C-reactive protein as a predictor for cardiac events in Chinese elderly patients with coronary heart disease

Background and objective To assess the predictive value of C-reactive protein(CRP) for major adverse cardiac events and the association between CRP level and the coronary lesion morphology and extent in patients with coronary heart disease (CHD). Methods CRP was measured on admission in 177 consecutive elderly (age>60 years) patients with CHD who underwent coronary angiography. Patients were divided into high CRP group (CRP≥3mg/L) and normal CRP group (CRP <3mg/L). The association between CRP levels and the coronary lesion features, including severity of stenosis (mild, moderate, severe), extent of lesion (diffused or non-diffused), eccentricity of the plaque (eccentric or non-eccentric) were analyzed. Patients were followed up for a mean of 8 months for the occurrences of major adverse cardiac events (MACE). Results Compared with patients in normal CRP group, patients in high CRP group were more frequently to have unstable angina, multi-vessel, diffuse, eccentric lesions, positive remodeling, and non-smooth plaques (P<0.01). Kaplan-Meier analysis showed patients in high CRP group had a significantly lower MACE-free survival rate than patients in normal CRP group (Log-rank =12.0, P<0.01); Cox regression analysis indicated CRP level as an independent predictor for the occurrence of MACE (OR=3.16, P<0.05) Conclusions High CRP level is associated with more extend, severe and eccentric coronary lesions and is an independent predictor for MACE in elderly patients with CHD.     

FTIR直接测定法对川贝母和珠贝、小东贝的区别鉴定

目的 对川贝母、浙贝母和东贝母进行区别鉴定。方法 采用傅里叶变换红外光谱法直接测定植物中药材的红外光谱。结果 川贝母、浙贝母和东贝母的红外光谱差别较大。结论 可以采用FTIR直接、快速、准确地测定同属不同种的川贝母、浙贝母和东贝母。     

腔镜甲状腺切除术并发症的防治(附169例报告)

目的：探讨腔镜甲状腺切除术后并发症的防治经验。方法：对169例患施行腔镜甲状腺切除术，总结本类手术术后并发症的危险因素及防治措施。结果：共163例患成功施行腔镜甲状腺切除术，6例中转开放手术。共出现11例并发症：脂肪液化2例，皮下气肿1例，皮肤淤斑2例，术后头痛2例，一过性声音低钝1例，一过性声音嘶哑2例，术后甲状腺危象1例，未发现复发及死亡。结论：腔镜甲状腺切除术有其特殊并发症，通过精细的术中操作和适当的围手术期处理可以降低其发生率。     

杨文华教授辨治慢性再生障碍性贫血经验浅析

从慢性再生障碍性贫血的中医病因病机及临证遣方用药特点等方面对杨文华教授的治疗经验进行归纳、总结,以期为临床治疗提供借鉴。杨文华教授认为慢性再生障碍性贫血发病以肾虚精亏为本,脉络瘀阻为标,“肾虚精亏、髓枯血瘀”为病机关键,治疗以“补肾生髓、祛瘀生新”为根本大法,同时注重调补阴阳,善用血肉有情之品、炭类止血药物及中药药对等治疗,临床疗效显著。     

Cardioprotective effects of mitochondrial KATP channels activated at different time

Backgroud Recent studies in adult hearts have indicated that KATP channels in the inner mitochondrial membrance are responsible for the protection. And we investigated whether opening of mitochondrial KATP channels (mKATP) could provide myocardial protection for immature rabbits and determined its role in cardioprotection.Methods Thirty-four 3-4-week-old rabbits, weighing 300-350 g, were divided randomly into five groups: Group Ⅰ (control group, n=8); Group Ⅱ ［diazoxide preconditioning group; n=8; the hearts were pretreated with 100 μmol/L diazoxide for 5 minutes followed by 10-minute wash out with Krebs-Henseleit buffer (KHB)］; Group Ⅲ ［diazoxide+5-hydroxydeconate (5-HD) preconditioning group; n=5; the hearts were pretreated with 100 μmol/L diazoxide and 100 μmol/L 5-HD); Group Ⅳ (diazoxide+cardioplegia group; n=8; cardioplegia containing 100 μmol/L diazoxide perfused the hearts for 5 minutes before ischemia); Group Ⅴ (diazoxide+5-HD+cardioplegia group; n=5; the cardioplegia contained 100 μmol/L diazoxide and 100 μmol/L 5-HD). All hearts were excised and connected to langendrff perfusion system and passively perfused with KHB at 38℃ under a pressure of 70 cmH2O. After reperfusion, the recovery rate of left ventricular diastolic pressure (LVDP), ±dp/dtmax, coronary flow (CF), the creatinine kinase (CK), lactate dehydrogenase (LDH), aspartate aminotransferase (AST) in coronary sinus venous effluent and the tissue ATP were measured. Mitochondria were evaluated semiquantitatively by morphology.Results After ischemia and reperfusion (I/R), the two groups that were treated by diazoxide only (Groups Ⅱ and Ⅳ) had a significant improvement in LVDP, ±dp/dtmax, and CF recovery. AST, LDH, and CK were decreased, and the levels of tissue ATP in the two groups were higher. Mitochondria was protected better in Group Ⅳ than in other groups. Conclusions Activating mKATP channels before and during ischemia can similarly protect immature rabbit hearts, and the mechanism is related to the direct protective effect on mitochondria. Opening of mKATP channel during ischemia provides a better protection for mitochondria than it does before ischemia.     

