高脂血症时血清二乙基对硝基苯磷酸酯酶活性的变化

目的 :研究tritonWR 13 3 9致小鼠高脂血症时血清二乙基对硝基苯磷酸酯酶 (ParaoxonaseI ,PON 1)活性的变化及PON 1活性与血浆脂质含量之间的关系。方法 :在小鼠尾静脉注射tritonWR13 3 9后的 3h ,6h ,12h ,2 4h ,48h ,72h ,眼球摘除术取血 ,用酶标法测定小鼠血浆总胆固醇 (TC) ,甘油三酯 (TG ) ,高密度脂蛋白 -胆固醇 (HDL -C) ,载脂蛋白AI (ApoAI) ,载脂蛋白B (ApoB含量 ) ,并计算出ApoAI/ApoB ,HDL -C/TC比值 ,用分光光度计法测定PONI活性。结果 :TritonWR 13 3 9尾静脉注射后 3h ,小鼠血浆TC和TG含量即急剧增高 ,与对照组相比 ,P <0 .0 1,分别在注射后 2 4h和 3h达到峰值 ,随后逐渐下降 ,其中血浆TG含量在注射后 48h即恢复正常水平。tritonWR13 3 9尾静脉注射后 3h ,小鼠血浆HDL -C和ApoB含量急剧增高 ,与对照组相比 ,P <0 .0 5,分别在注射后 2 4h和 6h达到峰值 ,随后逐渐下降 ,分别在注射后 48h和 72h恢复正常水平。tritonWR13 3 9尾静脉注射后 3h ,小鼠血浆ApoAI含量即急剧降低 ,与对照组相比 ,P <0 .0 5,随后逐渐增高 ,在注射后 6h即恢复正常水平。tritonWR 13 3 9尾静脉注射后 3h ,小鼠血浆ApoAI/ApoB和HDL-C/TC比值减少 ,与对照组相比 ,P <0 .0 1,随后逐渐增高 ,其中ApoAI/ApoB比值在 72h恢复     

伊贝沙坦与苯那普利、卡托普利对高血压肾病患者尿总蛋白排泄量及内生肌酐清除率影响的比较

目的 :观察伊贝沙坦 (irbesartan)和血管紧张素转换酶抑制剂对高血压肾病患者尿总蛋白排泄量 (UPER)与内生肌酐清除率 (Ccr)的影响 ,比较不同的血管紧张素拮抗剂上述作用的差别。方法 :以序贯试验的方法选择了用伊贝沙坦或苯那普利中卡托普利治疗的高血压肾病患者共 6 6例 ,分为人数相等的 3组 ,进行了治疗前、后 3组间降压效果、UPER、Ccr的比较。结果 :伊贝沙坦了压效果与苯那普利、卡托普利相似 ,但伊贝沙坦对UPER、Ccr的效果优于苯那普利和卡托普利 ,3组比较有统计学的差异 (P <0 .0 1)。伊贝沙坦组未见于干咳现象 ,而苯那普利组及卡托普利组分别干咳发生率分别为 4 .5 %和 13.6 %。结论 :肾功能轻、中度损害的高血压肾病患者服用伊贝沙坦 ,不仅可有效降低血压 ,还可以更好地降低UPER ,提高Ccr。     

以病人选择医生为契机 全力推进人事分配制度改革

介绍了邯郸市中心医院在病人选医生中,努力完善制度,提高素质,深化内容,并以此为突破口,建立了灵活、高效的人事分配制度.用较为低廉的医疗费用,为人民群众提供了较好的医疗服务.     

多种血管新生指标在肝细胞肝癌中的表达及敏感性比较

目的　探讨血管新生指标CD34、CD31、vWF、Ⅳ型胶原纤维及层粘连蛋白在肝细胞肝癌(HCC)中的表达及意义 ,同时比较上述几种血管新生因子与增殖细胞核抗原 (PCNA)、病理指标及预后的相关性 ,以便筛选出有效的临床预后指标。方法　采用免疫组化方法 ,对 5 3例肝细胞肝癌的标本进行CD31、CD34、vWF、Ⅳ型胶原纤维及层粘连蛋白的染色、计数 ,并用检测数据与患者的临床资料进行统计分析。结果　统计染色的血管面积后发现 ,CD34与多种临床病理指标无相关性 ;CD31与肝内门静脉浸润相关 ;vWF与肿瘤的TNM分期及肝内门静脉浸润呈正相关 ;CollⅣ与肝内门静脉浸润呈正相关、与术后生存期呈负相关 ;Lam与肝硬化及术中出血量呈负相关、与术后生存期呈正相关。PCNA与肿瘤TNM分期有关。结论　在HCC中 ,CollⅣ、vWF、及CD31为肝细胞肝癌的有效血管新生及预后指标 ;Lam则与肝硬化及术中出血相关 ;PCNA指数肿瘤分期有关 ;CD34不能用作血管新生或预后指标     

