主动脉内气囊反搏对冠心病泵衰竭的治疗作用

为评价主动脉内气囊反搏（IABP）对冠心病泵衰竭的治疗作用，本文回顾性分析了7例因急性心梗心原性休克及冠心病心脏直视手术低心输出量而应用IABP的病例。结果表明行IABP后30分钟反搏压达65～130mmHg，心脏指数由1．60±0.20L／min／m2上升到2．27±0．20L／min／m2（P＜0．001），平均动脉压由47.0±16.0mmHg上升到85.3±25.4mmHg（P＜0.001），并有相应的临床改善，未见并发症。因此，IABP是治疗冠心病泵衰竭的有效手段。     

Pulmonary artery diastolic pressure: a simultaneous Doppler echocardiography and catheterization study

Pulmonary hypertension is an important determinant of the clinical presentation of and surgical approach to patients with heart disease. To confirm the utility of continuous wave Doppler echocardiography in assessing the pulmonary artery diastolic pressure in patients with pulmonary regurgitation, 51 patients representing the wide hemodynamic spectrum of pulmonary artery pressure underwent simultaneous determination of pulmonary artery diastolic pressure by continuous wave Doppler echocardiography and cardiac catheterization. Pulmonary artery diastolic pressure was estimated from the Doppler recordings by the end-diastolic pressure gradient obtained by the modified Bernoulli equation plus the estimated right atrial pressure. A correlation was observed (r = 0.935, SEE = 7.4 mmHg) between Doppler and catheterization pulmonary artery diastolic pressure. In addition, comparison between the mean diastolic pressure gradient across the pulmonary valve by Doppler and pulmonary artery diastolic pressure at catheterization yielded a high correlation (r = 0.947, SEE = 5.1 mmHg). These data demonstrate that continuous wave Doppler echocardiography is a useful noninvasive technique for evaluating the pulmonary artery diastolic pressure in patients with pulmonary regurgitation.     

体感交互技术训练对帕金森病患者平衡功能、足底压力及跌倒发生率的影响

目的 分析体感交互技术训练对帕金森病患者平衡功能、足底压力及跌倒发生率的影响。方法 选取2020年2月-2022年4月三二〇一医院收治的115例帕金森患者,按不同训练方案分为常规组（n=56）与体感交互组（n=59）。常规药物治疗期间,常规组实施传统平衡训练,体感交互组接受体感交互技术训练。比较两组训练4周后Berg平衡量表（Berg Balance Scale,BBS）评分,动、静态足底压力分布,跌倒发生率。结果 训练后体感交互组BBS评分高于常规组（P＜0.05）;训练前后比较,常规组BBS评分无统计学意义（P＞0.05）,体感交互组BBS评分有所提升,具有统计学意义（P＜0.05）。训练前两组静态、动态足底压力分布无统计学意义（P＞0.05）,两组静态站立时双脚压力由低到高排序为：2区＜1区＜3区＜6区＜5区＜4区＜7区＜8区;行走时左足：2区＜6区＜1区＜3区＜5区＜4区＜7区＜8区,右足：2区＜6区＜1区＜3区＜5区＜7区＜8区＜4区。训练后两组站立时双足的3区压力上升,双足压力：2区＜1区＜6区＜5区＜3区＜4区＜7区＜8区;行走时左足：2区＜6区＜1区＜5区＜3区＜4区＜7区＜8区,右足压力分区未变。训练后两组静态跌倒风险指数评分上升,动态跌倒风险指数评分下降,且体感交互组评分优于常规组（P＜0.05）。1个月随访期间,常规组发生11例跌倒,体感交互组发生2例,体感交互组跌倒发生率3.39%低于常规组19.64%（P＜0.05）。结论 体感交互技术训练能有效改善帕金森患者平衡功能康复情况,有助于更好调整动、静态足底压力分布,降低跌倒风险,减少跌倒发生情况。     

儿童动脉缺血性脑卒中研究进展

儿童动脉缺血性脑卒中(AIS)是重要的全球健康问题。近年来多项国际合作研究的开展使儿童AIS的诊疗有了重要进展。文章对儿童AIS的诊疗新进展进行综述,主要内容包括脑动脉病的分类和诊治进展、AIS相关基因及再灌注治疗三个方面。     