电针对庆大霉素耳中毒豚鼠耳蜗内琥珀酸脱氢酶的影响

目的　观察电针对豚鼠庆大霉素 (gentamicin ,GE)耳中毒引起的耳蜗琥珀酸脱氢酶 (succinatede hydrogenase ,SDH)变化的影响。方法　将动物随机分成 3组 :GE组动物肌肉注射GE80mg·kg-1 d-1,连续注射 2 0天 :针刺组肌肉注射GE同GE组 ,每天电针双侧听宫、翳风、肾俞穴 1次 ,持续刺激 15min ;对照组动物不做任何处理。以脑干听觉诱发电位 (BAEP)、SDH组织化学检测为观察指标。结果　对照组BAEP和SDH两项指标无明显变化 ;GE组BAEP反应阈明显升高 ,SDH显色变淡或消失 ,毛细胞受损显著 ;针刺组BAEP反应阈升高幅度和SDH变化及毛细胞损害程度均明显低于GE组。结论　针刺组能减轻GE耳毒性 ,对SDH有保护作用     

防范护理纠纷加强自我保护意识

随着我国经济的迅速增长,人民生活水平的不断提高,法制化进程的逐步加快,人们的法律意识、健康意识和自我保护意识大大增强,特别是新的《医疗事故处理条例》的实施,将医患纠纷的举证责任倒置,使医疗机构处于相对不利的位置,更增加了医疗纠纷的发生比例,增加了处理医疗纠纷的难度。护理人员如果仍停留在陈旧的工作模式上,不接受新知识、新理念,法律意识淡漠,不懂得运用法律武器来保护自己,不依法办事,工作中会引起不必要的纠纷。故加强自我保护意识,分析护理纠纷发生的原因,采取有力的防范措施,才能维护病人及护士的合法权益。     

甲型副伤寒杆菌ompX基因原核表达及表达产物免疫原性鉴定

目的构建甲型副伤寒杆菌外膜蛋白基因ompX的原核表达系统,确定其重组表达产物rOmpX免疫原性。方法采用PCR从甲型副伤寒杆菌标准株50001扩增目的基因并构建其原核表达系统,IPTG诱导表达目的蛋白,提取并纯化表达产物。采用免疫扩散法和Western blot鉴定其免疫原性。结果成功构建了ompX的原核表达系统,rOmpX表达量约为细菌总蛋白的28%。rOmpX免疫家兔可产生抗体并能与重组蛋白rOmpX产生阳性Western blot杂交信号。结论成功构建甲型副伤寒杆菌外膜蛋白基因ompX的原核表达系统,rOmpX具有良好的免疫原性,可作为甲型副伤寒杆菌基因工程疫苗候选抗原之一。     

慢性咽喉炎应用蓝芩口服液治疗的临床分析

目的：探讨慢性咽喉炎应用蓝芩口服液治疗的临床分析。方法将2013年7月—2014年7月在该院内科治疗的100例慢性咽喉炎患者随机分为两组,对照组采用常规治疗的方法,观察组在此基础上服用蓝芩口服液,治疗2个疗程后比较两组患者的临床效果、症状改善时间、不良反应等。结果对照组治疗有效率为82%,观察组治疗有效率为94%,差异有统计学意义（P＜0.05）;观察组咽部疼痛充血、咽部粘膜干燥、咽痒咽干、咽部异物感等在症状改善时间上明显短于对照组,差异有统计学意义（P＜0.05）;两组均未有明显不良反应（P＞0.05）。结论慢性咽喉炎应用蓝芩口服液治疗效果显著,利于症状的缓解,减少复发,具有积极的临床意义。