地黄合剂降血糖作用的实验性研究

本文通过用四氧嘧啶复制小白鼠糖尿病模型,以血清中血糖及胰岛素水平为指标,研究了地黄合剂对高糖动物的降血糖作用。结果表明,注射四氧嘧啶前小白鼠血糖为173.47±5.23mg/100ml注射后血糖升高至419.78±22.70mg/100ml(P<0.01),差异有高度显著性。实验组服用地黄合剂后,血糖值从410.25±2739mg/100ml下降至313.51±29.39mg/100ml(P<0.05)差异有显著性。因而认为地黄合剂对于四氧嘧啶性糖尿病有显著的降血糖作用。     

Acute Cellular Rejection with CD20-Positive Lymphoid Clusters in Kidney Transplant Patients Following Lymphocyte Depletion

Lymphoid clusters (LC) containing CD20-positive B cells in kidney allografts undergoing acute cellular rejection (ACR) have been identified in small studies as a prognostic factor for glucocorticoid resistance and graft loss. Allograft biopsies obtained during the first episode of ACR in 120 recipients were evaluated for LC, immunostained with CD20 antibody, and correlated with conventional histopathologic criteria, response to treatment and outcome. LC were found in 71 (59%) of the 120 biopsies. All contained CD20 positive B cells that accounted for 5-90% of the LC leukocyte content. The incidence of LC was highest in the patients who had no lymphoid depletion or had been treated with Thymoglobulin preconditioning (79% vs. 75%, respectively) compared to 37% in patients pretreated with Campath (p = 0.0001). Banff 1a/1b ACR were more frequent in the LC-positive than the LC-negative group (96% vs. 80%, respectively; p = 0.0051). With a posttransplant follow-up of 953 +/- 430 days, no significant differences were detected between LC-postitive and LC-negative groups in time to ACR, steroid resistance, serum creatinine and graft loss. CD20+LC did not portend glucocorticoid resistance or worse short to medium term outcomes. CD20+LC may represent a heterogenous collection in which there may be a small still to be fully defined unfavorable subgroup.     

肾动脉狭窄支架植入术的临床疗效观察

目的探讨肾动脉狭窄支架植入术的临床疗效.方法1997年1月～2004年12月,我院行支架介入治疗肾动脉狭窄27例.对27例术前、术后及随访期内血压、肾功能以及生活质量进行评估,并与同期单纯药物治疗肾动脉狭窄27例进行比较.结果介入组27例植入支架40枚,手术成功24例(88.9%,24/27),失败3例(11.1%,3/27),手术并发症5例(18.5%,5/27).术后在血压下降(包括收缩压舒张压)肌酐下降,肾小球滤过率增加方面,介入组获益率明显优于药物组,两组比较差异均有显著性,术后随访6个月～8年6个月,中位数为1年9个月,介入组有19例能比较健康的生活和工作,药物组仅12例能维持生活和工作.结论支架介入治疗较单纯药物治疗肾动脉狭窄疗效显著.     

食管癌围手术期死亡原因分析

目的探讨食管癌围手术期死亡原因及影响因素。方法总结1970年-2004年1858例食管癌手术患者临床资料,选择17个可能影响围手术期死亡的因素,应用Cox回归模型进行多因素分析。结果1858例食管癌手术患者围手术期死亡36例(1.94%)。呼吸系统并发症是引起围手术期死亡最常见的原因(41.7%)。Cox模型多因素分析显示严重吞咽困难、长期重度吸烟史、手术时间和手术年代是影响食管癌围手术期死亡的独立因素(P<0.05)。结论加强营养、改善肺功能、缩短手术时间是降低食管癌围手术期死亡率的重要方法。     

去带盲升结肠可控膀胱术后远期并发症(附105例报告)

目的 探讨去带盲升结肠可控膀胱术后远期并发症的发生及防治.方法 回顾性分析1995年10月至2003年1月105例去带盲升结肠可控膀胱术后患者资料.男83例,女22例.年龄32～78岁,平均60岁.随访时间9～82个月,平均40.5个月.结果 发生远期并发症27例（25.7%）,其中导尿插管困难4例（3.8%）,3例行尿道扩张后治愈,1例再次手术利用末段回肠重建输出道;贮尿囊结石5例（4.8%）,4例行贮尿囊切开取石治愈,1例无自觉症状者未行处理;贮尿囊穿孔1例（0.9%）,行手术修补后痊愈;贮尿囊过度扩张1例（0.9%）,行贮尿囊缩小术;肾积水8例（7.6%）,合并输尿管返流1例,合并下段输尿管狭窄4例,其中2例行狭窄段输尿管切除再吻合,1例术前为氮质血症者发展为尿毒症需行规律血透;血氯增高7例（6.7%）,1例出现高氯性酸中毒需长期口服碳酸氢钠;单纯表现为症状性泌尿系感染1例（0.9%）.27例中另合并症状性泌尿系感染10例,根据尿培养结果予敏感抗生素治愈.结论 去带盲升结肠可控膀胱术后远期并发症多与症状性泌尿系感染相关,积极防治泌尿系感染,规律、充分的贮尿囊冲洗及定时清洁导尿对远期并发症的预防有重要作用.     

