肺心病人血清胰岛功能测定

本文采用放射免疫分析法，对26例空腹血糖在正常范围的肺心病人，进行了血清胰岛素，胰高血糖素水平的测定，结果显示肺心病人存在着不同程度的潜在糖代谢异常，血清胰岛素及胰高血糖素测定，能够较为敏感地反映这一障碍，对指导临床治疗有一定的价值。     

Na/Ca交换在心肌细胞Ca~(2+)平衡和CICR过程中的作用

Ca~（2+）平衡是维持心肌细胞正常电生理活动的重要前提。在各种机制中,肌质网Ca-ATPase与肌膜Na/Ca交换蛋白对于维持胞内Ca~（2+）的平衡发挥主要作用。其中肌膜Na/Ca交换蛋白是Ca~（2+）排出胞外的主要途径,并通过调节细胞内静息状态下[Ca~（2+）]调节肌质网的[Ca（2+）]含量,从而调节心肌细胞的收缩力。少量Ca（2+）内流入胞后可触发肌质网释放大量Ca（2+）（CICR）。已证实动作电位峰电位及平台期有Ca（2+）通过Na/Ca内流,这种除极化诱导的Ca（2+）经Na/Ca内流可能是触发CICR的主要因素。总之Na/Ca交换蛋白在兴奋-收缩耦联中的作用需要重新加以评价。     

Blunt cardiac rupture with prehospital pulseless electrical activity: a rare successful experience

Blunt cardiac rupture is highly associated with mortality. In the recent literature, the reported mortality rates of cardiac rupture ranged from 59.7% to 100%. The probability of survival for those with prehospital pulseless electrical activity was extremely low. This case report describes a rare example of survival of a female patient with life-threatening cardiac rupture and cardiac tamponade after a major car accident. The victim developed pulseless electrical activity at admission. She recovered from the accident, however, without developing any signs of neurologic deficits. This case study emphasizes the value of the primary survey of patients and prompt and accurate interventions, including focused abdominal sonography for trauma, pericardiocentesis, and an urgent thoracotomy in the operating room for primary repair of cardiac rupture without applying a cardiopulmonary bypass system. The study showed that early diagnosis and aggressive interventions are crucial factors to the successful outcome of patient's survival.     

Nitrite-induced methaemoglobinaemia - aetiology, diagnosis and treatment

A 41-year-old woman presented with the clinical features of methaemoglobinaemia after drinking Chinese herbal medicine. A life threatening methaemoglobin level of 68% was measured. Both clinical and laboratory diagnostic difficulties were encountered. The pitfalls of pulse oximeter, blood gas analysis and co-oximeter interpretation during diagnosis and after methylene blue administration are discussed.     

Intra-abdominal and Retroperitoneal Lymphangiomas in Pediatric and Adult Patients

Intra-abdominal and retroperitoneal lymphangiomas are a rare, congenital malformations of the lymphatics, which are found predominantly in children. The aim of this study is to evaluate the clinical features of this tumor, highlighting the differences in adults and pediatric patients. We also evaluate the preoperative diagnosis, radiological features, surgical treatment, and outcome of this rare condition. Between 1990 and 2004, 14 patients who underwent surgical resection of an intra-abdominal lymphangioma were reviewed retrospectively. There were five pediatric patients between fetal age and 17 years of age and nine adults between 31 and 62 years of age. Overall, females outnumbered males in the series, with a male-to-female ratio of 3:4. However, males predominated in the pediatric age group with a male-to-female ratio of 1.5:1. The clinical presentation of children was more acute ranging from 3 days to 2 months. In adults, four patients were asymptomatic, and the remaining five had symptom duration ranging from 2 weeks to a year. The lymphangiomas occurred in the mesentery (n = 4), retroperitoneum (n = 4), omentum (n = 3), pancreas (n = 2), and spleen (n = 1). All the patients underwent total surgical resection with or without organ resection, and there were no recurrences at a median follow-up of 2 years (range; 3 months–13 years). This series demonstrates that abdominal lymphangiomas have a male preponderance and present more acutely in pediatric patients, whereas in adults, female patients predominate and the history is more chronic. Presented orally at the 19th World Congress of the International Society for Digestive Surgery (Yokohama) December 2004     

