凝集素微量离心柱法检测甲胎蛋白异质体用于肝癌的诊断及分析

目的 应用凝集素微量离心柱法(ACSC)检测甲胎蛋白异质体(AFP-L3),分析AFP-L3在鉴别肝细胞癌(HCC)与良性肝脏病变中的价值.方法 选择132例临床检测AFP为阳性的肝病患者血清.应用装有耦联了小扁豆凝集素(LCA)的微量离心柱分离、洗脱获得AFP-L3,采用配套试剂在美国雅培AXSYM酶免疫分析仪检测AFP以及AFP-L3含量,计算AFP-L3在AFP中的比例即AFP-L3%.结果 以ACSC法分离AFP-L3操作简便;HCC患者血清AFP-L3%异常升高,其均值明显高于良性肝病患者(P<0.01);根据AFP-L3%计算受试者工作曲线(ROC)曲线下面积为0.807.以AFP-L3%≥10%为临界值,分析79例HCC患者与53例良性肝脏疾病患者,AFP-L3%异常的灵敏度为84.8%(67/79);特异性为92.5%(49/53),与临床总体符合率为87.9%.结论 应用ACSC辅助检测的AFP-L3在HCC与良性肝脏病变鉴别诊断中有一定临床价值.     

复发木尼孜其颗粒对大鼠心肌缺血/再灌注损伤的保护及其与核因子NF-κB信号通路的相关性

目的 探讨复方木尼孜其颗粒（Munziq）对大鼠模型心肌缺血/再灌注损伤（MIRI）的影响及其机制。方法 选择70只SD大鼠随机分为4组:正常假手术组（简称Con组）10只、正常缺血再灌注组（简称IR组）20只、复方木尼孜其颗粒组（5.06g/kg）20只、阿托伐他汀组（AT,20 mg/kg）20只,灌胃干预21天。检测各组心肌组织NIK, IKKα,pIKKα,及 p65表达及血清CTN-T、CK-MB、LDH、MDA IL-1β, IL-6, TNF-α, IL-10 及 ICAM-1含量。结果：心肌HE染色中复方木尼孜其组和阿托伐他汀组心肌细胞出现轻度颗粒变性和空泡变性。红细胞和淋巴细胞浸润,血管扩张和充血几乎没有观察到。同样这两组损伤心肌细胞的病理学特征均明显减轻。心肌细胞肿胀减少。cTn-T, CK-MB, LDH, 及 MDA水平变化：MIRI组的CTN-T、CK-MB、LDH、MDA水平显著高于假手术组（P＜0.05）。与MIRI组比较,复方木尼孜其颗粒和阿托伐他汀组的CTN-T、CK-MB、LDH、MDA含量显著降低（P＜0.05）。NIK, IKKα, pIKKα,及p65水平的变化：与假手术组相比,MIRI组的NIK、IKKα、PIKKα、P65水平显著高于对照组（P＜0.05）。而复方木尼孜其组和阿托伐他汀组的上述蛋白含量明显低于MIRI组（P＜0.05）。IL-1β, IL-6, TNF-α, IL-10 及 ICAM-1.水平变化： MIRI组IL-1β、IL-6、TNF-α、IL-10水平均高于假手术组（P＜0.05）。假手术组与MIRI组比较有显著性差异（P＜0.05）。复方木尼孜其与MIRI组、阿托伐他汀组和MIRI组比较差异有统计学意义（P＜0.05）。结论 复方木尼孜其颗粒在缺血再灌注损伤中具有心脏保护作用。这种作用可能通过抑制NF-κB信号通路来发挥作用。复方木尼孜其颗粒可能作为保护心脏围手术期心肌缺血再灌注损伤的干预药物。     

50例消化道出血的护理及体会

消化道出血是消化内科常见的疫病之一,其发病一般较快,发病原因比较复杂,症状表现不典型,并且并发症较多,往往会有较高的死亡率,若不及时就医或采取恰当的措施进行处理,往往会造成比较严重的后果,因此,加强对该病知识的宣教,及时准确地诊断并采取有效的止血措施,加强对患者的护理,可使患者快速脱离危险,甚至转危为安,从而有效降低患者的死亡率,提高治愈率。     

