化疗对淋巴瘤伴乙肝病毒感染患者肝功能影响的回顾性分析

目的研究化疗对淋巴瘤伴乙肝病毒感染患者肝功能的影响。方法回顾性病例分析，比较50例HBsAg（-）、20例HBsAg（＋）和18例小三阳的恶性淋巴瘤患者化疗后肝功能变化情况。结果HBsAg（-）组、HBsAg（＋）组和小三阳组化疗后Ⅲ级以上肝功能损害分别是0％、15％、55％。结论伴乙肝病毒感染的淋巴瘤患者化疗后肝功能损害明显，尤其小三阳患者损害更为严重，甚至死亡。     

吗啡对机械通气病人的应用

为获得病人在接受呼吸机期间充分的镇静、良好的耐管并与呼吸机合拍达到满意的治疗效果，对６０例不同年龄的患者在进行呼吸机支持治疗期间，采用平均０４５ｍｇ／（ｋｇｄ）的吗啡量持续微量泵静脉注入，间断辅助安定的方法．用药后连续２ｈ观察血压、心率、呼吸、意识等变化．结果：在用药期间病人血压、心率、呼吸平稳，保持清醒，安静耐管，解决了病人与呼吸机拮抗的矛盾．结果表明：该法在临床上有广泛使用价值     

高压交变电磁场对心血管疾病康复的应用

应用高压交变电磁场对134例冠心病及高血压病患者进行临床应用，结果显效67例，好转55例，无效12例；有效地改善了脂蛋白代谢，降低TG、Tc、LDL-c及致动脉硬化指数．升高HDL-c浓度；降低了高血压病患者的血压；改善了冠心病患者的心电图；同时可改善心功能参数及心室负荷。由此可见，高压交变电磁场能抗动脉粥样硬化，对心血管疾病有显著的治疗作用。     

Hemodynamic Parameters Influencing Clinical Performance of Novacor Left Ventricular Assist System

The interrelationships between hemodynamic variables including right ventricular (RV) performance with filling/ejection dynamics of the Novacor left ventricular assist system (LVAS) were determined in 10 of 11 patients who received LVAS as a bridge to heart transplant. Nine were successfully transplanted. Data were obtained intraoperatively, at periodic intervals up to 48 h postimplant and at explant. The hypotheses investigated included (a) RV performance influences LVAS filling characteristics and (b) LVAS pump output is influenced by systemic vascular resistance (SVR). During the period of LVAS support (2-126 days), pumping characteristics included a mean filling volume of 51 ml (range, 24-70), residual volume of 4.9 ml (range, 1-18), pump rate of 113/min (range, 63-175), and pump output of 5.81/min (range, 2.8-8.2). Multiple regression analysis identified pulmonary vascular resistance (PVR), RV stroke work index (RVSWI), and pulmonary capillary wedge pressure, but not RV ejection fraction, pulmonary artery pressure, or central venous pressure (CVP) as the most important correlates with LVAS filling volume (p less than 0.001, R2 = 0.6). In addition, LVAS pump output was influenced mainly by RVSWI, PVR, and SVR (p less than 0.001, R2 = 0.7). It was concluded that LVAS performance is highly dependent on RV function and systemic/pulmonary vascular resistances.     

细脉者左心室舒缩功能的研究

采用超声心动图对43例细脉者左心室舒缩功能进行了检测,并以26例滑脉和30例平脉作为对照组,发现细脉者8项左心室舒缩功能指标与各对照组比较有非常显著性差别(P>0.01)。说明细脉者具有左心室收缩功能和舒张功能的异常.左心室舒缩功能的减退是细脉产生的重要原因之一。不同原因的细脉者左心室舒缩功能的差别无显著性(P>0.05),揭示不同原因的细脉其产生的机理存在着同一性。     

Role of β2 integrins in glomerular leucocytes in Henoch-Schoenlein purpura nephritis: an age-matched comparative study with immunoglobulin A nephropathy

