目的掌握低血糖神经症群的临床特点,以利于早期明确诊断。方法对39例低血糖神经症群患者于发病后1～5.5h(平均2.5h)进行血糖检查(参照Whipple低血糖的诊断标准),进行分析诊断,72h颅脑CT检查阴性为鉴别要点。结果39例低血糖神经症群患者诊断明确。结论对老年突发意识障碍、肢体瘫痪、酷似急性脑卒中的患者,尤其是有糖尿病的患者,应常规检查血糖。

AIM: To investigate the relationship between the effects of benazepril and plasma neuropeptide Y in renal hypertensive patients with chronic renal failure (CRF). METHODS: The levels of plasma NPY concentration, SBP, DBP and SCr were measured before and after four week treatment with benazepril in thirty renal hypertensive patients. Thirty blood donors from healthy subjects were taken as controls. RESULTS: The plasma NPY concentration was higher in renal hypertensive patients with CRF than in normal controls before and after the treatment. After the treatment, the plasma NPY concentration and SBP, DBP and SCr in renal hypertensive patients were reduced dramatically (P

Animal models are of great value in the study of allergic bronchial asthma.There are a varie-ty of methods to build asthma models,and model evaluation lacks standardized criteria.By retrieval analyzing the recent articles about asthma animal experiments at home and abroad,we conduct a comprehensive assessment on the experimental animal selection,model preparation,especially establishment and evaluation of ovalbumin-in-duced models,to help on the application and optimization about asthma models.

Objective To investigate the effect of different prenatal stimulation on fearful behavior of offspring.Methods On gestational days 11,primigravid female rats were randomly assigned to three groups:enriched group,stressed group and the control group.Only male offspring were used in the present study.Open field test and the defensive withdrawal test were performed at P25,P45 and P60.Results1.Open-field test:PS offspring at any age had greater central grille time,decreased total cross number and stand number than their corresponding controls (all P ＜ 0.05 ).On the contrary,the prenatal enriched offspring at 25 days of age had increased total cross number ( 101.75 ± 11.87 ;89.13 ± 11.20 ; P ＜ 0.05 ) and shorter central grille time ( ( 1.88 ± 0.64) s;(3.63 ± 1.41 )s; P ＜ 0.05) than their controls.2.Defensive-withdrawal test:when compare to the controls,PS offspring had greater latencies at P25,greater latencies and decreased number of exits from the chamber at P45,and greater latencies,decreased number of exits from the chamber and increased time in the chamber with restraint at P60 ( all P ＜ 0.05 ).On the contrary,the prenatal enriched offspring at 25 days of age had shorter latencies ( ( 10.43 ± 4.27 ) s; ( 22.16 ± 4.50) s; P ＜ 0.05 ) and increased number of exits from the chamber than their controis (6.34 ± 1.03 ;3.94 ± 1.08 ; P ＜ 0.05 ).Conclusion Environmental enrichment during pregnancy only can decrease fearfulness and enhance exploratory behavior of their infancy offspring.

