急性脑梗死患者血清基质金属蛋白酶-9和神经元特异性烯醇化酶检测的临床意义

[目的]研究急性脑梗死患者血清基质金属蛋白酶-9（MMP-9）,神经元特异性烯醇化酶（NSE）水平的变化,并探讨其在急性脑梗死诊断及预后评估中的临床价值。[方法]选取临床确诊的58例急性脑梗死病例及同期同年龄组体检健康者30例。分别用酶联免疫吸附法（ELISA）和电化学发光免疫分析技术（ECLIA）测定血清中的MMP-9和NSE浓度。根据脑卒中患者临床神经功能缺损程度评分标准对患者入院时及入院3周后状态进行评分,作为预后分级标准。应用SPSS 11.5软件包进行统计学处理。[结果]患者组MMP-9和NSE血清浓度与对照组间存在统计学差异（P〈0.01）,急性期和恢复期患者差异也存在显著性意义,血清MMP-9和NSE水平与脑梗死体积和预后之间存在相关性（P〈0.01）。[结论]急性脑梗死患者血清MMP-9和NSE水平明显增高,且其增高程度能够为中枢神经系统受损程度提供定量信息,并可作为预后评估的重要参数。     

慢性非传染性疾病对老年与非老年急性脑梗死患者发生多器官功能不全综合征的影响对照研究

目的分析慢性非传染性疾病对急性脑梗死患者发生多器官功能不全综合征（MODS）的影响。方法将864例急性脑梗死患者分为两组：老年组（n=594）[平均年龄（71．39±6．70）岁（60-94岁）]，和非老年组（n=270）[年龄（49．58±8．34）岁（18-59岁）]。老年组发生MODS154例（25．9％），非老年组发生MODS39例（14．4％）。将可能对急性脑梗死患者MODS的发生产生影响的慢性非传染性疾病进行多因素Logistic回归分析，寻找其中的危险因素。结果在老年组，慢性非传染性疾病中糖尿病、高血压、心血管慢性病、呼吸系统慢性病、肾脏慢性病是急性脑梗死患者多器官功能不全综合征发生的主要危险因素；在非老年组，高血压、心血管慢性病是主要危险因素。结论老年组的慢性基础病和多器官功能衰竭的发生率高于非老年组。不同年龄组的脑梗死患者发生MODS的主要危险因素不完全相同。     

Association between pentosidine and arteriosclerosis in patients receiving hemodialysis

Background It has been suggested that advanced glycation endproducts (AGEs) accumulate in arteriosclerotic lesions, playing an important role in the development and progression of arteriosclerosis. A chemical quantification method using high-performance liquid chromatography (HPLC) has been established to determine pentosidine levels in these products. Some studies reported that the abdominal aorta calcification index (ACI), obtained by computed tomography (CT), was useful for noninvasively diagnosing arteriosclerosis and determining its severity. In the present study, we measured the ACI and plasma pentosidine in patients receiving maintenance hemodialysis, and investigated the association between arteriosclerosis and pentosidine.Methods In 73 patients receiving maintenance hemodialysis (43 men; 30 women), we determined the ACI, and investigated the association of the ACI with plasma total pentosidine, total cholesterol, triglyceride, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, serum creatinine, and parathyroid hormone (PTH), as well as the product of serum calcium and serum phosphorus, duration of dialysis, and age.Results The ACI did not correlate with total cholesterol, triglyceride, HDL cholesterol, LDL cholesterol, serum creatinine, PTH, or the product of serum calcium and serum phosphorus. Age, duration of dialysis, and plasma total pentosidine correlated with the ACI: (y = –33.12 + 0.913x; r = 0.407; P 0.01), (y = 13.94 + 0.403x; r = 0.488; P 0.01), and (y = 14.13 + 0.630x; r = 0.365; P 0.01), respectively.Conclusions It is suggested that pentosidine may be associated with arteriosclerotic development in hemodialysis patients.     