Thromboprophylaxis post vaginal delivery: are we forgetting it? Audit on thromboprophylaxis prescription post vaginal births.

Pulmonary thromboembolism is the leading direct cause of maternal deaths in the UK. The majority of deaths occur in the puerperium. Caesarean section has been recognised as a risk factor but there is concern that more attention to thromboprophylaxis after vaginal births is needed. The hospital maternity unit in Dumfries has written guidelines on thromboprophylaxis after vaginal births. This audit assessed the compliance with these guidelines within this maternity unit. The case notes relating to spontaneous vaginal births over a 2-month period (n=148) and instrumental vaginal births over a 7-month period (n=29) were reviewed. Information concerning venous thromboembolism risk and any thromboprophylaxis given was extracted. The audit showed that 9% of spontaneous vaginal births and 62% of instrumental vaginal births required specific thromboprophylaxis. However, only 31% of the spontaneous vaginal births and 22% of the instrumental vaginal births in which thromboprophylaxis was indicated did indeed receive the required treatment. Failure to respond to venous thromboembolism risk factors was common. Measures to increase the awareness of maternity staff to these factors are suggested.     

Tissue-engineered trachea: History, problems and the future.

This review tries to summarize the efforts over the past 20 years to construct a tissue-engineered trachea. After illustrating the main technical bottlenecks faced nowadays, we discuss what might be the solutions to these bottlenecks. You may find out why the focus in this research field shifts dramatically from the construction of a tubular cartilage tissue to reepithelialization and revascularization of the prosthesis. In the end we propose a novel concept of 'in vivo bioreactor', defined as the design of a perfusion system inside the scaffold, and explain its potential application in the construction of a tissue-engineered trachea.     

The effect of low dose lofepramine in depressed elderly patients in general medical wards.

A double-blind randomised controlled trial of the effect of low dose lofepramine (70 mg once daily) against placebo was carried out on depressed elderly inpatients on general medical wards for the elderly, comparing measures of depression and side-effects between the randomised groups. Patients were identified for the study using the Geriatric Depression Scale (GDS) and the Brief Assessment Schedule Depression Cards (BASDEC). Sixty-three subjects were randomised: 46 patients completed the entire trial of 28 days treatment. BASDEC and GDS were administered on day 8 post-admission, and depressed patients were randomised double-blind to either low dose lofepramine (70 mg daily) (n = 23) or placebo (n = 23). Assessment of changes in depressive states were made using the Montgomery Asberg Depression Rating Scale (MADRS) on days 8, 18 and 36 post-admission. Both groups improved by a similar amount during the trial. Lofepramine tended to be more effective than placebo in those patients who were more depressed (GDS > or = 18). On the other hand, subjects who were less depressed (i.e. GDS < 18) improved more on placebo than lofepramine. Low dose lofepramine may prove useful in moderately or severely depressed patients treated for only 4 weeks. However, low dose lofepramine is not indicated for mild (GDS 15-18) depression.     

系统性红斑狼疮女性患者血清CA125,CA199化学发光法测定的临床应用

目的 :探讨系统性红斑狼疮 (SLE)女性患者血清肿瘤标志物CA12 5 ,CA199含量变化及临床意义。方法 :用化学发光法测定 30例正常女性和 38例SLE女性患者血清中CA12 5 ,CA199含量。结果 :正常组CA12 5含量为 11.14± 6 .4 8U/ml,CA199含量为 3.75± 2 .89U/ml;SLE组CA12 5 ,CA199分别为 2 2 .5 6± 2 0 .4 6U/ml,9.5 7± 9.34U/ml。SLE患者CA12 5 ,CA199阳性率分别为 2 1.1% ,7.89%。结论 :SLE患者血清CAl2 5 ,CA199含量较正常组增高 (P <0 .0 5 )。CA12 5 ,CA199在SLE女性患者中可出现阳性 ,对临床诊断SLE有一定价值。     

特发性肺间质纤维化的研究及其药物疗效的回顾

本文采用国内、外文献综述方法，分析了特发性肺间质纤维化的研究进展及治疗现状。特发性肺间质纤维化在诊断、治疗等方面尚存在许多问题，其更有效的治疗药物还有待于医、药学工作者的不断研究。