DTI评价猪急性心肌梗死再灌注治疗的实验研究

目的:探讨应用多普勒组织运动成像技术(DTI,Dopplar Tissue Motion Imaging)评价实验猪心肌梗死再灌注治疗后左室功能变化的价值。方法:取试验用家猪24头,随机分成2组,A组(10头)B组(14头)。A组作为对照组,未做任何处置,只是在相应时间点获取数据。B组实验猪经开胸,于前降支起始1 cm处,放置特制银夹,可以缓慢夹闭前降支血管,银夹自放置至完全闭合需6小时,9小时后再次开胸,取出银夹,进行心肌再灌注。A组与B组夹闭前、夹闭后6小时造影检查确定前降支完全闭塞、9小时闭塞状态取出银夹、12小时再灌注3小时进行常规超声心动图检查和DTI,获取对照组和模型组夹闭前、夹闭后6小时、9小时、12小时的左室舒张末期内径Edd(Left Ventricular End Diastolic Diameter)、收缩末期内径Esd(Left Ventricular End Systolic Diameter)、每搏输出量SV(cardiac stroke volume)、射血分数EF(ejection fraction)、短轴缩短率Fs(Fraction Shortening);舒张期二尖瓣前向血流频谱E峰、A峰、E/A等常规参数。转TVI(Tissue Velocity Imaging)模式下DTI测量二尖瓣环组织运动参数:收缩期峰值速度Sa、舒张早期峰值速度Ea、舒张晚期峰值速度Aa、及Ea/Aa。结果:1).B组实验猪在夹闭6小时、9小时、12小时DTI所测数据Sa峰值变化比常规数据变化明显(P0.01)2)。DTI所测数据Ea、Aa、Ea/Aa变化较舒张期二尖瓣前向血流数据E峰、A峰、E/A变化出现早。3).病理显示夹闭9小时时前壁心肌出现坏死,心肌细胞被破坏及炎细胞浸润。结论:DTI可以准确及时评价实验猪急性心肌梗死再灌注治疗左室功能的变化。     

无创性颈动脉瞬时减速度波强测定评价左心室舒张功能的研究

目的：探讨无创检测心功能的指标—颈动脉瞬时减速度波强（W2）评价左心室舒张功能的价值。方法：测量40例高血压病患者和43例健康对照者的左、右侧颈总动脉W2,组织多普勒测定二尖瓣环运动速度和血清脑利钠肽前体（N-terminal probrain natriuretic peptide,NT-proBNP）,分析W2与各参数间的相关性。结果：①高血压组W2低于对照组,以左侧明显（1126±996vs1690±1126 mmHg.m/s3,P〈0.01）;②高血压组与对照组比较：E/Em（二尖瓣舒张早期峰值速度/二尖瓣环舒张早期纵向运动峰值速度）增大（9.37±3.32vs7.39±1.83,P〈0.01）,NT-proB-NP升高（94.6±48.5vs45.2±13.8,P〈0.01）;③相关性分析：W2与E/Em负相关（r=-0.46,P〈0.05）,与NT-proBNP负相关（r=-0.21,P〈0.05）。结论：无创性评价血流动力学的新技术指标W2是反映早期左室舒张功能受损的敏感指标。     

超声心动图对缺血性二尖瓣反流血流动力学的研究

目的:应用超声心动图研究缺血性二尖瓣反流(IMR)所致左室、二尖瓣环动力学变化。方法:超声心动图检测86例缺血性二尖瓣反流患者(前壁心肌梗死49例,下壁心肌梗死37例)和30例正常人的心脏,测量左室参数及二尖瓣环形态参数。结果:IMR组左室EDV、ESV增加,LVEF减低,但与对照组无显著差异;二尖瓣环面积及位移与对照组有显著差异;不同部位心肌梗死均发生明显左室重构;下壁梗死组PPM-AMP明显延长。结论:超声心动图作为心肌梗死患者的常规检查,可以针对不同患者进行不同的参数检查,这也为临床医生选择个性化治疗方案和疗效评价提供了依据。     

