葛根素对肾动脉狭窄患者内皮素及血管紧张素Ⅱ影响临床观察

目的：观察葛根素对动脉粥样硬化性肾动脉狭窄（ARAS）患者血浆内皮素（ET）及血管紧张素Ⅱ（AngⅡ）浓度的影响。方法：将动脉粥样硬化性肾动脉狭窄57例随机分为观察组30例，对照组27例。对照组采用常规治疗，观察组在常规治疗基础上加用葛根素，对照组加用丹参注射液，比较两组对ET及AngⅡ浓度的影响。结果：观察组治疗后ET及AngⅡ浓度均有显著下降（P〈0．05，P〈0．01）。结论：葛根素具有降低ET及AngⅡ浓度的作用。     

培哚普利对老年慢性心力衰竭患者内皮细胞结构和功能的影响

目的：探讨老年慢性心力衰竭（CHF）患者内皮细胞结构和功能的变化,并观察培哚普利对其影响。方法：286例老年CHF患者随机分为2组,培哚普利治疗组（Pe组）及常规治疗组（sham组）,测定2组患者治疗前后及正常对照组血液中循环内皮细胞（CEC）、一氧化氮（NO）和内皮素（ET）含量。结果：2组患者治疗后心功能均有明显改善（P〈0．05）,Pe组改善更明显（P〈0．01）。CHF患者血中CEC和ET明显增加（P〈0．05）,NO浓度明显下降（P〈0．05）,它们的变化程度与心衰严重程度相一致。治疗后各指标均有明显的改善,CEC和ET明显下降（P〈0．05）,NO浓度明显升高（P〈0．05）,但Pe组改善更明显（P〈0．05）。结论：老年CHF患者内皮细胞的结构和功能明显受损,培哚普利能改善CHF患者内皮细胞的结构和功能,保护内皮细胞,同时明显改善老年CHF患者的心功能。     

维吾尔族高血压病患者血浆内皮素与神经降压素水平变化的研究

目的：探讨维吾尔族高血压病（EH）患者血浆内皮素（ET）、神经降压素（NT）水平与EH的关系。方法：采用放免法检测76例EH患者（维吾尔族32例，汉族44例）及健康人64例（维吾尔族34例，汉族30例）血浆ET及NT的含量。结果：①EH患者ET水平较健康组显著升高（P〈0．05）；②维吾尔族健康组ET水平明显低于汉族（P〈0．05），但两民族EH组间未发现有差异；③EH组与对照组间及两民族间NT差别均无显著性。结论：EH患者ET水平较对照组明显升高，维吾尔族健康人群低于汉族，提示ET可能与EH的发病有关。NT与EH的关系有待进一步研究。     

细胞因子与航空人员原发性高血压关系的研究

目的通过观察原发性高血压（EH）患者一氧化氮（NO）、内皮素（ET）、假性血友病因子（VWF）和血管紧张素Ⅱ（AngⅡ）的血浆水平变化，探讨细胞因子与原发性高血压的关系，为原发性高血压的发病机制和临床治疗提供实验依据。方法正常对照组30例，原发性高血压患者76例，其中血压控制理想组60例，不理想组16例。诊断符合高血压分级。Ⅰ级66例，Ⅱ级10例。应用放射免疫方法测定血浆ET和AngⅡ的水平，硝酸还原酶法测定NO水平，VWF测定采用酶联免疫吸附法。结果①Ⅰ级高血压VWF、AngⅡ与对照组相比升高（P〈0．05）。Ⅱ级高血压中，VWF、ET、AngⅡ与对照组相比升高（P〈0．05），NO比对照组降低（P〈0．05）。②血压控制理想组NO、AngⅡ与对照组相比有显著差异（P〈0．05），理想组VWF、NO、ET、AngⅡ与不理想组相比有显著差异（P〈0．05）。结论①随着分级升高，VWF、NO、ET、AngⅡ水平差异有统计学意义。其水平变化可以做为临床监测EH状况和作为治疗EH时判断疗效的指标之一。②在EH不同分级中AngⅡ均较对照组增高（P〈0．05），是EH的独立危险因素。③有效控制血压在理想水平，可以抑制缩血管物质的表达，增强舒血管物质的表达和分泌，明显改善内皮功能。     

急性脑损伤血浆内皮素与一氧化氮改变的临床意义探讨

目的探讨急性脑损伤血管舒缩因子的变化。方法测定急性脑血管疾病患者血浆内皮素和一氧化氮水平。结果急性脑损伤患者血浆内皮素和一氧化氮有明显改变,与对照组比较差异显著,脑梗塞组血浆ET还明显高于脑外伤组（前者P〈0．01后者P〈0．05）。结论急性脑损伤患者血浆中血管舒缩因子存在异常,而ET和NO的变化与本病的病理改变有密切关系。     

