Related factors of cognitive impairment after stroke

BACKGROUND: Cognitive impairment after stroke associates with various factors, such as age, educational years, etc. Besides concerning about the recovery of limb function after stroke, we should also focus on the rehabilitation of cognition. Moreover, we'd better pay attention to the control of all the risk factors of stroke, and improve the quality of life in stroke patients. OBJECTIVE: To analyze the factors that affect cognitive impairment after stroke. DESIGN: A related factors analysis. SETTINGS: Department of Neurology of Dalian Port Hospital and Dalian Second People's Hospital. PARTICIPANTS: Totally 148 stroke inpatients were selected from Department of Neurology, Dalian Port Hospital and Dalian Second People's Hospital from April 2004 to December 2005, including 100 males and 48 females, aging 45-75 years with an average age of (67±8) years; Their educational years ranged 2-10 years with an average of (6.1±3.7) years; The disease course ranged 15-30 days; All were right-handed. Inclusive criteria: All were accorded with the diagnostic standard set by the Fourth National Academic Meeting for Cerebrovascular Disease; Confirmed by CT or MRI; Informed consents were obtained from all the subjects. METHODS: After the disease conditions were stable, the patients were assessed with Wechsler memory scale (WMS) and Wisconsin card sorting test (WCST). WMS included forward and backward recitation of numbers and short-term memory (verbal memory, visual recognition). The number of times for correct and wrong classifications in WCST and the time to complete the trail making tests A and B were recorded. The focal volume, area and layer were recorded at 24 hours after admission. The general data of the patients were recorded, including name, sex, age, educational years, history of hypertension, history of diabetes mellitus. Electroencepalograph (EEG) was examined to record the wave shape, blood lipids were detected, and the cognition related indexes were analyzed with the Pearson correlation analysis. The correlation between cognitive indexes after stroke and the influencing factors were analyzed with multiple linear regression analysis. MAIN OUTCOME MEASURES: ① Correlation between cognitive indexes and imaging indexes; ② Influencing factors for cognitive indexes after stroke. RESULTS: All the 148 stroke patients were involved in the analysis of results. ① Correlation between cognitive indexes and CT indexes: There were obvious negative correlations between numerical symbol and focal layer (r =-0.234, P < 0.05), as well as between verbal memory and the focal area and volume (r =-0.363, -0.279, P < 0.05); Trail making test A had obvious positive correlation with focal area and volume (r =0.256, 0.256, P < 0.05). Results of multiple linear regression analysis: Correct classification was correlated with triglyceride (partial wave and θ wave (partial regression coefficient=0.231-0.908, P < 0.05); Verbal memory was correlated with EEG α wave, focal volume, sex, educational years and diabetes mellitus (partial regression coefficient=0.219-1.017, P < 0.05-0.01). Visual recognition had correlation with educational years and hypertension (partial regression coefficient=0.326, -1.163, P < 0.01). Trail making tests A and B were correlated with focal volume (partial regression coefficient=4.680, -18.561, P < 0.05). CONCLUSION: The factors that affect the cognitive function after stroke include sex, age, educational years, hypertension, diabetes mellitus, triglyceride, EEG wave shape, and the focal area, volume and layer     

99Tcm-MIBI显像评价乳腺癌新辅助化疗疗效

目的 探讨^99Tc^m-甲氧基异丁基异腈（MIBI）显像评价乳腺癌新辅助化疗（NCT）疗效的价值。方法 35例局部进展期乳腺癌（LABC）患者术前化疗前后分别触诊估测肿瘤最大垂直长径及行^99Tc^m-MIBI显像，术后对乳腺癌标本行病理检查及P-糖蛋白（P-gP）、增殖细胞核抗原（PCNA）免疫组织化学染色。观察注射^99Tc^m-MIBI后60min显像图。采用目测法和半定量法，以病灶／本底（T／N）放射性比值降低〉35％为有效。临床疗效按WHO标准评价。化疗后肿瘤细胞病理形态学改变以Ⅱ、Ⅲ级定为显效，Ⅰ级定为弱效。结果 病理检查显效与弱效组间，显像目测法分析NCT有效率分别为75％和9％，差异有显著性（P〈0．01），灵敏度、特异性和准确性分别为75％、91％和80％；半定量法评价NCT疗效的灵敏度、特异性和准确性分别为84％、80％和83％；临床测量肿瘤最大垂直长径则分别为50％、64％和54％。^99Tc^m-MIBI显像评价疗效的灵敏度、准确性明显高于临床确诊。24例病理检查示显效的患者中，^99Tc^m-MIBI摄取与PCNA水平相关，与P-gP水平无关。结论 ^99Tc^m-MIBI显像可有效监测LABC患者术前NCT疗效。     

