Diagnosis and management of obstetric acute disseminated intravascular coagulation]

Twenty-seven in-patients with obstetric DIC in our hospital from Jan. 1971 to Dec. 1990 were analysed retrospectively. The incidence was 0.12% in the first decade and 0.02%, in the second, showing a difference of significance between them. The most common predisposing factors included amniotic fluid embolism, abruptio placenta and hemorrhagic shock. Bleeding from multi-organs in various extent and coagulation disorders occurred in all those 27 cases. [Besides anti-shock treatment, heparin was employed together with fibrinogen in 4 postpartum and 1 antepartum DIC patients, fibrinogen alone in 8 cases, and hysterectomy in 11 cases. 17 patients were saved and 9 died. It is important that early diagnosis and much attention paid to clinical characteristics together with serial laboratory tests. Key management should include prompt treatment and eradication of predisposing factors. Quick decision spite of to terminate the pregnancy and even hysterectomy should be done in some risks.     

透刺法配合按摩治疗周围性面神经麻痹病人的临床观察及护理

周围性面神经麻痹称之面瘫，以口眼向一侧歪斜为主症，俗称口眼歪斜。本病如果治疗不及时或治疗不当，则久治不愈，给病人造成极大痛苦。若单用针刺治疗疗程较长，疗效不显著。我科在运用针灸按摩治疗本病的同时，对病人实施了针对性的全面的护理措施。现介绍如下。     

血管重塑对大鼠血管成形术后再狭窄的影响

目的：建立大鼠颈动脉再狭窄模型，原位灌注固定取材。评价PTA后血管重塑（VR）的动态变化规律，定量分析血管重塑在血管再狭窄过程中的变化及作用。方法：制作70只SD雄性大鼠颈总动脉再狭窄模型，分原位灌注实验组、对照组，于术后1h、3、7、14、28和42天原位灌注固定取材，行HE染色、Masson染色，观察标本血管狭窄情况。结果：①血管重塑指数（VRI）在PTA后即刻最大，3天组明显降低，7天组稍有增大，其后不断减小，剩余血管腔面积百分比同VRI的变化曲线基本一致。②FFA后，血管腔面积总体呈逐渐缩小趋势，内弹力板围绕面积（IELA）1h组较对照组明显增大，3天组较1h组明显缩小，14、28、42天组较对照组明显缩小。外弹力板围绕面积（EELA）逐渐缩小。EELA、IELA的变化与血管腔面积变化呈正相关。③VRI与血管腔面积的变化呈正相关，新生内膜面积与剩余狭窄率、血管腔面积无直线相关。结论：再狭窄过程中存在扩张性重塑和收缩性重塑现象，管腔的狭窄与否取决于血管重塑指数的变化，而不是新生内膜的变化，新生内膜的形成是血管重塑过程中的一部分。IELA和EELA可作为判断管腔狭窄及评价血管重塑的指标。     

微量元素硒和维生素E联合应用对家兔实验性脂质过氧化的保护作用

目的:探讨Se和VitE联合应用对胆固醇诱发家兔脂质过氧化的保护作用。方法:制作动物模型,设对照组,分组进行脂代谢观察。结果:Se、VitE联合应用降脂、抗脂质过氧化作用,优于单独应用。结论:Se、VitE联合应用有协同抗脂质过氧化作用,亦可升高HDL水平。     

MRI顺磁性造影剂增强及护理

目的 :进一步探讨 MRI增强前后的准备与护理方法。材料与方法 :共增强 833例 ,男 5 85例 ,女 2 4 8例。使用顺磁性造影剂 Gd- DTPA,按 0 .2 m L/kg体重给药。其中双倍量增强 110例 ,增强前认真履行告知义务和签署同意书。发生造影剂外漏者给予鲜马铃薯片外敷。结果 :增强效果达良好以上共 82 5例 ,占 99% ,未发生严重负反应。 3例造影剂外漏 ,鲜马铃薯片外敷后 3h痊愈。结论 :增强前充分细致的准备是保证增强效果的重要因素。认真履行告知义务和签置同意书 ,不仅尊重了病人的权利 ,也是依法行医 ,保证医疗安全的需要     