组织运动二尖瓣环位移技术评价缺血性二尖瓣反流

目的:探讨缺血性二尖瓣反流与二尖瓣环位移的关系。方法:2011年1月至2012年12月前壁或下壁心肌梗死的患者107人和40名健康志愿者,分为反流组和无反流组。应用超声心动图组织运动二尖瓣环位移技术检测他们的左室射血分数、二尖瓣环最大位移、二尖瓣环中点位移及其占左室长径百分比。结果:反流组与无反流组二尖瓣环位移测值均低于对照组,差别有统计学意义(P0.05)。前壁心梗反流组和下壁心梗反流组二尖瓣环最大位移较相应的无反流组减低,差别有统计学意义(P0.05);二尖瓣环前壁-下壁中点位移及其所占左室长径百分比减少,与无反流组相比差别有统计学意义(P0.01)。结论:应用二尖瓣环运动自动追踪技术能够更准确地测量二尖瓣环运动,可以用来评价缺血性二尖瓣反流,为定量分析左心功能提供了新的检查方法。     

定量组织速度成像预测心肌梗死PCI 术后心功能不全的研究

目的:应用定量组织速度成像技术(QTVI)检测经皮冠状动脉介入治疗(PCI)后的ST段抬高的急性心肌梗死(STEMI)患者左心室收缩功能的改变;评价QTVI指标对该类患者未来发生心力衰竭的预测价值。方法:选择行急诊PCI术治疗的冠状动脉单支病变的急性心肌梗死患者,术后一周测量患者的左心室射血分数(LVEF),LVEF<50%者排除,LVEF≥50%者入选。共38例。并设正常对照组30例。入选者继续测二尖瓣环室间隔侧和左室侧壁侧QTVI曲线上心室收缩期速度峰值(Sa),并计算左室平均收缩期速度峰值(mean Sa)。术后12个月随访,查LVEF。结果:PCI术12个月后有17位患者LEVF<50%,21位患者LEVF≥50%。入选的STEMI者术后7天的左室平均Sa波峰值低于正常对照组。术后12个月出现LVEF减低(<50%)的患者,其术后7天的左室平均Sa波峰值低于PCI术12个月后LVEF正常的患者(P<0.01)。结论:通过QTVI检测二尖瓣环的运动速度能够早期发现单支病变所致的急性心肌梗死患者在急诊PCI术后的左心室功能受损;PCI术后LVEF正常的STEMI患者,术后7天QTVI测得的左室平均Sa波峰值减低可能预示着将来发展为LVEF减低的左心室收缩功能不全。     

不同三尖瓣成形术治疗风湿性二尖瓣病变合并三尖瓣关闭不全临床研究

目的:比较行不同成形术治疗风湿性二尖瓣病变合并功能性三尖瓣关闭不全的外科疗效。方法:选取风湿性二尖瓣病变合并功能性三尖瓣关闭不全患者119例,按照治疗方法将患者分为对照组、三尖瓣人工环植入成形术组(成形环组)以及三尖瓣缝线成形术(缝线组),分别统计患者年龄、性别、手术方式、术前及术后心功能分级等指标,采用t检验对患者术前、术后2周以及术后6个月心脏各腔内径进行统计学分析。结果:患者行三尖瓣人工环植入成形术以及三尖瓣缝线成形术治疗后,心脏各腔内径均明显缩小,成形环组患者术后心脏内径缩小最显著,行三尖瓣缝线成形术患者次之。术前成形环组左心房、右心房以及右心室内径较对照组扩大明显(P0.05);术前缝线组左心房、右心房以及右心室内径较对照组扩大明显(P0.05);术前成形环组与缝线组右心房、右心室内径组间无明显差异;术后2周以及术后6个月三组间左心房内径无明显差异(P0.05)。术后2周成形环组以及缝线组右心房以及右心室内径仍大于对照组(P0.05),术前成形环组与缝线组组间无显著差异。术后6个月成形环组右心房以及右心室内径较缝线组显著缩小(P0.05),成形环组和对照组间无明显差异。结论:治疗风湿性二尖瓣病变合并功能性三尖瓣关闭不全的方法中,三尖瓣人工环植入成形术效果优于三尖瓣缝线环缩术。     

