D-二聚体定量测定在AMI溶栓治疗监测中的应用

目的:观察急性心肌梗死(AMI)患者溶栓治疗前后D-二聚体含量的变化,探讨在AMI患者溶栓治治疗监测中的应用.方法:对46例AMI患者,测定在溶栓治疗前及治疗后1h、2h、4h、6h、8h、12h、24h、48h、72h、168h血浆D-二聚体的含量及正常对照组30例D-二聚体含量.结果:再通组与未通和未溶栓组比较,溶栓治疗前无显著差异(P＞0.05),溶栓治疗后再通组与其它两组有非常显著的差异(P＜0.01),于溶栓后6h达高峰.结论:D-二聚体定量测定在AMI溶栓治疗监测中,是一项非常有价值的指标,与溶栓治疗效果有密切相关性.     

D-二聚体和肌钙蛋白I在急性心肌梗死与主动脉夹层早期鉴别中的应用

目的 探讨D-二聚体、肌钙蛋白I(cTnI)在急性心肌梗死(acute myocardial infarction,AMI)与主动脉夹层(aortic dissection,AD)早期鉴别中的诊断价值.方法 选取2019年1月至2020年12月来我院住院治疗的相关病例进行回顾性分析,比较2组患者一般资料、入院后首次D-二聚体及cTnI的检测水平;绘制ROC曲线分析D-二聚体、cTnI及二者联合检测对AMI与AD早期鉴别的诊断价值.结果(1)2组患者年龄、高血压、高血脂、糖尿病病史比较,差异具有统计学意义(P<0.05),男性比例比较,差异无统计学意义(P>0.05);(2)AD组患者血浆D-二聚体水平显著高于AMI组患者,AMI组患者血浆cTnI水平显著高于AD组患者,差异均具有统计学意义(P<0.05);(3)ROC曲线显示,D-二聚体鉴别诊断AMI和AD的AUC为0.955,95％CI在0.930～0.981之间,最佳界点值为1.40μg/mL,灵敏度、特异性为0.877、0.934;cTnI鉴别诊断AMI和AD的AUC为0.843,95％CI在0.801～0.885之间,最佳界点值为0.07ng/mL,灵敏度、特异性为0.886、0.705;D-二聚体联合cTnI鉴别诊断AMI和AD的AUC为0.982,95％CI在0.969～0.994之间,灵敏度、特异性为0.930、0.958,差异具有统计学意义(P<0.05).结论 D-二聚体、cTnI联合检测对急性心肌梗死与主动脉夹层的早期鉴别有较高的诊断价值.     

尿激酶辅助 PCI 术治疗 STEMI 患者的疗效评价

目的:探究尿激酶(Urokinase,UK)辅助经皮冠状动脉介入术(Percutaneous coronary intervention,PCI)治疗急性ST段抬高型心肌梗死(ST-segment elevation myocardial infarction,STEMI)患者的效果.方法:回顾性收集2017年1月至2020年4月我院104例STEMI患者,按治疗方案不同分成A组、B组,各52例.B组接受PCI治疗,A组接受UK辅助PCI治疗.对比两组患者术后即刻心肌灌注情况、治疗前与治疗30 d后血清细胞因子指标、半乳糖凝集素-3(Galectin-3,Gal-3)、N末端脑钠肽元(N-terminal pro-brain natriuretic peptide,NT-proBNP)水平及心脏不良事件发生率等.结果:A组心肌梗死溶栓实验血流分级较B组优,ST段回落率较B组高,心脏不良事件发生率较B组低(P<0.05);与治疗前相比,各治疗组的血清白细胞介素-6、肿瘤坏死因子-α、NT-proBNP、GAL-3水平均明显降低(P<0.05),其中A组更为显著(P<0.05).结论:UK辅助PCI术治疗STEMI患者能进一步改善心肌灌注情况,缓解炎性反应,促进病情恢复,降低心脏不良事件发生风险.     

非对称二甲基精氨酸测定在急性冠脉综合征中的临床应用价值

目的 探讨血浆非对称二甲基精氨酸（ADMA）浓度与急性冠状动脉综合征（ACS）及其不同亚组之间的相关性,以及对ACS的早期诊断价值.方法 将随机选择的102例ACS患者根据临床诊断、心电图检查及冠状动脉造影结果,分为不稳定型心绞痛（UA）组（51例）、非ST段抬高性心肌梗死（NSTEMI）组（27例）和ST段抬高性心肌梗死（STEMI）组（24例）,其中NSTEMI组和STEMI组又同属于急性心肌梗死（AMI）组;对照组（24例）为同期冠状动脉造影正常的患者.通过酶联免疫分析法（E LISA）测定血浆ADMA含量.结果 ACS组血浆ADMA浓度显著高于对照组,血浆ADMA浓度在UA和AMI两组间差异无统计学意义.ADMA的ROC曲线的曲线下面积AUC为0.813（0.7 ＜A ＜0.9）,cut-off值为5.28μg/L.结论 UA、NSTEMI、STEMI三组中血浆ADMA浓度皆升高,且有组间差异,血浆ADMA浓度对ACS有中等水平的诊断价值.     

