锁骨下动脉损伤及创伤性假性动脉瘤手术方法探讨

目的探讨锁骨下动脉损伤及创伤性动脉瘤的外科治疗方略。方法1991—2005年对2例锁骨下动脉损伤，6例锁骨下假性动脉瘤根据病变的部位、程度及受伤时间、累及范围等选择手术入路，采用血管缝扎、血管壁修补、血管吻合、血管移植、辅助体外循环及球囊止血技术实施手术。结果6例痊愈，1例动静脉狭窄，1例动脉闭塞伴臂丛损伤。平均失血800mL。结论锁骨下动脉损伤及假性动脉瘤手术复杂，术前对病变进行仔细评估，选择合理的切口及手术方法是减少并发症的关键。     

Multiclefted nuclei. A helpful feature for identification of intermediate trophoblastic cells in uterine curetting specimens.

Intermediate trophoblast is a distinct form of trophoblast, the presence of which in uterine curettings is considered a reliable indicator of intrauterine pregnancy even in the absence of chorionic villi. However, the appearance of intermediate trophoblastic cells have not been described in sufficiently specific terms to permit their reliable identification, and distinction from decidual cells can be difficult. We have noticed for some time that the intermediate trophoblastic cells often show multiple deep clefts in the nuclei, and the present study was performed to address the issue of whether this nuclear feature is reliable for their identification. We reviewed 242 uterine curettings of intrauterine pregnancy, documented by the presence of chorionic villi, and were able to find a distinct population of cells with large, hyperchromatic, multiclefted nuclei scattered in the decidua in 88% of the cases. In most instances, these cells produced a characteristic variegated pattern that was readily recognizable at low magnification. Positive immunostaining for cytokeratin (CAM 5.2) in these isolated cells within the decidua confirmed their trophoblastic nature. In contrast, multiclefted nuclei were absent in the 51 negative control cases, which included decidualized endocervical polyps (40 cases), uterine curettings from patients with tubal pregnancy (10 cases), and endometriosis with decidual change (one case). We conclude that intermediate trophoblastic cells can usually be reliably identified in curettings of intrauterine pregnancy by their characteristic nuclear multiclefting.     

Variation of Apolipoprotein A-I in Cirrhosis and its Clinical Value

The serum apolipoprotein A- I (apo A-I) Concentrations in 39 patients with posthepatitis cirrhosis were reported to be 0.87±0.27 g/L lower than that of controls 1.15±0.14 g/L P<0.01. The, decrease of apo. A-I was correlated with the severityof impaired liver function. Apo A- I concentrations in serum correlated positively with decrease of serum albumin (r=0.503 P< 0.01) and negatively with serum bilirubin increase (r=- 0.508 P <0.01) . The data indicate that decreasing of apo A- I concentration may be regarded as one of the reliable indices reflecting the degree of liver function impairment.     

用速率法测定尿NAG活性及其临床应用

本文报道用５５０型全自动生化分析仪，以速率法测定尿ＮＡＧ活性及本室尿ＮＡＧ活性的正常参考范围；并对可能影响尿ＮＡＧ活性的尿ＰＨ，尿素浓度等进行了干扰试验及分析。     

二阶导数光谱法测定尿中呋喃妥因浓度

本文采用有酸性条件下用乙酸乙酯萃取呋喃妥因后，通过二阶导数光谱法测定尿中呋喃妥因的浓度。该法定量信息为３７４￣３７７ｎｍ处的峰谷之间距离，最低检出浓度为１．５ｍｇ／Ｌ，回收率为９８％，相对标准差小于３％；本法与ＨＰＬＣ法进行了对照性研究。两法具有明显的相关性（ｒ＝０．９９９１）。本法可用于呋喃妥因药动学的研究。     

中西医结合治疗急性胰腺炎疗效观察

目的:观察中西医结合治疗急性胰腺炎的疗效。方法:西药组23例用西药治疗,中西医结合组19例在用西药治疗的基础上加用柴芍承气汤及丹参注射液治疗。结果:中西医结合组疗效明显优于西药组(P<0.05)。结论:中西医结合治疗急性胰腺炎可明显改善急性期症状,减少并发症,改善预后。     

健康和病变人声带振动特性声门图

本文用多功能声门图仪测定了健康受试者(男46名,女34名)和不同喉病患者(男134名,女87名)声门图的波形及其特征参数。根据测出的正常声门图及其参数分布研究了恶性喉病变、声带麻痹、喉内关节病变、功能性声门发声障碍、声带息肉、声带小结、喉炎和早期喉病的临床声门图表现及其与声带振动模式变异之间的关系,并探讨了上述病变声门图的鉴别诊断指标和用声门图对喉病手术治疗、药物治疗和功能治疗的疗效进行定性和定量评价。研究结果证实:声门图方法能准确、定量、灵敏地反映声带振动模式及其变异;在喉病诊治中具有重要的应用价值。     

被动吸烟与肺癌的病例—对照研究

我们针对确定被动吸烟与肺癌关系设计了以医院人群为基础的病例对照研究.应用Mantel Haenssel方法及条件Logistic回归方法进行了单因素及多因素分析.结果表明:在研究对象家中有人吸烟、有1人吸烟、有2人吸烟,均发现与肺癌有显著意义的关联,OR值和95%CI分别为2.30,1.042～4.073、2.28,1.206～4.117、2.52,1.20～5.288;研究对象家中有1人在其出生前吸烟、其OR值为1.82,95%CI1.088～3.055,父亲吸烟及父亲在研究对象出生前吸烟其OR值与95%CI分别为2.13,1.179～3.858、2.28,1.275～4.061,同时我们还发现与吸烟的配偶生活20年以上者患肺癌的危险增加,OR值和95%CI为2.17,1.203～3.914;做饭年限超过25年,厨房与卧室相通者与肺癌间存在显著意义的关联.OR和95%CI分别为2.06,1.042～4.073、2.78,1.137～6.791.本研究未发现有统计学上显著意义的交互作用.有关母亲吸烟,服用维生素C,维生A,肺癌家族史及经济水平等因素均未发现在统计学上有显著意义的关联.     

反相高效液相色谱法同时测定水杨酸原料中水杨酸和微量杂质苯酚含量

本文采用反相高效液相色谱法同时测定水杨酸原料中水杨酸及微量杂质苯酚含量。该法简便、快速、样品测定在１０ｍｉｎ内完成，其中水杨酸平均回收率为１００．４２％（ＲＳＤ１．４５％），苯酚平均回收率为１０２．２７％（ＲＳＤ２．１２％）。     

间置空肠贲门再造术在抗返流性食管炎上的应用

作者对１５例贲门癌患者行根治术同时，采用食管残胃间插入带蒂空肠并附加贲门再造术，通过ＳＰＥＣＴ胃食管返流指数测定、食管下端ｐＨ检测及返流症状评定方法，并与单纯食管胃套叠吻合术进行随机对比分析，证明该术式具有单向住屏障作用，能有效地预防返流性食管炎的发生。