卒中后抑郁患者认知功能与ApoE基因多态性的关联研究

目的 探讨卒中后抑郁患者( post-stroke depression,PSD)认知功能损害与ApoE基因多态性之间的相关性.方法 根据24项汉密尔顿抑郁量表(HAMD-24)评分将患者分为PSD组(83例)和卒中组(96例),选取健康志愿者(53例)作为对照组.采用事件相关电位( ERP) P300作为认知功能的评定指标.采用基因测序法测定载脂蛋白E基因第四外显子112位( rs429358)和158位(rs7412)单核苷酸位点多态性.结果 1.EPR测定卒中后抑郁组N2、P3波潜伏期较卒中组和对照组延长,P3波幅降低,差异有统计学意义(P＜0.05).2.PSD组ε3/ε4基因型频数(24例)高于对照组(7例),ε4/4基因频数(8例)高于卒中组(2例),差异有统计学意义(P＜0.05);ε4等位基因频率(24.7％)高于卒中组(16.1％)和对照组(9.4％),差异有统计学意义(P＜0.05).3.PSD组携带ε4等位基因的HAMD-24评分、N2潜伏期、P3潜伏期高于非携带ε4等位基因组,差异有统计学意义(P＜0.05).结论 PSD患者存在认知功能损害,ε4等位基因可能与PSD患者的认知功能损害和抑郁情绪具有一定相关性.     

脑卒中后抑郁症患者载脂蛋白E水平检测

目的:了解脑卒中后抑郁症(PSD)患者载脂蛋白E(ApoE)水平特点.方法:采用实时荧光定量PCR技术和酶联免疫吸附法对31例PSD患者及33例脑卒中后非抑郁患者进行了ApoE水平检测.结果:PSD组ApoEmRNA表达量低于脑卒中非抑郁组(t=2.854,P=0.006);PSD组血清ApoE水平高于脑卒中非抑郁组(...     

针刺联合氟西汀治疗对卒中后抑郁患者的抑郁情绪及认知功能的影响

目的:探讨针刺治疗与氟西汀联用治疗对卒中后抑郁(PSD)患者抑郁情绪和认知功能的影响,为PSD的临床治疗提供更有效的途径.方法:将84例PSD患者分为氟西汀治疗组(A组)和针刺治疗与氟西汀联用治疗组(B组),在治疗前后分别对两组患者进行了抑郁量表(HAMD)评定和事件相关电位(ERP)测定,并将结果加以比较.结果:首次评定两组HAMD及ERP结果差异无统计学意义(P>0.05);12周后再次评定时,两组ERP中N2、P3波潜伏期较首次缩短,P3波幅升高,HAMD评定分值较首次降低,但B组改变更为明显,差异具有统计学意义(P<0.01).结论:针刺治疗与氟西汀联用可较好的改善脑卒中患者的抑郁情绪和认知功能,对促进其预后和康复有较高的临床价值.     

卒中后抑郁患者载脂蛋白H与认知功能的相关性

目的观察卒中后抑郁(PSD)患者载脂蛋白H(ApoH)水平和认知功能障碍的相关性。方法选择2010年1月至2015年12月新乡医学院第三附属医院收治的脑卒中患者188例,根据是否伴有卒中后抑郁将患者分为PSD组(n=92)和单纯脑卒中组(n=96);另选取90名健康志愿者作为对照组。采用聚合酶链式反应检测ApoH mRNA的表达量,酶联免疫吸附试验检测Apo H蛋白水平,采用事件相关电位(ERPs)来评定患者的认知功能。结果 3组研究对象N_1、P_2潜伏期比较差异均无统计学意义(P>0.05)。PSD组患者N_2及P_3潜伏期长于对照组和单纯脑卒中组,P_3波幅低于对照组和单纯脑卒中组(P<0.05);单纯脑卒中组和对照组受试者N_2、P_3潜伏期,P_3波幅比较差异均无统计学意义(P>0.05)。PSD组、单纯脑卒中组和对照组受试者ApoH mRNA表达量分别为0.89±0.16、0.76±0.14、0.67±0.14。PSD组患者ApoH mRNA表达量高于单纯脑卒中组和对照组(P<0.05);单纯脑卒中组患者ApoH mRNA表达量高于对照组(P<0.05)。PSD组、单纯脑卒中组和对照组受试者ApoH蛋白水平分别为(0.98±0.13)、(0.79±0.23)、(0.61±0.33)g·L~(-1)。PSD组患者Apo H蛋白水平高于单纯脑卒中组和对照组(P<0.05);单纯脑卒中组患者ApoH蛋白水平高于对照组(P<0.05)。PSD组患者血清ApoH蛋白水平与N_2、P_3潜伏期成正相关(P<0.05);其余指标之间无相关性(P>0.05)。结论 PSD患者认知功能障碍与ApoH蛋白存在相关性。     

