纳米氧化锌对大鼠血脂和血清炎症因子水平的影响

目的:探讨纳米氧化锌对动脉粥样硬化发生发展的影响机制。方法:40只雄性Wistar大鼠随机分为对照组和纳米氧化锌低、中、高剂量组,每组10只。纳米氧化锌低、中、高剂量组大鼠分别用1.25、2.50、5.00mg/kg的纳米氧化锌悬浮液气管灌注染毒,对照组大鼠同法灌注PBS溶液(1mL/kg),每周1次,共12周;染毒结束后测定各组大鼠体质量、血清总胆固醇(TC)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、肿瘤坏死因子α(TNF-α)和血红素加氧酶-1(HO-1)水平。结果:随染毒时间延长,染毒大鼠逐渐出现毛发蓬松,活动减少,精神状态差,生长缓慢等体征。各组大鼠血清HDL、LDL、TNF-α、HO-1、TC水平比较差异有统计学意义(F=32.410、34.600、23.957、38.519、32.652,P<0.001)。纳米氧化锌中、高剂量组大鼠血清TC、LDL、HO-1、TNF-α水平均高于对照组(P<0.05);纳米氧化锌低、中、高剂量组大鼠血清HDL水平均低于对照组(P<0.05)。结论:纳米氧化锌可引起大鼠血清脂代谢紊乱和炎症因子释放,可能导致动脉粥样硬化的发生发展。     

Expression of core?binding factor alpha 1 and collagen Ⅱ in patients with chronic kidney disease stage 5

Objective To study the relationship between the medial artery calcification and expression of core?binding factor alpha 1 (Cbfα?1) and collagen Ⅱ (ColⅡ) in chronic kidney disease(CKD) stage 5 patients. Methods Pieces of radial arteries were taken from 40 patients with CKD stage 5 during internal arteriovenous fistula operation. Ten patients with subtotal gastrectomy and normal renal function were chosen as control. The vessels were examined for calcification by von Kossa stain and for the presence of Cbfα?1 and ColⅡ by immunohistochemistry. According to von Kossa stain, CKD stage 5 patients were divided into no calcification group, mild?moderate calcification group and severe calcification group. Other related factors including serum calcium,phosphate, intact parathyroid hormone (iPTH), C?reactive protein (CRP), triglyceride(TG), cholesterol(TC) and low?density lipoproteins(LDL) were also detected. Results Seventeen (42.5%) of CKD Stage 5 patients showed vascular calcification, while calcification was not found in controls. Most calcification occurred in medial layer．Positive immunohistochemical staining of core?binding factor and ColⅡ was found in the smooth muscular cell plasma of medial layer in the vessels with calcification. However, above positive staining was also observed in 78.3% of no calcification group. But there was little staining in control group. Positive staining score of Cbfα?1 and ColⅡ in severe calcification group was significantly higher than that in no calcification group. Same findings were obtained in mild?moderate calcification group, but the difference between them was not statistically significant. CRP and Ca×P were positively correlated with staining score of Cbfα?1 and ColⅡ. Serum phosphate was positively correlated with Cbfα?1 (r=0.786, P<0.01) and ColⅡ (r=0.785, P<0.01) respectively． Conclusions 42.5% of CKD stage 5 patients in our group shows vascular calcification, which occurrs mainly in medial layer. High expression of Cbfα?1 and ColⅡ can be observed in vascular calcification of radial arteries, which is earlier than vascular histological changes. Cbfα?1 and ColⅡ may be involved in the development of vascular calcification.     

42d龄婴儿脑外间隙与新生儿缺氧缺血性脑病关系的CT分析

目的 研究42d龄婴儿脑外间隙与新生儿期缺氧缺血性脑病的关系,回顾性评价新生儿期缺氧缺血性脑病的诊断并及时指导临床给予适当治疗改善预后.方法 将38例新生儿期患轻度缺氧缺血性脑病的42 d龄婴儿作为一组,将28例因呼吸道引起发热、惊厥以及外伤而行CT头颅检查,并且结果 为阴性的同龄婴儿作为对照组,分别测量2组婴儿的脑外间隙宽度并进行统计学分析.结果 缺氧缺血性脑病组婴儿的额前间隙及前纵裂间隙宽度明显大于对照组,有显著性差异(P＜0.01),而外侧裂间隙宽度的比较无统计学意义(P＞0.05).结论 通过对42 d龄婴儿额前间隙及前纵裂间隙宽度的测量分析有助于新生儿期缺氧缺血性脑病的诊断.     

