氦氖激光治疗脑梗死患者对血液流变学、血清神经元特异性稀醇化酶的影响

目的：观察氦氖激光血管内照射(ILIB)治疗脑梗死患者对血液流交学、血清神经元特异性稀醇化酶(NSK)的影响。方法：38例脑梗死随机分为两组：ILIB组21例，对照组17例，两组均在基础治疗下，ILIB组加用ILIB治疗，对照组不用ILIB。治疗后第3天和第14天检测血液流变学、血清NSE浓度，并行神经功能缺损的评定。结果：两组同步治疗后血液流变学指标除红细胞体积分数外，其余4项指标均有下降，但两组治疗后比较，ILIB组较对照组下降更显著，差异有显著性；血清NSK浓度与神经功能缺损评定，治疗后两组均有下降，但ILIB组下降也更显著，差异有显著性。结论：ILIB可改善脑梗死患者血液流变学情况，且可降低血清NSK浓度，有利于促进神经功能恢复。     

血浆同型半胱氨酸水平与不同亚型脑梗死关系的研究

目的探讨血浆同型半胱氨酸（homocysteine HCY）水平与TOAST分型不同亚型脑梗死的关系及在诊疗中的意义.方法收集大动脉粥样硬化脑梗死（large artery arterioslerosis LAA）、心源性脑栓塞（cardiac embolismCE）、小动脉闭塞性脑梗死（smll artery occlusion SAO）3种不同亚型脑梗死患者共140例及健康对照组40例,采用ADVIA Centaur全自动免疫化学发光仪测定不同组血浆同型半胱氨酸水平,分析不同型脑梗死患者血浆同型半胱氨酸水平的差异.结果小动脉闭塞性脑梗死（SAO）组血浆同型半胱氨酸水平明显高于其他3组（P〈0.05）,大动脉粥样硬化脑梗死（LAA）、心源性脑栓塞（CE）之间血浆同型半胱氨酸水平无显著差异,3种亚型脑梗死组血浆同型半胱氨酸水平明显高于对照组（P〈0.05）.结论 HCY在脑梗死的发病机制中发挥着重要的作用,尤其是高HCY患者更易发生小动脉闭塞性脑梗死.     

清热化痰法治疗急性脑梗死后睡眠障碍的临床研究

目的 探讨清热化痰法治疗痰热上扰型急性脑梗死后睡眠障碍患者的临床疗效及其多导睡眠图的特点。方法 将144例痰热上扰型急性脑梗死后睡眠障碍患者随机分为中药组和西药组,每组72例。中药组服用黄连温胆汤,西药组服用佐匹克隆,采用《急性脑梗死后睡眠障碍中医证候评定表》和《匹兹堡睡眠质量指数量表》对观察指标评定,并对因子进行分析,同时进行多导睡眠监测,在治疗前、治疗结束后各进行1次测评。结果 两组患者治疗后睡眠质量指数积分、中医证候积分、多导睡眠参数均较治疗前改善,差异有统计学意义（P<0.05）,且中药组中医证候积分改善明显（P<0.01）,提示中药组治疗效果优于西药组。结论 黄连温胆汤可显著改善痰热内扰型急性脑梗死后睡眠障碍患者睡眠质量,疗效确切,不良反应发生率低。     

IMAGING DIAGNOSIS—MEDULLARY TIBIAL INFARCTION IN A HORSE

An Andalusian Stallion with left hind limb lameness had a radiolucent lesion in the medullary cavity of distal tibial metaphysis. After euthanasia for other disease, the tibia was examined with magnetic resonance (MR). The MR imaging sequences were characterized by a double line sign, although showing quite different lesion area intensities. Histologically, the lesion was compatible with medullary infarction being characterized by normal spongy bone, areas of abundant fibrous tissue and numerous necrotic adipocytes in various stages of destruction.     

Echocardiographic assessment of coronary artery flow in normal canines and model dogs with myocardial infarction

This study was conducted to evaluate the usefulness of coronary arterial profiles from normal dogs (11 animals) and canines (six dogs) with experimental myocardial infarction (MI) induced by ligation of the left coronary artery (LCA). Blood velocity of the LCA and right coronary artery (RCA) were evaluated following transthoracic pulsed-wave Doppler echocardiography. The LCA was observed as an infundibular shape, located adjacent to the sinus of Valsalva. The RCA appeared as a tubular structure located 12 o''clock relative to the aorta. In normal dogs, the LCA and RCA mean peak diastolic velocities were 20.84 ± 3.24 and 19.47 ± 2.67 cm/sec, respectively. The LCA and RCA mean diastolic deceleration times were 0.91 ± 0.14 sec and 1.13 ± 0.20 sec, respectively. In dogs with MI, the LCA had significantly (p < 0.01) lower peak velocities (14.82 ± 1.61 cm/sec) than the RCA (31.61 ± 2.34 cm/sec). The RCA had a significantly (p < 0.01) rapid diastolic deceleration time (0.71 ± 0.06 sec) than that found in the LCA (1.02 ± 0.22 sec) of MI dogs. In conclusion, these profiles may serve as a differential factor for evaluating cardiomyopathy in dogs.     

糖尿病并发急性心肌梗塞的临床研究

对１７例糖尿病并发急性心肌梗塞１７例非糖尿病的急性心肌塞患者作了配对比较研究。结果表明：糖尿病患者的无痛型心梗发生较多，心室晚电位检出阳性率明显和蔼同，超声心动图测定左室功能受损严重。提示糖尿病并发急性心肌梗塞有其临床特殊性，并作了讨论。     

Relationship between NLRP3 inflammasome-IL-1β axis and End-MT after acute myocardial infarction in rats

AIM: To investigate whether activation of NLRP3 inflammasome-IL-1β axis is consistent with endothelial-mesenchymal transition (End-MT) during the process of myocardial fibrosis after acute myocardial infarction (AMI). METHODS: Adult male SD rats (n=30) were randomly divided into sham operation group (n=15) and AMI group (n=15). After 28 d, Masson staining was used to detect the level of myocardial fibrosis. The activation of NLRP3 inflammasome including NLRP3, ASC, pro-caspase-1 and caspase-1, the endothelial cell markers CD31 and VE-cadherin, and the mesenchymal cell markers α-SMA and FSP1 were analyzed by Western blot. The expression of IL-1β was measured by ELISA. RESULTS: The levels of myocardial fibrosis and End-MT, the activation of NLRP3 inflammasome, and the expression of caspase-1 and IL-1β were significantly increased in AMI group compared with sham operation group (P<0.05). CONCLUSION: The activation of NLRP3 inflammasome-IL-1β axis is significantly consistent with End-MT process, suggesting that NLRP3 inflammasome-IL-1β, as a potential target for the activation of End-MT, will provide a novel theoretical target for the treatment of myocardial fibrosis and heart failure after AMI.     

MRI诊断脑干梗塞的临床价值（附71例报告）

本组７１例脑干梗塞患者均作ＭＲＩ检查，其中５４例为亚临床病变，其临床表现与ＭＲＩ所见的病灶不符，且５４例均在ＭＲＩ检查前误诊，误诊率为７９％（５４／７１），误诊病种达１２种，且尤以误诊为颈内动脉系统梗塞最多（３２例），同时发现一些单颅神经损害和所谓的“椎动脉供血不足”实为脑于梗塞所致。最后本文对上述情况进行讨论。