中风病急性期证候演变规律的研究

应用证候量化诊断的方法,对733例经CT或MRT确诊的中风病始发态患者,进行了为期4周的7次追踪调查.结果显示:(1)证候的得分均值、发生概率、组合形式、组合形态是动态变化的随时间序列呈现一定的规律性,并受到病变性质的影响;(2)求得了不同时间序列6个基本证候的逐阶转移概率和高阶转移概率.研究结果对深入认识中风病急性期病因病机,判断病势转归,指导辨证治疗,防止向恶转变,具有重要的理论意义和应用价值.     

Incorporation and integration of implanted myogenic and stem cells into native myocardial fibers: anatomic basis for functional improvements

BACKGROUND: Myoblasts and stem cells implanted into myocardium can differentiate into myocytes and may functionally improve impaired ventricles. For implanted cells to actually contribute to the synchronous contractions of the heart, however, they must be anatomically integrated with the existing native myocardial fibers. METHODS: Isogenic Lewis rats were used as donors and recipients to simulate clinical autotransplantation. Either skeletal myoblasts or marrow stromal stem cells were isolated from donors, culture expanded, and labeled with 4',6-diamidino-2-phenylindole (4',6-diamidino-2-phenylindole). Labeled cells were then injected into the myocardium of recipients. At intervals specimens were obtained, sectioned, and stained with hematoxylin and eosin and immunohistochemically against connexin-43 to demonstrate gap junctions (intercalated discs). RESULTS: At 1 week the labeled cells were still undifferentiated, but early expression of connexin-43 could be detected at contact points between the implanted cells and the native myocytes. By 4 to 6 weeks, labeled, fully differentiated myocytes could be seen to interconnect among themselves and with native cardiomyocytes by means of intercalated discs. In sections parallel to the myofibers, full integration of new labeled myocytes with the native myofiber cells could be observed. Furthermore, the labeled myofibers were in parallel with the native, unlabeled fibers. We postulate that such supracellular structural integration was enhanced by fiber stretching during cardiac contractions, sending signals for cellular reorientation and incorporation, in which the cytoskeletal system may play an important role. CONCLUSION: We conclude that implanted precursor cells can be integrated into native myocardial structure so as to contribute to myocardial function. Direct cell-to-cell contact seems to be an important signaling mechanism, which has implications for cellular implantation strategies.     

糖尿病合并类鼻疽伯克霍尔德菌败血症临床研究

目的分析糖尿病合并类鼻疽伯克霍尔德菌败血症的临床特点，并探讨其诊疗策略和措施。方法回顾性分析21例糖尿病合并类鼻疽伯克霍尔德菌败血症的临床特点、诊疗经过和转归。结果类鼻疽伯克霍尔德菌败血症临床表现多样化，缺乏特异性，常表现为急性暴发性败血症和常伴组织器官脓肿形成及易诱发糖尿病酮症酸中毒（DKA），病情凶险，误诊率和死亡率高且可选用的有效抗生素较少，易复发，治疗周期长。结论早期诊断，尽旱足量应用敏感抗生素，有脓肿者宜配合外科治疗，以及使用胰岛素积极控制好血糖和加强支持疗法是治疗成功的关键。     

不同人群患代谢综合征调查分析

目的调查城市干部群体代谢综合征及其相关疾病的患病情况,并与农民群体对比。方法检测中山市1 116例处级干部血糖、血脂、血压和体重指数等,对结果进行统计分析并和同期农民群体相比较。结果干部体检人员中高血糖、高血压、血脂紊乱、超重或肥胖、代谢综合征的患病率分别为23.7%、52.6%、53.9%、31.5%、18.1%。明显高于农村群体的4.3%、32.4%、27.3%7、.8%、2.9%。结论干部群体中代谢综合征及其相关疾病的患病率较农民群体显著增高,应列为重点防治人群。     