逆行隐神经岛状皮瓣的临床应用

目的 报告逆行隐神经岛状皮瓣的临床应用结果。方法 应用这种技术修复6例足跟部软组织缺损,切取的皮瓣面积为4cm×6 cm至7cm×10 cm。结果 所有的皮瓣完全成活,取得了满意的效果。1例术后4d发生表浅感染,经换药愈合。结论 大隐静脉、隐神经和伴行的动脉网是该皮瓣的轴,该皮瓣具有血管解剖恒定、血管蒂长和操作简单等优点,而且较薄,适宜修复足部软组织缺损。     

Lethal effect of mononuclear cells derived from human umbilical cord blood differentiating into dendritic cells after in vitro induction of cytokines on neuroblastoma cells

BACKGROUND: Dendritic cell is the most major antigen presenting cell of organism. It is proved in recent studies that human umbilical cord blood mononuclear cells induced and cultured in vitro by recombinant human granulocyte-macrophage colony stimulating factor (rhG-MCSF) and recombinant human interleukin-4(rhIL-4) can generate a great many dendritic cells and promote the lethal effect of T cells on human neuroblastoma, but it is unclear that whether the lethal effect is associated with the most proper concentration of dendritic cells. OBJECTIVE: To investigate the lethal effect of human umbilical cord blood mononuclear cells induced in vitro by cytokines differentiating into dendritic cells on human neuroblastoma, and its best concentration range. DESIGN: Open experiment. SETTING: Department of Pediatrics, the Medical School Hospital of Qingdao University. MATERIALS: The study was carried out in the Shandong Provincial Key Laboratory (Laboratory for the Department of Pediatrics of the Medical School Hospital of Qingdao University) during September 2005 to May 2006. Human umbilical cord blood samples were taken from the healthy newborn infants of full-term normal delivery during October to November 2005 in the Medical School Hospital of Qingdao University, and were voluntarily donated by the puerperas. Main instruments: type 3111 CO2 incubator (Forma Scientific, USA), type 550 ELISA Reader (Bio-Rad, USA). Main reagents: neuroblastoma cell line SK-N-SH (Shanghai Institute of Life Science, Chinese Academy of Sciences), RPMI-1640 culture fluid and fetal bovine serum (Hyclone), rhIL-4 (Promega, USA), rhG-MCSF (Harbin Pharmaceutic Group Bioengineering Co.Ltd), rat anti-human CD1a monoclonal antibody and FITC-labeled rabbit anti-rat IgG (Xiehe Stem cell Gene Engineering Co.Ltd). METHODS: ① Human umbilical cord blood mononuclear cells obtained with attachment methods differentiated into human umbilical cord blood dendritic cells, presenting typical morphology of dendritic cells after in vitro induction by rhG-MCSF and rhIL-4. ② Different concentrations of dendritic cells[ dendritic cells: neuroblastoma cells=20∶1,50∶1,100∶1（2×108 L-1，5×108 L-1，1×109 L-1）], 1×109 L-1 T cells and 1×107 L-1 neuroblastoma cells were added in the experimental group. 1×109 L-1 T cells and 1×107 L-1 neuroblastoma cells were added in the control group. ③ Main surface marker CD1a molecules of dendritic cells were detected with indirect immunofluorescence, and the percent rate of dendritic cells was counted with ultraviolet light and expressed as the expression rate of CD1a+ cells. ④ Single effector cells and target cells were respectively set in the experimental group and control group to obtain the lethal effect. The lethal effect of dendritic cells on neuroblastoma cells was indirectly evaluated by detecting cellular survival with MTT assay. The lethal effect(%)=（1-A experimental well-A effector cell well/A target cell well）×100%.⑤The experimental data were presented as Mean ±SD, and paired t test was used. MAIN OUTCOME MEASURES: ① Morphological characters of dendritic cells in the process of induction and differentiation. ②CD1a+ cellular expression rate. ③Lethal effect of dendritic cells on neuroblastoma cells. RESULTS: ①Morphological characters of dendritic cells in the process of induction and differentiation: On the 15th day after human umbilical cord blood mononuclear cells were induced by rhG-MCSF and rhIL-4, typical morphology of dendritic cells could be seen under an inverted microscope. ②Expression rate of CD1a+ cells was （43.12±5.83）%. ③Lethal effect of dendritic cells on neuroblastoma cells: Lethal effect of dendritic cells stimulated T cells in each experimental group ( dendritic cells: neuroblastoma cells=100∶1,50∶1,20∶1 respectively) on neuroblastoma cells was significantly higher than that in control group[（31.00 ±4.41）%，（30.92±5.27）%，(33.57±5.35)%,(26.23±5.20)%, t=3.51，2.98，4.24, P < 0.01）; But the lethal effect of dendritic cells on neuroblastoma was significantly lower when their ratio was 100∶1 and 50∶1 in comparison with 20:1 （t=2.01，2.36, P < 0.05）, and no significant difference in lethal effect existed between the ratio at 100∶1 and 50∶1（t=0.06,P > 0.05）. CONCLUSION: Dendritic cells differentiated from human umbilical cord blood mononuclear cells after in vitro induction of cytokines can promote the lethal effect of T cells on neuroblastoma cells. The lethal effect is associated with the concentration of dendritic cells within some range.     

