奶牛食道梗塞的诊治

奶牛食道梗塞是由奶牛食道的某一段被食团或异物堵塞,使之吞咽、嗳气及反刍发生障碍而引起的疾病。以黑龙江省哈尔滨市双城区某1奶牛病例为例进行分析,得出结论,该病临床经合理有效的治疗,症状可以得到缓和和痊愈。

REASSESSMENT OF DEFIBRASE IN TREATMENT OF ACUTE CEREBRA LINFARCTION :A MULTICENTER ,RANDOMIZED ,DOUBLE-BLIND ,PLACEBO-CONTROLLED TRIAL

Objoctive To evaluate the efficacy and safety of defibrase in patients with acute cerebral infarction by a large sample, multicenter, randomized, double-blind, placebo-controlled clinical trial. Mothods Patients with acute cerebral infarction within 12 hours of stroke onset were randomly assigned to receive either an initial intravenous infusion of defibrase 15 U plus normal saline 250 mL or 250 mL of normal saline only. Subsequent infusions of defibrase 5 U or placebo (normal saline) were given on the 3rd, 5th, 7th, and 9th day, respectively. Both groups received standard care of acute cerebral infarction. The primary efficacy outcome was functional status (Barthel Index) at 3 months after treatment. Safety outcome were bleeding events and mortality rate. Secondary outcome included Chinese Stroke Scale (CSS) score at 14 days and recurrence rate of stroke at 1 year. A total of 1053 patients were enrolled at 46 centers from September 2001 to July 2003, and 527 patients were randomly assigned to receive defibrase and 526 to receive placebo. A similar proportion of patients in both groups completed a full course of treatment. There was a significantly greater proportion of favorable functional status (Barthel Index 1≥95) in defibrase group than in placebo group at 3 months (52.2% vs. 42.8%, P 〈 0.01), and the proportion of dependent functional status (Barthel Index ≤60) was a little lower in defibrase group compared with placebo group (27.7% vs. 32.4%). These differences were more obvious among patients who were treated within 6 hours of stroke onset. Patients in defibrase group had better improvement with respect to CSS score than those in placebo group at 14 days (P 〈 0.05). Recurrence rate of stroke at 1 year was lower in the defibrase group compared with placebo group (6.2% vs. 10.1%, P = 0.053). Patients in defibrase group had higher risk of extracranial bleeding events (4.7% vs. 1.5%, P 〈 0.01 ) and a tendency of higher risk of symptomatic intracranial hemorrhage. The hemorrhage incidence was higher in patients with fibrinogen level 〈 130 mg/dL than ≥ 130 mg/dL (10.6% vs. 3.8%, P 〈 0.05). Mortality rate at 3 months were slightly higher in defibrase group than placebo group (5.9% vs. 4.2%). Conclusions The defibrase is effective to improve neurological function and function of daily living for patients with acute cerebral infarction within 12 hours of symptom onset. The efficacy was even better for acute cerebral infarction within 6 hours of onset. The increased risks of intra- and extracranial hemorrhage during defibrase administration were related to the plasma fibrinogen level.

GAP-43 Expression and Pathological Changes of Temporal Infarction in R.ats and Effects of Batroxobin

To study the changes of the expression of growth-associated protein-43 (GAP-43) and pathology in temporal infarction of rats photochemically induced and the effects of batroxobin. METHODS: Immunohistochemical technique and hematoxylin-eosin stain was used to show the changes of the expression of GAP-43 and pathology. RESULTS: In infarction group, GAP-43 expression was markedly increased on the infarction and surrounding tissues at 24 h cerebral infarction. The expression reached peak level at 72 h after cerebral infarction and was decreased at 7 d after cerebral infarction. However, in batroxobin-treated group, GAP-43 expression was increased and the pathological changes were much slight as compared with infarction group. CONCLUSION: The expression of GAP-43 increases in infarction of temporal neocortex and batroxobin promotes the expression of GAP-43 and ameliorates the pathological changes in infarction of temporal neocortex.

