老年认知功能障碍与脑结构CT测量的相关性研究

目的探讨脑萎缩与老年认知功能障碍之间的相关性。方法对开滦集团公司1063名离退休职工进行健康查体,用简易精神状态量表(MMSE)评定认知功能,按分界值将本次研究对象分为认知功能障碍组和认知功能正常组,同时用CT线性测量脑的相关部位以诊断脑萎缩情况,并对各型脑萎缩与认知功能的相关系数及提示老年认知功能障碍的敏感度、特异度、准确度进行分析。结果1063名观察对象中符合入选标准并资料完整者共计511名,其中108名有认知功能障碍,髓质脑萎缩55名、皮质萎缩5名、混合型萎缩30名;认知功能正常者403名,髓质脑萎缩214名、皮质萎缩13名、混合型萎缩62名。认知功能障碍组脑萎缩的发病率高于认知功能正常组,差异具有统计学意义(P<0.005);2组间颞叶海马钩回间距(26.86mm±3.73mmvs25.95mm±3.80mm)及海马钩回间距/大脑左右径的比值(0.21±0.02vs0.20±0.02)差异具有统计学意义(P<0.05);海马钩回间距、皮质脑萎缩、混合型脑萎缩与认知功能障碍呈负相关(分别为r=-0.094,P=0.034,r=-0.156,P≈0.000,r=-0.147,P≈0.000),以海马钩回间距20mm提示老年认知功能障碍的敏感度最高(98.14%),混合型脑萎缩的特异度(84.86%)、准确度最高(72.80%)。结论CT测量相关脑结构,判断脑萎缩类型可以为老年认知功能障碍的诊断提供有价值的信息。     

直肠癌根治会阴部造口术后二期股薄肌移植肛门成形

目的　回顾性总结32例直肠癌根治会阴部造口术后二期股薄肌移植肛门成形术的治疗效果。方法　采用Williams 5级评分法对重建前后肛门功能进行评价。结果　二期股薄肌移植肛门成形术前,32例患者肛门功能均在4级以上[4级28.4%(9/32),5级71.6%(23/32)],二期股薄肌移植肛门成形术后肛门功能明显好转。结论　二期股薄肌移植肛门成形术是直肠癌根治会阴部造口术后有效的肛门重建手段。     

实验性肝纤维化大鼠肝组织钠-氢交换泵-1的表达

Na^＋/H^-交换泵（NHE）为参与细胞内外Na^＋/H^-交换的细胞膜大分子。已证实有6种形式的NHE，分别命名为NHE1～NHE6，其中以NHE-1组织分布最广泛。NHE-1与人类疾病的关系是近年才刚刚开始研究的领域。其与肝纤维化的关系逐渐被人们认识。近年的研究结果表明，细胞因子、生长因子及氧应激激活HSC都与NHE-1有密切的关系。我们通过观察肝纤维化大鼠肝组织中NHE-1 mRNA表达的变化，以期了解NHE-1在肝纤维化发生发展中的作用。     

Is chronic nitrate therapy associated with a different clinical presentation of acute coronary syndrome?

BACKGROUND: Nitrate therapy can induce ischemic preconditioning with a consequent increase in tolerance to ischemia. In the context of acute coronary syndromes (ACS), nitrates may result in a different presentation. with greater protection. OBJECTIVES: To investigate in a population of patients with ACS whether previous chronic use of nitrates results in a different presentation of ACS. METHODS: We studied 287 patients (65 +/- 13 years, 66% male) admitted to our department in the first six months of 2005 with ACS (with and without ST-segment elevation). Of these, 8% were under nitrate therapy at the time of admission. In this group, 27% presented ACS without ST-segment elevation, while in the group without nitrates this value was 58% (p = 0.005). By univariate analysis, the use of nitrates was a predictor of the preferential occurrence of non-ST-segment elevation ACS (OR 0.27, 95% CI 0.10-0.71). After correction for the potential influence of variables (age, gender, previous revascularization and smoking) by multivariate logistic regression, nitrate therapy remained a borderline predictor of clinical presentation as non-ST-segment elevation ACS (OR 0.37, 95% CI 0.13-1.04, p = 0.059). CONCLUSIONS: Previous use of nitrates was associated with a tendency to present as non-ST-segment elevation ACS. This finding may be explained by the hypothesis that nitrates induce pharmacological preconditioning, reducing the transmural extent of myocardial infarction.     

