低氧环境下粘附因子与动脉粥样硬化相关关系的研究

目的：检测血清可溶性ICAM-1、VCAM-1、E-选择素、P-选择素表达水平与高原地区动脉粥样硬化形成的相关性。方法：利用酶联吸附免疫法对西宁、玉树和果洛地区动脉粥样硬化患者（动脉粥样硬化组42例）及健康对照者（对照组40例）进行血清可溶性ICAM-1、VCAM-1、E-选择素、P-选择素表达水平的检测。结果：ICAM-1、VCAM-1、E-选择素及P-选择素表达与西宁、玉树或果洛动脉粥样硬化患者患病具有明显相关性;但是ICAM-1、VCAM-1、E-选择素及P-选择素各因子表达在西宁、玉树或果洛高海拔正常对照组、动脉粥样硬化患者组之间无明显差异性。结论：血清可溶性ICAM-1、VCAM-1、E-选择素及P-选择素与高原动脉粥样硬化的形成无关。     

舒利迭治疗支气管哮喘的疗效分析与临床研究

目的 研究分析舒利迭(沙美特罗+丙酸氟替卡松)对支气哮喘(哮喘)患者的疗效与临床意义.方法 将90例轻、中度哮喘患者随机分为舒利迭组、对照组,观察吸入舒利迭8周后患者的临床症状、肺功能、痰中嗜酸细胞计数及嗜酸细胞阳离子蛋白(ECP)的变化.结果 舒利迭组患者治疗后其临床症状减轻,FEV1、PEF提高,痰中嗜酸细胞计数、嗜酸细胞阳离子蛋白浓度下降.结论 舒利迭对支气管哮喘有较好的临床疗效,值得在临床上推广应用.     

PET联合血清肿瘤标志物对肺鳞癌与小细胞癌的鉴别价值

目的研究PET/CT与血清肿瘤标志物联合对肺鳞癌和小细胞癌的鉴别价值。方法回顾性分析34例肺鳞癌患者和48例小细胞癌患者的临床、血清肿瘤标志物及18F-FDG PET/CT的资料。测量肺癌原发病灶的最大标准摄取值(SUVmax)并记录CEA、Cyfra21-1及NSE的血清水平。采用独立样本t检验比较鳞癌和小细胞癌间SUVmax和血清肿瘤标志物水平的差异。二元Logistic回归分析用于联合SUVmax和血清肿瘤标志物。ROC曲线进一步评估SUVmax,每种血清肿瘤标志物,CEA+Cyfra21-1+NSE和SUVmax+血清肿瘤标志物的鉴别诊断效能。结果鳞癌的SUVmax显著高于小细胞癌(P=0.028);小细胞癌患者中NSE显著高于鳞癌患者(P=0.001),鳞癌患者中Cyfra21-1显著高于小细胞癌患者(P=0.012),而CEA在鳞癌和小细胞癌患者间无显著性差异(P=0.746)。单独使用SUVmax、CEA、Cyfra21-1和NSE鉴别鳞癌和小细胞癌的ROC曲线下面积(AUC)分别为0.672、0.554、0.712和0.777。当三种肿瘤标志物联合时,CEA+Cyfra21-1+NSE的AUC增加至0.929,而当SUVmax进一步加入时,SUVmax+血清肿瘤标志物的AUC进一步提升,增加至0.937。结论PET/CT紧密结合肺癌相关血清肿瘤标志物可以实现对肺鳞癌和小细胞癌更好地鉴别。     

心肺复苏后患者血清sICAM-1、sVCAM-1、sE-selectin水平变化

目的 探讨心肺复苏后存活48 h以上患者血清可溶性细胞间黏附分子（sICAM-1）、可溶性血管细胞黏附分子（sVCAM-1）、可溶性E-选择素（sE-selectin）变化特点及其临床意义.方法 对非感染因素心脏骤停行心肺复苏后存活48 h以上的患者,测定复苏前、复苏后1、4、8、12、48 h血清sICAM-1、sVCAM-1、sE-selectin水平,比较各时段变化差异.结果 复苏后12 h之前,血清sICAM-1、sVCAM-1、sE-selectin水平呈现逐渐增高趋势,各时段差异有统计学意义（P〈0.01）;而在复苏后24 h,除sICAM-1、sE-selectin持续升高外,sVCAM-1出现降低（P〈0.01）;在复苏后48 h,sICAM-1、sVCAM-1也呈现缓慢或显著降低态势,而sE-selectin却持续有意义走高（P〈0.01）.结论 心肺复苏后恢复自主循环使组织得到一定灌注,但血管内皮的损伤依然未终止,组织器官的功能进一步衰化.     

