Risk factors and ankle brachial indexes in cerebral infarction combined with peripheral arterial disease

BACKGROUND: Ankle brachial index(ABI)is widely involved in researches and clinical application of peripheral vascular injury of patients with diabetes (DM);however ,the application in cerebral infarction(CI)is rare.OBJECTIVE: To investigate the possible risk factor of cerebral infarction plus peripheral arterial disease(PAD),compare metabolic characteristics of patients who having CI plus PAD or only having CI,and understand the significance of ABI on screening and diagnosing CI plus PAD of lower limb.DESIGN: Contrast observation based on CI patients.SETTING: Deparment of Neurology,Nanxishan Hospital of Guangxi Zhang Autonomous Region.PARTICIPANTS:A total of 124 CI patients were selected from Department of Neurology.Nanxishan Hospital of Guangxi Zhuang Autonomous Region from July 2005 to April 2006,including 72 males and 52 females aged from 45 to 88 years.All patients met the diagnostic criteria of cerebrovascular disease established by National Academic Conference of Cerebrovascular Diseases in 1995 and determined as cerebral infarction with MRI or CT examination.All patients provided informed consent.There were 46 cases(37.2%)with CI plus PAD and 78 cases(62.8%)only with CI.METHODS: Blood pressure of bilateral ankles and upper extremities was measured at plain clinostatism with DINAMAP blood pressure monitor(GE Company).The ratio between average systolic pressure of lateral ankle and average systolic pressure of both upper extremities was regarded as ABI.The normal ABI was equal to or more than 0.9.If ABI＜0.9 occurred at one side,patients were diagnosed as PAD.On the second morning after hospitalization,blood was collected to measure fasting blood glucose(FBG),2-hour postprandial blood glucose(PBG2h),glycosylated hemoglobin(HbAlc),triglycerides(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C)and low-density lipoprotein cholesterol(LDL-C).Among them,blood glucose.lipid and other biochemical markers were measured with enzyme chemistry assay and HbA1c was measured with HbA1c meter based on high liquid phase.Measurement data and enumeration data were compared with t test and Chi-square test.and multiple factors were deat with Logistic regression analysis and multivariate linear regression analysis.MAIN OUTCOME MEASURES: Results of correlation between ABI and metabolic markers with multivariate linear regression analysis;risk factors of CI plus PAD with Logistic regression analysis;comparisons of metabolic markers between PAD and non-PAD patients.RESULTS:All 124 patients with acute CI were involved in the final analysis.①Comparisons of metabolic markers:Levels of serum LDL-C and uric acid(UA)were higher of PAD patients than those of non-PAD patients(t=2.051 9,3.339 1,P＜0.05);however,there were no significant differences among other metabolic markers(P＞0.05).②Results of multivariate linear regression analysis:PBG2h,LDL.C and UA were obvious correlation with ABI of posterior tibial artery of lower limb and dorsal pedis artery rpartial regression coefficient:-0.231 to-1.010,P＜0.05).③Risk factors of CI plus PAD with Logistic regression analysis:Age.Smoking history,sum of CI focus(≥3)and LDL-C were independent risk factor of CI plus PAD(OR=1.524-5.422,P＜0.05-0.01 ).CONCLUSION:①Levels of serum LDL-C and UA of patients with CI plus PAD are high.②ABI of lower limbs is correlation with PBG2h,LDL-C and UA.In addition,measuring ABI is beneficial for early diagnosing PAD of lower limbs of patients who have poorly controlled blood glucose,abnormal lipid and poor renal function.③Age,LDL-C and sum of CI focus(≥3)are independent risk factors of CI plus PAD.It is of significance for screening non-PAD patients to evaluate risk degrees and prognosis and select therapeutic methods based on ABI measurement.     

介入治疗移植肾动脉狭窄一例

我院收治1例。肾移植后并发移植肾动脉狭窄（TRAS）者，采用经皮血管腔内成形术（PTA）及留置支架治疗后痊愈，现报告如下。     

Effect of Difference of Proliferative Ability on Fragmentation of Hertwig＇s Epithelial Root Sheath

Objective To verify a novel hypothesis that it is the difference of proliferative ability between Hertwig＇s epithelial root sheath （HERS） and the neighboring mesenchyme that leads to fragmentation of HERS. Methods Developmental processes of rat mandibular first molars from postnatal （PN） 10 to 25 days were observed. HERS was traced by immunohistochemistry for keratin 14. The activity of proliferation was examined by immunohistochemistry and immunofluorescence for proliferating cell nuclear antigen （PCNA） at PN 10 and 25 days respectively. Results At PN 10, HERS grew to its maximum length and maintained integrity. Subsequently, along with tooth root elongation, HERS was gradually fragmented. Either at PN 10 or 25 days, there were more PNCA-positive cells in the neighboring mesenchyme than in the HERS. Conclusion During rat tooth root development, the neighboring mesenchyme possesses higher proliferative ability than HERS, which results in the fragmentation of HERS.     

