Contrast-induced nephropathy after a second percutaneous coronary intervention in patients with chronic kidney disease

Background Data are limited regarding the risk of contrast-induced nephropathy (CIN) for patients after the second contrast exposure. Objective To examine the risk of CIN after the second contrast exposure in patients of acute coronary syndrome (ACS) with chronic kidney disease (CKD). Methods Patients of ACS scheduled for a second elective PCI. Patients were required to have an estimated creatinine clearance (CrCl) between 15 and 60 ml/min. The value of serum creatinin (sCr) prior to the second contrast exp...     

老年CCCI患者情绪、认知功能评价及相关性研究

目的评价老年慢性脑缺血患者(CCCI)情绪和认知功能状态,探讨其相关性。方法用蒙特利尔认知评估量表(MoCA)、正性负性情绪量表(PANAS)对69例前循环CCCI,57例后循环CCCI患者进行分组测试,并与90名健康老人比较,采用线性回归分析情绪与认知功能损伤的相关性。结果 CCCI患者认知功能损伤检出率和严重程度均显著高于健康老人(P<0.01),认知功能损伤主要表现在视空间执行能力、言语流畅性和延时记忆三个领域。CCCI患者负性情绪(NA)较健康老人明显增高,正性情绪(PA)明显下降(P<0.01),情绪与认知功能损伤密切相关(P<0.01)。结论 NA是认知功能损伤的高危因素,PA则是认知功能的保护性因素。老年CCCI患者存在较为明显的认知功能损伤和情绪障碍,情绪障碍与认知功能损伤存在关联。     

Decreased striatal dopamine receptor binding in primary focal dystonia: A D2 or D3 defect?

Dystonia is an involuntary movement disorder characterized by repetitive patterned or sustained muscle contractions causing twisting or abnormal postures. Several lines of evidence suggest that abnormalities of dopaminergic pathways contribute to the pathophysiology of dystonia. In particular, dysfunction of D2‐like receptors that mediate function of the indirect pathway in the basal ganglia may play a key role. We have demonstrated with positron emission tomography that patients with primary focal cranial or hand dystonia have reduced putamenal specific binding of [¹⁸F]spiperone, a nonselective D2‐like radioligand with nearly equal affinity for serotonergic 5‐HT(2A) sites. We then repeated the study with [¹⁸F]N‐methyl‐benperidol (NMB), a more selective D2‐like receptor radioligand with minimal affinity for 5‐HT(2A). Surprisingly, there was no decrease in NMB binding in the putamen of subjects with dystonia. Our findings excluded reductions of putamenal uptake greater than 20% with 95% confidence intervals. The analysis of the in vitro selectivity of NMB and spiperone demonstrated that NMB was highly selective for D2 receptors relative to D3 receptors (200‐fold difference in affinity), whereas spiperone has similar affinity for all three of the D2‐like receptor subtypes. These findings when coupled with other literature suggest that a defect in D3, rather than D2, receptor expression may be associated with primary focal dystonia. © 2010 Movement Disorder Society.     

Outpatient versus inpatient laparoscopic cholecystectomy:a single center clinical analysis

BACKGROUND:Outpatient laparoscopic cholecystectomy (OPLC) developed in the United States and other developed countries as one of the fast-track surgeries performed in ambulatory centers.However,this practice has not been installed as a routine practice in the major general hospitals and medical centers in China.We designed this case-control study to evaluate the feasibility,benefits,and safety of OPLC.METHODS:Two hundred patients who had received laparoscopic cholecystectomy for various benign gallbladder p...     

大鼠FK506套管模型与自体神经移植模型脊髓背角c-fos表达的比较研究

目的建立大鼠外消旋聚乳酸/FK506（PDLLA/FK506）复合套管模型和大鼠外周神经自体神经移植神经再生模型,观察对比各模型神经恢复过程中机械痛觉超敏的变化及脊髓背角c-fos表达的改变,探讨两种神经再生模型中神经再生与神经性疼痛的联系。方法雄性Wistar大鼠60只随机分成3组,每组20只。A组为自体神经移植再生模型组;B组为PDLLA/FK506套管修复模型组;C组假手术组。分别制成模型,术后24d起检测机械刺激阈值,术后27d起计数c-fos阳性细胞。结果 A、B组各项指标与C组比较有显著差异（P〈0.05）;A组与B组比较c-fos表达阳性细胞计数及机械痛阈无显著差异。结论两种模型再生神经生长进入去神经支配区域时,均出现支配区域的痛觉超敏和疼痛相关行为,神经性疼痛程度无差异。     