木贼对大白鼠实验性高脂血症的影响及急性毒性实验研究

实验结果表明,木贼高,低剂量组,安妥明组均有显著阻止高脂饲料升高大白鼠血清总胆固醇、甘油三酯作用,表明木贼对大白鼠实验性高脂血症有防治作用。急性毒性实验表明其毒性很低。     

扩散法被动式甲醛个体监测器（Ⅱ型）的研制

介绍了一种基于气体分子扩散原理的被动式甲醛个体采样器，它是在Ⅰ型采样器的基础上完成的。采用甘油（２０％）／偏重亚硫酸钠（０．２５％）浸渍的定量滤纸（φ４２ｍｍ）作为吸收层，空气中甲醛扩散到吸收层上，形成稳定的化合物。采样一定时间后，取出吸收层，洗脱后，用ＡＨＭＴ化学比色法测定所采集到的甲醛。这种采样器的平均采样速率为８３ｍｌ／ｍｉｎ，标准偏差为７．２ｍｌ／ｍｉｎ，与有动力吸收管采样的方法相比较，总不确定度小于±２５％。     

县级医院经济活力及其与不同奖金制度之间的关系分析

该利用山东省县级医院普查资料，通过比较性分析方法，对奖金制度转变和医院经济活力之间的关系进行了分析。研究结果表明：在过去的20年中，医院经济活力得到了较大提高，奖金制度转变有利于医院提高经济活力。     

原发性膀胱腺癌临床病理分析

对６例原发性膀胱腺癌进行临床病理分析，患者年龄４０～７６岁，男４例，女２例。术前病程多为２个月，以血尿症状为主。６例均经病理检查证实，其中４例加做ＰＡＳ染色，证实有ＰＡＳ阳性物质，免疫组化标记ＣＥＡ４例，有３例呈阳性结果。本组随访结果５例死亡，存活时间９～４３月，１例尚存活１３月。结合文献着重讨论了影响膀胱腺癌预后诸因素。     

致倦库蚊有机磷抗性相关扩增酯酶B基因的多样性

本实验从佛山和成都两地的致倦库蚊群体中筛选出３个酯酶类型不同的有机磷（ＯＰ）抗性品系，ＦＳ－１、ＦＳ－２和ＣＤ－１品系。各品系的酯酶基因Ｂ扩增水平、酯酶活性和ＯＰ抗性水平三者一致。各品系酯酶Ｂ基因限制性酶切片段比较分析表明，我国的ＯＰ抗生库蚊群体中不仅有世界性分布的酯酶Ｂ１和Ｂ２，而且在佛山和成都地区各有一个新的独立扩增的酯酶Ｂ，分别命名为Ｂ６和Ｂ７。