乳酸及降钙素原对一氧化碳中毒后迟发性脑病的预测价值

目的探讨检测血乳酸、降钙素原和联合检测对急性一氧化碳中毒后迟发性脑病(DEACMP)的预测价值。 方法随机抽取我院在急诊科收住院的ACMP患者70例,随访3个月,以其中发生DEACMP患者10例为DEACMP组,其余60例为非DEACMP组,随机抽取同期笔者医院40例健康体检者为对照组。对患者立即行动脉血Lac和血清PCT检测,并计算Lac和PCT诊断DEACMP的灵敏度、特异度。 结果DEACMP组血Lac和PCT检测值均明显高于非DEACMP和对照组,差异有统计学意义(采用秩和检验,P<0.05);检测异常率亦明显高于非DEACMP组及对照组,差异有统计学意义(采用χ²检验,P<0.05)。Lac和PCT升高预测DEACMP的敏感度均为90.0% ,特异度分别为50.0%和65.0% ,准确性分别为55.7%和68.6%。联合检测时若其中1个指标为阳性时即预测DEACMP发病,则联合检测的敏感度为100.0%,特异度为41.7%,阳性预测值为21.7%,阴性预测值为100.0%,准确性为71.4%。 结论DEACMP患者早期动脉血Lac和PCT均明显升高,PCT诊断价值优于Lac,联合检测较单项指标检测对DEACMP发病预测价值更理想。     

益气止血药对脾不统血证模型动物前列腺素的作用

采用复合因素的脾不统血证大鼠模型 ,以 6 酮 前列腺素F1α(6 酮 PGF1α)和血栓素B2(TXB2 )作为观测指标 ,对益气止血药对脾不统血证模型大鼠血浆和子宫前列腺素的影响进行了研究。结果 :大剂量组益气止血药能降低脾不统血证模型血浆和子宫的 6 酮 PGF1α及子宫 6 酮 PGF1α/TXB2 比值。说明 6 酮 PGF1α及 6 酮 PGF1α/TXB2 比值升高可能是脾不统血证的重要机理之一。     

Cloning and identification of a novel variant of human vascular endothelial growth factor

Vascular endothelialgrowth factor ( VEGF) is amultifunctional cytokine thatexerts in vivo a key rolein physiologicalneoangiogenesisduring embryonicde-velopmentor the female cycle and pathologicalneoan-giogenesis of many diseases including hypervascular-ized tumors,rheumatoid arthritis,and retinopathiesdiseases[1— 3] by stimulating endothelial cell prolifera-tion and vessel hyperpermeability.VEGF exists asone of five different isoforms,VEGF1 2 1 ,VEGF1 65 ,VEGF1 83,VEGF1 89and VEGF2 …     

还原型谷胱甘肽治疗尿毒症贫血的初步探讨

目的　观察外源性还原型谷胱甘肽对尿毒症贫血的治疗效果。方法　将 42例尿毒症贫血患者随机分为两组。两组患者均给予重组人红细胞生成素 (r- Hu EPO) 30 0 0 U,每周两次皮下注射 ,疗程 12周。治疗组患者同时静脉给予外源性还原型谷胱甘肽 (GSH) 12 0 0 mg,每周两次 ,疗程 12周。于治疗前和治疗后抽静脉血测定血红蛋白 (Hb) ,红细胞 (RBC)和红细胞压积 (HCT)水平。结果　 r- Hu EPO治疗后两组患者 HB,RBC和 HCT水平均显著上升 (P<0 .0 1)。 GSH治疗组 Hb,RBC和 HCT水平与对照组比较上升明显 (P<0 .0 5 ) ,治疗组 Hb,RBC和HCT的上升幅度高于对照组 (P<0 .0 5 )。结论　外源性还原型谷胱甘肽能显著提高 r- Hu EPO治疗肾性贫血的疗效 ,GSH可能是治疗尿毒症贫血的有效药物。     

