青年维持性血液透析患者心血管疾病调查及危险因素分析

目的调查青年维持性血液透析（MHD）患者心血管疾病的发病情况和病变特点，并探讨其危险因素。方法采用横断面研究。MHD患者98例，以45岁为界分为青年组（47例）和中老年组（51例）。收集患者临床资料和生化指标。心脏超声检查测量心脏腔径及心功能参数。分析青年组患者心脏结构和功能异常的患病率、病变特点及其影响因素。结果（1）47例青年患者中有30例（63．8％）存在心脏结构异常，主要表现为左心室肥厚、左心房增大和瓣膜反流，患病率分别为61．7％、38．3％和34．0％。（2）青年组患者向心性肥厚的患病率为86．2％，离心性肥厚的患病率为13．8％，与中老年组相比，差异有统计学意义（P〈0．05）。（3）与无心脏病变青年MHD患者相比，伴心脏病变者的超滤量、收缩压、血磷和甲状旁腺激素明显增高，而Kt／V、血红蛋白和血清白蛋白明显降低，差异有统计学意义（P〈0．05）。Logistic回归分析结果显示，超滤量、收缩压、血红蛋白和血甲状旁腺激素是青年MHD患者并发心脏病变的独立危险因素。结论青年MHD患者心血管疾病的患病率较高，主要表现为左心室肥厚、左房增大和瓣膜反流。超滤量、收缩压、血红蛋白和血甲状旁腺激素水平可能是影响青年MHD患者并发心脏病变的独立危险因素。     

动态心电图对起搏器间歇性感知功能异常的诊断价值

目的 :探讨动态心电图检测对起搏器间歇性感知功能异常的诊断价值。方法 :采用MarquetteMars30 0 0动态心电图仪 ,对 36例 (4 9例次 )安装起搏器的患者进行随访 ,分析起搏、感知及与起搏器相关的心律失常。结果 :共检出起搏器间歇性感知功能异常 17例 (2 4例次 ) ,检出率为 4 7.2 % ,有 5例 (7例次 )合并两项感知异常。所有感知异常除 1例在常规心电图中检出外 ,其余 16例只在动态心电图中发现。检出与起搏器相关的心律失常 12例。根据动态心电图结果进行相应临床处理后 ,部分起搏器的感知功能异常消失。结论 :起搏器的感知功能异常多为间歇性的 ,动态心电图对间歇性感知异常的检出率较高 ,应是起搏器随访不可或缺的手段。     

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     

Toxic effects of Fusarium mycotoxin butenolide on rat myocardium and primary culture of cardiac myocytes.

Mycotoxin toxicosis has been implicated in the etiopathogenesis of Keshan disease (KD), an endemic cardiomyopathy prevailing in some regions of China. Butenolide (4-acetamido-4-hydroxy-2-butenoic acid gamma-lactone, CAS No. 16275-44-8), a mycotoxin produced by several Fusarium species such as Fusarium tricinctum and Fusarium graminearum, is frequently detected from the cereals in the endemic areas of KD. The present study is undertaken to investigate whether this mycotoxin can induce myocardial damage. Exposure of primary culture of cardiac myocytes to butenolide resulted in significant cytotoxicity, manifested by changes in cell morphology and decreases in cell viability. Consistent with the in vitro findings, distinct myocardial toxicity in vivo was observed after administration of rats by gavage with butenolide (10 and 20 mg/kg/day) for 2 months, and the myocardial injuries were characterized by focal necrosis of myocardium and fragmentation of myofiber. Butenolide also induced significant oxidative damage to the myocardium in vitro evidenced by a concentration-dependent lipid peroxidation in the myocardial homogenates, whereas antioxidants superoxide dismutase (SOD), N-acetylcysteine (NAC) and glutathione (GSH) provided significant protections against this oxidative effect. Taken together, these results clearly reveal that butenolide possesses the potential to induce myocardial toxicity. The present findings may reinforce the hypothesis that toxicosis by mycotoxins is one of the etiological factors for KD.     

