药物治疗对痴呆的作用

目的 观察老年期痴呆的治疗.方法 治疗组老年期痴呆患者36例详录治疗前后实验室检查数据.健康老年人34例为对照组,以其体检时所得相关指标与治疗组比较分析.结果 有效率85%.S-TC明显下降,P-SOD明显升高,P-LPO,Ht,Va 降低、EET缩短.结论 对于老年痴呆应予早治疗,悬着合理有效的药物     

胃-食管单层宽边吻合法的临床应用

为了降低吻合口瘘的发生,我院自1988年以来,在对食管癌、贲门癌患者行胃食管吻合术或空肠代胃的空肠-食管、空肠-空肠及空肠-胃吻合术时,均采用单层宽边吻合法,取得了较好的效果。 1.临床资料:本组359例中,年龄35～71岁;食管癌217例,贲门癌142例;胃食管吻合347例。对全胃切除、空肠代胃及空肠间置患者施行食管-空肠单层宽边吻合12例,空肠-空肠单层宽边吻合12例,空肠-胃单层宽边吻合1例。其中胸内吻合154例,颈部吻合205例,腹内吻合12例。发生颈部吻合口瘘4例(1.9％),胸内吻合口瘘1例(0.6％),腹内吻合口无瘘发生。术后3～30个月复查未见吻合口狭窄发生。     

非综合征型唇裂伴或不伴腭裂的遗传方式

目的 为探讨非综合征型唇裂伴或小伴腭裂的遗传方式,对其高发家系进行遗传学研究. 方法 采用分离分析法和多基因阈值理论分析法对37个非综合征型唇裂伴或不伴腭裂的高发家系进行分析. 结果先证者的亲属患病率分别是一级亲属为29.89%(26/87),二级亲属为2.70%(4/148);其亲属发病率高低与血缘关系近远相关,与先让者血缘关系越近的亲属患病率越高;非综合征型唇裂伴或不伴腭裂的遗传方式不同于常染色体单基因显性、隐性遗传及性连锁遗传,而符合多基因遗传,其一级、二级亲属加权平均遗传度为(148.40±8.20)%. 结论非综合征型唇裂伴或不伴腭裂的遗传方式为多基因遗传.     

还原叶酸载体1基因A80G多态性与非综合征型唇腭裂的相关性研究

目的探讨还原叶酸载体(RFC)1基因A80G多态性与非综合症型唇腭裂(NSCL/P)相关性。方法收集97个核心家庭和104个对照家庭,用聚合酶链式反应-限制性片段长度多态性方法,进行RFC1基因A80G位点多态性检测,用人群关联研究分析、NSCL/P核心家庭的TDT、HHRR、FBAT等检验统计分析。结果人群关联研究分析,子代、父亲、母亲病例组和对照组之间基因型和等位基因的分布差异无显著性(P>0.05)。AG基因型相对于AA基因型的比值比OR(95%CI)、P值分别为子代0.87(0.44～1.70)、0.657;父亲1.09(0.54～2.21)、0.788;母亲1.63(0.79～3.36)、0.152。GG基因型相对于AA基因型的OR(95%CI)、P值分别为子代0.48(0.19～1.23)、0.094;父亲0.93(0.38～2.23)、0.850;母亲1.30(0.46～3.67)、0.584。G基因相对于A基因的OR(95%CI)、P值分别为子代1.22(0.78～1.94)、0.386;父亲1.02(0.64～1.61)、0.945;母亲0.91(0.58～1.41)、0.660。携带有突变基因G并不能增加患NSCL/P的危险。NSCL/P核心家庭分析,TDT检验中传递G等位基因给患病子代的为40次,传递A等位基因的为71次,等位基因A比突变等位基因G更易传递给患病子代(χ2=8.658,P<0.05;HHRR检验χ2=10.31,P<0.05;FBAT检验Z=2.942,P<0.05)。结论利用核心家庭资料进行统计分析的结果则认为RFC1基因A80G位点变异存在传递不平衡现象,这与NSCL/P发病危险之间存在有一定的关联关系,等位基因A可能与NSCL/P的高危显性有关系。     

意识障碍的鉴别诊断及治疗

目的 总结急诊意识障碍的主要病因以利快速准确地做出诊断.方法 回顾性分析156例急诊意识障碍患者的病因.结果 急诊意识障碍病因以急性脑血管病为主(60.9%),其中出血性脑血管病最易引起昏迷,大面积脑梗死、脑水肿明显时也可出现昏迷.其次为中毒类疾病及代谢紊乱.结论 本组资料从病因分析看,都以常见病为主,关键是病史不清,病情紧迫.因此临床一线医生必须注意临床特殊体征,并引导家属询间病史和认真查体,结合相关辅助检查,争取最佳抢救时间.     