高原肺水肿的早期影像检查及影像表现探讨

目的对高原肺水肿（high altitude pulmonary edema,HAPE）的早期影像学表现进行探讨,为HAPE的早期诊断寻找更为可靠的检查手段和依据。方法对482例经临床筛选出的高度疑似HAPE对象进行常规X线检查及CT扫描;对确诊为HAPE的病例,在治疗恢复过程中的肺部病变进行动态观察,分析HAPE病例的X线检查及CT扫描特点。结果 482例高度疑似HAPE对象中,确诊为HAPE142例。常规X线检查,142例HAPE患者中,47例（33.10%）发现肺部有明确改变,95例（66.90%）未发现明确改变;CT扫描,142例HAPE患者均存在水肿,且以肺间质异常为主。其中磨玻璃样改变61例（42.96%）,小结节样影34例（23.94%）,散在、孤立终末支气管肺泡水肿15例（10.56%）,纤细网纹状影13例（9.15%）,肺纹理增粗、增多12例（8.45%）,大片状云絮样影7例（4.93%）。142例HAPE早期患者治疗过程中,CT扫描均能清楚地反应肺部病变的恢复情况,其中1例第11d再次复查病变仍呈少量磨玻璃样改变残留。结论 HAPE早期肺部病变以肺间质异常为主,此时常规X线检查容易漏诊,对于临床症状明显,而常规X线检查肺部未见明显异常的高度疑似HAPE病例,CT扫描具有重要诊断价值。     

^125Ⅰ粒子对人结肠腺癌裸鼠皮下移植瘤的敏感性研究

目的探讨125Ⅰ粒子组织间植入对裸鼠皮下低分化结肠腺癌移植瘤的敏感性。方法应用人结肠癌HCT116细胞株及雄性BALB/c-nu裸鼠,建立人低分化结肠腺癌裸小鼠皮下移植瘤模型。荷瘤鼠随机分为125Ⅰ粒子治疗组（n=24）和对照组（n=24）。每3天观测裸鼠肿瘤生长情况,测量肿瘤长短径,计算肿瘤体积。每7天各处死治疗组及对照组一批裸小鼠,共4批。采用相对定量荧光RT-PCR检测HIF-1αmRNA表达,应用流式细胞术（FCM）PI单染法检测肿瘤细胞周期的再分布。结果 125Ⅰ粒子治疗组肿瘤体积明显缩小,瘤重减轻（P〈0.05）。第7、14、21、28天4个时间点治疗组HIF-1αmRNA的表达水平逐渐降低（P〈0.05）,对照组HIF-1αmRNA表达无明显改变（P≥0.05）,治疗组与对照组HIF-1αmRNA表达比较,差异有统计学意义（P〉0.05）。随着放射时间的延长,治疗组出现G2/M期细胞阻滞（P〈0.05）,G0/G1期、S期无明显改变（P〉0.05）。结论 125Ⅰ粒子近距离照射能够抑制HCT-116肿瘤细胞的生长,可能与125Ⅰ粒子近距离照射改变HCT116细胞周期分布并抑制肿瘤血管的新生有关。     

缺血性心脏病干细胞治疗的争论热点与最新进展

文章讨论了细胞修复治疗在缺血性心脏病中的应用。介绍了不同类型细胞的心脏修复效应。重点介绍了胚胎干细胞(ESCs)及诱导型多能干细胞(iPS)临床应用障碍,而ESC及iPS源心脏前体细胞,心肌源性干细胞等修复心肌的最新进展。尤其重点描述了来自于人胚外或胚胎中胚层的脐带华通胶源间充质干细胞的细胞生物学特性,如：兼有胚胎干细胞及间充质干细胞标志特征,无伦理道德问题,多向分化而无致肿瘤性,多代增殖保持干性特征,独特的免疫调节功能等,使之WJ MSCs将成为心脏再生医学中最具希望的种子细胞。