缺血性脑血管疾病患者颈动脉彩超检测的应用价值

在动脉粥样硬化的情况下,颈总动脉至颈内外动脉分叉处容易形成粥样硬化斑块性狭窄及血栓,从而导致一过性脑缺血发作(TIA)或脑卒中。本文应用彩色多普勒超声通过对62例缺血性脑血管疾病患者颈动脉血管的检测,对颈动脉硬化斑块性质及血流受阻程度研究,以探讨缺血性脑血管疾病的早期的发现和预防治疗的措施。     

彩色多普勒超声检查评估老年退行性心脏瓣膜病与颈动脉粥样硬化的相关性研究

目的:应用彩色多普勒超声评估老年退行性心脏瓣膜病(SDHVD)与颈动脉粥样硬化相关性。方法:选择2016年5月-2018年7月中国医科大学航空总医院收治的老年SDHVD患者240例作为观察组,根据心瓣膜钙化程度分级标准将所有患者分为1级组61例、2级组84例以及3级组95例。另取同期于我院住院治疗的非SDHVD患者100例作为对照组。所有患者均接受彩色多普勒超声检查,比较观察组与对照组患者的基础疾病合并情况,对比不同组别患者颈动脉内膜中层厚度(IMT)、颈动脉斑块积分以及颈动脉管腔狭窄程度情况,分析SDHVD与颈动脉粥样硬化相关性。结果:观察组冠心病、糖尿病、高血压以及高脂血症发生率分别为47.08%、50.42%、93.75%、81.67%,均分别高于对照组的24.00%、29.00%、68.00%、52.00%(P0.05)。对照组、1级组、2级组、3级组的IMT以及颈动脉斑块积分比较存在统计学差异,且随着心瓣膜钙化程度分级的逐渐提高,IMT以及颈动脉斑块积分呈逐渐上升趋势(P0.05)。随着心瓣膜钙化程度分级的逐渐升高,颈动脉管腔狭窄程度在50%-70%以及71%-99%中的发生率呈逐渐升高趋势(P0.05)。经Pearson相关性分析显示:SDHVD严重程度与IMT、颈动脉斑块积分以及颈动脉管腔狭窄程度均呈正相关(P0.05)。结论:彩色多普勒超声检查可有效评估SDHVD与颈动脉粥样硬化的严重程度,且SDHVD患者多并发基础疾病,临床应积极预防。     

B超检测颈动脉粥样硬化与脑梗死相关性的研究

目的:探讨颈动脉粥样硬化变化与脑梗死的关系.方法:选择我院2007年4月～2009年脑梗死患者103例作为观察组,同时选择本院同期住院非脑梗死患者51例作为对照组,彩色多普勒超声仪检测显示颈部动脉:经总动脉远端:颈内动脉起始部和颈动脉分叉处,观察血管解剖形态内膜情况有无斑块形成以及斑块的形态大小性质及管腔是否狭窄狭窄程度.结果:①两组患者内膜增厚发生率比较,差异无统计学意义,P＞0.05;两组患者斑块形成发生率相比,差异有统计学意义,P＜0.05;②斑块发生在颈总动脉膨大部,占43.8%;发生在颈总动脉主干,占30.1%;发生在颈内动脉起始部13.6%;发生在颈内动脉主干,占6.8%;发生在椎动脉,占5.4%;③观察组和对照组在轻度狭窄发生率、中度狭窄发生率、重度狭窄发生率比较,差异有统计学意义,P＜0.05.结论:颈动脉粥样硬化在一定程度上能够反映脑动脉粥样硬化的情况,与脑梗死的关系密切,是预测脑梗死风险的重要指标,早期发现颈动脉粥样硬化对预防脑梗死的发生有着重要意义.     

彩色多普勒超声测量椎动脉血流量对后循环缺血的诊断价值

目的：探讨彩色多普勒超声技术测量椎动脉血流量对后循环缺血（PCI）的诊断价值。方法：选取2012年1月至2013年1月在本院神经内科住院并接受治疗的PCI患者58例作为观察组,另选取同期住院并确诊为非后循环缺血症的患者50例作为对照组。所有患者均接受颈部血管超声检查,测量椎动脉内径及血流量,观察组患者需行头颅CTA检查,比较两组患者的椎动脉内径、血流量及颈动脉硬化斑块发生率等。结果：观察组患者的椎动脉内径及血流量明显低于对照组,两组比较差异有统计学意义（P〈0．01）;观察组颈动脉硬化斑块的发生率为77．5％（44例）,对照组颈动脉硬化斑块的发生率为42％（21例）,两组比较差异有统计学意义（P〈0．05）。无狭窄、轻度狭窄、重度狭窄及闭塞的椎动脉血流量的变化（此处所指的血流量是指小于200mL/min那部分患者）有明显差异（P〈0．05）。结论：与头颅CTA对比检查,彩色多普勒具有直接、准确、方便及可重复性等优点,可有效的诊断后循环缺血症状。     

