冠状动脉粥样硬化性心脏病患者红细胞流变性特征在红花注射液干预后的表现

目的:经红花注射液干预后,观察冠状动脉粥样性心脏病患者红细胞电泳指标及红细胞变形性的变化。方法:①选取2001-02/2002-10河北北方学院附属第一医院心内科住院的冠状动脉粥样硬化性心脏病患者50例作为冠状动脉粥样硬化性心脏病组,男31例,女19例,平均年龄(43.9±5.6)岁,对本实验知情同意,均自愿参加。②纳入标准:经心电图、超声心动图证实有典型心绞痛、心绞痛不典型或陈旧性心肌梗死史,由专科医师确诊冠脉造影狭窄率≥50%;治疗前均未进行降脂、利尿剂、促血尿酸排泄药、阿司匹林及肝素(包括低分子肝素钠)治疗;无肝肾疾病、内分泌系统疾病。③以30例自愿体检受试的健康学生及医务人员作为正常对照组,男女各15例,平均年龄(35.4±7.4)岁。两组间年龄、性别差异无显著性意义。④“得强”红花注射液,主要成分为红花黄色素,由太原华卫药业有限公司生产,批号010302。⑤冠状动脉粥样硬化性心脏病组取红花注射液6.0～8.0mL,溶于500mL葡萄糖注射液中,静点,1次/d,15d为1个疗程,共1个疗程。正常对照组未给予任何干预措施。⑥治疗前后两组空腹抽取肘静脉血5mL,应用红细胞变形分析仪检测红细胞电泳指标及红细胞变形性的变化。结果:50例冠状动脉粥样硬化性心脏病患者均进入结果分析。①治疗前后红细胞电泳指标的变化:与正常对照组比较,冠状动脉粥样硬化性心脏病组治疗前红细胞电泳时间显著延长,红细胞电泳长度与红细胞迁移率显著降低(t=3.198～6.963,P均<0.01);治疗后红细胞电泳时间缩短,红细胞电泳长度与红细胞迁移率增加(t=2.212～3.672,P<0.05或0.01),但仍与正常对照组存在显著性差异(t=1.700～4.792,P<0.05或0.01)。②治疗前后不同切变率下红细胞变形性变化:与正常对照组比较,冠状动脉粥样硬化性心脏病组治疗前在300S-1,230S-1,115S-1切变率下的红细胞变形性均显著降低(t=1.956～2.459,P<0.05或0.01);治疗后各切变率下的红细胞变形性均显著增强(t=3.162～4.187,P均<0.01),且在230S-1、115S-1切变率下冠状动脉粥样硬化性心脏病组红细胞变形性显著高于正常对照组(t=2.089～2.748,P<0.05或0.01)。结论:冠状动脉粥样硬化性心脏病患者给予红花注射液后,红细胞电泳时间、电泳长度及迁移率均有所好转,且不同切变率下的红细胞变形性亦有所增强,提示红花注射液对冠状动脉粥样硬化性心脏病的干预与改善红细胞流变性异常有关。     

骨形态发生蛋白信号去除后Sonic hedgehog对小脑颗粒细胞发育的影响

目的:骨形态发生蛋白信号在神经细胞的生长、分化、增殖、凋亡等方面发挥作用,而Sonic hedgehog能调节小脑颗粒细胞的增殖,故实验设计了去除骨形态发生蛋白信号后Sonic hedgehog信号在小脑颗粒细胞发育中作用的观察。方法:实验于2004-11/2005-10在美国费城儿童医院Crenshaw实验室和北京大学医学部解剖学神经研究实验室完成。①实验材料:C57Bl/6J小鼠40只;Bmpr1b敲除鼠系来源于Karen Lyons博士。②实验过程:通过敲除骨形态发生蛋白Ⅰ型受体的Bmpr1a和Bmpr1b两个亚型基因,去除骨形态发生蛋白信号在小脑内的传导。③实验评估:使用原位杂交和免疫组织化学方法检测了新生幼鼠小脑中Sonic hedgehog信号的表达情况。结果:①在胚胎11.5d,磷酸化SMAD免疫阳性的细胞被观察到在正常鼠神经管背侧的菱形唇附近,受体基因双敲除的小鼠背侧神经管中未发现免疫阳性细胞,此结果提示通过骨形态发生蛋白Ⅰ型受体传导的骨形态发生蛋白信号已消失。当小鼠出生后,磷酸化SMAD免疫阳性细胞主要位于正常小鼠的内颗粒层,在基因敲除鼠只有一小部分区域有磷酸化SMAD蛋白的表达。②Sonic hedgehog表达在正常新生鼠小脑的颗粒细胞层和蒲肯野氏细胞层;基因敲除鼠Sonic hedgehog信号只表达在小脑一小部分区域的颗粒细胞层和蒲肯野氏细胞层,而大部分区域则缺少它的表达。PTCH和N-myc在小脑中的表达与Sonic hedgehog表达部位类似。这提示Sonic hedgehog信号及其PTCH和N-myc都参与了小脑颗粒细胞的发育。结论:实验阐明了骨形态发生蛋白信号去除后,Sonic hedgehog信号对小脑颗粒细胞发育所起到的重要作用。     

