冠心病患者QT离散度与冠脉病变的关系及其干预治疗

目的:探讨冠心病患者QT离散度(QT dispersion,QTd)与冠状动脉(简称冠脉)病变狭窄程度及累及血管支数的关系,并观察冠心病合并糖尿病患者予以美托洛尔治疗后QTd的变化.方法:选择192例行冠状动脉造影且心电图资料完整者,据造影结果分为非冠心病组49例和冠心病组143例;冠心病组依冠脉病变支数分为单支病变组...     

小剂量多巴酚丁胺-异舒吉超声心动图负荷试验检测冠心病人存活心肌

目的探讨异舒吉(Isoket)对小剂量多巴酚丁胺超声负荷试验(LDDSE)的影响。方法研究对象39例依据冠脉造影的结果分为三组:对照组(CON)12例、冠心病1组(CAD1)15例和冠心病2组(CAD2)12例,其中CAD2行LDDSE Isoket,其余两组行LDDSE,以冠脉介入性治疗(PCI)后室壁运动改善的结果作为评价LDDSE的标准。结果Isoket可以明显增加心率,降低收缩压,但对舒张压影响轻微。CAD1组室壁运动双相反应的发生率为62.50%,存活心肌检出敏感性为61%,特异性为76%;CAD2组室壁运动双相反应的发生率为72.20%,存活心肌检出敏感性为82%,特异性为88%;CAD2组存活心肌的检出率和敏感性明显高于CAD1组。结论Isoket可提高LDDSE存活心肌检出率。     

小剂量多巴酚丁胺-异舒吉超声心动图负荷试验检测冠心病人存活心肌

目的探讨异舒吉(Isoket)对小剂量多巴酚丁胺超声负荷试验(LDDSE)的影响.方法研究对象39例依据冠脉造影的结果分为三组:对照组(CON)12例、冠心病1组(CAD1)15例和冠心病2组(CAD2)12例,其中CAD2行LDDSE+Isoket,其余两组行LDDSE,以冠脉介入性治疗(PCI)后室壁运动改善的结果作为评价LDDSE的标准.结果 Isoket可以明显增加心率,降低收缩压,但对舒张压影响轻微.CAD1组室壁运动双相反应的发生率为62.50%,存活心肌检出敏感性为61%,特异性为76%;CAD2组室壁运动双相反应的发生率为72.20%,存活心肌检出敏感性为82%,特异性为88%;CAD2组存活心肌的检出率和敏感性明显高于CAD1组.结论 Isoket可提高LDDSE存活心肌检出率.     

多层螺旋CT冠状动脉成像在冠心病中的应用

目的 探讨多层螺旋CT(MSCT)冠状动脉成像在冠心病诊断中的应用,分析影响其成像质量的因素.方法 采用MSCT对42例拟诊冠心病,4例冠状动脉支架术后1年患者行冠状动脉成像检查.将CT冠状动脉图像质量分级予以评价,分析其影响图像质量的因索.结果 图像质量优良率为83.3%(35/42).结论 MSCT冠状动脉成像是一种较可靠的冠状动脉评价方法,在冠心病诊断中有一定的应用价值.     

多层螺旋CT冠状动脉成像在冠心病中的应用

目的 探讨多层螺旋CT（MSCT）冠状动脉成像在冠心病诊断中的应用,分析影响其成像质量的因素。方法采用MSCT对42例拟诊冠心病,4例冠状动脉支架术后1年患者行冠状动脉成像检查。将CT冠状动脉图像质量分级予以评价,分析其影响图像质量的因素。结果图像质量优良率为83．3％（35／42）。结论MSET冠状动脉成像是一种较可靠的冠状动脉评价方法,在冠心病诊断中有一定的应用价值。     

川崎病冠脉损害患儿血脂水平变化及洛伐他汀的干预作用

目的探索川崎病出现冠脉损害的患儿血脂水平的变化,以及他汀类降脂药物对其干预作用。方法研究39例川崎病冠脉损伤患儿血脂水平变化。对血脂异常者随机分成治疗组和非洛伐他汀对照组。对照组常规治疗,治疗组在对照组基础上加用洛伐他汀一月后对比血脂水平。结果冠脉损害患儿血脂水平明显存在差异（P〈0．05）,洛伐他汀治疗后冠脉损害患儿血脂水平可显著改善（P〈0．05）。结论川崎病冠脉损害患儿普遍存在血脂水平紊乱,洛伐他汀可改善川崎病患儿血脂水平。     