环氧合酶-2和血管内皮生长因子共表达与肝细胞癌血管形成的关系

目的　探讨环氧合酶 (COX) 2与肝细胞癌血管形成的关系。方法　利用免疫组织化学、Westernblot方法检测 48例肝癌组织中COX 2和血管内皮生长因子 (VEGF)蛋白及逆转录 聚合酶链反应法 (RT PCR)检测COX 2和VEGFmRNA的共表达 ,对共表达COX 2和VEGF蛋白和mRNA的肝癌组织进行微血管记数。结果　免疫组织化学检测中 ,48例肝癌组织 3 6例共表达COX 2和VEGF蛋白。类似结果见于蛋白电泳分析。RT PCR显示 ,48例肝癌组织 3 6例共表达COX 2mRNA和VEGFmRNA。两者之间的表达明显相关 (γ =0 .845 )。共表达COX 2和VEGF蛋白和mRNA的肝癌组织中 ,平均微血管数 (5 6.8± 17.5 )个 ,明显高于阴性表达组。结论　COX 2可能与肝细胞癌的血管形成有关 ,且其作用之一可能是通过上调VEGF通道来发挥的     

椎管内原发性孤立性纤维性肿瘤临床病理观察(附2例报告)

目的探讨椎管内孤立性纤维性肿瘤的临床病理特征、诊断和鉴别诊断,以期提高对该肿瘤的诊断水平。方法复习2例椎管内原发性孤立性纤维性肿瘤的临床资料,并观察其组织学特征和免疫组化标记。结果2例患者男、女各1例,年龄分别为23岁和32岁,临床表现为局部神经压迫症状。MRI示椎管内髓外硬膜内占位。组织学特征为梭形、卵圆形细胞呈束状、波浪状或旋涡状排列,富于胶原纤维及伴有分支状薄壁血管。细胞未见异型性和核分裂像。免疫组化示瘤细胞Vimentin( ),CD34( ),CD99( ),Bcl-2( ),AACT(-),Actin(-),S-100(-),EMA(-),GFAP(-),CD68(-),CD117(-),SMA(-),NF(-)。结论椎管内原发性孤立性纤维性肿瘤是一种罕见的肿瘤,诊断主要依靠病理形态学及免疫组化,并应与椎管内的其他梭形细胞肿瘤鉴别。     

Inhibition of a dihydropyridine, omega-conotoxin insensitive Ca2+ channel in rat synaptosomes by venom of the spider Hololena curta.

Inhibition of the N and L type Ca2+ channels with omega conotoxin GVIA (omega-CgTx) together with the dihydropyridine (-)-202-791 produces slight reduction (congruent to 25%) of K(+)-evoked Ca2+ influx in mammalian synaptosomes. These results and others suggest the existence of a third high threshold voltage sensitive calcium channel (VSCC) responsible for the majority of influx. Venom from the funnel web spider Hololena curta potently and persistently inhibited Ca2+ influx in rat cortical synaptosomes (IC50 1:10,000 or 4.21 micrograms/venom protein/ml of synaptosomes). Also Ca2+ influx in cerebellar synaptosomes was inhibited in a similar manner. K(+)-evoked tritium release from synaptosomes labeled with [3H]noradrenaline was inhibited by Hololena venom (congruent to 60% reduction at 10 micrograms/venom protein). Inhibition of Ca2+ influx by venom was unaffected by combined omega-CgTx and (-)-202-791 pretreatment (both 1 microM). Hololena venom and its active constituent should provide useful tools to investigate the role of this novel Ca2+ channel in neuronal function.     

Macrophages are activated by 17beta-estradiol: possible permission role in endometriosis.

On the basis of the common occurrence of high concentration of estrogen and activated macrophages in patients with endometriosis, we postulate that interaction between 17beta-estradiol and macrophage may be an important affair in endometriosis. So our study was focused on the effect of 17beta-estradiol on macrophage. First morphology of macrophages was examined with environmental scanning electron microscopy. Increased size, extension of more microvilli, expression of retraction fibers and elaboration of membrane ruffles were detected in 17beta-estradiol treated macrophages. Then Nitrate and nitrite level in the supernatant was measured by the method of Griess and iNOS expression was analyzed using immunohistochemical staining. It showed that 17beta-estradiol could induce NO release from peritoneal macrophages and expression of iNOS was increased. Also more TNF-alpha in supernatant that was measured by MTT via L929 cell was produced by macrophages under the inducing of 17beta-estradiol. Furthermore, [Ca2+]i, which was viewed by microscope in a laser scanning confocal unit, elevated 39.8% in peritoneal macrophages after 17beta-estradiol 100 nmol/L treated. The results above demonstrated that peritoneal macrophage had been activated in both morphology and cytokine line when interaction with 17beta-estradiol, which indicated that macrophage activated by 17beta-estradiol might play a permission role in development of endometriosis.