Exogenous advanced glycosylation end products induce diabetes-like vascular dysfunction in normal rats: a factor in diabetic retinopathy

BACKGROUND. Diabetic retinopathy has been shown to be directly associated with the degree and duration of hyperglycemia, and advanced glycosylation end products (AGEs) have been implicated in this pathological process. The purpose of the experiments reported here was to study the effect of AGE deposition on retinal vascular damage which leads to diabetic retinopathy. METHODS. Intravenous injection of exogenous AGEs was used to treat wild-type non-diabetic Sprague-Dawley rats. One of the two retinal slides from each animal was treated using immunohistochemical staining to label retinal vascular AGE deposition, the other H&E staining for counting of capillary pericytes. The results were compared with the findings in untreated wild-type and diabetic controls and in rats treated with unmodified rat serum albumin (RSA). RESULTS. After 2 weeks of continuous treatment, AGEs were identified in the retinal vascular tissue of the AGE-RSA-injected group. The average number of retinal capillary pericytes per 10x100 microscope power field was 4.313+/-0.34 (mean +/- SD) in the AGE-RSA-injected group, compared with 5.798+/-0.481 in the control group ( P<0.01). CONCLUSION. These experiments demonstrate that AGEs, independent of other metabolic factors, can induce vascular change resembling that of diabetic retinopathy.     

中药生精冲剂对精索静脉曲张大鼠的治疗

目的：研究中药生精冲剂对大鼠精索静脉曲张的影响及疗效。方法：从80只SD雄性大鼠中随机抽出20只作为假手术组，余60只均建立精索静脉曲张病理模型后随机均分为模型组、生精冲剂组和克罗米芬组。造模后15d生精冲剂组和克罗米酚组分别给予生精冲剂4g/（kg·d）和克罗米芬20mg/（kg·d）灌胃，模型组和假手术组正常喂食。造模后45d放免法测定血清性激素（FSH、LH和T）及观察各组大鼠睾丸组织结构。结果：生精冲剂组大鼠光镜下睾丸组织结构优于模型组和克罗米芬组；血清FSH、LH生精冲剂组显著低于模型组和克罗米芬组（P〈0.05），而克罗米芬组显著高于其他3组。T在生精冲剂组、克罗米芬组和假手术组之间无显著差异，但均显著高于模型组（P〈0.05）。结论：中药生精冲剂对精索静脉曲张引起的睾丸损害有保护及修复作用，且可能优于克罗米芬。     

应激性溃疡时幽门区局部一氧化氮含量变化对胆汁返流的影响及机理探讨

目的探讨胆汁返流与幽门区局部神经递质一氧化氮的变化对应激性溃疡发病的影响及可能的机理。方法采用冷束缚应激方法复制应激性溃疡的动物模型，将60只成年SD大鼠分为两部分，第1部分：对照组10只，溃疡组30只，用于观测影响应激性溃疡发生的相关因素；第2部分：左旋硝基精氨酸甲酯（L—NAME）预处理组10只（L—NAME组），生理盐水预处理组10只（生理盐水组），用于观测幽门区局部一氧化氮含量变化对其他因素的影响。分别检测各组胃内胆汁酸浓度、胃黏膜溃疡指数（Guth评分）以及胃内pH值，用生化试剂盒检测幽门区一氧化氮的含量。结果溃疡组应激结束后1h幽门区一氧化氮含量达到峰值（P〈0．01），应激结束后2h胃内胆汁酸浓度和pH值均达到峰值（P〈0．01），应激结束后4h胃内溃疡指数达到峰值（P〈0．01）。L-NAME组的胃内胆汁酸浓度、溃疡指数及一氧化氮含量较生理盐水组显著降低（P〈0．01，P〈0．05），而胃内pH值的差异无统计学意义（P〉0．05）。幽门区一氧化氮含量与胆汁酸浓度呈正相关（r=0．715，F=12．55，P=0．017）。结论幽门区一氧化氮含量变化与胆汁的返流量之间存在正相关关系，而L—NAME的幽门区局部干预使幽门区一氧化氮含量减少，幽门松弛程度降低，胆汁返流量也随之减少，进而降低溃疡指数，起到保护胃黏膜的作用。     