应用多普勒检测糖尿病患者颈动脉粥样硬化斑块并分析其与hs-CRP、HCY的关系

目的:探讨糖尿病患者血C反应蛋白(hs-CRP)、同型半胱氨酸(HCY)蛋白与颈动脉粥样硬化的关系.方法:收集58例糖尿病患者和42例体检正常者血浆,测定血hs-CRP、HCY蛋白水平,应用多普勒超声诊断仪检测颈动脉内膜、中层厚度(MT),观察颈动脉粥样斑块,并分析hs-CRP、HCY蛋白水平与颈动脉粥样硬化的关系.结果:糖尿病患者血hs-CRP、HCY含量、颈动脉MT和粥样斑块数较对照组明显增加(P<0.05);血hs-CRP、HCY水平与颈动脉MT及斑块数分别呈正相关(P<0.01).结论:hs-CRP、HCY可能在促进糖尿病及动脉粥样硬化的发生和发展中发挥了重要作用.可作为判断糖尿病患者病情程度和预后的评价指标.     

颈动脉粥样硬化斑块发生的危险因素及与脑梗死的关系

目的:研究颈动脉粥样硬化斑块发生的危险因素及与脑梗死的关系。方法:选取2013年7月到2014年7月我院收治的脑梗死患者120例(研究组),另选取非脑梗死患者或者健康体检者120例(对照组),对所有入选者实施颈部血管超声检查,并检测其血糖、血浆纤维蛋白原和血脂,比较两组颈动脉粥样硬化斑块的数目、部位、颈动脉内径并分析脑梗死危险因素。结果:研究组斑块检出率和斑块数显著高于对照组,两组比较差异具有统计学意义(P0.05);颈总动脉内径显著小于对照组,两组比较差异具有统计学意义(P0.05);斑块存在于颈总动脉者最多,且与脑梗死部位存在同侧相关性(P0.05);研究组年龄、高血压、糖尿病和血脂、纤维蛋白原(FIB)也显著高于对照组,两组比较差异具有统计学意义(P0.05)。结论:颈动脉粥样硬化斑块发生和脑梗死存在密切关系,年龄、糖尿病、高血压、FIB和血脂均是其危险因素。     

老年无症状性脑梗死患者颈动脉粥样硬化以及血清微量元素水平的改变

目的:研究老年无症状性脑梗死患者颈动脉粥样硬化以及血清微量元素水平的改变情况。方法:选取2014年1月至2015年6月在我院体检的无症状脑梗死患者78例为观察组和健康人群78例为对照组,分析两组患者的血清中微量元素、同型半胱氨酸水平(Hcy)和颈动脉粥样硬化状况。结果:经过超声检验发现,观察组患者中发现颈动脉粥样斑块的患者41例,无斑块患者37例,对照组人群78例中发现斑块的患者为21例,无斑块患者57例。根据检测结果显示,观察组的Hcy含量高于对照组,血清中的微量元素含量Zn~(2+),Mg~(2+),Cu~(2+),Pb~(2+)的含量观察组显著低于对照组,Ca~(2+),Fe~(2+),Cr~(2+)含量显著高于对照组。差异具有显著性(P0.05)。结论:人体内锌、铜、铅、镁这几种微量元素的含量与颈动脉粥样硬化与老年无症状性脑梗死的发生率呈负相关,血清内同型半胱氨酸水平(Hcy)的含量、铁、钙、铬元素的含量与颈动脉粥样硬化与老年无症状性脑梗死发生率呈正相关。     

彩色多普勒超声对青少年椎动脉型颈椎病的诊断价值

目的:探讨彩色多普勒超声对青少年椎动脉型颈椎病的诊断价值。方法:选择我院2012年2月-2016年1月收治的80例青少年椎动脉型颈椎病患者作为研究组,选择同期100例门诊体检同龄健康者作为对照组,使用Acuson Sequoia 512以及HDI5000彩色多普勒超声仪进行检查,观察两组椎动脉和颈外动脉血流指标,记录椎间段血流参数:包括舒张末流速(EVD)、收缩期峰值流速(PSV)、血流量(Q)和阻力指数(RI)。结果:实验组椎动脉内径、EDV、PSV和血流量(Q)比对照组低(P0.05),实验组阻力指数(RI)比对照组高(P0.05)。结论:彩色多普勒超声对青少年椎动脉型颈椎病患者的血流相关指数检查对该病的诊断具有明显作用,适合在临床上推广应用。     