硬化注射缝合加内扩括约肌侧切治疗直肠前突的临床研究

目的 探讨硬化注射缝合后加内扩括约肌侧切法治疗直肠前突的有效性.方法 将64例中度及中度以上的直肠前突患者随机分成两组,各32例.试验组行硬化注射缝合加内扩括约肌侧切法治疗,对照组行经直肠切开修补术,并观察两组的治疗效果及并发症.结果 治疗后两组患者症状评分较治疗前降低,两组治疗效果相比无统计学差异,但试验组在术中出血、术后疼痛等并发症方面则优于对照组.结论 硬化注射加柱状缝合法是一种简便有效的治疗直肠前突的方法.     

硬化注射缝合加内扩括约肌侧切治疗直肠前突的临床研究

目的探讨硬化注射缝合后加内扩括约肌侧切法治疗直肠前突的有效性。方法将64例中度及中度以上的直肠前突患者随机分成两组,各32例。试验组行硬化注射缝合加内扩括约肌侧切法治疗,对照组行经直肠切开修补术,并观察两组的治疗效果及并发症。结果治疗后两组患者症状评分较治疗前降低,两组治疗效果相比无统计学差异,但试验组在术中出血、术后疼痛等并发症方面则优于对照组。结论硬化注射加柱状缝合法是一种简便有效的治疗直肠前突的方法。     

Clinical observation and analysis on the comprehensive intervention in the treatment of hypertension complications

目的 研究高血压及其合并疾病、并发症在高血压综合干预进程中的变化趋势,以利于更科学制定高血压的治疗方案.方法 自1999年起我们对本单位高血压患者实施了5年综合干预治疗措施,以门诊病历、随访和年度体检为依据,追踪记录血压患者合并冠心病、糖尿病和血脂异常的发生情况;根据高血压患者是否伴有糖尿病和血脂异常,分为低危组(A组:一般高血压)、中危组(B组:高血压伴糖尿病或血脂异常)和高危组(C组:高血压伴糖尿病和血脂异常),分别统计高血压患者临床并发症的发生率,并进行x2检验.结果 与1999年相比较,2003年高血压患者治疗率由67.6％提高到了90.7％,控制率由50.3％提高到了76.8％,知晓率由69.2％提高到了96.4％,差异均有统计学意义(P＜0.05).高血压合并冠心病的发生率由9.5％上升到12.3％,合并糖尿病的发生率由13.3％上升到16.9％,合并血脂异常的发生率由36.0％上升到43.4％.追踪观察1999-2003年高血压患者临床并发症的发生情况,左心室肥厚、心肌梗死、冠状动脉血运重建、心力衰竭、视网膜病变、腔隙性脑梗塞、缺血性卒中、出血性卒中和肾脏损害的发生率均呈逐年下降趋势.比较高血压患者综合干预治疗前后5年间临床并发症的发生情况,心肌梗死、视网膜病变、缺血性脑卒中和肾脏损害的发生率分别由1.55％、15.32％、3.39％和9.02％下降至1.53％、10.99％、1.82％和6.05％,差异均有统计学意义(P＜0.05);三组危险等级临床并发症的发生率随危险等级的升高,心肌梗死、冠状动脉血运重建、视网膜病变、腔隙性脑梗塞、缺血性卒中和肾脏损害的发生率分别由1.01％、0.14％、7.09％、2.75％、1.45％和1.45％上升至3.85％、2.56％、16.03％、6.41％、3.21％和16.03％,差异均有统计学意义(P＜0.05).结论 与传统的治疗方法比较,高血压综合干预治疗能有效降低临床并发症的发生风险,尤其能有效减少心肌梗死、视网膜病变、缺血性脑卒中和肾脏损害的发生率.     