婴儿痉挛症的智能水平和脑诱发电位的相关分析

本实验发现:P-300不仅适用于有配合能力的受试者,也适用于无配合能力的低智 IS 患儿,它既能代表大脑皮层的感知能力,也可能反映特定大脑皮层功能的成熟程度,与 IQ 密切相关,随年龄增长而趋于稳定。多动手对侧 P-300的波幅、VEP 晚期成分及 ABEP 中枢传导时间均与智能水平相关,临床上可望用以对接受治疗的 IS 患儿进行随访,观察疗效和病情变化。视觉信息和听觉信息的处理过程在不同程度上影响 IS 患儿的智能发育。     

笑气与导乐联合用于分娩镇痛

分娩疼痛是一种不愉快的主观感觉，常与恐惧、紧张形成恶性循环，影响母儿的健康。随着人们生活水平的提高及围产医学的发展，对分娩提出了更高的要求，减轻或消除分娩疼痛成为产科的重要课题。2003年4月～2004年4月用笑气吸人加导乐应用于分娩镇痛，报告如下。     

国产唑来膦酸治疗肿瘤高钙血症多中心Ⅱ期临床观察

Objective： To evaluate the effect and safety of clinical use of zoledronic acid in the treatment of malignant hypercalcemia. Methods： A multi-center, open phase II clinical trial was conducted in 15 cases with malignant hypercalcemia who received zoledronic acid intravenously for 15 min. The level of blood calcium and side effects were recorded regularly within 28 days after injection. Results： One case was dropped out due to bad compliance. The complete response rate （the corrected serum calcium was reduced to normal level） was 100.00% （14/14）. The medium time of complete response rate was 5.07 days. The medium maintain time was 22.30 days. Slight, or moderate fever was observed. Conclusion： Zoledronic acid can effectively reduce the malignant hypercalcemia. The use of zoledronic acid appears to be safety and convenient.     

应用外科皮瓣修复颅骨缺损修补材料外露创面

目的探讨颅骨修补术后造成修补材料外露的原因和治疗方法。方法采用外科皮瓣转移修复颅骨缺损修补术后修补材料外露创面，临床治疗3例，创面面积分别为3．5cm×2．0cm、3．0cm×3．0cm和2．5cm×3．Ocm,并和以往的治疗方法进行比较。结果3例术后切口全部1期愈合，随访半年至1年半，无感染、皮缘坏死、皮下积液等并发症发生。结论对颅骨修补术后修补材料外露的创面，应用外科皮瓣整复可获得较好的临床效果。     

血管内皮生长因子与妊娠高血压综合征发病的关系

目的　探讨血管内皮生长因子 (VEGF)在妊娠高血压综合征发病中的作用。方法　分别采用酶联免疫吸附试验检测 40例妊高征孕妇的血清VEGF水平 ,免疫组化检测胎盘及蜕膜组织VEGF及CD3 4表达情况 ,35例正常孕妇作对照。结果　①妊高征组孕妇的外周血VEGF水平及胎盘组织MVD明显低于正常妊娠组 (P <0 0 5 ) ;②两组胎盘绒毛滋养叶细胞和蜕膜组织中均有VEGF阳性表达 ,胎盘组织强阳性表达高于蜕膜。与对照组比较 ,其胎盘组织VEGF强阳性表达的轻度妊高征无显著性差异 ;而中度和重度妊高征与对照组相比 ,则明显降低 ,差异显著 (P <0 0 5 )。各组孕妇蜕膜组织中VEGF的表达强度和差异无显著性。③孕妇外周血VEGF水平与新生儿出生体重 (r =0 2 9,P <0 0 5 )和胎盘重量 (r =0 34,P <0 0 1)均存在直线正相关关系。结论　妊高征患者血清VEGF水平和胎盘组织MVD降低 ,胎盘组织VEGF表达明显下降 ,都可能在妊高征的发病中起一定的作用。