铂类制剂致后根神经节神经元凋亡机制

铂类制剂是建立在一个金属元素基础上的抗癌药物,是临床应用最广泛的抗恶性肿瘤药物之一。但此类药物均存在不同程度的周围神经毒性,从而限制了临床应用。现从细胞分子生物学角度对其致周围神经系统毒性靶器官后根神经节(DRG)神经元凋亡方面的研究进展作一综述。     

依折麦布联合阿托伐他汀对2型糖尿病患者ApoB/ApoA1的影响

目的:探讨依折麦布联合阿托伐他汀(10 mg/d+10 mg/d)与阿托伐他汀(20 mg/d)单药治疗对2型糖尿病患者ApoB/ApoA1的影响?方法:90例2型糖尿病合并血脂异常患者[低密度脂蛋白胆固醇(LDL-C)>2.6 mmol/L]随机分为2组:联合组42例,在常规治疗基础上服用依折麦布和阿托伐他汀各10 mg/d;他汀组48例,在常规治疗基础上服用阿托伐他汀20 mg/d,共12周?观察2组患者治疗前后的ApoB/ApoA1?血脂?血糖水平变化及不良反应?结果:治疗12周后,只有联合组ApoB/ApoA1值较治疗前显著降低(P < 0.01);两组LDL-C?总胆固醇(TC)?甘油三酯(TG)均较治疗前显著降低(P < 0.01),且联合组较他汀组下降更明显(P < 0.05);两组高密度脂蛋白胆固醇(HDL-C)均较治疗前升高,但组间差异无统计学意义?治疗前后两组空腹血糖(FPG)?糖化血红蛋白(HbA1c)?血肌酐(Scr)?丙氨酸氨基转移酶(ALT)?天门冬氨酸氨基转移酶(AST)及肌酸激酶(CK)无明显变化?结论:依折麦布联合阿托伐他汀能够更好地改善2型糖尿病患者的血脂谱,可能较他汀单药治疗更有效降低患者发生心血管并发症的风险?     

光学相干断层扫描比较不稳定性和稳定性心绞痛患者粥样硬化斑块特征

Objective To compare the characterization of coronary atherosclerotic plaques in patients with unstable angina pectoris (UAP) and stable angina pectoris (SAP) by optical coherence tomography (OCT). Methods OCT was performed in 47 patients (23 UAP and 24 SAP) undergoing coronary angiography. Lipid-rich plaque (defined by ≥ 2 quandrants of the cross-section area), thin cap fibroatheroma (TCFA), thickness of fibrous cap, plaque rupture, calcification and thrombus visualized by OCT were compared between UAP and SAP patients. Results OCT imaging was successfully in 44 out of 47 patients (22 UAP, 22 SAP). Proportion of lipid-rich plaques was similar between UAP and SAP groups [91% (20/22) vs, 73% (16/22),P =0. 741]. The minimum thickness of fibrous cap in the UAP group was significantly thinner than that in SAP group [(69.5±34.7) μm vs. (141.1±68.5) μm, P = 0.000] and the rate of fibrous cap erosion in the UAP group was significantly higher than that in the SAP group [59% (13/22) vs. 9% (2/22), P=0.000]. Percents of TCFA [73% (16/22) vs. 14% (3/22) ,P = 0.000] and plaque rupture [50% (11/22) vs.9% (2/22) , P = 0.003] were significantly higher in UAP group compared those in SAP group. Incidence of thrombus and calcification were similar between two groups. Conclusions OCT imaging can clearly define plaque characterization of coronary atherosclerosis. UAP patients have thinner fibrous cap, higher incidences of fibrous cap erosion, plaque rupture and TCFA compared patients with SAP.     