Investigation on the high risk factors of 3786 patients with myocardial infarction in Shenzhen city

目的 调查分析深圳市心肌梗死患者高危因素.方法 选取2011年1～12月3 786例心肌梗死患者为研究对象,将所有患者的发病高危因素进行调查研究.结果 3 786例心肌梗死患者的高危因素包括基本资料、生活习惯及伴随疾病情况等三个大的方面,其中年龄≥65岁的发病率高于55～64岁、45～54岁及≤44岁者,男性发病率高于女性,BMI≥30者高于25～30及＜25者,有家族史者高于无家族史者,吸烟、饮酒者高于未进行吸烟、饮酒者,锻炼较少者高于其他,伴随基础疾病者高于其他,均P＜0.05,差异有统计学意义,多因素Logistic回归分析显示上述研究指标均为心肌梗死发生的独立危险因素.结论 心肌梗死的高危因素主要包括基本资料、生活习惯及伴随疾病情况等三方面,应给予高危人群足够的重视以预防心肌梗死的发生.     

Developing a Web 2.0 Diabetes Care Support System with Evaluation from Care Provider Perspectives

Diabetes is a life-long illness condition that many diabetic patients end up with related complications resulted largely from lacking of proper supports. The success of diabetes care relies mainly on patient’s daily self-care activities and care providers’ continuous support. However, the self-care activities are socially bounded with patient’s everyday schedules that can easily be forgotten or neglected and the care support from providers has yet been fully implemented. This study develops a Web 2.0 diabetes care support system for patients to integrate required self-care activities with different context in order to enhance patient’s care knowledge and behavior adherence. The system also supports care managers in a health service center to conduct patient management through collecting patient’s daily physiological information, sharing care information, and maintaining patient-provider relationships. After the development, we evaluate the acceptance of the system through a group of nursing staffs.     

Processing Environmental Stimuli in Paranoid Schizophrenia: Recognizing Facial Emotions and Performing Executive Functions

ObjectiveTo study the contribution of executive function to abnormal recognition of facial expressions of emotion in schizophrenia patients.MethodsAbnormal recognition of facial expressions of emotion was assayed according to Japanese and Caucasian facial expressions of emotion (JACFEE), Wisconsin card sorting test (WCST), positive and negative symptom scale, and Hamilton anxiety and depression scale, respectively, in 88 paranoid schizophrenia patients and 75 healthy volunteers.ResultsPatients scored higher on the Positive and Negative Symptom Scale and the Hamilton Anxiety and Depression Scales, displayed lower JACFEE recognition accuracies and poorer WCST performances. The JACFEE recognition accuracy of contempt and disgust was negatively correlated with the negative symptom scale score while the recognition accuracy of fear was positively with the positive symptom scale score and the recognition accuracy of surprise was negatively with the general psychopathology score in patients. Moreover, the WCST could predict the JACFEE recognition accuracy of contempt, disgust, and sadness in patients, and the perseverative errors negatively predicted the recognition accuracy of sadness in healthy volunteers. The JACFEE recognition accuracy of sadness could predict the WCST categories in paranoid schizophrenia patients.ConclusionRecognition accuracy of social-/moral emotions, such as contempt, disgust and sadness is related to the executive function in paranoid schizophrenia patients, especially when regarding sadness.     

Tamsulosin as medical expulsive therapy for lower ureterolithiasis： A meta-analysis

ObjectiveTo review the evidence for tamsulosin as medical expulsive therapy in enhancing the effectiveness of distal ureteral stone clearance rate.MethodsWe searched Pubmed/Medline, Embase, CBM and the Cochrane Library up to October 2011. All randomized controlled trials in which tamsulosin was evaluated with distal ureterolithiasis were eligible for the analysis. Outcome measure assessed was stone clearance rate. Two authors independently assessed study quality and extracted data. All data were analyzed using RevMan 5.1.ResultsThirteen studies involving 1067 participants met the inclusion criteria. Study duration ranged from 7 to 42 d. The pooled analysis showed an improvement of 41% in stone clearance rate of tamsulosin as medical expulsive therapy for distal ureteral calculi (RR=1.41, 95% CI=1.18 to 1.70). According to stone size (6 mmRR=1.52, 1.75, 1.05, 95% CI=1.30 to 1.77, 1.25 to 2.45, 0.95 to 1.16, respectively). Adverse effects of tamsulosin, mainly retrograde ejaculation, dizziness and hypotension, were reported in 7 included trials.ConclusionTreatment with tamsulosin appears to be a safe and effective medical expulsion therapy for distal ureterolithiasis. To make a definite clinical recommendation to use tamsulosin as medical expulsive treatment for distal ureteral calculi, high quality multicentric, randomized, double blinded, controlled trials are necessary to prove its efficacy.