荭草苷对大鼠急性心肌梗死的保护作用及机制研究

目的 探讨荭草苷对急性心肌梗死模型大鼠的保护作用及机制。方法 建立异丙肾上腺素致大鼠急性心肌梗死模型,将大鼠分为正常对照组、模型组、阳性药普萘洛尔组及低、高剂量荭草苷干预组（1.0、2.0 mg/kg）;采用多道生理记录仪采集心电图、血流动力学指标,检测血清中心肌酶、抗氧化物酶的活性,HE染色观察心肌组织病理学改变,ELISA法检测心肌组织环鸟苷酸（cGMP）水平。结果 与模型组比较,预防性ip 2.0 mg/kg荭草苷连续7 d,可降低大鼠心电图ST段高度变化,明显改善大鼠血流动力学指标,降低大鼠血清心肌酶LDH、ALT和AST的水平,减轻心肌梗死大鼠心肌纤维变性坏死及水肿程度,亦可升高大鼠血清中抗氧化酶SOD、GSH-Px活性及心肌组织中cGMP水平。结论 荭草苷对大鼠急性心肌梗死具有明显保护作用,其保护机制可能与增强体内抗氧化酶活性,提高心肌组织cGMP水平和调节NO/cGMP信号通路有关。     

不典型肝血管瘤误诊为肝囊腺瘤1例报告

<正>1病例资料患者女性,54岁,因“上腹部及背部困痛”于2022年8月16日就诊,入院查体、实验室检查、肝功能检查及肿瘤标志物均在正常范围内,未检测到肝炎病毒感染的血清学标志物。增强CT检查：肝右叶多房囊性占位,内见钙化及分隔,增强可见囊壁及分隔强化,考虑囊腺瘤（图1）;MRI肝脏特异性增强检查：肝S7见囊性长T1长T2混杂信号影,大小3.2 cm×3.4cm,内见多发薄壁分隔,增强扫描三期可见囊壁及分隔强化,ADC呈高信号,考虑囊腺瘤（图2）。完善相关检查后,患者行腹腔镜下部分肝切除术。     

急性心肌梗死冠状动脉内抽吸物的病理分析

Objective To analyze the components of retrieved materials from the culprit lesion in ST-segment elevation myocardial infarction (STEMI) patients by manual aspiration during primary percutaneous coronary intervention (PCI). Methods Visible retrieved materials were collected, fixed in formalin and processed for paraffin embedding, sectioned and stained with hematoxylin and eosin (HE). The retrieved materials were microscopically divided into erythrocyte-rich thrombi, platelet/fibrin-rich thrombi, combined thrombi (similar proportions of erythrocytes and platelet/fibrin components), atherosclerotic plaque materials and edematous components. Based on pathological findings, thrombus materials were classified into fresh (< 1 d), lytic (1-5 d), frash/lytic and organized thrombi(>5 d) after formation. All patients were further classified into plaque positive and plaque negative groups. Clinical and angiographic data were also obtained for analyzing possible association between pathological findings and surrogates of myocardial reperfusion, including myocardial blush grade (MBG), enzymatic estimated infarction size (peak CK and CK-MB levels), left ventricular end diastolic diameter (LVEDD) and left ventricular ejection fraction (LVEF) which were assessed 16 h after procedure. Results Visible samples were collected from 49 patients by manual catheter aspiration (thrombus components in 46 patients, atherosclerotic plaque only in 3 patients). Frequency of erythrocyte-rich thrombi, platelet/fibrin-rich thrombi and combined thrombi were 41.3% (19/46), 30.4% (14/46) and 28.2% (13/46), respectively. The incidence of fresh, lyric, fresh/lytic and organized thrombi were 47. 8% (22/46), 32. 6% (15/46), 10.9% (5/46) and 8.7% (4/46), respectively. Plaque materials were found in 57.1% (28/49) patients, including ruptured plaque accompanied by thrombus formation [8.2% (4/49)], fibrous plaque [6.1% (3/ 49)] and thickened intima [2.0% (1/49)]. Baseline characteristics did not differ between plaque positive (n=28) and plaque negative (n=21) groups. Ratios of MBG 3 were higher in plaque positive group than in plaque negative group [82.1% (23/28) vs. 52. 4% ( 11/21 ), P=0.025]. Peak CK and CK-MB levels were lower in the former than in the later [(1705±1647)U/L vs. (2629±2013)U/L, P=0. 042; (146± 136) μg/L vs. (258±215) μg/L, P=0.016; respectively]. Furthermore, LVEF were higher in plaque positive group than in plaque negative group (0.59±0. 10 vs. 0.52±0.08, P=0.012). Conclusion Manual catheter aspiration during primary PCI in STEMI patients is an effective way for removing thrombus and plaque materials, and plaque debulking before stenting or pre-dilation and this procedure might probably improve myocardial reperfusion, limit infarction size and improve cardiac function.     

