溶栓治疗在急性心肌梗死患者的作用及护理

目的总结8例心肌梗死患者溶栓治疗的护理及体会。方法溶栓前后持续心电监护、监测生命体征、胸痛改善情况、定时复查心电图、CK-MB、血常规、PT+APTT、重视绝对卧床休息、做好心理护理。结果顺利渡过溶栓,通过溶栓达到了冠状动脉再通,心肌再灌注的目的 ,预防和减少了肾功能衰竭、严重心律失常及心力衰竭的发生。结论争取时间是溶栓成功的关键,冠状动脉再通率越高,护士必须熟悉溶栓方法有效指征和病情监测及护理要点。     

Over-expression of VEGF in marrow stromal cells promotes angiogenesis in rats with cerebral infarction via the synergistic effects of VEGF and Ang-2

This study explored whether the transplantation of modified marrow stromal cells (MSCs) has angiogenic effects in a left middle cerebral artery occlusion infarction/reperfusion (MCAO I/R) rat model and preliminarily examined the mechanism of angiogenesis following cerebral infarction.MSCs were isolated by using a direct adherent method and cultured.Vascular endothelial growth factor (VEGF) was transfected into MSCs by employing the liposome transfection.The transfection efficiency was measured by the optical density method.The protein expression of VEGF gene before and after transfection was measured by Western blotting.SD rat model of transient occlusion of the left middle cerebral artery was established by using an approach of intra-luminal occlusion.Tetrazolium (TTC) and HE staining were performed to observe the cerebral infarction.ELISAs were used to measure the levels of VEGF in the rat cerebral tissues.The expression patterns of angiopoietin-2 (Ang-2) and CD34 in cells surrounding the area of infarction were immunohistochemistrically oserved.Ang-2 protein expression in the tissue surrounding the area of infarction was measured by Western blotting.VEGF expression in the MSCs increased after transfection at a rate of approximately 28%±3.4%.ELISA showed that the expression of VEGF in the cerebral tissue was significantly increased after induction of infarction,peaking on the 4th day and decreasing to the levels of the sham surgery group (normal) within 7 to 10 days.The VEGF level was significantly higher at each time point in the VEGF-MSC and MSC groups compared to the model group.Moreover,the VEGF level was higher in the VEGF-MSC group than in the MSC group and stayed relatively high until the 10th day.The immunohistochemical results showed that 10 days after the infarction,the number of Ang-2 and CD34-expressing cells in the area surrounding the infarction was significantly higher in the VEGF-MSC group and the MSC group compared to the model group.Moreover,the VEGF level was higher in the VEGF-MSC group th     

血管回声跟踪技术检测2型糖尿病患者股动脉弹性

目的 应用血管同声跟踪(echo tracking,ET)技术评价2型糖尿病患者早期股动脉硬化.方法 选择60例2型糖尿病患者(糖尿病组)和60名体检结果正常者(对照组),以上对象均已行双侧股动脉常规高频超声检查排除斑块形成及狭窄,应用血管ET技术检测2组的双侧股动脉,比较2组的压力-应变弹性系数(Ep)、硬度指数(B)、顺应性(AC)及脉搏波传导速度(PWVβ).结果 糖尿病组的股动脉Ep、β、PWVβ均较对照组升高(均为P<0.01).AC较对照组降低(P<0.01).结论 血管ET技术能准确评价2型糖尿病患者早期股动脉弹性改变.为临床提供血管早期病变的诊断依据.     

晶体盐红细胞保存液的亚急性和细胞毒性观察

由中国医学科学院输血研究所研制的晶体盐红细胞保存液(SAGS),主要含氯化钠、腺嘌呤、葡萄糖、蔗糖和庆大霉素等成份,可用于分浆后压积(Hct≥90％)红细胞的重悬贮存和输用,能较好地维持红细胞的活力和功能,血液4℃保存期为35天,临床应用效果良好。为评价SAGS对人体应用的安全性,我们用改良的晶体盐红细胞保存液(SAGM,含氯化钠、腺嘌呤、葡萄糖和甘露醇)作对照,进行了亚急性和细胞毒性研究,结果如下。     