大白鼠心室肌细胞ClC-2型氯通道的特性

目的研究在生理及病理条件下C lC-2型氯通道(简称C lC-2)的特性。方法以酶解法分离大白鼠心室肌细胞,先后用正常、改变渗透压以及不同的pH值的灌流液灌流,并采用膜片钳全细胞记录法观察心室肌细胞C lC-2通道的活性变化。结果①正常心室肌细胞的C lC-2通道具有电压依赖性。它在细胞膜超极化(-40~-100 mV)时激活,由C l-介导的一种内向整流电流(IC I,ir)。低渗时细胞膨胀会加速激活,增加电流强度。高渗时反之。它可以被9-蒽甲酸(9-AC)所阻断,但对乙拌磷1,2-二苯乙烯衍生物SITS不敏感。②当pH值从7.4升高到8.0时,IC l,ir强度减小;当pH值从7.4下降到6.8时IC l,ir强度明显增加。在pH值为5.5的时候,电流几乎为零。结论C lC-2通道介导的IC l,ir,在超极化、低渗、细胞肿胀及酸性环境下其电流强度明显增加。     

胸水结核抗体对结核性胸膜炎的诊断意义

目的 了解结核性胸膜炎的诊断意义。方法 检查205例胸水的病因分析。结果 胸水结核抗体对结核性胸膜炎阳性率最高83.1%。结论 胸水结核抗体对鉴别结核性胸膜炎有较高实用价值。     

Galanin antisense oligonucleotides reduce galanin levels in dorsal root ganglia and induce autotomy in rats after axotomy.

Antisense (AS) oligonucleotides (ONs) to galanin (GAL) were applied to the proximal end of a transected sciatic nerve, allowing their cellular uptake and transport into injured axons. GAL expression in dorsal root ganglia and self-mutilation behavior (autotomy) were then studied. AS-ONs with phosphorothioate or allyl modifications significantly suppressed the axotomy-induced increase in GAL levels, as demonstrated by immunohistochemistry and exaggerated autotomy behavior, whereas no significant effect on GAL mRNA levels could be demonstrated with in situ hybridization. Allyl-ONs were more effective than phosphorothioate-ONs. An AS-ON with three base mismatches did not induce any of the above effects. These results support the view that the inhibition of axotomy-induced GAL up-regulation is related to autotomy.     

N糖基化对SMMC7721移植瘤生长及FAS,NM23,ICAM-1表达的调控

目的观察N糖基化抑制剂swainsonine对人肝癌细胞株SMMC7721体内生长的影响及探讨其可能的作用机制.方法将SMMC7721接种于裸鼠,对比研究饮用含1 mg/Lswainsonine饮用水的荷瘤裸鼠和对照组裸鼠的生存期及肿瘤大小指数,运用免疫组织化学的方法观察两组瘤组织标本的FAS,NM23,ICAM-1的表达情况.结果 swainsonine能延长实验组荷瘤裸鼠的生存期,抑制SMMC7721在荷瘤小鼠上的生长,其肿瘤生长抑制率为36%.FAS,NM23,ICAM-1的表达在实验组明显增强.结论 N糖基化抑制剂swainsonine能抑制人肝癌细胞株SMMC7721在裸鼠体内的生长,其对肿瘤组织fas,nm23 ICAM-1表达的调控可能与其作用机制有关.     

3alpha-Hydroxysteroid dehydrogenase type III deficiency: a novel mechanism for hirsutism

