颈动脉粥样硬化斑块与脑梗死的相关性研究

目的探讨脑梗死与颈动脉粥样斑块硬化之间的关系。方法对脑梗死患者和非脑梗死患者进行颈动脉彩色多普勒超声检查,分析脑梗死与颈动脉粥样硬化斑块之间的关系。结果脑梗死组颈动脉粥样硬化斑块检出率、颈动脉软斑及混合斑检出率均明显高于对照组(P0.05);重型脑梗死的颈动脉软斑及混合斑检出率显著高于轻型脑梗死(P0.05)。结论脑梗死发病与颈动脉粥样硬化斑块相关。脑梗死病情的轻、重在一定程度上与硬化斑块的性质有关。     

颈动脉粥样硬化与急性脑梗死的关系探讨

目的通过对急性脑梗死患者进行颈动脉超声检测,探讨颈动脉粥样硬化与急性脑梗死之间的关系。方法选取2015-07—2016-07我院收治的急性脑梗死患者41例,同时选取同期健康体检者50例为对照组,所有患者均进行颈动脉超声检查,测量颈动脉后壁内中膜厚度(IMT)、血管内径、粥样硬化斑块形成、斑块数量、斑块回声强度、斑块部位及形态、管腔是否狭窄及狭窄程度。结果颈动脉斑块发生部位以颈总动脉分叉处发生率最高,其次为颈内动脉。实验组在颈内动脉分叉处、颈内动脉起始段发生率高于对照组(P0.01),实验组颈内动脉内膜增厚发生率高于对照组(P0.01)。颈动脉粥样硬化斑块类型以混合斑发生率最多,实验组其次为软斑、硬斑,对照组其次为硬斑、软斑。实验组软斑及混合斑发生率高于对照组(P0.05),2组硬斑发生率无显著差异(P0.05)。颈内动脉狭窄程度以轻度狭窄为主,2组轻度狭窄发生率无显著差异(P0.05),实验组中度狭窄及重度狭窄发生率明显高于对照组(P0.05)。结论颈动脉粥样硬化是引起缺血性脑梗死的重要原因,需对脑梗死及脑血管疾病患者行超声检测颈动脉,早期发现颈动脉的狭窄及斑块,给予早期干预,以降低脑血管疾病的发生。     

缺血性脑梗死与颅外段颈动脉粥样硬化及斑块类型的关系

目的探讨缺血性脑梗死患者与颅外段颈动脉粥样硬化及斑块形态学类型的关系。方法统计400名脑梗死患者,均经双功能超声检测颈总动脉、颈动脉分又、颈内动脉的内膜、中层厚度和斑块,分型：硬斑、软斑、混合斑。结果183例内膜中层增厚,231例颈动脉形成粥样斑块,提示：共297例（74．2％）颈动脉粥样硬化,并且斑块的类型与脑梗死形成有一定关系。结论缺血性脑梗死患者颈动脉颅外段的粥样斑块并不少见,软斑更易形成脑梗死。     

彩色多普勒超声对脑梗死患者颈动脉粥样硬化斑块的诊断价值

目的探讨彩色多普勒超声对脑梗死患者颈动脉粥样硬化斑块的诊断价值。方法选取198例脑梗死患者为实验组,102例非脑梗死病人为对照组,运用双功能超声显像仪对患者颈动脉进行检测,并记录管径、数量、斑块形态、血流参数等指标。对2组结果进行对比分析。结果实验组颈动脉粥样硬化斑块的检出率为81.6%,对照组为45.8%,检出率比较差异有统计学意义(P0.05);对照组以硬斑为主,实验组以扁平斑和硬斑为主,二者差异无统计学意义(P0.05)。但实验组软斑及溃疡斑发生率高于对照组,尤其是大面积脑梗死的软斑和溃疡斑的发生率比较差异具有统计学意义(P0.05)。实验组颅内梗死灶和颈动脉粥样硬化斑块存在侧向关系,与对照组相比差异有统计学意义(P0.05)。结论脑梗死与颈动脉粥样硬化斑块存在相关性,彩色多普勒超声在脑梗死患者颈动脉样硬化斑块的诊断中具有应用价值。     

颈动脉粥样斑块与脑梗死的关系

目的 探讨颈动脉粥样斑块与脑梗死的关系.方法 选取80例脑梗死患者进行颈动脉血管超声检查.结果 颈动脉粥样斑块与脑梗死部位存在同侧相关性,有软斑、混合斑的病人脑梗死的发生率较有硬斑的病人脑梗死的发生率明显增多(P＜0.05).结论 颈动脉粥样斑块脱落是脑梗死的重要危险因素,颈动脉血管超声检查可以监测颈动脉粥样斑块的存在及斑块的性状,给脑梗死提供防治的客观依据.     