MRI对糖尿病急性脑梗死患者颈动脉粥样硬化斑块稳定性的评估价值

目的:探讨核磁共振成像(MRI)对急性脑梗死合并糖尿病患者颈动脉粥样硬化斑块稳定性的评估价值。方法:选取2013年5月-2015年5月在我院接受治疗的83例糖尿病合并急性脑梗死患者作为研究组,另选择单纯急性脑梗死患者61例作为对照组。两组患者均采用MRI评估颈动脉血管及斑块稳定性,并分析影响颈动脉斑块稳定性的危险因素。结果:研究组患者颈动脉粥样硬化易损斑块的发生率高于对照组,差异具有统计学意义(P0.05);研究组患者斑块最大厚度明显高于对照组,差异具有统计学意义(P0.05);两组患者血管总面积、血管壁面积、血管腔面积及血管壁标准化指数比较,差异均无统计学意义(P0.05)。性别、糖尿病以及饮酒是影响急性脑梗死患者颈动脉斑块稳定性的独立危险因素(P0.05)。结论:MRI能够有效评估急性脑梗死患者颈动脉粥样硬化斑块的稳定性,有利于临床诊断以及确定治疗方案,值得推广应用。     

阿托伐他汀联合普罗布考对动脉硬化家兔血流及斑块影响

目的:探讨阿托伐他汀钙片联合普罗布考治疗对兔颈动脉斑块稳定性的影响及血液流场改变。方法:选取清洁级日本大耳白兔40只,随机分为正常组、模型组、实验组、对照组,每组10只,复制颈动脉粥样硬化模型。对照组按照阿托伐他汀钙10 mg/(kg·d)的剂量,给兔按照不同体重予以不同药量治疗,将药物以生理盐水稀释至5 mL灌胃,实验组在对照组基础上加用普罗布考片0.25 g/(kg·d),与阿托伐他汀钙一同以生理盐水稀释至5 mL灌胃,模型组及正常组予以5 mL生理盐水灌胃。干预持续4周。用动物超声影像系统对兔进行颈动脉超声检查,彩色多普勒血流显像及血管成像检测颈动脉狭窄程度,血流速度,血流动力学改变。结果:1治疗后实验组阿托伐他汀钙片联合普罗布考治疗对兔颈动脉内-中膜厚度、斑块面积与模型组相比均明显改善,稳定斑块数明显增加,与对照组比较,实验组改善明显,差异有统计学意义(P0.05);2正常组颈动脉正常,治疗后,实验组狭窄明显减轻,血流速度接近正常,对照组有所改善,模型组颈动脉狭窄程度最重,血流速度快,血流动力学发生改变,斑块不稳定性增加,差异有统计学意义(P0.05)。结论:阿托伐他汀钙片联合普罗布考治疗能够有效提高兔颈动脉粥样硬化斑块的稳定性,改善颈动脉狭窄,使血液流速接近正常水平,值得做进一步药理研究及深入探讨。     

六种藓类植物茎的比较解剖学研究

通过对6种藓类植物,即褶叶青藓(Brachythecium salebrosum(Web.et Mohr.)B.S.G.)、湿地匐灯藓(Plagiomnium acutum(Lindb.)Kop.)、侧枝匐灯藓(Plagiomnium maximoviczii(Lindb.)Kop.)、大凤尾藓(Fissidensnobilis Griff.)、大羽藓(Thuidium cymbifolium(Doz.et Molk.)B.S.G.)和大灰藓(Hypnum plumaeforme Wils.)嫩茎和老茎的石蜡切片和显微观察发现,同一藓类植株的嫩茎和老茎,茎结构稳定,不同种藓类植物茎横切面具有不同特征.植物体茎横切面形状、表层细胞的层数、细胞大小和细胞壁厚薄、皮层细胞大小和形状、中轴的有无以及比例等特征可以作为藓类植物的分科分类依据之一.     

Photoregulation of seed germination of wild-type and of an aurea-mutant of tomato

Seed germination of an aurea mutant of tomato ( Lycopersicon esculentum Mill.) is promoted by continuous irradiation with red, far-red or long-wavelength far-red (758 nm) light as well as by cyclic irradiations (5 min red or 5 min far-red/25 min darkness). Far-red light applied immediately after each red does not change the germination behaviour. Seed germination of the isogenic wild-type, cv. UC-105, is promoted by continuous and cyclic red light while it is inhibited by continuous and cyclic far-red light and by continious 758 nm irradiation. Far-red irradiation reverses almost completely the promoting effect of red light. The promoting effect (in the aurea mutant) and the inhibitory effect (in the wild-type) of continuous far-red light do not show photon fluence rate dependency above 20 nmol m⁻² s⁻¹. It is concluded that phytochrome controls tomato seed germination throgh low energy responses in both the wild type and the au mutant. The promoting effect of continuous and cyclic far-red light in the au mutant can be attributed to a greater sensitivity to P_fr.     

