不同海拔地区健康人血清α＿1－抗胰蛋白酶水平的比较分析

本文应用火箭免疫电泳法分别测定了不同海拔地区总共５７３例健康人血清α＿１－ＡＴ水平，其中上海（海拔５ｍ）３５９人，西宁（海拔２２６０ｍ）１２９人，青海热水（海拔３７００ｍ）８５人。结果为：上海地区健康人血清α＿１—ＡＴ水平２．８１±０．６８ｇ／Ｌ，西宁３．９１±１．１１ｇ／Ｌ，热水３．３６±０．８２ｇ／Ｌ。结果表明，健康人血清α＿１－ＡＴ水平由高到低依次是西宁、热水、上海。经统计学分析三组之间差别有高度显著性意义（Ｐ＜０．０１），而与性别无关（Ｐ＞０．０５）、提示健康人随居住地海拔增高血清α＿１－ＡＴ水平有增高趋势。这种改变可能与海拔增高，空气中氧分压下降刺激肝细胞和肺泡巨噬细胞合成α＿１－ＡＴ增加有关，但随着海拔进一步增高，这种作用反而受到抑制。     

ApoE基因敲除鼠12周游泳运动前后纤溶激活功能的改变

目的：探讨ＡｐｏＥ在长期有氧运动中影响纤溶激活作用中的有关机制。方法：以ＡｐｏＥ基因敲除（ＡｐｏＥ－／－）鼠为实验组、以相同遗传背景的Ｃ５７ＢＬ／６Ｊ鼠为对照组建立运动模型。结果：１２周游泳后，对照组鼠ＴＧ（０．９６±０．３０ｖｓ０．５４±０．０７０ｍｍｏｌ／Ｌ，Ｐ＜０．０１）和ＰＡＩ（０．９２±０．０７ｖｓ０．８０±０．０９ＡＵ／ｍｌ，Ｐ＜０．０５）降低，ｔＰＡ升高（０．６０±０．１２ｖｓ１．０４±０．２３ＩＵ／ｍｌ，Ｐ＜０．０１）；而ＡｐｏＥ－／－鼠的ＴＧ（１．２８±０．３４ｖｓ１．２９±０．３２ｍｍｏｌ／Ｌ，Ｐ＞０．０５）和ＰＡＩ（０．７４±０．１０ｖｓ０．７９±０．０４ＡＵ／ｍｌ，Ｐ＞０．０５）均没有显著变化，ｔＰＡ（０．７１±０．１５ｖｓ０．９７±０．１７ＩＵ／ｍｌ，Ｐ＜０．０１）升高。结论：长期有氧运动使对照小鼠纤溶激活作用明显改善，其机制与ＴＧ和含ＡｐｏＥ脂蛋白水平降低导致ＬＲＰ清除ｔＰＡ－ＰＡＩ作用加强、ＰＡＩ抑制作用减弱及ｔＰＡ合成水平增加有关。Ａｐ ｏＥ－／－鼠运动后，ＰＡＩ水平稳定而ｔＰＡ活性增加，提示ｔＰＡ合成作用增强。     

高原老年人右心室舒张功能的脉冲多普勒超声研究

海拔２２６０ｍ老年１３例（Ａ组），海拔３５００～４２００ｍ老年１２例（Ｂ组），年龄６０～７４岁。ＥＣＧ、ＵＣＧ、心三位片和肺功能无右室肥大和器质性心脏病及慢阻肺。脉冲多普勤测定三尖瓣口Ｅ＿ｖ、Ａ＿ｖ、Ｅ＿Ｉ、Ａ＿Ｉ、Ａ＿ｖ／Ｅ＿Ｉ、ＥＤＴ、ＡＴ。结果发现Ｂ组的Ａ＿ｖ／Ｅ＿ｖ增大（Ｐ＜０．００１）；ＥＤＴ及ＡＴ缩短（分别Ｐ＜０．００１）；ＡＴ与ＥＤＴ呈高度正相关（ｒ＝０．９３５、Ｐ＜０．０１）；ＡＴ与Ａ＿ｖ／Ｅ＿ｖ呈高度负相关（ｒ＝－０．９１６、Ｐ＜０．０１）；且ＥＤＴ与Ａ＿ｖ／Ｅ＿ｖ亦呈高度负相关（ｒ＝－０．９０７、Ｐ＜０．０１）；表明尚无高原心脏病的海拔３５００ｍ以上高原老年人，右室舒张功能减低，右室后负荷已有一定程度增加，两者间呈高度正相关关系。     