RT-3DE 评估急性心梗PCI术后左室收缩功能及同步性的临床价值

目的:探讨实时三维超声心动图技术(realtime three dimensional echocardiography,RT-3DE)对评价急性心肌梗死(acute myocardial infarction,AMI)经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)术后左室收缩功能及同步性的临床应用价值。方法:选择30例左室急性前壁及前间壁心梗并进行急诊PCI术的患者和30例正常对照组,应用Philips IE33彩色多普勒超声成像仪对PCI术前及术后1个月的左心室功能指标进行二维常规超声检查及三维超声心动图检查,应用Q-lab6.0软件进行分析。结果:二维超声心动图显示AMI组术前左心室收缩末容量(ESV)及舒张末容量(EDV)较对照组比较明显增大(P0.01),左心室射血分数(EF)较对照组明显减小(P0.01);急性心肌梗死(AMI)组术后1个月左心室ESV及EDV较术前比较减小(P0.05),左心室EF较术前增大(P0.05);AMI组术后1个月左心室ESV及EDV较对照组比较增大(P0.05),左心室EF较对照组减小(P0.05);三维超声心动图的各参数比较,AMI组PCI术前梗死节段局部收缩末期容量(RESV)及局部舒张末期容量(REDV)较对照组增大(P0.05),左心室梗死节段局部射血分数(REF)较对照组减小(P0.05);AMI组患者梗死节段RESV及REDV术后1个月较术前比较减小(P0.05),梗死节段REF较术前比较有所增大(P0.05),AMI组术后1个月梗死节段RESV及REDV较对照组增大(P0.05),梗死节段REF较对照组减小(P0.05);左室16节段从QRS波起点到最小收缩容积时间的标准差和最大差值(Tmsvl6-SD、Tmsvl6-Dif)以及用R-R间期校正后的Tmsvl6-SD%(左室收缩不同步指数systolic dyssynchrony index,SDI)和Tmsvl6-Dif%较术前比较减小(p0.05)。结论:PCI手术前、后应用RT-3DE能够准确评价左心室17节段的局部收缩功能及运动同步性,对AMI患者心功能的研究具有重要意义。     

TDI技术评估妊高症患者左室舒张功能的临床价值分析

为探讨组织多普勒成像技术(TDI)在评估妊高症患者左室舒张功能上的临床价值,选取我院确诊的妊高症患者80例(妊高症组)、同期正常妊娠妇女80例作为对照组,收集时间2016年1月至2016年12月,采用TDI技术测量两组妊娠妇女左室舒张早期血流峰值流速(E峰)、舒张晚期血流峰值流速(A峰)、收缩期左心房面积(LAA)、左室舒张末期内径(LVDd)、二尖瓣环舒张早期运动速度(Ea)、二尖瓣环舒张晚期运动速度(Aa)并进行比较。结果显示,妊高症组妇女的A峰、LAA、LVDd、Aa测定值均显著的高于对照组妊娠妇女(p0.05),妊高症组妇女的E峰、E/A、Ea值小于对照组妇女(p0.05);轻度子痫组妇女的A峰、LAA、LVDd、Aa测定值均显著的高于妊娠高血压组妇女(p0.05),轻度子痫妇女的E峰、Ea值小于对照组妇女(p0.05),轻度子痫和妊娠高血压妇女的E/A值之间无统计学意义(p0.05)。妊高症妇女左室舒张功能受损较正常妊娠妇女明显,并且病情加重会进一步损害患者左室舒张功能,TDI技术可以有效的检查出患者的心功能受损情况。     