Organ size is limited by the number of embryonic progenitor cells in the pancreas but not the liver

The determinants of vertebrate organ size are poorly understood, but the process is thought to depend heavily on growth factors and other environmental cues. In the blood and central nervous system, for example, organ mass is determined primarily by growth-factor-regulated cell proliferation and apoptosis to achieve a final target size. Here, we report that the size of the mouse pancreas is constrained by an intrinsic programme established early in development, one that is essentially not subject to growth compensation. Specifically, final pancreas size is limited by the size of the progenitor cell pool that is set aside in the developing pancreatic bud. By contrast, the size of the liver is not constrained by reductions in the progenitor cell pool. These findings show that progenitor cell number, independently of regulation by growth factors, can be a key determinant of organ size.     

Graves病患者血中细胞因子的变化

目的:探讨白细胞介素6(IL-6),干扰素γ(IFN-γ),肿瘤坏死因子α(TNF-α)在Graves病(GD)发病机制中的作用,寻找GD新的诊断指标.方法:用双抗体夹心ELISA法测定试验组68例GD患者和对照组29健康人IL-6、IFN-γ、TNF-α血中浓度,同时,用电化学发光法测定试验组和对照组成员促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺激素(FT4).结果:试验组GD患者血中浓度IL-6、IFN-γ、TNF-α均高于对照组(P＜0.05).FT3、FT4分别与IL-6、IFN-γ、TNF-α不相关(P＞0.05).结论:IL-6、IFN-γ、TNF-α参与了GD的发病,在GD发病机制中起重要的作用,在临床上似可作为诊断GD的参考指标.     

川崎病患儿血小板参数的变化与冠状动脉病变的关系

目的研究川崎病患儿血小板参数变化与冠状动脉病变的关系.方法用全自动血球计数仪测定34例川崎病患儿血小板参数及其动态变化.结果川崎病患儿首次测定的血小板计数(PLT)(598±128)×109/L显著高于正常对照组(P＜0.01),动态观察发现川崎病并发冠状动脉病变急性期血小板平均容积(MPV)明显高于无冠状动脉病变组(P＜0.01),治疗后PLT较未并发冠状动脉组升高(P＜0.01).结论血小板参数的动态测定有助于对川崎病患儿并发冠状动脉损伤的早期判断.     

川崎病患儿血小板参数的变化与冠状动脉病变的关系

目的研究川崎病患儿血小板参数变化与冠状动脉病变的关系.方法用全自动血球计数仪测定34例川崎病患儿血小板参数及其动态变化.结果川崎病患儿首次测定的血小板计数(PLT)(598±128)×109/L显著高于正常对照组(P＜0.01),动态观察发现:川崎病并发冠状动脉病变急性期血小板平均容积(MPV)明显高于无冠状动脉病变组(P＜0.01),治疗后PLT较未并发冠状动脉组升高(P＜0.01).结论血小板参数的动态测定有助于对川崎病患儿并发冠状动脉损伤的早期判断.     

川崎病患儿血小板参数的变化与冠状动脉病变的关系

目的研究川崎病患儿血小板参数变化与冠状动脉病变的关系。方法用全自动血球计数仪测定34例川崎病患儿血小板参数及其动态变化。结果川崎病患儿首次测定的血小板计数(PLT)(598±128)×109L/显著高于正常对照组(P<0.01),动态观察发现:川崎病并发冠状动脉病变急性期血小板平均容积(MPV)明显高于无冠状动脉病变组(P<0.01),治疗后PLT较未并发冠状动脉组升高(P<0.01)。结论血小板参数的动态测定有助于对川崎病患儿并发冠状动脉损伤的早期判断。     

