超声心动图潘生丁负荷试验诊断冠心病

超声心动图潘生丁负荷试验诊断冠心病与（９９ｍ）ＴＣ—ＭＩＢＩ心肌灌注显像结果对照。结果表明，以节段性室壁运动失调为标准诊断冠心病的敏感性和特异性分别为６８％和１００％。而当其结合多普勒二尖瓣血流参数后（Ｅ／Ａ＜１），敏感性则升至８４％，且特异性无任何降低。该结果与（９９ｍ）ＴＣ—ＭＩＢＩ心肌显像结果十分接近。两者在冠心病的诊断方面显示出良好的一致性。     

小儿泌尿系结石的超声诊断及临床意义

目的探讨小儿泌尿系结石的超声诊断和临床意义。方法．对47例小儿泌尿系结石的超声影像特征及临床治疗进行分析总结。结果肾结石病13例；输尿管结石26例；肾及输尿管结石3例；膀胱结石5例。本组病例临床采取四种方法治疗。结论小儿泌尿系结石的超声诊断具有重要价值，为临床拟定治疗方案提供可靠依据。     

热休克蛋白70对心脏移植大鼠供心心肌生化指标的影响

目的:观察应激情况下产生的热休克蛋白70对心脏移植大鼠供心心肌相关生化指标的影响。方法:实验于2006-04/09在青岛市市立医院中心实验室完成。①实验动物及分组:取成年SPF级雄性Wistar大鼠18只,按随机数字表法分为2组,每组9只。对照组腹腔注射生理盐水0.5mL,注射后24h取离体心脏,灌注HTK心脏保护液,并置于HTK液4℃保存3h后建立Langendorff离体心脏灌注模型,灌注K-H液2h。实验组腹腔注射重酒石酸去甲肾上腺素(溶于生理盐水中)3.1μmol/kg(0.53mg/kg),24h后取离体心脏,余处理步骤同对照组。②实验评估:应用全自动生化分析仪测定心肌肌酸激酶、乳酸脱氢酶含量;计算心肌肌酸激酶(乳酸脱氢酶)10min漏出率、心肌含水量;采用羟胺法测定超氧化物歧化酶活性,采用硫代巴比妥酸法测定丙二醛含量,采用双缩脲法测定组织蛋白含量;采用免疫组织化学法,以染色阳性面积占视野面积的百分比作为心肌组织热休克蛋白70的表达量。结果:18只大鼠全部进入结果分析,无脱失。①心肌组织热休克蛋白70含量:实验组高于对照组(t=17.96,P<0.01)。②相关生化指标:实验组大鼠心肌肌酸激酶、乳酸脱氢酶10min漏出率、心肌含水量及丙二醛含量显著均低于对照组(t=4.13～15.81,P<0.01),实验组大鼠心肌超氧化物歧化酶活性显著高于对照组(t=10.89,P<0.01)。结论:热休克蛋白70的高表达能减少氧自由基对供心心肌的损害,是热休克蛋白70发挥其供心心肌保护作用的可能途径之一。     

犬颧骨牵张成骨后新生骨成熟状况与厚度和密度特征

目的:通过新生骨骨质结构和骨密度分析观察犬颧骨牵张成骨效果。方法:实验于2004-10/2005-4在解放军第四军医大学实验外科实验室完成。①以6只犬为实验动物,实验侧,全麻下截除部分上颌骨颧突制作宽约10mm节段性缺损,模拟上颌骨大型缺损,施行颧骨牵张成骨,0.5mm/次,2次/d,连续10d,共牵引10mm。保留对侧骨质完好为对照侧。②固定期X射线观察,分别于8,12,16周取材,行骨密度分析、大体标本、扫描电镜观察。结果:①6只犬实验内容按计划完成,牵张区新骨生成顺利,快速。②于固定期8周时,新骨形成良好,但骨质结构、密度和成熟状况与正常骨相比尚存在一定差距,实验侧骨密度为对照侧骨密度的56.9%,此后,各项指标进行性加强,至16周时,新生骨骨质结构已接近于正常骨,并具备相当的密度,实验侧骨密度为对照侧骨密度的86.1%。结论:颧骨牵张成骨效果确切,在固定期8周时,新生骨生成良好,骨缺损修复基本完成,此后,骨质不断改建和成熟,骨密度进行性加强,固定期16周时,新生骨在成熟状况,厚度、密度等方面接近于正常骨。固定期8～12周时可考虑卸下牵张器,确定进一步治疗方案。     

