颈动脉粥样硬化斑块与血浆髓过氧化物酶预测冠状动脉狭窄程度

目的 探讨以颈动脉内-中膜厚度(IMT)、粥样斑块Crouse积分联合血浆髓过氧化物酶(MPO)浓度预测冠状动脉粥样硬化性心脏病患者冠状动脉狭窄程度的价值.方法 收集131例疑似急性冠脉综合征患者,均于入院第2天接受血浆MPO浓度检测,入院1周内接受冠状动脉造影(CAG)及颈动脉超声检查.根据CAG结果将其分为冠心病组和对照组,计算颈动脉斑块的IMT积分及粥样斑块Crouse积分,应用ROC分析分别比较颈动脉IMT积分、粥样斑块Crouse积分、血浆MPO浓度及三者联合检测冠心病的价值.结果 冠心病组血浆MPO浓度、颈动脉IMT和粥样斑块Crouse积分均明显高于对照组(P均＜0.01),IMT积分、Crouse积分及血浆MPO浓度均与冠状动脉狭窄程度呈正相关.IMT积分、Crouse积分、MPO及三者联合检测冠心病的ROC曲线下面积分别为0.657、0.792、0.785及0.814,提示三者联合预测冠状动脉狭窄程度明显优于单个指标.结论 联合应用彩色多普勒超声检测颈动脉IMT及粥样斑块Crouse积分与血浆MPO浓度检测可作为评估冠状动脉粥样硬化性心脏病患者血管狭窄程度的有效辅助方法.     

重组人粒细胞集落刺激因子对Aβ1-42诱导老年痴呆模型大鼠认知功能的改善作用

目的 探讨重组人粒细胞集落刺激因子(rhG-CSF)对老年痴呆模型大鼠认知障碍的改善以及抗凋亡方面的作用.方法 随机将84只健康雄性Wistar大鼠分为Aβ组、rhG-CSF治疗组及假手术组,每组28只.注射Aβ1-42 10μg制备Alzheimer病模型.rhG-CSF组皮下注射rhG-CSF 50μg/(kg·d),Aβ组给予同体积牛理盐水,连续5d.分别于给药后第7,14,21,28天进行Morris水迷宫测试,记录其逃避潜伏期和目的 象限游泳距离百分比,然后取脑组织采用免疫组织化学法检测海马区caspase-3蛋白的表达,计数免疫阳性细胞数.结果 (1)给药后第14、21、28天,rhG-CSF组逃避潜伏期[分别为(34.33±6.47)s,(42.08±6.36)s,(46.88±7.66)s],短于AB组[分别为(49.79±4.87)s,(50.25±6.81)s,(51.33±6.90)s],rhG-CSF组目的 象限游泳距离百分比[分别为(41.00±7.62)%,(43.33±8.16)%,(44.67±8.07)%],长于AB组[分别为(25.33 ±6.89)%,(23.83±4.67)%,(21.50±4.64)%],差异均具有显著性(P<0.05).(2)假手术组海马区Caspase-3蛋白表达差异无显著性;注射Aβ1-42后,AB组、rhG-CSF组与 假手术组相比各时间段海马区Caspase-3蛋白的表达明显增加(P<0.05);给予rhG-CSF后,rhG-CSF组第7、14天caspase-3蛋白表达[分别为(7.93±6.33),(8.83±5.94)],明显低于Aβ组[分别为(10.43±7.16),(11.34±5.17)],差异具有显著性(P<0.05),第21,28天两组比较差异无显著性.结论 rhG-CSF能改善Aβ1-42诱导Alzheimer病模型大鼠的认知障碍,减少海马神经元的凋亡,在一定程度上延缓学习记忆功能的衰退.