冠心病合并2型糖尿病女性患者冠状动脉造影特点分析

目的分析冠心病合并2型糖尿病女性患者冠状动脉造影特点及临床危险因素,探讨糖尿病对冠状动脉病变的作用机制。方法将2005年11月～2008年11月在我院经冠状动脉造影确诊为冠心病的女性患者168例,按有无2型糖尿病（DM）分为糖尿病组（DM组）和非糖尿病组（nonDM组）,对其冠状动脉造影资料、危险因素进行分析研究。结果冠状动脉病变特点：冠状动脉受累血管及严重程度DM组比nonDM组显著高（P〈0．01）。临床危险因素：收缩压、舒张压、空腹血糖（FBG）、餐后2h血糖（2hBG）、糖化血红蛋白（GHbA。C）、总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL—C）、载脂蛋白B（ApoB）DM组比nonDM组高（P〈0．05）,且与冠状动脉狭窄程度呈正相关（P〈0．05）。高密度脂蛋白胆固醇（HDL—C）、载脂蛋白A1（Apo A1）DM组比nonDM组显著低（P〈0．01）,且与冠状动脉狭窄程度呈负相关（P〈0．05）。两组年龄、体重指数（BMI）差异无显著性（P〉0．05）。结论冠心病合并2型糖尿病女性患者冠状动脉病变程度重,除糖尿病外,常与高血压、高血脂等危险因素同时存在。     

ST/HR斜率与单光子发射计算机断层摄影术心肌灌液显像

分析了ST/HR斜率对冠心病(CHD)的诊断价值,应用ST/HR斜率计算机自动分析系统与运动介入单光子发射型计算机断层摄影术(SPECT)心肌显像同时进行,检测60例临床怀疑CHD患者,并对30例健康正常人进行了ST/HR斜率检测。结果表明:ST/HR斜率与SPECT心肌显像二者结果有良好的相关性(r=0.58,P<0.005),符合率为80%,SPECT阳性者其斜率值高于SPECT阴性者及正常人群(均P<0.05);若以SPECT为标准,ST/HR斜率与普通运动试验诊断CHD的敏感性分别为81.6%和73.9%(P>0.05),特异性分别为77.3%和45.5%(P<0.05),以正常人为ST/HR斜率与普通运动试验的特异性分别为93.3%和70.0%(P<0.05);SPECT显示2个以上节段心肌缺血者,其斜率值明显高于单一节段缺血者(P<0.05)。     

A common progenitor for haematopoietic and endothelial lineages in the zebrafish gastrula

It has been proposed that haematopoietic and endothelial cells share a common progenitor, termed the haemangioblast. This idea was initially conceived as a result of the observation that these two cell types develop in close proximity to each other within the embryo. Support for this hypothesis was provided by studies on single-cell-derived colonies that can produce both haematopoietic and endothelial cells in vitro. Although these data point towards the existence of a common progenitor for these two lineages, the presence of a bipotential progenitor cell has yet to be demonstrated in vivo. Through the construction of single-cell-resolution fate maps of the zebrafish late blastula and gastrula, we demonstrate that individual cells can give rise to both haematopoietic and endothelial cells. These bipotential progenitors arise along the entire extent of the ventral mesoderm and contribute solely to haematopoietic and endothelial cells. We also find that only a subset of haematopoietic and endothelial cells arise from haemangioblasts. The endothelial descendants of the haemangioblasts all clustered in a specific region of the axial vessels regardless of the location of their progenitors. Our results provide in vivo evidence supporting the existence of the haemangioblast and reveal distinct features of this cell population.     

Correlation between platelet gelsolin levels and different types of coronary heart disease

Gelsolin is an important cytoskeletal protein of platelets and studies have shown a close relationship between gelsolin and cardiovascular disease.However,the role of gelsolin in the development of coronary heart disease(CHD) is unclear.In this study,we record the distribution of gelsolin in human platelets and plasma and its association with different types of CHD.This study included 114 cases,with 33 stable angina pectoris(SAP) cases,81 acute coronary syndrome(ACS) cases—composed of 39 unstable angina pectoris(UAP) and 42 acute myocardial infarction(AMI) cases,and 31 healthy control participants.Gelsolin concentration in platelet rich plasma(PRP) and platelet poor plasma(PPP),actin filament(F-actin) and Gc-globulin of PPP were determined by enzyme-linked immunoadsorbent assay(ELISA).The fluorescence intensity of CD62p and cytoplasmic calcium([Ca2+] i) in human platelets measured by flow cytometry.We also used turbidimetry to detect the platelet aggregation rate(PAR).We analyzed the correlation between platelet gelsolin concentration and CD62p or plasma F-actin levels among each different patient group.Compared with the control group,the gelsolin level in PRP of UAP and AMI groups increased significantly(P<0.01),while the gelsolin level in PPP of all the three patient groups decreased markedly(P<0.01),and the CD62p,PAR,[Ca2+] i of platelets,F-actin and Gc-globulin of the UAP and AMI groups increased significantly(P<0.01).Compared with the SAP group,the gelsolin level in PRP,the PAR,[Ca2+] i of platelets and CD62p of other two groups increased significantly(P<0.01),F-actin of the AMI group increased markedly(P<0.01).Platelet cytoskeleton protein dynamics vary among the different types of CHD.Platelet gelsolin levels are markedly increased and accompanied by increased platelet activity,F-actin and [Ca2+] i of ACS patients,while gelsolin levels in PPP are markedly lower.Abnormally increased platelet gelsolin levels show high positive correlation with the level of platelet activity.Therefore,platelet gelsolin might be a novel molecular marker and/or a new potential therapeutic target of anti-platelet therapy of ACS.     