SAGS红细胞保存液的毒性研究

本文报道了SAGS红细胞保存液的毒性实验结果，表明SAGS对大鼠体重增长无影响；对动物心、肝、脾、肺、肾重量未见不良影响及病理损害；对红细胞、白细胞、血红蛋白、骨髓细胞的生成亦未见不良反应；对中国仓鼠肺成纤维细胞（V_(79)）无毒性反应。致突变试验显示：SAGS对Ames标准菌株无诱发基因点突变；无诱发小鼠骨髓细胞PCE微核增加；亦不诱发人外周血淋巴细胞姐妹染色单体互换（SCE）频率增加；即该剂无致突变作用。     

晶体盐红细胞保存液的致突变性和细胞毒性研究

由中国医学科学院输血研究所研制的晶体盐红细胞保存液(Saline-Adenine-Glllcose-Sucrose.SAGS),主要用于分浆后压积红细胞的重悬贮存与输用。经临床应用表明有扩充血容量,节约血浆、降低输血反应等优点。适用于内科心、肾和各种贫血病人,可选择性地用于外科手术和失血性休克病人,可配合全血输用。但从输液制品的质量监护出发,本实验旨在研究晶体盐红细胞     

用Ames法和致畸试验研究醋氨己酸锌的遗传毒性

用Ａｍｅｓ试验和致畸试验对醋氨己酸锌进行了致突变和致畸作用研究。结果表明醋氨己酸锌在Ａｍｅｓ试验的ＴＡ９７、ＴＡ９８、ＴＡ１００和ＴＡ１０２４个标准菌株±Ｓ９ｍｉｘ条件下,１－５０００μｇ／皿６个剂量的标准平皿掺入试验中,未诱发各菌株阳性突变反应。小鼠致畸试验３２７９ｍｇ／ｋｇ·ｂｗ、２６２３４ｍｇ／ｋｇ·ｂｗ和５２４６７ｍｇ／ｋｇ·ｂｗ剂量组,在母鼠妊娠期６－１５ｄｐ．ｏ给药,各剂量组活胎率与溶剂对照组比较,无显著差异（Ｐ＞００５）。对胎鼠外观、骨骼和内脏无致畸作用。但５２４６７ｍｇ／ｋｇ·ｂｗ组对妊娠母鼠体重、胎鼠体重和尾长有影响,显示一定的母体和胚胎毒性。     

头颈癌患者外周血PGE_2及SIL-2R水平测定

目的探讨头颈癌患者外周血PGE2及SIL－2R的临床意义。方法应用放射免疫分析法及双抗体夹心ELISA法分别检测头颈癌患者外周血PGE2及SIL－2R水平。结果头颈癌患者外周血PGE2、SIL－2R水平显著高于头颈部良性疾病患者及正常人（P＞0．05）。30例喉癌患者各期血浆中PGE2含量无差异（P＞0．05），但均显著高于正常人组（P＜0．05）。喉癌患者血清SIL－2R水平除1期与正常人无差异外，其余皆高于正常人组（P＜O．o1），且与临床分期有关。结论头颈癌患者外周血PGE2及SIL－2R水平显著增高，SIL－2R水平与喉癌临床分期密切相关。     

环卫工人血培养检出创伤弧菌并成功治愈1例

报道1例于山西省汾阳医院确诊的由创伤弧菌引起的血流感染病例,为创伤弧菌感染诊治提供参考依据。患者男性,系环卫工人,工作时不慎划伤右前臂,因右前臂肿痛伴发热入院,该患者近期居住当地,无外出务工史,无近期接触海水或生食海鲜史,入院第2天上午4瓶血培养瓶均报阳,对阳性血培养瓶肉汤直接涂片,同时转种至血平板、嗜血巧克力平板,镜下为革兰阴性杆菌,菌体呈弯曲杆状,下午（培养约7 h）取菌膜经基质辅助激光解析电离飞行时间质谱仪（matrix-assisted laser desorption ionization-time of flight mass spectrometer, MALDI-TOF MS）鉴定后为创伤弧菌。创伤弧菌所致的败血症死亡率较高,还可引起坏死性筋膜炎,在多学科的相互配合下,患者好转出院。通过此病例,对于发热和肢体红肿疼痛（肢体有外伤史）患者应将创伤弧菌感染纳入鉴别诊断,通过血培养等技术,及时找到病原菌,尽早手术干预,并成立多学科联合小组,可改善患者预后。