高原低氧与循环内皮素细胞计数及内皮素—1和心钠素含量的相关性研究

目的：探讨高原低氧环境下血管内皮细胞（ＶＥＣ）的损伤情况及功能变化;方法：对从平原（海拔１４００ｍ）进驻海拔３７００ｍ（１０人）与５３８０ｍ（２０人）高原第７天和年年的青年进行循环内皮细胞计数（ＣＥＣ）、血浆内皮素－１（ＥＴ－１）和心钠素（ＡＮＰ）含量测定,并与平原作对照。结果：在高原缺氧条件下,血浆ＣＥＣ计ＥＴ－１、ＡＮＰ含量明显高于平原（Ｐ〈０．０１）,且随海拔高度的升高而增高（Ｐ〈０．０１）     

高原红细胞增多症患者血清EPO含量变化及其意义

目的：探讨ＥＰＯ在高原红细胞增多症发病机制中的作用。方法：采用放射免疫法检测了高红症患者、高原移居健康者及平原健康人外周血清中的ＥＰＯ含量。结果：在红症患者及高原健康人血清ＥＰＯ水平显著高于平原对照组（Ｐ〈０．０１）；而高红症患者血清ＥＰＯ水平原对照组（Ｐ〈０．０１）；而高红症患者血清ＥＰＯ水平同高原健康人相比无显著性差异。结论：血清ＥＰＯ在高原红细胞增多症的发病过程中起一定的作用。     

高原低氧与循环内皮细胞计数及内皮素-1和心钠素含量的相关性研究

目的：探讨高原低氧环境下血管内皮细胞（ＶＥＣ）的损伤情况及功能变化;方法：对从平原（海拔１ ４００ｍ ）进驻海拔３ ７００ｍ （１０ 人）与５ ３８０ｍ （２０ 人）高原第７ 天和半年的青年进行循环内皮细胞计数（ＣＥＣ）、血浆内皮素－１（ＥＴ－１）和心钠素（ＡＮＰ）含量测定,并与平原作对照。结果：在高原缺氧条件下,血浆ＣＥＣ计数和ＥＴ－１、ＡＮＰ含量明显高于平原（Ｐ＜ ０．０１）,且随海拔高度的升高而增高（Ｐ＜ ０．０１）,初入高原时明显高于在高原居住半年的数值（Ｐ＜ ０．０５ 或Ｐ＜ ０．０１）。在不同海拔高度居住不同时间的ＥＴ－１与ＣＥＣ和ＡＶＰ呈高度正相关;结论：血管活性肽ＥＴ－１、ＡＮＰ分泌可能对急、慢缺氧环境下的心血管系统功能及神经内分泌调节具有重要意义。     