依达拉奉对急性脑梗死神经功能的保护作用

目的探讨依达拉奉(Edaravone)治疗急性脑梗死的临床疗效。方法采用随机对照试验,选择发病48h内的ACI患者56例,随机分为治疗组(28例)及对照组(28例)。对照组用银杏达莫注射液+肠溶阿司匹林,治疗组在常规治疗的基础上加用依达拉奉30mg,每日2次,静脉滴注,疗程均为14d。分别在治疗前、治疗14d进行美国国立卫生研究院卒中量表(NIHSS)和日常生活活动能力量表(BI)指数评分。结果14d后治疗组、对照组NIHSS、ADL相比差异有统计学意义(P<0.05),两组无明显不良反应。结论依达拉奉能有效改善急性脑梗死的神经功能缺失和日常生活活动能力,无明显不良反应。临床疗效好,安全性高。     

威海市急性脑梗死院前延迟的原因分析与对策

目的研究威海市区2家医院脑梗死患者到达医院前时间（院前延迟）的影响因素及对策。方法回顾性研究了进入医院急诊就诊的急性脑梗死病人的院前延迟影响因素，并制定相应对策。对所有资料分别采用KruskalWal—lis检验方法和logistic回归进行单变量和多变量分析。统计学软件采用SPSS12．0和SAS6．0。结果患者平均到达医院急诊时间为312min，27．27％于发病2h内到达医院急诊，42．08％于发病5h内到达医院急诊。单因素分析显示：女性、非独居、有医疗保险、首发症状为传统症状、病人能识别卒中症状、病人或救助者能认识脑梗死治疗紧迫性、由120救护车或110警车进行运送有利于及早到达医院急诊。多因素回归模型显示：影响及早到达医院急诊最重要因素是运送方式和首发症状，使用120救护车或110警车运送病人而非使用其他运送方式和卒中表现为传统症状能缩短入院时间。结论57．92％急性脑梗死患者不能在发病后5h内到达医院。为了缩短到达医院急诊时间，应加强对民众急性脑梗死知识的宣传教育；提高社区医生脑梗死诊治水平；进一步完善城镇基本医疗保险制度和新型农村合作医疗制度建设，扩大参保、参合率；重视敬老院、老年公寓建设，减少独居老年人比例。     

奥扎格雷钠对急性脑梗死患者血清C反应蛋白与疗效的影响

目的 观察奥扎格雷钠对急性脑梗死(ACI)患者血清C反应蛋白(CRP)含量与疗效的影响.方法 136例急性脑梗死患者随机分为观察组和对照组各68例,对照组采用脑梗死常规治疗,观察组在常规治疗基础上加用奥扎格雷钠治疗,治疗前及14 d后测定CRP水平变化,并对神经功能缺损进行标准评分.结果 治疗后14 d观察组CRP水平较对照组降低,差异有统计学意义(P<0.05),观察组神经功能缺损评分低于对照组,差异有统计学意义(P<0.05).结论 奥扎格雷钠能降低ACI患者血清CRP水平,有利于减轻炎症反应,提高临床疗效.     

Dietary quercetin exacerbates the development of estrogen-induced breast tumors in female ACI rats

Phytoestrogens are plant compounds that structurally mimic the endogenous estrogen 17β-estradiol (E₂). Despite intense investigation, the net effect of phytoestrogen exposure on the breast remains unclear. The objective of the current study was to examine the effects of quercetin on E₂-induced breast cancer in vivo. Female ACI rats were given quercetin (2.5 g/kg food) for 8 months. Animals were monitored weekly for palpable tumors, and at the end of the experiment, rats were euthanized, breast tumor and different tissues excised so that they could be examined for histopathologic changes, estrogen metabolic activity and oxidant stress. Quercetin alone did not induce mammary tumors in female ACI rats. However, in rats implanted with E₂ pellets, co-exposure to quercetin did not protect rats from E₂-induced breast tumor development with 100% of the animals developing breast tumors within 8 months of treatment. No changes in serum quercetin levels were observed in quercetin and quercetin + E₂-treated groups at the end of the experiment. Tumor latency was significantly decreased among rats from the quercetin + E₂ group relative to those in the E₂ group. Catechol-O-methyltransferase (COMT) activity was significantly downregulated in quercetin-exposed mammary tissue. Analysis of 8-isoprostane F_2α (8-iso-PGF_2α) levels as a marker of oxidant stress showed that quercetin did not decrease E₂-induced oxidant stress. These results indicate that quercetin (2.5 g/kg food) does not confer protection against breast cancer, does not inhibit E₂-induced oxidant stress and may exacerbate breast carcinogenesis in E₂-treated ACI rats. Inhibition of COMT activity by quercetin may expose breast cells chronically to E₂ and catechol estrogens. This would permit longer exposure times to the carcinogenic metabolites of E₂ and chronic exposure to oxidant stress as a result of metabolic redox cycling to estrogen metabolites, and thus quercetin may exacerbate E₂-induced breast tumors in female ACI rats.     