功能性消化不良患者事件相关电位P300的变化和意义

目的:探讨事件相关电位P300在功能性消化不良患者中的变化和意义。方法:对27例FD患者和27例健康对照者应用汉密尔顿抑郁焦虑量表、FD主要症状评分表评分和脑电生理仪测定事件相关电位P300,对FD组经四周心理介入(小剂量阿米替林和心理疏导)治疗后,应用上述方法再次评测。结果:FD患者事件相关电位P300较健康对照者P3潜伏期延长(P<0.05)、P3波幅降低(P<0.05),FD患者抑郁焦虑量表评分和主要临床症状评分较健康对照组均高并有差异(P<0.05),FD患者焦虑抑郁评分与P3潜伏期、临床症状评分呈正相关(P<0.01)。FD患者焦虑抑郁评分与P3波幅呈负相关(P<0.01)。心理介入治疗后事件相关电位P300、抑郁焦虑量表评分和主要临床症状评分均明显改善。结论:伴有焦虑抑郁FD患者有认知功能障碍,认知功能可能介入FD发病机制。     

老年脑卒中患者血清皮质醇水平与卒中后抑郁的相关性研究

目的 探讨老年脑卒中患者血清皮质醇水平与卒中后抑郁(PSD)是否具有相关性.方法 对41例老年卒中患者在发病后2周进行血清皮质醇检测,并在发病后3月对患者进行抑郁量表评定,观察皮质醇正常组以及皮质醇增高组卒中后抑郁发生率,并进行卡方检验,同时对各组内皮质醇水平和抑郁程度进行相关性分析.结果 皮质醇正常组和皮质醇增高组PSD发生率差异有显著性(χ2=4.11;P <0.05),皮质醇正常组平均汉密尔顿分值为(15.29±7.28)分,皮质醇增高组为(25.85±10.81)分,2组差异有显著性( P <0.01).皮质醇正常组皮质醇水平与抑郁程度无明显相关( r =0.295;P =0.194),皮质醇增高组皮质醇水平与抑郁程度明显相关( r =0.702;P =0.001).结论 老年人脑卒中后早期皮质醇水平增高提示患者发生抑郁可能性增大,检测皮质醇可以为PSD防治提供理论依据据.     

卒中后抑郁Nogo-P300的执行功能分析

目的通过事件相关电位检测,探讨卒中后抑郁患者的执行功能。方法对12例卒中后抑郁患者(观察组)及12例健康者(对照组)进行事件相关电位检测,受试者须对稀有声刺激执行按键反应(代表Go反应),对标准声刺激不执行按键反应(代表Nogo反应),通过头顶中央(Cz)记录大脑对听觉刺激信号产生的Nogo-P300波形,对Nogo-P300中的主成分Nogo-N2、Nogo-P3的波幅分别测量。结果观察组Nogo-N2、Nogo-P3波幅低于对照组,2组相比差别有统计学意义(P<0.01)。结论Nogo-N2、Nogo-P3显示反应抑制,可为卒中后抑郁提供执行功能的依据。     