一起二次供水污染的报告

一起二次供水污染的报告安徽省马鞍山市卫生防疫站（２４３０１１）马芹１９９６年１０月３１日，本站收到华东冶金学院宿舍２栋４个楼层的自来水样４份，该院居民反映水质混浊有异味，部分居民饮用此水后出现腹痛、腹泻、食欲不振等症状。当日即对水样进行理化和微生物分...     

妊娠期高血压疾病并发脑血管病20例回顾性分析

目的 探讨妊娠期高血压疾病并发脑血管疾病的预防与治疗.方法 对20例妊娠合并脑血管疾病病例进行总结.结果 19例病人通过解痉、镇静、降压取得较好效果.结论 妊娠期高血压疾病并发脑血管病经积极治疗和早期预防,预后多良好.     

入院前电话通知对中老年ST段抬高心肌梗死患者进急诊室至球囊扩张时间的影响

目的 探讨入院前心电图采集和电话通知对ST段抬高心肌梗死(STEMI)患者进入急诊室至球囊扩张时间[进门至球囊扩张(door to balloon,D2B)时间]的影响. 方法 对2006年1月至2007年12月就诊于北京安贞医院抢救中心并接受直接经皮冠状动脉介入治疗(PCI)的STEMI患者的临床资料进行分析.将患者分为3组:无入院前心电图(无心电图)组、有入院前心电图(有心电图)组和依据入院前心电图进行电话通知(电话通知)组.主要分析指标为D2B时间.次要分析指标为住院期间患者病死率. 结果 纳入研究患者402例,其中无心电图组137例(34.1%),有心电图组176例(43.8%),电话通知组89例(22.1%).3组患者年龄、性别、既往病史及心肌梗死部位比较,差异无统计学意义(P0.05).与无心电图组比较,有心电图组和电话通知组患者D2B时间缩短,3组分别为113 min、96 min和86 min(均P<0.01).3组患者住院期间病死率[分别为4例(2.9%)、4例(2.3%)和3例(2.2%)]比较,差异无统计学意义(均P0.05). 结论 入院前心电图采集和早期电话通知能缩短STEMI患者D2B时间,使更多的患者D2B时间<90 min.入院前与医院建立电话联系可缩短再灌注时间.     

下肢多功能枕的设计与应用

<正>目前,髋关节脱位是髋关节置换术后常见的并发症之一,初次置换术后脱位发生率为3.2%~6.5%,全髋关节翻修术后脱位发生率为7.4%~11.4%[1],早期脱位因髋关节周围肌肉、关节囊的力量没有恢复正常,而病人又将下肢放置在容易发生关节脱位的危险体位所致。目前应用最多的是梯形枕和三角枕,但此类枕头不利于侧卧时使用,病人常因患肢过度悬空而     

马鞍山市2010～2011年食源性致病菌监测结果分析

目的为了解食源性致病菌污染状况,控制食品生物性污染。方法按国家食源性致病菌监测方案要求,无菌采集超市(商店)、农贸市场、餐饮店制售的10类食品496份,监测10种致病菌。结果肉类、餐饮食品、速冻熟制米面制品、即食非发酵性豆制品、动物水产品检出单核细胞增生李斯特氏菌、金黄色葡萄球菌、蜡样芽孢杆菌、副溶血性弧菌四种致病菌24株;单核细胞增生李斯特氏菌占致病菌构成比的62.50%,金黄色葡萄球菌29.17%;肉类食品致病菌检出率高达11.21%。结论肉类及其制品是食源性疾病的高危食品,单核细胞增生李斯特氏菌、金黄色葡萄球菌则是食源性疾病的高风险致病菌。     

讲话瓣膜在气管造口患者中的应用

讲话瓣膜（Passy-Muir tracheostomy speaking valve，PMV）在国外的呼吸科、耳鼻喉科、神经内外科、儿科等已应用十几年，主要针对气管切开术后需长期保留气管造口的患者；但我国目前尚少报道。现将我科应用PMV情况报道如下。     

狂犬病误诊为病毒性脑炎一例分析

目的 分析狂犬病的临床表现、发病机制及易误诊原因,以期引起临床医生的重视.方法 回顾性分析狂犬病误诊为病毒性脑炎1例的临床资料.结果 本例因触水后有汗毛竖起感、发作性步态不稳、视物成双、精神异常就诊.于外院影像学检查诊断为脑动脉供血不足,予相关治疗后无好转.转我院,经脑电图、痰涂片等医技检查诊断为：发热原因待查？病毒性脑炎.予对症治疗无缓解,追问病史有狗抓伤史并未注射狂犬疫苗,考虑狂犬病.转传染病院治疗,1d后因呼吸及循环功能衰竭死亡.结论 临床遇及狂犬病可疑病例时,要详细追问病史,并结合狂犬病特征性症状进行诊断,以减少误诊.