黔南州汉族、布依族、苗族冠心病患者血脂水平比较研究

选择2011年1月²013年12月在贵州省黔南民族医学高等专科学校第二附属医院首次确诊冠心病汉族患者113例,布依族107例,苗族患者103例为研究对象,分别检测三民族患者血清TG、TC、HDL-C、LDL-C、Lp(a)、ApoAⅠ、ApoB含量水平及ApoB/ApoAⅠ比值,并进行统计学分析。结果布依族组冠心病患者基本资料、血脂、脂蛋白(a)、载脂蛋白AⅠ、载脂蛋白B水平及ApoB/ApoAⅠ比值分别与汉族组和苗族组比较,差异均有统计学意义(P<0.01);布依族血脂正常率为27.10%、高血脂率44.85%、边缘升高血脂率28.04%;汉族组为56.64%、18.58%、19.47%;苗族为66.02%、19.42%、14.56%。布依族组正常血脂、高血脂及边缘升高血脂发生率分别与汉族组和苗族组比较,差异均有统计学意义(P<0.01)。黔南地区布依族冠心病患者血脂水平及高血脂发生率与汉族和苗族存在一定差异。     

尘肺并发肺癌标记物的临床应用

尘肺一旦并发肺癌,可促使尘肺结节融合,加速尘肺的进展,而尘肺又加快肺癌的生长。为早期发现肺癌,尽早进行肿瘤标记物的检测,检测肿瘤标记物对肿瘤的早期诊断、观察评价治疗效果及判断预后具有重要意义。我们就尘肺并发肺癌标记物在临床中的应用进行了探讨。     

功能性内镜鼻窦手术的并发症及其处理方法

功能性内镜鼻窦手术(functional endoscopic sinussurgery,FESS)是在鼻腔鼻窦生理学、病理生理学的理论指导下的内镜手术方法,是通过鼻内镜下的鼻窦开放治疗慢性和复发鼻窦炎的一种新的术式,其方法由Messerklinger于1978年首先介绍。手术的目的是仅去除不可逆病变组织,重建和恢复鼻窦通气引流及黏膜纤毛清除功能。Kennedy将此术式命名为功能性鼻内镜手术(FESS)。自90年代初EFSS在国内开展以来,功能性鼻镜手术在我国发展较快,手术涉及     

原发性高血压动态血压曲线平滑指数与早期肾功能损害的关系

目的 研究反映血压波动程度的新指标动态血压曲线平滑指数（SI）与原发性高血压（EH）患者早期肾功能损害的关系。方法 选择89例EH患者进行24h动态血压监测（ABPM），分析动态血压曲线SI、动态血压变异性（ABPV）。同时用放射免疫法测定早晨微量白蛋白尿（MAU），根据MAU量分为EH早期肾功能异常组41例（MAU≥8．68mg／L）和正常组48例（MAU〈8．68mg／L）。结果 肾功能异常组24h收缩压ABPV（24h SABPV）、夜间收缩压ABPV（nSABPV）明显高于肾功能正常组（P〈0．05）。24h收缩压SI（24h SiS）、24h舒张压SI（24 h SID）、夜间收缩压SI（nSIS）、夜间舒张压SI（nSID）明显低于肾功能正常组（P〈0．01）。多元逐步回归分析：MAU与24 h SABPV呈正相关；与24 h SIS、nSIS、nSID之间呈负相关。结论 SI可以作为一种反映血压波动的新监测指标，其与ABPV联合观察可以更好地反映血压的波动与早期肾功能损害的关系。     

乙型肝炎病毒母婴传播抗病毒联合免疫阻断研究进展

全世界约有20亿人感染HBV,其中约有3.5亿人成为慢性感染者[1].中国是乙型肝炎的高流行区,全国HBV的平均携带率为9.7%,其中25%以上的携带者将发展为慢性肝炎,并可能进展为肝硬化和肝癌[2].     

自然戒断期成瘾药物依赖者CD4^+CD25^+CD127^(low)调节性T细胞的变化特征及意义北大核心CSCD

目的研究自然戒断期成瘾药物依赖者外周血CD4+CD25+CD127low调节性T细胞(Treg)及外周血单个核细胞(PBMC)中转化生长因子-β1(TGF-β1)mRNA表达水平的变化,探讨成瘾药物对成瘾药物依赖者体内Treg的影响。方法采集自然戒断6个月和18个月半的成瘾药物依赖者各40例及30例健康人的外周血,使用流式细胞仪检测Treg,用RT-PCR检测PBMC中TGF-β1 mRNA表达水平。结果与对照组比较,戒断18个月组Treg、TGF-β1 mRNA含量显著增高,而戒毒6个月组未发现显著性变化。结论成瘾药物对依赖者Treg的影响是长期性的,其介导的Treg异常,可能是引起成瘾药物依赖者免疫功能紊乱的原因之一。     