Isolation of rare circulating tumour cells in cancer patients by microchip technology

Viable tumour-derived epithelial cells (circulating tumour cells or CTCs) have been identified in peripheral blood from cancer patients and are probably the origin of intractable metastatic disease. Although extremely rare, CTCs represent a potential alternative to invasive biopsies as a source of tumour tissue for the detection, characterization and monitoring of non-haematologic cancers. The ability to identify, isolate, propagate and molecularly characterize CTC subpopulations could further the discovery of cancer stem cell biomarkers and expand the understanding of the biology of metastasis. Current strategies for isolating CTCs are limited to complex analytic approaches that generate very low yield and purity. Here we describe the development of a unique microfluidic platform (the 'CTC-chip') capable of efficient and selective separation of viable CTCs from peripheral whole blood samples, mediated by the interaction of target CTCs with antibody (EpCAM)-coated microposts under precisely controlled laminar flow conditions, and without requisite pre-labelling or processing of samples. The CTC-chip successfully identified CTCs in the peripheral blood of patients with metastatic lung, prostate, pancreatic, breast and colon cancer in 115 of 116 (99%) samples, with a range of 5-1,281 CTCs per ml and approximately 50% purity. In addition, CTCs were isolated in 7/7 patients with early-stage prostate cancer. Given the high sensitivity and specificity of the CTC-chip, we tested its potential utility in monitoring response to anti-cancer therapy. In a small cohort of patients with metastatic cancer undergoing systemic treatment, temporal changes in CTC numbers correlated reasonably well with the clinical course of disease as measured by standard radiographic methods. Thus, the CTC-chip provides a new and effective tool for accurate identification and measurement of CTCs in patients with cancer. It has broad implications in advancing both cancer biology research and clinical cancer management, including the detection, diagnosis and monitoring of cancer.     

冠心病患者C反应蛋白的临床研究及阿司匹林对其影响

目的探讨C反应蛋白(CRP)与冠心病(CHD)的关系及阿司匹林对其影响。方法:CHD患者208例,其中急性心肌梗死84例(AMI组)不稳定心绞痛69例(UAP组)稳定心绞痛55例(SAP组)。正常对照者30例(NCHD组)。观察4组的CRP浓度以及不同剂量阿司匹林对CRP浓度的影响。结果:CHD患者的CRP浓度较正常对照组显著增高(P<0.05),UAP组与AMI组比较无明显差异(P>0.05),大剂量的阿司匹林可降低CHD患者的CPR浓度(P<0.05)。结论:CRP浓度可作为评价冠心病病情严重程度的一个参考指标。     

非心肌梗死冠心病患者心率变异性分析

目的探讨非心肌梗死冠心病（NⅧcHD）患者在合并心力衰竭和／或合并非恶性室性心律失常情况下心率变异性的变化情况。方法39例NMICHD患者根据有无合并室性心律失常和有无合并心力衰竭分A、B、C、D4组,与30例健康志愿者的心率变异性进行分析对比。结果A、B、C组的SDNN较健康对照组降低（P〈0．05）,D组的SDNN、SDNNindex、rMSSD、PNN50与健康对照组比较差异无显著性（P〉0．05）;A或B组较C或D组的SDNN、SDNNindex、rMSSI）、PNN50皆豆著降低（P〈0．05）;A与B组之间,C与D组之间的SDNNindex、rMSSD、PNN50差异无显著性（P〉0．05）。结论在观察的心率变异性时域指标中,SDNN是反映非心肌梗死冠心病患者自主神经受损最敏感的指标。非心肌梗死冠心病患者合并心力衰竭较合并非恶性室性心律失常更易引起心率变异性下降,可能具有更高的危险性。