Miniature self-contained intravascular magnetic resonance (IVMI) probe for clinical applications.

A miniature (1.73 mm in diameter) NMR probe, which contains a magnet and a radiofrequency (RF) coil, is presented. This probe is integrated at the tip of a standard catheter and can be inserted into the human coronary arteries, creating local magnetic fields needed to obtain the NMR signal from the blood vessel walls, without the need for external magnet or RF coils. The basic theory governing the probe performance in terms of signal-to-noise-ratio and contrast parameters is presented, along with measured results from test samples. The NMR signal can be analyzed to obtain tissue contrast parameters such as T1, T2 and the diffusion coefficient, which may be used to detect lipid-rich vulnerable plaques in the coronary arteries.     

“Inside‐Out” PEGylation of Bovine β‐Cross‐Linked Hemoglobin

The development of a blood substitute is urgent due to blood shortages and potential communicable diseases. A novel method, inside‐out PEGylation, has been used here to conjugate a multiarm maleimide‐PEG (Mal‐PEG) to β‐cross‐linked (βXL‐Hb) hemoglobin (Hb) tetramers through the Cys β93 residues. This method produces a polymer with a single PEG backbone that is surrounded by multiple proteins, rather than coating a single protein with multiple PEG chains. Electrophoresis under denaturing conditions showed a large molecular weight species. Gel filtration chromatography and analytical ultracentrifugation determined the most prevalent species had three βXL‐Hb to one Mal‐PEG. Thermal denaturation studies showed that the cross‐linked and PEGylated species were more stable than native Hb. Cross‐linking under oxy‐conditions produced a high oxygen affinity Hb species (P₅₀ = 9.18 Torr), but the oxygen affinity was not significantly altered by PEGylation (P₅₀ = 9.67 Torr). Inside‐out PEGylation can be used to produce a hemoglobin‐based oxygen carrier and potentially for other multiprotein complexes.     

TVT-O治疗女性压力性尿失禁长期疗效分析

目的 探讨由内向外经闭孔尿道中段无张力悬吊术(TVT-O)治疗女性压力性尿失禁(SUI)的长期疗效.方法 分析2004年8月至2006年8月应用TVT-O手术治疗68例女性SUI患者的临床和随访资料,探讨TVT-O术后至少6年的治愈率及常见并发症.结果 以尿失禁症状消失和咳嗽试验阴性定义为临床治愈,在TVT-O术后6周、1年和6年的治愈率分别是85.3％(58/68)、82.4％(56/68)和80.9％(55/68),差异无统计学意义(P＞0.05).术后排尿困难3例,新发尿急4例,大腿根部和腹股沟区疼痛13例,均行相关处理.术后复发3例,采用其他疗法.结论 TVT-O是治疗女性SUI的有效术式,其长期疗效持续稳定.TVT-O严重并发症少见,但术后腹股沟疼痛需引起高度重视.     

两种肠内营养加温方法的临床观察

目的：比较肠内营养护理中热水加温法和加温器加温法的疗效。方法：将148例患者随机分为两组,分别采用热水加温法和加温器加温法,观察并比较两组患者的不良反应。结果：使用加温器的患者不良反应明显轻于热水加温法的患者。两组治疗总有效率比较,有显著性差异（P〈0.05）。结论：加温器加温方法优于热水加温法。     

多发性创伤病人院前院内急救的护理

[目的]总结多发性创伤病人院前院内的急救和护理以提高医疗护理质量.[方法]对我院急诊的80例多发性创伤病人进行现场救护、转运途中救护、急诊室救治及心理护理.[结果]80例病人中有2例在送往我院途中死亡,2例入院后因并发急性肾衰竭抢救无效死亡,2例入院后因创伤性休克抢救无效死亡,69例治愈或住院进一步治疗,5例因其他原因转院治疗.[结论]多发性创伤病人病情复杂、凶险、病死率高,早期、准确、主动采取救护措施是抢救成功的关键.急诊医护人员在抢救过程中应分秒必争,及时有效地进行院前(现场)救护,快速、安全地转运病人,为挽回病人生命赢得宝贵的抢救时机.     