高原失血性休克与代谢性酸中毒的研究

山羊１２只，随机分为平原失血性休克组（Ｌ）和高原失血性休克组（Ｈ）．Ｈ组山羊于模拟４０００ｍ高原低压舱内连续减压２４小时，两组动物分别于平原（３００ｍ）和模拟高原（４０００ｍ）复制失血性休克。结果显示：高原失血性休克组与平原组比有如下特点：①致休克失血量明显减少，仅为平原组的６８．７％（Ｐ＜０．０５）；②血浆ＰＨ和ＢＥ显著降低，回输血后２ｈ分别为７．２２６±０．１７３（平原组７．４８１±０．０５２）和一１６．５０±４．７０ｍＭ／Ｌ（平原组一１．７０±２．７７ｍＭ／Ｌ），与平原组相比，Ｐ值均小于０．０１；③存活时间缩短、死亡率增加，平均存活时间为６．２±４．２ｈ，１２ｈ存活率为１６．７％，而平原组动物在２４ｈ观察期内无一例死亡。表明模拟４０００ｍ高原２４ｈ，山羊对失血的耐受性明显降低，在休克过程中发生严重代谢性酸中毒，存活时间缩短、在活率降低。     

高原健康人与高原红细胞增多症患者血浆促红细胞生成素含量分析

为了探讨高原红细胞增多症（ＨＡＰＣ）的发病机理,在海拔３６８５ｍ～４５００ｍ的海拔高度对高原人血浆促红细胞生成素（ＥＰＯ）的含量进行了测定分析,取受检者静脉血,以酶标法测定血浆ＥＰＯ含量。结果显示,健康对照和ＨＡＰＣ患者的血浆ＥＰＯ含量汉族高于藏族,且ＨＡＰＣ患者的血浆ＥＰＯ含量汉族高于藏族,且ＨＡＰＣ患者组高于对照组,差异具有显著意义,藏族ＨＡＰＣ患者血ＥＰＯ含量为（１３．０６±２．１２）ｍＩｕ／ｍｌ,与藏族对照（６．１３±０．５９）ｍＩｕ／ｍｌ和汉族ＨＡＰＣ患者（６１．２４±１９．８９）ｍＩ…     

健康青年进驻高原血清TNF-α和IL-6的变化

目的：探讨高原低氧环境下外周血肿瘤坏死因子（ Ｔ Ｎ Ｆ－ α） 和白细胞介素－ ６（ Ｉ Ｌ－ ６） 水平的变化及其意义。方法：对从平原进驻海拔３ ７００ ｍ 和５ ３８０ ｍ 高原第７ ｄ 和半年的健康青年，应用放射免疫分析法测定血清 Ｔ Ｎ Ｆ－ α和 Ｉ Ｌ－ ６ ，并与平原（ 海拔１ ４００ ｍ） 健康青年作对照。结果：高原低氧环境 Ｔ Ｎ Ｆ－ α和 Ｉ Ｌ－ ６ 水平明显高于平原（ Ｐ＜ ０ ．０５ 或 Ｐ＜ ０ ．０１） ，且随海拔高度的升高而增高（ Ｐ＜ ０ ．０１） ，随居住时间的延长而降低（ Ｐ＜ ０ ．０５ 或＜ ０ ．０１） 。结论： Ｔ Ｎ Ｆ－ α和 Ｉ Ｌ－ ６ 参与了机体急、慢性低氧的应激过程，诱导体内免疫细胞因子网络系统处于激活状态。     

部队在高原越野前后RBC—SOD和血液流变学的变化

探讨海拔５０００ｍ以上地区剧烈运动前后ＲＢＣ──ＳＯＤ活性和血液流变性的变化。５１名平原青年在海拔３７００和５２７０ｍ处进行５公里跑步越野，越野前静息状态和越野后即刻检测ＲＢＣ－ＳＯＤ和６项血液流变学指标。ｔ检验分组比较，结果：静息状态随海拔升高ＲＢＣ－ＳＯＤ活性逐步下降，５２７０ｍ较３７００ｍ下降非常显著（Ｐ＜０．０１），ＨＣＴ和ηｂ逐步增高，亦相差非常显著（Ｐ＜０．０１），ＰＦＣ无显著改变。ＴＫ在３７００ｍ较１４００ｍ增加非常显著（Ｐ＜０．０１），５２７０ｍ较３７００ｍ虽有增加但无统计学意义。ＴＦＬ随海拔升高增加非常显著或增加显著（Ｐ＜０．０１或Ｐ＜０．０５），ＭＳＴ虽有增加但无显著性差异（Ｐ＞０．０５）。越野后即刻较越野前，海拔３７００ｍＲＢＣ－ＳＯＤ、ηｂ、ＴＦＬ显著降低（Ｐ＜０．０５），ＭＳＴ降低非常显著（Ｐ＜０．０１）。海拔５２７０ｍＲＢＣ－ＳＯＤ和ηｂ降低非常显著（Ｐ＜０．０１），其它指标无显著性改变。结论：随海拔升高ＲＢＣ－ＳＯＤ活性降低，血液粘度增高；剧烈运动后ＲＢＣ－ＳＯＤ进一步降低，血液粘度相对降低。     