雷珠单抗玻璃体内注射对早产儿视网膜病变患儿临床疗效及视网膜功能发育的影响

目的:探讨雷珠单抗玻璃体内注射对早产儿视网膜病变(ROP)患儿临床疗效及视网膜功能发育的影响。方法:收集2014年6月～2018年6月我院收治的80例ROP患儿,随机分为对照组和观察组各40例,对照组患儿采用激光治疗方案,观察组患儿采用雷珠单抗玻璃体内注射治疗方案。比较治疗后两组疗效和复发情况;随访6个月,采用闪光视网膜电图(F-ERG)检查治疗后视网膜功能的发育状况。结果:治疗后,观察组病变控制率明显高于对照组,病变进展率和复发率明显低于对照组(P0.05);F-ERG检查结果显示,对照组视杆细胞系统反应振幅较观察组明显降低,潜伏期较观察组明显延长,最大混合反应a、b波振幅明显低于观察组(P0.05);两组间最大混合反应波振幅比值b/a、潜伏期比较差异无统计学意义(P0.05)。两组间视锥细胞反应a波潜伏期及a、b波振幅比较差异无统计学意义(P0.05);对照组视锥细胞反应b波潜伏期明显比观察组延长,震荡电位(Ops)比观察组明显降低(P0.05)。结论:雷珠单抗玻璃体内注射治疗ROP患儿,疗效确切,操作简单且快速,视网膜功能的发育比激光治疗更趋向正常,适用于ROP患儿。     

妊高症患者心功能损伤程度与血浆NT-proBNP水平的相关性

采用组织多普勒成像技术(TDI)评估妊高症患者心脏功能损伤情况,并探讨该病患者心功能损伤程度与血浆NT-proBNP水平之间的关系。选取2015年1月至2016年12月本院确诊的妊娠高血压患者114例(妊高症组)、同期正常妊娠妇女80例(对照组),采用TDI技术测量两组妊娠妇女左室舒张末期内径(LVDd)、左室射血分数(LVEF)、心肌收缩峰值速度(Vs)、心肌舒张早期峰值速度(VE)、心肌舒张晚期峰值速度(VA)、二尖瓣环舒张早期运动速度(Ea)、二尖瓣环舒张晚期运动速度(Aa)并进行比较,探讨上述指标与患者血浆NT-proBNP的关系。结果显示,与对照组比较,妊高症组的LVDd、Aa值均明显升高(p0.05);妊高症组的LVEF、Vs、VE、VA、Ea、Ea/Aa值均明显降低(p0.05);与妊娠期高血压、轻度子痫组比较,重度子痫患者的LVDd、Aa值均明显升高(p0.05);重度子痫患者的LVEF、Vs、VE、VA、Ea、Ea/Aa值均明显降低(p0.05);与妊娠期高血压组比较,轻度子痫组的VE、Ea、Ea/Aa值均明显降低(p0.05);妊高症患者血浆NT-proBNP水平与LVDd值呈正相关关系(p0.05),妊高症患者的血浆NT-proBNP水平与LVEF、Vs、VE、VA、Ea、Ea/Aa则呈负相关关系(p0.05)。不同分期妊娠高血压患者心功能损伤存在差异,其中以舒张功能损伤较明显,并且与血浆NT-proBNP水平呈相关性。     

枇杷花茶水提物的镇咳、抗炎与抗氧化作用研究

采用小鼠氨水致咳法研究枇杷花茶水提物镇咳效果,以二甲苯致小鼠耳肿胀法研究其抗炎效果,并从枇杷花茶的还原能力及对超氧阴离子和羟自由基的清除作用分析枇杷花茶水提物的抗氧化效果。结果表明,枇杷花茶的水提物高剂量组(3000 mg·kg-1)、低剂量组(700 mg·kg-1)均有镇咳抗炎效果,水提物的浓度越高,效果越好。各浓度枇杷花茶水提物均表现出一定的还原能力,对于羟基自由基和超氧阴离子都有一定的清除效果。其中,20 mg·mL-1水提物还原效果最好(吸光值0.903),超过0.2 mg·mL-1抗坏血酸(吸光值0.814);10 mg·mL-1的水提物对超氧阴离子的清除率为47.32%;20 mg·mL-1水提物对于羟基自由基的清除效果非常明显,清除率为91.62%。枇杷花茶水提物镇咳、抗炎、抗氧化效果明显。     

Systematic analysis of residual density suggests that a major limitation in well‐refined X‐ray structures of proteins is the omission of ordered solvent

In the residual electron density map of a fully refined X‐ray protein model, there should be no peaks arising from modeling errors or missing atoms. Any residual peaks that do occur should be contributed by random residual intensity differences between the model and the data. If the model is incomplete (i.e., some atoms are missing), there will be more positive peaks than negative ones. On the other hand, if the model includes inappropriately located atoms, there will be an excess of negative peaks. In this study, random residual peaks are quantified using the probability density function P(x), which is defined as the probability for a peak having peak height between x and x + dx. It is found that P(x) is single‐exponential and symmetric for both positive and negative peaks. Thus, P(x) can be used to discriminate residual peaks contributed by random noise in complete models from residual peaks being attributable to modeling errors in incomplete models. For a number of representative structures in the PDB it is found that P(x) has far more large (greater than 5 sigma) positive peaks than large negative peaks. This excess of large positive peaks suggests that the main defect in these refined structures is the omission of ordered water molecules.     

