300例冠状动脉造影结果与舌象关系分析

冠状动脉粥样硬化性心脏病 (冠心病 )是一种严重危害人类健康的心脏病。由于冠状动脉的主要血管及分支发生粥样硬化 ,导致管腔狭窄或阻塞 ,引起心肌缺血 ,心肌坏死 ,因而又称为缺血性心脏病。我院心脏中心自 1997年 10月开展冠状动脉造影 (简称冠脉造影 )检查 ,现对 3 0 0例冠脉造影结果与舌象关系进行分析 ,探讨冠心病的舌象改变 ,以指导临床对冠心病的辨证施治。1　资料与方法1.1　一般资料　选取 1997年 10月— 2 0 0 1年 9月于我院进行冠脉造影的 3 0 0例住院病人 ,其中男 188例 ,女 112例 ,年龄5 9 .2 6岁± 10 .98岁。中医诊断及辨证…     

Human Papillomavirus and Tonsillar and Base of Tongue Cancer

In 2007, human papillomavirus (HPV) type 16 was recognized as a risk factor by the International Agency for Research on Cancer, for oropharyngeal squamous cell carcinoma (OSCC), where tonsillar and base of tongue cancer (TSCC and BOTSCC) dominate. Furthermore, patients with HPV-positive TSCC and BOTSCC, had a much better clinical outcome than those with corresponding HPV-negative cancer and other head and neck cancer. More specifically, survival was around 80% for HPV-positive TSCC and BOTSCC vs. 40% five-year disease free survival, for the corresponding HPV-negative tumors with conventional radiotherapy and surgery, while this could not be observed for HPV-positive OSCC at other sites. In addition, the past 20–40 years in many Western Countries, the incidence of HPV-positive TSCC and BOTSCC has risen, and >70% are men. This has resulted in a relative increase of patients with HPV-positive TSCC and BOTSCC that may not need the intensified chemo-radiotherapy (with many more severe debilitating side effects) often given today to patients with head and neck cancer. However, before tapering therapy, one needs to enable selection of patients for such treatment, by identifying clinical and molecular markers that together with HPV-positive status will better predict patient prognosis and response to therapy. To conclude, there is a new increasing group of patients with HPV-positive TSCC and BOTSCC with good clinical outcome, where options for better-tailored therapy are needed. For prevention, it would be of benefit to vaccinate both girls and boys against HPV16 infection. For potential future screening the ways to do so need optimizing.     

Vallecular cysts in newborns and young infants

Vallecular cyst is a rare cause of stridor and respiratory distress in infancy and has been associated with sudden airway obstruction resulting in death. In a retrospective review of eight cases over a 20-year period all infants developed symptoms during the first week of life. All had stridor and feeding difficulties and two required endotracheal intubation. Other common findings included signs of increased work of breathing and episodes of cyanosis. Failure to thrive was present in five patients diagnosed later than the first week of life. An abnormal or a hoarse cry was present in only two patients. Diagnosis in all cases was made by endoscopy. Where a VC is clinically suspected, it is important to stress the need to visualize the base of the tongue during any diagnostic endoscopic procedure. At endoscopy, a smooth localized mass arising from and distorting the lingual surface of the epiglottis was identified. Histologically, the cysts contained respiratory epithelium with mucous glands with an external lining of squamous epithelium. Treatment by cyst marsupialization is safe and definitive, in particular when performed by CO2 laser.     

Differences in Joint Mobility and Foot Pressures Between Black and White Diabetic Patients

