结蛋白诊断早期心肌梗死的特异性研究

目的 探讨结蛋白在早期心肌梗死死后诊断的特异性。方法 应用免疫组织化学Ｓ－Ｐ法检测梗死心肌和其他非梗死性的直接或间接心肌损害的心肌结蛋白染色的变化。结果 梗死心肌均可见不同程度的结蛋白缺染,其他非梗死性的直接或间接心肌损害的心肿,如心脏挫伤、心肌炎、出血性休克、电击死、机械性窒息、有机磷中毒等,也有不同程度的结蛋白缺染。 结论 应用结蛋白免疫组织化学方法诊断早期心肌梗死需慎重。     

Sexual Behavioral Disinhibition Associated with Nucleus Lentiformis Lesion: A Forensic Neuroscience Perspective Through a Case

Organic brain disturbances particularly related to frontal cortex structures and subcortical areas including the basal ganglia may play a role in behavioral disinhibition disorders. Kluver–Bucy syndrome (KBS), which is one of the better knowns of these syndromes, includes hyperorality, visual agnosia, and hypersexuality, has been reported to occur after temporal lobe and amygdala lesions; however, several patients who had focal lesions in areas other than the temporal cortex and amygdala have been reported to present partial KBS symptoms. Nucleus lentiformis refers to a large portion of the basal ganglia including the putamen and globus pallidus, and specific structures within this broad area are known to be important for reward and value-based decision making. To date, KBS symptoms including hypersexual behavior associated with nucleus lentiformis lesions have never been reported. Here, we present a 38-year-old male patient who developed increased sexual interest and hyperorality after infarctions in the right lenticular nucleus and right occipitotemporal region and committed a first-degree sexual assault. He was sent to our institution for the assessment of criminal responsibility to the index sexual crime. According to a comprehensive and thorough forensic psychiatric evaluation, he was diagnosed as having an organic personality disorder with partial KBS symptoms. To the best of our knowledge, this is the first reported case of deviant sexual behavior and hyperorality developing after nucleus lentiformis infarction. We aimed to discuss possible neurobiologic explanations of late-onset deviant sexual behavior, which resulted in sexual criminal behavior following a cerebrovascular infarction.     

Two consecutive fatal cases of acute myocardial infarction caused by free floating thrombus in the ascending aorta and review of literature

Free floating thrombus in the ascending aorta is an uncommon source of acute myocardial infarction. We report on two cases of young women who died of acute myocardial infarction caused by a free floating thrombus in the sinus of Valsalva obstructing the coronary arteries' ostia. The first case reports on a 30-year-old pregnant woman who anamnestically had episodes with short loss of consciousness and weakness. The second case presents a 37-year-old woman suffering from multiple sclerosis with no previous history of thrombotic events. The review of literature revealed a predominance of women (eight females and three males). Interestingly, the coronary arteries bear no preference concerning the right (RCA) or left coronary artery (LCA) being more often occluded by a free floating thrombus. Especially, younger women (mean age 45.5 years, range 30-59 years) with no history of cardiac symptoms and without atherosclerotic changes seem to be predispositioned. The hypothesis that thrombus formation in cases without plaque disruption may depend on an endothelial erosion which seems to be more common in younger women and promoted by a hyperthrombogenic state is supported by our two cases. A comprehensive literature search revealed, that these are the first two reports on a free floating thrombus being the cause of fatal acute myocardial infarction in a pregnant woman, respectively, a woman suffering from multiple sclerosis.     

Sudden Collapse due to Medullary and Cervical Cord Infarction—An Unusual Presentation of Hepatocellular Carcinoma

Hepatocellular carcinoma (HCC) is a common cancer worldwide with a great potential for metastatic spread. Hepatocellular carcinoma often arises in people with underlying viral hepatitides or liver cirrhosis and may present in various ways including abdominal pain, liver mass, and signs of hepatocellular decompensation. Many tumors may have metastasized to other organs such as the lungs, lymph nodes, bone, and adrenal glands at the time of diagnosis. However, it is uncommon for HCC to present purely due to its metastasis, such as spinal cord compression from vertebral metastasis. Here, an unusual presentation of a sudden cardiovascular collapse due to medullary and cervical cord infarction from compression of the cervical cord is presented. The importance of clinical investigations, the usefulness of postmortem computed tomography scans, and the examination of the cervical spine and cervical cord in people with no obvious cause of death after standard autopsy procedures are emphasized.     

