α-(取代苯丙酮酰氨基)-β-取代苯基丙烯酸乙酯化合物的360兆核磁共振氢谱和碳谱

本文由360兆核磁共振仪测定的PMR和CMR谱,结合元素分析、IR及MS等数据,确定了三个未知化学结构的化合物为α-(取代苯丙酮酰氨基)-β-取代苯基丙烯酸乙酯,并归属了全部CMR谱线。由80兆PMR则无法判明。     

老年糖尿病患者疾病认知的社区护理干预

糖尿病是一种以发病率高并发症严重的慢性终身性疾病。近年来,由于人类饮食结构、环境因素的改变,全球糖尿病的发病率迅速上升。目前全球糖尿病平均患病率为4%,总人数超过2亿,我国糖尿病患者数约4000万[1,2]。糖尿病及其并发症严重影响人们的生活质量,增加了经济负担。护理干预不仅能够帮助患者提高生活质量,减少医疗开支,同时可改善新陈代谢紊乱。社区护理干预对老年糖尿病患者的健康显得尤为重要,现报道如下。     

血浆同型半胱氨酸的表达及变化在不同病因大细胞贫血患者中的鉴别及治疗意义

Objective To examine the serum homocysteine,folic acid and Vitamin B12 levels in macrocytic anemia patients and observe their dynamic changes following therapy. Methods Homocysteine,folic acid and Vita-min B12 were analyzed by electro-chemiluminescence immunoassay. Complete blood cell count was analyzed by opti-cal method and resistance method. Results The homocysteine is significantly higher in nutritional megaloblastic a-nemia[ (71.26±27.84)μmoL/L ] than in drug-induced megaloblastic anemia[(11.44±5.06)μmol/L],in myel-odysplastic syndrome[ (9.51±4.13)μmol/L] and in the normal control group[(8.74±5.42)μmoL/L] (P<0.01). After treated with low-dosage folic acid and Vitamin B12,the patients with megaloblastic anemia presented slow declining but eventually normal homocysteine levels,compared with those received high-dosages. Conclusion Homocysteine can be used for differential diagnosis of macrocytic anemia. The duration of remaining of abnormal ho-mecysteine levels is related to the dosage of folic acid and Vitamin B12.     

输卵管妊娠的药物保守治疗观察

输卵管妊娠是妇科常见的急腹症。近年来发病率不断上升，我院应用米非司酮联合甲氨蝶呤（MTX）治疗未破裂型输卵管妊娠取得较好的效果，现总结如下。     

老年人消化性溃疡并上消化道出血误诊26例分析

将我院 1999- 0 1～ 2 0 0 3- 0 4收治的老年人消化性溃疡并出血误诊 2 6例分析如下。1　临床资料本组男 2 1例 ,女 5例 ,年龄 6 0～ 80岁 ,平均 6 5 .17岁。上腹轻微不适者 12例 ,胸骨后疼痛者 5例 ,吞咽时咽部阻塞感 6例 ,头晕、胸闷、乏力 3例。有明确溃疡病史者 19例 ,病史时间 0 .5～ 5 0 a,平均 12 .7a;有明显合并症者 2 3例 ,其中冠心病 8例 ,高血压病 12例 ,肺气肿、肺心病 8例 ,糖尿病 4例 ,胆道系统疾病 5例 ,风湿性关节炎 2例 ,无明显合并症者 3例。入院时心电图检查 8例有明显缺血表现 ,其中 2例伴房性早搏 ;6例血红蛋白为 9～ …     

血浆同型半胱氨酸的表达及变化在不同病因大细胞贫血患者中的鉴别及治疗意义

Objective To examine the serum homocysteine,folic acid and Vitamin B12 levels in macrocytic anemia patients and observe their dynamic changes following therapy. Methods Homocysteine,folic acid and Vita-min B12 were analyzed by electro-chemiluminescence immunoassay. Complete blood cell count was analyzed by opti-cal method and resistance method. Results The homocysteine is significantly higher in nutritional megaloblastic a-nemia[ (71.26±27.84)μmoL/L ] than in drug-induced megaloblastic anemia[(11.44±5.06)μmol/L],in myel-odysplastic syndrome[ (9.51±4.13)μmol/L] and in the normal control group[(8.74±5.42)μmoL/L] (P<0.01). After treated with low-dosage folic acid and Vitamin B12,the patients with megaloblastic anemia presented slow declining but eventually normal homocysteine levels,compared with those received high-dosages. Conclusion Homocysteine can be used for differential diagnosis of macrocytic anemia. The duration of remaining of abnormal ho-mecysteine levels is related to the dosage of folic acid and Vitamin B12.     

胶质母细胞瘤MGMT基因启动子甲基化与蛋白表达

Objective To study the correlation of MGMT gene promoter methylation and protein expression and their regional variation in different specimens obtained from different regions within the tumor in patients with newly diagnosed glioblastoma. Methods Two to four samples in the same tumor were collected from different regions in 30 patients with newly diagnosed glioblastoma patients. In five patients among them,mutispecimens were obtained under assistance of neuronavigation system during the operation. In all samples,MGMT promoter profile were analyzed by Methylation - specific polymerase - Chain - reaction analysis, MSP ,while MGMT protein expression was detected in tissue sections by immunohistochemistry,IHC. Results MGMT promoter methylation was detected in 43. 56% (44/101) specimens. MGMT protein expression in tissue sections was assessed and scored:(1 :no or positive tumor cells < 10%, 2: ≥ 10% ≤50% ,3: > 50%) ,The rate of MGMT staining with a score 1,2,3 in all of tumor sections was 32. 67% ,43.56% ,23. 76% respectively. No significant correlation between MGMT protein expression and promoter methylation(x2 =2. 905, P =0.088) was found. The regional heterogeneity of MGMT protein expression within the same tumor was in 57% (17/30) patients ;and the regional heterogeneity of gene promoter methylation was in37%(11/30)patients. Conclusions MGMT promoter methylation is probably not the only modulating element in MGMT protein expression. The heterogeneity of MGMT protein expression and its promoter methylation in the same tumor questions their guiding significance in making therapeutic scheme for individual patients with malignant glioma in clinical practice.     

血液流变学与糖尿病视网膜病变关系的研究

目的为探讨分析血液流变学与糖尿病视网膜病变的关系,而对45例糖尿病DR患者,34例糖尿病无DR患者和31例正常人的血液流变学指标进行了检测。结果糖尿病视网膜病变(DR)组、糖尿病无视网膜病变(NDR)组血浆纤维蛋白原、血液粘度、红细胞聚集指数均明显高于正常对照组。这些变化在DR组患者更为显著。结论DR的发生发展与血液流变学异常所致的微循环功能障碍有关。     

胰高血糖素瘤1例

胰高血糖素瘤是一种极为罕见的胰腺内分泌肿瘤,本科在2009年2月收治1例并确诊,现报道如下. 患者,女,51岁.因"双下肢反复出现皮损3个月"入院.患者3个月前双下肢出现对称性红斑伴瘙痒,反复发作.入院后行腹部CT示胰尾实性占位,伴胰管扩张,脾内可见不均匀强化.血胰高血糖素为600 pg/mL.2010月2月9日行剖腹探查术.术中探查胰尾处可及实性肿物约7 cm×6 cm×4 cm,累及脾门伴脾内转移,行胰体尾+脾切除.术后病理示胰尾部恶性胰高血糖素瘤,免疫组化结果见图1.术后24h皮疹消退明显,1周后皮疹基本消失.