2型糖尿病患者血浆apelin-13水平与胰岛素抵抗及高血压相关性的研究

目的探讨2型糖尿病患者血浆apelin-13水平与胰岛素抵抗、高血压的相关性。方法 2012年11月至2013年1月期间,将诊治的30例单纯2型糖尿病作为观察I组,30例2型糖尿病合并高血压患者作为观察II组,同期30例健康体检者作为对照组,对3组血浆apelin-13、空腹血糖(FPG)、空腹胰岛素(FINS)、胰岛素抵抗指数(IR),以及血压水平进行检测和比较。结果与对照组相比,观察I组apelin-13水平明显升高,观察II组apelin-13水平明显降低(P<0.05);与观察I组相比,观察II组apelin-13水平显著降低(P<0.05);血浆apelin-13水平与FINS、IR及收缩压(SBP)呈负相关性。结论血浆apelin-13水平在2型糖尿病患者中明显升高,在合并高血压的2型糖尿病患者中显著降低,并与FINS、IR、SBP呈负相关性。     

基于EICU患者家属心理需求的护患认知差异分析

目的了解EICU患者家属需求的期望值及护士对EICU患者家属需求的满足现状及认知差异。方法应用急危重患者家属需求量表(CCFNI)对42名EICU患者家属及72名护士进行心理需求调查,内容包括获得支持领域、获取信息领域、病情保证领域、接近患者领域和自身舒适领域。结果护士在信息、接近、舒适及保证因子评分低于患者家属的评分,有显著性差异(P<0.01);家属最重要的需求是保证需求。结论 EICU护士对患者家属一些需求重视不足。及时与患者家属进行沟通,理解和重视患者家属的心理需求,可以减轻EICU患者家属的负性心理,减少医患纠纷。     

风湿性心脏病心房颤动心房肌缝隙连接蛋白40和43 mRNA表达水平的变化

目的测定风湿性心脏瓣膜病(风心病)心房颤动(Af)心房肌缝隙连接蛋白(Connexin)40(Cx40)和Connexin43(Cx43)mRNA表达水平的变化。方法11例风心病患者[Af8例,窦性心律3例;男4例,女7例;平均年龄(50.8±13.7)岁;平均Af时间(5.6±6.5)年]的右心耳心肌1小块,提取所有标本的总RNA,等量转移至尼龙膜上,用PCR合成的特异cDNA探针,标记上放射性同位素(α32PdCTP)后与尼龙膜杂交,然后将杂交膜与X光胶片行放射自显影,在灰度扫描仪下得到每例标本mRNA水平的灰度值,为了进一步矫正转膜时可能的定量不统一,将同1块杂交膜先后与Cx40探针、Cx43探针和内参照βactin杂交,以Cx40/βactin和Cx43/βactin的百分比作为统计变量进行分析。结果在Af与窦性心律标本中,Cx40和Cx43的mRNA表达量未发生明显改变(P>0.05)。结论在风心病Af患者中,未发现缝隙连接蛋白Cx40和Cx43的mRNA表达量明显改变。     

经导管封堵成人多孔型房间隔缺损的体会

目的:通过对多孔型房间隔缺损(ASD)进行经导管封堵治疗,探讨多孔型ASD介入治疗的适应证及注意事项。 方法:先经心脏超声检查确诊为多孔型ASD,后在局部麻醉下用测量球囊进行试封堵,同时用心脏超声检测试封堵时两ASD闭合情况及孔间距,并确定置入封堵器数量及大小,术后用心脏超声进行随访观察。 结果:全组6例双孔型ASD患者中2例分别置入2个封堵器,4例置入1个封堵器。术后随访1个月至2年,4例无残余分流,1例随访2年虽仍有少许残余分流,但自觉症状好转,心影缩小。另1例术后1个月因残余分流而被迫手术取出。 结论:经导管封堵成人多孔型ASD安全、有效,对两ASD相距较远者应放置2个封堵器,对两ASD相距较近者则可用1个封堵器封堵。     

全身放射损伤对皮肤伤口组织细胞的影响及康复新的促愈作用(英文)

目的研究全身放射损伤对皮肤伤口组织细胞的影响及康复新(W11-α12)的促愈作用,探讨放创复合伤时创伤难愈的机制与促愈措施。方法100只雄性健康昆明种小鼠,体质量(20±2)g,以随机数字表法设单纯创伤(单伤)和全身放射损伤合并创伤(复合伤)组。小鼠6Gy照射后,于背部造成两个皮肤切口伤,观察伤后伤口愈合速度、伤口炎细胞、成纤维细胞和毛细血管数量及表皮细胞中碱性成纤维细胞生长因子(bFGF)含量的变化。结果伤后3,5,7d,单纯创伤组(单伤组)伤口愈合速度(%)为63.22,83.47,94.61,放创复合伤组(复合伤组)则显著降低(t=7.84,7.26,8.18,P<0.01),分别为52.67,69.18,82.88。伤后1,3,5d,复合伤组伤口炎细胞数量分别比单伤组下降26.53%,62.11%,38.91%;成纤维细胞数量下降43.73%,52.70%,25.32%;毛细血管数量在伤后5d降低55.97%;应用康复新后,两伤组均见伤口愈合速度加快、细胞数量增加,但复合伤组的增幅要大于单伤组。伤后3,5d,复合伤组表皮细胞bFGF含量比单伤组低59.15%和36.15%,当应用康复新后,复合伤组增幅分别比单伤组高35.90%和10.97%。结论伤后伤口局部细胞数量减少和表皮细胞中bFGF含量下降是合并放射损伤后创面难愈的重要原因之一,康复新对伤口的细胞游走、增殖及表皮细胞分泌bFGF的功能具有促进作用。     

Clinical significance of vascular endothelial growth factor expression and neovascularization in colorectal carcinoma

