急性缺血性脑卒中患者血浆胰岛素、瘦素、内脂素水平的改变及其临床意义

目的 对急性缺血性脑卒中患者中内脂素、瘦素、胰岛素的改变和临床意义进行探究.方法 将2016年6-12月来陕西省汉中市中心医院就诊的216例急性缺血性脑卒中患者设为A组,并根据是否合并2型糖尿病(T2DM)分成A1组(合并T2DM,100例)和A2组(不合并T2DM,116例),同时选择同期来该院体检的136例健康人员设为B组.收集不同人群临床资料,对比不同时间A、B两组血清瘦素水平、内脂素水平、空腹胰岛素水平.结果 A、B两组的年龄、性别、体重指数、高密度脂蛋白比较差异无统计学意义(P>0.05).A组的舒张压、收缩压、体脂含量、腰臀比、总胆固醇、三酰甘油、低密度脂蛋白都高于B组(P<0.05).在入院第1、3、7、14天,A组的低密度脂蛋白、总胆固醇、空腹血糖、胰岛素抵抗指数、胰岛素、内脂素、瘦素均大于B组(P<0.05).A1组、A2组的胰岛素抵抗指数在入院第3天均达到峰值,瘦素水平、胰岛素水平在入院第7天均达到峰值.A1组入院第7天,内脂素水大于A2组,入院第3、7、14天瘦素水平大于A2组(P<0.05).A1组入院第1、3、7、14天的胰岛素水平、胰岛素抵抗指数均大于A2组(P<0.05).结论 内脂素、胰岛素、瘦素水平同急性缺血性脑卒中的发生可能存在一定相关性,在急性缺血性脑卒患者中,合并T2DM的瘦素、胰岛素水平显著高于未合并T2DM者.     

AUTOLOGOUS TRANSFUSION AFMC EXPERIENCE (1992–1996)

In this era of Acquired Immune Deficiency Syndrome (AIDS) and other infectious diseases – complications of homologous blood transfusion, autologous transfusion is the safest possible blood for transfusion. The present study was conducted from January 1992 to August 1996 to analyse the programme of autologous transfusion. A total of 471 pre-operative autologous collections were undertaken out of a total of 27,542 blood collections during this period. The present study shows a significant increase in autologous collections from 0.44 per cent in 1992 to 3.94 per cent till August 1996. 37.1 per cent autologous donors were from the urosurgery ward. Of the total 471 autologous blood units collected, 171 were transfused to the autologous donors (27.5%).KEYWORDS: Autologous transfusion, Pre-operative, Safe blood     

MILITANCY TRAUMA : PENETRATING AND NONPENETRATING CARDIAC INJURY

Two hundred and eighty patients with serious chest injuries were treated at a service hospital during a period of 41 months. Out of 9 patients who suffered cardiac trauma S had penetrating cardiac injuries, 2 had penetrating pericardial injury and 2 patients had myocardial contusions. Myocardial contusions simulated myocardial infarction. All patients except one had polytrauma, associated injury to the lung or intra-abdominal organs. Early evacuation, resuscitation, high index of suspicion for cardiac injury and prompt surgical intervention were the keys to successful management in these patients. Thoracotomy was performed to repair the myocardial perforation and lacerated lung injuries. Associated infra-abdominal injuries were managed with laparotomy. Two patients died due to lack of cardiopulmonary bypass facilities and resistant cardiac arrhythmias. Seven patients had uneventful recovery.KEY WORDS: Heart injuries, Thoracic injuries, Traumatology, Wounds, gunshot, Wounds, nonpenetrating, Wounds, penetrating     

99Tc-MDP联合钙剂、活性维生素D3治疗甲亢继发骨质疏松症的疗效评价

目的 评价99Tc-MDP治疗甲亢继发骨质疏松症的疗效。方法 将89例甲亢继发骨质疏松患者按治疗方法分为联合治疗组（A组 42例）和对照组（B组 47例）,两组均采用131I治疗甲亢,联合治疗组采用常规口服钙剂加活性维生素D3治疗,同时加用99Tc-MDP注射治疗,10d为1个疗程,连续3个疗程,每疗程之间间隔3~4w; 对照组常规口服钙剂加维生素D3治疗。分别观察 2 组治疗前及治疗后 3、6、12 个月骨密度( BMD) 、血清骨钙素( BGP) 、骨碱性磷酸酶( B-ALP) 以及甲状腺功能各项指标( FT3、FT4、TSH) 的变化。结果 （1）131I治疗6个月后联合治疗组BGP、B-ALP开始下降,治疗前后比较差异有统计学意义（P＜0.05）;（2）联合治疗组BMD值在治疗后 12 个月较治疗前增加,与对照组比较差异有统计学意义( P＜0. 05);(3)治疗3、6、12个月后两组间甲状腺功能指标变化无差异（P>0.05）;（4）联合治疗组与对照组总有效率分别为92.8%,76.6%,联合治疗组优于对照组,差异有统计学意义（P<0.05）。结论 99Tc-MDP与钙剂及活性维生素D3联用,对甲亢继发骨质疏松症有较好疗效,具有一定临床推广价值。     

