高危病人血液化学变化与多器官功能障碍综合征早期诊断关系的探讨

多器官功能障碍综合征(MODS)取代沿用了20年之久的多器官功能衰竭(MOF)。已为国内外医学界所认同。作为综合征一连串病理过程的终结,MOF的临床诊断多无困难。然而,对MOF之前一段时期的病理过程,尚缺乏足够而准确的认识。因此,迄今没有一个统一的早期和分期诊断标准也是必然的。这也正是当今国内外危重病急救医学争相研究的热点所在。     

急性病毒性心肌炎的心电图分型和急救

急性病毒性心肌炎ＥＣＧ分型对治疗十分重要，我们对６２例心肌炎患者做ＥＣＧ后可划分为四个类型，并针对各个类型进行救治，观小结如下。１资料与方法１１病历选择为１９８９～１９９８年随机来我科诊治的符合急性病毒性心肌炎诊断标准的病人６２例，其中男３４例，女...     

不同栓塞剂治疗支扩大咯血的比较研究

目的 探讨并比较不同栓塞剂治疗支扩大咯血中、远期疗效。方法 32例支扩大咯血行支气管动脉栓塞术,分别使用PVA和明胶海绵（GS）颗粒两种栓塞材料。评价栓塞后的近期、中远期疗效,按照栓塞材料进行分组对照、统计分析。结果 32例行支气管动脉栓塞术,应用PVA和GS栓塞剂各16例。随访29例,有8例复发,其中GS颗粒栓塞组7例,PVA颗粒栓塞组1例。结论 作为治疗支扩大咯血的栓塞剂,PVA颗粒优于GS颗粒：500μm左右的PVA颗粒值得推荐。     

实时动态血糖监测系统在不同时段检测的准确性变化特征及其与血糖波动的关系

目的 研究实时动态血糖监测系统(real-time continuous monitoring system,RT-CGMS)在不同时段检测的准确性及其与血糖波动的关系.方法 33例1型或2型糖尿病患者佩戴RT-CGMS5 d,每天测定7次毛细血管血糖值.应用相关分析、误差栅格分析(EGA)、Bland-Altman分析方法研究RT-CGMS在不同时段和总体水平与毛细血管血糖相关性、准确性和一致性;计算不同时段和总体水平的平均血糖波动幅度(MAGE)及血糖波动频率(FGE).结果 (1)RT-CGMS在空腹时段、餐后时段和总体水平与毛细血管血糖相关系数分别为0.94、0.92和0.93(均P＜0.01).(2)EGA显示,空腹时段、餐后时段和总体水平分别有98.82%、98.39%和98.64%的点落在A区和B区;1.18%、1.61%和1.36%的点在D区;没有点落在C区和E区.(3)RT-CGMS在空腹时段、餐后时段和总体水平与毛细血管血糖的一致性良好.(4)空腹时段、餐后时段和总体水平的MAGE分别为(3.57±2.66)、(4.07±3.09)和(4.02±3.04)mmol/L(P＞0.05);FGE分别为(0±0.5)、(3±1)和(1±3)次/d(P＜0.01).结论 RT-CGMS在空腹时段检测准确性高于餐后时段和总体水平;餐后时段血糖波动频率高于空腹时段和总体水平.

Abstract：

Objective To study the accuracy of real-time continuous monitoring system (RT-CGMS) at different stages and its association with glucose excursion. Methods Totally 33 patients with type 1 diabetes or type 2diabetes were under surveillance of RT-CGMS for 5 d. Capillary glucose values were measured 7 times daily.Correlation coefficient, error grid analysis (EGA), and Bland-Altman analysis methods were used to assess the correlation, accuracy and agreement of RT-CGMS at different stages and in general level; The mean amplitude of glucose excursion (MAGE) and the frequency of glucose excursion ( FGE ) were also calculated. Results ( 1 ) The correlation coefficient of RT-CGMS with capillary glucose values at fasting, postprandial stages, and in general level were 0.94,0.92, and 0.93 respectively( P＜0.01 ). (2) EGA showed that 98.82%, 98.39%, and 98.64% of the results fell in the A and B zones and 1. 18%, 1.61%, and 1.36% fell in the D zone respectively at fasting,postprandial stages, and in general level. There is no result fell in C and E zones. ( 3 ) The agreement analysis showed that RT-CGMS readings were in close agreement with capillary glucose values at fasting, postprandial periods, and in general level. (4)The MAGE at fasting, postprandial periods, and in general level were (3.57±2.66), (4.07±3.09), and (4. 02 ±3.04) mmol/L (P＞0. 05), (0±0. 5), (3± 1), and( 1 ±3) d for FGE (P＜0. 01 ).Conclusion RT-CGMS at fasting stage has higher accuracy than postprandial stage and general level, FGE at fasting stage is higher than postprandial stage and general level.     

小鼠谷胺酸脱羧酶65基因克隆的初步报告

目的克隆小鼠谷胺酸脱羧酶05（GAD65）基困。方法（1）刚RT-PCR的方法扩增小鼠GAD65基因。（2）将GAD65克隆到T载体PUCm-T上。（3）对质粒PUCm-T／GAD65进行酶切鉴定和序列分析。结果克隆的DNA片段为1758bp的小鼠GAD65的全基因编码序列。结论成功的克隆了小鼠GAD65摹因，为构建GAD65基因疫苗以及精尿病的免疫干预治疗打下基础 。