瑞芬太尼复合普鲁泊福靶控输注用于脊柱手术中控制性降压临床研究

目的探讨瑞芬太尼复合普鲁泊福靶控输注用于脊柱手术中控制性降压的安全性与可行性。方法选择60例ASA分级I～Ⅱ级拟在全麻下行脊柱手术患者,以随机数字表法分为观察组（30例）和对照组（30例）。观察组设定瑞芬太尼血浆靶浓度4μg／L,普鲁泊福3mg／L维持麻醉：对照组用瑞芬太尼0．1μg／（kg·min）持续输注并吸人2％异氟烷维持麻醉。手术进入骨质操作时行控制性降压,观察组提高瑞芬太尼血浆靶浓度5μg／L,普鲁泊福6mg／L;对照组使用瑞芬太尼0．15μg／（kg·min）输注并吸人2．5％异氟烷;降压目标为平均动脉压（MAP）60～65mmHg（1mmHg=0．133kPa）,必要时辅用硝酸甘油0．5～1．0μg／（kg·min）静脉输注降压。结果控制性降压后两组患者MAP均达到降压目标。观察组和对照组降压中5、30、60minMAP均显著低于降压前（P〈0．05）;观察组停止降压10min、对照组停止降压30minMAP恢复至降压前水平。观察组降压中5、30、60min心搴（HR）均显著低于降压前（P〈0．05）;观察组停止降压10minHR恢复至降压前水平;对照缉停止降压5、10、30minHR均显著高于降压前（P〈0．05）。观察组降压前后中心静脉压（CVP）比较差异无统计学意义（P〉0．05）;对照组降压后30minCVP显著低于降压前（P〈0．05）。需辅用硝酸F‘油降压者观察组3例（10％）;对照组18例（60％）,两组比较差异有统计学意义（P〈0．05）。结论在脊柱手术中使用瑞芬太尼复合普鲁泊福行控制性降压,具有迅速、易于维持、停止降压后血压恢复快、安全、有效、易于调控的特点;并且降压更平稳,对CVP、HR影响小,不影响患者术毕清醒和拔管,是全麻手术行控制性降压较好的选择药物。     

中成药联和TDP腹部照射治疗慢性盆腔炎的疗效观察

目的:了解中成药止痛化癥胶囊联合TDP(特定电磁波治疗仪)下腹部照射治疗慢性盆腔炎的临床效果。方法:给49例慢性盆腔炎患者口服止痛化癥胶囊的同时,每天TDP下腹部照射共3个疗程。结果:49例反复腹痛患者治疗3个疗程后,腹痛消失者42例,7例有减轻。结论:中成药止痛化癥胶囊联合TDP腹部照射治疗慢性盆腔炎有较好的疗效。     

用支架内引流替换T管外引流的胆总管术式

胆总管切开后传统处理方法为T管引流,但放置T管有许多不利因素。近年来寻找安全、微创、价廉、适应证广、易推广的胆总管一期缝合方法成为重要课题。我科2006年1月以来应用“胆道塑料支架”作内引流代替T管外引流行胆道减压,并行胆总管一期缝合术,疗效满意,无严重不良反应发生,现报道如下。     

燃煤污染型氟中毒大鼠学习记忆能力及胆碱酯酶活性改变

Objective To observe the influence of coal burning fluorosis on learning and memory ability in rats and reveal its possible mechanisms. Methods Healthy 48 SD rats were divided into control, low-fluoride and high-fluoride group. All rats in fluoride exposed groups were fed with the eom polluted by drying processes with burning coal containing high level of fluoride obtained from the endemic fluorosis area to produce the animal model of fluorosis. The experiment period were 3,6 mouths, respectively. The ability of leaning and memory was measured by Morris test and cholinesterase activity detected by photometric method at 3 or 6 month after experiment, respectively. Results Fluoride contents signifieantlly influenced the escape latency, the numbers of crossing the platforms and the time of staying the platforms(the value of F was 29.29,6.47,6.50, respectively, P<0.01).In addition, the numbers of crossing the platforms and the time of staying the platforms were influenced by the exposed time(the value of F was 16.11,45.59, P<0.01). Furthermore, the fluoride contents and the exposed time had an interaction between the numbers of crossing the platforms and the time of staying the platforms (the value of F was 4.67,5.68, P<0.05 or<0.01). Three months after the experiment, the mean values of escape latency [(14.71± 4.85)s] of rats in highly fluoride exposed group were significantly prolonged as compared with controls [(9.28±4.22)s]; 6 month after the experiment, the mean values of escape latency[(12.42±8.03)s, (17.48± 8.05)s] of rats in both groups exposed to fluoride were significantly prolonged as compared to controls [(7.04± 3.29)s, P<0.05]. The decreased numbers of crossing the platforms[(1.62±0.87)number] and the declined time of staying the platforms[(16.70±5.02)s] were found in the rats exposed to high fluoride as compared to controls [(3.53±1.67 )number, (23.33±5.35)s, P<0.05]. The fluoride contents obviously influenced the activities of acetylcholinesterase and butylcolinesterase (the value of F was 12.83,13.27, P<0.01). On the other hand, the times of breeding also influnced the activities of butylcolinesterase (the value of F was 16.26, P<0.01). In 3 months of the experiment, the activities of butylcolinesterase [(0.55±0.12)kU/g] in low fluoride exposed group were significantly decreased in comparison with controls[(0.73±0.10)kU/g, P<0.05]. The activities of acetylcholinesterase[(0.62±0.42)kU/g] and butylcolioesterase[(0.58±0.10)kU/g] in high fluoride group were significantly decreased as compared to eontrois[(1.41±0.52), (0.73±0.10)kU/g, P<0.05]. The correlation analysis showed that there was a negative correlation between the cholinesterase and the escape latency(r=-0.68, P< 0.01), and a positive correlation between the cholinesterase and the time of staying the platforms(r=0.57, P< 0.01). Conclusions The ability of learning and memory in rats with coal buring fluorosis was decreased, which might be connected to the decreased activity of cholinesterase in a dose-effect correlation.