Interconnection of parameters of regulation system of lipid peroxidation and of morphophysiological parameters of mouse liver

A complex analysis of seasonal fluctuations of the mean group parameters of the system of regulation of lipid peroxidation has been performed in liver of Balb/c mice. Association of lipid characteristics and morphophysiological parameters is studied in the Balb/c mouse liver. An inter-connection is revealed between the liver index and the amount of lysoforms of phospholipids, the scale and character of the interconnection differing essentially depending on proportion of phos-phatidylcholine in mouse liver phospholipids.     

龙胆科药用植物化学成分的研究现状

龙胆科植物在我国的分布范围很广,且多数为药用植物,其多数种属的药用植物,至今其化学成分尚未被系统研究。综述了目前龙胆科药用植物的化学成分的研究现状及一般提取方法,对近年来发现的环烯醚萜及裂环烯醚萜类化合物进行了总结,为本科药用植物的更深入研究提供了参考。     

Physiological characteristics of various species of strains of carboxydobacteria

Seven strains of aerobic carbon monoxide-oxidizing bacteria (carboxydebacteria) when growing on CO as sole source of carbon and energy had doubling times which ranged from 12–42 h. The activity profiles obtained after discontinuous sucrose density gradient centrifugation indicated that the CO-oxidizing enzymes are soluble and the hydrogenases are membrane-bound in all strains examined. The CO-oxidizing enzymes of Pseudomonas carboxydohydrogena, Pseudomonas carboxydoflava, Comamonas compransoris, and the so far unidentified strains OM2, OM3, and OM4 had a molecular weight of 230,000; that of Achromobacter carboxydus amounted to 170,000. The molecular weights of the CO-oxidizing and H₂-oxidizing enzymes turned out to be identical. The cell sonicates were shown to catalyze the oxidation of both CO and H₂ with methylene blue, thionine, phenazine methosulfate, toluylene blue, dichlorophenolindophenol, cytochrome c or ferricyanide as electron acceptors. Methyl viologen, benzyl viologen, FAD⁺, FMN⁺, and NAD(P)⁺ were not reduced. The spectrum of electron acceptors was identical for all strains tested. Neither free formate, hydrogen nor oxygen gas were involved in the CO-oxidation reaction. Methylene blue was reduced by CO at a 1:1 molar ratio. The results indicate that CO-oxidation by carboxydobacteria is catalyzed by identical or similar enzymes and that the reaction obeys the equation CO+H₂OCO₂+2H⁺+2e^- as previously shown for Pseudomonas carboxydovorans.Dedicated to Otto Kandler remembering almost three decades of enjoyable cooperation     

Modulation of allostery of pyruvate kinase by shifting of an ensemble of microstates

Since the introduction of the concepts of allostery about four decades ago, much advancement has been made in elucidating the structure-function correlation in allostery. However, there are still a number of issues that remain unresolved. In this review we used mammalian pyruvate kinase (PK) as a model system to understand the role of protein dynamics in modulating cooperativity. PK has a triosephosphate isomerase (TIM)(α/β)₈ barrel structural motif. PK is an ideal system to address basic questions regarding regulatory mechanisms about this common (α/β)₈ structural motif. The simplest model accounting for all of the solution thermodynamic and kinetic data on ligand-enzyme interactions involves two conformational states, inactive E^T and active E^R. These conformational states are represented by domain movements. Further studies provide the first evidence for a differential effect of ligand binding on the dynamics of the structural elements, not major secondary structural changes. These data are consistent with our model that allosteric regulation of PK is the consequence of perturbation of the distribution of an ensemble of states in which the inactive E^T and active E^R represent the two extreme end states. Sequence differences and ligands can modulate the distribution of states leading to alterations of functions. The future work includes: defining the network of functionally connected residues; elucidating the chemical principles governing the sequence differences which affect functions; and probing the nature of mutations on the stability of the secondary structural elements, which in turn modulate allostery.     

（鱼句）亚科花（鱼骨）型鱼类骨骼系统的比较

对我国花型Hemibarbuspattern鱼类作了骨骼系统比较,结果表明,此类型鱼类脑颅较长,副蝶骨平直或稍弯曲,眶蝶骨腹纵嵴发达(铜鱼Coreius septentrionalis例外),下颞窝和咽突中等大,基枕骨后突发达;脑颅中的上筛骨的后突、侧筛骨的外筛突,蝶耳骨的外突、上耳骨的后突、围眶骨和后颞窝等均有明显的差异;咽颅中的舌颌骨、尾舌骨、鳃盖骨和下咽齿的列数等又有显著的区别;附肢骨骼中的腰带骨、脊椎骨中的复合神经骨和第4椎骨腹侧的悬器等也有不同之处。据此,这些差异和区别可作为属间或种间的分类依据。     

真菌类遗传学分析的知识结构教学

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