高压氧对中重度新生儿缺氧缺血性脑病神经保护作用

目的观察高压氧对中、重度新生儿缺氧缺血性脑病血清神经元特异性烯醇酶的影响,探讨高压氧的神经保护作用。方法对33例中、重度新生儿缺氧缺血性脑病随机分为高压氧治疗组18例和常规治疗组15例,采用放射免疫分析法测定两组患儿高压氧治疗前和治疗后10天血清神经元特异性烯醇酶的水平,并与正常对照组15例比较。结果高压氧治疗组治疗10天神经元特异性烯醇酶明显下降,与常规治疗组有显著性差异,与正常对照组无显著性差异。结论高压氧能有效降低中、重度新生儿缺氧缺血性脑病血清神经元特异性烯醇酶水平,对神经具有保护作用。     

新生儿缺氧缺血性脑病血清神经元特异性烯醇酶变化及意义

神经元特异性烯醇酶(Neuron speeixie enolase．NSE)特异存在于神经元和神经内分泌细胞中，脑损害时血清及脑脊液中NSE浓度常有明显升高。为探讨血清NSE在新生儿缺氧缺血性脑病(HIE)时的变化及临床意义，笔者对38例HIE新生儿测定了NSE，现报告如下。     

不同热性惊厥患儿脑脊液及血清IL-2、7和NSE的改变

目的通过分析单纯型和复杂型热性惊厥（FS）患儿脑脊液及血清白细胞介素2（IL-2）、白细胞介素7（IL-7）和神经元特异性烯醇酶（NSE）的变化,探讨单纯型和复杂型热性惊厥（FS）发作后脑损伤与白细胞介素2（IL-2）、白细胞介素7（IL-7）和神经元特异性烯醇酶（NSE）的关系。方法选取我院2008年1月-2011年1月住院治疗的22例单纯型FS、19例复杂型FS和20例发热而无惊厥患儿为研究对象,发热而无惊厥患儿为对照组。采用ELISA法对患儿的血清、脑脊液中IL-2、IL-7和NSE进行测定。结果复杂型和单纯型FS组脑脊液IL-2、IL-7水平较对照组明显增高,差异有显著性（P〈0．01）,复杂型FS组较单纯型FS组明显升高,差异具有显著性（P〈0．01）。结论白细胞介素2（IL-2）、7（IL-7）和神经元特异性烯醇酶（NSE）水平与脑损伤程度有关。     

血清特异性神经元烯醇酶与脑梗死程度的关系

各种致脑内神经元损伤和坏死的疾病均可导致脑脊液和血清中特异性神经元烯醇酶（NSE）的增高。我们测定脑梗死急性期血清NSE水平,探讨其与梗塞灶直径、神经功能缺损程度的关系。报告如下。     

神经元特异性烯醇酶和凝血功能在评价脑外伤预后中的意义

目的探讨神经元特异性烯醇酶和凝血功能在评价脑外伤预后中的意义。方法选取2009年1月～2011年12月在我院住院治疗的脑外伤患者66例为观察组,同期健康体检者30例为对照组,按照脑外伤的严重程度将观察组分为轻型组22例,中型组26例,重型组18例。检测并比较血清中神经元特异性烯醇酶（NSE）,凝血酶原时间（PT）,活化部分凝血活酶时间（APTT）和纤维蛋白原定量（Fbg）水平。结果血清NSE、PT、APTT和Fbg水平在对照组、轻型组、中型组和重型组中依次升高,差异均有高度统计学意义（均P〈0.01）。生存组血清NSE、PT、APTT和Fbg水平较死亡组明显降低,差异均有高度统计学意义（均P〈0.01）。结论脑外伤患者血清NSE、PT、APTT和Fbg水平与病情有关,对于判断预后有着重要意义。     

神经元特异性烯醇酶与癫痫

神经元特异性烯醇酶(ｎｅｕｒｏｎ－ｓｐｅｉｆｉｃｅｎｏｌａｅ,ＮＳＥ)是神经元损伤的敏感性标志物,具有较高的特异性。在神经系统疾病,如中枢神经系统肿瘤、脑梗死、脑缺血、感染性疾病、多发性神经病、心肌梗死后昏迷、低氧血症、蛛网膜下腔出血、脑外伤和癫痫中显著增高[１~５]。人们逐步把ＮＳＥ看作是神经损伤的一项指标。近年来,随着对ＮＳＥ研究的深入,发现     