AIM: To clarify the association of vascular endothelial growth factor (VEGF) and microvascular density (MVD)expression with the angiogenesis and prognosis of colorectal cancer.METHODS: A total of 97 cases of colorectal carcinomas were examined by immunohistochemical staining (SP method), using anti-VEGF and anti-factor CD34+ monoclonal antibodies. RESULTS: VEGF positive staining was obtained in 68 out of 97 cases (70.1%), and observed mainly in the cytoplasm of tumor cells, and also frequently in stromal cells. VEGF expression was more intense in poorly differentiated adenocarcinoma in comparison with others, but there was no significant correlation between VEGF expression and age,sex and stage. A significant correlation was found between the MVD and grades, and there was no significant relationship between the MVD and age, sex, and stage. The MVD in the VEGF positive group (68 cases) was higher than that in the negative group. Upon multivariate analysis, the significant variables were stage, tumor grade and MVD; VEGF expression was not an independent prognostic factor. CONCLUSION: The expression of VEGF has a significant correlation with MVD; MVD expression has prognostic value but VEGF has not in colon cancer.     

血红蛋白、胆红素在预测心衰患者全因死亡风险中的作用

目的研究血红蛋白浓度（Hb）及总胆红素水平（Tbil）是否能预测慢性心衰患者全因死亡。方法对入选的1197例慢性心力衰竭（CHF）患者进行随访,全因死亡为随访终点。先比较不同Hb及Tbil水平其他临床指标分布的差异;再应用Kaplan-Meier曲线及Log-rank检验进行不同水平生存描述及比较;单因素Cox回归判断各影响因素与心衰死亡的关系,将有统计学意义的指标引入多元Cox回归,以明确低Hb、高Tbil是否为心衰死亡的独立预测因子。结果完成随访1025例（失访率14.4%）,死亡360例（35.1%）。随访中位数44个月。不同Hb及BMI水平的心衰患者在合并症、血压、左室射血分数（LVEF）、多种检验项目及用药方面存在显著差异。随着Hb减低及Tbil增高,死亡率增加。单因素分析显示,总胆红素（Tbil）、肌酐、尿酸（UA）升高以及血红蛋白（Hb）、血钠（Na）降低均可增加心衰患者死亡风险。校正其他影响因素后,Hb、Tbil、Scr和UA与心衰死亡独立相关,Hb减低（HR1.142）及Tbil〉19umol/L（HR1.312）均为心衰患者死亡的独立预测因素。结论 Hb、Tbil和UA与心衰死亡独立相关,Hb降低和Tbil升高均为心衰死亡的独立预测因素。     

埋藏式心律转复除颤器在43例遗传性心律失常患者中应用的疗效评价

目的:对因遗传性心律失常植入埋藏式心律转复除颤器(ICD)患者术后情况及ICD治疗效果进行总结。方法:对我院从2004-01至2011-06出院诊断为长QT综合征、Brugada综合征、致心律失常性右心室心肌病及肥厚型心肌病并且植入了ICD的43例患者进行随访,了解患者术后室性心律失常的发作情况以及ICD的治疗效果。结果:43例患者共随访8～84(37.0±20.6)个月,无患者死亡。经ICD共记录到369次室性心动过速(室速)事件及13次心室颤动(室颤)事件,均被ICD成功终止,ICD共启动治疗程序498次。16例(37.2%)患者在随访期内发生室速/室颤事件,被ICD正确识别并接受了恰当的治疗。无患者因室速/室颤事件发生晕厥。对于室速事件,抗心动过速起搏终止的总成功率为53.4%(197/369),首次成功率为20.8%(77/369)。6例(13.9%)患者发生了不恰当识别,1例(2.3%)患者发生了未识别事件。结论:ICD是治疗遗传性心律失常患者室性恶性心律失常的有效措施,合理设置治疗方案及参数可使ICD更充分地发挥预防猝死的作用。     

Effect of multiple activation stimuli on the generation of Th1-polarizing dendritic cells

It was originally reported that only a small fraction of total matured dendritic cells (DCs) produced interleukin (IL)-12, but it has never been determined whether different combinations of activating signals now shown to maximize secreted IL-12 do so through increasing output by the same IL-12 producers, or by recruiting additional cytokine-secreting cells. We therefore tested all combinations of bacterial lipopolysaccharide (LPS) (TLR4 ligand), R848 (TLR8 ligand), interferon (IFN)-γ, and CD40L for activating human monocyte-derived dendritic cells (DC), and determined by intracellular flow cytometry that enhanced IL-12 secretion was accomplished in large part by markedly increasing the proportion of cells producing IL-12, with the triple and quadruple combinations recruiting the most DC. This optimization requirement for multiple signals was not reflected in differential Toll-like receptor (TLR) expression by the cells. Interestingly, DCs activated with single TLR ligands plus IFN-γ were capable of responding with a second burst of IL-12 upon later CD40L stimulation, whereas DCs activated with R848 plus LPS were not, despite the trend of the latter for superior polarization of naive T cells toward IFN-γ-secreting Th1. These results have implications for the biology of IL-12-secreting DCs and choice of activation regimen for prospective use in DC-based immunotherapy.     

多肽C16/Ang1联合胎盘间充质干细胞对视神经脊髓炎大鼠的保护作用

目的:评价多肽C16/血管生成素1(Ang1)联合胎盘来源间充质干细胞(PDMSCs)治疗大鼠视神经脊髓炎(NMO)的效果.方法:分离培养大鼠PDMSCs,通过脑室及脊髓蛛网膜下腔注射水通道蛋白4(APQ4)抗体与人补体C5蛋白诱导大鼠NMO模型,将大鼠分为5组,即正常组、NMO模型组、PDMSCs组、C16/Ang1...