纤维支气管镜在开胸术后肺不张中的应用

目的探讨纤维支气管镜吸痰与支气管灌洗术在开胸术后肺不张、肺部感染患者中的应用价值.方法分析48例术后肺不张、肺部感染患者,在监护条件下,行纤维支气管镜吸痰和灌洗术,并根据痰培养药物敏感试验结果选择抗生素治疗并评价效果.结果全组患者纤维支气管镜吸痰和灌洗术后恢复良好,合并肺部感染者均得以控制,无严重并发症发生.结论对开胸术后并发肺不张、肺部感染患者,行纤维支气管镜吸痰和灌洗术,能正确指导抗生素应用,是安全可行的治疗手段.     

蛋氨酸合酶基因A275 6G位点多态性与非综合征型唇腭裂的关联性研究

Objective To study the association of the A2756G polymorphism of the methionine synthase (MS) gene with nonsyndromie cleft lip with or without cleft palate (NSCL/P) in Chinese. Methods Ninety-seven NSCL/P case-parent triads were selected as the case group. One hundred and four healthy subjects and their biological parents were selected as control group. For all subjects the A2756G polymorphism of the MS gene was examined by PCR-RFLP method. Results There was no statistical difference in genotype and allele frequencies for MS A2756G variants among family members between case group and control group. The GG genotype was not detected in the offsprings and mothers. The odds ratio and confidence interval of genotype AG in offspring, father and mother were 1.78(0.74-4.34), 0.80(0. 36-1.79) and 1.26(0. 54-2.93) respectively. The odds ratio and confidence interval of allele G in offspring, father and mother were 1.70(0.78-3.73), 0. 88(0. 49-1. 75) , and 1.23(0.59-2.60) respectively. The G allele did not increase the risk of NSCL/P. Transmission disequilibrium test (TDT) analysis yielded no evidence of linkage disequilibrium (χ2=0.034,P>0. 05). The results of haplotype-based haplotype relative risk (HHRR) analysis (χ2=0.03,P>0.05) and family-based association tests (FBAT) (Z=0. 186, P> 0.05) failed to show association between the MS A2756G variant and the risk of NSCL/P. Conclusion The A2756G polymorphism of the MS gene was not associated with NSCL/P in Chinese in the present study.     

蛋氨酸合酶基因A275 6G位点多态性与非综合征型唇腭裂的关联性研究

Objective To study the association of the A2756G polymorphism of the methionine synthase (MS) gene with nonsyndromie cleft lip with or without cleft palate (NSCL/P) in Chinese. Methods Ninety-seven NSCL/P case-parent triads were selected as the case group. One hundred and four healthy subjects and their biological parents were selected as control group. For all subjects the A2756G polymorphism of the MS gene was examined by PCR-RFLP method. Results There was no statistical difference in genotype and allele frequencies for MS A2756G variants among family members between case group and control group. The GG genotype was not detected in the offsprings and mothers. The odds ratio and confidence interval of genotype AG in offspring, father and mother were 1.78(0.74-4.34), 0.80(0. 36-1.79) and 1.26(0. 54-2.93) respectively. The odds ratio and confidence interval of allele G in offspring, father and mother were 1.70(0.78-3.73), 0. 88(0. 49-1. 75) , and 1.23(0.59-2.60) respectively. The G allele did not increase the risk of NSCL/P. Transmission disequilibrium test (TDT) analysis yielded no evidence of linkage disequilibrium (χ2=0.034,P>0. 05). The results of haplotype-based haplotype relative risk (HHRR) analysis (χ2=0.03,P>0.05) and family-based association tests (FBAT) (Z=0. 186, P> 0.05) failed to show association between the MS A2756G variant and the risk of NSCL/P. Conclusion The A2756G polymorphism of the MS gene was not associated with NSCL/P in Chinese in the present study.     

周边型小肺癌的几个临床问题

我科共手术治疗原发性肺癌587例，包括周围型小肺癌49例。其中腺癌29例，鳞癌9例，腺鳞癌3例．大细胞癌2例，未分化小细胞癌6例。pTNM分期。Ⅰ期(T1N0M0)32例。Ⅱ期(T1N1M0)9例。ⅢA期(T1N2M2)8例。共实行52术次，(3例Ⅰ期腺癌术后复发二次手术)。结果鳞癌的5年生存率优于腺癌和其他组织类型肺癌；同组织类型小肺癌比较，N0优于N1，N1优于N2。既便是早期小肺癌。尤其是腺癌。预后也不全令人乐观。初步研究结果提示，小肺癌并不全是早期肺癌。术后的综合治疗仍是不可缺少的。