继发性脑梗死32例临床分析

<正>近几年来随着神经外科学及医学影像学的不断发展,临床上越来越多的继发性脑梗死被发现,并越来越受到重视,现将我院2005年1月至2012年6月收治的32例继发性脑梗死的病例进行分析及讨论,现报告如下。     

云南白药的临床应用

云南白药是中外驰名的中成药之一,具有活血祛瘀,消炎散肿、防腐生肌等功效。近年来在临床的应用愈来愈广泛。1　治疗婴幼儿秋冬季腹泻[1]用70%酒精将云南白药粉适量,调成稀糊状,局部用75%酒精作常规消毒后,将调好的药糊剂敷盖于肚脐上,然后用无菌纱布覆盖,再用胶布或绷带...     

自发性高血压大鼠缺血再灌注后视网膜毛细血管细胞凋亡及p53基因表达

Objective To investigate the effect of apoptosis-related gene p53 on the apoptosis of retinal capillary cells in rats with spontaneously hypertensive (SHR) after ischemic reperfusion injury. Methods A total of 60 SHR rats were randomly divided into sham group (SHR-SH) and retinal ischemie reperfusion group (SHR-RIR), which were subdivided into 5 subgroups according to the time after RIR: 2, 6, 24, and 72 hours and 7 days, with 6 rats in each subgroup. Another 60 Wistar-Kyoto (WKY) rats were divided into the same groups as the SHR rats as the control. The RIR model was set up. The apoptosis of retinal capillary cells was detected by terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) methods and the expression of p53 was determined by streptavidin-perosidase (SP) immunohistochemistry. Results The apoptosis rate of retinal capillary cells in the 5 SHR-RIR groups was (8.64±0.56)%, (14.92±0.99)%, (24.72±2.98)%, (16.53±1.80)%, and (7.12±1.10)%,respectively. The expression of p53 in SHR-RIR groups increased at the 2nd hour after RIR, reached the peak at the 24th hour, kept the high level at the 72nd hour, and remained a little at the 7th day, which was significantly different from which in the SHR-SH groups (P<0. 01). The expression of p53 were higher in SHR-IR groups than that in the WKY-RIR groups (P<0. 01). Conclusions p53 may play a part in RIR injury by inducing or promoting apoptosis. The apoptosis of retinal capillary cells after RIR is more severe under the hypertension, and reaches the peak at the 24 hour after RIR.     

自发性高血压大鼠缺血再灌注后视网膜毛细血管细胞凋亡及p53基因表达

Objective To investigate the effect of apoptosis-related gene p53 on the apoptosis of retinal capillary cells in rats with spontaneously hypertensive (SHR) after ischemic reperfusion injury. Methods A total of 60 SHR rats were randomly divided into sham group (SHR-SH) and retinal ischemie reperfusion group (SHR-RIR), which were subdivided into 5 subgroups according to the time after RIR: 2, 6, 24, and 72 hours and 7 days, with 6 rats in each subgroup. Another 60 Wistar-Kyoto (WKY) rats were divided into the same groups as the SHR rats as the control. The RIR model was set up. The apoptosis of retinal capillary cells was detected by terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) methods and the expression of p53 was determined by streptavidin-perosidase (SP) immunohistochemistry. Results The apoptosis rate of retinal capillary cells in the 5 SHR-RIR groups was (8.64±0.56)%, (14.92±0.99)%, (24.72±2.98)%, (16.53±1.80)%, and (7.12±1.10)%,respectively. The expression of p53 in SHR-RIR groups increased at the 2nd hour after RIR, reached the peak at the 24th hour, kept the high level at the 72nd hour, and remained a little at the 7th day, which was significantly different from which in the SHR-SH groups (P<0. 01). The expression of p53 were higher in SHR-IR groups than that in the WKY-RIR groups (P<0. 01). Conclusions p53 may play a part in RIR injury by inducing or promoting apoptosis. The apoptosis of retinal capillary cells after RIR is more severe under the hypertension, and reaches the peak at the 24 hour after RIR.     

超细纤维支气管镜在定位新生儿气管导管深度中的应用

目的 探讨超细纤维支气管镜（纤支镜）定位新生儿气管导管深度的准确性。方法 80例手术室内麻醉诱导气管插管后的新生儿,分别采用超声定位（A1组）和纤支镜定位（F1组）调整气管导管的深度,各40例。另选40例新生儿ICU(NICU)拟摄床旁X线片定位气管导管深度的新生儿,随机分为拍摄X线片定位组（A2组）和纤支镜定位组（F2组）,各20例。记录各组气管导管深度不当、拍摄X线片的例数,观察并记录定位前、定位时、定位后患儿心率（HR）、血压、血氧饱和度（Sp O2）变化及相关并发症发生情况。结果 A1组35例（87.5%）深度合适,5例（12.5%）深度不合适;F1组30例（75%）深度合适,10例（25%）深度不合适,深度不当例数高于A1组,但差异无统计学意义（P> 0.05）。A2组15例（75.0%）导管过深,均需X线片定位;F2组14例（70.0%）导管过深,2例需X线片定位,F2组X射线辐射率低于A2组（P <0.05）。与A组（A1、A2）比较,F组（F1、F2）定位过程中HR、血压略有变化,但差异均无统计学意义（均P> 0.05）;F2组定位时SpO2低于定位前...     

