神经生长因子对拟AD模型大鼠脑内神经原纤维缠结的影响

目的: 研究神经生长因子对拟阿尔茨海默病(Alzheimer's Disease,AD)模型大鼠海马及皮层中神经原纤维缠结(NFT)的影响.方法: 采用冈田酸(Okadaic Acid,OA)海马CA1区微量多次注射建立拟AD大鼠模型,侧脑室注射神经生长因子(nerve growth factor, NGF)进行预处理,观察大鼠行为学变化,Bielschowsky染色观察海马及皮层神经原纤维缠结(neurobrillary tangles,NFT).结果: OA注射后,大鼠出现认知能力、学习记忆能力减退,海马及皮层出现较多NFT;注射NGF预处理后,上述症状改善,海马及皮层NFT数量减少.结论: NGF可显著改善拟AD大鼠模型学习记忆能力,表明NGF可抑制NFT的形成,改善AD病的症状.     

急性心肌梗死介入治疗研究进展

经皮冠状动脉介入治疗(PCI)已广泛应用于急性心肌梗死(AMI)病人,临床疗效良好。它可分为直接PCI、立即PCI、延迟PCI、挽救性PCI等,近年还诞生了易化PCI等新的介入治疗方法。本文就上述介入治疗方法的最新进展作一综述。     

室间隔缺损介入治疗的并发症防治

目的探讨小儿室间隔缺损(VSD)经导管介入治疗的并发症原因及其防治。方法选择VSD患儿362例。男152例,女210例;年龄2-14(9.3±5.8)岁;体质量11.0-65.0(20.5±11.8)kg。并动脉导管未闭(PDA)16例,并房间隔缺损(ASD)8例,并肺动脉瓣狭窄(PS)2例,常规行介入手术治疗。结果患儿术前均经胸超声检测VSD为2.7-13.0 mm,平均6.5 mm;术中心室造影测量VSD为2.5-14.0 mm,平均6.2 mm;345/362例(96.2%)封堵成功。所选封堵器为4.0-16.0 mm,平均8.6mm。发生心脏并发症33例,血管并发症13例,其他并发症4例,包括Ⅲ度房室传导阻滞5例,Ⅱ度房室传导阻滞3例,交界区性心律4例,室性期前收缩5例,完全性左束支传导阻滞6例,完全性右束支传导阻滞4例,主动脉瓣关闭不全、残余分流各3例,基底核区脑梗死1例,股动脉假性动脉瘤、股动静脉瘘各5例,股动脉血栓3例,溶血、血尿1例,交换导丝断裂、猪尾导管断裂各1例。结论经导管介入治疗小儿VSD操作简单、成功率高、相对安全、近期临床疗效好,但应进一步加强心律失常、血栓等并发症的防治。     

婴儿肝炎与病毒感染种类的相关性

目的探讨引起婴儿肝炎病毒种类及其对肝脏的损害程度,达到预防及治疗婴儿肝炎目的。方法使用ELISA法检测51例住院肝炎婴儿血清巨细胞病毒(CMV)、弓形虫(TOX)、风疹病毒(RV)和单纯疱疹病毒(HSV)抗体IgM,并对TORCH-IgM阳性患儿母亲进行TORCH-IgM筛查。结果51例住院婴儿肝炎中TORCH-IgM阳性23例(45%)。其中CMV-IgM阳性13例(25.5%),HSV-IgM阳性5例(9.8%),RV-IgM阳性4例(7.84%),TOX-IgM阳性1例(1.96%)。母婴配对16例TORCH感染。病原体对肝功能均有损害,其中ALT>200 U/L,CMV肝炎5例,HSV肝炎、RV肝炎各1例。婴儿肝炎中血TBIL>220.6μmol/L者,CMV肝炎8例,HSV肝炎、RV肝炎各2例,TOX肝炎1例。结论住院婴儿肝炎中TORCH感染情况较多见,其中以CMV感染为多,RV、HSV感染次之,TOX肝炎发病率最低。CMV感染对肝脏损害较其他病原体严重,日龄小于7 d新生儿肝炎常有其他多脏器功能损害。     

多内分泌腺瘤病研究进展

多内分泌腺瘤病1型(MEN1)发生的重要原因是MEN1基因突变,导致肿瘤细胞11号染色体不同程度的杂合缺失,menin蛋白消失,临床主要表现有甲状旁腺腺瘤、胃肠胰腺内分泌肿瘤和垂体前叶瘤.多内分泌腺瘤病2型(MEN2)主要由原癌基因RET突变所致,又分为MEN2A和MEN2B,临床表现为甲状腺髓样癌、嗜铬细胞瘤、甲状旁腺增生和黏膜神经纤维瘤.RET基因突变类型有一定的规律性,即基因型和表现型之间有非常好的相关性.本文将主要介绍MEN1和MEN2发生机制方面的最新研究进展.     

