颅内外动脉粥样硬化性大动脉狭窄与脑梗死关系

目的:探讨动脉粥样硬化性颈动脉狭窄、颅内大脑中动脉狭窄与急性脑梗死的关系及脑梗死复发原因.方法:采用多普勒超声对136例急性脑梗死患者进行颅内外动脉检测,并对随访期间复发患者进行动脉彩色多普勒超声检测分析.结果:136例脑梗死患者大脑中动脉狭窄42例,颈动脉中、重度狭窄12例.随访期内脑梗死复发26例,其中颈动脉中、重度狭窄10例.结论:急性脑梗死与大脑中动脉严重狭窄者密切相关,复发性脑梗死与颈动脉狭窄密切相关.     

小剂量尿激酶加法安明在脑梗塞早期的应用

目的 :研究小剂量尿激酶和法安明在脑梗塞早期应用的临床疗效。方法 :将 10 8例脑梗塞患者分为三组 ,分别采用小剂量尿激酶治疗 (简称尿激酶组 ) ;小剂量尿激酶加法安明治疗 (简称联合组 ) ;传统疗法 (简称对照组 )。治疗前后采用欧洲卒中评分法进行神经功能评分。结果 :治疗前各组分数无显著性差异 ,治疗后联合组 >尿激酶组 >对照组 ,差异均有显著性。联合组的卒中继续进展及再梗塞发生率明显降低。结论 :小剂量尿激酶与法安明联用能有效阻止血栓进展 ,减少再梗塞 ,有利于神经功能恢复 ,疗效显著而无明显副作用。     

Polymorphisms in the genes for coagulation factor II,V,VII in patients undergoing coronary angiography

INTRODUCTIONCoronaryarterydisease (CAD)continuestobethemajorcauseofmorbidityandmortalityinourcountry .TheactivityofbloodcoagulationfactorshasbeenshowntobeanimportantriskindicatorforCAD .However,circulatinglevelsofcoagulationfactorsmaynotaccuratelyreflectt…     

Dynamic resistance exercise increases skeletal muscle-derived FSTL1 inducing cardiac angiogenesis via DIP2A–Smad2/3 in rats following myocardial infarction

PurposeThe aim of this study was to investigate the potential of dynamic resistance exercise to generate skeletal muscle-derived follistatin like-1 (FSTL1), which may induce cardioprotection in rats following myocardial infarction (MI) by inducing angiogenesis.MethodsMale, adult Sprague-Dawley rats were randomly divided into 5 groups (n = 12 in each group): sham group (S), sedentary MI group (MI), MI + resistance exercise group (MR), MI + adeno-associated virus (AAV)–FSTL1 injection group (MA), and MI + AAV–FSTL1 injection + resistance exercise group (MAR). The AAV–FSTL1 vector was prepared by molecular biology methods and injected into the anterior tibialis muscle. The MI model was established by ligation of the left anterior descending coronary artery. Rats in the MR and MAR groups underwent 4 weeks of dynamic resistance exercise training using a weighted climbing-up ladder. Heart function was evaluated by hemodynamic measures. Collagen volume fraction of myocardium was observed and analyzed by Masson''s staining. Human umbilical vein vessel endothelial cells culture and recombinant human FSTL1 protein or transforming growth factor-β receptor 1 (TGFβR1) inhibitor treatment were used to elucidate the molecular signaling mechanism of FSTL1. Angiogenesis, cell proliferation, and disco interacting protein 2 homolog A (DIP2A) location were observed by immunofluorescence staining. The expression of FSTL1, DIP2A, and the activation of signaling pathways were detected by Western blotting. Angiogenesis of endothelial cells was observed by tubule experiment. One-way analysis of variance and Student''s t test were used for statistical analysis.ResultsResistance exercise stimulated the secretion of skeletal muscle FSTL1, which promoted myocardial angiogenesis, inhibited pathological remodeling, and protected cardiac function in MI rats. Exercise facilitated skeletal muscle FSTL1 to play a role in protecting the heart. Exogenous FSTL1 promoted the human umbilical vein vessel endothelial cells proliferation and up-regulated the expression of DIP2A, while TGFβR1 inhibitor intervention down-regulated the phosphorylation level of Smad2/3 and the expression of vascular endothelial growth factor-A, which was not conducive to angiogenesis. FSTL1 bound to the receptor, DIP2A, to regulate angiogenesis mainly through the Smad2/3 signaling pathway. FSTL1–DIP2A directly activated Smad2/3 and was not affected by TGFβR1.ConclusionDynamic resistance exercise stimulates the expression of skeletal muscle-derived FSTL1, which could supplement the insufficiency of cardiac FSTL1 and promote cardiac rehabilitation through the DIP2A–Smad2/3 signaling pathway in MI rats.     