尼可地尔辅助治疗对老年糖尿病并STEMI患者的疗效观察

目的:探究尼可地尔辅助治疗对老年糖尿病并急性ST段抬高心肌梗死(Acute ST-segment elevation myocardial infarction,STEMI)患者心室重构、心肌损伤指标及心肌微循环的影响.方法:选取我科2017年10月至2020年10月期间125例老年糖尿病并STEMI患者为研究对象,根据入院顺序分为两组,对照组62例给予依那普利叶酸片,观察组63例增加尼可地尔,治疗12 w后对比两组患者心室重构、心肌损伤指标、心肌微循环.结果:观察组左心室舒张末期内径、左心室舒张末期容积指数水平低于对照组,左心室射血分数水平高于对照组(P<0.05);观察组肌钙蛋白、心肌酶同工酶、脑利钠肽前体变化水平低于对照组(P<0.05);观察组局部心肌血容量(A值)、心肌内血流灌注速度(β值)和局部心肌血流量(A*β值)高于对照组(P<0.05).结论:尼可地尔辅助治疗对老年糖尿病并STEMI患者疗效确切,可改善心肌微循环,降低心肌损伤程度,促进心功能恢复.     

D-二聚体在急性心肌梗死治疗中的检测分析

目的:探讨D-二聚体在急性心肌梗死治疗的诊断效果。方法:对我院2009年5月至2010年5月诊治的50例急性心肌梗死患者检测结果进行分析,于治疗前、治疗后1h、6h、12h检测D-二聚体水平。并选择门诊体检的50例健康成人作为对照组进行比较。所有患者均行心电图、心肌酶谱和超声检查。结果:急性心肌梗死的超声心动图表现为节段性室壁异常,梗死区对应的心室壁运动幅度降低,室壁变薄或消失,心室壁回声异常(表现为增强或减弱),心内膜回声不均匀。有42例被诊断超声心动图诊断为心肌梗死,检出率为84%。溶栓治疗后D-二聚体水平逐渐升高,6h达到峰值,12h时有所回落。溶栓前心肌梗死患者的D-二聚体均显著高于正常对照组。溶栓前及溶栓后不同超声诊断结果的心肌梗死患者其D-二聚体差异无统计学意义。结论:将定量的D-二聚体检查和定性的超声检查结合起来,验证了超声诊断心肌梗死血栓的可靠性,对于辅助指导临床合理用药有较大的帮助,值得在临床上推广应用。     

自动成像技术评价不同透壁程度急性心肌梗死患者左心室纵向收缩功能

目的应用自动功能成像(AFI)技术评价不同透壁程度急性心肌梗死(AMI)患者室壁运动特点,探讨其在诊断心肌梗死中的应用价值。方法选择47例首次确诊AMI患者(AMI组),其中男性30例,女性17例;年龄39～77岁,平均年龄56.7岁。选择50例健康体检者(对照组),其中男性36例,女性14例;年龄40～75岁,平均年龄52.1岁。AMI组根据心电图分为非ST段抬高型(NSTEMI)亚组和ST段抬高型(STEMI)亚组。超声心动图获得左心室心尖长轴切面、心尖四腔切面和心尖两腔切面,左心室心尖部、乳头肌、二尖瓣水平各短轴切面的二维灰阶动态图像,通过图像分析测定AFI参数及左心室射血分数(LVEF),进行各组统计学分析。结果 AMI组、NSTEMI亚组、STEMI亚组分别与对照组比较,左心室整体收缩期纵向峰值应变(LPSS)均减低(t=-5.923、-3.656、-9.377, P0.01),梗死节段心肌LPSS较正常对应节段心肌LPSS明显减低,差异有显著统计学意义(t=-11.422、-9.957、-12.135,P0.01)。NSTEMI亚组梗死节段心内膜LPSS与STEMI亚组比较,差异无统计学意义(t=-1.840,P 0.05),但心外膜LPSS高于STEMI亚组,差异有显著统计学意义(t=-14.523,P0.01)。NSTEMI亚组梗死节段心内膜LPSS低于对照组,差异有显著统计学意义(t=-13.902,P 0.01);心外膜LPSS与对照组比较,差异无统计学意义(t=-1.927,P 0.05)。AMI组、STEMI亚组分别与对照组比较,LVEF均减低,差异有显著统计学意义(t=5.909、11.638, P0.01);NSTEMI亚组与对照组LVEF比较,差异无统计学意义(t=1.985,P 0.05);NSTEMI亚组与STEMI亚组LVEF比较,差异有显著统计学意义(t=6.841,P0.01)。结论 AFI技术可以准确评估不同透壁AMI室壁节段性运动异常的特点,准确检测AMI受累范围及程度,具有广泛临床应用价值。     