磁共振增强扫描中欧乃影不良反应的临床观察及预防措施

目的探讨欧乃影在临床应用中不良反应的发生和预防措施。方法观察2003年10月至2006年7月所作1000例增强扫描者静脉注射欧乃影0.2mL/kg(其量浓度(c)为0.5mol/L)后,不良反应发生的情况。结果1000例患者中,出现不良反应6例,其中,非过敏反应3例,轻度过敏反应3例,无中度及重度过敏反应。结论欧乃影在磁共振增强扫描中不良反应发生率低,临床应用安全。     

795例肺癌术后发生心律失常的多因素分析

目的探讨肺癌术后发生心律失常的危险因素及其防治。方法回顾分析2002年1月～2004年1月我院肺癌手术795例，其中全肺切除术176例，肺叶切除术509例，楔型切除术110例。术后发生心律失常273例，应用Logistic回归对影响术后发生心律失常可能的危险因素进行分析。结果本组病例心律失常总发生率为34.3％（273／795），多因素Logistic逐步回归分析显示高龄、吸烟史、心律失常史、全肺切除、术中心包损伤、术后肺不张是术后心律失常的主要危险因素（P〈0.05），术后镇痛是保护因素（P=0.017）。结论心脏的储备功能降低、对手术损伤及缺氧的耐受力降低是导致术后心律失常的原因，采取一些预防措施可以减少其发生率。     

血管性勃起功能障碍动物模型的建立

目的探索建立血管性勃起功能障碍(ED)动物模型。方法雄性新西兰大白兔给予胆固醇及高脂饮食,同时用球囊导管损伤双侧髂内动脉内皮。测定术后4周、8周血脂并观察阴茎勃起情况、交配情况,同时用阴茎海绵体注射盐酸罂粟碱、阴茎血管双核素检查、髂内动脉数字减影造影(DSA)等方法研究勃起功能。结果与对照组相比,术后4周、8周模型组动物出现明显高脂血症,勃起程度明显下降,交配实验的各项观察指标均显著降低(P＜0.01),动脉造影显示双侧髂内动脉管腔直径明显缩小,双核素检查动脉显像指数(PIA)及静脉显像指数(PIV)明显降低,但第4周的模型组与对照组PIV结果没有统计学差异(P＞0.05)。结论高脂、高胆固醇饮食同时用球囊导管扩张动物髂内动脉,可以加速模型的形成,从而用于血管性ED的进一步研究。     

福参的苷类成分

目的 从福参Angelica morii提取分离活性成分。方法 采用乙醇提取，溶剂萃取，大孔树脂、聚酰胺、硅胶柱层析，LH-20、重结晶等纯化，对福参饮片进行系统提取分离；运用波谱学方法及理化常数对照进行结构鉴定。结果 从正丁醇和水部分分离到6个苷类化合物，分别为升麻索苷(prim-O-glucosylcimifugin，Ⅰ)、紫花前胡苷(marmesinin，Ⅱ)、芹菜素7-O-β-D-葡萄糖苷(apigenin 7-O0-β-D-glucoside，Ⅲ)、木犀草素7-O-β-D-葡萄糖苷(1ute—olin 7-O-β-D-glucoside，Ⅳ)，umbeliferone 7-apiosylglucoside(V)和胡萝卜苷(daucosterol，Ⅵ)。结论 6个化合物均为首次该植物中分得；化合物Ⅲ首次从当归属中分得。     

与铁稳态有关的生物分子

根据近几年来发表的与铁稳态有关的生物分子的研究文献 ,将这些生物分子根据其与铁的吸收、转运、储存以及对铁稳态的监控调节等方面的关系 ,对这些生物分子进行了分类。特别是对细胞膜载体、运铁蛋白受体、铁调蛋白及铁反应元件等作了较为详细地论述     

蚌埠医学院在校学生心理卫生调查

目的　了解蚌埠医学院在校学生心理状况 ,为素质教育提供服务。方法　采用症状自评量表 (SCL- 90 )对该校 1～ 4年级学生进行调查分析。结果　该校在校生有 5个因子得分高于全国大学生常模 ,高年级学生得分高于低年级 ,男女生在人际、抑郁、敌对、偏执等方面差异有显著性。结论　应针对大学生的心理特点 ,在大学院校进行心理健康教育。