内皮素鞘内注射后的脊髓形态学观察

对18只大鼠进行内皮素脊髓鞘内注射,观察及记录大鼠后肢功能状态,并将18只大鼠分为3个不同的时间处死,进行病理形态学观察。结果表明:3组均表现缺血缺氧病理改变。2及4h实验组病变重于30min实验组。脊髓下胸段、腰段病变重于颈段及骶尾段。同时发现,大鼠后肢的功能状态与其脊髓相应的病理形态学变化不呈正比。     

中西医结合治疗缺血性脑血管病临床疗效观察

目的 回顾性分析中西医结合治疗缺血性脑血管病的疗效。方法 对126例缺血性脑血管病患者，在早期西医溶栓、抗凝、降低血液粘度、扩张血管和促进脑细胞代谢等治疗基础上，结合中医辩证施治治疗。结果 42例瘫肢肌力恢复达V级；48例肌力≥Ⅳ级，言语流畅；27例生活能基本自理，可依杖散步，肌力≥Ⅲ级：9例与治疗前对比肌力提高Ⅰ～Ⅱ级，但生活仍不能自理。结论 在西药治疗基础上，结合益气活血中药调理可显著提高患者的疗效。     

Involvement of Apoptosis in 3-nitropropionic Acid-induced Ischemicl Tolerance to Transient Focal Cerebral Ischemia in Rats

Preconditioningofbraintissueswithsub lethalstressesorstimulicanresultinresistancetosubse quentlethalischemiceventsinaresponsecalledis chemictolerance .Recently ,severalstudieshaveshownthatasinglesystemicdoseof 2 0mg/kg 3 NPAcausednohistopathologicalabnorm…     

参附注射液对大鼠缺血再灌注小肠细胞Bax、Bcl-2及c-myc蛋白表达的影响

目的　探讨参附注射液对大鼠缺血再灌注小肠细胞Bax、Bcl 2及c myc蛋白表达的影响及它们与肠细胞凋亡的内在联系。方法　健康SD大鼠 36只随机分为 3组 ,空白对照组 (S组 )、缺血再灌注 +生理盐水组 (IR +NS组 )、缺血再灌注 +参附注射液组 (IR +SF组 ) ,每组 12只。采用钳闭肠系膜前动脉制备小肠缺血再灌注模型。免疫组化检测Bax、Bcl 2及c myc蛋白的表达 ,每组选 2 4个视野分别测量光密度值 (OD值 )。TUNEL法检测凋亡的小肠细胞并计算凋亡指数。结果　IR +NS组BaxOD值明显高于S组 (P <0 .0 1) ,IR +SF组BaxOD值明显低于IR +NS组 (P <0 .0 1) ,且低于S组 (P <0 .0 5 )。IR +NS组Bcl 2OD值高于S组 (P <0 .0 5 ) ,且IR +SF组Bcl 2OD值高于S组 (P <0 .0 1) ,但IR +NS组与IR +SF组比较无显著差异。IR +NS组c mycOD值明显高于S组 (P<0 .0 1) ,且明显高于IR +SF组 (P <0 .0 1)。IR +NS组细胞凋亡指数明显高于S组和IR +SF组 (P <0 .0 1) ,而IR +SF组高于S组 (P <0 .0 5 )。结论　参附注射液增加小肠组织Bcl 2蛋白的表达 ,降低Bax及c myc蛋白的表达 ,抑制小肠细胞凋亡 ,保护缺血再灌注小肠。     

缺血性脑血管病患者血清基质金属蛋白酶水平及影响因素分析

目的 比较急性脑梗死、短暂脑缺血发作(TIA)和陈旧脑梗死患者血清基质金属蛋白酶-9(MMP-9)水平并分析其影响因素.方法 缺血性脑血管病患者136例,分为急性脑梗死组57例,TIA组22例,陈旧脑梗死组57例,进行神经功能评分及血压、血常规、血脂、血糖检查.依据ELISA法进行血MMP-9测定.结果 MMP-9水平分别为急性脑梗死患者(444.13±418.46)ng/ml,TIA患者(374.36±278.31)ng/ml,陈旧脑梗死患者(231.11±367.43)ng/ml.急性脑梗死和TIA患者血MMP-9水平明显高于陈旧脑梗死患者(P＜0.05).MMP-9水平与血白细胞水平(r=0.192,P=0.025)、低密度脂蛋白(r=0.261,P=0.002)、收缩压(r=0.232,P=0.006)呈正相关;与高密度脂蛋白(r=-0.219,P=0.011)和血糖(r=-0.254,P=0.003)呈负相关.MMP-9与收缩压(β=0.259,P=0.001)、血白细胞(β=0.209,P=0.008)、低密度脂蛋白(β=0.586,P=0.000)、胆固醇(β=-0.458,P=0.007)和血糖(β=-0.200,P=0.014)具有线性关系.结论 MMP-9水平在急性脑梗死及TIA时升高,收缩压、血白细胞和低密度脂蛋白均可能为其影响因素.     