Diagnosis and surgical treatment of multiple endocrine neoplasia

Background Multiple endocrine neoplasia (MEN) is relatively rare. But more patients could be found by detailed examination. We discuss the diagnosis and surgical treatment of MEN. Methods The clinical data of 95 MEN cases were retrospectively analyzed. There were 30 cases of MEN1 including 19 cases from 6 families. The MEN1 gene mutation was detected in 81.48% of cases admitted after 1997. There were 22 cases of primary hyperparathyroidism (PHPT), 10 cases of enteropanceatic tumor including 9 cases of insulinoma, 15 cases of pituitary adenoma, 9 cases of adrenal adenoma, 2 cases of thymic carcinoid. Two patients had 4 glands involved, 3 patients had 3 glands involved, 16 patients had 2 glands involved, and 6 patients had only one gland involved. Three patients had neither clinical symptoms nor biochemical changes, and was diagnosed by MEN1 gene mutation. Six patients presented with nephrolithasis and 6 patients had impaired pancreatic endocrine function. There were 60 cases of MEN2a and 5 cases of MEN2b. 58 cases of MEN2a belongs to 19 kindreds. All MEN2a patients but one presented RET gene mutation in codon 634, and all MEN2b cases had mutation in codon 918. 48 cases of MEN2a had thyroid masses with elevated calcitonin levels. 27 patients had pheochromocytoma including 12 cases of multiple loci and 5 malignancy. 13 patients presented with hyperparathyroidism. 5 MEN2b patients had medullary thyroid carcinoma and mucosal ganglioneuromatosis with Marfanoid. Among them, 3 patients had bilateral pheochromocytoma. Results In MEN1, subtotal parathyroidectomy was performed in 12 patients with PHPT and one patient received parathyroid adenoma enucleation. Insulinomas were enucleated in 4 patients. Two patients underwent thymus tumor extirpation. Total thyroidectomy with bilateral dissection of regional lymph nodes was performed in 16 patients with MEN2a and nodule enucleation was performed in 9 patients. Twenty two MEN2a patients underwent pheochromocytoma enucleation including bilateral adrenal resection in 10 cases. 5 MEN2b patients underwent total thyroidectomy with bilateral lymph node dissection. Among them, 3 cases underwent bilateral adrenal operations. Conclusions MEN varies in symptoms. Germline mutation test is helpful in establishing a diagnosis. Surgical management should be aimed at the improvement of life quality in MEN1 and prevention of the fetal tumors in MEN2.     

胰岛素样生长因子-I水平与冠脉病变严重程度的关系

目的研究血清胰岛素样生长因子-I(IGF-I)与冠心病、冠脉病变的严重程度、斑块的不稳定性以及血脂和C反应蛋白等之间的关系.方法入选75名住院行冠脉造影的患者,测定血清IGF-I水平与C反应蛋白、血脂水平、纤维蛋白原和颈动脉内膜厚度等指标,并根据冠心病的不同临床表现分型,根据临床表现和冠脉造影的结果,评价病变的严重程度和斑块的稳定性.结果血清IGF-I在冠心病患者中明显降低,与反映冠脉病变严重程度的Gensini积分呈负相关,与颈动脉内膜厚度呈负相关.结论血清IGF-I与冠脉病变的严重程度和斑块的不稳定性相关,且与颈动脉内膜厚度呈负相关.     

尿激酶溶栓治疗急性脑梗死患者血浆NO、ET和D-二聚体含量变化及临床意义

目的探讨急性脑梗死患者尿激酶溶栓治疗前后血浆一氧化氮(NO)、内皮素(ET)和D-二聚体含量动态变化及临床意义。方法测定38例急性脑梗死患者溶栓前及溶栓后2 h、4 h2、4 h4、8 h血标本NO、ET和D-二聚体含量,并与正常对照组33例进行比较。结果脑梗死患者NO含量明显低于正常对照组(P<0.01),血浆ET和D-二聚体含量显著高于对照组(P<0.01和P<0.05)。溶栓后有效组24 h后NO明显升高,与溶栓前差异有统计学意义,而无效组无显著变化。有效组4 h后ET明显下降,以后降幅较小,但明显低于无效组。结论血浆NO、ET和D-二聚体含量可以作为急性脑梗死的诊断指标,溶栓治疗后NO、ET与D-二聚体水平变化对判断疗效有一定指导意义。     

牙科综合治疗机供水系统的改进

一种简易净水装置，解决没有配备滤水装置的牙科综合治疗机经常出现的手机脏堵问题。     

载脂蛋白E基因多态性对血脂的影响

[目的]探讨载脂蛋白E（ApoE）基因多态性对血脂的影响。[方法]采用聚合酶链式反应-限制性片段长度多态性分析方法（PCR-RFLP），测定252名河南省汉族研究对象的血脂及ApoE基因型。[结果]ApoE基因型以E3／3型常见为77．0％，等位基因频率ε2、ε3和ε4分别为5．7％、87．1％和7．5％。在不同基因型组间，总胆固醇（TC）和低密度脂蛋白胆固酵（LDL-C）水平均按E3／4＋E4／4〉E3／3〉E2／2＋E2／3顺序递减（P〈0．05），甘油三脂（TG）、高密度脂蛋白胆固醇（HDL-C）水平在各组间比较无差异（P〉0．05）。[结论]ApoE基因多态性影响血脂水平，ε4等位基因携带者有较高的TC，LDL-C水平（P〈0．05），ApoE基因多态性是个体间血脂水平差异的独立遗传因素。