急性心肌梗死早期死亡患者危险因素分析

目的探讨急性心肌梗死(acute myocardial infarction,AMI)患者早期死亡的危险因素。方法收集148例AMI患者,其中19例发生早期死亡。比较死亡组与非死亡组的一般临床资料及血浆CPK、CRP和BNP水平,并进行多因素参与的logistic回归分析。结果两组间在年龄、症状发生到来院时间、CRP、CPK和BNP水平方面均有显著性差异(P<0.01)。死亡组上述指标均明显高于非死亡组。二分类Logistic回归分析结果显示:年龄(OR1.142,P=0.011)、既往心衰史(OR 0.003,P=0.031)、症状发生到来院时间(OR 1.626,P=0.046)及血浆BNP浓度(OR 1.009,P=0.042)、CPK浓度(OR 1.011,P=0.009)为AMI后早期死亡的独立危险因素。结论年龄大、既往有心衰史、症状发生到来院时间长及较高的血浆BNP、CPK浓度为AMI后发生早期死亡的高危因素。     

超声检查在梗阻性黄疸中的应用价值

目的提高超声对梗阻性黄疸诊断重要性的认识。方法回顾性分析59例经手术病理证实的梗阻性黄疸病例的超声特征。其中最常见的胆总管结石42例,胆总管癌9例,胰头癌5例,肝门胆管癌、胆囊癌、壶腹癌各1例。结果超声诊断胆总管结石38例,符合率(准确率)90.5%,诊断胆总管癌7例,符合率(准确率)77.8%,胰头癌3例,符合率(准确率)60%,超声诊断梗阻性黄疸的符合率为(准确率)86.4%。结论超声检查对梗阻性黄疸的诊断及病因诊断有很大的价值。     

ErbB2 mRNA表达和细胞凋亡在柔红霉素致大鼠心肌病中的作用

目的研究柔红霉素对心肌细胞的损伤及致心肌病的机制。方法建立柔红霉素致大鼠心肌病的模型,采用逆转录聚合酶链反应(RT-PCR)法检测心肌组织ErbB mRNA表达。光学显微镜下观察心肌病理改变,采用TdT介导的脱氧核苷酸缺口末端标记技术(TUNEL)法检测心肌细胞凋亡,超声检查心脏射血功能,检测大鼠心肌组织活性氧(ROS)、丙二醛(MDA)、超氧化物歧化酶(SOD)和谷胱甘肽过氧化物酶(GSH-PX)活性。结果与对照组比较,柔红霉素损害的大鼠心脏组织ErbB2 mRNA表达下降(P＜0．05),凋亡指数增加(P＜0．01),病理积分升高(P＜0．05),左室射血分数下降(P＜0．05),ROS、MDA产生增加(P＜0．05),SOD、GSH- PX活性减低(P＜0．05)。结论Neuregulin-ErbB信号传导削弱所致的凋亡和脂质过氧化损伤参与柔红霉素心肌病的发生。     

VEGF stimulates lymphangiogenesis in colorectal cancer and the treatment via anti-lymphangiogenesis

Lymph node metastasis is the most common and basic way in the extending of colorectal tumor. It is an important reason for the difficulty of curing the tumor and the tumor's high mortality. And it is also an important factor that effects surgery treatment. Vascular endothelial growth factor( VEGF) family is a group of factors which specificly act on endothelial cell. VEGF has been shown to be an important regulator of tumour angiogenesis.but its effect on lymphan-giogenesis is not so clear. In this review, we discussed VEGF's effect on lymphangiogenesis, the colorectal microenviron-ment's effect on the factors expression and the therapeutics via antilymphangiogenesis by inhibiting VEGFR-3 signaling.     

Progress in the treatment of myocardial infarction with stem cells transplantation

1Introduction Myocardialinfarctionisischemicmyocardial necrosisresultedfromabruptreductionincoronary bloodflowtoasegmentofmyocardium.Myocardial infarctioncaninducecardiacremoldingandresultin heartfailure.Generalmethodsincludingthrombolytic therapy,PTCA,CABGandTMGcanonlyredredge theobturatlybloodvessel,improvemyocardialis chemiaandsavecardiacmuscleclosingtoputres cence,buttheycannotregeneratenecroticcardiac muscle.Thelong datedprognosisisnotgood.Heart transplantationisprobablythebestaltern…     

Phacoemulsification in eyes with corneal opacities after deep anterior lamellar keratoplasty

