急性大血管闭塞性轻型卒中血管内治疗的疗效及安全性观察

目的 观察急性大血管闭塞性轻型卒中患者血管内治疗的疗效及安全性。
方法 回顾性分析2018年1月-2019年5月行血管内治疗的急性大血管闭塞性轻型卒中（NIHSS评分
≤5分）患者的临床资料。观察术后血管成功再通率（mTICI≥2b级）、围手术期并发症、90 d良好预后率
（mRS评分≤2分）等。
结果 共纳入13例患者，平均年龄58.7±14.5岁，男性11例（84.6%）。术后血管成功再通率100%；围
手术期并发症2例，假性动脉瘤1例、无症状性颅内出血1例；90 d良好预后率100%。
结论 急性大血管闭塞性轻型卒中行血管内治疗可能是安全、有效的。     

中医情志的发生机制刍议

在情志学说和脑主神明理论指导下对情志产生的生理机制作新的诠释。认为脑神的气化出入及整合作用是情志发生的生理基础 ;五脏所化的气血精津为情志发生的物质基础     

早期大剂量维生素C对重症急性胰腺炎大鼠核因子-κB的影响

目的:观察早期大剂量应用抗坏血酸(维生素C)对重症急性胰腺炎(SAP)大鼠的核因子-!B(NF-!B)的影响,研究其作用机制。方法:将72只SAP模型SD大鼠随机分成3组,每组各24只。A组:由大鼠股静脉滴注生理盐水5 ml/kg。B组:大鼠股静脉滴注Vit C 15 mg/kg加生理盐水至5 ml/kg。C组:由大鼠股静脉滴注Vit C 150 mg/kg加生理盐水至5 ml/kg。另取8只SD大鼠作为正常对照组。各组分别于8 h和24 h处死8只大鼠,采血测淀粉酶、脂肪酶、维生素C(PV-C)、超氧化物歧化酶(SOD)、TNF-αI、L-6。大鼠处死时分别取胰头组织3份,一份组织HE染色,行光镜检查,按Kusske的方法,对水肿、炎症、出血和坏死分别评分;一份制成超薄切片,行电镜检查;另一份SP法进行免疫组化染色,检测NF-!B的表达。每组另外8只大鼠观察3 d内存活情况,计算3 d成活率。结果:各组大鼠3 d内的生存率为正常对照组100%(8/8),A组0%(0/8),B组12.5%(1/8),C组50%(4/8),C组的3 d生存率显著高于其他两组(P<0.05)。各组的4项病理学评分均高于正常对照组(P<0.01),C组的4项病理学评分均低于A、B组(P<0.05)。透射电镜检查示C组中分泌颗粒较少,其包膜完整、内质网轻度肿胀、线粒体清晰,未见大片坏死。SAP大鼠体内淀粉酶、脂肪酶、细胞因子TNF-α和IL-6的水平明显增高,血清SOD和P-VC降低,胰腺组织中NF-!B活化阳性胰腺细胞数明显增多。C组的血清淀粉酶和脂肪酶低于A、B组(P<0.05),SOD和P-VC水平高于A、B组(P<0.05),血清TNF-αI、L-6水平低于A、B组(P<0.05),胰腺组织NF-!B活化水平低于A、B组(P<0.05)。结论:早期大剂量应用Vit C有助于及时提高SAP大鼠的P-VC、E-SOD水平,降低体内淀粉酶、脂肪酶、TNF-αI、L-6水平,其作用机制可能与大剂量Vit C抑制SAP大鼠体内NF-!B活化、在整体水平上抑制细胞因子基因表达、有助于机体免受自由基和过量细胞因子的损伤及减轻胰腺组织的病理性改变等因素有关。     

FasL基因表达对缺氧状态下直肠癌细胞增殖凋亡的影响

Objective To elucidate the effect of FasL gene expression on the proliferation and apoptosis of hypoxic rectal carcinoma cells. Methods The normoxic expression level of FasL in HR-8348 subtype cells (HR-8348B, HR-8348L, HR-8348F and HR-8348As) with different invasive power were verified by Western blot. Hypoxia models for HR-8348B, HR-8348L, HR-8348F and HR-8348As were constructed with chemical modeling, then the FasL levels in all groups at 12 h after hypoxia were quantitated by Western blot. Distribution of different cell life cycles was determined with flow cytometry. Cell reproductive activities were detected with MTT method, and cell apoptesis was assessed with TUNEL. Results FasL protein was pigmentized at the position of 40 000 by Western blot, and the expression level of FasL was significantly higher in HR-8348F cells than those in HR-8348B, HR-8348L and HR-8348As cells(F=361.149, P<0.01) in normoxia. At 12 h after hypoxia, the FasL level was also significantly higher in HR-8348F cells than those in other groups (F=278.766, P<0.01), but was not markedly different as compared to themselves in normoxia (t=1.762, P>0.05). The proliferation index was significantly higher in HR-8348F (60.43±3.72) than those in HR-8348B (40.01±3.30), HR-8348L (41.30±4.06) and HR-8348As cells (35.87±4.39), respectively (F=39.477, P<0.01). However, both inhibition rate of proliferation and apoptotic index were remarkably lower in HR-8348F (17.30±1.98 and 13.10±1.04) than those in HR-834B (33.70±4.33 and 21.60±1.31), HR-8348L (34.20±3.92 and 20.10±1.15), and HR-8348As (38.00±4.55 and 23.90±1.23), respectively (F=28.811 and 76.462, respectively, P<0.01). Conclusion The expression enhancement of intracellular FasL in rectal carcinoma in hypoxia can lead to accelerated proliferation and reduced apeptosis of cells, which will promote tumor cells to adapt microenvironmental hypoxia.     