DCIK细胞联合化疗治疗晚期消化道肿瘤的临床疗效

目的：评价树突状细胞调节的细胞因子诱导的杀伤细胞（DC activated and cytokins induced killer,DCIK）联合化疗治疗晚期消化道肿瘤的疗效。方法：实验采用武警总医院2005年6月至2007年8月应用DCIK联合全身化疗治疗晚期消化道肿瘤的患者23例作为联合治疗组。同期进行单纯化疗的20例晚期消化道肿瘤患者作为对照组。联合治疗组患者均于化疗前采集外周血单个核细胞（PBMC）。将PBMC体外培养产生DCIK细胞。联合治疗组患者首先行2周期全身化疗,化疗结束后回输质量合格的DCIK细胞。单纯化疗组仅进行2周期全身化疗。观察两组近期疗效、临床受益反应改善程度、肿瘤标志物、免疫指标及1年、3年生存率。结果：两组近期疗效无显著性差异（P〉0.05）。联合治疗组治疗后KPS评分升高（P〈0.05）,单纯化疗组治疗后KPS评分较治疗前无改善（P〉0.05）。联合治疗组患者治疗后外周血CD3＋CD8＋、CD3＋CD56＋细胞的比例大幅升高（P〈0.01）;而单纯化疗组患者无明显变化（P〉0.05）。联合治疗组1年生存率78.3%;单纯化疗组1年生存率80%（P〉0.05）。联合治疗组3年生存率52.2%;单纯化疗组3年生存率30%（P〈0.01）。结论：DCIK联合化疗治疗晚期消化道肿瘤具有更好的疗效,其临床受益反应有较大的提高,免疫功能有所改善,3年生存率提高。     

Characterization of colony-forming cells in adult human articular cartilage

Recent studies have shown that adult human articular cartilage contains stem-like cells within the native structure. In this study, we aimed to determine the localization of putative stem cell markers such as CD90, STRO-1, OCT-3/4, CD105 and CD166 in adult human articular cartilage tissue sections and demonstrate the expression of these markers within the expanded surface zone colony-forming (CF) cells and evaluate their differentiation potential. Biopsy samples were either fixed immediately for immunohistochemical analyses or processed for in vitro cell culture. Immunohistochemical and flow cytometry analyses were performed by using CD90, STRO-1, OCT-3/4, CD105 and CD166 antibodies. Isolated colony-forming (CF) cells were further stimulated, by using the appropriate growth factors in their pellet culture, to obtain cartilage, bone and adipose lineages. We observed that the expression of the stem cell markers were in various zones of the human adult cartilage. Flow cytometry results showed that in CF cells the expression of CD90 and CD166 was high, while OCT-3/4 was low. We also determined that CF cells could be stimulated towards cartilage, bone and adipose lineages. The results of this research support the idea that the resident stem-like cells in adult human articular cartilage express these putative stem cell markers, but further experimental investigations are needed to determine the precise localization of these cells.     

凝血酶激活的纤溶抑制物基因3’端+1583A/T多态性与动脉粥样硬化性脑梗死的关系

目的分析中国汉族人群凝血酶激活的纤溶抑制物(TAFI)基因3’端+1583A/T多态性与动脉粥样硬化性脑梗死发病的关系。方法本研究采用病例-对照研究,选择中国汉族人群225例动脉粥样硬化性脑梗死(病例组)和184例健康体检者(对照组)为对象,应用聚合酶链反应-限制性内切酶片段长度多态性分析方法(PCR-RFLP)检测TAFI+1583A/T多态性。结果 TAFI+1583 A/T在病例组的A等位基因频率为24.7%,对照组为25.0%,两组比较经χ2检验差异无显著性(P=0.913)。病例组AA基因型为6.7%,对照组为3.8%,两组比较经χ2检验差异无显著性(P=0.202)。结论 TAFI+1583A/T与脑梗死的发病无关。