急性脑血管病患者血清肌钙蛋白Ⅰ的检测及临床意义

目的 探讨血清肌钙蛋白Ⅰ(cTn-I)对急性脑血管病(ACVD)后心肌损伤的诊断价值.方法 检测160例ACVD患者入院后24h内、3d、7d的血清cTn-I和肌酸激酶同工酶(CK-MB),比较不同病程、不同类型、不同病情程度ACVD患者血清cTn-I和CK-MB的测定结果,观察预后与cTn-I、CK-MB的关系.结果 病后24h内和7d血清cTn-I较CK-MB的阳性率高;脑出血和重症患者病后7d cTn-I仍增高;病后30d内死亡者的cTn-I和CK-MB增高比例高于存活者.结论 血清cTn-I对ACVD后心肌损伤的检测具有比CK-MB更高的敏感性、特异性和更宽的诊断窗口.     

Buccal mucosal graft for urethral reconstruction.

Urethral reconstruction with graft substances, such as skin and bladder mucosa, has been previously used when primary anastomosis cannot be achieved. However, stricture and meatal prolapse are associated with these grafts. We report the use of buccal mucosa for the reconstruction of urethral defects in 3 patients. One patient with failed operation for hypospadias received tube buccal mucosal graft for urethral replacement. Two patients with urethral necrosis and stricture received onlay buccal mucosal graft. All patients were disease-free during follow-up (range, 12 to 49 months; mean, 36 months). One patient had a pinhole fistula that was successfully managed with simple repair. This technique appears to be useful for urethral reconstruction when a local graft is not available, even in patients with complicated conditions.     

原发性眼眶静脉曲张的CT和MRI表现

目的探讨原发性眼眶静脉曲张(POV)的CT及MRI表现。方法临床诊断的30例原发性眼眶静脉曲张患者,9例行CT横断位和冠状位扫描,21例行MR扫描,4例行CT和MR检查。结果30例中30只患眼,左眼18例,右眼12例,均为单侧发病。病变部位眼睑3例,眼眶前部1例,眼眶后部(球后)17例,眼睑和眼眶前部5例,眼睑、眼眶前部和眼眶后部2例,眼眶前部和眼眶后部2例。形态17例为不规则块状,4例为卵圆形,9例为不规则条状。CT冠状位,病变均显示为软组织密度,有明显强化;静脉石2例;眶骨受压变薄、眶腔扩大3例。MR扫描,颈部加压后25例均显示病变,11例呈等T1长T2信号,7例呈长T1长T2信号,1例呈等T1等T2信号,6例呈长T1长T2为主的混杂信号,增强的22例中,14例呈明显均匀强化,8例呈不均匀强化。结论CT横断位和冠状位及颈部加压或俯卧位MRI在原发性眼眶静脉曲张的诊断和鉴别诊断方面有重要价值。     

Measurement of γ-enolase release, a new method for selective quantification of neurotoxicity independently from glial lysis

We have developed a sensitive enzymatic-immunoassay to quantify the level of gamma-enolase (a specific neuronal enzyme) which is released from cultured cells after exposure to various toxins. We show that this method can estimate selectively neuronal cell death without significantly interfering with glial cell death. Indeed, no gamma-enolase is released when glial cells are killed with free-radical producing agents. Experiments comparing the levels of neuronal cell death induced by NMDA or free-radical producing drugs, performed either by measuring gamma-enolase release or using the classical fluorescein diacetate method, yielded similar results. In addition to selectively follow neuronal death in a mixed population of neurons and glial cells, this method provides a way of determining the cell death kinetics from a single culture dish, since enolase can be measured on small samples taken from the culture medium. Finally, we propose these two methods as being complementary and useful neuronal and other cellular death indexes and also to understand the complex problem of glial influence on neuronal survival or death.     

