亚急性重症乙型肝炎患者血浆纤维蛋白原与纤维蛋白单体聚合功能的测定及临床意义

为测定亚急性重症乙型肝炎患者血浆中纤维蛋白原的浓度与纤维蛋白单体聚合能力,以了解其凝血功能。用蕲蛇酶水解纤维蛋白原,用计算机测定其相关数值。发现20名亚急性重症乙型肝炎患者,其纤维蛋白聚合反应速率为(0.315±0.065)g/min;最大吸光度为(0.176±0.035)OD;纤维蛋白原浓度为(150±30)mg/dl;纤维蛋白单体聚合反应速率/最大吸光度比值为1.789±0.160;反应延滞时间为(-21±5)s。结果表明亚急性重症乙型肝炎患者的纤维蛋白原反应时间增快,但其它各项指标均下调,表明患者出血与凝血功能受损。     

慢性乙型肝炎纤维蛋白原系列测定及分析

目的 :探讨慢性乙型肝炎患者血浆中纤维蛋白原 (Fibrinogen,Fbg)水平与功能变化的临床意义。方法 :用蕲蛇酶水解纤维蛋白原 ,以计算机测定其相关数值。结果 :慢性乙型肝炎患者 30例 ,其纤维蛋白聚合反应速率为 (0 .35 5±0 .93) g/ m in;最大吸光度为 (0 .1 86± 0 .0 39) OD;纤维蛋白原浓度为 (1 .92± 0 .4 1 ) g/ L,反应延滞时间为 (9± 5 ) s。结论 :慢性乙型肝炎患者除 Fbg下降外 ,还有功能反应受抑     

晚期肺癌和肺部良性疾病患者血浆纤维蛋白原水平与功能的研究

目的观察晚期肺癌及慢性支气管炎、肺气肿等良性肺部疾病患者血浆纤维蛋白原水平与功能.方法用蕲蛇毒水解纤维蛋白原,采取计算机自动检测系统测定.结果40例晚期肺癌患者和40例良性肺部疾病患者纤维蛋白单体聚合反应速率(FMPV)分别为0.910±0.178及0.783±0.220,最大吸光度(Amax)分别为0.468±0.098及0.397±0.113,凝固性纤维蛋白原含量(S)分别为5.79±1.75g/L及4.76±1.85g/L,均显著高于正常对照组(P＜0.01),而肺癌组与肺部良性疾病组相比有显著性差异(P＜0.05).反应延滞时间(DT)为15±13s及21±12s,纤维蛋白原功能与量的比值(FMPv/Amax)为1.953及1.973,低于正常对照组.结论晚期肺癌和肺部良性疾病患者血浆纤维蛋白原水平与功能均高于正常对照,两组间差异有显著性.本研究表明晚期肺癌患者机体处于高凝状态,有血栓形成趋势.     

胰岛素缓释载体聚乙二醇-聚己内酯-聚甲基丙烯酸-N,N-二乙氨基乙酯的制备及评价

目的 制备pH敏感聚乙二醇-聚己内酯-聚甲基丙烯酸-N,N-二乙氨基乙酯(mPEG-PCL-PDEAEMA)载胰岛素缓释纳米粒,考察其体外释放效果和体内降糖活性.方法 结合开环聚合反应和原子转移自由基聚合反应合成具有不同疏水链段的mPEG-PCL-PDEAEMA,用傅里叶红外光谱和核磁共振氢谱表征其结构;采用纳米沉淀技术制备聚合物载胰岛素纳米粒,动态光散射法测定粒径,透射电子显微镜观察其形态;BCA法测定载药情况,并考察其体外释放行为;建立糖尿病大鼠模型,监测给药后血糖水平.结果 在pH1.2~7.4时,聚合物纳米粒的粒径随pH增大而减小.以90%wt投药比制备mPEG5k-PCL13k-PDEAEMA10k和mPEG5k-PCL10k-PDEAEMA10k载胰岛素纳米粒时的包封率和载药率为最佳,包封率分别为(81.99±1.77)%和(53.12±0.62)%,载药率分别为(42.46±0.53)%和(32.34±0.26)%,粒径分别为181.9±6.67 nm和169±7.1 nm.体外释放结果显示聚合物载胰岛素纳米粒具有出色的缓释行为,并且随着疏水链段的增长,药物释放速度减慢.体内药效实验表明mPEG5k-PCL13k-PDEAEMA10k载胰岛素纳米粒能够在体内保持48 h的降血糖效果,较游离胰岛素的降糖作用时间明显延长.结论 pH敏感三嵌段聚合物mPEG-PCL-PDEAEMA有望成为理想的胰岛素缓释载体.     