电生理检查在格林-巴利综合征中的应用

目的探讨格林巴利综合征（GBS）肌电图及神经传导速度检测的特征及临床意义。方法对57例GBS患者的临床资料进行分析，并做针极肌电图（EMG）及神经传导速度（NCV）检测和分析，观察静息状态时自发电位，测定轻收缩时运动单位电位（MUP）的时限、波幅，大力收缩时的慕集相。测定运动、感觉神经的传导速度（MCV、SCV）及动作电位的末端潜伏期（ML）、波幅（AMP）、F波等。结果共检测164条肌肉、276条神经。EMG提示57例患者均呈神经原性改变；运动神经在下肢的异常率明显高于上肢，胫后神经异常率分别为：DM-lat 69．64％，AmP 66．07％。腓总神经异常率分别为：DM-lat 75．51％．MCV 55．10％，AmP 61．22％。所有被测运动与感觉神经的SCV、MCV异常率分别为54．79％与55．43％；10例（17．54％）F波未引出，38例（63．16％）F波潜伏期延长。结论GBS存在广泛的周围神经损害，肌电图和神经电图检查对GBS早期诊断和预后判断有重要指导价值。     

The membrane‐proximal intermolecular disulfide bonds in glycoprotein Ib influence receptor binding to von Willebrand factor

Summary. Background: In the platelet glycoprotein (GP)Ib–IX complex, the binding site for its ligand von Willebrand factor (VWF) is restricted to the N‐terminal domain of the GPIbα subunit. How the other subunits in the complex, GPIbβ and GPIX, regulate the GPIbα–VWF interaction is not clear. Objectives and methods: As GPIbα connects with two GPIbβ subunits via disulfide bonds, we tested whether these intersubunit covalent links were important to the proper VWF‐binding activity of the GPIb–IX complex by characterizing the structure and VWF‐binding activity of a mutant GPIb–IX complex that lacked the GPIbα–GPIbβ disulfide bonds. Results: Mutating both Cys484 and Cys485 of GPIbα to serine prevents GPIbα from forming covalent disulfide bonds with GPIbβ, while maintaining the integrity of the complex in the membrane. The mutations cause two GPIbβ subunits to form a disulfide bond between themselves. As compared to Chinese hamster ovary (CHO) cells stably expressing the wild‐type GPIb–IX complex at a comparable level, CHO cells stably expressing the mutant GPIb–IX complex bind to significantly less soluble VWF in the presence of ristocetin and roll on the immobilized VWF under flow at a higher velocity. Conclusions: The disulfide bonds between GPIbα and GPIbβ are necessary for optimal GPIbα binding to VWF. The structural plasticity around the disulfide bonds may also help to shed light on the inside‐out mechanism underlying GPIbβ modulation of VWF binding.     

小脑大面积脑梗死外科手术治疗体会

【摘要】目的分析小脑大面积脑梗死的外科手术治疗方法。方法本文选择了90例小脑大面积脑梗死患者进行研究,将这些患者随机分成3组,A组患者通过脑室穿刺外引流术合并后颅窝开颅单纯外减压术进行治疗．B组患者采用脑室穿刺外引流术和后颅窝开颅内外联合减压术进行治疗,而C组患者则采用后颅窝内外联合减压术进行治疗,对比3组治疗效果。结果对所有患者进行6个月日常生活活动随访计分．A组（43．14±27．96）分;B组（65．40±30．84）分;C组（64．61±28．51）分。A组与其他两组比较,差异有统计学意义（P〈0．05）。B组和C组差异无统计学意义（P〉0．05）。结论后颅窝开颅内外联合减压术是治疗小脑大面积脑梗死的理想方式。