基质金属蛋白酶抑制剂抑制兔晶状体后囊膜混浊的研究

Objective To determine whether matrix metalloproteinase (MMP) inhibitor can provide therapeutic effects for rabbits posterior capsule opacification in vivo and to observe the side effects of this drug on surrounding intraocular structures. Methods Experimental research. New Zealand white rabbits were undertaken phacoemulsification operation. GM6001 at different concentrations ( 100,200 and 500 μmol/L)and GM6001 negative control liqueur were infused into the capsule bags of the rabbits at the end of operation and two days after the operation. The incidence of posterior capsule opacification was assessed and the histological sections of posterior capsules were observed under microscope 12 weeks after the surgery. The anterior chamber response was observed on day 2 post-operatively. The changes of intraocular pressure were measured by day 2 and day 7. Corneal endothelial cells were observed under scanning electron microscopeand iris, ciliary body and retina were observed under microscope on day 7. Results GM6001 significantly prevented posterior capsule opacification (P=0. 007 ). No opacification occurred on the rabbit posterior capsule in eyes with 200 and 500μmol/L GM6001 on week 12 post-operatively in vivo. No cells were found on posterior capsule in 500 μmol/L group, whereas lens epithelial cells and fibroblasts were found in the controls under microscope. No difference of anterior chamber flare between the eyes with GM6001 at different concentrations and the control group (P=0. 380) by day 2 after the operation. The intraocular pressure in eyes with GM6001 was the same as that in the control 2-days ( F = 0. 642, P = 0. 597 ) and 7-days ( F =0. 179 ,P =0. 909) post-operation. The corneal endothelial cells in eyes with 500 μ mol/L GM6001 arranged regularly and did not show any difference from that in the control eyes under scanning electron microscope 7-day after the operation. The iris, ciliary body and retina in eyes with 500 μmol/L GM6001 were normal in appearance 7-day after the operation. Conclusions MMP inhibitor can prevent posterior capsule opacification effectively in rabbits in vivo and does not cause damage to surrounding intraocular structures,suggesting that MMP inhibitor may become a medication used for the prevention of lens posterior capsule opacification.     

基质金属蛋白酶抑制剂抑制兔晶状体后囊膜混浊的研究

Objective To determine whether matrix metalloproteinase (MMP) inhibitor can provide therapeutic effects for rabbits posterior capsule opacification in vivo and to observe the side effects of this drug on surrounding intraocular structures. Methods Experimental research. New Zealand white rabbits were undertaken phacoemulsification operation. GM6001 at different concentrations ( 100,200 and 500 μmol/L)and GM6001 negative control liqueur were infused into the capsule bags of the rabbits at the end of operation and two days after the operation. The incidence of posterior capsule opacification was assessed and the histological sections of posterior capsules were observed under microscope 12 weeks after the surgery. The anterior chamber response was observed on day 2 post-operatively. The changes of intraocular pressure were measured by day 2 and day 7. Corneal endothelial cells were observed under scanning electron microscopeand iris, ciliary body and retina were observed under microscope on day 7. Results GM6001 significantly prevented posterior capsule opacification (P=0. 007 ). No opacification occurred on the rabbit posterior capsule in eyes with 200 and 500μmol/L GM6001 on week 12 post-operatively in vivo. No cells were found on posterior capsule in 500 μmol/L group, whereas lens epithelial cells and fibroblasts were found in the controls under microscope. No difference of anterior chamber flare between the eyes with GM6001 at different concentrations and the control group (P=0. 380) by day 2 after the operation. The intraocular pressure in eyes with GM6001 was the same as that in the control 2-days ( F = 0. 642, P = 0. 597 ) and 7-days ( F =0. 179 ,P =0. 909) post-operation. The corneal endothelial cells in eyes with 500 μ mol/L GM6001 arranged regularly and did not show any difference from that in the control eyes under scanning electron microscope 7-day after the operation. The iris, ciliary body and retina in eyes with 500 μmol/L GM6001 were normal in appearance 7-day after the operation. Conclusions MMP inhibitor can prevent posterior capsule opacification effectively in rabbits in vivo and does not cause damage to surrounding intraocular structures,suggesting that MMP inhibitor may become a medication used for the prevention of lens posterior capsule opacification.     