比索洛尔和美托洛尔对PCI术后患者心率变异性及血液流变学状态的影响

目的:探讨比索洛尔和美托洛尔对经皮冠状动脉(Percutaneous coronary intervention,PCI)术后患者心率变异性及血液流变学状态影响.方法:选取本院2020年1月至2022年1月PCI术后167例急性ST段抬高型心肌梗死(Acute ST-segment elevation myocardial infarction,STEMI)患者为研究对象,随机分为比索洛尔组(n=84)和美托洛尔组(n=83),比索洛尔组给予比索洛尔治疗,美托洛尔组给予美托洛尔治疗,两组均治疗3 m.比较两组患者治疗前后心率变异性(窦性心搏RR间期标准差、R间期平均值标准差、相邻RR间期差值均方根),血液流变学指标(纤维蛋白原、血浆黏度)及治疗期间不良反应发生率.结果:治疗后比索洛尔组心率变异性指标高于美托洛尔组(P<0.05);治疗后比索洛尔组血液流变学指标低于美托洛尔组(P<0.05);两组用药后不良反应发生率无明显差异(P>0.05).结论:比索洛尔治疗PCI术后STEMI患者临床治疗效果优于美托洛尔,能够有效改善患者血流动力学及心率变异性且用药安全性较高.     

不同肺部疾病患者血小板计数和血浆D-二聚体水平分析

目的:检测分析不同肺部疾病患者血小板计数和血浆D-二聚体水平变化。方法:测定95例涂阳肺结核、110例结核性胸膜炎、38例肺炎及45例肺癌患者入院治疗前血小板计数及血浆D-二聚体水平,比较不同疾病组之间以及与健康对照组测定水平的差异。结果:涂阳肺结核、结核性胸膜炎和肺癌组血小板计数明显高于健康对照组,差异有统计学意义(P0.05);涂阳肺结核、结核性胸膜炎明显高于肺癌组(P0.05)。所有疾病组的血浆D-二聚体水平均明显高于健康对照组,差异有统计学意义(P0.05),以结核性胸膜炎组最高;结核性胸膜炎组和肺癌组高于细菌性肺炎组和肺结核组(P0.05)。结论:血小板计数和血浆D-二聚体水平测定有利于临床医师了解上述患者凝血功能和/或血栓性病变。     

D-二聚体与冠心病的关系研究

目的研究血浆D-二聚体含量与冠心病症状严重程度关系.方法对急性心肌梗死(AMI)15例、心绞痛35例和30例健康人D-二聚体含量对比. 结果冠心病D-二聚体水平明显高于健康对照组,其中AMI组增高更显著. 结论高水平D-二聚体是冠心病发病中的一个危险因素,并与病变程度有关.     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.     

The case for allele‐specific recognition by the TCR

There is a sharp difference in how one views TCR structure–function–behaviour dependent on whether its recognition of major histocompatibility complex‐encoded restriction elements (R) is germline selected or somatically generated. The generally accepted or Standard model is built on the assumption that recognition of R is by the V regions of the αβ TCR, which is not driven by allele specificity, whereas the competing model posits that recognition of R is allele‐specific. The establishing of allele‐specific recognition of R by the TCR would rule out the Standard model and clear the road to a consideration of a competing construct, the Tritope model. Here, the case for allele‐specific recognition (germline selected) is detailed making it obvious that the Standard model is untenable.     

The universal muscular chamber. A basic unit of the genitourinary, cardiovascular, gastro-intestinal, skeletal, cutaneous, respiratory and other systems, endocameral hypertension; and spasm, the key to their idiopathic diseases and arthropathies

Starting with the integument, we see many organs are contractile sacs or multiples thereof, which tubes or bags constitute the major part of the entire body. Recognition of this basic unit and its characteristics sheds new light, individually and collectively, on many disorders previously considered unrelated. Muscular tears and perforations develop in the walls of these chambers, being no way peculiar to those organs, wherein, hydrochloric acid occurs. So, it is not necessary to explain the absence of excessive acid from patients who exhibit holes in the gastric, uterine, aortic, duodenal, rectal, pulmonary, retina, and other walls. Muscle, not acid is the great common factor relating idiopathic disorders in the gastrointestinal tract to each other and to similar diseases in other systems. When the units are linked together, the lesions tend to appear as arthropathies, i.e. at the joints. Rephrasing common-place observations, frees us from conventional, conceptual cul-de-sacs. An observation is only as good as its interpretation, so all possibilities must be considered, otherwise, we will remain blinded by our misconceptions.