多发性脑梗死与单发性脑梗死危险因素对比分析

目的分析比较多发性脑梗死(multiple cerebral infarction,MCI)与单发性脑梗死(solitary cerebral infarction,SCI)的危险因素,以利于临床有针对性的防治脑梗死.方法分析自2009年1月~2012年1月收治的脑梗死患者,根据临床和影像学资料诊断,其中MCI 132例,SCI 241例,对可能影响MCI及SCI的因素进行分析,比较2组间有无差异,然后进行非条件logistic多元回归分析,校正混杂因素的影响.结果引发脑梗死的主要因素为高血压39.68%(178/373),吸烟26.54%(99/373),饮酒19.84%(74/373).MCI组与SCI组比较,吸烟、卒中家庭史、高血压、糖尿病、短暂性缺血发作史均具有显著性意义(P<0.05).多因素Logistic回归分析表明,MCI与SCI对比,吸烟、卒中家庭史、糖尿病、短暂性缺血发作史,为MCI发病的独立危险因素(P<0.001,0.002).结论与SCI相比,吸烟、卒中家庭史、高血压、糖尿病、短暂性缺血发作史为MCI的独立危险因素.     

高血压与非高血压性脑梗死患者的临床研究

目的 比较高血压与非高血压性脑梗死患者的发病类型、危险因素和预后的差异.方法 将自2009年7月-2011年10月收治的脑梗死患者398例,根据高血压病史将其分为高血压组(201例)和非高血压组(197例).针对患者的发病类型、危险因素和预后对2组患者分别进行单因素和多因素分析.结果 高血压组既往脑梗死史、腔隙性脑梗死和后循环脑梗死发生率明显高于非高血压组;非高血压组中高龄、心脑血管疾病、糖尿病等明显比高血压组多,差异有统计学意义(P＜0.05).结论 引起脑梗死的常见类型为腔隙性脑梗死和后循环脑梗死.高血压是引起脑梗死最重要的因素,同时高龄、心脑血管疾病、糖尿病等也是引起脑梗死不容忽视的因素.     

快速识别孤立性眩晕型脑梗死临床方法研究

目的研究头脉冲-眼震-扭转偏斜(head impulse, nystagmus, test of skew, HINTS)床旁检查和Essen卒中风险评分(essen stroke risk score, ESRS)量表联合眼动检查对孤立性眩晕型脑梗死识别的敏感性和特异性。方法选取2018年1月至2021年4月收治于东莞市滨海湾中心医院神经内科的急性孤立性眩晕患者为研究对象。记录患者的基本临床资料,由经过培训的急诊内科医师和神经内科医师共同诊断,根据患者HINTS床旁检查和ESRS(≥3分支持后循环卒中)量表的基础上,形成初步诊断,作为对照组诊断资料;在此基础上加做眼动检查(平滑跟踪试验、扫视试验),再次诊断,作为观察组诊断资料,分别记录两次诊断结果,作为统计资料。所有患者诊断为孤立性眩晕型脑梗死者,按照卒中处理,发病24 h内启动绿色通道,急诊完成磁共振三序列[磁共振血管成像(magnetic resonance angiography, MRA)+弥散加权成像(diffusion weighted imaging, DWI)+液体衰减反转恢复(fluid attenuated in...     

中枢性孤立性眩晕的临床特点及影像学分析

目的 加深对孤立性眩晕起病的急性脑梗死的认识。方法 回顾性分析2020年8月至2022年8月民航总医院神经内科收治的由孤立性眩晕起病的急性脑梗死患者(病例组25例)及非急性脑梗死患者(对照组25例),分析其人口学特征、脑血管病危险因素及影像学特征。结果 病例组中男性比例以及55岁以上患者比例显著高于对照组[分别为72%vs 44%,80%vs 52%(P<0.05)]。病例组中合并高血压和糖尿病的比例均高于对照组,(分别为72%vs 56%,52%vs 40%),合并高脂血症的比例少于对照组(84%vs 96%),差异无统计学意义(P>0.05)。病例组中临床表现为恶心、呕吐、听力下降和眼球震颤的比例多于对照组(分别为68%vs 56%,52%vs40%,16%vs 4%,24%vs 16%),而表现为耳鸣的比例少于对照组(8%vs 16%),组间差异无统计学意义(P>0.05)。病例组中小脑梗死18例(72%),脑干梗死5例(20%),枕叶梗死1例(4%),海马梗死1例(4%)。结论 以孤立性眩晕起病的急性脑梗死患者中男性发生急性脑梗死的风险显著高于女性,55岁以上...     