深圳市环境非结核分枝杆菌的初步调查

目的了解深圳市非结核分枝杆菌主要分布情况。方法采集深圳市的几家大的市属医院和各区人民医院的处理前后污水以及医院候诊室、病房、输液宣的空调过滤网灰尘，另外采集各区有代表性的居民生活区明沟污水和各区农贸市场的污水（特别是肉类、禽类、鱼类摊挡的污水），进行非结核分枝杆菌培养。结果各样本培养的阳性率，医院污水处理前为87．5％、处理后为37．5％、医院空调为6．3％、农贸市场污水为54．5％、居民区生活污水为70．3％、沫浴场海水为25％、生态区海水为0、沙滩沙为0、宾馆喷泉为12.5％、生活区水景池水为0、居民游泳池水为0、山泉水、井水为0。结论环境非结核分枝杆茵在医院污水、居民区明沟污水、农贸菜场污水存在较多，应引起重视，以便采取有效措施，保护人群的身体健康。     

食管癌组织中Survivin基因的表达及其与Bcl-2,P53的相关性

目的:探讨凋亡抑制基因Survivin在食管癌组织中的表达及其与Bc l-2和P53基因表达的相关性。方法:检测Survivin、Bc l-2、P53基因在10例癌旁组织及30例食管癌组织中表达。结果:60%食管癌组织表达Sur-vivin,而癌旁组织不表达。Survivin基因表达与食管癌临床分期、年龄不相关,而与Bc l-2、P53基因显著相关,食管癌组织中P53蛋白表达阳性、阴性中,Survivin基因阳性率分别为73.68%,18.18%;两者有显著差异性(p<0.05);Bc l-2蛋白表达阳性、阴性中,Survivin基因阳性率分别为70.58%、7%,亦有显著差异(p<0.05)。结论:Survivin基因的异常表达而引起的细胞凋亡抑制,在食管癌的发生中起一定作用,Survivin基因的表达与食管癌组织中P53、Bc l-2蛋白的异常表达有一定相关性。     

Caldwell—Luc进路联合鼻内镜治疗上颌窦病变

目的 探讨治疗上颌窦良性病变较好的手术方法。方法 采用传统的Caldwell—Luc手术进路与鼻内镜手术联合治疗39例上颌窦病变。上颌窦息肉12例，其中伴鼻腔筛窦息肉7例，出血坏死性息肉3例，上颌窦后鼻孔息肉2例；上颌窦、筛窦息肉术后复发9例；慢性上颌窦炎3倒；真菌性上颌窦炎7例；上颌窦囊肿5例；上颌蜜内翻性乳头状瘤2例；上颌窦炎性假瘤1例。结果 39例经6个月～3年的随访，治愈32例（82．1％），好转6例（15．4％）．1例炎性假瘤术后1个月复发并发眶内感染，总有效率为97．4％。结论 Caldwell—Luc手术联合鼻内镜治疗上颌窦病变。视野清楚，操作方便．既能彻底清除病变，叉保证了窦内黏膜纤毛系统功能的恢复，减少了复发率。     

移植肾功能延迟恢复的护理体会

1临床资料我院1997-11/2004-11共行肾移植562(男386,女176)例,期中87例患者出现移植肾功能延迟恢复(DGF),男性58例,女性29例,年龄16～62(平均38.5)岁.术后常规服免疫抑制剂:环孢素,强的松,骁悉.发生DGF最早术后第4日,最晚20 d,均采用综合治疗措施,纠正水、电解质紊乱,控制血压,预防感染等,同时对不同原因引起的DGF采用相应的治疗、护理.85例患者均在术后3wk左右肾功能恢复,2例因并发症死亡.     

肾移植围手术期预防感染的护理体会

1临床资料肾移植是终末期慢性肾功能衰竭可靠的手术治疗方法.我院2000-01/2004-12共完成肾移植手术437(男299,女138)例,年龄14~72(平均35)岁.