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.     

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.     

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）     

Die rechtsmedizinische Identifizierung — Bedeutung und Beweiswert —

Zusammenfassung Bei der rechtsmedizinischen Identifizierung kann die Identität im strengen Sinn allenfalls bei lebenden Personen festgestellt werden; sonst läßt sich nur von Teilen auf das Ganze (vom Untersuchungsobjekt auf die Person) schließen, wobei die verschiedenen Merkmale des Untersuchungsobjektes entsprechend der Hdufigkeit ihres Vorkommens eine unterschiedliche Beweiskraft haben. Bei der Schädelidentifizierung mit Hilfe moderner photographischer oder elektronischer Superprojektionsverfahren ergeben sich unter Berücksichtigung der Weichteildicken so viele (fiktive) Vergleichspunkte, daß bei geeignetem Vergleichsmaterial (Photographien) Identität wegen der Vielzahl übereinstimmender Bezugspunkte in den meisten Fällen evident ist.     

Imaging of abdominal nodal spread in malignant disease

This is a review of the role of imaging procedures for the assessment of abdominal and pelvic lymph nodes. The diagnosis of malignant lymphatic spread is rarely the sole purpose of imaging, because it is usually part of a general abdominal examination, most frequently with CT or US, or increasingly with MRI. These studies are often requested in order to obtain information about the situation to be encountered during surgery, or to alert the surgeon to irresectability or to unexpected metastases outside the initially planned area of exploration. In most surgically treated tumours the role of imaging for preoperative staging is limited, due either to its insufficient sensitivity or because the initial treatment is independent of the lymph node stage. Imaging is commonly used to verify treatment response to chemo- or radiotherapy and for follow-up.Correspondence to: S. Delorme     

改进的定位技术在胸部肿瘤穿刺活检中的应用

目的：探索CT-SIM三维定位系统、体模固定技术和PET-CT融合影像导引定位技术在胸部肿瘤经皮穿刺活检中的应用价值。方法：对380例胸部肿瘤患者行改进的CT定位技术下的经皮穿刺活检术。根据肿瘤的大小、深度、毗邻关系、活动度以及患者的心肺功能状态,综合运用CT-SIM系统、体模固定技术和PET-CT融合影像导引技术,为患者进行穿刺前定位。统计穿刺定位时间长度、成功率、确诊率、并发症发生情况,并与210例采用传统铅栅定位下胸部肿瘤穿刺活检的相应资料进行比较。结果：采用改进的CT定位技术的380例患者穿刺定位精确,平均定位时间（9.5 min）较传统方法（16.8 min）缩短7.3 min,活检成功率和确诊率分别是98.7%和95.3%,高于传统定位方法的93.3%和83.3%,两者差异均具有统计学意义（P〈0.05）。穿刺并发症发生率相似,气胸发生率分别为2.8%和2.9%,咯血发生率分别为11%和12.8%。结论：根据患者状态及肿瘤特点,在CT-SIM系统快速精确定位技术的基础上,综合运用体模固定技术和PET-CT融合影像导引技术,能显著缩短经皮穿刺活检的定位时间,提高活检成功率。