Flavonoids and cognitive function: a review of human randomized controlled trial studies and recommendations for future studies

Evidence in support of the neuroprotective effects of flavonoids has increased significantly in recent years, although to date much of this evidence has emerged from animal rather than human studies. Nonetheless, with a view to making recommendations for future good practice, we review 15 existing human dietary intervention studies that have examined the effects of particular types of flavonoid on cognitive performance. The studies employed a total of 55 different cognitive tests covering a broad range of cognitive domains. Most studies incorporated at least one measure of executive function/working memory, with nine reporting significant improvements in performance as a function of flavonoid supplementation compared to a control group. However, some domains were overlooked completely (e.g. implicit memory, prospective memory), and for the most part there was little consistency in terms of the particular cognitive tests used making across study comparisons difficult. Furthermore, there was some confusion concerning what aspects of cognitive function particular tests were actually measuring. Overall, while initial results are encouraging, future studies need to pay careful attention when selecting cognitive measures, especially in terms of ensuring that tasks are actually sensitive enough to detect treatment effects.     

A sequence-coupled vector-projection model for predicting the specificity of GalNAc-transferase.

The specificity of GalNAc-transferase is consistent with the existence of an extended site composed of nine subsites, denoted by R4, R3, R2, R1, R0, R1', R2', R3', and R4', where the acceptor at R0 is either Ser or Thr to which the reducing monosaccharide is being anchored. To predict whether a peptide will react with the enzyme to form a Ser- or Thr-conjugated glycopeptide, a new method has been proposed based on the vector-projection approach as well as the sequence-coupled principle. By incorporating the sequence-coupled effect among the subsites, the interaction mechanism among subsites during glycosylation can be reflected and, by using the vector projection approach, arbitrary assignment for insufficient experimental data can be avoided. The very high ratio of correct predictions versus total predictions for the data in both the training and the testing sets indicates that the method is self-consistent and efficient. It provides a rapid means for predicting O-glycosylation and designing effective inhibitors of GalNAc-transferase, which might be useful for targeting drugs to specific sites in the body and for enzyme replacement therapy for the treatment of genetic disorders.     

A method for assessing recovery of fine motor function of the hand in a rhesus monkey model of cortical injury: an adaptation of the Fugl–Meyer Scale and Eshkol–Wachman Movement Notation

Motor dysfunction of the upper extremity can result from stroke, cortical injury and neurological diseases and causes significant disruption of activities of daily living. While some spontaneous recovery in terms of compensatory movements does occur after injury to cortical motor areas, full recovery is rare. The distinction between complete recovery and compensatory recovery is important as the development of compensatory movements in the upper extremity may not translate into full functional use in human patients. However, current animal models of stroke do not distinguish full recovery from compensatory recovery. We have developed a Non-Human Primate Grasp Assessment Scale (GRAS) to quantify the precise recovery of composite movement, individual digit action, and finger-thumb pinch in our rhesus monkey model of cortical injury. To date, we have applied this GRAS scale to assess the recovery of fine motor function of the hand in young control and cell-therapy treated monkeys with cortical injury confined to the hand representation in the dominant primary motor cortex. We have demonstrated that with this scale we can detect and quantify significant impairments in fine motor function of the hand, the development of compensatory function during recovery and finally a return to full fine motor function of the hand in monkeys treated with a cell therapy.     