急性心肌梗死合并急性胆囊炎及溶血性贫血1例分析

我们经过内科保守治疗成功救治1例急性心肌梗死合并急性胆囊炎及溶血性贫血的患者,现报告如下。1病历摘要男,62岁。主因发作性胸痛15d,加重4d入院。患者15d前晚餐后出现胸痛,每次持续30min～1h,可自行缓解,未诊治。     

中学生睡眠质量及其影响因素的调查分析

目的：通过对会宁二中高一至高三年级学生进行问卷调查，分析中学生睡眠质量厦相关影崎因素。方法：调查对象为会宁二中高一至高三年级学生，采用分层抽样的方法，每年级发放200份问卷，男女生各100份。最终回收有效问卷500份，采用SPSS统计学软件进行分析。结果：500份有效问卷，分成男、女两组，其中男生组存在睡眠质量问题的有45名（17．8％），女生组存在睡眠质量问题的有46名（18．5％），平均有18．2％的学生存在睡眠质量问题；且性别、年龄、所在地区、家庭环境、考试成绩、学习压力、个人情绪、多梦、饮食等因素均是影响学生睡眠质量的重要因素。结论：当前中学生存在不同程度的睡眠问题，要想改善此现状，除需学生自身养成良好作息习惯外，还需要教师及学校的努力，学校可通过设立心理、睡眠咨询室，来指导学生养成良好的睡眠习惯，改善学生睡眠质量。     

冠心病患者冠状动脉病变进展的相关危险因素的研究

目的探讨影响初发冠状动脉粥样硬化性心脏病(冠心病)患者冠状动脉病变进展的相关危险因素。方法纳入2008年1月至2012年12月在北京电力医院心内科行冠脉造影检查(CAG)的患者122例,所有患者初次行CAG检查时被确诊为冠心病,在此期间完成第2次CAG检查。根据两次CAG检查结果将患者分为冠脉病变进展组和无进展组。比较两组患者基线时的冠心病相关危险因素包括性别、年龄、吸烟史、高血压病史、糖尿病病史、血脂水平和冠脉病变的特点,采用二分类logistic回归分析研究冠脉病变进展的独立预测因素。结果两次冠脉造影检查平均间隔时间为(33.4±19.5)个月。第2次冠脉造影检查时71例(58.2%)患者有冠脉病变进展,51例(41.8%)患者无冠脉病变进展。与无进展组患者相比,进展组患者基线吸烟者比例更高(59.2%vs.39.2%,P=0.03),基线高密度脂蛋白胆固醇(HDL-C)水平较低(0.97±0.25 mmoL/L vs.1.18±0.25 mmoL/L,P=0.029),基线冠脉造影三支病变者更多(38.0%vs.15.7%,P=0.007),更多患者基线冠脉造影检查时行经皮冠状动脉介入(PCI)治疗(88.7%vs.70.6%,P=0.011)。二分类logistic回归分析显示,基线HDL-C水平(OR=0.167,95%CI:0.033～0.854,P=0.032),基线冠脉造影检查时接受PCI治疗(OR=3.281,95%CI:1.268～8.491,P=0.014),基线时冠脉三支病变(OR=4.289,95%CI:1.447～12.712,P=0.009)和两次冠脉造影检查间隔时间(OR=1.029,95%CI:1.007～1.052,P=0.01)是冠脉病变进展的独立预测因素。结论基线HDL-C水平、基线冠脉造影时接受PCI治疗、三支病变和两次冠脉造影检查间隔时间是冠心病进展的独立预测因素。     

血清胱抑素C和同型半胱氨酸与颈动脉粥样硬化及脑梗死的相关性研究

目的 探讨胱抑素C(Cys-C)、同型半胱氨酸(Hcy)与脑梗死及颈动脉粥样硬化的相关性.方法 选取2017年1月至2019年8月于本院神经内科住院治疗的289例患者作为研究对象,其中脑梗死患者作为观察组(n=150),非脑梗死患者作为对照组(n=139),两组均行颈动脉多普勒超声和血生化检查.根据颈动脉多普勒超声检查...     