Objective To discuss the influence of tibolone on near and long-term postoperative effect of osteoporosis patients with bone cementless type artificial total hip replacement effect.Methods 136 patients with hip fracture by bone cementless type artificial total hip replacement were selected.According to the situation of osteoporosis,all patients were divided into osteoporosis group and control group.The osteoporosis group received tibolone treatment,followed up for 12 weeks.The intraoperative blood loss,operating time were analyzed.Enzyme-linked immunosorbent assay was used to determine serum bone alkaline phosphatase(sBAP),osteocalcin(sOC),C-terminal peptide collagen cross-linking Ⅰ type(sCTx).Harris hip score was applicated to evaluate hip function.Before and after treatment,lumbar vertebra bone mineral density(BMD) was detected by dual-energy X-ray absorption metry method.Results The intraoperative blood loss,operating time between the two groups had no significant differences(all P>0.05).The serum sBAP and sOC levels of the osteoporosis group were (28.41±6.13)U/L,(22.74±5.87)g/L,which were significantly lower than those of the control group[(35.18±7.21) U/L,(27.42±6.38)g/L],the serum sCTx level[(0.56±0.21)ng/mL]was higher than that of the control group[(0.42±0.11)ng/mL].The differences were statistically significant(tsBAP=5.36,tsOC=6.62,tsCTx=6.71,all P<0.05).On behalf of the hip joint function in the osteoporosis group was 58.82%,which was lower than 71.76% in the control group(χ2=6.78,P<0.05).The lumbar spine BMD of the control group at 12 weeks was higher than the osteoporosis group,but there was no statistically significant difference(P>0.05).Conclusion The type of bone cement after total hip arthroplasty patients with osteoporosis bone metabolism and bone mineral density in osteoporosis patients are poor in the hip joint function recovery is poorer,postoperatively for drug resistance to osteoporosis treatment can effectively avoid further loss of bone mass,it is worthy of further clinical promotion.

Objective To investigate the clinical and pathological features of Miyoshi myopathy(MM) with dysferlin protein deficient. Methods The clinical and pathological data of the 3 patients with MM were analysed. Results 3 patients were onset at youngster.The clinical manifestation were myastheria and myoatrophy in distal of lower limbs.1 case combined myalgia and tumefaction in lower limbs at early stage of onset;1 case showed myathenia in proximal of lower limbs.The level of serum creatine phosphokinase (CK) was significantly ligher in the 3 cases (7543 IU/L, 5657 IU/L, 8721 IU/L respectively). The level of serum lactic dehydrogenase (LDH) was significantly higher in the 2 cases (456 IU/L ,636 IU/L respectively).The result of muscle pathology was showed myogenic damage in all the cases. The expression of dysferlin protain in membrane of muscle cells was completely deficient, although the expression of dystrophin was normal. Inflammatory cells infiltration was found in 1 case's muscle tissue. Conclusions The clinical characters of MM patient are onset at youngster,myasthenia and myoatrophy in lower limbs.The deficit of dysferlin protain can be found by pathology.

Objective To discuss the factors that maybe related to the analysis of results of percutaneous balloon pulmonary valvuloplasty (PBPV) and the changes of cardiac morphology after PBPV. Methods Multiple linear regression was used to study peak gradient, balloon-anulus ratio (BAR), pulmonary orifice area and time of inflation before and after PBPV. One hundred and thirty-eight patients (age between 6 months and 28 years old, mean 8.34?0.81). T test was used to study the diameter and thickness of the right ventricle (RV), and Rv 1 of ECG before and during the follow-up. F test was used to determine peak gradient before and after PBPV and during the follow-up. Results There was a notable reduction in the peak to peak gradient from 13.55?0.69 kPa to 4.51?0.41 kPa (P

Objective To investigate the effects of cyclooxygenase-2 (COX-2) on the expressions of vascular endothelial growth factor (VEGF) and prostaglandin E_2 (PGE_2) in pancreatic carcinoma both in vitro and in vivo, and to clarify the possible mechanism of PGE_2 in mediating COX-2 inducing angiogenesis of pancreatic carcinoma. Methods In vitro study, the inhibitory effects of Celebrex, a selective cyclooxygenase-2 inhibitor, on the expression of VEGF and PGE_2 in pancreatic carcinoma cell lines PC-3 were determined using either enzyme-linked immuno-absorbent assay (ELISA) or radioimmunoassay (RIA). Effect of exogenous PGE_2 on the down-regulation of VEGF by Celebrex was also assessed. In vivo study, PC-3 cell line xenograft nude mice model was established. Changes of VEGF expression and PGE_2 of tumor tissues after the treatment of Celebrex were investigated using Western blotting or RIA. Results Celebrex suppressed the expressions of VEGF and PGE_2 in cultured PC-3 cell line with a manner of dose- and time-dependence. Exogenous PGE_2 up-regulated the expression of VEGF, which was suppressed by Celebrex in a dose-dependent fashion. In vivo study, administration of Celebrex into xenograft nude mice inhibited expressions of VEGF and PGE_2 significantly. Conclusion COX-2 is involved in angiogenesis in pancreatic carcinoma probably through the inhibition of the production of angiogenic factors such as VEGF. PGE_2 is likely to act as an important mediator in this process.