CONTEXT: Dihydrotestosterone (DHT), the primary active androgen in peripheral target tissues, is metabolized by 3alpha-hydroxysteroid dehydrogenase type III (3alpha-HSD), encoded by the AKR1C2 gene, forming 5alpha-androstane-3alpha,17beta-diol (3alpha-diol). 3alpha-HSD may play a role in the pathogenesis of hirsutism. OBJECTIVES: Our objective was to evaluate the role of 3alpha-HSD in hirsutism by comparing 1) tissue levels of active androgens, 2) relative gene expression of AKR1C2, and 3) activity of 3alpha-HSD in genital skin from normal and hirsute women. DESIGN: Genital skin was obtained from normal and hirsute women. After homogenization, testosterone (T) and DHT levels were quantified by conventional RIA. From isolated RNA, relative expression of AKR1C2 was determined by real-time PCR. In addition, minced genital skin was incubated with [(3)H]DHT, and the product, [(3)H]3alpha-diol, was quantified by radio-HPLC. SETTING: The study took place at an inner-city hospital. Patients: Patients included women undergoing posterior colporrhaphy. MAIN OUTCOME MEASURES: We assessed 1) tissue levels of T, DHT, and 3alpha-diol; 2) relative expression of AKR1C2; and 3) conversion ratio of [(3)H]3alpha-diol to [(3)H]DHT. Results: In genital skin, tissue DHT and T concentrations in hirsute women were 1.90-fold and 1.84-fold higher than in normal women (P =0 .002 and 0.03), and relative expression of AKR1C2 mRNA was reduced approximately 7-fold (P = 0.04). Genital skin from hirsute women showed less metabolism of [(3)H]DHT to [(3)H]3alpha-diol (conversion ratio, 0.24 +/- 0.19 vs. 0.85 +/- 0.55, P = 0.01). CONCLUSIONS: In genital skin of hirsute women, reduced AKR1C2 gene expression and 3alpha-HSD activity results in decreased DHT metabolism and elevated tissue levels of DHT. Diminished DHT metabolism may play an important role in the pathogenesis of hirsutism.     

Microsatellite instability and novel mismatch repair gene mutations in northern Chinese population with Hereditary non‐polyposis colorectal cancer

OBJECTIVE: Hereditary non‐polyposis colorectal cancer (HNPCC) syndrome is the most common cause of hereditary colorectal cancer with an early age of onset. Microsatellite instability (MSI) and germline mutation in one of the DNA mismatch repair (MMR) genes are found in the majority of HNPCC families and provide an opportunity for genetic diagnosis and prophylactic screening. The MMR gene mutation spectrum may vary across different populations and be influenced by founder mutations that prevail in specific ethnic groups. China is a big and ancient nation with enormous genetic diversity, which is especially notable between the northern and southern Chinese populations. A MMR gene mutation database for the southern Chinese population based in Hong Kong has been previously established. This study compares the MMR gene mutation spectrum and the MSI of HNPCC between the northern and southern Chinese populations. METHODS: Twenty‐five HNPCC families from northern China were systematically analyzed. The MSI analysis was performed using five loci in the USA National Cancer Institute (NCI) panel (D2S123, D5S346, BAT‐25, BAT‐26 and BAT‐40) by PCR from the tumor and normal tissue. MSH2, MSH6 and MLH1 were performed using immunohistochemical staining. Two founder mutations of MSH2 and MLH1 were examined by PCR base analyses using primers flanking the two deletion sites (c.1452_1455delAATG in MSH2 and 1.8 kb deletion involving exon 11 of MLH1) . RESULTS: Of the 25 families collected, 19 met Bethesda guideline (BG) 1 and six met BG3. Twenty‐two (15.7%) were extra‐colonic cancers with gastric cancer (in seven patients) being the most common cancer type. Of the 25 tumors analyzed, 21 (84%) were high level microsatellite instability (MSI‐H) and four (16%) were microsatellite stable (MSS). Eighteen (86%) of the 21 MSI‐H tumors showed loss of either the MLH1 or the MSH2 protein. Three MSI‐H tumors and all four MSS tumors showed no loss of expression of the three MMR proteins. Out of the 21 patients with MSI‐H tumors, 12 (57%) showed pathogenic germline mutations in either MLH1 (n = 8) or MSH2 (n = 4). Overall, three novel mutations (in patients H22, H17 and H29) have been identified. One of them, c.503_4insA, caused a frameshift mutation in the MLH1 gene. The other two were found in the MSH2 gene, including a frameshift (c.899_890insAT) and a splice junction (IVS7‐1G→A, SA of Exon 8) mutation. CONCLUSIONS: The results suggest a distinctly different mutation spectrum of MMR genes between northern and southern Chinese populations and call for a systematic, nationwide study to facilitate the design of a MMR gene mutation detection strategy tailored for individual populations in China.