原发性软骨肉瘤CT诊断2例

软骨肉瘤的X线诊断已有较多研究,但软骨肉瘤的CT诊断较少研究,为此,提供经穿刺活检病理证实的软骨肉瘤2例,以提高对软骨肉瘤的CT诊断水平。病例1男,52岁。左肩关节疼痛、活动受限10年余,加重半年。查体:左肩关节活动受限、僵直,不能抬举。实验室检查:碱性磷酸酶增高。CT表现:左肱骨、干骺端骨质破坏,病变上下连续约6·0cm,中心呈大囊状,周围呈小囊状,破坏区中见1·5cm×1·5cm的不规则高密度灶,肱骨外侧骨皮质不连续,向周围软组织侵犯,形成软组织肿块,肿块内钙化灶呈斑块状。无骨膜反应,肩关节间隙可,关节面未见侵犯(图1)。CT诊断:①左…     

Extragastrointestinal stromal tumor possibly originating from the prostate

We report a case of extragastrointestinal stromal tumor possibly originating from the prostate. The patient underwent radical prostatectomy because of no metastatic evidence. No recurrence and metastasis have been found during 14 months of follow up. To our knowledge, this may be the third such case published in a report in terms of pathological type.     

高频超声诊断新生儿卵巢增大、并腹股沟疝的临床意义

新生儿期卵巢增大,可形成卵巢囊肿、影响卵巢进入正常位置而形成腹股沟疝,导致小儿性早熟,影响小儿身高及心理发育等。自2006年1月-6月我们连续发现5例新生儿卵巢增大,予以报道。1材料与方法临床资料见表1,应用彩色多普勒超声诊断仪:Philps HD、HDI 5000,高频探头7-10mmHz。行常规下腹部及腹股沟、会阴区扫查。2结果超声检查所见及诊断结果见表1。表1 5例临床资料与超声检查结果比较异及丘脑-垂体-卵巢器质性病变产生过多激素,刺激胎儿卵巢内卵泡增生过大、内液潴溜,是导致卵巢增大的原因[3]。5例新生儿8枚卵巢增大的原因分析,说明胎儿期…     

试论七情发生和脑主神明与抑郁症病机证治的关系

抑郁症是一组以抑郁心境自我体验为中心的临床症状群或状态.中医多将其归在郁证之类,对其理论解释的重点多是在心主神明论指导下的以五脏为中心的肝,临床治疗亦多遵疏肝解郁这一基本大法,并取得了一定成效.     

Studies of the human oropharyngeal airspaces using magnetic resonance imaging IV--the oropharyngeal retention effect for four inhalation delivery systems.

Magnetic resonance imaging (MRI) of the oropharyngeal region from 20 adult volunteers using four model inhalation devices (varying mouthpiece diameters, airflow resistances) and tidal breathing was carried out. Statistical analysis (convex hull method) selected 12 scans from 80 data sets representing the extremes of all dimensions in the population. Twelve physical mouth-throat models were made by stereolithography using the exact scan data. The aim was to produce models with varying dimensions to span the adult population, and to investigate if oropharyngeal dimensions affected throat retention for different delivery systems. In an in vitro analysis, the models were used to determine the retention effect of the oropharyngeal airspaces when drug aerosols were administered from four inhalation delivery systems: a pressurised metered dose inhaler (pMDI), two different dry powder inhalers (DPIs A and B), and a nebulizer. The aims of this work were to determine the key parameters governing mouth-throat retention and whether retention was dependent on the delivery system used. Characterizing the throat models by measuring 51 different dimensional variables enabled determination of the most influential variables for dose retention for each inhalation delivery system. Throat model retention was found to be dependent on the delivery system (pMDI approximately DPI(A) > DPI(B) > Neb.). The most influential variable was the total throat model volume. Throat models representing high, median, and low oropharyngeal filtration in healthy adults have been identified.