Limited joint mobility is common in diabetes and is related to high foot pressures and foot ulceration. We have examined the differences in joint mobility and foot pressures in four groups matched for age, sex, and duration of diabetes: 31 white diabetic, 33 white non-diabetic, 24 black diabetic, and 22 non-diabetic black subjects. Joint mobility was assessed using a goniometer at the fifth metacarpal, first metatarsal, and subtalar joints. In-shoe and without shoes foot pressures were measured using an F-Scan system. Neuropathy was evaluated using clinical symptoms (Neuropathy Symptom Score), signs (Neuropathy Disability Score), and Vibration Perception Threshold. There was no difference between white and black diabetic patients in Neuropathy Symptom Score, Neuropathy Disability Score, and Vibration Perception Threshold. Subtalar joint mobility was significantly reduced in white diabetic patients (22 ± 7°) compared to white controls (26 ± 4°, black diabetic patients (25 ± 5°), and black controls (29 ± 7°), and increased in black controls compared to white controls and black diabetic patients (level of statistical significance p < 0.05). Without shoes foot pressures were higher in white diabetic patients (8.31 ± 400 kg cm^?2) compared to white controls (6.81 ± 2.31 kg cm^a2), black diabetic patients (6.2 ± 2.53 kg cm^?2) and black controls (5.00 ± 1.24 kg cm^?2) and lower in black controls compared to white and black diabetic patients (p < 0.05 in all cases). We conclude that racial differences exist in joint mobility and foot pressures between black and white subjects. Thus, in black diabetic patients the joint mobility, although reduced compared to black healthy subjects, is increased when compared to white diabetic patients. This contributes to lower foot pressures, comparable to non-diabetic white subjects and probably reduces the risk of foot ulceration in black diabetic patients.     

Effects of Three Techniques on Maximum Posterior Movement of the Tongue Base

Effects of three techniques designed to improve maximum range of posterior movement of the base of tongue were investigated under videofluoroscopy in 20 subjects. Retraction of the tongue base during 3-ml pudding swallows, tongue pull-back, yawn, and gargle tasks was measured in millimeters, with the second cervical vertebra as a reference point and was judged subjectively as well. The gargle task was the most successful in eliciting most tongue base retraction for the group of subjects, although not in every subject. Gargle also resulted in greater tongue base movement than swallow more often than the other two voluntary tasks. Clinicians' subjective judgment of ``most' retracted tongue base position was generally reliable in comparison with actual measurements. The number of repeat swallows on each bolus correlated significantly with the approximate percentage of residue in the valleculae as judged clinically.     

高血压与焦虑抑郁障碍相关性的研究进展

研究发现,高血压与焦虑抑郁障碍密切相关,现就近年有关高血压与焦虑抑郁情绪之间的相关性研究进展做一简要综述。     

高血压与炎症的研究进展

高血压病的发生机制是一个复杂的病理过程。其中,全身动脉血管炎症反应参与高血压的病理生理过程,它是多种炎症细胞、递质、细胞因子共同作用的结果。现综述炎性细胞、炎性细胞因子在高血压发生发展过程中的作用,并介绍高血压的抗炎治疗进展。     

年龄与血液流变学关系的探讨

许多报道表明,血液流变学上的异常变化与许多老年病如心脑血管病、肺心病、视网膜血管栓塞的病因、病情和病程有关。但血液流变学与年龄关系,至今未见报道,本文对以上及有关问题进行了探讨。     

体温与卒中的关系

体温是影响脑缺血预后的一个重要因素。发热通过多种机制可直接或间接与卒中有关。文章回顾 了体温与脑缺血的关系以及体温对预后的影响,探讨了其可能的机制。     

MicroRNA和动脉粥样硬化的关系

MicroRNA是一组生物进化过程中高度保守的非编码的小RNA,在转录后水平调节基因表达.研究显示MircoRNA在心血管系统中高度表达,在动脉粥样硬化中起重要的作用.MicroRNA126,MicroRNA221/222,MicroRNA92-a参与调节内皮细胞功能与血管生成, MicroRNA217促进内皮细胞的衰老,MicroRNA221/222,MicroRNA34对内皮祖细胞有调节作用,MicroRNA145/143,MicroRNA221/222参与调节血管平滑肌细胞的表型转化,增殖和迁移.MicroRNA-125a-5p参与巨噬细胞对致动脉粥样硬化脂质的炎症应答.本文简要介绍近年有关MicroRNA与动脉粥样硬化关系研究的部分进展.     