Free triiodothyronine level correlates with statin responsiveness in acute myocardial infarction

Background Although thyroid hormone （TH） has important effects on lipid metabolism, the relationship between TH and statin responsiveness has never been investigated. We hypothesize that TH plays an important role in statin responsiveness in patients with acute myocardial infarction （AMI）. Methods Consecutive 1091 hospitalized AMI patients in Fuwai hospital （Beijing, China） were enrolled into this current study. The study population was divided into three groups based on the intensity of statin treatment： low-intensity （n = 221）, moderate-intensity （n = 712） and high-intensity （n = 158）. Lipid levels were measured after statin therapy lasting for 10-14 days. The association between TH, lipid profile levels and achievement of low-density lipoprotein cholesterol （LDL-C） lowering goals was explored in patients with AMI on statin therapy. Results By general linear analysis, a significant linear trend between free triiodothyronine （FT3） and LDL-C level （linear coefficient r = -0.082, P = 0.001） and FT3 and total cholesterol （TC） level （r = -0.105, P = 0.031） was observed in the moderate-intensity statin group. A more apparent linear trend was detected in the high-intensity statin group （for LDL-C： r = -0.113, P = 0.005; for TC： r = -0.172, P = 0.029, respectively）. However, no significant correlation was observed in the low-intensity statin group. Compared with the low-FT3 group （defined as FT3 〈 1.79 pg/mL）, the OR （95% CI） for attaining a LDL-C 〈 3.0mmol/L was found to be 2.217 （1.001–4.839） in the higher FT3 group （〉 2.95 pg/mL）. The OR （95% CI） for attaining the more intensive goal （LDL-C 〈 1.8mmol/L） was 2.836 （1.014–5.182）. Conclusions Our study reveals that variation in FT3 levels is related to the cholesterol-lowering responsiveness of statins in AMI patients. These findings suggest that low FT3 may be a factor responsible for lack of LDL-C goal attainment and patients’ poor responsiveness to statin treatment.

INFLUENCE OF ACUPUNCTURE ON BRAIN-TAXIS OF TETRAMETHYLPYRAZINE IN ACUTE CEREBRAL INFARCTION RATS

Purpose: To observe the effect of acupuncture on the brain-taxis of tetramethylpyrazine (TMP) and to explore into the underlying mechanisms of combined action of acupuncture and medicine in the treatment of acute cerebral ischemia. Methods: 37 male Wistar rats were randomly divided into normal control group (n=10), sham-operation group (n=10), acute cerebral ischemia (ACI) + drug group (model group, n=8)and ACI+drug+acupuncture group (acupuncture group, n=9). Rat ACI model was established by using photochemical method. "Neiguan"(PC 6) and "Shuigou"(GV 26) were punctured and stimulated with both hand manipulation and electroacupuncture, 30 min and 16hrs after ACI. TMP was given to the rats of the later 2 groups using gastric perfusion method. High pressure chromatography (HPLC) was used to detect the target absorption level of TMP in the brain. Results: The content of TMP in the brain in acupuncture group was significantly higher than that in model group (P<0.01), suggesting that acupuncture can strengthen the brain-taxis of TMP in ACI rats, and combined administration of acupuncture and Chinese drug maybe work better for treatment of acute cerebral infarction. Conclusion: Acupuncture can strengthen the chemo-taxis of TMP to the brain in ACI rats.

CD100与心肌梗塞关系的临床研究

目的探讨心肌梗塞患者外周血CD100变化,及其与血脂、心肌梗塞标志物浓度变化的关系。方法收集102例AMI患者为AMI组,另收集87例健康体检者为对照组,采用流式细胞术检测2组对象外周血细胞CD100的表达,运用化学比色法检测血脂、化学发光法测定心肌梗塞标志物浓度。结果与对照组相比,AMI组患者外周血CD3+细胞CD100的表达显著升高,差异有统计学意义(P<0.05);且血脂及心肌梗塞标志物浓度明显升高,差异有统计学意义(P<0.05)。结论心肌梗塞患者外周血CD100表达异常,与血脂、心肌梗塞标志物浓度变化呈显著正相关。