氨甲蝶呤对脑梗塞患者红细胞与内皮细胞粘附的影响

目的:探讨氨甲蝶呤对脑梗塞患者红细胞与内皮细胞粘附的影响及其机制。方法:采用流室系统,定量研究氨甲蝶呤对脑梗塞患者红细胞与内皮细胞粘附影响。结果:用氨甲蝶呤处理红细胞、内皮细胞或血浆,红细胞与内皮细胞粘附明显减少,随切应力增加,红细胞与内皮细胞粘附数目趋近于零。结论:氨甲蝶呤能明显降低脑梗塞患者红细胞与内皮细胞粘附的作用。     

The computer at the pathologist's laboratory

Computers are coming into practical use by pathologists. The computer hardware and software are briefly outlined. The software is discussed while drawing up protocols on the examination of biopsies, operative materials and autopsies. A special attention is given to the SNOP and SNOMED coding of diagnoses. How to operate on a computer is described in the paper. The latter provides evidence for applying the computer to the formulation of laboratory documents.     

Antibodies to morbilli virus of the Baikal seal in its natural host

Morbillivirus of Baikal seal (BSM) was isolated from organs of a dead animal during 1987-1988 epizootic of Baikal seal (Phoca sibirica). A method of cellular enzyme immunoassay for testing for virus-specific antibodies was developed using BSM. The method was used for antibody detection in sera of 115 apparently normal seals collected in the spring of 1989. Antibody to BSM were found in sera from 75 animals. Examinations of seropositive animals of different age and sex were carried out. The results obtained indicate a possible role of BSM in the epizootic.     

NICU中集体测量患儿体温最佳部位的临床研究

目的探寻NICU中集体测量患儿体温的最佳部位。方法将睡在暖箱中、远红外暖床上、单面光疗箱中、婴儿床里的足月儿和早产儿共210例分别测量颈温、背温、腹温、肛温并进行统计学分析,采用t检验。结果暖箱和单面光疗箱中的足月儿、早产儿的背温与肛温无显著性差异(P>0.05),远红外暖床上和婴儿床里的足月儿的背温与肛温无显著性差异(P>0.05),远红外暖床上的早产儿的背温与肛温有显著性差异(P<0.05),背温低于肛温。结论除远红外暖床上的早产儿外,其他不同环境下测量患儿背温是N ICU中集体测量体温的最佳方法。     

云南省人和家畜立克次体病血清流行病学调查

目的了解云南省正常人及主要家畜立克次体血清流行病学特点。方法按地理位置,选择云南省东北寻甸回族彝族自治县、西北玉龙纳西族自治县及南部的思茅地区3个调查点,以间接免疫荧光法检测莫氏立克次体、黑龙江立克次体、恙虫病东方体、贝氏柯克斯体、横赛巴尔通体、查菲埃立克体及人粒细胞无形体等8种常见立克次体血清IgG或IgM抗体。结果3个调查点237份成人,莫氏立克次体、巴尔通体及贝氏苛克斯体IgG抗体阳性率分别为16．46％、6．33％、9．28％。50岁人群最高（21．74％、9．57％及14．78％）,而4-6岁儿童调查结果显示,英氏立克次体IgG抗体阳性率最高,达12．35％（10／31）,动物8种病原体抗体IgG及IgM抗体均检出,其中莫氏立克次体阳性率最高（61．48％）,且地区间差异无显著意义。结论云南省正常农业人群及家畜存在多种立克次体感染,以莫氏立克次体、巴尔通体及贝氏柯克斯体为多。     

PD-1/PD-L1免疫检查点抑制剂对右心室功能的影响

目的:采用二维斑点追踪技术评估PD-1/PD-L1免疫检查点抑制剂(immune checkpoint inhibitors,ICIs)对肿瘤患者右心室功能的影响.方法:选择2018年6月至2020年11月在天津医科大学第二医院泌尿外科和肿瘤科住院的肿瘤患者46例,患者均未使用过ICIs,且进一步需要ICIs治疗.患者...