超声乳化联合小梁切除治疗白内障合并青光眼

目的　探讨超声乳化联合小梁切除治疗白内障合并青光眼的方法。方法　白内障合并闭角型青光眼15例 (15只眼 ) ,经巩膜隧道切口进行白内障超声乳化及人工晶状体植入 ,然后垂直剪开切口一侧 ,使之呈三角形巩膜瓣 ,在同一切口进行小梁切除及周边虹膜切除。结果　手术后随访 3～ 6月 ,矫正视力≥ 0 .5者 9例 ,6例视力较差的主要原因为青光眼性视神经萎缩。平均眼压 (14.2 1± 2 .74) mm Hg,14例为 、 型功能滤泡。结论　在同一切口施行白内障超声乳化、人工晶状体植入联合小梁切除治疗白内障合并闭角型青光眼 ,方法简单、安全、有效。     

获得性大疱性表皮松解症基底膜自身抗体靶抗原的定位研究

目的 探讨获得性大疱性表皮松解症(EBA)基底膜带自身抗体(BMZ—Ab)的靶抗原及其定位情况。方法 用免疫印迹(IB)、盐裂皮肤间接免疫荧光(IIF)、间接免疫电镜(IIEM)等方法检测6例EBA血清中。IgG型及IgA型BMZ—Ab识别的真表皮抗原以及抗原定位情况。结果 6例EBA血清中IgG型BMZ—Ab均结合真皮提取物中290ku蛋白，3例同时伴有结合290ku蛋白的IgA型BMZ—Ab。盐裂皮肤IIF显示BMZ真皮侧IgG线状沉积，IIEM示金颗粒沉积于BMZ致密下层，即真皮锚原纤维的Ⅶ型胶原处。结论 位于BMZ致密下层的Ⅶ型胶原是EBA中BMZ-Ab的特异性靶抗原，Ⅶ型胶原上的抗原表位可被EBA血清中IgG及IgA型BMZ—Ab识别。     

PULMONARY BLOOD DISTRIBUTION AFTER TOTAL CAVOPULMONARY CONNECTION OF DIFFERENT TYPES

Objective. To assess the feature of pulmonary blood flow distribution after total cavopulmonary connection (TCPC) of different types, and to provide the selection of the best type .Methods. Thirty-two consecutive survival patients after TCPC underwent radionuclide lung perfusion imaging. According to the radionuclide counts in the left and right lungs, analyses of the distribution of blood flow from superior venous cava (SVC) and inferior venous cava (IVC) and the whole pulmonary blood flow in both lungs were made. All patients were divided into 4 groups by the the anastomosis between IVC and pulmonary artery.Results. Group Ⅰ: The flow ratio of the IVC to left lung was greater than that to the right lung , P≤0. 01; the flow ratio of the SVC to right lung was greater than that to the left lung, P≤0. 01; and the whole pulmonary blood flow went dominantly to the left lung, P≤0. 05, which is not in line with physiological distribution. Group Ⅱ: the flows from the SVC and IVC were mixed in the middle of     

苓桂术甘汤的临床运用

苓桂术甘汤出自<伤寒论·辨太阳病脉证并治>:"伤寒若吐若下后,心下逆满,气上冲胸,起则头眩,脉沉紧,发汗则动经,身为振振摇者,茯苓桂枝白术甘草汤主之".<金匮要略·痰饮咳嗽病脉证并治>:"心下有痰饮,胸胁支满,目眩,苓桂术甘汤主之","夫短气有微饮,当从小便去之,苓桂术甘汤主之.肾气丸亦主之".     

Liposome-mediated transfer of vascular endothelial growth factor cDNA augments survival of random-pattern skin flaps in the rat.

Tissue engineering is an application for gene therapy that is in its infancy. We show that simple liposomal-mediated gene transfer could result in a potentially useful biological effect in the field of wound healing. cDNA encoding the 165 amino acid form of vascular endothelial growth factor complexed to commercially available liposomes was injected into rat skin 1 week before raising a random pattern 3 x 10 cm flap. The flap survival was enhanced by 14 percent, and was accomplished without accessing the arterial inflow of the territory. These results were statistically significant (p<0.002) and reproducible. No adverse effects were seen. Histological analysis of the angiogenesis localized much of the new vessel formation to the area around the hair follicles. Polymerase chain reaction amplification of extracted flap tissue confirmed the presence of the transgene.     

早期脑室置管行颅内压监护对中型颅脑损伤患者的预后影响

目的　探讨早期脑室置管行颅内压 (ICP)和脑灌注压 (CPP)监护在中型颅脑损伤中的临床应用价值。方法　将 12 5例伤后 2 4h入院无手术指征的中型颅脑损伤 (GCS 9～ 12分 )患者 ,随机分为ICP监护组 :入院后即经恻脑室内穿刺置管行ICP与CPP连续监测 ,根据颅内压变化调整治疗方案 ;对照组 :入院后不做ICP监测 ,依据临床观察的意识及生命体征变化 ,进行治疗。结果　颅内压监护组脱水剂剂量、应用时间均低于对照组 ,疗效优于对照组 ,两组差异有显著意义 (P <0 0 5 )。结论　中型颅脑损伤病情极不稳定 ,早期行ICP监护能及早发现病情变化 ,对及时采取有效治疗措施 ,降低死残率 ,改善预后有重要意义。     

臂丛加强化麻醉后并发颈部抽动9例分析

目的探讨臂丛加强化麻醉后颈部抽动的原因及防治。方法对近年来在麻醉方法、用药相同,术后颈部抽动患者的观察治疗过程进行分析。结果臂丛麻醉并发颈部抽动给予充分镇静后可完全治愈。结论麻醉后并发颈部抽动为药物副作用及颈局部刺激的综合作用。     

至生胶囊对人食管癌细胞Eca-109侵袭作用的影响

目的:探讨人食管癌细胞Eca-109对重组基底膜的侵袭作用及至生胶囊时其侵袭能力的影响.方法:取12只健康日本大耳白兔,随机分为至生胶囊高剂量组、低剂量组、复方斑螫胶囊对照组、生理盐水空白组4组,每组3只,连续给药3 d,末次给药后2 h内分别从耳中央动脉无菌采血,制备含药血清,采用TransweU细胞培养小室建立人肿瘤细胞体外侵袭模型,光学显微镜观察侵袭细胞的相对数目来表示肿瘤细胞的侵袭能力.结果:至生胶囊高剂量组、低剂量组对人食管癌细胞Eca-109有明显的抑制作用,与对照组、空白组比较,组间有显著性差异(P<0.05).结论:至生胶囊能明显抑制人食管癌细胞Eca-109对重组基底膜侵袭能力.     

Working‐correlation‐structure identification in generalized estimating equations

Selecting an appropriate working correlation structure is pertinent to clustered data analysis using generalized estimating equations (GEE) because an inappropriate choice will lead to inefficient parameter estimation. We investigate the well‐known criterion of QIC for selecting a working correlation structure, and have found that performance of the QIC is deteriorated by a term that is theoretically independent of the correlation structures but has to be estimated with an error. This leads us to propose a correlation information criterion (CIC) that substantially improves the QIC performance. Extensive simulation studies indicate that the CIC has remarkable improvement in selecting the correct correlation structures. We also illustrate our findings using a data set from the Madras Longitudinal Schizophrenia Study. Copyright © 2008 John Wiley & Sons, Ltd.