舒血宁注射液干预急性心肌梗死介入治疗患者血浆糖原合成酶激酶3β水平的变化

目的:观察急性心肌梗死经皮冠脉内介入治疗患者血浆糖原合成酶激酶3β及脂质过氧化反应水平变化及舒血宁注射液的干预作用。方法:选取2004-11/2005-09在解放军总医院行急诊经皮冠脉内介入治疗的急性心肌梗死患者45例。随机数字表法分为舒血宁组23例,男15例,女8例,平均年龄(56.8±10.3)岁。在经皮冠脉内介入治疗基础上加用舒血宁注射液40mL静脉注射,1次/d,共7d。对照组22例,男13例,女9例;平均年龄(55.3±11.5)岁。行经皮冠脉内介入治疗,另取15例健康人血浆为正常对照,平均年龄(52.3±8.3)岁。分别应用ELISA法、分光光度计法、聚合酶链反应法和western blotting法,检测患者入院时及术后第1,3,7天的血浆糖原合成酶激酶3β、肿瘤坏死因子α、白细胞介素6、超氧化物歧化酶、丙二醛水平。结果:45例患者、15名正常人全部进入结果分析。①血浆糖原合成酶激酶3βmRNA及糖原合成酶激酶3β蛋白含量:舒血宁组和对照组患者入院时、术后1d较正常组升高;术后3d和7d舒血宁组低于对照组(3d:0.224±0.023比0.321±0.036,0.401±0.044比0.524±0.054;7d:0.186±0.021比0.245±0.033,0.154±0.025比0.215±0.022,P<0.01)。②血浆超氧化物歧化酶、丙二醛及肿瘤坏死因子α、白细胞介素6水平:舒血宁组和对照组患者入院时、术后1d血浆白细胞介素6、肿瘤坏死因子α、丙二醛水平均高于正常组;术后3d和7d患者血浆白细胞介素6、肿瘤坏死因子α、丙二醛水平显著降低,舒血宁组低于对照组,超氧化物歧化酶活性高于对照组。结论:心肌梗死经皮冠脉内介入治疗患者血浆糖原合成酶激酶3βmRNA及蛋白水平呈先上升后下降的趋势,舒血宁注射液能减轻再灌注损伤,具有心肌保护作用,该作用可能与血浆糖原合成酶激酶3βmRNA及蛋白调节有关。     

赤芍总苷诱导K562细胞凋亡及对线粒体膜电位和Ca2+的影响

目的:赤芍总苷能诱导鼠HepA和S180细胞凋亡,但赤芍总苷能否抑制K562细胞增殖及其诱导K562细胞凋亡的机制尚不明确.观察赤芍总苷诱导人红白血病细胞株K562细胞凋亡及线粒体膜电位与Ca2 水平的变化,以探讨凋亡机制.方法:实验于2007-03-02/2007-10-20在北京中医药大学细胞生化实验室,国家重点实验完成.①实验材料:赤芍总苷由西安奥晶科技发展有限公司提供,批号:060417,纯度>95%.人红白血病K562细胞株购自上海中科院细胞库.②实验方法:取对数生长期的K562细胞,培养24 h后加入50 mg/L赤芍总苷进行干预,光镜下观察细胞形态.MTT显色法检测25,50,75,100,150,200,400 mg/L赤芍总苷对K562细胞增殖的抑制作用,以仅加入无血清培养基培养的为对照.③实验评估:采用Annexin V/PI双标记法检测凋亡效应,罗丹明123(Rh123)染色流式检测线粒体膜电位和荧光染料Fluo-3AM流式检测K562细胞内游离Ca2 浓度.结果:①50 mg/L 赤芍总苷作用K562细胞24 h后,出现核固缩、核碎裂和凋亡小体等形态学改变.②与对照组相比,不同质量浓度赤芍总苷能明显抑制K562细胞的增殖(P < 0.01),并具有量效关系,呈时间和剂量依赖性.③细胞线粒体经Rh123染色呈现明亮绿,不同质量浓度赤芍总苷干预组荧光强度均较对照组明显减弱,膜电位水平较高.④赤芍总苷可引起细胞线粒体膜电位下降.不同质量浓度赤芍总苷组细胞内游离Ca2 浓度均升高, 线粒体膜电位下降,与对照组比较差异显著(P < 0.01).结论:赤芍总苷诱导K562细胞凋亡的可能机制是通过减低细胞内线粒体膜电位及提高游离Ca2 水平,从而导致细胞凋亡.     

Affect and Incident Participation Restriction in Adults With Knee Osteoarthritis

Objective

Participation restriction, common among people with knee osteoarthritis (OA), may be influenced by affect. We examined the risk of incident participation restriction over 84 months conferred by positive and negative affect among people with knee OA.

Methods

Participants were from the Multicenter Osteoarthritis Study and had or were at high risk of knee OA. Participation restriction was measured using the Instrumental Role Limitation subscale of the Late‐Life Disability Index, and affect was measured using the positive affect and depressed mood subscales of the Center for Epidemiologic Studies Depression Scale. Robust Poisson regression was used to calculate the risk of incident participation restriction over 84 months conferred by combinations of low and high positive and negative affect, adjusting for covariates.

Results

Of 1,810 baseline participants (mean age 62.1 years, 56% female), 470 (26%) had incident participation restriction over 84 months. Participants with low positive affect had 20% greater risk of incident participation restriction than those with high positive affect; participants with high negative affect had 50% greater risk of incident participation restriction compared to those with low negative affect. Participants with both low positive and high negative affect had 80% greater risk of incident participation restriction compared to other combinations of positive and negative affect.

Conclusion

Low positive and high negative affect, both alone and in combination, increase the risk of participation restriction among adults with knee OA. Efforts aimed at preventing participation restriction in this population should consider these mood states.

     

Multistate outbreak of hepatitis A associated with frozen strawberries.

A multistate outbreak of hepatitis A was traced to frozen strawberries processed at a single plant. Among 827 students and 60 teachers at an elementary school in Georgia during a 2-week period, 15 developed hepatitis A. Three months later, among 174 residents and 467 staff in an institution for the developmentally disabled in Montana during a 3-week period, 13 developed hepatitis A. Primary attack rates were 10% in the school and 8% in the institution. Cohort analysis in the school implicated consumption of strawberry shortcake in hepatitis A virus (HAV) infection (relative risk, 7.6; 95% confidence interval, 1.04-55.6). In the institution, such analysis implicated desserts and uncooked strawberries as the most biologically plausible vehicle of HAV transmission. Molecular analysis of HAV from patients in the two outbreaks revealed that the viral genomes were genetically identical and distinct from other known US strains. Contamination of food products before retail distribution is rare but should be considered in investigating common-source outbreaks of hepatitis A.