Objective To evaluate the clinical efficacy of percutaneous vertebroplasty (PVP) with flexible bone cement injector through unilateral puncture. Method Unilateral puncture line PVP treatment for thoracolumbar vertebral compression fracture was conducted in 78 patients, which was divided into observation group and control group according to the use of different equipment. The flexible bone cement injector was used in 36 cases of observation group, which injected the bone cement into three places at the vertebral body. The ordinary straight bone cement injector was applied in the 42 cases of the control group. The operation time, the time of radiation exposure, and the amount of bone cement injection were recorded, and the leakage of bone cement was observed. The visual analogue scale (VAS), relative vertebral height and Cobb angle were recorded at 1 week, 1 and 2 years follow-up. The time of operation, the time of radiation exposure, the amount of bone cement injection, the incidence of bone cement leakage, VAS, relative height of vertebral body and Cobb angle were compared between the two groups using independent samples t test orχ2 test. Result All patients in the two groups were successfully treated by surgery. There were no significant differences between the observation group and the control group in the operation time and the time of radiation exposure and the incidence of bone cement leakage (P>0.05). The injection amounts of bone cement in the observation group and the control group were (5.6 ± 0.7) and (3.2 ± 0.6) ml, with statistically significant difference (P<0.05). There were no significant differences in VAS score, relative vertebral height and Cobb angle between the two groups at 1 week after operation (P>0.05). At 1 year and 2 years after operation, the differences of the above indexes between the two groups were significantly different (P<0.05), with the observation group being superior to the control group. Conclusions Application of flexible bone cement injector for PVP operation is safe and feasible. Compared with the traditional straight bone cement injector, the use of flexible bone cement injector will not increase the operation time, radiation exposure time and the incidence of bone cement leakage but will improve the long-term effect.

Objective To study the expression of intercellular adhesion molecule-1 (ICAM-1), interleukin-1? (IL-1?) and ultrastructure changes in capillaries and to explore whether capillaries may play a role in the pathogenesis of polymyositis (PM). Methods Ten cases of patients with PM were collected. Control group 1 consists of 6 patients with other myopathies,Control group 2 consists of 2 muscle specimens without clinical and histological evidence of a neuromuscular disorder. An immunohistochemical technique was applied to indentify the expression of ICAM-1 and IL-1? in capillaries in the PM group, Control group 1 and Control group 2. The first analysis was a qualitative assessment. For the second analysis, the number of positive mononuclear cells and capillaries of the whole tissue section from each patient and control was estimated for all the immunologic markers investigated. 10 PM patients were also examined by electron microscopy in order to observe capillary changes in muscles. Results We found that the capillaries in tissues from PM (median (64?20)/mm~2 of tissue, ranging 44—106/mm~2) were significantly less than those from controls (median (157?46)/mm~2 of tissue, ranging 93—213/mm~2) (t=-4.523, P=0.003). A significantly higher number of capillaries expressed IL-1? in the PM group than in the Control group 1(median 15/mm~2 of tissue (ranging 6—46/mm~2) vs 3/mm~2 of tissue (ranging 0—16/mm~2)) (t=3.721, P=0.003). There was no significant difference between PM group and Control group 1 in the number of capillaries expressing ICAM-1 (t=0.529,P=0.617). However, ICAM-1 expressions in endothelial cells of capillaries were stronger in PM patients as IL-1?. Electronic microscopy found capillary changes in 6 PM patients, showing as thickening and duplication of basement membrane, swelling of endothelial cells, stenosis or occlusion of vessels.Conclusion Our findings indicate that capillary changes might take a role in the pathogenesis of PM.