Ⅰ、Ⅱ型精神分裂症事件相关电位对比及相关性研究

目的探讨Ⅰ、Ⅱ型精神分裂症患者事件相关电位P300的特点及事件相关电位与阴性、阳性症状的相关性.方法对46例精神分裂症患者及32名健康志愿者进行事件相关电位P300的检测,并把患者组按PANSS的评分结果分为Ⅰ型精神分裂症和II型精神分裂症.结果与正常组比较,患者组靶刺激时P300的N2、P3潜伏期延迟(P＜0.01～0.05),P2、P3波幅降低(P＜0.01～0.05);与Ⅰ型组比较,Ⅱ型组靶刺激的N1、P2、N2和P3潜伏期均明显延迟(P＜0.01～0.05),P3波幅明显降低(P＜0.05);P300的主要指标与精神症状有相关性(P＜0.01～0.05).结论提示事件相关电位P300在协助精神分裂症的诊断、分型及推测预后方面有一定意义.     

糖尿病合并脑白质疏松症患者事件相关电位分析

目的观察糖尿病(DM)合并脑白质疏松症(LA)患者认知功能事件相关电位P300、N400的特征。方法对217例DM合并LA患者(DM合并LA组)、55例单纯DM患者(DM组)和30例健康志愿者(对照组)进行P300、N400、失配性负波(MMN)检测和简易精神状态检查量表(MMSE)检查,并对结果进行比较。结果 DM组和DM合并LA组患者MMSE评分显著低于对照组(P<0.05,P<0.01),DM合并LA组患者MMSE评分显著低于DM组(P<0.01)。与对照组比较,DM组和DM合并LA组患者事件相关电位P300、MMN和N400潜伏期显著延长(P<0.05,P<0.01),波幅显著降低(P<0.05,P<0.01);与DM组比较,DM合并LA组患者事件相关电位P300、MMN和N400潜伏期显著延长(P<0.01),波幅显著降低(P<0.05)。随着脑白质损害程度的加重,事件相关电位P300和N400潜伏期显著延长(P<0.01),波幅显著降低(P<0.01)。结论事件相关电位P300、N400检测可客观评价DM合并LA患者的认知功能。     

老年2型糖尿病患者伴和不伴缺血性脑损害听觉事件相关电位的对比研究

目的 探讨老年2型糖尿病伴和不伴缺血性脑损害患者认知功能的改变.方法 72例老年2型糖尿病患者经CT检查分为单纯糖尿病组(单纯DM组)38例,糖尿病合并缺血性脑损害组(DM并脑缺血组)34例,行听觉事件相关电位(P300)及简易智能量表(MMSE)检测,将两组检测结果与正常对照组31例比较.结果 MMSE评分单纯DM组27.5±1.9与正常对照组28.5±1.7比较差异无统计学意义(P>0.05);DM并脑缺血组26.4±2.2,较正常对照组降低,差异有统计学意义(P<0.01).老年2型糖尿病两组听觉事件相关电位(P300)的N2潜伏期(Lat)分别为(264.7±33.2)ms和(285.1±40.7)ms,P3潜伏期(Lat)分别为(370±38.0)ms和(408.5±48.1)ms,比正常对照组(分别为(232±33.2)ms,(333.6±40.4)ms]均明显延长,差异有统计学意义(P<0.01);两组P3波幅(Amp)分别为(6.6±3.1)mV和(5.0±3.0)mV,较对照组(9.4±3.7)mV明显降低,差异有统计学意义(P<0.01).DM并脑缺血组N2、P3潜伏期较单纯DM组延长,差异有统计学意义(P<0.01),波幅差异无统计学意义(P>0.05).结论 2型糖尿病可引起老年患者认知功能损害,合并缺血性脑损害可加重患者的认知功能损害,事件相关电位P300检测可作为老年糖尿病认知损害早期诊断和动态监测的敏感指标.     

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.     

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.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.