中医现代化方法学研究

本文从方法学研究的角度，提出1．现代中医“四诊”多维信息集成诊断智能系统的目标与发展思路，重点任务为：新型传感染手段的应用研究，人体生理信号处理方法研究，机体功能状态特征信息提取方法研究；2．功能性检测在中医诊断中应用研究的目标与发展思路，重点任务为：应用人体功能检测技术开展中医证候与人体内在功能变化的关联性研究，以及中医四诊指征与人体内在功能变化的关联性研究，研制有中医特色的人体功能检测仪器。     

Is the AMPA receptor subunit GluR2 mRNA an early indicator of cell fate after ischemia? A quantitative single cell RT-PCR study

After a moderate global cerebral ischemia, two hypothetical populations of pyramidal neurons are present among the hippocampal CA1 pyramidal neurons: one that will die and another one that will survive. Prior analysis of dissected hippocampal CA1 regions has shown a reduction of the GluR1-3 mRNA following ischemia. In order to identify these changes in single neurons, quantitative single cell RT-PCR was used to analyze the expression of GluR1-4 mRNA in rats 24 h after ischemia and also in rats after tolerance inducing ischemia. Control CA1 cells had a median copy-number of 290, 247, 207 and 16 GluR1-4, respectively. The tolerant cells showed small significant up-regulations of GluR1, 3 and 4 mRNA, while the GluR2 mRNA showed a more than 4-fold up-regulation compared to control cells. All the cells from ischemic animals displayed down-regulations of GluR1-3 mRNA. The GluR4 mRNA was not detectable in the ischemic animals. Our results thus show that the CA1 neurons react uniformly 24 h after a moderate ischemia independent of the fate of the neuron: thus two neuron populations with different GluR2 profiles cannot be identified in post-ischemic animals at 24 h. It seems however that an increased level of GluR2 can be used as an indicator of tolerance to ischemia.     

正常人手部神经感觉定量的测定

目的：研究正常人手部定量感觉测试（QSD的阈值及意义。方法：检测230例正常人左手大小鱼际肌的冷觉、温觉、冷痛觉、热痛觉，对其中28例右手做相同测试，对其中21例2周后做重复测试。结果：本组正常人QST测试的重复性较好，左右手QST阈值左右侧之间差异无显著性。各年龄段温度觉阈值存在显著性差异。结论：年龄对定量感觉检查影响显著，应该按年龄段制定正常参考值。定量感觉检查具有可重复性。身体两侧同一部位定量感觉检查具有对称性。     

颧骨弓伴发关节结节骨折的临床探讨

目的探讨颧骨弓伴发关节结节骨折的诊断及治疗方法。方法对30例颧骨弓伴发关节结节骨折的患者可疑骨折区行螺旋CT三维重建检查。18例关节结节骨折移位明显,其中10例行颧骨弓骨折或颧上颌骨折手术治疗,同时行关节结节骨折复位固定术,另8例未行关节结节骨折复位固定;12例关节结节骨折移位不明显者仅行颧骨弓骨折复位固定术。术后观察面部形态及张口度。结果螺旋CT扫描三维重建均能清晰显示患者的关节结节骨折部位、骨折的移位程度、与周围结构的空间关系。10例行颧骨弓骨折或颧上颌体骨折手术同时行关节结节骨折复位术者中,9例有效纠正畸形及改善张口度。8例关节结节骨折移位明显但未行关节结节骨折复位固定者,5例畸形及张口受限明显。另12例关节结节骨折未明显移位并未行固位术者,其面部形态可,其中2例张口轻度受限。结论螺旋CT三维重建对颧骨弓伴发关节结节骨折的诊断具有重要的价值;对关节结节骨折移位明显者,行颧骨弓骨折或颧上颌体骨折手术治疗的同时行关节结节骨折复位术,有助于纠正面部畸形及改善张口度。     

Nonspecific velocity and amplitude hunting reveals different specific detection performance of flexion and extension movements in the human knee joint