乙醇对大鼠大脑皮层和纹状体细胞内Ca^2＋的影响

目的观察乙醇对大鼠大脑皮层和纹状体细胞内Ca^2＋的影响。方法 雄性Wistar大鼠30只,随机分为对照组,乙醇灌胃后0．5h组,1．5h组,3h组和、5h组（各6只）。实验组用60％（V／V）白酒一次性灌胃（灌胃体积为10ml／kg）,对照组用等体积生理盐水灌胃。在各时间点急性分离大脑皮层和纹状体细胞,用Ca^2＋敏感荧光指示剂Fluo-3／AM负载,共聚焦显微镜测定细胞内游离Ca^2＋结果。染毒后大鼠大脑皮层和纹状体细胞内游离Ca^2＋荧光强度均降低（与对照组比较）,其中,1．5h组降低有显著差异（P〈0．01,P〈0.05）。结论乙醇产生神经行为毒性可能与大脑皮层和纹状体细胞内Ca^2＋尝试降低有关。     

Risk of cardiac rupture after acute myocardial infarction is related to a risk of hemorrhage

Although cardiac rupture (CR) is a fatal mechanical complication of acute myocardial infarction (AMI), to date no predictive model for CR has been described. CR has common pathological characteristics with major bleeding. We aimed to investigate the relationship between the risk factors of major bleeding and CR. A total of 10 202 consecutive AMI patients were recruited, and mechanical complications occurred in 72 patients. AMI patients without CR were chosen as control group. Clinical characteristics including bleeding-related factors were compared between the groups. The incidences of free wall rupture (FWR), ventricular septal rupture (VSR), and papillary muscle rupture (PMR) were 0.39%, 0.21%, and 0.09%, respectively, and the hospital mortalities were 92.5%, 45.5%, and 10.0%, respectively. Female proportion and average age were significantly higher in the groups of FWR and VSR than in the control group (P<0.01); higher white blood cell count and lower hemoglobin were found in all CR groups (P<0.01). Compared to the control group, patients with CR were more likely to receive an administration of thrombolysis [26.39% vs. 13.19%, P<0.05], and were less likely to be treated with primary percutaneous coronary intervention (PCI) [41.67% vs. 81.60%, P<0.05]. The major bleeding scores (integer scores) of FWR, VSR, and PMR were (17.70±7.24), (21.91±8.33), and (18.60±7.88), respectively, and were significantly higher than that of the control group (11.72±7.71) (P<0.05). A regression analysis identified age, increased heart rate, anemia, higher white blood cell count, and thrombolysis as independent risk factors of CR, most of which were major bleeding-related factors. The patients with CR have a significantly higher risk of hemorrhage compared to the group without CR. Risk of CR after AMI is related to the risk of hemorrhage.     

Measuring perceived competence and social acceptance in children with cerebral palsy

The Dutch Pictorial Scale of Perceived Competence and Social Acceptance for Children with Cerebral Palsy was translated and administered to an English sample. This scale was developed to assess the child's perception on cognitive, physical and social domains. Thirty-two children, aged 4 to 9 years, were tested twice. The results indicate good test/retest reliability and good internal consistency. The results on the intercorrelations between the four sub-scales supported internal validity of the pictorial scale. It is concluded that the pictorial scale for young children with cerebral palsy is a reliable and valid instrument for determining the perception of children with cerebral palsy, and application in clinical and class settings is discussed.     

