华支睾吸虫对自然感染动物模型猫肝脏/胆管及生理生化指标的影响

目的 了解自然状态下猫感染华支睾吸虫的现状及该病对肝脏／胆管及生理生化指标的影响。方法 观察活猫的精神状态，处死后肝脏形态及切开后的眼观形态；通过病理切片观察肝脏、胆管及胆囊的病理变化；测定血常规及肝脏功能指标。结果 7.3％的肝脏（8／218，218为阳性猫）表面有明显的黄豆粒大小的肿瘤；94％（205／218）的肝脏质地变硬，结缔组织增生；29．8％（25／218）肝脓肿，肝色较黄，小叶结构模糊：54．1％（118／218）胆管内上皮细胞增生，淋巴细胞浸润；感染猫血红细胞显著降低（P〈0．01），血清丙氨酸氨基转移酶显著升高（P〈0．05）。结论 华支睾吸虫对肝脏、胆管及胆囊造成了严重伤害，很可能是肝癌、胆管癌的诱因之一。     

Absence of a relationship between umbilical cord thickness and coiling patterns.

OBJECTIVE: The purpose of this study was to evaluate a relationship between the umbilical cord thickness and cord coiling patterns during the fetal sonographic anatomic survey in the second trimester of pregnancy. METHODS: This was a prospective study of 470 patients with singleton pregnancies who had a fetal anatomic survey with recorded umbilical coiling patterns between 18 and 23 weeks' gestation. The umbilical cord thickness was assessed as an umbilical diameter at the level of the fetal abdominal cord insertion and compared with the antenatal umbilical coiling index (aUCI), calculated as a reciprocal value of the distance between a pair of umbilical cord coils. RESULTS: Three hundred twenty-one patients had adequate sonographic umbilical cord images and maternal demographic, antenatal, and labor data to meet inclusion criteria. The mean aUCI was 0.41 with 10th and 90th percentiles of 0.21 and 0.60, respectively. A total of 10.6% (34/321) and 9.3% (30/321) of patients were categorized as having hypocoiled and hypercoiled umbilical cords, respectively. The mean cord diameter +/- SD was 9.48 +/- 0.97 mm (range 7.0-12.5 mm). There was no statistically significant correlation between aUCI and umbilical cord thickness (P = .1164). CONCLUSIONS: An aUCI, or umbilical coiling pattern, does not correlate with umbilical cord thickness. It appears that a lesser amount of the umbilical supportive tissue, mainly Wharton jelly, is not related to an increased umbilical cord coiling pattern.     

北京城区居民体质指数与慢性病危险因素关系分析

对 1 995～ 1 998年营养与食品安全所老年与临床营养室在北京地区慢性病社区防治研究中积累的1 2 4 6例 2 5～ 74岁居民的部分体检资料进行分析 ,观察不同人群体质指数 (BMI)、腰围 (WC)水平与慢性疾病相关因素 血清总胆固醇 (TC)、高密度脂蛋白胆固醇 (HDL C)、甘油三酯 (TG)、收缩压 (SBP)、舒张压 (DBP)、血糖 (FBG)及与高血压、高脂血症、糖尿病的检出率的关系。结果 :该人群超重及肥胖率男性为 41 7%及1 4 6 % ,女性为 32 0 %及 2 0 4%。超重及肥胖组高血压、高脂血症、糖尿病的检出率明显高于BMI正常组。相关分析结果表明BMI、WC与TC、TG、SBP、DBP呈显著正相关 ;与HDL C、HDL C TC呈显著负相关 ,WC与FBG呈显著正相关。提示为早期预防慢性病 ,应对BMI>2 4的人群给予充分关注     

广州市大气污染与肺癌关系的探讨

大气污染与肺癌的关系非常复杂,这不但由于肺癌的发生有较长的潜隐期,而且大气污染的程度又是在时时变化之中,要研究两者的关系,必需有长期观察资料为依据。本文对广州市近20年的大气污染调查资料进行系统的整理,并结合12年的肺癌死亡调查资料进行分析,发现大气污染较严重的地区,肺癌死亡率也较高。     

胰腺癌细胞的增殖同膜脂质饱和度,膜胰岛素受体的关系

外源性表皮生长因子(或生长抑素)能促进(或抑制)胰腺癌细胞的增殖。胰腺癌细胞增殖速率的高低与细胞膜脂质饱和度的降、升;与膜胰岛素受体数量的增减密切相关。测定细胞膜脂质饱和度和胰岛素受体数量,是判断胰腺癌增殖状态的灵敏指标,有一定临床价值。     

Pulsatility and resistance indices in intrarenal arteries of normal adults

In order to establish the normal range of values of Pulsatility (PI) and Resistance (RI) Indices in the intrarenal vasculature, a study of 50 healthy volunteers (23 males, 27 females), divided into five groups of 10 according to age, was performed with Duplex Doppler ultrasound. Both kidneys were examined in all individuals and, in 12, indices were also compared between upper and lower poles of both kidneys. In addition, repeat examinations were performed in nine subjects on three different days, in order to assess the reproducibility of the method. No differences were found in the mean values of both indices between males and females, upper and lower poles, right and left kidneys. A statistically significant increase (p < 0.01, unpaired t-test) was demonstrated when the oldest age group (7th decade) was compared to the youngest age group (3rd decade). The method appeared remarkably reproducible for RI (4.2–7%), with wider variation in the PI (9.5–22.7%).     

