 3.1%. The greatest CV for MP8-10 was 5.2% for MP8-10(6th) on days 2 versus 3 and 2 versus 4. The mean CV for peak power for all pairwise combinations of days 4, 11, and 12 was 2.8%. CONCLUSIONS: In conclusion, satisfactory reliability of intermittent cycling tests is achieved after two familiarization sessions identical to the tests, and that reliability can be maintained for 6 d.     

高压氧对脑缺血大鼠学习、记忆能力的影响

目的 探讨高压氧治疗对脑缺血后大鼠学习、记忆能力的影响.方法 将38只雄性健康Sprague-Dawley大鼠,采用随机数字表法分为4组,正常对照组10只,假手术组10只,缺血组9只,高压氧组9只.参照Pulsinelli等报道的四血管阻断方法并加以改良,建立脑缺血模型.高压氧组于术后当天行高压氧治疗,连续7 d,1次/d.各组于术后第7天开始行Morris水迷宫实验,连续6 d,比较各组前5 d每天的逃逸潜伏期及第6天穿越平台的次数.结果 (1)前5 d的逃逸潜伏期比较:高压氧组在第3～5天时均小于缺血组(P＜0.01或P＜0.05);高压氧组在第1～5天时与假手术组差异无统计学意义;缺血组在第3～5天时大于假手术组(P＜0.01或P＜0.05);正常对照组在第2～5天时均小于假手术组(P＜0.01或P＜0.05).(2)第6天穿越平台的次数比较:高压氧组大于缺血组(P＜0.05),与假手术组差异无统计学意义;缺血组小于假手术组(P＜0.01);正常对照组大于假手术组(P＜0.01).结论 高压氧治疗对脑缺血后大鼠学习、记忆能力的恢复有改善作用.