铜-二正丁胺络合体系催化的2,6-二甲基苯酚聚合反应研究

采用间歇溶液聚合法制备了聚苯醚(PPO),对铜-二正丁胺络合体系催化的2,6-二甲基苯酚聚合反应进行了研究。探讨了络合反应对催化剂活性的影响,优化了二正丁胺用量以及单体的浓度和滴加速度。实验表明聚合反应适宜的条件是:温度为(32±2)℃,聚合反应时间为2.5-3.0h。     

探讨血浆纤维蛋白原单体聚合功能在妊高征中的临床意义

目的 :研究妊高征患者血浆纤维蛋白原单体聚合功能的临床意义。方法 :用蕲蛇酶 (Acutulase)水解纤维蛋白原 ,采用计算机自动检测系统对 70例正常晚期妊娠妇女和 6 0例妊高征患者进行定量检测。结果 :轻度妊高征组的血浆纤维蛋白原单体聚合反应速率 (FMPV)、血浆凝固性纤维蛋白原含量 (S)和最大吸光度 (Amax)分别为 0 77± 0 .10 ,(45 2 .33± 85 .96 )mg/dL ,0 .4 0± 0 .0 5 ,明显高于对照组 [0 .6 6± 0 .15 ,(370 .89± 112 .2 0 )mg/dL ,0 .35± 0 .0 8],差异有显著性 (P <0 .0 5 ) ;重度妊高征组分别为 0 .5 7± 0 .14 ,(30 8.4 5± 93.97)mg/mL ,0 .30± 0 .0 8,明显低于对照组 (P <0 .0 5 ) ,且显著低于轻度妊高征组 (P≤ 0 .0 0 1)。结论 :应用计算机自动检测系统动态监测纤维蛋白原单体聚合功能 ,对妊高征的凝血功能状态及并发症的判断及指导治疗 ,具有一定的临床价值。     

经内镜鼻胰管引流在重症急性胰腺炎治疗中的应用

目的 :初步总结经内镜鼻胰管引流在重症急性胰腺炎治疗中应用的疗效。　方法 :自 1998年 3月以来 ,在重症急性胰腺炎患者入院后常规非手术监测治疗的同时 ,随机床旁行经内镜置放鼻胰管引流 14例。其中明确合并胆结石 8例。观察每天胰管引流量和入院后第 5天在体温、心率、白细胞计数、血糖、血钙、动脉氧分压和血、尿淀粉酶的变化 ,并与第 1天比较 ,记录治疗结果和住院时间。　结果 :经鼻胰管引流时间为 (7.3± 4 .0 )天 ,前 5天的胰液引流量分别为每天 (2 36 .4± 176 .6 )、(2 87.1± 16 4 .7)、(2 84 .6± 2 16 .4 )、(435 .0± 35 7.8)ml和 (377.8± 2 2 3.8)ml。入院后第 1天和第 5天的体温为 (38.2± 0 .6 )和 (37.2± 0 .8)℃ (P <0 .0 1)、心率为 (10 2 .3± 17.0 )和 (82 .9± 14 .5 )次 /min(P <0 .0 1) ,白细胞计数为 (14 .6± 4 .2 )和 (10 .1± 5 .4 )× 10 9/L(P <0 .0 5 ) ,血糖为 (10 .0± 4 .9)和 (8.6± 3.3)mmol/L(P >0 .0 5 ) ,血钙为 (2 .1± 0 .2 )和 (2 .2± 0 .2 )mmol/L(P >0 .0 5 )　动脉氧分压为 (78.0± 16 .3)和 (113.0± 4 1.6 )mmHg(P <0 .0 1) ,血淀粉酶为 (6 95 .7± 4 4 5 .2 )和 (82 .6± 4 7.1)U/L(P <0 .0 1) ,尿淀粉酶为 (3174 .1± 2 5 4 2 .5 )和(2 86 .8± 2     

先天性心脏病肺动脉高压心内直视手术患者吸入NO对再灌注肺功能的影响

目的　评价先天性心脏病合并肺动脉高压患者吸入一氧化氮 (NO)对再灌注肺功能的影响 .方法　先天性心脏病合并中重度肺动脉患者 4 4例 ,分为对照组 (2 2例 )和吸入NO组 (2 2例 ) .吸入 NO组在升主动脉开放即刻连续吸入NO2 0 m L· L- 1 2 4 h,监测和计算平均动脉压 (m Bp)、平均肺动脉压 (m PA)、肺血管阻力 (PVR)、心排出量 (CO) ;氧分压(Po2 )、二氧化碳分压 (Pco2 )、肺泡动脉氧分压差 (A- a Do2 )、肺内动静脉分流 (Qs/ Qt) .结果　吸入 NO组 m PA肺再灌注后3,6 ,12 ,2 4 h分别为 (5 .8± 1.9) ,(5 .6± 1.6 ) ,(5 .1± 1.3)和 (4.4± 1.1) k Pa,对照组为 (7.8± 1.6 ) ,(7.3± 1.7) ,(6 .8± 1.5 )和 (6 .9± 1.5 ) k Pa,吸入 NO组下降显著 (P<0 .0 5 ) ;吸入 NO组 m PVR肺再灌注后 3,6 ,12 ,2 4 h分别为(87± 17) ,(79± 12 ) ,(6 7± 9)和 (6 0± 9) k Pa· s· L- 1 ,对照组为 (14 5± 2 2 ) ,(135± 16 ) ,(130± 14 )和 (114± 11) k Pa· s- 1·L- 1 ,吸入 NO组下降明显 (P<0 .0 5 ) ;吸入 NO组肺再灌注后 6 ,12 ,2 4 h分别为 (4.2± 1.2 ) ,(4.5± 0 .9)和 (4.4± 1.2 )L· min- 1 ,对照组为 (3.3± 0 .8) ,(3.4± 0 .8)和 (3.5± 0 .9)L· min- 1 ,吸入 NO组明显升高 (P<0 .0 5 ) .与对照     