Annexin A1、Lp-PLA2、Bax与人颈动脉粥样硬化斑块的关系

目的 探讨膜联蛋白A1(AnnexinA1)、脂蛋白相关磷脂酶A2(Lp-PLA2)和Bax与人颈动脉粥样硬化斑块形成及稳定性的关系. 方法 选择郑州大学第五附属医院血管外科自2010年5月至2011年6月行颈动脉内膜剥脱术(CEA)的颈动脉粥样硬化狭窄(＞70％)患者45例作为颈动脉粥样硬化组,根据术前颈动脉超声检查结果再分为软斑组、混合斑组、硬斑组,每组15例;选取郑州大学第一附属医院同期外科手术切除的正常肠系膜动脉标本20例作为标本对照组;选取社区健康志愿者20例作为健康对照组.酶联免疫法(ELISA)测定颈动脉粥样硬化组和健康对照组血清中Lp-PLA2的含量;反转录-聚合酶链反应(RT-PCR)和Western blotting分别检测颈动脉粥样硬化组和标本对照组中AnnexinA1、Bax mRNA和蛋白的表达. 结果 与健康对照组相比,软斑组、混合斑组、硬斑组患者血清中Lp-PLA2含量均增高,而且软斑组Lp-PLA2的含量高于硬斑组,差异有统计学意义(P＜0.05);与标本对照组相比,软斑组、混合斑组、硬斑组Annexin A1、Bax mRNA及蛋白表达水平均上调,而且软斑组Annexin A1 mRNA及蛋白表达水平低于硬斑组,Bax mRNA及蛋白表达水平高于硬斑组,差异均有统计学意义(P＜0.05). 结论 Annexin A1、Lp-PLA2和Bax参与了人颈动脉粥样硬化斑块的形成及稳定.     

高迁移率蛋白1、核因子-κB与人颈动脉粥样硬化斑块稳定性关系的研究

目的探讨高迁移率蛋白1(HMGB1)、核因子-κB(NF-κB)与人颈动脉粥样硬化斑块的稳定性关系。方法收集54例人颈动脉粥样硬化斑块标本作为颈动脉斑块组,其依据术前螺旋CTA检查将颈动脉粥样硬化斑块分为软斑组(A1组,n=21)、混合斑组(A2组,n=15)、硬斑组(A3组,n=18)。收集25例人肠系膜动脉标本及其血清作为对照组(B组,n=25)。分别采用反转录-聚合酶链反应(RT-PCR)及Western Blotting检测HMGB1mRNA及蛋白表达水平,用酶联免疫法(ELISA)法检测颈动脉斑块组和对照组血清中NF-κB含量。结果颈动脉粥样硬化斑块的HMGB1 mRNA及蛋白表达与对照组相比显著上调,差异有统计学意义(P<0.05);而且软斑组HMGB1 mRNA及蛋白表达水平明显高于硬斑组,差异有统计学意义(P<0.05);混合斑组与软斑组和硬斑组分别比较无统计学差异(P>0.05)。颈动脉斑块组患者血清中NF-κB含量明显高于对照组(P<0.05);其中软斑组患者血清中NF-κB含量明显高于混合斑及硬斑组(P<0.05);混合斑组与软斑组和硬斑组分别比较无统计学差异(P>0.05);颈动脉斑块组中NF-κB含量与HMGB1蛋白表达水平呈明显正相关表达(r=0.721,P<0.05)。结论 HMGB1和NF-κB与人颈动脉粥样硬化斑块稳定性密切相关,其可能成为预测人颈动脉斑块病变情况及稳定性的指标。     

颈动脉粥样硬化斑块与急性脑梗死患者血脂、血压关系的探讨

目的探讨急性脑梗死患者血脂浓度、血压与颈动脉粥样硬化斑块的关系。方法应用彩色多普勒超声检查急性脑梗死患者的颈动脉内膜-中膜厚度、斑块数和性状，同时检测血压。查血脂；121例急性脑梗死患者根据有无高血压分为脑梗死组47例、高血压并发脑梗死组74例，年龄相匹配的正常对照组35例。各项数据用SPSS10．0软件统计分析。结果脑梗死合并高血压组颈动脉粥样硬化斑块发生率最高（69．7％），且以软斑及混合斑为主，脑梗死组次之（59．6％），正常组最低（20％）。有颈动脉粥样硬化斑块与无颈动脉粥样硬化斑块相比．血清LDL—C水平明显升高。结论颈动脉粥样硬化斑决是脑梗死的重要危险因素，高血压及高LDL—C血症是颈动脉粥样硬化的危险因素．     

