心电图多指标诊断冠心病的意义

对３０例冠心病患者及２８例正常对照者进行心电图踏车运动试验，测量ＳＴ及非ＳＴ参数，结果显示：（１）各指标诊断冠心病的敏感性依次为：ΔＱ－Ｔｃ（８３．３％）、ΔＱ（７６．７％）、ΔＲＳＴ及ΔＪ－Ｔｃ（６６．７％）、ΔＲ（６３．３％）、ΣＲ（５６．７％）、ＳＴ（５０％）、Ｕ波倒置（３０％）；特异性依次为：Ｕ波倒置（１００％）、ΣＲ（８９．３％）、ＳＴ及ΔＪ－Ｔｃ（８２．１％）、ΔＲ（７８．６％）、ΔＲ     

晚期糖基化终产物在糖尿病血管并发症中的作用机制

晚期糖基化终产物（AGEs）是蛋白质或脂质经过糖基化反应的产物。AGEs存在于糖尿病患者的血管中,促进动脉粥样硬化的发展。多种不同的细胞上AGEs的存在和聚集影响着细胞内外的结构和功能。AGEs通过与细胞外基质基底膜上的分子形成交联和与其受体（RAGE）结合引起多种微血管和大血管并发症。RAGE被AGEs激活后导致转录因子NF-κB和它的靶因子的表达。AGEs可诱发糜蛋白酶的表达和糜蛋白酶依赖性血管紧张素Ⅱ的生成,从而作用于糖尿病血管并发症的发展。     

胃下垂的中医辨证护理浅识

目的探讨采用辨证施护的综合护理措施对胃下垂进行护理的效果。方法从饮食、情志、生活起居、用药、特殊疗法等多方面入手,实施辨证施护。结论实施辨证施护对胃下垂护理,缓解了疾病的进展速度,增强体力,提高了生活生命质量。     

Obesity-related glomerulopathy: insights from gene expression profiles of the glomeruli derived from renal biopsy samples

Obesity-related glomerulopathy (ORG) is an important complication of obesity. The pathophysiological mechanism of glomerular injury in ORG is incompletely understood. Gene expression profiles in the glomeruli obtained from renal biopsy samples of patients with ORG were investigated, using a microdissection technique combined with Affymetrix microarray analysis. Six patients presented with obesity, proteinuria, and biopsy-proven ORG were enrolled. Two sex- and age-matched donor kidneys were applied as the controls. Glomeruli were dissected out from renal biopsy samples under microscope, and total RNA was extracted using RNeasy Micro kit. After two rounds of T7 promoter-based RNA amplification, gene expression profiles of the glomeruli samples were detected using Affymetrix U133A gene chips. Bioinformatic tools were applied to analyze the microarray data. Results of candidate ORG-related genes were further confirmed by real-time quantitative PCR and immunohistochemistry staining using renal biopsy samples of a larger pool of 15 ORG patients. Genes related to lipid metabolism, inflammatory cytokines, and insulin resistance were the most highlighted subgroups that significantly changed in the glomerular gene expression profiles of the ORG patients, compared with the controls. The expression levels of several key genes in lipid metabolism were increased over 2-fold, including low-density lipoprotein receptor, fatty acid binding protein 3, and sterol regulatory element binding protein 1. Moreover, some inflammatory cytokines and their downstream molecules were increased as well, including TNF-alpha and its receptors, IL-6 signal transducer, and interferon-gamma. As the indicators of insulin resistance in the local glomerular cells, levels of glucose-transporter 1, leptin receptor, peroxisome proliferator-activated receptor-gamma, and vascular endothelial growth factor increased, too. In addition to lipid dysmetabolism and insulin resistance, the activation of an inflammatory process in the glomeruli might play a unique role in the development of obesity-related glomerulopathy. Our results expand the understanding of obesity-induced glomerular injuries and shed light on new approaches in the treatment of this disease.     

谈《伤寒论》中的欲愈候

欲愈候是预示疾病将愈的一类证候。文章列举《伤寒论》中6种典型欲愈候,并结合后世医家评述,分别探讨其临床指征、作解机理、现代临床意义,这对于临床把握疾病的发展规律以及指导临床用药等,均具有一定的积极意义。     

慢性汞中毒致神经系统损害的临床观察

目的 分析慢性汞中毒对患者神经系统损害的表现,以提高对慢性汞中毒的临床认识.方法 总结分析2006--2010年首都医科大学宣武医院神经内科收治的8例慢性汞中毒患者的临床资料.结果 慢性汞中毒造成的神经系统损害包括周围神经病变以及感觉异常(6/8例)、思维缓慢及精神异常(3/8例)、肢体无力萎缩(3/8例)、震颤(4/8例)、睡眠障碍(3/8例)等.结论 慢性汞中毒可以有各种各样的神经系统损害的表现,在临床工作中要注意鉴别.尽早诊治会减少患者痛苦.     

结直肠癌和息肉病人中的T抗原的检测

为验证Ｔ抗原检测对结直肠癌普查的价值，用Ｓｈａｍｓｕｄｄｉｎ和Ｅｌｓａｙｅｄ介绍的半乳糖氧化酶法，对１５６例不同对象的直肠粘液标本进行Ｔ抗原检测。结果发现，３２份结直肠癌和５５份结直肠息肉病人的标本中，Ｔ抗原阳性率分别为８４．４％和２９．１％，与６９份对照组标本的阳性率（７．２％）相比，差异均有极显著性（Ｐ＜０．００１和Ｐ＜０．０１）。Ｔ抗原检测在已确定的结直肠癌中，敏感性为８４．４％，特异性为９２．８％。Ｔ抗原检测方法简便，结果易重复，且具有较高的敏感性和特异性，因此，颇具潜在的结直肠癌筛选普查的应用价值，同时也为结直肠息肉的筛选提供了一种可供选择的方法。     

血管性认知障碍的诊断

血管性认知障碍是指由血管因素引起的或与之伴随的认知障碍,对血管性疾病所致认知障碍患者的早期预防和治疗具有重大的社会和经济意义.文章对血管性认知障碍的诊断标准、神经心理学检查、神经影像学以及生物学标记物研究的进展做了综述.