经旋股内侧动脉深支和旋股外侧动脉升支介入治疗股骨头缺血性坏死的应用解剖

对 50例成人下肢标本的旋股内侧动脉深支和旋股外侧动脉升支的起源、起点、外径、走行、分布以及经这二支血管介入有关的结构进行观测 ,为介入治疗股骨头缺血性坏死提供更接近病变部位及可进行插管的血管。结果表明 ,旋股外侧动脉升支与横支共干起自旋股外侧动脉者占 68% ,升支单独起自旋股外侧动脉占 2 6 % ;旋股内侧动脉深支由旋股内侧动脉主干延续而来。旋股内、外侧动脉深支或升支起点外径分别为 3 0± 0 8mm、 2 8± 0 7mm。从股动脉的起点 ,经股深动脉、旋股外侧动脉至其升支长度为 7 1± 1 1cm ;经股深动脉、旋股内侧动脉至其深支长度为 5 6± 1 4cm。旋股内侧动脉与其深支间约呈 90 。 角 ;旋股外侧动脉与其升支间约呈 1 33。 角。旋股内、外侧动脉深支 (升支 )为营养股骨头和颈的血管 ,这二支血管符合导管插入要求     

Acupoint-specific fMRI patterns in human brain

Specific central nervous system (CNS) responses to acupuncture have recently attracted attention. It is important to understand the differences in fMRI images of the brain evoked by acupuncture at an acupoint and at a nearby "sham" point. Here, we report analyses of fMRI images of the brains of 37 healthy volunteers in response to acupuncture at Liv3 (Taichong) and LI4 (Hegu) versus their sham points. We found common activation areas in response to Liv3 or LI4 acupuncture in the middle temporal gyrus and cerebellum, along with deactivation areas in the middle frontal gyrus and inferior parietal lobule, compared with the effects of acupuncture at sham points. Acupuncture at Liv3 evoked specific activation at the postcentral gyrus, posterior cingulate, parahippocampal gyrus, BA 7, 19 and 41, but deactivation at the inferior frontal gyrus, anterior cingulate, BA 17 and 18, compared with acupuncture at its sham point. Acupuncture at LI4 evoked specific activation at the temporal pole, but deactivation at the precentral gyrus, superior temporal gyrus, pulvinar and BA 8, 9 and 45, compared with acupuncture at its sham point. These observations reveal that acupuncture at acupoints induces specific patterns of brain activity, and these patterns may relate to the therapeutic effects of acupuncture.     

Ca2+ channel actions of the non-dihydropyridine Ca2+ channel antagonist Ro 40-5967 in vascular muscle cells cultured from dog coronary and saphenous arteries

Summary We studied the membrane effects of (1S,2S)-2-(2-[[3-2(benzimidazolyl) propyllmethylamino]ethyl)-6-fluoro-1,2,3,4-tetrahydro-l-isopropyl-2-naphthyl-methoxy-acetate dihydrochloride, Ro 40-5967, a new non-dihydropyridine (DHP) Ca²⁺ channel antagonist, on dog coronary and saphenous arterial vascular muscle cells using the whole-cell patch-clamp method. Long-lasting (L-type) inward currents in 20 mM Ba²⁺ were measured over a range of test potentials (300 ms) from –50 mV to + 90 mV from a holding potential of –80 mV in the presence of 1 M Bay k8644 (a DHP Ca²⁺ agonist). Ro 40-5967 caused a concentration-dependent suppression of Ca²⁺ channel currents in muscle cells from both arteries, with greater potency on coronary than saphenous arterial cells. The concentration of Ro 40-5967 which inhibited the magnitude of peak inward currents by 50% (IC₅₀) was estimated to be 1 M (n = 5) in muscle cells from coronary artery and 10 M (n = 4) in saphenous artery. Ro 40-5967 (1 M) decreased the amplitude of the activation current-voltage relationship for coronary L-type Ca²⁺ channel currents over a wider range of membrane potentials than verapamil, diltiazem, or nifedipine. In contrast, block of Ca²⁺ channel currents in saphenous artery cells by 1 M Ro 40-5967 was only observed at command potentials positive to 0 mV. Ro 40-5967 (1 M) significantly shifted the voltage-inactivation curve downward by 40% in coronary (n = 4), but only by 18% in saphenous arterial muscle cells (n = 3). The non-parallel shift of the coronary artery inactivation curve suggests that pronounced resting channel block is a notable feature of Ro 40-5967. The marked inhibition of Ba²⁺ current by 1 M Ro 40-5967 in the inactivation protocol in coronary arterial muscle cells was found over the entire range of membrane holding potentials tested, while inhibition in the saphenous artery inactivation curve occurred only from holding potentials more positive than –40 mV. Therefore, Ro 40-5967 is unique: 1) in acting over a wider range of voltages, on both instantaneous and resting Ca²⁺ currents, than other Ca²⁺ antagonists; 2) in producing more significant resting state block; and 3) in acting with selectivity for coronary over saphenous arteries.This research was supported by National Institutes of Health grants HL38537, HL38645, and by F. Hoffmann-La Roche, Basel, Switzerland     