颈动脉粥样硬化斑块对脑梗死患者病情及其复发的影响

目的探讨颈动脉粥样硬化斑块对脑梗死患者病情及复发的影响。方法本研究采用前瞻性队列法设计。应用多普勒超声进行颈动脉斑块探查及定性,将患者分为斑块组和无斑块组。采用NIHSS评分法评估入选患者入院时、入院后第7 d、第14 d神经功能。对患者进行1年的随访,观察脑梗死复发情况。结果根据多普勒超声结果将患者分为斑块组173例(70.3%)和无斑块组73例(29.7%)。与无斑块组比较,斑块组年龄、NIHSS评分及高血压、糖尿病、高脂血症、高纤维蛋白原血症的比率均显著高于无斑块组(P0.05~0.01)。在完成随访的患者中,斑块组脑梗死复发39例(24.84%),复发时间为10.12个月;非易损斑块患者脑梗死复发时间为11.82个月,混合斑块患者为10.62个月,易损斑块患者为9.13个月。无斑块组脑梗死复发7例(10.45%),复发时间为11.56个月。斑块组脑梗死复发率显著高于,复发时间显著早于无斑块组(均P0.05)。易损斑块患者复发时间显著早于非易损斑块患者(P=0.034)。结论颈动脉粥样硬化斑块可使急性脑梗死的病情加重,复发率增高,尤其是易损斑块患者。     

阿托伐他汀治疗急性缺血性卒中患者颈动脉斑块临床研究

目的 探讨阿托伐他汀对脑梗死及短暂性脑缺血发作患者颈动脉粥样硬化斑块的治疗作用。方法 将126例伴有颈动脉粥样硬化斑块的脑梗死及短暂性脑缺血发作患者随机分为治疗组与对照组;治疗组口服阿托伐他汀及抗血小板聚集等常规治疗,对照组仅予抗血小板聚集等常规治疗,于治疗前、治疗后1个月、治疗后6个月进行血脂检测、颈动脉粥样硬化斑块的性质和内-中膜厚度检测,比较治疗前后总胆固醇（TC）、低密度脂蛋白-胆固醇（LDL-C）、高密度脂蛋白-胆固醇（HDL-C）、颈动脉斑块性质和内-中膜厚度的变化情况。结果 在完成随访的120例病例中,治疗组治疗1个月及6个月后TC和LDL-C水平均降低,差异有统计学差异（P＜0.01）。治疗组治疗6个月后颈动脉斑块内-中膜厚度变小,与治疗前及对照组比较差异有统计学意义（P＜0.01）。与对照组比较,治疗组在治疗后1个月与6个月时,低回声斑块与混合回声斑块所占比例均下降（P＜0.01）,高回声斑块所占比例均明显增高（P＜0.01）;在治疗组,服药后6个月与1个月相比较,高回声斑块所占比例显著增高（P＜0.01）;在对照组,治疗前后斑块性质变化不明显。结论 阿托伐他汀可有效降低TC和LDL-C水平,并有利于稳定、逆转颈动脉粥样硬化斑块。     

Fibrous xanthomas and xanthosarcomas of the meninges and the brain

Summary Three cases of intracranial fibrous xanthomas and a case of multicentric cerebral xanthosarcoma are reported. All three fibrous xanthomas developed in the temporal area of boys in their early teens, one was within the leptomeninges (without dural attachment), the other two involved meninges and the superficial portions of the temporal lobe itself. These tumors were characterized by mono- and multinucleated cells with morphological features of histiocytes, Touton type giant cells and a storiform pattern in areas of spindleshaped tumor cells.Because of cellular atypism, giant cells and mitotic figures such tumors may suggest the diagnosis of glioblastoma multiforme but the absence of glial fibers, negative Cajal impregnation, presence of reticulin fibers in close proximity to tumor cells and the morphological similarity to the bizarre cells found in atypical xanthofibromas of the skin and soft tissues help to establish the diagnosis. Since the menigeal forms are probably derived from local meningeal mesenchyme, occasional abortive whorls and pseudopsammoma bodies may be encountered, the overall picture, however, is very different from meningiomas. Two patients had a 2.5 and a 12 year long symptomfree survival, respectively. The third boy had a local recurrence 14 months after initial removal which was excised and the patient is presently doing well.The xanthosarcoma first developed in the right frontal lobe of a 26 year old woman. This tumor was almost exclusively made up of various sized anaplastic cells filled with birefringent lipids. It is suggested that this tumor which had a diffuse network of reticulin, had originated from primitive adventitial cells. It was histologically more malignant than the first three and the patient died within a year after removal of the frontal lobe tumor, from a second mass in the cerebellum. The relationship of this tumor to glioblastomas and to other types of giant cell sarcomas is discussed.This paper was presented in part at the 6th International Congress of Neuropathology in Paris, France, on August 31, 1970.     