Functional Base of Tongue Fat Injection in a Patient with Severe Postradiation Dysphagia

Lipofilling is a well-established technique in reconstructive plastic surgery. It is used primarily in recontouring of the body and face to correct post-traumatic and congenital defects. The regenerative properties of adipose tissue have allowed the use of the lipofilling technique for the treatment of burn sequelae and irradiated breast to improve tissue quality and elasticity. We report on the case of a patient treated with radiation therapy for a nasopharyngeal carcinoma who presented with severe postradiation dysphagia. The lipofilling technique was successfully used to improve abnormal swallowing. The technical details and functional outcomes are discussed.     

The Association Between Callus Formation,High Pressures and Neuropathy in Diabetic Foot Ulceration

The presence of an ulcer beneath callus on the diabetic foot has been a well-documented and common clinical finding. We have conducted a prospective study to examine whether callus can be used to predict plantar intrinsic neuropathic diabetic foot ulcer formation. Sixty-three diabetic patients (43 male, 25 Type 1), median age 62 years (IQ range 52, 67), median diabetes duration 17 years (IQ range 8,25) participated in the study. All had neuropathy and peak plantar foot pressures (measured using a dynamic optical pedobarograph) ⩾10 kg cm⁻². Calluses and previous ulcers were documented and classified. All ulcers occurring prior to and during the study were recorded, re-examination was 15.4 (range 10–22) months from baseline. Seven ulcers (6 patients) occurred during the study. Pressures were higher in the ulcer than non-ulcer sub-group (p = 0.04) with a relative risk of developing an ulcer of 4.7 for an area of elevated plantar pressure. This compares with a relative risk of 11.0 for an ulcer developing under an area of callus, and a relative risk of 56.8 for an ulcer developing on a site of previous ulceration. This study confirms that a history of previous ulceration is the highest risk factor for ulceration and demonstrates, for the first time, that the presence of plantar callus is highly predictive of subsequent ulceration. Careful history taking and examination of the foot to detect the presence of callus require no special training or equipment and callus should be recognized as a ‘high risk’ factor for foot ulceration.     

半胱氨酸蛋白酶抑制因子Cystatin C基因与中国人脑卒中的关系

目的本文通过多中心病例．对照研究，拟探讨Cystatin C基因启动子区多态性位点rs2897119（-177C／T）和rs6114208（-1704C／G）与中国人脑卒中和血浆中半胱氨酸水平的关系。方法采用聚合酶链反应-限制性片段长度多态性（PCR-RFLP）分析技术，检测脑卒中组520例（血栓性脑梗塞组211例，腔隙性脑梗塞组145例，脑出血组164例），和非脑卒中对照组630例Cystatin C基因多态性的分布。用高效液相色谱仪和荧光检测仪测定血浆总Hey水平。结果脑卒中组和对照组Cystatin C基因rs2897119和rs6114208多态性基因型频数分布符合Hardy-Weinber平衡。两组rs2897119和rs6114208多态性基因型和等位基因型分布差异无明显统计学意义。各亚型组与对照组的基因型和等位基因型相比差异也均无显著统计学意义。两组多态性基因型与相应血浆同型半胱氨酸的水平也无显著统计学意义。结论Cystatin C基因多肽位点rs2897119（-177C／T）和rs6114208（-1704C／G）与中国人脑卒中和血浆同型半胱氨酸的水平不存在关联关系。Cystatin C基因多肽位点rs2897119和rs6114208可能不是中国人脑卒中的遗传影响因素。     

过氧化物酶与动物衰老关系的研究

本文研究了不同月龄小白鼠体内过氧化物酶(POD) 活性的变化。结果表明,随着小鼠月龄增加,POD的活性明显降低(P<0.01)。提示过氧化物酶观察是动物衰老的客观指标之一。     

兰尼碱受体2调节及其与心律失常的关系

兰尼碱受体2是广泛存在于肌浆网上的Ca2+释放通道,受到多种因子的调节,兰尼碱受体2参与心肌细胞的兴奋-收缩耦联,兰尼碱受体2的结构或调节异常与心力衰竭及致死性心律失常的发生关系密切。现对兰尼碱受体2的结构、调节及其在心律失常中的作用机制作一阐述。