北京市老年人肝肾功能参数的参考值范围调查

目的:观察北京市60岁以上不同年龄段健康老年人肝肾功能检验项目水平的差异,建立各自的参考值范围。方法:随机挑选600例60岁以上的北京市健康老人,按照不同年龄段分为三组,空腹采血,采用Modular仪器及原装试剂测定血清ALT(丙氨酸氨基转移酶)、AST(天冬氨酸氨基转移酶)、TP(总蛋白)、ALB(白蛋白)、Bun(尿素氮)、Crea(肌酐)、UA(尿酸)水平,结果利用SPSS11.0进行统计分析,根据统计学结果,判断参考值范围,并比较不同组间水平的差异。同时随机选择371例健康青年,与老年组进行这些项目水平的比较。结果:统计学结果显示,AST、TP、UA组间无显著差异;ALT、ALB随年龄增加而下降;Bun、Crea随年龄增加而升高。结论:通过上述实验,对老年人群的ALT、AST、TP、ALB、Bun、Crea、UA等项目的参考区间进行初步分析,对现行参考区间的设定提供建议与参考。各实验室应建立自己的参考值范围。     

北京市老年人肝肾功能参数的参考值范围调查

目的：观察北京市60岁以上不同年龄段健康老年人肝肾功能检验项目水平的差异,建立各自的参考值范围。方法：随机挑选600例60岁以上的北京市健康老人,按照不同年龄段分为三组,空腹采血,采用Modular仪器及原装试剂测定血清ALT（丙氨酸氨基转移酶）、AST（天冬氨酸氨基转移酶）、TP（总蛋白）、ALB（白蛋白）、Bun（尿素氮）、Crea（肌酐）、UA（尿酸）水平,结果利用SPSS11.0进行统计分析,根据统计学结果,判断参考值范围,并比较不同组间水平的差异。同时随机选择371例健康青年,与老年组进行这些项目水平的比较。结果：统计学结果显示,AST、TP、UA组间无显著差异;ALT、ALB随年龄增加而下降;Bun、Crea随年龄增加而升高。结论：通过上述实验,对老年人群的ALT、AST、TP、ALB、Bun、Crea、UA等项目的参考区间进行初步分析,对现行参考区间的设定提供建议与参考。各实验室应建立自己的参考值范围。     

Etiological Theories of Function: A Geographical Survey

Formulations of the essential commitment of the etiological theory of functions have varied significantly, with some individual authors' formulations even varying from one place to another. The logical geography of these various formulations is different from what is standardly assumed; for they are not stylistic variants of the same essential commitment, but stylistic variants of two non-equivalent versions of the etiological theory. I distinguish these strong and weak versions of the etiological theory (which differ with respect to the role of selection in their definitions of function), draw out their respective implications, and argue that the weak version is to be preferred to the strong.     

不同健康状况百岁老人肠道菌群的差异性

探索广西不同健康状况百岁老人肠道菌群的特征。

采用1∶1病例对照研究方法,在广西长寿地区按年龄收集不同健康状况的21对百岁老人粪便和血样标本,同时收集个体一般信息和食物摄入信息;使用标准量表测量身体机能和认知功能（MMSE）,测定血生化指标,采用16S rRNA的V4–V5区序列进行高通量测序分析肠道菌群的差异。

非健康组百岁老人较健康组百岁老人肠道菌群丰度和多样性显著降低（t = 3.987、4.000、3.703,均P＜0.001）;健康组百岁老人肠道菌群中蓝藻菌门（Cyanobacteria）、黏胶球形菌门（Lentisphaerae）丰度显著高于非健康组,拟杆菌门（Bacteroidetes）丰度显著低于非健康组;健康组百岁老人肠道菌群中别样杆菌属（Alistipes）、瘤胃球菌属（Ruminococcus）、气味细菌属（Odoribacter）、厌氧菌属（Anaerotruncus）、丁酸单胞菌属（Butyricimonas）丰度显著高于非健康组;非健康组百岁老人肠道菌群中拟杆菌纲（Bacteroidia）、拟杆菌目（Bacteroidales）、拟杆菌种（Bacteroides coprophius）丰度显著高于健康组;非健康组百岁老人身体机能、MMSE评分显著降低（t = 2.775、2.058,P = 0.008、0.046）。

广西不同健康状况百岁老人肠道菌群丰度和多样性具有显著特征,健康状况良好的百岁老人可能具有更好的肠道菌群构成。