Abstract：

Objective To investigate the effects of rhG-CSF on the improvement of cognitive impairment and anti-apoptosis of Alzheimer disease (AD) induced by Aβ1-42 in rat. Methods Healthy male Wistarirats were randomly assigned to the Aβ group, treatment group and sham operation group. Aβ1-42 (10μg) was injected into bilateral hippocampus to create the rat model of AD. Rats in rhG-CSF group were subcutaneously subjected to 50μg/(kg · d) rhG-CSF for 5 days, while rats in Aβ group were subjected to normal saline. Morris water maze tests were done and expressions of caspase-3 protein were determined by immunohistochemical method on the 7th, 14th, 21st, and 28th day after administration. Results (1) The avoiding latent periods of rhG-CSF group ( ( 34. 33 ±6. 47 ) s, (42. 08 ± 6. 36 ) s, (46. 88 ± 7. 66 ) s, respectively ) were shorter than that of Ap group ((49.79 ±4.87)s, (50.25 ±6.81 )s, (51. 33 ±6.90)s, respectively). The percentages of swimming distances in the target quadrant in rhG-CSF group ( (41.00 ±7.62)% ,(43.33 ±8. 16)% ,(44. 67 ±8.07)% ,respectively) were increased comparing with Ap group((25.33 ±6.89)% , (23. 83 ±4.67)% ,(21.50 ±4.64)% ,respectively). The differences were all statistically significant (P<0.05). (2) Compared with sham operation group,the positive rate of caspase-3 protein in rat's hippocampus of Ap group significantly increased after injecting Aβ1-42 The positive rates of caspase-3 protein in rhG-CSF group on the 7th, 14th day ( (7. 93 ±6. 33) and (8. 83 ±5. 94) were lower than Aβ group ( ( 10.43 ±7. 16) and ( 11. 34 ± 5. 17 ) . The differences were statistically significant (P< 0.05). Conclusion RhG-CSF can improve the cognitive impairment of Alzheimer Disease (AD) induced by Aβ1-42 in rat, decrease the apoptosis of hippocampal neurons and delay the decline of its learning and memory ability to some extent.     

高频振荡通气叠加常频通气治疗新生儿重症气胸的临床疗效研究

目的探讨高频振荡通气叠加常频通气治疗新生儿气胸的临床疗效。方法选取2006年1月-2011年1月我院收治的重症气胸并呼吸衰竭新生儿49例,均进行胸腔闭式引流。25例高频振荡通气（HFOV）治疗设为对照组,24例高频振荡通气叠加常频通气（HFOV＋SIMV）治疗设为治疗组,观察两组患儿2、8、12、24h吸入氧浓度、动脉血气氧分压、二氧化碳分压、氧合指数以及胸片恢复时间、呼吸机使用时间、住院天数、住院费用。结果治疗不同时间,治疗组吸入氧浓度、动脉血气氧分压、二氧化碳分压、氧合指数、动脉／肺泡氧分压比值与对照组相比差异有显著性（P〈0．05）。治疗组胸片恢复时间、呼吸机使用时间、住院天数、住院费用优于对照组,差异有显著意义（P〈0．05）。结论高频振荡通气叠加常频通气治疗新生儿重症气胸较单纯高频振荡通气治疗疗效显著。     

重组牛碱性成纤维细胞生长因子联合藻酸盐敷料治疗老年人慢性溃疡创面

目的:观察外用重组牛碱性成纤维细胞生长因子(rb-bFGF)联合藻酸盐敷料治疗老年人慢性溃疡创面的临床效果.方法:将90例有慢性溃疡创面的老年患者按收治的先后顺序随机分为联合组(采用rb-bFGF联合藻酸盐敷料治疗)、bFGF组(采用rb-bFGF治疗)和常规组,每组30例.比较3组治疗第1、7、14、21天创面渗液量...     

糖尿病及其合并视网膜病变者特质应对方式分析

目的了解糖尿病及其合并视网膜病变患者的特质应对方式及其影响因素。方法采用特质应对方式问卷(TCSQ)和自编的基本情况问卷对51例正常对照者和331例糖尿病及其合并视网膜病变者进行调查。了解患者特质应对得分情况,通过广义线性回归分析其影响因素。结果糖尿病及其合并视网膜病变者消极应对得分均高于正常对照者(P<0.05)。广义线性回归分析显示,年龄越大、文化程度和家庭人均月收入越高、病情越轻的患者易采取积极应对(P均<0.05);年龄越小、文化程度和家庭人均月收入越低、病情越重的患者则倾向于采取消极应对(P均<0.05)。结论年龄、文化程度、家庭人均月收入、病情是影响患者特质应对的主要因素。应根据患者的不同特点,有针对性地指导其积极应对疾病,从而提高生存质量。     