How can we predict ureteral obstruction after gynecological surgery? The changes in Doppler resistive index and plasma creatinine and magnesium concentrations after surgical, unilateral ureteral obstruction in a rabbit model

The aim of this study is to evaluate the changes in Doppler resistive index (RI) and plasma creatinine and magnesium concentrations after unilateral ureteral obstruction in a rabbit model. Fourteen adult female rabbits were used in this study. In seven rabbits, the left ureter was ligated with silk suture, and the control group was sham operated. Before surgery and on the second and seventh days after surgery, blood samples were obtained to measure plasma creatinine and magnesium concentrations. Doppler RIs of both kidneys were also measured before surgery and on the second and seventh days after the surgical procedure. With regard to magnesium levels, there was a significant within-subjects sessions difference [F(2, 20) = 15.21, P= 0.001] indicating a decrease through sessions. Magnesium concentrations decreased significantly at the postoperative second and seventh days compared to preoperative baseline levels (P= 0.003 and P= 0.001, respectively). Multifactorial analysis of variance was applied for each session separately with laterality, and groups as factors. The Doppler RI and the creatinine level did not show any significant differences or interactions for all sessions (P > 0.05). The decreasing plasma magnesium concentration after surgery may indicate ureteral injury; however, Doppler studies and creatinine levels may not be useful as well.     

2型糖尿病(消渴病)微观辨证的临床研究

目的　为糖尿病的临床辨证、治疗用药提供客观依据和帮助。方法　观察 2型糖尿病 (消渴病 ,diabetesmellitus)不同证型患者各 30例 ,正常对照组 30例 ,检测血清一氧化氮 (NO)、血浆α -颗粒膜蛋白 (GMP 14 0 )、血浆D -二聚体 (D D)、血清白细胞介素 - 6 (IL 6 )这些微观指标的变化 ,探讨其与中医辨证分型的关系。结果　①血清NO值在各组中的变化是阴虚热盛组 >正常对照组>气阴两虚组 >气滞血瘀组 ,每两组间具有显著性差异 (P <0 0 5 ) ,其中气滞血瘀组与其它 3组具有非常显著性差异 (P <0 0 1)。②糖尿病各组患者血浆GMP 14 0、D D值均较正常对照组有非常显著性增高 (P <0 0 1) ,在糖尿病组各证型中 ,呈阴虚热盛组 <气阴两虚组 <气滞血瘀组变化趋势 ,且血浆GMP 14 0和D D的变化呈正相关 (r=0 6 6 )。③血清IL 6在糖尿病组较正常对照组升高 ,其变化呈阴虚热盛组 <气阴两虚组 <气滞血瘀组趋势 ,每两组间具有非常显著性差异 (P <0 0 1)。结论　糖尿病发病以正气不足为内在依据。随着病程的进展 ,脾肾亏虚及血瘀加重是必然趋势。治疗应重视补脾肾和活血化瘀     

体重指数对全膝关节置换术后功能的影响

目的回顾性分析体重指数(BMI)对骨关节炎(OA)患者全膝关节置换术(TKA)后功能的影响.方法由同一组医生使用同一种假体对320例(520膝)骨关节炎患者行全膝关节置换.按体重指数分为4组非肥胖组(BMI＜25.0 kg/m2)、超重组(BMI 25.1～27.0 kg/m2)、肥胖组(BMI 27.1～30.0kg/m2)和病理性肥胖组(BMI＞30.0 kg/m2),分别记录术前及随访时HSS膝评分、功能评分、膝关节最大屈曲、伸直度数和并发症.结果术前超重组、肥胖组和病理性肥胖组功能评分较非肥胖组低(P＜0.05),但膝评分差异无显著性.通过平均28.3个月的随访,无论膝评分和功能评分各组术后均明显提高,各组提高的幅度比较差异无显著性.虽然超重组、肥胖组和病理性肥胖组术后最大屈曲、伸直度数较非肥胖组小,但是改善幅度仍相当,差异无显著性(P＞0.05).肥胖组和病理性肥胖组围手术期并发症明显增高(P＜0.05),在总共93例(181膝)中,有14膝(9.2%)出现伤口并发症,其中1膝(0.5%)感染,感染发生于术后10周内,与伤口并发症有关;2膝(1.3%)内侧副韧带损伤.超重组166例(258膝)中有6膝(2.3%)出现伤口并发症,无感染及内侧副韧带损伤病例.非肥胖组61例(81膝)中有1膝(1%)出现伤口并发症,无感染及内侧副韧带损伤病例.结论TKR是进展期OA患者有效的治疗措施,肥胖并不是膝关节置换手术的障碍.但围手术期并发症增多,包括伤口愈合、感染、内侧副韧带损伤,应注意伤口缝合技术和保护内侧副韧带.     

Ankle-brachial index and extent of atherothrombosis in 8891 patients with or at risk of vascular disease: results of the international AGATHA study.

AIMS: AGATHA (a Global Atherothrombosis Assessment) was designed to assess the extent of atherothrombosis and the use of the ankle-brachial index (ABI) in vascular patients. The principal hypotheses were that (1) in diseased patients, a low ABI was related to the number and site of vascular beds affected and (2) in at-risk patients without disease, a low ABI was related to the number of risk factors present. METHODS AND RESULTS: Patients were recruited consecutively by 482 clinicians in 24 countries and the ABI measurement was performed at a single visit. Of 8891 patients recruited, 1792 were defined as at risk and 7099 as with disease. Of the with-disease patients, 65.2% had one arterial bed affected, 27.6% two and 7.1% all three. Abnormal ABI (< or =0.9) was present in 30.9% of at-risk and 40.5% of with-disease patients. A lower ABI was weakly associated with an increasing number of risk factors in at-risk patients (r=-0.056, P=0.02) and with the site and number of arterial beds affected in with-disease patients (P<0.001). CONCLUSION: This large international study confirms that atherothrombotic disease often occurs at more than one site. The ABI is related to the risk factor profile and to the site and extent of atherothrombosis.