颅中窝径路解剖定位的临床意义

目的　为颅中窝入路手术提供相应的解剖学依据 .方法　对 2 0具甲醛固定的成人尸颅进行测量 ,确定翼点、颧弓点至颅中窝各结构及面神经管裂孔至弓状隆起、内耳门、棘孔的夹角和距离 .结果　翼点至圆孔、卵圆孔、棘孔、三叉神经压迹、面神经管裂孔、弓状隆起、内耳门的连线长度和各连线与正中矢状面成角分别为 (5 8.0± 3.7) mm(71.5± 6 .4 )°,(5 9.9± 3.9) mm (5 6 .2± 6 .4 )°,(5 9.2± 3.8) mm (49.2±6 . 8)°,(6 3.0± 3.8) mm (5 2 .8± 6 .7)°,(5 9.6± 3.6 ) mm(41.0± 5 .4 )°,(6 2 .9± 4 .7) mm(2 7.3± 5 .6 )°,(6 9.5± 4 .1)mm (40 .3± 5 .1)°.颧弓点至圆孔、卵圆孔、棘孔、三叉神经压迹、面神经管裂孔、弓状隆起、内耳门的连线长度和各连线与正中矢状面成角分别为 (5 2 .4± 3.0 ) mm (90 .2± 5 .6 )°,(48.5± 3.9) mm (74 .4± 6 .1)°,(44 .4± 2 .6 ) mm (6 5 .9±5 .8)°,(5 3.7± 3.4 ) mm (6 6 .3± 5 .9)°,(47.0± 2 .6 ) mm(5 4 .6± 7.2 )°,(5 4 .1± 3.3) mm(40 .7± 5 .8)°,(6 0 .1± 2 .8)mm (5 3.4± 5 .9)°.面神经管裂孔至弓状隆起、内耳门、棘孔的连线长度和各连线与正中矢状面成角分别为 (17.5± 2 .8)mm(337.2± 9.2 )°,(14 .5± 1.2 ) mm(44 .3± 12     

大鼠慢性压迫性脊髓损伤及减压后神经营养素的表达

目的　观察神经营养素在慢性压迫性脊髓损伤后及减压后的表达变化 .方法　同龄 Wistar大鼠 6 0只 ,设 A组正常对照组、B组行后路渐进式慢性压迫、C组减压组、D组手术组 ,应用免疫组化方法观察各组脑源性神经营养因子、(BD-NF ) ,胶质源性神经营养因子 (GDNF) ,神经营养素 - 3(NT-3) ,神经营养因子 (NGF)及其受体 Trk A,Trk B,Trk C表达的变化 .结果　行慢性压迫后及减压后神经营养素及其受体表达变化明显 ,各组差异有显著性意义 .与正常组与假伤组比较 ,慢性压迫后 1d的标记指数 BDNF(32 .4± 1.6 ) vs(4.8± 1.0 ) ,GDNF(2 1.2± 3.8) vs(3.7± 1.1) ,NT- 3(2 6 .2±2 .8) vs (5 .5± 0 .6 ) ,NGF (9.2± 0 .9) vs(1.7± 0 .4 ) ,Trk A(2 3.7± 1.7) vs (0 .6± 0 .5 ) ,Trk B (34.3± 3.3) vs(3.2± 0 .5 ) ,Trk C(30 .1± 3.9) vs(1.2± 0 .4 ) (P<0 .0 5 ) .与正常组与压迫 30 d组比较 ,减压后 1d的标记指数 BDNF(30 .2± 1.6 ) vs(5 .8± 1.8) ,GDNF (2 0 .0± 3.6 ) vs(3.6± 1.1) ,NT- 3(2 5 .8± 2 .3) vs(5 .6± 0 .5 ) ,NGF(8.7± 0 .7) vs(1.7± 0 .4 ) ,Trk A(2 1.4± 4 .2 ) vs(0 .7± 0 .4 ) ,Trk B(32 .7± 3.3) vs(3.5± 0 .5 ) ,Trk C (2 8.7± 3.8) vs (1.2± 0 .6 ) (P<0 .0 5 ) .结     

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…     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

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.