SUMMARY: A comparative immunohistological study was performed for the glomerular deposition of complements (C1q and C3c), fibrin/fibrinogen‐related antigen (FRA), the expression of intercellular adhesion molecule‐1 (ICAM‐1), and the infiltration of leucocytes bearing β₂ integrins (leucocyte function associated antigen‐1 (LFA‐1), complement receptor 3 (CR3) and complement receptor 4 (CR4)) on renal biopsy specimens from 49 cases with Henoch‐Schoenlein purpura nephritis (HSPN), and 49 age‐matched cases with immunoglobulin A nephropathy (IgAN). the glomerular expression of ICAM‐1 was signifcantly correlated with the glomerular infiltration of leucocyte function associated antigen (LFA)‐1⁺ leucocytes in both diseases, and with that of CR3⁺ leucocytes in HSPN. the expression of ICAM‐1 was closely localized with the infiltration of LFA‐1⁺ leucocytes in the study with double immunostaining. the incidence and intensity of glomerular deposition of FRA were significantly higher in HSPN than in IgAN (P< 0.001), and those of C3c were significantly lower in HSPN than in IgAN (P< 0.001). the glomerular deposition of FRA was significantly correlated with the glomerular infiltration of CR4⁺ leucocytes in HSPN (P<0.05) but not in IgAN. In contrast, the glomerular deposition of C3c was significantly correlated with the glomerular infiltration of CR4⁺ leucocytes in IgAN (P<0.05), but not in HSPN. Studies with double immunostaining revealed a close association of CR4⁺ leucocytes with FRA deposition in HSPN and with C3c deposition in IgAN, respectively. the number of glomerular leucocytes bearing β₂ integrins was significantly correlated with urinary protein at the time of renal biopsy in both diseases. These results suggested the differential roles of β₂ integrins in the induction of glomerular injury in HSPN and IgAN. the ICAM‐1/LFA‐1 interaction may commonly be involved in the glomerular infiltration of leucocytes in both diseases. the ICAM‐1/CR3 interaction may be involved only in HSPN. Complement receptor 4 may function as a fibrin/fibrinogen receptor in HSPN, while CR4 may function as a complement receptor in IgAN.     

Impact of photon energy recovery on the assessment of left ventricular volume using myocardial perfusion SPECT

BACKGROUND: Photon energy recovery (PER) is a spectral deconvolution technique validated for scatter removal in patients and phantom studies. The purpose of this study was to examine the impact of PER on left ventricular volume measurement based on myocardial perfusion single photon emission computed tomography (SPECT). METHODS AND RESULTS: SPECT acquisitions were performed by use of a static cardiac phantom and in 25 patients after a rest injection of technetium 99m sestamibi by use of multiple energy windows (126-136, 137-144, and 145-154 keV). Data were successively reconstructed with and without PER, by use of iterative reconstruction and post-processing filtering (Butterworth filter; order, 5; cutoff, 0.30 cycles/pixel). Image contrast was evaluated in reconstructed data, and volumes were calculated by use of QGS. PER increased reconstructed image contrast from 62% +/- 2.7% to 84.3% +/- 5.7% in the phantom studies (P <.0001) and from 49% +/- 2% to 73% +/- 2% in patients (P <.0001). Although it remained underestimated (P <.0001), phantom volume was higher after PER correction compared with uncorrected data (50.9 +/- 0.8 mL vs 44.6 +/- 1 mL, P <.0001). The error in volume measurement was decreased by PER correction (16.6% +/- 1.3% vs 27% +/- 1.7% [uncorrected data], P <.0001). In patients, left ventricular volume increased from 83 +/- 10 mL to 91 +/- 10 mL (P <.0001), and the PER-induced volume increase was correlated with the image contrast increase (r = 0.61, P =.001). Finally, the percentage of volume increase was higher in patients with small left ventricular volumes. CONCLUSIONS: PER has a significant impact on image contrast and left ventricular volume measurement by use of perfusion SPECT. PER improves the accuracy of phantom volume assessment. In patients, volume increase is correlated to image contrast increase and is higher in those with small ventricles.     

失重对成骨细胞基因表达和细胞功能影响的研究进展

骨骼可以适应包括重力在内的各种机械刺激，并对骨形成与骨吸收之间的平衡进行调整。失重状态下的骨质减少主要归因于骨形成的减少，这与成骨细胞功能下降有关，表现为细胞增殖粘附能力下降，与分化成熟相关的物质(碱性磷酸酶，骨钙素和I型胶原)的mRNA及蛋白合成均减少，多种生长因子的分泌量以及细胞对其反应性下降。成骨细胞功能下降的机制尚不明确，有假说认为失重时细胞形态的改变导致了基因表达与功能的变化。     

EFFECTS OF ANGIOTENSINS II AND III ON GLOMERULOTUBULAR BALANCE IN RATS

1. The role of angiotensin as a modulator of proximal glomerulotubular (GT) balance was investigated in anaesthetized rats by examining the relationship between glomerular filtration rate (GFR) and absolute proximal reabsorption (APR) during removal of endogenous angiotensin II (AII) and III (AIII) with enalaprilat (CEI) and then during their subsequent replacement by intravenous infusions. 2. Enalaprilat lowered mean arterial blood pressure (MABP) and increased renal blood flow (RBF), GFR, urine flow rate and sodium excretion. Filtration fraction (FF) was not altered. Absolute proximal reabsorption, derived from fractional lithium clearance, increased by only 48% of the change expected for 'perfect' GT balance. 3. Angiotensin II replacement corrected MABP, GFR and plasma renin level, but reduced RBF and increased FF; APR was decreased and GT balance was restored. Urine flow and sodium excretion remained above control values with AII. 4. Replacement with AIII did not correct the hypotension but completely reversed the renal and renin responses to enalaprilat and restored GT balance without affecting FF. 5. It was concluded that the relation between proximal reabsorption and GFR is considerably modified by the intrarenal angiotensin concentration. The findings are best explained by a direct stimulation of proximal tubular sodium transport by angiotensin at the concentrations existing in anaesthetized rats.