VITEK ESBL实验在检测产超广谱β-内酰胺酶细菌中的临床应用

目的 :评价VITEKESBL试验和双纸片试验 ( 2 -disk)检测产超广谱β -内酰胺酶细菌 (ESBLs)的能力。 方法 :对 5 9株细菌进行敏感性和特异性检测。结果 :所测得细菌都具有典型的ESBLs的特征。VITEKESBL和 2 -disk检测ESBLs的敏感性和特异性结果分别为 98 3%和 10 0 %、96 6 1%和 96 6 1%。结论 :VITEKESBL试验比 2 -disk法易于操作。 2 -disk法对结果判读会产生主观影响 ,VITEKESBL试验可正确检测ESBLs。     

移动平均数质控法在凝血试验中的应用

目的：建立凝血试验移动平均数质控法。方法：用移动平均数代替算术平均数,选择凝血验凝血酶原时间（ＰＴ）,活化的部分凝血激酶时间和纤维蛋白原３个项目,比较两种质控方法,同时用标准血浆作为质控。结果：当用适当的移动平滑系数时,移动平均数质控法既能排除病人标本非随机必的干扰,又能很好地反映试验前因素的影响。结论 ;移动平均数空法可用于凝血试验的实验室质控。     

透析中的终末期肾脏病可逆性探讨

透析中的终末期肾脏病 (ＥＳＲＤ) ,有不少医师认为已属不可治性 ,只能靠透析或肾移植维持生存。但也有人报道ＥＳＲＤ在透析治疗后有一定可逆缓解率〔1 ,2〕,部分患者肾功能可能恢复至氮质血症期甚至更低水平 ,并能脱离透析 ,避免肾移植或使之延后。本文回顾性分析本院 3 52例透析的ＥＳＲＤ病例 ,对ＥＳＲＤ的可逆缓解率及相关因素作初步探讨。对象与方法一、病例来源1992年 5月～ 1999年 9月曾在本院行血透治疗的所有慢性肾功能不全病例 ,符合下述条件者入选 :①患者有尿毒症的临床表现 (消化道症状及贫血为必备条件 ) ,肌酐清除率Ｃｃｒ…     

102例脑血管疾病患者血清脂蛋白(a)的检测

本文采用免疫透射比浊法对58例脑出血患者和44例脑梗塞患者血清Lp(a)进行检测并与健康体检者进行分析比较,三者结果分别为336.0±168.7mg/L和350.7±173.1mg/L及184.1±132.2mg/L,患者血清Lp(a)较正常人明显升高(P<0.01),Lp(a)是脑血管疾病一种重要危险因子。     

实验性局灶性脑缺血再灌注Fos蛋白的表达

目的　探讨大鼠局灶性脑缺血再灌注Fos蛋白表达的意义及其机制。方法　采用免疫组化法观察Fos蛋白在大鼠局灶性脑缺血再灌注后皮层和基底节区的动态变化。结果　Fos蛋白在大脑中动脉阻断 1h后 ,随再灌注时间延长其分布不同。基底节区持续时间长 ,阳性细胞多 ,而皮层持续时间短 ,阳性细胞少。其中再灌注 90min ,Fos蛋白表达最显著。大脑中动脉供血中心区皮层几无表达。结论　Fos蛋白的表达与神经细胞存活密切相关 ,出现Fos蛋白表达的区域神经元易于耐受缺血性损害而存活 ,可能是神经细胞自我保护机制之一 ,Fos蛋白的表达存在扩散抑制     

溶栓后早期T波的变化与冠脉再通的关系

目的 探讨急性心肌梗塞溶栓后早期Ｔ波的变化与闭塞冠脉再通的关系。方法 对８０例接受静脉溶栓治疗的ＡＭＩ患者进行前瞻性研究,根据溶栓后２４小时内有无Ｔ波倒置分为两组。依据临床间接判断冠脉再通的标准观察两组血管再通情况。结果 Ｔ波倒置组与未倒置组血管再通率分别为９３．１％和１１．３％（Ｐ〈０．０１）。结论 溶栓后早期Ｔ波倒置可作为判定梗塞相关血管再通的参考指标。     

职业紧张测量工具研究

目的 :研究适合评价我国职业人群职业紧张状态的测量工具。方法 :根据目前国际上通用的标准 ,从国外大量现用的职业紧张测量工具中选择信度、效度较高的、使用较广的测量工具进行研究和修订。研究内容包括职业紧张因素 ,紧张反应 ,个体因素 ,缓解因素等。研究对象为六种不同职业的作业者共 65 6人。研究方法为职业流行病学方法。信度的评估指标为内部一致性信度指标 ,包括平均项目 -总分相关系数和Cronbach’α系数 ,效度的评估指标为所研究的因素与各种相关因素之间的相关系数和所研究因素在紧张结局变量系统多元回归方程中的因素贡献率。结果 :职业紧张测量工具的平均项目 -总分相关系数绝大多数均在 0 60以上。Crohach’α系数绝大多数均在 0 70以上 ,大多数样本和总样本中的职业紧张因素、个体因素和中和缓解因素与紧张结局之间的相关系数绝大多数具有显著性和非常显著性意义。结论 :所研究的职业紧张测量工具均具有可接受的信度和效度水平。可在实际工作中加以推广应用。