中药合敷穴治疗肺结核142例

笔者自 1 990～ 2 0 0 1年应用中药辨证施治配合敷穴疗法治疗肺结核 1 42例 ,疗效满意 ,介绍如下。一般资料1 42例中男性 1 1 2例 ,女性 30例 ;年龄 1～ 5 9岁 ,平均 30岁 ;病程 6～ 36个月 ,平均 2 1个月。中医辨证属肺阴亏虚型者 43例 ,阴虚火旺型者 38例 ,气阴耗伤型者 34例     

烟叶外敷疗疖

疖是一种生于皮肤浅表的化脓性疾患。具有色红 ,灼热 ,疼痛 ,突起根浅 ,肿势局限 ,范围多在 3～ 6ｃｍ左右 ,出脓即愈的特点。但因治疗或护理不当可形成“蝼蛄疖”或呈反复发作、日久不瘥的“疖病”。在临床上采用新鲜烟叶外敷 ,治疗疖初起未成脓者 ,疗效显著。现把具体方法介绍如下 :1　方法取新鲜烟叶 2张 ,食盐 3ｇ ,捣如泥备用。疖局部常规消毒。取捣好之烟叶敷于患部 ,纱布外敷、固定 ,12小时后换药。2　病例介绍患者 ,男 ,14岁 ,学生 ,颈部后发际下起疖两枚 ,感疼痛 ,灼热 ,遂用手挤压 ,次日疼痛加剧 ,手不可触 ,疖肿增大 ,口服抗菌素…     

加减补阳还五汤和额尔敦—乌日勒对大白兔脑缺血的保护作用及血液流变性的影响

观察中药（补阳还五汤加减）和蒙药（额尔敦－乌日勒，嘎日迪－13）对大白兔实验性脑缺血再灌注损伤的保护作用及对血液流变性的影响，并与盐水模型，阿斯匹林肠溶片，补阳还五汤做对照，结果表明，补阳还五汤加减与蒙药均对大白兔脑缺血再灌注损伤具有显著的保护作用，并且对血液流变性亦有一定的改变作用，初步为中蒙医药治疗脑缺血提供了可靠的实验依据。     

Vascular dilatory functions of ovo-lactovegetarians compared with omnivores

Familial hypercholesterolemia (FH) and familial defective apolipoprotein B-100 (FDB) cause early onset of coronary heart diseases (CHD). According to the recommendations of the international MEDPED program, we tried to find FH cases. We analyzed 73 FH probands and their 304 first-degree relatives. A total of 39 probands were found from the 21000 subjects screened (1:538) from family doctors' registers recording all citizens, while the remaining 34 were derived from screened patients from lipid clinics. In our FH probands, four cases of FDB (R3500Q mutation) were diagnosed with allele-specific PCR, and the mutation was also detectable in five cases out of seven living family members. In the remaining 69 FH families, 156 people were diagnosed clinically with FH, and 31.8% of the males (against 13% of the not clinically diagnosed FH males, P<0.01), and 32.4% of the females (against 13.5% of the not clinically diagnosed FH females, P<0.01) suffered from early onset CHD. The plasma total cholesterol level of the FDB patients, especially in the younger patients, was very close to normal values. Therefore, the FDB patients seem to be under-represented in this type of survey. Because FDB is one of the independent causes of early onset CHD, the R3500Q mutation should be considered in families with a high frequency of cardiovascular diseases.     

Mutation analysis and the correlation between genotype and phenotype of Arg778Leu mutation in chinese patients with Wilson disease