下半身充气保温在胸腔镜肺癌根治术患者中的应用效果观察

目的 探讨下半身充气保温对胸腔镜肺癌根治术患者核心体温及细胞免疫功能的影响。方法 选择2020年3月至2022年10月在我院拟行胸腔镜肺癌根治术患者83例,采用随机数字表法分为观察组(42例)与对照组(41例)。在常规手术室保温干预的基础上,对照组给予充气式保温毯覆盖上半身,观察组给予充气式保温毯覆盖下半身。麻醉诱导前(T₀),麻醉诱导后30 min(T₁)、60 min(T₂)、90 min(T₃)、120 min(T₄)、术毕(T₅),比较两组核心体温(鼓膜温度);T₀、T₅时比较两组T淋巴细胞亚群;观察两组寒颤、恶心呕吐、低氧血症、躁动等并发症发生情况。结果 观察组T₁、T₂、T₃、T₄、T₅时核心体温均高于对照组(P<0.05);T₅时CD3⁺、C...     

光学相干断层扫描比较不稳定性和稳定性心绞痛患者粥样硬化斑块特征

Objective To compare the characterization of coronary atherosclerotic plaques in patients with unstable angina pectoris (UAP) and stable angina pectoris (SAP) by optical coherence tomography (OCT). Methods OCT was performed in 47 patients (23 UAP and 24 SAP) undergoing coronary angiography. Lipid-rich plaque (defined by ≥ 2 quandrants of the cross-section area), thin cap fibroatheroma (TCFA), thickness of fibrous cap, plaque rupture, calcification and thrombus visualized by OCT were compared between UAP and SAP patients. Results OCT imaging was successfully in 44 out of 47 patients (22 UAP, 22 SAP). Proportion of lipid-rich plaques was similar between UAP and SAP groups [91% (20/22) vs, 73% (16/22),P =0. 741]. The minimum thickness of fibrous cap in the UAP group was significantly thinner than that in SAP group [(69.5±34.7) μm vs. (141.1±68.5) μm, P = 0.000] and the rate of fibrous cap erosion in the UAP group was significantly higher than that in the SAP group [59% (13/22) vs. 9% (2/22), P=0.000]. Percents of TCFA [73% (16/22) vs. 14% (3/22) ,P = 0.000] and plaque rupture [50% (11/22) vs.9% (2/22) , P = 0.003] were significantly higher in UAP group compared those in SAP group. Incidence of thrombus and calcification were similar between two groups. Conclusions OCT imaging can clearly define plaque characterization of coronary atherosclerosis. UAP patients have thinner fibrous cap, higher incidences of fibrous cap erosion, plaque rupture and TCFA compared patients with SAP.     

Ⅰ期综合心脏康复对ST段抬高型心肌梗死急诊经皮冠状动脉介入术后患者的疗效

目的 探究Ⅰ期综合心脏康复对于急性ST段抬高型心肌梗死（ST elevation myocardial infarction, STEMI）患者急诊经皮冠状动脉介入治疗（percutaneous coronary intervention, PCI）后的康复疗效。方法 选取2021年6月至2022年6月国家电网公司北京电力医院心血管内科收治的72例急性ST段抬高型心肌梗死并行急诊PCI的患者作为研究对象,采用随机数字表法将其随机分为常规治疗组和康复组,每组各36例。常规治疗组采用常规护理与健康宣教,康复组在此基础上实施Ⅰ期综合心脏康复,包括初期评估（心血管综合评估）、运动训练（运动训练和呼吸训练）、日常活动指导与健康教育、出院评估（6分钟步行试验和Barthel指数评估）。比较两组患者出院时Barthel指数（BI）得分、出院时6分钟步行试验测试距离（6MWD）、住院期间及出院1个月内主要不良心血管事件（major adverse cardiovascular event,MACE）的发生率和住院时间等。结果 干预后,康复组6MWD和BI得分均优于常规治疗组,差异有统计学意义（P &l...