To evaluate the maneuverability and efficacy of phacoemulsification and intraocular lens (IOL) implantation in eyes with corneal opacities after deep anterior lamellar keratoplasty (DALK), twelve eyes of 12 patients with mild to moderate corneal opacities after DALK and coexisting cataracts were analyzed retrospectively. Phacoemulsification and IOL implantation assisted with anterior capsule staining, as well as non-invasive optical fiber illumination, were performed on all eyes. No intraoperative or postoperative complications were noted. Mean corrected distance visual acuity (logMAR) improved from 1.24±0.17 to 0.73±0.22. Post-phaco intraocular pressure was maintained between 13 to 20 mm Hg in all cases throughout the follow-up period. Mean endothelial cell density decreased from 2258.42±205.94 to 1906.25±174.23 cells/mm2. Phacoemulsification and IOL implantation are safe and valid in eyes with mild to moderate corneal opacities after DALK and coexisting cataracts when assisted with anterior capsule staining and non-invasive optical fiber illumination.     

“一站式”预约系统的设计与研究

目前就诊排队是普遍的社会问题，为提高服务质量，减少候诊时间，设计完成“一站式”预约系统。结合不同检验检查的预约规则、预约模式，建立数学模型，对非抢占有限优先权的预约模式进行结合实际情况的比对分析。在模式设计中，利用简单工厂模式与策略模式相结合的方法，减少代码重用，使系统更加强壮。同时利用数学模型，通过系统给用户一系列的理论值，使用户感受更加直观。理论值与实际情况相比较，进行误差分析，结合门诊预约等多种模式，做到“一站式”预约，即有排队等待的地方就有预约。     

认知储备及其在精神疾病中的研究进展

认知储备概念为脑结构或功能损伤与实际临床表现间存在的差异提供了合理的解释,可能是精神疾病患者认知功能损害个体化的理论基础。现从认知储备的理论研究进展、评估方法等方面综述近年来相关研究进展,为其在精神疾病中的进一步研究提供依据。     

Changes in intraarticular pressure on the blood supply in the retinaculum of the femoral neck

BackgroundThis study aimed to analyze the effects of intracapsular pressure (IAP) on blood flow in the femur after a femoral neck fracture.MethodsFour simplified vascular models were used to measure the effect of vessel length on arterial blood flow in 10 New Zealand white rabbits. Ten models were evaluated under 10 different blood pressures.FindingsIAP increased following fracture of the femoral neck, and deformation had the greatest potential effect on blood flow in the retinacular artery. When blood pressure was fixed at 60 mm Hg, an increase in IAP caused a reduction in blood flow. When the IAP was relatively high (above 60 mm Hg), and higher than the blood pressure, blood flow continued to drop as intracapsular pressure increased. Shortening of blood vessels had no significant effect on blood supply. However, the p-value was uniformly significant (<0.05) when stretched and twisted blood vessels were compared with normal blood vessels.InterpretationThe results of computational fluid-structure interaction similarly indicated that a smaller blood vessel diameter and twisted blood vessels will result in decreased flow velocity when IAP increases. This study also revealed a close relationship between IAP and the hip joint's position and traction.     

Immune function of peripheral T cells in patients with venous thromboembolism or coronary artery atherosclerosis

Introduction and ObjectivesRecent studies have shown that the major risk factors for arterial thrombotic diseases are closely associated with venous thromboembolism (VTE). This study aimed to investigate the expression of CD3, CD4 and CD8 in T lymphocytes, the CD4/CD8 ratio and high-sensitivity C-reactive protein (hs-CRP) levels in patients with VTE, coronary artery atherosclerosis (CAA) and healthy subjects.MethodsA total of 82 healthy subjects, 51 VTE patients and 114 CAA patients were recruited, and the expression of CD3, CD4 and CD8 in T lymphocytes and the CD4/CD8 ratio were determined. Serum hs-CRP was also measured.ResultsCompared to healthy subjects, VTE patients had significantly reduced CD3 expression (p=0.019), comparable CD4 expression (p=0.868), significantly reduced CD8 expression (p<0.001) and increased CD4/CD8 ratio (p=0.044). However, VTE patients had comparable expression of CD3, CD4 and CD8 and CD4/CD8 ratio to CAA patients. In addition, among patients with VTE or CAA, the proportion of patients with reduced CD3+ and CD8+ T lymphocytes or increased CD4/CD8 ratio was significantly higher than in healthy subjects. In addition, hs-CRP in both VTE and CAA groups was significantly higher than in healthy subjects.ConclusionsThe antigen recognition and signal transduction activation of T cells is significantly reduced in patients with VTE or CAA, and the killing effect of T cells on pathogens, including viruses, is also significantly compromised. In addition, inflammatory and immune mechanisms are involved in the occurrence and development of venous and arterial thrombosis.