门诊病历抽评698份质量分析

0　引言　保证门诊病历书写质量是医院为患者提供全方位优质服务的组成部分 ,为使临床医师对门诊病历质量引起足够重视 ,并确保医院门诊病历质量管理制度化 ,要求标准化、书写规范化 ,我们对门诊各级医师的门诊病历书写质量进行了调查统计 ,分析出影响我院门诊病历质量的诸因素 ,提出改进管理措施 .1　材料和方法1 .1　材料　依照三级甲等医院门诊病历书写要求 ,我们制定了具体严格的评定标准 .门诊病历书写内容 :1就诊科室 ;2就诊时间 ;3主诉 (包括主要症状部位及持续时间 ) ;4)现病史 (包括与本次疾病有关的过去史、个人史及家族史 ) ;5 )…     

Inhibin forms in serum from postmenopausal women with ovarian cancers

BACKGROUND AND OBJECTIVE: Previous studies have shown that serum inhibin as measured by alpha subunit-directed radioimmunoassay (RIA) and inhibin A ELISA was elevated in postmenopausal women with mucinous and granulosa cell cancers, with the RIA showing a more frequent elevation than the inhibin A ELISA. It was thus hypothesised that these cancers may also produce inhibin B or the free alpha subunit. The aim of the study was to identify the forms of inhibin found in a range of ovarian cancers using a range of inhibin assays with varying specificities. DESIGN: Serum samples obtained from women with ovarian cancer were assayed by inhibin B ELISA and Pro-alpha C subunit ELISA and compared with inhibin RIA and inhibin A ELISA. PATIENTS: Blood samples were obtained from 34 postmenopausal women (> 55 years) with no history of endocrine disease and from women with ovarian serous cystadenocarcinomas (n = 66), mucinous cystadenocarcinomas (n = 20), granulosa cell tumours (n = 9-11), miscellaneous ovarian cancers (n = 46) and non ovarian cancers (n = 23). MEASUREMENTS: Inhibin B and inhibin Pro-alpha C subunit levels were determined by ELISA and compared to values obtained by RIA and inhibin A ELISA. Cancers were discriminated from controls based on values obtained 2SD above the geometric mean of the control values. RESULTS: Granulosa cell tumours were detected by RIA and inhibin B ELISA (100%), Pro-alpha C ELISA (90%) and inhibin A ELISA (77%). Mucinous tumours were detected by RIA (70%), inhibin B ELISA (60%), Pro-alpha C ELISA (55%) and inhibin A (20%). Serous tumours were detected by RIA (35%) and the other assays (< 15%). Miscellaneous tumours were detected by RIA (41%) and other assays < 30%. CONCLUSIONS: Ovarian neoplasms may produce a variety of peptides related to the inhibins, including dimeric inhibin A and B. Inhibin B is detected in more ovarian cancers than inhibin A but does not discriminate as well as the alpha subunit directed assays. The higher discrimination index obtained with the RIA compared to the Pro-alpha C ELISA suggests that assays detecting all inhibin forms containing the alpha subunit and not just those detecting the Pro-alpha C subunit will provide the most useful detection method.     

A new 'total' activin B enzyme-linked immunosorbent assay (ELISA): development and validation for human samples

Background and objective  There are currently no sensitive and specific assays for activin B that could be utilized to study human biological fluids. The aim of this project was to develop and validate a 'total' activin B ELISA for use with human biological fluids and establish concentrations of activin B in the circulation and fluids from the reproductive organs.
Design  The new ELISA was validated and then used to measure activin B levels in the circulation of healthy participants, IVF patients, pregnant women and in ovarian follicular fluid and seminal plasma.
Patients and measurements  Healthy adult subjects ( n  = 143), subjects from an IVF clinic ( n  = 27) and pregnancy groups ( n  = 29) were sampled.
Results  The sensitivity of the assay was 0·019 ng/ml. Validation of the activin B ELISA showed good recovery (90·7 ± 9·8%) and linearity in biological fluid and cell culture media and low cross-reactivity with related analytes (inhibin B = 0·077% and activin A = 0·0034%). There was a negative correlation between activin B concentration ( r  = −0·281, P  < 0·011) and females with increasing age. Patients attending IVF clinics had significantly lower levels of activin B compared with gender-matched control subjects. Ovarian follicular fluid and seminal plasma had 50–80 fold higher levels of activin B (mean = 5·35 and 3·66 ng/ml respectively) than sera (mean = 0·071 ng/ml).
Conclusions  This fully validated ELISA for activin B offers a tremendous utility for measuring this protein in a variety of normal physiological processes and in various clinical pathologies.     

New Insights into the Management of an EHV-1 (Equine Hospital) Outbreak

In May 2018, Wolvega Equine Hospital (WEH) experienced an EHV-1 outbreak. This outbreak caused significant economic losses and negative publicity for the hospital. How should hospitals prepare themselves for these outbreaks and prevent shedding of the virus on multiple neighboring premises? The hospital transformed most of its activities into mobile practice and the entire infected hospital population was moved to a separate remote location. The hospital was cleaned and disinfected according to the latest recommendations before reopening. Four neighboring professional equine businesses and three privately owned premises were affected by the spread of the virus from the hospital population and initiated quarantine restrictions. Equine hospitals should prepare themselves for EHV-1 outbreaks as the intake of the virus cannot be prevented. A management protocol should include public information protocols, swift client information and quarantine measures that ensure quick containment of the outbreak. Timely reopening of the hospital can be achieved by rehousing the contaminated population. It should also include good regulations with clients and a properly carried out release protocol. Equine sports organizations should establish sufficient vaccination coverage in order to decrease the frequency of EHV-1 outbreaks.