Alz-50 immunoreactivity in the hypothalamus of the normal and Alzheimer human and the rat

Alz-50 is a monoclonal antibody recognizing a 68 kilodalton protein that is abundant in Alzheimer's disease (AD) but not detectable by immunoblotting methods in normal brains. When used for immunohistochemistry in AD cortex, Alz-50 recognizes large numbers of neurofibrillary tangles (NFT), neuritic plaques, and some neurons that show no evidence of neurofibrillary degeneration by conventional histopathological staining methods. Alz-50 immunoreactivity is described at the light and electron microscopic levels in the hypothalamus of brains obtained at autopsy from normal and AD subjects. Alz-50 immunoreactivity in the rat hypothalamus is also described. A well-defined population of Alz-50 immunoreactive hypothalamic neurons was identified in both the normal human and rat. At the light microscopic level in the normal human, immunoreactive neurons were most concentrated in the periventricular region, but were also scattered throughout the arcuate nucleus (ARC), lateral hypothalamic area, and tuberal region. Immunoreactive fibers were seen in the periventricular region, dorsal division of the ventromedial nucleus (VMNd), ARC, and external layer of the median eminence (ME). In the rat, reactive neurons were seen only in the periventricular region, and reactive fibers were seen in the periventricular zone, medial preoptic nuclear complex, suprachiasmatic nucleus, VMNd, ARC, and external layer of the ME. Ultrastructurally, all immunoreactivity in the normal human and rat hypothalamus was associated with intraneuronal vesicles. In the AD hypothalamus, Alz-50 identified numerous senile plaques and NFT in addition to the cells and fibers that were stained in the normal brains. Immunoreactive plaques and NFT were most numerous in regions previously reported to undergo neurofibrillary degeneration. At the ultrastructural level, the immunoreactivity in the AD hypothalamus was associated with filaments as well as vesicles. The significance of the selective staining of a specific population of vesicles by Alz-50 is unknown; however, the present results suggest that it is independent of AD pathology.     

Investigating the construct validity of the SPAI-C: comparing the sensitivity and specificity of the SPAI-C and the SAS-A

Investigates the construct validity of the Social Phobia and Anxiety Inventory for Children (SPAI-C) by comparing its sensitivity and specificity with another self-report measure of social anxiety, the Social Anxiety Scale for Adolescents (SAS-A). Participants were 252 adolescents (124 males and 128 females) 13-17 years old. Adolescents completed the SPAI-C and the SAS-A and were interviewed using the Anxiety Disorders Interview Schedule for DSM-IV: Child Version (ADIS-IV:C). Parents were also interviewed and composite diagnoses were formed. Youth were classified as socially phobic or non-anxious based on these composite diagnoses. By comparing clinical cutoff scores with diagnostic group classification, the sensitivity and the specificity of the SPAI-C and SAS-A were compared. Results indicated that the SPAI-C was a more sensitive measure than the SAS-A (61.5% vs. 43.6%) providing evidence of the scale's construct validity. The two measures were similar with regard to specificity (82.7% for both). Implications of these results for assessment and research are discussed.     

Imaging and modelling of digestion in the stomach and the duodenum

Gastroduodenal physiology is traditionally understood in terms of motor-secretory functions and their electrical, neural and hormonal controls. In contrast, the fluid-mechanical functions that retain and disperse particles, expose substrate to enzymes, or replenish the epithelial boundary with nutrients are little studied. Current ultrasound and magnetic resonance imaging allows to visualize processes critical to digestion like mixing, dilution, swelling, dispersion and elution. Methodological advances in fluid mechanics allow to numerically analyse the forces promoting digestion. Pressure and flow fields, the shear stresses dispersing particles or the effectiveness of bolus mixing can be computed using information on boundary movements and on the luminal contents. These technological advances promise many additional insights into the mechanical processes that promote digestion and absorption.