以专业建设为契机在教学评估中推进学校的建设与发展

自贡卫生学校位于有“盐都、龙乡、灯城”美誉的四川省自贡市。学校创建于1918年，前身系加拿大基督教会创办的仁济义济高级护士职业学校，“大仁求学、大医济人”的校训有其深远的历史渊源。2005年被教育部批准为国家级重点卫生职业学校。护理专业被批准为省级重点专业。学校现有120多个班级，     

Clinical Observation on Effect of Acupuncture in the Treatment of Optic Atrophy

Opticatrophy,acommondiseasewhichleadstoblindness,respondstofewtreatment.However,acupuncturehasbeenactuallyusedandtheclinicaleffectintreatingthisconditionisratherpreferable.Byusingtheacupunctureformula"Three--EyeNeedling",remarkableclinicaloutcomeisachievedandtheresultoftherelatedelectrophysiologicalparametersfollowingtheacupuncturepracticeintreatingopticatrophyhasbeenobserved.METHODSClinicalD8tsTheclinicalmaterialswerecollectedintheSpecialClinicofOpticAtrophyoftheDepartmentofAcupuncture…     

Effects ofTripterygium hypoglaucum (Lévl.) Hutch on male fertility

Tripterygium hypoglaucum (Lévl.) Hutch (TH) is a perennial used in Chinese traditional medicine for the treatment of rheumatoid arthritis and various skin disorders. One study showed that daily oral doses of TH significantly reduced the fertility of male rats without apparent toxicity. The effects of daily oral doses of TH on the fertility of men taking it for the treatment of rheumatoid arthritis were evaluated. Sperm concentration, motility and motility grade all were significantly reduced in the 13 men taking TH compared to 11 untreated controls. TH therapy did not affect testosterone, FSH, LH levels, and its antifertility effects appeared to be reversible.

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Resumen Triperygium hypoglaucum (Lévl.) Hutch (TH) es una perenne usada en la medicina tradicional china para el tratamiento de artritis reumatoidea y de varios desórdenes de la piel. Un estudio demostró que orales diarias de TH reducían significativamente la fertilidad en ratas macho, sin toxicidad aparente. Se evaluaron los efectos de dosis diarias orales de TH en la fertilidad de hombres que le tomaban para el tratamiento de la artritis reumatoidea. La concentración de espermatozoides, la motilidad y el grado de motilidad, se encontraron significativamente reducidos en los 13 hombres tomando TH comparados con 11 controles no tratados. La terapia con TH no afectó los niveles de testosterona, FSH y LH y sus efectos antifertilidad parecían ser reversibles.

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Resumé LeTriperygium hypoglaucum Hutch (TH) est communément utilisé en médecine traditionnelle chinoise pour le traitement de la polyarthrite chronique évolutive (PCE) et de divers troubles cutanés. Une étude a montré que l'administation quotidienne de doses orales de TH réduisait considérablement la fécondité de rats mâles sans provoquer de toxicité apparente. On a évalué les effets de doses quotidiennes administrées par voie orale sur la fécondité d'hommes atteints de PCE et traités au TH. La concentration, la motilité et le degré de motilité du sperme avaient significativement diminué chez 13 hommes traités au TH par comparaison avec 11 témoins non traités. Le traitement au TH n'a eu aucun effet sur les niveaux de testostérone, FSH et LH et ses effets anti-fécondants semblent être réversibles.