电针心经穴位对急性心肌缺血模型大鼠内侧隔核白细胞介素-2、JunB蛋白及c-fos表达水平的影响

目的 观察电针心经对急性心肌缺血（acute myocardial ischemia,AMI）大鼠内侧隔核白细胞介素（interleukin,IL）-2水平、JunB蛋白及c-fos表达水平的影响,探究内侧隔核在针刺抗AMI中的作用及机制。方法 将大鼠分为伪手术组、模型组和电针组,每组6只;结扎冠状动脉左前降支复制AMI大鼠模型;电针组大鼠选取手少阴心经“神门—通里”段进行干预,每次30 min,每日1次,连续电针3 d,刺激电流为1 mA,频率为2 Hz;伪手术组、模型组大鼠不进行电针干预。采用ELISA法检测大鼠大脑内侧隔核IL-2水平,Western blot法检测大鼠大脑内侧隔核区JunB蛋白表达水平,免疫荧光法检测大鼠大脑内侧隔核区c-fos免疫反应阳性神经元表达水平。结果 与伪手术组比较,模型组大鼠大脑内侧隔核区IL-2、JunB蛋白水平显著升高（P＜0.05）,c-fos免疫反应阳性神经元数和平均吸光度（optical density,OD）值显著增加（P＜0.05）;与模型组比较,电针组大鼠大脑内侧隔核区IL-2、JunB蛋白水平显著降低（P＜0.05）,c-fos免疫反应阳性神经元数和平均OD值显著减少（P＜0.05）。结论 内侧隔核参与电针心经抗AMI的作用,其机制可能与电针降低大脑内侧隔核区IL-2、JunB蛋白及c-fos表达水平有关。     

LSAB法检测肌动蛋白肌红蛋白纤维联接蛋白在心肌梗死中的应用

利用LSAB法，比较抗肌动蛋白单克隆抗体（HHF35）、抗肌红蛋白（Mb）和抗纤维联接蛋白（Fn）多克隆抗体在22例实际案例人心肌梗死检材中的应用效果。发现：在22例人心肌切片中，HE均能显示明显心肌梗死区，三种抗体的免疫组化都能在同区内显示心肌梗死，对于梗死心肌细胞的反应，表现为HHF35、Mb出现心肌细胞的缺染或弱染，Fn在梗死心肌细胞呈阳性特异性染色。图像分析表明：在相同视野内梗死面积所占比率为HHF35＞Fn＞Mb＞HE；在染色效果上，HHF35明显最佳。     

急性心肌缺血早期血管内皮生长因子的免疫组织化学实验

对大鼠急性心肌缺血早期的不同时间、心脏不同部位的血管内皮生长因子（VEGF）的表达，运用免疫组织化学方法进行了研究。结果发现：缺血30min后在缺血心肌局部开始出现VEGF阳性表达，而缺血边缘区域和正常区域心肌在缺血1h后也开始出现VEGF阳性表达，并随着缺血时间的延长，VEGF的表达强度也越来越强。对照组未发现有阳性表达结果.表明运用免疫组化方法检测心肌缺血后心肌局部VEGF的表达，可望作为因心肌缺血导致心脏性猝死案例的诊断标准之一。     

失血即刻死亡心肌超微结构,组织化学及免疫组化研究

本研究应用电镜、组织化学、免疫组化及形态计量分析等方法和技术，观察失血即刻死亡时家兔心肌超微结构、琥珀酸脱氢酶（ＳＤＨ）活性、肌红蛋白（Ｍｂ）脱失的变化特点。结果发现，失血即刻死亡时家兔心肌细胞轻度水肿，肌原纤维普遍强度收缩，肌节缩短，Ｚ线增粗，心肌细胞内ＳＤＨ活性明显下降，Ｍｂ轻度局灶性脱失．     

针药并治脑梗死50例

目的：观察针药并用治疗脑梗死的疗效。方法：100例脑梗死病人被随机分为治疗组和对照组，并观察两组的疗效。结果：在疗程结束后，两组疗效有显差异（P＜0．05），治疗组疗效优于对照组，结论：针药并用治疗脑梗死的疗效优于单纯针刺组。     

36例外伤性脑梗塞鉴定分析

通过对36例外伤性脑梗塞的鉴定，就其临床表现、发病机理、伤病关系以及法医学损伤程度的评定等方面进行了分析．认为外伤性脑梗塞主要为外伤后血管内膜的损伤所致．