加热与常温渗漉-层析提取工艺对丹参水提物的影响

分别采用渗漉层析耦合和不同温度下加热提取工艺,从同一批丹参中提取水溶性成分丹酚酸,并采用高效液相色谱分析产物,研究提取工艺和温度对丹参水提物中丹酚酸B的含量、提取率及产物色谱谱图的影响。结果表明,用渗漉层析耦合工艺得到的丹参水提物中的丹酚酸B含量最高且小分子酚酸类化合物很少;采用加热提取工艺时小分子酚酸类化合物种类及含量随温度（60~100 ℃）的升高而增加,丹酚酸B含量及提取率随提取温度的升高呈现由高到低又增高的规律、两者在100 ℃时达到最大值。研究表明应根据对丹参水提物及其制剂的质量与安全性要求选择合适的工艺及工艺条件。     

沉默视黄酸核受体α损伤大鼠原代海马神经元的钙兴奋性

目的:了解视黄酸核受体α (RARα)对大鼠神经元功能的必要性.方法:采用组织消化原代贴壁法分离培养大鼠原代海马神经元,利用腺病毒载体特异沉默RARα;利用Real-Time PCR分析沉默RARα对神经元视黄酸(RA)信号各受体以及神经细胞标志物的影响;利用活细胞钙影像分析沉默RARα对神经元钙兴奋性的影响.结果:免...     

良性前列腺增生与肥胖相关性研究

目的 探讨良性前列腺增生(BPH)与肥胖或中心性肥胖的关系.方法 选择老年男性患者109例,分为BPH组(59例)和非BPH组(50例),检测血清前列腺特异性抗原(PSA)及性激素、血脂等相关生化指标;测量身高、体质量、腰围等物理指标;经腹超声测量前列腺体积,并随访至少3次.结果 肥胖组BPH患病率(73.33%)及超体质量组BPH患病率(64.28%)均较正常组(26.67%)增高(x2分别为13.991,6.836,均P＜0.002),中心性肥胖组BPH患病率(71.19%)较非中心性肥胖组(36.00%)明显增高(x2=12.156,P＜0.001);BPH组腰围身高指数、腰围、体质量、体质指数、臀围[0.56±0.05、(93.6±8.8)cm、(72.6±9.7)kg、(25.7±3.4)kg/m2和(100.2±6.6)cm]明显高于非前列腺增生组[0.52±0.06、(87.0±10.1)cm、(64.5±9.3)kg、(23.1±2.9)kg/m2和(95.6±8.1)cm](t分别=-3.30,-3.65,-4.38,-4.17,-3.18,均P＜0.01);肥胖组前列腺总体积高于正常组[(40.8±23.5)ml与(20.1±6.1)ml,t=-2.82,P＜0.01),中心性肥胖组明显高于非中心性肥胖组[(42.8±25.6)ml与(26.9±11.2)ml],(t=-3.93,P＜0.001);中心性肥胖组雌二醇/总睾酮(E2/TT)比值、胰岛素抵抗指数(HOMA-IR)(9.06±4.36、2.81±2.80)高于非中心性肥胖组(7.38±3.11、1.55±0.76)(t分别=-2.02,-4.24,均P＜0.05),血清TT、性激素结合蛋白(SHBG)则低于非中心性肥胖组[(4.54±1.54)nmol/L对(5.20±1.54)nmol/L,(45.8±17.24)nmol/L对(59.6±26.09)nmol/L,均t分别=2.16,2.79,P＜0.05];Logistic逐步回归分析表明,腰围是影响前列腺体积的主要因素(x2=19.52,P=0.000);前列腺总体积的年增长率在肥胖组同样高于正常组[(7.14±8.09)ml与(1.49±5.14)ml,t=-2.19,P＜0.05],在中心性肥胖组明显高于非中心性肥胖组[(7.96±13.81)ml与(1.35±5.36)m1,t=-3.28,P＜0.01];中心性肥胖组的前列腺特异性抗原密度(PSAD)低于非中心性肥胖组(0.048±0.036对0.090±0.093,t=2.02,P＜0.05);肥胖组的PSAD低于正常组(0.052±0.039与0.091±0.080,t=3.13,P＜0.01).结论 BPH的发生与肥胖,尤其是中心性肥胖密切相关,其机制可能与肥胖患者体内性激素失衡、生长激素-胰岛素样生长因子轴的紊乱有关.