A multiparametric index of platelet in vitro aggregation in cerebrovascular disease

148 patients with various forms of cerebrovascular disease (CVD) were studied by means of a multiparametric analysis ofin vitro platelet aggregation, based on the following six parameters: ADP and epinephrine primary and secondary aggregation thresholds and percent maximum aggregation induced by optimal concentrations of ADP and epinephrine. These patients were assigned to four study groups, according to clinical diagnosis supported by CT scan, of transient ischemic attack and reversible neurological deficit (TIA-RIND), or completed stroke, in the presence or absence respectively of antiplatelet medical treatment at the time of the study. A statistically significant increase of thein vitro platelet aggregation was found in 44.4% of the untreated TIA-RIND patients and in 33.9% of the untreated stroke patients. However this last group showed a higher percentage of very marked hyperaggregation. Differences between the two treated study groups and controls were not signicant. No difference was found in collagen-and ristocetin-induced aggregation between the patient groups and the controls.

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Sommario 148 pazienti con varie forme di malattia cerebrovascolare, sono stati studiati con analisi multiparametriche dell'aggregazione piastrinica in vitro sulla base dei seguenti sei parametri: le soglie di aggregazione primaria e secondaria e l'aggregazione massima percentuale indotta da ADP ed Epinefrina. Questi pazienti sono stati suddivisi in 4 gruppi di studio in accordo con la diagnosi clinica confortata dai dati della TAC e cioè: TIA, RIND, o rammollimento in presenza o in assenza rispettivamente di un trattamento antiaggregante nel momento dello studio. è stato trovato un aumento statisticamente significativo dell'aggregazione in vitro delle piastrine nel 44.4% dei casi TIA, RIND non trattati e nel 33,9% dei casi di rammollimento non trattati. Quest'ultimo gruppo, però, ha dimostrato una più alta percentuale di iperaggregazione molto marcata. Le differenze tra i 2 gruppi di studio trattati con antiaggreganti e i controlli non erano significative. Inoltre nessuna differenza è stata riscontrata tra i gruppi e i controlli nell'aggregazione indotta da collageno e ristocetina.

     

TDP局部照射用于治疗儿童髋关节一过性滑膜炎的疗效观察

目的:探讨加速儿童髋关节一过性滑膜炎疾病的愈合.方法:随机性分析2005年1月～2006年4月共100例髋关节一过性滑膜炎患儿的治疗效果,把病人随机分为治疗组及对照组.治疗组按常规方法治疗加TDP灯局部照射,对照组仅按常规方法治疗.结果:治疗1周后,治疗组B超检查增厚滑膜厚度变化差值、关节腔间隙宽度变化值、关节腔积液好转率、"4"字试验阴性率均明显优于对照组(P＜0.05).结论:TDP灯用于治疗儿童髋关节一过性滑膜炎能加速疾病愈合,提高治疗效果.     

肢体抖动短暂性脑缺血发作(LS-TIA)的临床及影像

目的 肢体抖动短暂性脑缺血发作（LS-TIA）临床少见,本文旨在提高临床医师对这一症候的认识.方法 总结北京协和医院诊断为肢体抖动短暂性脑缺血发作患者7例,行颈部血管超声、脑电图、头部核磁共振、经颅多普勒超声、核磁血管成像,4例行数字减影血管造影,2例行CT灌注成像检查.结果 均表现为发作性短暂不能控制的抖动,5例发作有明显诱因.全部患者均有抖动肢体对侧至少1条以上颅内和/或颅外动脉重度狭窄或闭塞.头部核磁共振4例显示抖动肢体对侧内分水岭脑梗死.脑电图均未见痫样放电,6例可见病变血管同侧额颞部慢波灶.经扩容和抗血小板聚集或者血管内支架治疗后,所有患者病情稳定.结论 肢体抖动短暂性脑缺血发作通常提示大血管严重的狭窄或闭塞,低灌注是其最可能的发病机制.     

Concomitant mitral valve repair and left ventricular reconstruction in a patient with chronic ischemic mitral regurgitation and inferior left ventricular aneurysm

The surgical approach to ischemic mitral regurgitation with concomitant inferior left ventricular aneurysm remains uncertain in terms of the indication for operation and the short-and long-term outcomes. We performed concomitant mitral valve repair, left ventricular reconstruction, and aortic valve replacement on a 71-year-old male with severe ischemic mitral regurgitation, inferior left ventricular aneurysm, and degenerative aortic regurgitation. Postoperative status was in New York Heart Association functional class I without mitral regurgitation 8 months after operation. We discuss, and review the procedures reported in the literature.     

脑梗死急性期降压治疗对预后的影响

目的 研究脑梗死急性期降压及在不同时间进行降压治疗对患者近期预后的影响.方法 据发病后是否降压及进行降压的时间,将198例急性脑梗死患者分为6组,观察各组患者神经功能缺损程度及心脑血管事件的再发生率和病死率.结果 在发病后进行降压治疗的患者中其心脑血管事件再发率和病死率明显低于未降压组（P＜0.01） 3d后降压组患者神经功能恢复的程度明显好于未降压组（P＜0.01）.结论 降压治疗可以降低患者心脑血管事件的发生率和病死率3d后进行降压治疗的患者神经功能恢复明显要好.