重型颅脑损伤患者颅内压与神经元特异性烯醇化酶、C-反应蛋白及D-二聚体水平变化关系研究

探讨重型颅脑损伤患者颅内压改变与神经元特异性烯醇化酶、C-反应蛋白和D-二聚体的关系。 采用电化学发光免疫分析法检测两组血清神经元特异性烯醇化酶,免疫比浊法检测C-反应蛋白和D-二聚体水平。 重型颅脑损伤患者神经元特异性烯醇化酶、C-反应蛋白和D-二聚体指标的水平均显著高于健康者,监测颅内压重度增高组患者的神经元特异性烯醇化酶、C-反应蛋白和D-二聚体水平均显著高于中度增高组。结果说明,重型颅脑损伤患者颅内压改变与患者血清中神经元特异性烯醇化酶、C-反应蛋白和D-二聚体指标水平存在明显的正相关性。     

新生儿缺血缺氧性脑病患儿血清神经元特异性烯醇化酶测定及临床意义

目的通过对新生儿缺血缺氧性脑病患儿血清神经元特异性烯醇化酶的测定来探讨其对新生儿缺血缺氧性脑病患儿早期诊断的临床意义。方法选2007年1～12月在我院儿科住院新生儿缺血缺氧性脑病患儿30例作为新生儿缺血缺氧性脑病组，其中轻度13例。中度10例，重度7例。对照组20例，均于入院后24h内抽取股静脉血2～3ml，3000r／min离心后采用ABC—ELISA试剂盒进行检测。结果新生儿缺血缺氧性脑病轻度组血清神经元特异性烯醇化酶浓度略高于对照组，无显著性差异；而新生儿缺血缺氧性脑病中，重度组的血清神经元特异性烯醇化酶水平与对照组比均明显上升，与对照组相比有显著性差异（P〈0．01），且重度与中度新生儿缺血缺氧性脑病患儿血清神经元特异性烯醇化酶水平差异亦显著（P〈0．01）。结论新生儿缺血缺氧性脑病患儿神经元特异性烯醇化酶的测定是判断新生儿缺血缺氧性脑病简便、可靠且快速的生化指标。此项研究对新生儿缺血缺氧性脑病的早期诊断、治疗及判断预后有重要意义，降低了儿童致残率，提高了儿童生存质量，并对人类医学发展起了积极作用。     

托吡酯对重度新生儿缺氧缺血性脑病的保护作用

目的观察托吡酯对重度新生儿缺氧缺血性脑病血清神经元特异性烯醇酶(NSE)的影响,探讨托吡酯的神经保护作用。方法对35例重度新生儿缺氧缺血性脑病分为托吡酯治疗组15例和常规治疗组20例,采用放射免疫分析法测定两组患儿入院时和治疗后14d血清NSE的水平,并与正常对照组15例比较。结果托吡酯治疗组治疗14d血清NSE明显下降,与常规治疗组有显著性差异。结论托吡酯可有效降低重度新生儿缺氧缺血性脑病血清NSE水平,对神经具有保护作用。     

新生儿缺氧缺血性脑病细胞因子研究进展

缺氧缺血性脑病 (ｈｙｐｏｘｉａｉｓｃｈｅｍｉｃｅｎｃｅｐｈａｌｏｐａｔｈｙ ,ＨＩＥ)是新生儿的常见疾病 ,其病机复杂 ,病情凶险 ,病死率高 ,存活者多遗留永久性神经功能损害。因此 ,深入开展ＨＩＥ的临床研究 ,已成为围生医学的重要课题 ,其中 ,ＨＩＥ的研究热点分子生物学研究取得了新的进展。现将近几年来ＨＩＥ细胞因子研究进展简要综述。1　神经元特异性烯醇酶神经元特异性烯醇酶 (ｎｅｕｒｏｎｓｐｅｃｆｉｃｅｎｏｌａｓｅ ,ＮＳＥ)是一种具有特殊定位的神经系统特异性蛋白质 ,为神经元损伤非常敏感的标记物 ,存在于神经元及神…     

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.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.     

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.