重度烧伤患者休克期血浆B型钠尿肽含量变化及意义

Objective To study the plasma content of B-type natriuretic peptide (BNP) in patients with severe burn during shock stage and probe its clinical significance. Methods Forty-two patients aged 18-60 years, with total burn surface area ≥30%TBSA or full-thickness burn area ≥10% TBSA, hospital-ized within 4 hours after burn, were divided into A group (with total burn surface area 30% -50% TBSA or full-thickness burn area 10% -20% TBSA, n = 21 ), and B group (with total burn surface area 50% TB-SA or full-thickness burn area > 20% TBSA, n = 21 ). Twenty patients admitted during the same time for plastic surgery were enrolled as control group. The plasma levels of BNP, creatine kinase (CK), CK-MB, troponin I (Tnl) of all patients were determined on admission. The levels of BNP, Tnl and fluid resuscita-tion volume were examined at 8, 16, 24, 48 post burn hour (PBH) in A and B groups. Analysis of correla-tion between BNP and fluid resuscitation volume was performed. Results On admission: BNP level in A group (68±19 ng/L) and B group (99±38 ng/L) , respectively, was increased as compared with that in control group (17±7 ng/L, P <0.01 ). Tnl level in A group (2.13±0.67 μg/L) and B group (2.98± 0.58μg/L), respectively, was increased as compared with that in control group (0.12 ± 0.03 μg/L, P < 0.01). There was no obvious difference in CK, CK-MB levels among A, B, and control groups ( P > 0.05). BNP levels in A, B groups continuously rose during 8 - 48 PBH, and they were positively correlated with fluid resuscitation volume. TnI level peaked at 24 PBH, and decreased at 48 PBH. Conclusions The plasma level of BNP is sensitive to reflect changes in myocardial ischemia and hypoxia as a rise in level of TnI in shock stage of severe burn, and it was positively correlated with fluid resuscitation volume. BNP can be used to guide fluid resuscitation during shock stage.     

利用ACL-100型凝血仪测定凝血因子的简易方法介绍

ＡＣＬ— 10 0型凝血仪是美国库尔特公司生产的用于测定出凝血系统疾病的一种仪器 ,由于因各种凝血因子缺乏或减少而引起的疾病发病率低 ,ＡＣＬ— 10 0型凝血仪中配套的因子缺乏基质血浆(ⅧⅨⅪⅫⅫ )价格昂贵 ,很不适应基层医院使用 ,所以我们利用ＡＣＬ— 10 0型凝血仪结合手工操作原理 ,设计了一种简便的检测凝血因子的方法(以Ⅷ因子检测为例 ) ,即经济、简便、快速、准确 ,现介绍如下。1　原理1 1　部分凝血活酶时间测定 (ＡＰＴＴ) ,为内源性凝血系统的一种敏感的过筛试验 ,凡参与凝血活酶生成的任何因子的减少或缺乏 ,凝血因子均可延…     

Ⅲ型、Ⅳ型胶原在慢性胰腺炎组织中的表达

目的检测Ⅲ、Ⅳ型胶原在CP及正常胰腺组织中的表达水平,研究其在胰腺间质纤维化形成中的作用。方法免疫组织化学方法检测16例CP标本及6例正常胰腺组织中Ⅲ、Ⅳ型胶原的表达。结果16例CP中,Ⅲ型、Ⅳ型胶原表达均为轻度以上深染,其中重度深染50%（8/16）,中度深染31.25%（5/16）;而正常胰腺组织Ⅲ、Ⅳ型胶原表达均为浅染。正常胰腺组织中Ⅲ、Ⅳ型胶原表达于基底膜、间质纤维、导管壁、血管壁,Ⅲ型胶原以间质纤维表达最明显,Ⅳ型胶原以基底膜表达最明显。CP组织中Ⅲ型胶原表达于基底膜、间质纤维、导管壁、血管壁,以间质纤维最明显;Ⅳ型胶原表达于基底膜、间质纤维、导管壁、血管壁,以基底膜最明显。结论Ⅲ、Ⅳ型胶原的表达增强在胰腺纤维化的形成中可能有重要作用。     

儿童1型糖尿病患者的个性特征分析

为分析儿童 1型糖尿病患者的个性特征 ,为 1型糖尿病患者的病情控制和心理健康提供科学依据 ,使用EPQ问卷对住院确诊的 1型糖尿病患者 36例及健康对照进行问卷调查 ,内容包括一般资料 (性别、年龄等 )和个性评估。结果病例组与健康组EPQ的T分比较显示病例组N分和P分明显高于健康组 (P <0 0 5 ) ,E分和L分两组差异无统计学意义 (P >0 0 5 )。病例组与健康组N维度各型人数比较显示病例组个性特征不稳定性所占比例明显高于健康组 (P <0 0 1)。不同病程患者在个性的 3个纬度 (N、P、E)尚未发现差异有统计学意义 (P >0 0 5 )。儿童 1型糖尿病患者的个性与健康人群比较 ,具有神经质倾向     

复方丹参滴丸对2型糖尿病合并微血管病变的临床观察

随着人们生活水平的不断提高和人口的老龄化,2型糖尿病的发病率不断上升,而微血管病变是糖尿病的非常重要的一组并发症.近年来,我们应用复方丹参滴丸治疗2型糖尿病合并微血管病变,并通过甲皱循环这一窗口进行观察,取得了一定疗效,现报告如下.     

P型和Q型钙通道的性质差异及其可能的结构基础

P型和Q型钙通道虽然被发现得较晚,但因其在神经递质释放中的重要作用而倍受关注.构成这两类通道孔道的均为α1A亚单元,但它们在失活特性、对阻断剂的敏感性上有明显差异.通道α1A亚单元的相关肽段序列以及参与共表达的β亚单元的不同是这两类通道性质差异可能的结构基础.     

胃原发性恶性淋巴瘤3例（摘要）

1986年以来共收治胃肿瘤243例．经手术和病理证实胃原发性恶性淋巴瘤3例，占1.2%。这3例均为男性．年龄分别为62、40和27岁。临床表现均为上腹部疼痛，未扪到腹部包块．胃镜检查均示溃疡型胃癌改变；钳取活组织检查的2例中仅1例组织内找到少量可疑肿瘤细胞。术后病理证实为恶性淋巴瘤，瘤组织浸润至肌层。