舌下含服粉尘螨疫苗治疗变应性鼻炎疗效观察

目的:观察粉尘螨疫苗治疗变应性鼻炎的临床疗效。方法:选择接受舌下含服粉尘螨疫苗治疗3年的变应性鼻炎420例,对所有患者治疗前及治疗后6周、12周、6个月、18个月、36个月各时段有关鼻炎症状视觉模拟量表评分、鼻分泌物嗜酸性粒细胞计数、总血清免疫球蛋白E、特异性免疫球蛋白E测定结果,以及合并哮喘者测定哮喘控制评分、肺功能检查结果进行统计分析。结果:(1)所有患者治疗12周后鼻部症状VAS评分与治疗前比较,差异非常显著(P<0.01);(2)所有患者治疗12周后嗜酸性粒细胞计数与治疗前比较,差异非常显著(P<0.01),而血清总免疫球蛋白E与特异性免疫球蛋白E治疗前后比较,差异不显著(P>0.05);(3)合并哮喘患者治疗12周后哮喘控制评分、呼气峰流速及第1s用力呼吸容积与治疗前比较,差异显著(P<0.05)。结论:舌下含服粉尘螨治疗变应性鼻炎效果较好。     

sICAM-1、sVCAM-1和P选择素检测对胰腺癌诊断和预后评估的价值

目的 探讨血清可溶性细胞间黏附分子-1(slCAM-1)、可溶性血管内皮细胞黏附因-1(sVCAM-1)和 P 选择素检测对胰腺癌诊断和预后评估的临床价值.方法 2007年10月-2008年6月收治的胰腺癌患者70例,包括胰头癌45例,胰体、胰尾癌25例;TNM 分期Ⅰ-Ⅱ期34例,Ⅲ-Ⅳ期36例,采用酶联免疫法(ELISA)法测定患者手术前后血清sICAM-1、sVCAM-1和 P 选择素水平,并与30例胰腺良性病变患者进行比较.结果 胰腺癌患者血清sICAM-1、sVCAM-1和 P 选择素水平明显高于胰腺良性病变患者(P<0.01);Ⅲ一Ⅳ期胰腺癌患者血清slCAM-1、sVCAM-1和P选择素水平明显高于Ⅰ-Ⅱ期患者(P<0.05).siCAM-1、sVCAM-1和P选择素检测的敏感度分别为81.4%、85.7%、84.3%,三者联合检测的敏感度为92.9%.行根治性手术组(39例)术后血清sI-CAM-1、sVCAM-1和P选择素水平均较术前显著降低(P<0.05),而姑息性手术组(31例)则无明显变化(P>0.05).结论 血清sI-CAM-1、sVCAM-1和P选择素水平是胰腺癌诊断和预后判断的敏感性指标,三者联合应用可提高胰腺癌早期诊断的敏感性.     

军人花粉症106例快速免疫治疗

目的　探讨军人花粉症治疗的有效方法。方法　采用提高起始浓度和快速递增浓度 ,上臂外侧皮下注射的方法对 10 6位军人花粉症患者行快速免疫治疗 ,并对每一位患者治疗前后检测血清中总IgE和嗜酸细胞阳离子蛋白 (ECP)。 结果　治疗前后患者总IgE和ECP值有显著性差异。 10 6例患者经 1～ 3年随访复查 ,78例 2个以上发病季节未发作 ,或仅有轻微鼻痒、眼痒 ,18例症状减轻 ,发病时间缩短半月 ,10例症状无明显改善。显效 82例 ,有效 14例 ,无效 10例 ,总有效率为 90 .5 7%。结论　快速免疫治疗能使患者血清总IgE和ECP下降 ,对军人花粉症疗效好。     