A debate exists in the literature as to what extent perception is conscious. In some publications regarding proprioception, the term proprioception has explicitly only been seen as properly used when subjects were able to report the imposed movement's direction. Detections of movements without movement-direction perception, have been seen as nonspecific. Since a lot of studies discussed this point but never tested it explicitly, we tested it by using nonspecific hunting paradigms (only the occurrence of a movement has to be detected, not its direction) with the following rationale. If the perception performance is really nonspecific, no difference regarding the movement's direction should be found. Thus, if we found a different detection performance regarding flexion and extension by means of a nonspecific paradigm, it would demonstrate that this "nonspecific" perception is already specific. Therefore, we measured the perception characteristics separately for flexion and extension. The perception characteristics have been determined from the amplitude-velocity-relation curve. Two different, nonspecific hunting paradigms, modifications of our previously published specific hunting paradigm, have been used. Thus, we determined pairs of threshold values, regarding amplitude hunting using three different angular velocities (0.1 degrees s(-1), 0.25 degrees s(-1), and 0.5 degrees s(-1)) and regarding velocity hunting using three different angular displacements (0.25 degrees, 0.5 degrees, and 1 degrees) as well, for flexion and extension, respectively. We found that both threshold paradigms (velocity hunting and amplitude hunting) revealed the same perception characteristics for a given movement direction. With an increasing angular velocity, angular displacement threshold values converged toward a common value for flexion and extension (about 0.2 degrees); with an increasing angular displacement, angular velocity threshold values converged toward separate values for flexion (about 0.06 degrees s(-1)) and extension (about 0.1 degrees s(-1)). Thus, our findings demonstrate that detection performance is specific and not bound to conscious perception, since specific thresholds for flexion and extension were revealed with nonspecific hunting paradigms.     

胸腔积液细胞形态学、生物化学、肿瘤标志物检测对诊断恶性肿瘤的临床意义

目的:对胸腔积液进行细胞形态学、生物化学、肿瘤标志物的检测,探讨其结果在诊断恶性肿瘤方面的临床意义。方法:胸腔积液细胞形态学检测采用离心推片法及瑞氏-姬姆萨复合染色鉴定细胞性质;LDH、TP、Cl、ALB、TC、Crp生物化学指标在奥林巴斯2700全自动生化分析仪上检测;CEA、CYFRA21-1、NSE肿瘤标志物在Elecsys 2010上检测,FDP检测采用酶联免疫胶乳凝集法。结果:在选择的60例胸腔积液标本中,有30例胸腔积液为恶性肿瘤,查到癌细胞24例,检出率80%,与病理学、影像学恶性肿瘤诊断符合率为95%,但是未查到癌细胞并不一定能排除恶性肿瘤,本组资料的癌细胞阳性率为80%(24/30)。LDH阳性率为67%(20/30),FDP阳性率为47%(14/30),CEA阳性率为50%(15/30),CYFRA21-1阳性率为77%(23/30)。TP、Cl、ALB、TC、Crp、NSE的检测在鉴别肿瘤方面无显著性差异(P>0.05)。结论:查到癌细胞和CEA、CYFRA21-1、LDH、FDP的联合检测在鉴别恶性肿瘤方面有显著性差异(P<0.01),为恶性肿瘤的鉴别诊断提供了可靠依据。因此在临床诊断中综合分析这些指标可作为恶性肿瘤诊断的依据,值得大力推广。     

黄芪对体外培养心肌细胞保护作用的实验研究

目的：观察黄芪对体外培养的缺糖缺氧损伤心肌细胞的保护作用。方法：心肌细胞原代单层培养，观察心肌细胞形态学变化、细胞生化数据的改变以及超微结构形态学的变化。结果：药物组与药物对照组的心肌细胞内上述细胞损伤变化均得到明显恢复。结论：黄芪对体外培养的缺糖缺氧心肌细胞具有明显的保护作用。     

超声背向散射积分联合肝功能、肝脏血流对脂肪肝的定量诊断

目的：探讨超声背向散射积分对脂肪肝变性程度分析,及其与临床指标的关系。方法：运用肝超声背向散射积分检测家兔及患者脂肪肝的严重程度,并探讨与体重、血糖、血脂、胆固醇及肝血流之间的关系。结果：运用声学密度定量检测脂肪肝的严重程度与病理下肝细胞脂肪含量一致,重度脂肪肝与患者血脂、血胆固醇水平、胆汁酸、肝、门静脉血流相关。结论：超声背向散射积分联合检测肝功能及肝脏血流可以判断脂肪肝病变程度。     

高胆红素血症新生儿光疗中不同部位经皮胆红素测定水平的比较研究

目的比较研究高胆红素血症新生儿光疗中不同部位经皮胆红素的测定水平。方法对100例高胆红素血症接受光疗的新生儿,在每次光疗前、光疗结束时、光疗结束后12 h测定其常规部位（前额正中）和遮盖部位（前额眉心）的经皮胆红素水平,并比较两部位不同时间点胆红素水平的变化。结果光疗前和光疗后12 h常规部位和遮盖部位经皮胆红素水平无显著性差异（P〉0.05）,而光疗结束时遮盖部位的经皮胆红素水平显著高于常规部位（P〈0.05）。结论采用经皮胆红素检测高胆红素血症患儿的光疗效果时,应同时检测暴露部位和遮盖部位的胆红素值加以综合分析。