Study of clinical features of amyloid angiopathy hemorrhage and hypertensive intracerebral hemorrhage

Objective: The purpose of this study was to differentiate between cerebral amyloid angiopathy (CAA) and hypertension (HTN) based on hemorrhage pattern interpretation. Methods: From June 1994 to Oct., 2000, 83 patients admitted to our service with acute intracerebral hemorrhage (ICH) were investigated retrospectively; 41 patients with his-tologically proven diagnosis of cerebral amyloid angiography and 42 patients with clear history of hypertension were investigated. Results: Patients with a CAA-related ICH were significantly older than patients with a HTN-related ICH (74.0 years vs 66.5 years, P<0.05). There was a significantly higher number of hematomas>30 ml in CAA (85.3%) when compared with HTN (59.5%). No basal ganglional hemorrhage was seen in CAA, but in 40.5% in HTN. In CAA-related ICH, su-barachnoid hemorrhage (SAH) was seen in 26 patients (63.4%) compared to only 11 patients (26.2%) in HTN-related ICH. Intraventricular hemorrhage was seen in 24.4% in CAA, and in 26.2% in HTN. Typical features o     

高压氧治疗急性期脑梗死40例临床疗效观察与护理

目的 通过对急性脑梗死的患者,实施高压氧治疗及相应护理,观察其临床疗效.方法 40例急性脑梗死患者通过高压氧治疗2-3个疗程,观察其功能恢复,并与药物对照组治疗效果进行比较.结果 高压氧综合治疗组总有效率87.5%,显效47.5%.药物对照组总有效率77.8%,显效37.8%.两组差异有显著性(P＜0.05).结论 高压氧综合治疗急性脑梗死临床疗效是显著的,同时及时做好治疗时的护理工作十分必要.     

间歇运动激活LIF/LIFR/STAT3信号促进心梗大鼠心脏血管新生

摘要：目的：探讨间歇运动对心肌梗死(myocardial infarction,MI)大鼠白血病抑制因子(Leukemia inhibitory factor,LIF)表征和心脏血管新生的影响及其可能机制。方法：3月龄SD雄性大鼠,随机分为正常对照组(Control)、间歇运动组(CE)、假心梗组(Sham)、心梗安静组(MI)和心梗+间歇运动组(ME),每组12只。Control组和CE不手术。各心梗组采用左冠状动脉前降支结扎法制备MI模型。运动组在术后1周进行预适应运动(10～15 m/min,30 min/d×5 d/周)。间歇运动采用低强度和高强度依次交替的跑台训练,以10 m/min×10 min进行热身运动,以25 m/min×7 min和15 m/min×3 min依次进行中等强度与大强度交替的间歇运动(60 min/d×5 d/周×8周)。训练结束后次日,血流动力学检测心功能,迅速摘取心脏,RT-qPCR检测心肌LIF/LIFR mRNA表达,Western blot检测心肌LIF、LIFR、p-STAT3/STAT3、VEGF蛋白表达,免疫荧光和免疫组化检测vWF和CD31表达,酶活性试剂盒检测心肌细胞代谢指标。结果：1）间歇运动可激活正常大鼠心肌LIF/LIFR/STAT3通路;2）心梗大鼠心肌LIF/LIFR基因与蛋白表达和STAT3磷酸化水平升高,血管发生代偿性新生,心肌CVF%显著增加,心肌细胞代谢紊乱;3）间歇运动进一步显著上调心梗心肌LIF/LIFR基因与蛋白表达和STAT3磷酸化水平,促进血管新生,显著降低CVF%,改善心肌代谢紊乱。结论：间歇运动显著升高正常和心梗大鼠心肌LIF/LIFR基因和蛋白的表达,其下游信号通路蛋白STAT3的磷酸化水平显著升高,显著刺激心脏的血管再生,改善心梗大鼠心功能。