OSAS患者循环ICAM-1,VCAM-1及L-选择素水平与心血管疾病的研究

目的 :探讨阻塞性睡眠呼吸暂停综合征 (OSAS)患者循环细胞间黏附分子 - 1(intercellularadhesionmolecule 1,ICAM - 1)、血管细胞黏附分子 - 1(vasculaecelladhesionmolecule 1,VCAM -l)及L -选择素 (L -selection)水平及与心血管疾病的相关性。方法 :选取OSAS患者 12例 (男性 9例 ,女性 3例 ,平均年龄 5 1.6±4 .8岁 )及 12例年龄相匹配的健康对照者。采用ELISA法检测OSAS患者入睡前、睡醒后血浆ICAM - 1、VCAM - 1及L -选择素水平 ,并与正常对照组比较。结果 :OSAS患者入睡前ICAM - 1,VCAM - 1及L -选择素水平较正常对照组升高 (ICAM - 1:4 0 2 .8± 4 8.2vs 2 0 8.4± 5 6 ,P <0 .0 5 ;VCAM - 1:814± 88.9vs 5 82±4 4 .5 ,P <0 .0 5 ;L -选择素 :1390 .4± 76 .8vs 10 4 4 .3± 80 .2 ,P <0 .0 1) ,睡醒后ICAM - 1及L -选择素水平较正常对照组明显升高 (ICAM - 1:395± 4 5vs 2 0 5± 5 0 ,P <0 .0 5 ;L -选择素 :114 3.5± 196 .2vs 10 2 5 .6±5 0 .3,(P <0 .0 5 )。结论 :OSAS所致的低氧血症激活了循环黏附分子 ,参与了心血管疾病的发生与发展。     

抗击"非典"为改善医患关系提供了新契机

文章通过分析在抗击“非典”特殊时期医务人员为科学、为病人的献身精神，以及广大人民对医疗高风险、高费用的全面了解，论证抗击“非典”为病人重新认识医务人员，促进医患沟通，改善日趋紧张的医患关系提供了新契机。     

THE PITUITARY-LEYDIG CELL AXIS IN MEN WITH SEVERE DAMAGE TO THE GERMINAL EPITHELIUM

Eighteen men (mean age 27, range 18-30 years) treated for Hodgkin's disease with 6-8 courses of MVPP (Mustine, Vinblastine, Procarbazine and Prednisolone) have had Leydig cell function assessed by their steroidogenic responses to stimulation by a single bolus dose of HCG (1000 units intramuscularly). Normal age-matched men (n = 16) acted as controls. Baseline immunoreactive FSH was markedly raised in the patients (mean 18.1 +/- SD 6.9 vs 2.0 +/- 1.5 IU/l, P less than 0.0001) reflecting damage to the germinal epithelium. Immunoreactive LH was also greater in patients (10.3 +/- 3.9 IU/l) than in controls (3.9 +/- 1.9 IU/l, P less than 0.0001). There were no differences between the baseline testosterone, androstenedione, oestradiol, oestrone and sex hormone binding globulin (SHBG) concentrations. The testosterone/SHBG ratios were similar in the two groups and there was no correlation between baseline LH and testosterone concentrations or testosterone/SHBG ratios. Testosterone, androstenedione, oestradiol and oestrone secretion in response to HCG stimulation were similar at 24 h and 96 h in both groups. In order to explain the paradox of elevated immunoreactive LH in the face of normal testicular steroidogenesis in such patients, LH biological activity (B) as well as LH immunoreactivity (I) and FSH and testosterone were estimated in a second similar group of patients (n = 17, mean age 27, range 17-43 years) and in a further age-matched control group (n = 17). Bioactive and immunoreactive LH levels were significantly increased (P less than 0.005 and P less than 0.001, respectively) in the patient group.(ABSTRACT TRUNCATED AT 250 WORDS)     

Membrane flow within the myelin sheath in IDPN neuropathy

This report describes some aspects of beta,beta'-iminodipropionitrile (IDPN) neuropathy in rats as observed by ultrastructural methods and X-ray diffraction. Light microscopy shows gross swelling of the axons in proximal lumbar spinal roots 8 days after intraperitoneal injection of IDPN. Mean axon cross-sectional area and mean axon perimeter increased to 280% and 160% of their control values, respectively. At the same time, myelin membrane packing was not visibly disturbed. In addition, X-ray diffraction patterns, recorded under physiological conditions, demonstrate that the myelin lipid bilayer thickness and widths of the aqueous spaces between bilayers did not change. Related observations are made on posterior tibial nerve (PNS myelin) and ventral spinal cord (CNS myelin). The various observations together are interpreted in terms of a fluid myelin membrane. It is proposed that the myelin membrane flows during axon swelling even though normal membrane-membrane contacts are maintained within the sheath. Membrane flow and slippage between membranes are explained in terms of a molecular model of the myelin multilayer.     

Closed suction wound drainage and lower-segment caesarean section

Summary. In a randomized controlled study of wound suction drainage after transverse suprapubic incision for lower-segment caesarean section no significant advantages could be demonstrated for routine drainage in terms of wound infection, haematoma formation, duration of hospital stay or analgesic requirements.