永瓣藤化学成分的研究

永瓣藤化学成分的研究陈玲，谢平，戚薇，曾菊珍（药学系中药化学教研室）关键词永瓣藤，化学成分，三萜，蒜盘子甾酮永瓣藤（ＭｏｎｉｍｏｐｅｔａｌｎｍＣｈｉｎｅｎｓｅＲｅ－ｈｄ）系卫矛科永瓣藤属植物［１］，为我国特有的珍稀二类保护植物［２］，分布于江西东北部...     

神经系统功能磁共振联合应用研究进展

随着磁共振功能成像技术的发展,尤其是弥散张量成像(d iffusion tensor,DTI)及血氧依赖水平磁共振成像(b lood ox-ygenation level dependent,BOLD)技术的日臻完善,在活体状态下显示活动的皮质区并无创跟踪脑内白质纤维,反映解剖连通性已成为可能。本文就功能磁共振BOLD、DTI联     

162例气管插管患者的气道管理

笔者通过报道162例气管插管患者的气道管理，阐述痰痂形成的原因：(1)气道干燥，湿化不够。(2)吸痰管插入深度不够，吸痰不彻底。管理措施：(1)用金霉素眼膏润滑吸痰管，使之易于插入，保证吸痰管插入深度超过插管远端3-5cm。(2)预防气道干燥，注重湿化效果，重视吸痰环节。认为气囊不需定时放气，只需不定时调整气囊压力。     

主动吸入药物烟对大鼠一氧化氮的影响

目的　探讨主动吸入药物烟对大鼠NO的影响。方法　制备大鼠主动吸烟模型 ,采用硝酸还原酶法测定各组大鼠血清、肺、心肌及脑组织的NO含量。结果　非药物烟组大鼠血清、肺、心肌及脑组织中NO含量明显低于非给烟对照组 ,药物烟高、中剂量组NO含量明显高于非药物烟组 ,接近非给烟对照组。结论　吸烟对大鼠血液、肺、心肌及脑组织有不同程度的损伤作用 ,使NO含量降低 ;药物烟具有一定的保护和防止NO含量降低的作用。     

超声对宫角妊娠的诊断及治疗意义

目的 探讨对误诊率高，危害大的罕见特殊部位宫角妊娠的诊断和治疗。方法 对我院1991-2001年收治的宫角妊娠临床资料进行回顾性分析。结果 宫角妊娠17例中误诊宫内妊娠行人流失败4例。13例行腹部手术，3例行B超监视下人流术，1例行子宫动脉栓塞术。结论 宫角妊娠临床诊断困难，误诊率高，破裂后造成迅猛的腹腔内出血，应提高对少见部位宫角妊娠的认识，减少孕妇死亡。     

Long-term expression of the c-fos protein during the in vitro differentiation of cerebellar granule cells induced by potassium or NMDA.

Levels of the c-fos protein were assayed in mouse cerebellar granule cells during their in vitro development under different culture conditions. When grown in media favoring both their survival and differentiation, i.e. in the presence of 30 mM K+ or 12.5 mM K+ plus 100 microM N-methyl-D-aspartate (NMDA), the c-fos protein becomes detectable in the nucleus of granule cells on and after 6 days and persists to high levels until the culture begins to decline. The protein c-fos appears therefore after the critical period described for the survival effect of K+ depolarization or NMDA receptor stimulation which corresponds to days 2-5 after plating. The c-fos protein remains however scarcely detectable or undetectable throughout the life-span of cells cultured under conditions providing poor survival and differentiation, i.e. in the presence of low K+ (5 or 12.5 mM) alone or when the effect of NMDA is blocked by the NMDA receptor antagonist MK-801. Interestingly, in cortical and striatal neurons, the survival and differentiation of which being not affected by depolarizing media, no c-fos protein is detected whatever the culture conditions tested at least during the first 18 days in vitro. This suggests that long-term expression of the c-fos gene might be related to some aspect of the late in vitro differentiation process of cerebellar granule cells.