无框架脑立体定向手术

目的：应用国产ＣＲＡＳ－ＢＨ２型机器人系统（ｃｏｍｐｕｔｅｒ ａｎｄ ｒｏｂｏｔ ａｓｓｉｓｔｅｄ ｓｕｒｇｅｒｙ,ｔｙｐｅ ＢＨ２）,临床实施３０例无框回脑立体定向手术。方法：机器人系统由智能机械臂影像引导装置、三维定位软件等模块组成,该系统取代了传统的定向仪框架,通过识别贴附是头部的标志点,建立相庆的三维坐标体系,并可自动标出靶点位置和穿刺轨迹。智能机械臂按照模拟轨迹固定方向,为术者提供准确导     

脑外科手术中机器人的应用

临床应用国产机器人系统辅助完成脑外科立体定向手术。方法：机器人系统主要由影像引导装置，三维定位软件和智能机械臂等部分组成。手术时，机器人系统通过识别贴附于患者头部的标志点，建立相应的三维坐标体系；智能机械臂按照手术规划自动地锁定，为术者准确导航并提供操作平台。     

高血压脑出血行脑立体定向手术的护理体会

脑立体定向手术治疗高血压脑出血是采用CT引导立体定向抽吸脑内血肿置管外引流术，它具有创伤小、定位准确、操作简便、手术时间短、血肿清除理想等优点。我科于2000年12月至2005年12月，行脑出血立体定向手术102例，现将护理体会报告如下：     

CT引导立体定向手术治疗颅内金属异物11例

目的：探讨CT引导立体定向手术对颅内金属异物治疗的效果。方法：对11例颅内金属异物经CT定位确定靶点胪其坐标，选择脑内穿刺径路，在导向系统导航下，磁性导针穿刺达靶点后将异物吸出。结果：本组定位成功率100％，手术有效率81.8%，无并发症。结论：CT引导立体定向手术治疗颅内金属异物有定位准确、创伤小、疗效可靠、术后恢复快，并发症少、操作简便等优点。     

机器人辅助脑立体定向125↑碘内放射治疗恶性胶质瘤患者的护理

目的总结机器人辅助脑立体定向125↑籽粒内放射治疗恶性胶质瘤病人的护理体会。方法回顾性总结31名机器人辅助脑立体定向125↑籽粒内放射治疗恶性胶质瘤病人的术前、术中、术后护理。结果手术顺利完成,病人病情得到满意控制,术后并发症少,临床症状改善,提高了病人的生存质量。结论机器人辅助脑立体定向125↑籽粒内放射治疗恶性胶质瘤是一种疗效显著的手术方法,护理人员的术前详细宣教,术中密切配合,术后严密观察,对手术的顺利实施、术后并发症的减少、提高患者生存质量起到了有效的促进作用。     

丙型病毒性肝炎重叠感染分布特点

本文以１９９２．６－１９９３．７期间６６例抗－ＨＣＶ阳性患者为观察对象，分析丙型病毒性肝炎临床型分布、重叠感染分布等特点。结果：ＨＣＶ／ＨＡＶ重叠感染发病率６．０６％，ＨＣＶ／ＨＢＶ重叠感染发病率４８．４８％。丙型肝炎中抗－ＨＣＶ与ＨＢｓＡｇ阳性的病例４．５％，抗－ＨＣＶ与ＨＢｓＡｇ、抗－ＨＢｃ阳性占１９．７％，抗－ＨＣＶ与ＨＢｓＡｇ、抗－ＨＢｅ、抗ＨＢｃ阳性占７．６％，抗ＨＣＶ与ＨＢｓＡｇ，Ｈｂ     

机器人辅助脑立体定向1255碘内放射治疗恶性胶质瘤患者的护理

目的 总结机器人辅助脑立体定向125I籽粒内放射治疗恶性胶质瘤病人的护理体会.方法 回顾性总结31名机器人辅助脑立体定向125I籽粒内放射治疗恶性胶质瘤病人的术前、术中、术后护理.结果 手术顺利完成,病人病情得到满意控制,术后并发症少,临床症状改善,提高了病人的生存质量.结论 机器人辅助脑立体定向125I籽粒内放射治疗恶性胶质瘤是一种疗效显著的手术方法,护理人员的术前详细宣教,术中密切配合,术后严密观察,对手术的顺利实施、术后并发症的减少、提高患者生存质量起到了有效的促进作用.     

人原发性肝细胞癌地高辛素标记HBV DNA探针的原位杂交与C－myc和P_（53）癌基因表达相互关系的研究

取自肝癌高发区的４０例人原发性肝细胞癌（ＰＨＣ）标本，应用地高辛素（Ｄｉｇ）标记ＨＢＶＤＮＡ探针作原位杂交，检测ＰＨＣ和癌周肝组织内ＨＢＶＤＮＡ的表达，并用光敏生物素Ｃ－ｍｙｃ癌基因探针原位杂交和用免疫组化检测ＨＢｓＡｇ，ＨＢｃＡｇ及Ｐ５３癌基因在ＰＨＣ和癌周肝组织内的表达。Ｄｉｇ－ＨＢＶＤＮＡ探针肝内总阳性率为８０％，在ＰＨＣ内为６５％，而癌周肝组织中为７３％。ＨＢＶ－ＤＮＡ定位于肝细胞或癌细胞的胞浆和胞核内，而ＨＢＶＤＮＡ阳性颗粒在胞浆内比胞核内多。ＨＢＶＤＮＡ阳性细胞癌周比癌内更多。结果表明，ＰＨＣ病例与ＨＢＶ存在关系密切；癌内ＨＢＶＤＮＡ大都属整合型，而癌周属游离型。研讨ＰＨＣ内ＨＢＶＤＮＡ的表达与ＨＢｓＡｇ，ＨＢｃＡｇ，和Ｐ５３及Ｃ－ｍｙｃ癌基因的表达相互关系及致癌作用。     

唾液腺组织中HBsAg和HBcAg分布的探讨

应用多克隆抗体和卵白素—生物素—辣根过氧化物酶复合物法（ＡＢＣ法）对１３例乙型肝炎患者手术摘除的唾液腺组织中ＨＢｓＡｇ和ＨＢｃＡｇ进行检测。结果ＨＢｓＡｓ阳性４例，ＨｂｓＡｇ和ＨＢｃＡｇ阳性１例。对照组６例，，测得ＨＢｓＡｇ阳性１例。本实验结果首次为乙型肝炎患者唾液腺组织内ＨＢＢＶ的分布提供了形态学依据，表明乙型肝炎患者唾液中的ＨＢＶ源于受感染的唾液腺组织。     

立体定向手术结合尿激酶治疗脑内血肿的临床效果研究

目的：探讨立体定向手术结合尿激酶治疗脑内血肿患者的临床疗效。方法选取96例脑内血肿患者，所有患者均采用微创立体定向手术，辅以尿激酶进行联合治疗。结果采用微创术式立体定向手术联合尿激酶进行治疗的96例患者中无死亡病例，且术后2 d共有18例患者的血肿消除量高达95%，术后3～5 d 78例患者的清除量达80%，效果显著。结论采用新型立体定向手术结合尿激酶治疗脑内血肿不仅操作简单、定位精准，而且损伤小，效果显著，值得临床推广。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.