Present status of serum lipid levels in Beijing professional populations and its trend of changes over 15 years--a collaborative study of seven research and clinical laboratories in Beijing

BACKGROUND: China's economy has been growing rapidly since 1980, which may have affected blood lipid levels. We carried out a study on serum lipid levels and prevalence of lipid abnormalities in Beijing professional populations in 2001-2002 and assessed the changing trends of lipid levels by comparing the results with that of a similar study in 1984-1986. METHODS: The study population included 31,068 government employees, medical and educational workers and scientific research personnel (male/female 6:4). All participants had physical examination and blood chemistry tests. Lipid parameters analyzed included total cholesterol, low- and high-density lipoprotein (LDL and HDL) cholesterol and triglyceride. RESULTS: Total cholesterol, LDL cholesterol and triglyceride concentrations increased significantly as compared with the 1984-1986 study, but the variations of lipid levels with age and sex remained unchanged. Age-adjusted prevalence of dyslipidemia and its distribution in different sexes and age groups were statistically analyzed. Comparing the results with the data of the US in the 1990s, total cholesterol concentration was lower by 16 mg/dl in men and 18 mg/dl in women, whereas LDL cholesterol concentration was lower by 20 mg/dl in men and 15 mg/dl in women. HDL cholesterol was significantly higher than the US in both genders. CONCLUSIONS: The mean levels of total cholesterol (LDL cholesterol ) increased rapidly in the 1980s, stabilized and descended slightly in 1990s. Coronary lipid risk level in Beijing professional populations is significantly lower than in the US.     

Survival, regeneration and functional recovery of motoneurons after delayed reimplantation of avulsed spinal root in adult rat

We have established that extensive reinnervation and functional recovery follow immediate reimplantation of avulsed ventral roots in adult rats. In the present study, we examined the consequences of reimplantation delayed for 2 weeks after avulsion of the C6 spinal root. Twelve and 20 weeks after delayed reimplantation, 57% and 53% of the motoneurons in the injured spinal segment survived. More than 80% of surviving motoneurons regenerated axons into the reimplanted spinal root. Cholinesterase-silver staining revealed axon terminals on endplates in the denervated muscles. The biceps muscles in reimplanted animals had atrophied less than those in animals with avulsion only, as indicated by muscle wet weight and histological appearance. After electrical stimulation of the motor cortex or the C6 spinal root, typical EMG signals were recorded in biceps of reimplanted animals. The latency of the muscle potential at 20 weeks was similar to that of sham-operated controls. Behavioral recovery was demonstrated by a grooming test and ipsilateral forepaw movements were well coordinated in both voluntary and automatic activities. These results demonstrate that ventral root reimplantation can protect severed motoneurons, enable the severed motoneurons to regenerate axons, and enhance the recovery of forelimb function even when it is delayed for 2 weeks after avulsion.     

儿童原发性干燥综合征的临床特点

目的 探讨儿童发病的原发性干燥综合征(primary Sjogren’s Sydrome,pSS)临床特点,了解其与成人发病的pSS之间的差异。方法 回顾性分析我院门诊及住院诊治的pSS 421例,其中儿童发病者21例,成人发病者400例。结果 儿童组男2例,女19例,成人组男35例,女365例,两组间男女比例相似;成人发病者首发症状表现多样化,常见口眼干燥、关节疼痛、腮腺肿大、肾小管酸中毒等,儿童发病者首发症状以肾小管酸中毒、反复腮腺肿大、皮肤损害多见,未见肺部及神经系统明显受累;在整个发病过程中,儿童pSS肾小管酸中毒(52.4％)、皮疹紫癜(47.6％)均高于成人,而成人pSS的眼干燥(61.0％)和肺部病变(25.2%)则高于儿童(P均<0.01);实验室检查方面,儿童pSS类风湿因子(rheumatoid factor,RF)及γ球蛋白阳性率为100%,均高于成人pSS(p相似文献