BACKGROUND: The defective gene (ATP7B) that causes Wilson disease (WD) codes for a putative copper-transporting P-type adenosine triphosphatase. After cloning of ATP7B, the spectrum of mutations and their clinical consequences have been investigated in patients with WD in different ethnic populations. However, the spectrum of mutations and the correlation of genotype-phenotype in the Chinese population have not been extensively studied. OBJECTIVE: To investigate the characterization of mutations of ATP7B and the correlation between genotype and phenotype in the Chinese population. METHODS: We studied 60 unrelated healthy Chinese and 65 unrelated Chinese families, including 84 patients with WD and 126 parents. Genomic DNA was prepared from peripheral blood leukocytes using a salt-precipitation method. Polymerase chain reaction single-strand conformation polymorphism and subsequent direct sequencing were used to identify the mutations and polymorphisms of ATP7B. Statistical analysis was performed using t test or chi(2) test. RESULTS: We identified 18 mutations (7 novel) and 11 polymorphisms (3 novel). The novel mutations are -36C-->T, Trp650ter, Gln914ter, 2810delT, Thr935Met, Arg1041Pro, and Glu1173Lys. The novel polymorphisms are 1168A-->G (Ile390Val), 2785A-->G (Ile929Val), and 3316G-->A (Val1106Ile). Two mutations, Arg778Leu and Thr935Met, are relatively frequent, representing 37.7% and 10.0% of patients, respectively. To our knowledge, we are the first to report the correlation between the genotype and phenotype of Arg778Leu. The result shows that Arg778Leu homozygotes are associated with the early onset of WD with hepatic presentation. CONCLUSIONS: The Arg778Leu and Thr935Met mutations are hot spots in the Chinese population. The features of mutations of ATP7B differ between the Chinese and Western ethnic populations. The Arg778Leu mutation has severe effects on the function of ATP7B. These findings are valuable for developing a fast and effective method to diagnose the presence of the WD gene.     

Adenovirus-mediated Bak gene transfer induces apoptosis in mesothelioma cell lines

OBJECTIVE: Conventional treatment for mesothelioma is largely ineffective. We therefore evaluated the novel approach of adenoviral gene transfer of the proapoptotic Bcl-2 family member Bak in mesothelioma cancer cell lines, which are sensitive and resistant to adenoviral p53. METHODS: Binary adenoviral Bak (Ad/GT-Bak and Ad/GV16) and LacZ (Ad/GT-LacZ and Ad/GV16) vectors were used for transduction of the mesothelioma cell lines I-45 (p53 resistant) and REN (p53 sensitive). Protein levels were determined by Western blotting. Apoptosis was assessed by morphologic changes, caspase-3 cleavage, and fluorescence-activated cell sorter analysis of subdiploid populations. Cell viability was determined with the XTT assay. Statistical analysis was performed with analysis of variance and the Student t test. RESULTS: High levels of Bak gene transfer were seen after coadministration of Ad/GT-Bak and Ad/GV16 in both mesothelioma cell lines. Apoptosis was induced 24 hours after Bak but not LacZ gene transfer ([Bak: I-45, 36%; REN, 25%] vs [LacZ: I-45, 1%; REN, 3%], P <.05]) in p53-sensitive (REN) and p53-resistant (I-45) cell lines. Cellular viability was significantly decreased 48 to 72 hours after Bak gene transfer compared with control vector in both cell lines (72 hours: Bak I-45, 1.4% +/- 1.0%, and Bak REN, 4.7% +/- 1%, vs Lac-Z I-45, 83% +/- 3%, and Lac-Z REN, 100% +/- 1%; P <.05). CONCLUSIONS: Adenovirus-mediated overexpression of the Bak gene induces apoptosis and decreased cellular viability in p53-sensitive and p53-resistant mesothelioma cells. These data suggest that the gene transfer of proapoptotic Bcl-2 family members may represent a novel gene therapy strategy to treat mesothelioma.     

Three-field lymph node dissection for esophageal cancer in elderly patients over 70 years of age

BACKGROUND: The risk and benefit of esophagectomy with three-field lymph node dissection has not been well defined in elderly esophageal cancer patients. METHODS: A total of 441 patients underwent three-field lymph node dissection from 1986 to 1998. Patients were divided into two age groups: group 1 consisted of 79 patients aged 70 years or over, and group 2 consisted of 362 patients under 70 years of age. Patients' characteristics and surgical outcomes were compared between groups. Risk factors for morbidity, mortality, and survival of patients in group 1 were further studied by multivariate analysis. RESULTS: Significantly more patients had multiorgan dysfunction preoperatively in group 1 (24; 30.4%) than in group 2 (34; 9.4%, p < 0.001). The overall (65.8% vs 61.6%, p = 0.483) and surgically related complication rates (41.8% vs 52.2%, p = 0.093) were similar, but significantly more organ failure (11.4% vs 5.0%, p = 0.031) and infection (22.8% vs 13.8%, p = 0.045), defined as medical complications, occurred in group 1. There was no significant difference in 30-day (3.8% vs 0.8%, p = 0.074) or in-hospital mortality (7.6% vs 3.3%, p = 0.082) between groups. The overall (40.9% vs 48.1%, p = 0.235) and cause-specific 5-year survivals (55.4% vs 59.1%, p = 0.688) were comparably good in both groups, but the risk of death due to causes other than esophageal cancer was much higher in the elderly (p = 0.028). Multiorgan dysfunction was an independent predictive factor in elderly patients for overall and medical morbidity, overall survival, and risk of death from causes other than esophageal cancer. CONCLUSIONS: Esophagectomy with three-field lymph node dissection could be carried out safely in patients over 70 years of age with satisfactory long-term results. For elderly patients with multiorgan dysfunction, however, less invasive procedures might be more appropriate.     