复方木尼孜其颗粒对大鼠心肌缺血再灌注损伤的影响

目的探讨复方木尼孜其颗粒对心肌缺血再灌注损伤(MIRI)大鼠模型的影响及其机制。方法选择96只SD大鼠随机分为8组:正常假手术组(Con组),正常缺血再灌注组(IR组),异常体液载体动物假手术组(AS组),异常体液载体动物心肌缺血再灌注组(AS+IR组),复方木尼孜其颗粒大剂量组(10.12g/kg)、中剂量组(5.06g/kg)、小剂量组(2.53g/kg),阿托伐他汀(AT)组(20mg/kg),每组12只,灌胃干预21天。检测各组心肌组织HSP70、CGRP表达及血清MAD、SOD、IL-6、IL-8含量。结果与IR组比较,AS+IR组、AS组、AT组、小剂量组CGRP表达升高(P0.01,P0.05);各给药组SOD升高,MDA、IL-6、IL-8降低(P0.01)。与AS组比较,AS+IR组CGRP表达上调(P0.05),大剂量组HSP70表达上调(P0.01),各给药组SOD升高(P0.01),IL-6降低(P0.01),大剂量组及AT组MDA降低(P0.01,P0.05)。与AS+IR组比较,大剂量和中剂量组CGRP表达降低(P0.01),各给药组HSP70、SOD升高(P0.01),MDA、IL-6及IL-8降低(P0.01)。结论复方木尼孜其颗粒可增加MIRI模型大鼠心肌保护性蛋白HSP70的表达,减轻MIRI后心肌的炎症反应,从而达到保护MIRI的疗效。     

动眼神经麻痹的定位诊断及治疗进展

动眼神经麻痹是一种可由多种病因导致的眼球运动异常、上睑下垂及瞳孔受损的疾病,是非共同性斜视的重要病因之一。动眼神经麻痹的临床表现为上睑下垂、眼球上转、内转、下转受限、患眼瞳孔散大及对光反应迟钝或消失。常见病因有脑血管疾病、头部外伤、肿瘤、炎症及内分泌代谢疾病等。本文着重从动眼神经的解剖路径、定位诊断、常见病因及治疗等方面,对动眼神经麻痹的临床特征及处理原则进行概述。     

儿童人工晶状体屈光力的计算

选择准确合适的人工晶状体是儿童白内障手术的关键,儿童人工晶状体屈光力的计算存在较大的预测误差,这是由测量误差和人工晶状体计算公式误差造成的,所以恰当地选择各类测量仪器和人工晶状体计算公式很重要.Holladay 2公式对短眼轴患儿计算人工晶状体数值更准确.应用该公式时,需要测量7个参数,即角膜白到白直径、晶状体厚度、眼轴长、角膜屈光力、术前前房深度、术前屈光状态及年龄.该公式一定程度上实现了人工晶状体屈光度数计算的个性化,但所需参数多,对患儿配合要求高.另外,随着年龄的增长以及眼球的发育成熟儿童眼睛屈光度仍会改变,所以我们还应选择正确的术后屈光目标.     

间歇性肾性糖尿一例

患者,男,52岁,体检时空腹血糖5.2mmol/L,尿糖4 ,疑为肾性糖尿。连续复查3天,血糖分别为:4.9、5.3、4.7mmol/L,尿糖阴性。第四天空腹血糖5.1mmol/L,尿糖又出现4 ,此后连续复查6天,结果见表一。肾性糖尿是指血糖浓度正常而出现糖尿,患者空腹血糖及糖耐量均正常。各种先天或获得性     

冠状动脉旁路移植术同期行室壁瘤切除术61例疗效分析

目的 探讨冠状动脉旁路移植术同期行左心室室壁瘤切除术的疗效。方法 2008年1月至2014年10月,对冠心病合并室壁瘤手术治疗的61例患者临床资料进行分析,其中男性51例,女性10例;年龄(51.9+4.2)岁。所有患者均行冠状动脉旁路移植术,同期行线性缝合术30例,心内膜环缩成形术31例,血栓清除术18例。结果 术后左心室舒张末期内径较术前缩小;左心室射血分数较术前升高;差异均有统计学意义(P<0.05),围术期死亡2例,均死于严重低心排综合征。53例术后随访3-18个月,随访率87%,心功能I~II级,1例术后12个月死于左心功能衰竭。结论 根据室壁瘤的大小和病变程度合理的选择手术方式、有效的心肌保护是手术成功的关键。