卡托普利联合螺内酯治疗充血性心力衰竭40例

随着对充血性心力衰竭发病机制的进一步认识,对充血性心力衰竭的治疗也有了新的进展。充血性心力衰竭使动脉及肾血流量减少,交感神经兴奋、神经体液调节异常肾素-血管紧张素-醛固酮系统（RAAs）激活,致使血管紧张素Ⅱ（AngⅡ）及醛固酮（ALD）水平增加,产生一系列对心肌的损害,对血管及神经体液调节不平衡,使心脏发生重构心衰加重。故对充血性心力衰竭的治疗,不仅要纠正心泵功能,更应兼顾神经内分泌的改变。应用血管紧张素转换酶抑制（ACEI）及ALD拮抗剂治疗充血性心力衰竭,观察其临床疗效。现就联合应用卡托普利和螺内酯治疗充血性心力衰竭46例报告如下。     

颈动脉粥样硬化患者斑块稳定性与血浆ET、NO的相关性研究

目的：观察不同类型颈动脉粥样硬化斑块患者血浆内皮素（ET）、一氧化氮（NO）含量的变化及与斑块稳定性的相关性。方法：55例伴有颈动脉粥样斑块的患者根据超声斑块形态分为易损斑块（vulnerable plaque，VP）组30例和稳定斑块（stable plaque，SP）组25例，另选30例无斑块组（NCP）为对照组，分别测定血浆ET、NO的含量。结果：与无斑块组比较，有斑块组ET明显增高，NO明显降低，有显著差异（P〈0．05）；与稳定斑块组比较，易损斑块组ET明显增高，NO明显降低，有显著差异（P〈0．05）。结论：血清ET、NO在颈动脉粥样硬化患者中有明显变化，ET，NO与患者斑块稳定性相关。     

出血性脑中风血液流变性、ET和SOD的临床研究

目的探讨出血性脑中风血流变性的变化。方法测定出血性脑血管疾病患者血液流变学指标，血浆内皮素（ET）和血清超氧化物歧化酶（SOD）水平。结果本病血液流变学指标有变化但与对照组差异不大。血浆ET和血清s0D均明显高于对照组，（前者P〈0．01后者P〈0．05）。结论出血性脑中风患者血液流变性存在异常，而ET和SOD的变化与本病的病理改变有密切关系。     

卡维地洛对充血性心力衰竭神经激素及心功能的影响

为了解卡维地洛对充血性心力衰竭患者神经激素及心功能的影响 ,将 35例充血性心力衰竭病人双盲随机分为卡维地洛组、安慰剂组 ,两组病人基础临床特征相似。于治疗前、后检测血浆中去甲肾上腺素 (NE)、血管紧张素Ⅱ (AngⅡ )浓度、血浆肾素活性 (PRA) ,左心室射血分数 (LVEF)及左心室腔径变化 ,15例健康人为正常对照组。结果显示 :心衰患者血浆中NE、AngⅡ、PRA均较正常对照组升高 (P <0 .0 1) ,卡维地洛组与安慰剂组相比血浆NE、PRA、AngⅡ水平下降 (P <0 .0 1) ,LVEF升高 (P <0 .0 1) ,左室舒张末径 (LVDd)、左室收缩末径(LVDs)均缩短 (P <0 .0 1)、左室收缩末容量 (ESV)减小 (P <0 .0 1)。提示卡维地洛能阻断神经激素对充血性心力衰竭的不良影响 ,改善患者左心功能 ,长期使用可使扩大的左心室腔径缩小。     

床边单纯超滤治疗西宁地区难治性心衰及对神经内分泌因子的影响

对西宁地区27例经药物治疗无效的心衰患者,行床边单纯超滤,并在超滤前、超滤后24h、72h、7d检测血浆醛固酮（ALD）、肾素（N）、血管扩张素Ⅱ（AngⅡ）、心钠素（ANF）、内皮素（ET）。认为床边单纯超滤治疗高原地区难治性心衰不仅改变其血流动力学而且改变生物学特性。     

细胞自噬与肿瘤发生发展

自噬是真核生物中一种高度保守的胞内降解途径.其主要通过溶酶体或液泡进行饥饿状态下的营养动员,清除受损蛋白质、细胞器和胞内病原体.自噬主要包括巨自噬、分子伴侣介导自噬(CMA)和微自噬.自噬已被证实与多种人类疾病相关,其在肿瘤发生发展中具有重要意义.近年研究中,对于自噬和肿瘤关系有了进一步的认识,该文就自噬分子机制、调控通路以及与肿瘤发生发展关系的研究进展作一综述.     

Physiologic and pathologic calcifications and ossifications in the face and neck

The aim was to give a systematic presentation of physiologic and pathologic calcifications and ossifications in the face and neck with a special emphasis on clinical relevance. In a sometimes subacute setting one should recognize specific calcifications which often lead to important diagnoses such as fungal sinusitis or sclerosing labyrinthitis. In a more chronic situation intraocular calcifications in small children are pathognomonic for retinoblastoma. Juxtatumoral sclerosis of the laryngeal cartilage in laryngopharyngeal carcinoma is usually caused by tumor infiltration of the cartilage resulting in a higher tumor stage and, this way, has a major impact on the therapeutical strategy. Calcified lymph nodes are mainly unspecific but can be the result of tuberculosis or metastases of thyroid cancer. Cross-sectional imaging methods, most of all computed tomography, are ideally suited to reveal head and neck calcifications and ossifications, especially those which are clinically relevant.     