Abstract：

Objective To explore the relationship between benign prostatic hyperplasia (BPH)and obesity. Methods The 109 elder men were divided into two groups: BPH group (n=59) and non-BPH group (n= 50). The blood samples were collected for the detections of prostate specific antigen (PSA), triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), fasting blood glucose (FBG), insulin,androgen, estrogen, sex hormone binding globulin (SHBG) and dehydroepiandrosterone(DHEA).The anthropometric indexes including height, body weigh, waist circumference (WC), hip circumference (HC), systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI), waist-to-height ratio (WHtR) and waist-to-hip ratio (WHR) were measured and calculated. The total prostate volume (TPV) were measured by transabdominal ultrasonography three times at least. Results The morbidity rate of BPH was significantly higher in obesity group and over weight group than in health control group (73.33% and 64.28% vs. 26. 67%, x2 = 13. 991 and 6. 836, both P＜0. 002). So was in central obesity group versus in health control group (71.19% vs.36.00%, x2 =12. 156, P＜0. 001). The waist-height index, waist circumference, body weight, BMI and hip circumference were significantly higher in BPH group than in non-BPH group [(0. 56±0. 05)vs. (0.52±0.06), (93. 6±8.8) cm vs. (87.0± 10. 1) cm; (72.6±9.7) kg vs. (64.5±9.3) kg;(25.7±3.4) kg/m2 vs. (23.1±2.9) kg/m2; (100.2±6.6) cm vs. (95.6±8. 1) cm; t=-3.3, -3. 65, -4.38, -4. 17 and -3.18, respectively, all P＜0.01]. The TPV was higher in obesity groupthan in normal group [ (40.8± 23.5 ) ml vs. (20. 1 ± 6.1 ) ml, t = - 2.82, P＜ 0. 002] and obviously higher in central obesity group than in non-central obesity group [(42.8±25.6)ml vs. (26. 9±11.2)ml, t= -3. 93, P＜0. 001]. The ratio of E2/TT and HOMA-IR were higher in central obesity group [(9. 06±4.36) and (2.81 ±2. 80)] than in non-central obesity group [(7. 38±3. 11) and (1. 55±0.76), t= -2.02 and -4.24, both P＜0. 05]. Inversely, the TT and SHBG were lower in central obesity group than in non-central obesity group [(4.54 ± 1.54) nmol/L vs. (5.20 ± 1.54) nmol/L,(45.8± 17.24) nmol/L vs. (59.6 ± 26.09) nmol/L, t = 2.16 and 2.79, both P＜ 0. 05]. Logistic regression analysis showed that waist circumference was a major factor affecting TPV (x2= 19.52, P=0. 000). The annual growth rate of TPV was significantly higher in obesity group and central obesity group than in health control group [(7. 14±8. 09)ml vs. (1. 49±5.14)ml, (7. 96±13.81)mlvs. (1. 35±5.36)ml, t=-2.19 and -3.28, both P＜0. 05]; The PSAD was significantly lower in central obesity group than in health control group [(0. 048±0. 036) vs. (0. 090±0. 093), t=2.02, P＜0. 05], and lower in obesity group than in health control group [(0. 052 ±0. 039) vs. (0. 091 ±0. 080), t= 3. 13, P＜0. 01]. Conclusions The occurrence of BPH is closely related to obesity,especially central obesity. Its mechanism may be related to sex hormone imbalance and the GH/IGF-1 axis disorders in obese patients.     