完全右半肝-左半肝劈离式肝移植的临床应用:附四例报告

目的探讨完全右半肝-左半肝劈离式肝移植在成人-成人或成人-大体重儿童中的临床应用。方法回顾2019年1月至12月间首都医科大学附属北京友谊医院完成的4例完全右半肝-左半肝劈离式肝移植的供受者临床资料,分析劈离式肝移植的手术方式、冷缺血时间、手术时间、术中输血量,观察患者术后并发症及相关预后。结果4例完全右半肝-左半肝劈离式肝移植的受者包括3例成人和1例大体重儿童(45 kg),年龄范围14~48岁,体重范围45~61 kg,终末期肝病模型评分分别为21、12、41和30分。移植物质量与受者体质量比为0.85%~1.35%。冷缺血时间457~650 min,手术时长460~575 min。4例患者移植术后早期肝功能恢复顺利,均未出现小肝综合征。随访至术后6个月,其中1例出现胆道吻合口漏,经内镜逆行胰胆管造影术治疗后治愈;1例出现胆道狭窄,经皮肝穿刺胆道引流术治疗后反复胆道感染;1例术后6个月死于肺部感染。结论在严格病例选择的情况下,可以开展完全右半肝-左半肝劈离式肝移植。     

中国9个长寿地区65岁及以上人群血铅浓度与认知功能受损的关联研究

目的探讨65岁及以上人群血铅水平与认知功能受损的关联。方法研究对象来自2017-2018年在我国9个长寿地区开展的“老年健康生物标志物队列研究”,最终将1684名血铅和认知功能数据完整的65岁及以上人群纳入本研究。通过问卷调查和体格检测,收集调查对象的人口学特征、生活方式、健康状况及认知功能评分等信息;同时采集调查对象的静脉血以检测血铅水平。根据血铅水平的四分位数将调查对象分为4组(Q₁-Q₄组),采用多因素logistic回归模型分析血铅浓度与认知功能受损的关系,采用限制性三次样条检验血铅浓度与认知受损之间是否存在非线性关联。结果1684名研究对象年龄为(83.1±11.1)岁,其中女性843名(50.1%);认知功能受损者191名(11.3%)。调整相关混杂因素后,老年人血铅浓度每升高10μg/L,认知功能受损患病风险OR(95%CI)值为1.05(1.01~1.10);与血铅浓度Q1组老年人相比,血铅浓度较高者认知功能受损的患病风险较高,Q₂,Q₃,Q₄组的OR(95%CI)值分别为1.19(0.69~2.05)、1.45(0.84~2.51)和1.92(1.13~3.27)。结论我国9个长寿地区65岁及以上老年人血铅水平与认知功能受损患病风险存在关联。     

The prevalence of dementia and Alzheimer's disease in Shanghai, China: impact of age, gender, and education

We report the prevalence rates for dementia and Alzheimer's disease (AD) obtained from a probability sample survey of 5,055 noninstitutionalized older persons in Shanghai, China. A two-stage procedure was used for case finding and case identification. A Chinese version of the Mini-Mental State Examination was used to determine cases of possible dementia. Three different cutoff points on this mental status test were used depending on the respondent's level of education. Clinical evaluations, based on functional assessments and psychiatric interview, medical and neurological examinations, three standardized mental status tests, and a selected group of psychometric tests, were made in the second stage of the study to ascertain the clinical diagnosis of dementia and AD utilizing the Diagnostic and Statistical Manual for Mental Disorders, edition 3 and National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association criteria, respectively. The prevalence rate of dementia in persons 65 years and older was 4.6%. Clinically diagnosed AD accounted for 65% of the subjects with dementia. These findings indicate that the prevalence of dementia in Shanghai is very much higher than figures published earlier for China and Japan, and at the lower part of the range of values reported for community residents in the United States and other Western countries, but less than half of that reported in the recently published survey of the elderly in East Boston. Increasing age, gender (female), and low education are each highly significant and independent risk factors for dementia. One hypothesis to explain the increased prevalence in elderly women who had received no formal education invokes the possibility of an effect of early deprivation, perhaps lowering brain "reserve," allowing the symptoms of dementia to appear at an earlier date during disease progression.     

中药地榆的性状及显微鉴定

研究国内来源于地榆属8个不同种、变种与变型的地榆及2种混淆品的生药性状、组织构造及其粉末的鉴别特征,并分别列出生药性状、组织构造及粉末特征的检索表。