Head and neck infection and inflammation

This article discusses the imaging manifestations of infectious and inflammatory conditions of the head and neck. Special attention is paid to the sites, routes of spread, and complications of neck infections. Because the clinical signs and symptoms and the complications of these conditions are often determined by the precise anatomic site involved, anatomic considerations are stressed. Familiarity with the fascial layers, spaces of the neck, and the contents of each space is helpful for this discussion. The fascial layers of the neck are important barriers to infection, and once infection is established, the fascial layers play a part in directing its spread.     

Staging and surgical management of pancreatic and biliary cancer and inflammation

Management of benign and malignant diseases of the pancreas, liver, and biliary tract has made remarkable progress in the last two decades. Advances in minimally invasive surgery, interventional radiology, and diagnostic and therapeutic endoscopy have changed the treatment of common diseases such as cholelithiasis and more serious diseases such as pancreatic adenocarcinoma. Advances in biliary tract and pancreatic surgery have paralleled the advances in ultrasonographic imaging, CT, and MR imaging. This article outlines the surgeon's perspective on radiologic imaging and preoperative staging of benign and malignant biliary and pancreatic disease.     

The thyroid and parathyroid glands. CT and MR imaging and correlation with pathology and clinical findings

Thyroid imaging approach is based on the preliminary clinical evaluation. Lesions that are smaller than 2 cm should be assessed with US, which is capable of discriminating masses as small as 2 mm and distinguishing solid from cystic nodules. US-guided FNAB provides tissue for cytologic examination of thyroid nodules. CT and MR imaging are indicated for larger tumors (greater than 3 cm diameter) that extend outside the gland to adjoining structures, including the mediastinum, and retropharyngeal region. Metastatic lymph nodes in the neck and invasion of the aerodigestive tract are also in the realm of CT and MR imaging. Thyroid nodules are categorized on scintigraphy as hot or cold nodules. Hot nodules are rarely malignant, whereas cold nodules have an incidence of 10% to 20% of malignancy. Calcifications (amorphous, globular, nodular, and linear) occur in adenomas and carcinomas and have no differential diagnostic features except for psammomatous calcifications, which are a pathognomonic finding in papillary carcinomas and a small percentage of medullary carcinomas. Papillary carcinoma is the most common malignant tumor (80%) followed by follicular (20% to 25%); medullary (5%); undifferentiated; anaplastic carcinomas (< 5%); lymphoma (5%); and metastases. Lymph node metastases are common in papillary carcinoma, 50% at presentation, and less common in follicular carcinomas. The metastatic nodes in papillary carcinoma may enhance markedly (hypervascular); show increased signal intensity on T1-weighted images (increased thyroglobulin content or hemorrhage); and reveal punctate calcifications. Localized invasion of the larynx, trachea, and esophagus occurs predominantly in papillary and follicular carcinomas; the incidence is less than 5%. Ectopic thyroid tissue may be encountered in the tongue (foramen cecum); along the midline between posterior tongue and isthmus of thyroid gland; lateral neck; mediastinum; and oral cavity. Goiter and malignant tumors, notably papillary carcinoma, may develop in ectopic thyroid tissue. Carcinomas may also arise in thyroglossal duct cysts, which develop from duct remnants between the foramen cecum and thyroid isthmus. Infectious disease of the thyroid gland is not common and the CT and MR imaging findings are similar as described under neck infection. Other types of inflammatory disorders including Hashimoto's thyroiditis, granulomatous thyroiditis, and Riedel's struma display no specific imaging features. Imaging studies may, however, be indicated to confirm a suspected clinical diagnosis and assess compromise of the airway (Riedel's struma). HPT is a clinical diagnosis in which hypercalcemia is the most important finding. Parathyroid hyperplasia, adenoma, and carcinoma represent underlying lesions. To relieve the patient's symptoms surgical extirpation is indicated. The surgical success rate without imaging is 95%. The indications for imaging studies vary but it is generally agreed that reoperation after a previous failed surgical attempt and suspicion of an ectopic parathyroid adenoma should be investigated by imaging. These consist of US, nuclear medicine studies, CT and MR imaging. US and technetium sestamibi scanning have the highest accuracy rate for localizing an adenomatous gland at and near the thyroid gland. Ectopic adenomas, particularly if they are located in the mediastinum, are preferrably investigated with CT and MR imaging with gadolinium and fat suppression. Carcinomas and parathyroid cysts are optimally evaluated by CT and MR imaging. On MR imaging adenomas are low in signal intensity on T1-weighted images, high in signal intensity on T2-weighted images, and enhance post introduction of gadolinium.