SMIS检测分枝菌酸在分枝杆菌菌种鉴定中的作用

目的 评估用SMIS检测分枝菌酸在分枝杆菌菌种鉴定中的作用.方法 收集北京市结核病胸部肿瘤研究所2007年1-12月的分枝杆菌118株,通过PNB培养基初筛,其中结核分枝杆菌复合群25株,非结核分枝杆菌93株.同时用测序方法和SMIS分析分枝菌酸方法鉴定118株分枝杆菌,以16S rDNA和16-23S rDNA ITS测定作为菌种鉴定的标准,评估利用SMIS分离分枝菌酸鉴定分枝杆菌菌种的符合率及一致性;并验证以上两种方法鉴定结果分别与PNB初筛分结核分枝杆菌复合群和非结核分枝杆菌结果的符合率及一致性.结果 SMIS与测序鉴定分枝杆菌相比的符合率为92%(108/118),其中结核分枝杆菌复合群鉴定的符合率为95%(35/37),非结核分枝杆菌为90%(73/81),Kappa分析显示两种方法鉴定结果的一致性很好(Kappa=0.%).回顾验证初筛结果显示,SMIS与PNB培养基方法鉴定结果符合率90%(106/118),一致性较好(Kappa=0.73);测序方法与PNB培养基方法鉴定结果符合率也为90%(106/118),一致性较好(Kappa=0.74),但有11株测序和分枝菌酸菌种鉴定方法结果相同的结核分枝杆菌复合群与PNB实验结果不一致.结论 利用分枝菌酸对临床分离的分枝杆菌进行菌种鉴定是一种快速、简便和准确的方法,对处置应急和突发公共卫生事件中的分枝杆菌菌种鉴定具有一定的参考价值,是分枝杆菌菌种多相鉴定策略的重要组成部分.

Abstract：

Objective To evaluate the usefulness of mycolic acid for identification of Mycobacterium species using SMIS. Methods One hundred and eighteen clinical Mycobacterium isolates collected from Beijing Tuberculosis and Thoracic Tumor Research Institute through whole year of 2007 were analyzed. The 118 isolates contain 25 isolates of Mycobacterium tuberculosis and 93 non tuberculosis Mycobacterium identified by PNB method. Mycolic acid analysis using SMIS is evaluated for identification of a broad range of Mycobacteria in comparison with 16S rDNA , 16-23S rDNA ITS sequencing to measure the concordance rate and agreement, and verify the concordance rate and agreement among results of mycolic acid, sequencing and PNB in identifying Mycobacterium tuberculosis and non tuberculosis Mycobacterium. Results The concordance rate between mycolic acid method analysis and DNA sequencing is 92% ( 108/118), of which concordance rate in Mycobacterium tuberculosis complex and non tuberculosis Mycobacterium are 95% (35/37) and 90% (73/81) respectively, agreement of both is great( agreement Kappa value is 0. 96). Through retrospective analysis, the concordance of results between SMIS and PNB method analysis is 90% (106/118)and agreement is well( agreement Kappa value is 0. 73 ), the concordance of results between sequencing and PNB method analysis is also 90% ( 106/118 ) and agreement is well (agreement Kappa value is 0. 74 ),despite the identification results of 11 isolates by PNB method are discordant. Conclusion Mycolic acid analysis by SMIS enables rapid identification of a broad range of clinical Mycobacterium species, which could play an important role in polyphasic identification of Mycobacterium species.     

宫颈癌MRI分期与病理对照研究

目的 探讨宫颈癌磁共振成像(MRI)分期与病理分期的相关性.方法 80例经手术或活检病理证实的宫颈癌患者行盆腔MRI检查,MRI的成像序列包括T1加权像、T2加权像、脂肪抑制T2加权像、弥散加权成像,以及钆喷酸葡胺增强T1加权像.观察肿瘤的位置、信号特征及侵犯范围.将MRI所见与病理结果相对比.结果 MRI对宫颈癌分期总的准确率为88.73%.对宫旁侵犯判断的准确率为92.50%,特异度为91.18%,敏感度为100%.MRI与病理诊断的差异主要与宫旁浸润的评价差异有关.结论 MRI在宫颈癌临床分期中具有很高的准确性,是宫颈癌诊断中重要的影像学手段.