膝症状性骨关节炎335例临床分析

对335例膝骨关节炎(OA)临床分析结果显示:膝OA患病率随着增龄而增加,且病情也随之加重,部分可合并骨质疏松,并以女性多见。本组体块指数(BMI)平均值为26.1,有12％为肥胖,61％为超重。提示BMI过高是引起膝OA原因之一。以往临床不太重视的体征如骨摩擦音、骨关节肿胀等体征十分常见。因此,作好细致的体检,对提高本病的临床诊断有着重要意义。无论X线或MRI均可见病膝胫股关节的内侧部OA发生率较外侧部严重,可能与胫骨上端内翻、致承重线内移有关。MRI在显示关节结构以及早期诊断方面均优于X线。根据MRI特点可将膝OA分为三种类型,即①单纯型,②软组织型,③骨型。这将有利于提高对膝OA异质性的认识,达到治疗个体化的目的。     

雾化吸入对新生儿肺炎患儿血氧饱和度的影响

采用动脉血氧饱和度仪对５２例新生儿肺炎患儿，在雾化吸入治疗过程中的动脉血氧饱和度（ＳａＯ２）进行了监测，对比了吸氧与否对ＳａＯ２改变的影响。结查表明：与基础值比较，雾化吸入时患儿的ＳａＯ２显著下降（Ｐ＜０．０１），而雾化吸入同时吸氧者ＳａＯ２无明显变化（Ｐ＞０．０５），但两者比较具有显著性差异（Ｐ＜０．０１）。结果提示雾化吸入可使新生儿肺炎患儿ＳａＯ２下降；同时吸氧，对防止ＳａＯ２的下降有一定作用。     

核仁形成区嗜银蛋白形态定量在结肠良恶性病变鉴别诊断中的意义

应用银染技术对114例结肠癌,95例结肠腺瘤和10例正常结肠进行核仁形成区嗜银蛋白(Ag-NORs)数量、形态、大小和分布的定量研究。结肠癌的Ag-NORs均数/核(7.04 ±2.20)明显高于结肠腺瘤(3.43±0.88,P=0.0000)和正常结肠(1.25±0.09,P=0.0000)。结肠癌的异形Ag-NORs均数/100个核(61.39土22.38)明显高于结肠腺瘤(20.74土26.61,P=0.0000)和正常结肠(0,P=0.0000)。结肠癌的小型(2um)Ag-NORs均数/100个核(483.76±242·89和)78.08±23.06)明显高于结肠腺瘤(112.00±47·23和19·49±17.47 P值均=0.0000)和正常结肠(0和0.76土1.16,P值均=0.0000)。结肠癌Ag-NORs颗粒的聚合、分散、核仁内和混合型分布(23.64％、53.20％、9.30％和13.86％)明显不同于结肠腺瘤(77.72％、16.88％、5.46％和0.04％,P值均<0.05)和正常结肠(100％、0、0和0、P值均<0.05)。本研究结果提示Ag-NORs4项定量指标有助于结肠良恶性病变的鉴别诊断。     

A model of sterile vesicoureteric reflux in the sheep

Eighteen Coopworth ewe lambs were divided into three groups based on the initial cystourethrogram and cystometry findings at 5 – 7 weeks of age: group 1, 6 lambs with spontaneous low-pressure bilateral vesicoureteric reflux (VUR) on bladder filling were used to study the natural history of reflux; group 2, 5 lambs with no VUR detected were used to establish an experimental model of bilateral VUR using an unroofing surgical procedure; group 3, 7 lambs with spontaneous VUR detected during micturition had the same surgical procedure to increase the degree of VUR. All three animal groups were followed for 4 – 10 months. Spontaneous VUR was demonstrated in 13 of 18 lambs (25/36 ureters). The presence and severity of spontaneously occurring reflux in group 1 lambs diminished with increasing age. VUR was created successfully in group 2 and increased in degree in group 3 animals. The only significant histological finding in all three animal groups with grades II and III VUR was distal renal tubular dilatation. The sheep is a useful and readily available animal for studying VUR. During 4 – 10 months of follow-up, sterile reflux without bladder outflow obstruction resulted in distal renal tubular dilatation, but no renal parenchymal damage. Received April 17, 1997; received in revised form August 5, 1997; accepted August 21, 1997     

Experimental studies of electroacupuncture on ventricular fibrillation threshold in rats with acute ischemic myocardium

Summary By ligating the proximate left anterior descend (LAD) of coronary artery and inducing the ventricular fibrillation with electrical stimulation, the preventive effects of electroacupuncture (EA) on ventricular fibrillation were observed. The results showed that the ventricular fibrillation threshold (VFT) of rats with acute ischemic myocardium was raised after acupuncturing some acupoints, which could prevent the occurrence of ventricular fibrillation. Furthermore, the combination of EA and propranolol could enhance the VFT effectively, and they showed a good synergistic effect. This project was supported by grants from National Natural Science Foundation of China (No. 3870563).     