急性心肌梗死年轻患者血清可溶性E-选择素的测定意义

目的 :通过测量年轻人急性心肌梗死患者血清可溶性E -选择素 (sCD6 2E)水平的变化 ,探讨其发病机理。方法 :应用双抗体夹心酶联免疫吸附法检测sCD6 2E水平。结果 :各组不同性别之间sCD6 2E水平无明显差异 (P >0 .0 5 )。与年轻对照组相比 ,年轻人AMI组血清sCD6 2E水平明显增高 ,两组间具有显著性差异 (P <0 .0 1)。与中老年AMI组相比 ,年轻人AMI组血清sCD6 2E水平较低 ,两组间具有差异 (P <0 .0 5 )。结论 :sCD6 2E与年轻人AMI的发生有一定关系。     

特应性皮炎患者血清 IgE 水平检测临床意义

目的:探讨特应性皮炎(AD)与血清总IgE和抗原特异性IgE水平的关系。方法:选择AD患者44例及正常体检者(对照组)22例,采用MAST-CLA过敏原检测仪和MAST检测试剂盒,定量测定血清总IgE含量;采用血清过敏原特异性IgE抗体体外检测试剂盒,检测抗原特异性IgE水平。结果:AD患者血清总IgE浓度显著高于对照组,与AD病情严重程度呈正相关,抗原特异性IgE阳性率81.8%。结论:血清总IgE和抗原特异性IgE测定有助于判定特应性皮炎病情严重程度和活动度。     

高血压患者心房颤动急性发作后内皮功能生物学标志的改变

目的 观察高血压患者发生急性心房颤动(房颤)后其内皮功能生物学标志的改变.方法 高血压患者房颤急性发作者37例,在发作时间小于48h内复律,未给予抗凝治疗,复律后窦性心律维持1个月以上.根据是否服用血管紧张素转换酶抑制剂(ACEI)和(或)血管紧张素受体拮抗剂(ARB)分为两组:急性房颤1组(使用ACEI/ARB,n=17)和急性房颤2组(未使用ACEI/ARB,n=20),选择20例高血压合并窦性心律者为对照组.急性房颤患者分别于复律前,复律后1、7、14和30天检测血浆内皮素(ET)、一氧化氮(NO)、假性血友病因子(vWF)及可溶性E-选择素水平,并与对照组进行比较.结果 两个急性房颤组房颤急性发作时ET、vWF和E-选择素水平均显著高于对照组,NO水平显著低于对照组;两急性房颤组间上述指标无显著差异.复律后ET在急性房颤1组于第7天降至对照组水平,急性房颤2组于第30天降至对照组水平;NO、vWF水平在急性房颤1组于第14天恢复至对照组水平,急性房颤2组于第30天恢复至对照组水平;两组急性房颤患者E-选择素均于复律后第1天迅速上升,于第7天基本恢复到对照组水平.结论 高血压患者房颤急性发作时存在内皮功能障碍,复律后其内皮功能障碍可持续相当一段时间,ACEI/ARB类药物有助于其内皮功能的恢复.     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

The role of interventional radiology in trauma

Introduction Interventional Radiology has evolved into a specialty having enormous input into the care of the traumatized patient.In all hospitals,regardless of size,the Interventional Radiologist must consider their relationships with the trauma service in order to     

人体中的镭-226、镭-228、钋-210、铅-210

本文报道了广东阳江高本底地区6名、对照地区8名人尸体的骨²²⁶Ra、²²⁶Ra的浓度以及部分居民内脏器官中。²¹⁰Po、²¹⁰Pb的浓度。结果轰明阳江高本底地区和对照地区居民骨镭-226、镭-228的浓度分别为29.9pCi/kg, 26.9pCi/kgl 8.7pCi/kg, 8.2pCi/kg.由此估算出阳江高本底地区屠民骨中²²⁶Ra、²²⁸Ra的负薄璧及对骨衬、骨髓所产生的剂量当量分别为对照地区民民的3.4倍, 3.3倍。两地区居民内脏器官中^{210Po、210Pb的测定分析铡数较少但仍看出, 高本底地区均明显高于对照地区.}     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).