HPLC测定益肤丸中的落新妇苷

目的 采用HPLC法测定益肤丸中的落新妇苷.方法 采用Inertsil ODS-3色谱柱(250 mm× 4.6 mm,5μm),流动相为甲醇-0.1％冰乙酸(39∶61),流速1.0 mL· min-,柱温30℃,进样量20 μL,检测波长291 nm.结果 落新妇苷10.04～200.88 μg·mL-1与峰面积的线性关系良好(r =0.9999),平均加样回收率为100.44％,RSD=2.73％.结论 所用方法简单、快速、可靠,可用于益肤丸的质量控制.     

颅内动脉瘤动物模型的制作

颅内动脉瘤是最常见的脑血管病之一,发病率仅次于脑血栓形成和高血压性脑出血.动脉瘤破裂每年发病率约10/10万人,而未破裂动脉瘤由于多数无症状,发病率难以准确计算,根据尸检及影像检查结果估算为0.2%～8.9% [2].因此,探讨颅内动脉瘤的组织病理学与病理生理学改变、动脉瘤的演变过程和破裂机制对预防颅内动脉瘤破裂和临床治疗具有极其重要的意义,而这些研究在一定程度上均依赖于建立稳定可靠的颅内动脉瘤模型.     

姜黄素对自发性高血压大鼠脑缺血再灌注时海马神经元凋亡及c-Jun氨基末端激酶3和突触后密度蛋白95表达的影响

目的 探讨姜黄素对自发性高血压(SH)大鼠脑缺血再灌注时海马神经元凋亡及c-Jun 氨基末端激酶3(JNK3)和突触后密度蛋白95(PSD95)表达的影响.方法 与雄性WKY同源的SH大鼠135只和雄性WKY大鼠90只,清洁级,体重275～325 g,采用随机数字表法,将WKY大鼠随机分为2组(n=45):假手术组(W-S组)及脑缺血再灌注组(W-I/R组),将SH大鼠随机分为3组(n=45):假手术组(S-S组)和脑缺血再灌注组(S-I/R组)及姜黄素组(S-C组).采用四血管阻断法制备全脑缺血再灌注模型.W-S组和S-S组仅分离双侧颈总动脉,W-I/R组和S-I/R组于再灌注30 min时腹腔注射玉米油10 ml/kg,S-C组于再灌注30 min时腹腔注射姜黄素100 mg/kg.于再灌注2 h,6 h、1 d、3 d和7d时进行海马凋亡神经元计数,并测定海马JNK3和PSD95蛋白的表达水平.结果 与W-S组比较,S-S组海马凋亡神经元计数增加(P<0.05),JNK3蛋白表达差异无统计学意义(P>0.05);与S-S组比较,S-I/R组海马凋亡神经元计数增加,JNK3蛋白表达上调(P<0.05);与S-I/R组比较,S-C组海马凋亡神经元计数减少,JNK3蛋白表达下调(P<0.05).各组海马PSD95蛋白表达比较差异无统计学意义(P>0.05).结论 姜黄素可抑制SH大鼠脑缺血再灌注时神经元凋亡,其机制与下调海马JNK3蛋白表达有关,姜黄素下调海马JNK3蛋白表达可能与PSD95途径无关.     

中药制剂洁肠净片在临床影像学检查中的应用

1资料与方法1·1病例选择病例选自我院2004年3月~2007年3月行影像学检查和介入治疗的患者1 500例,男952例,女548例;年龄14~76岁,平均45岁。其中腹部血管造影60例,泌尿道造影529例,消化道钡剂灌肠420例,腹部和腰椎摄片检查505例。1·2设备和方法所用设备西门子800 mA数字化X线机、西门子DR、西门子血管减影机。中药制剂洁肠净片(批号:新药制Z20062693)为我科多年使用方剂,为服用方便,经药监部门审核批准,由我院制剂室制为片剂,服药的患者中剔除了年幼和衰老患者,患者在检查前1~2 d服用,每日3次,每次6片或视情况加减。1·3评价标准服药后根…     

自发性高血压大鼠缺血再灌注后视网膜毛细血管细胞凋亡及p53基因表达

Objective To investigate the effect of apoptosis-related gene p53 on the apoptosis of retinal capillary cells in rats with spontaneously hypertensive (SHR) after ischemic reperfusion injury. Methods A total of 60 SHR rats were randomly divided into sham group (SHR-SH) and retinal ischemie reperfusion group (SHR-RIR), which were subdivided into 5 subgroups according to the time after RIR: 2, 6, 24, and 72 hours and 7 days, with 6 rats in each subgroup. Another 60 Wistar-Kyoto (WKY) rats were divided into the same groups as the SHR rats as the control. The RIR model was set up. The apoptosis of retinal capillary cells was detected by terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) methods and the expression of p53 was determined by streptavidin-perosidase (SP) immunohistochemistry. Results The apoptosis rate of retinal capillary cells in the 5 SHR-RIR groups was (8.64±0.56)%, (14.92±0.99)%, (24.72±2.98)%, (16.53±1.80)%, and (7.12±1.10)%,respectively. The expression of p53 in SHR-RIR groups increased at the 2nd hour after RIR, reached the peak at the 24th hour, kept the high level at the 72nd hour, and remained a little at the 7th day, which was significantly different from which in the SHR-SH groups (P<0. 01). The expression of p53 were higher in SHR-IR groups than that in the WKY-RIR groups (P<0. 01). Conclusions p53 may play a part in RIR injury by inducing or promoting apoptosis. The apoptosis of retinal capillary cells after RIR is more severe under the hypertension, and reaches the peak at the 24 hour after RIR.