刺五加皂苷对外周刺激诱发的海马长时程增强效应的影响

目的：探讨刺五加皂苷（ASS）对大鼠海马CA1区长时程增强效应（LTP）的影响。方法：20只雄性SD大鼠随机分为对照组与ASS组,每组10只,两组单刺激（10～20 V,0.5 ms,1次/min,30 min）坐骨神经诱发海马CA1区场电位。强直刺激（35 V,0.5 ms,100 Hz,持续1 s,间隔10 s,4次）坐骨神经,诱发海马CA1区场电位LTP。ASS组在强直刺激前,于侧脑室内微量注入ASS 1.0μg/5μL,强直刺激后观察 其对LTP的影响。结果：电刺激坐骨神经可在海马CA1区诱发出潜伏期（172.33±1.65）ms和可重复出现的以负波为主的场电位,平均幅度（32.24±0.72）μV。对照组强直刺激后可出现持续时间2 h以上的LTP现象。ASS增强了强直刺激后海马CA1区LTP的诱导。结论：刺五加皂苷对大鼠海马CA1区LTP有明显促进作用,表明其可提高大脑学习、记忆能力。     

新生儿食管闭锁与食管气管瘘临床及X线诊断的相关分析

目的探讨新生儿食管闭锁与食管气管瘘临床特点及X线诊断的相关性。方法17例新生儿食管闭锁与食管气管瘘中，男婴10例，女婴7例，年龄为出生后3d-1岁。采用透视、拍片及用20％-30％的泛影葡胺行消化道造影检查。结果17例中，食管完全闭锁1例，上段食管盲袋4例，食管气管瘘12例，有3例合并其他畸形。均有典型的临床症状和X线表现。结论临床症状与X线检查相结合是诊断新生儿食管闭锁与食管气管瘘最佳手段。     

0.1％罗哌卡因和左旋布比卡因用于妊高征分娩镇痛的临床研究

目的研究0．1％罗哌卡因和0．1％左旋布比卡因在妊娠高血压综合征患者硬膜外分娩镇痛的效果及不良反应。方法将60例符合妊娠高血压综合征诊断标准的初产妇随机分成两组，每组30例。分别为治疗组（0．1％罗哌卡因）和对照组（0．1％左旋布比卡因），均在宫口开大3cm时经L3、4棘间隙行硬膜外阻滞，向头侧置管3cm，开放静脉通道。改仰卧头高位后，治疗组注入0．1％罗哌卡因5mL内含2μg／mL芬太尼，对照组注入0．1％左旋布比卡因5mL内含2μg／mL芬太尼，追加药物，调节麻醉平面至T10。30min后，经硬膜外导管接入镇痛泵。治疗组镇痛泵配方为0．1％罗哌卡因与2μg／mL芬太尼混合液50mL，对照组镇痛泵配方为0．1％左旋布比卡因与2μg／mL芬太尼混合液50mL。分别以6～8ml/h速度泵入上述混合液。当宫口开大（8～9cm）时，停止药液泵入。观察产妇活跃期及第二产程的血压和心率、胎儿心率。采用改良的Bromage评分法评定下肢阻滞程度、镇痛效果，观察产妇第一产程活跃期时间、第二产程时间及新生儿Apgar评分、记录产妇的分娩方式。结果①治疗组镇痛效果与对照组相比较差异无显著性（P〉0．05）。②镇痛后治疗组和对照组血压明显降低，心率减慢差异无显著性（P〉0．05）。③两组产妇运动阻滞有统计学差异。④在器械助产、会阴侧切、正常分娩及缩宫素使用情况及新生儿Apgar评分方面，两组产妇无统计学差异（P〉0．05）。⑤中转剖宫产率治疗组、对照组比较差异无显著性（P〉0．05）。结论0．1％罗哌卡因和0．1％左旋布比卡因硬膜外阻滞用于妊娠高血压综合征分娩镇痛效果良好，血压及心率稳中有降，不影响产程，对产妇和胎儿生理影响小等优点，均可安全用于妊娠高血压综合征分娩镇痛。