非典型后循环梗死75例临床分析

目的 探讨孤立性眩晕与后循环梗死的关系及临床特点.方法 收集诊治的75例孤立性眩晕患者,并行颈动脉B超、颅脑核磁等检查,将其分为眩晕组及梗死组,分析2组患者临床特征及其危险因素.结果 75例孤立性眩晕经颅脑核磁弥散检查明确后循环梗死患者17例,其中延髓梗死4例,桥脑梗死5例,中脑梗死2例,小脑梗死6例.脑梗死组患者高血压病、2型糖尿病、吸烟、＞65岁患者比例较眩晕组高,差异有统计学意义.结论 对于孤立性眩晕患者核磁共振检查是必要的检查项目之一,可对脑梗死进行早期鉴别诊断.有脑血管危险因素的老年孤立性眩晕患者梗死发生风险较高,临床中应引起重视.     

高血压与非高血压脑梗死患者危险因素分析

目的：探讨高血压与非高血压脑梗死的危险因素、亚型和预后的区别。方法：根据高血压病史将2440例脑梗死患者分为高血压组（1290例）和非高血压组（1150例）。对危险因素、脑梗死亚型和预后进行单因素和多因素分析。结果：高血压组既往脑梗死史、腔隙性脑梗死和后循环梗死发生率明显高于非高血压组。非高血压组高龄、心血管病和糖尿病明显多于高血压组，差异有统计学意义。结论：高血压、糖尿病、心血管病和高龄是脑梗死的主要危险因素，高血压是引起腔隙性脑梗死和后循环梗死的重要病因。     

252例脑梗死主要危险因素分析

目的 探讨脑梗死患者的主要危险因素。方法 对252例脑梗死患者的临床资料进行回顾性分析。结果 脑梗死发病主要危险因素有高血压病、高脂血症、心脏病、糖尿病、吸烟、卒中史和短暂性脑缺血发作，发病率随年龄增长呈上升趋势，男性多于女性。结论 高血压病、高脂血症、心脏病、糖尿病、吸烟、卒中史、短暂性脑缺血发作(TIA)为脑梗死患者的主要危险因素，控制好这些危险因素，对预防脑梗死发生和改善预后有重要的临床价值。     

脑梗死复发的危险因素分析

目的　了解脑梗死复发的危险因素。方法　采用回顾性对照分析。结果　发现脑梗死复发与高血压病史及病程、糖尿病、短暂性脑缺血发作 (TIA)、高脂血症、卒中家族史、吸烟或嗜酒有相关性。结论　高血压病史及病程、糖尿病、TIA、高脂血症、卒中家庭史、吸烟或嗜酒是脑梗死复发的危险因素     

高血压与非高血压脑梗死患者的临床观察

目的比较高血压和非高血压脑梗死患者的发病类型、危险因素以及预后差异。方法根据高血压病史将2003年5月～2008年6月收治的500例脑梗死患者分为高血压组（n=300例）,非高血压组（n=200例）,对其临床资料进行分析。结果非高血压组高血压脑梗死多,男性比例较高。高血压组后循环脑梗死与腔隙性脑梗死的发生率高于非高血压组;非高血压组的高龄、糖尿病和心血管病明显高于高血压组,差异有统计学意义。结论引起脑梗死最主要危险因素是高血压,尤其男性风险较高;非高血压脑梗死主要危险因素是高龄、糖尿病、心血管病。两组引起脑梗死最常见的为腔隙性脑梗死以及后循环梗死。     

多发性脑梗死性痴呆相关因素的临床分析

对多发性脑梗死性痂呆（MID）和无痂呆脑梗死患者的受教育程度,既往史、梗死部位进行对比分析,以探讨多发性脑梗死性痂呆发病的相关因素,结果,MID组受教育程度低,有高血压、糖尿病、≥2次卒中史,颞、顶、额叶、基底节、侧脑室旁多发性梗死、双侧梗死与对照组相比均有较显著差异（P＜0．05）。提示,文化水平低,高血压、糖尿病、反复卒中史是MID的危险因素、颞、顶、额叶、皮质下多发性梗死、双侧梗死与MID的发生有关。     

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.