THE EXPLORATION ON APPLIED VALUE OF BA IN DIAGNOSIS OF TIA

目的:探讨脑电地形图在短暂性脑缺血发作诊断中的应用价值.方法:在68例短暂性脑缺血发作患者中,进行了脑电地形图检查.结果:在67(98.52%)例患者中脑电地形图是异常的.40(58.82%)的患者脑电地形图在θ或δ频段显示高功率阴影,在α频段显示低功率阴影.14(20.59%)例患者在α频段显示低功率阴影.12(17.65%)例患者在θ或δ频段显示高功率阴影.1(1.47%)例患者在β频段显示低功率阴影.1(1.47%)例患者正常.结论:脑电地形图在短暂性脑缺血发作的临床诊断中具有重要意义.     

Activated status of tumour-infiltrating lymphocytes and apoptosis in testicular seminoma.

Testicular seminoma is characterized by a prominent lymphoid infiltrate and an excellent prognosis. Cytotoxic T-lymphocytes (CTLs) infiltrating seminoma tumour nests constitute a major subset of the lymphoid infiltrate. The objective of this study was to determine whether CTLs express markers of cytotoxic potential and activity and whether the number of activated CTLs correlates with the extent of apoptosis in testicular seminomas, as opposed to non-seminomatous testicular germ cell tumours (NSTGCTs). Twenty cases of pure seminoma as well as 20 cases of NSTGCTs including 16 mixed germ cell tumours (MGCTs) were studied. Immunohistochemistry for the cytotoxic markers TIA-1 (cytotoxic potential) and granzyme B (cytotoxic activity) and the T-cell markers CD3 and CD8 was performed on formalin-fixed, paraffin-embedded sections. The apoptotic index (AI) was determined by the TUNEL method. The number of CD3(+), CD8(+), TIA-1(+), and granzyme B(+) cells in tumour cell nests was markedly increased in testicular seminomas, compared with NSTGCTs (p<0.01). Activated granzyme B(+) cells numbered 25.6+/-5.2 per high power field in seminomas and 8.9+/-3.2, 8.1+/-3.9, and 0.4+/-0.2 for embryonal carcinomas, yolk sac tumours, and immature teratomas, respectively. Double immunohistochemical staining for granzyme B and CD8 revealed that 82.6+/-8.5% of granzyme B-expressing cells were CD8(+). The tumour cell AI was significantly increased in embryonal carcinoma, compared with the seminoma, yolk sac tumour, and immature teratoma subgroups (6.7+/-1.3, 2.3+/-0.3, 3.0+/-1.1, and 2.3+/-1.1, respectively, p<0.001). TUNEL/CD3 double immunostaining revealed that a significant proportion of the apoptotic seminomatous tumour cells were in direct contact with one or more CD3(+) lymphocytes (47.2+/-6.2%). The number of activated granzyme B(+) CTLs showed a strong linear correlation with the AI in the seminoma group (r=0.71, p<0.0001) but not in other subgroups. TUNEL/granzyme B double immunolabelling revealed that a proportion of activated granzyme B(+) lymphocytes (20%) were often seen in close contact with apoptotic tumour cells. The presence of increased numbers of activated cytotoxic lymphocytes in testicular seminomas suggests that apoptotic tumour cell death in this neoplasm may be triggered by cytotoxic granule effectors. This phenomenon may be one of the key host immune mechanisms leading to the excellent prognosis in this tumour.     

颈动脉系统TIA脑血液动力学的研究

目的：探讨短暂性脑缺血发作（ＴＩＡ）的发病机制。方法：对３０例劲动脉系统ＴＩＡ进行三维经颅多普勒超声（３Ｄ－ＴＣＤ）、脑血管血液动力学参数（ＣＶＤＩ）及血液流变学检查分析。结果：绝大我数患者存在严重脑动脉硬化、脑动脉狭窄、脑内循环障碍;病灶侧平均脑血流量下降,血管自身调节功能减退;全血粘度、血浆粘度及血小板聚集率明显增高。结论：脑血液动力学障碍是ＴＩＡ发病机制之一。     

降纤酶低分子肝素治疗短暂性脑缺血发作的研究

目的 观察降纤酶与低分子肝素治疗短暂性脑缺血发作的效果及副作用。方法 选择本院神经内科住院患者36例应用降纤酶10U加入加入250ml生理盐水中静脉滴注，隔日1次，共3次；低分子肝素0．5ml脐旁皮下注射，12h 1次，连用7—10d,同时常规给予复方丹参滴注，口服尼莫地平，维生素E，维生素C，停用低分了肝素后给予肠溶阿斯匹林75mg，每日1次口服。结果 治疗开始后TLA发作相继减少，停止发作时间分别为1d内9例，3d内15例，5d内12例。随访6个月—1年，1例2个月后复发，重新应用上药治愈。结论 降纤酶与低分子肝素治疗TLA安全有效、无明显副作用、不易复发。     

灯盏花素在脑血管病中的应用及研究近况

脑血管病是一类严重危害人类健康的疾病 ,其发病率、死亡率和致残率均相当高。中药制剂灯盏花素具有扩张微细血管、降低血液黏稠度的作用 ,可用于脑血管病的治疗。笔者就灯盏花素近年来的临床应用、研究近况综述如下。1　在脑梗死中的应用盛宝英[1] 用灯盏花素注射液治疗急性脑梗死患者 12 0例 ,其中治疗组 68例 (用复方丹参注射液治疗 ) ,对照组 5 2例。结果治疗组总有效率显著高于对照组 (Ｐ <0 .0 1) ,治疗组血清ＴＣ ,ＴＧ ,ＦＢＧ及血液黏度较对照组显著下降 (Ｐ均 <0 .0 1)。说明灯盏花素治疗急性脑梗死有显著疗效 ,其是通过降低血脂…     

丁咯地尔对颈内动脉系统TIA患者的血流动力学及血液流变学的影响

目的观察丁咯地尔（意速）注射液治疗颈内动脉系统TIA患者的血流动力学及血液流变学的变化。方法选择颈内动脉系统TIA患者56例，随机分为两组，每组28例，治疗组用意速200mg加入生理盐水250ml静滴，对照组用复方丹参注射液30ml加入生理盐水250ml静滴，每天1次，疗程均为15天，治疗前后检测血流动力学及血液流变学指标变化。结果治疗组治疗前后血流动力学指标明显改善（P〈0．01），两组间比较差异亦有显著性（P〈0．05）。治疗组治疗前后血液流变学指标比较，差异有显著性（t=2．01～2．26，P〈0．05），两组间治疗后比较，差异亦有显著性（t=3．56～4．36，P〈0．01）。结论意速可有效改善颈内动脉系统TIA患者血流动力学及血液流变学指标。     

华法林负荷量法抗凝治疗短暂性脑缺血发作的研究

目的 :观察华法林抗凝治疗短暂性脑缺血发作 (TIA)的安全性和疗效。方法 :2 0 0 3年 1月至2 0 0 4年 1月入院的TIA病人 ,适合抗凝治疗者 ,按Roberts依年龄调整华法林负荷量指南用药 ,对照组为 2 0 0 2年 1月至 2 0 0 3年 1月住院的TIA病人 ,并剔除用肝素治疗的病人。结果 :华法林组 10d内无脑卒中发生 ,仅有 4人次再次TIA ,未发现有出血者 ;对照组 10d内脑梗死 6例 ,再次TIA 12人次 ,华法林组于TIA发作后 10d内发生脑梗死及再次TIA较对照组低 (P <0 .0 5 )。结论 :按Roberts华法林负荷量指南抗凝治疗TIA优于非抗凝治疗 ,而且安全