Development and clinical evaluation of immunoluminometric assays for lactoferrin and elastase-alpha 1-proteinase inhibitor complexes in body fluids with special references to bronchoalveolar lavage and neonatal sepsis

Immunoluminometric assays for lactoferrin and elastase-alpha 1-proteinase inhibitor complexes were developed using solid-phase methodology, which has already been published from this laboratory. The aim of the study was to develop a rapid method to see whether elevated granulocyte activity was present in the lung, as for example in neonatal sepsis. The lactoferrin assay gave reliable results within 30 minutes, the elastase-alpha 1-proteinase inhibitor complexes, within 5 hours. The correlation between both analytes was good, so that the lactoferrin assay could replace the elastase-alpha 1-proteinase inhibitor assay in emergency cases. The lactoferrin assay was used for rapid answer, the elastase-alpha 1-proteinase inhibitor complex assay for "fine" monitoring of the progress of the disease. Both assays could be used to measure concentrations in plasma or bronchoalveolar lavage using a 10 microliters sample. Plasma for the elastase-alpha 1-proteinase inhibitor complex determination had to be diluted 1:50 before being assayed. Only EDTA plasma was used in the assay, as either heparin plasma or serum resulted in granulocyte destruction, thus giving rise to elevated, and non-reproducible results. The results from bronchoalveolar lavage show an excellent correlation between elastase-alpha 1-proteinase inhibitor complexes and lactoferrin. No interference was seen from lipaemic or icteric plasma samples. Results from haemolytic samples i.e. where lysis of erythrocytes and leukocytes had occurred, had to be treated with care if no clinical indication of intravascular haemorrhage was present. The assays lend themselves to perinatal diagnosis, as the total volume of plasma or lavage needed is theoretically under 50 microliters, i.e. ethically acceptable for regular monitoring of neonates.(ABSTRACT TRUNCATED AT 250 WORDS)     

肉桂挥发油对“虚证”模型环核苷酸系统反应性的影响

本实验用纯系CFW小鼠与Wistar大鼠建立“虚证”模型。以环核苷酸系统反应性为指标观察了肉桂挥发油的作用。通过气相色谱及气质联用等方法研究表明,本实验所提取的挥发油中桂皮醛含量约为92％。肉桂挥发油可显著降低“阳虚”——甲状腺素缺乏(甲减)模型升高了的cGMP系统反应性而使其降低了的耗O_2率升高;这是一种治疗作用。肉桂挥发油可显著升高“阴虚”——甲状腺素过多(甲亢)模型已升高了的cAMP系统反应性并使其升高了的耗O_2率进一步升高,这是一种恶化作用。这两种作用与中医对症治疗的原则是一致的。     

2型糖尿病对扩张型心肌病患者预后的影响研究

背景 2型糖尿病可增加患者心血管疾病的早发风险,对健康构成重大威胁。阐明2型糖尿病对扩张型心肌病患者预后的影响,有利于指导患者的管理。目的 探讨2型糖尿病对扩张型心肌病患者预后的影响。方法 回顾性选取广西医科大学第一附属医院心血管内科2015年1月至2020年5月收治的313例扩张型心肌病患者为研究对象。根据患者是否罹患2型糖尿病将患者分为糖尿病组（n=66）和非糖尿病组（n=247）,收集患者一般资料、实验室检查指标并进行随访,随访终点事件为全因死亡,随访日期截至2021-12-31。采用landmark比较两组患者的生存率。建立多因素Cox比例风险回归模型,探究扩张型心肌病患者全因死亡的影响因素。结果 Landmark分析结果显示,糖尿病组和非糖尿病组扩张型心肌病患者随访1年内的生存率比较,差异无统计学意义（χ2=1.520,P=0.218）;随访1年后,糖尿病组扩张型心肌病患者的生存率低于非糖尿病组（χ2=4.414,P=0.036）。分段拟合法构建的多因素Cox比例风险回归分析显示,收缩压[HR=0.965,95%CI(0.948,0.982)]、N末端B型利钠肽原[HR=9....     

多囊性肾脏发育不良胎儿的遗传学病因、影像学表现及妊娠结局分析

目的 探究多囊性肾脏发育不良胎儿的遗传学病因、影像学表现及妊娠结局。方法 回顾性分析2017年5月—2023年5月扬州大学附属淮安市妇幼保健院收治的80例多囊性肾脏发育不良胎儿的临床资料,分析其遗传学病因、影像学表现及妊娠结局。结果 80例多囊性肾脏发育不良胎儿中检出11例（13.75%）染色体异常,其中染色体数目异常1例（1.25%）,10例（12.50%）存在染色体拷贝数变异（CNV）。80例多囊性肾脏发育不良胎儿中,39例（48.75%）为左侧多囊性发育不良肾,37例（46.25%）为右侧多囊性发育不良肾,剩余4例（5.00%）为双侧多囊性发育不良肾;单纯泌尿系统异常64例（80.00%）,合并其他系统异常16例（20.00%）,以心血管系统异常（8例）、肢体骨骼异常（3例）和、神经系统异常（3例）最常见。单纯性泌尿系统异常胎儿、合并其他系统异常胎儿的致病性CNV检出率分别为10.94%（7/64）和12.50%（2/16）,差异无统计学意义（P >0.05）。单纯性泌尿系统异常胎儿中,单侧多囊性发育不良胎儿、双侧多囊性发育不良胎儿的致病性CNV检出率分别为9.84%（6/61）和33.33%（1/3）,差异无统计学意义（P >0.05）。对80例多囊性肾脏发育不良胎儿进行随访,失访8例（10.00%）,人工终止妊娠31例（38.75%）,胎死宫内0例（0.00%）,活产41例（51.25%）,其中产后死亡1例（1.25%）。结论 多囊性肾脏发育不良胎儿采用染色体微阵列分析技术可提高遗传学检出率,影像学检查在多囊性肾脏发育不良诊断中具有一定价值,可为多囊性肾脏发育不良胎儿的产前诊断、遗传咨询、预后评估提供依据。