深部病原真菌菌种4453株分析

目的 分析深部病原真菌菌种分布。方法 收集1991-2003年我院门诊及住院病人6533例，对其标本按真菌培养分离鉴定步骤进行鉴定。结果 分离出白念珠菌3555株(85．44％)，克柔念珠菌309株(7．43％)，高里念珠菌239株(5．74％)；呼吸系统分离出真菌3004株(68．35％)；消化系统真菌1291株(29．37％)；泌尿生殖系统87株(1．98％)；神经系统8株(0．18％)；血液5株(0．11％)。结论 念珠菌属尤其白念珠菌是我院近13年间系统性真菌感染的重要致病菌；合理应用抗生素及早期诊断尤为重要。     

宫腔镜双极汽化电切术临床分析

目的 探讨宫腔镜双极汽化切割术的安全性和疗效。方法 术前宫腔镜诊断均为黏膜下肌瘤和肌壁间凸向宫腔肌瘤36例，在宫腔镜下施行双极汽化电切术。结果 手术成功率100％，手术时间10-70分钟，平均32分钟；出血量12-100ml，平均28ml；标本重15-42g，平均31g。术中、术后无并发症。术后满意率94．4％。结论 宫腔镜双极汽化切割术具有手术时间短、出血少、无并发症等优点，疗效满意。     

肺癌的纤支镜检查与影像学征象对照观察的临床研究

目的 联合应用影像学(胸部X线和CT)提高纤支镜对肺癌的诊断。方法选择我院纤支镜后组织病理学确诊的肺癌177例，全部病例在做纤支镜前1周内进行胸部X线或CT检查，并将影像学征象与纤支镜下表现及其病理学类型进行对照分析。结果中央型肺癌165例，周围型肺癌12例；纤支镜下主要表现有：外向型生长98例，浸润型生长63例，仅见间接征象5例，未见异常12例；组织病理学类型：鳞癌117例，腺癌29例，小细胞癌24例，其它肿瘤7例；影像学征象表现有：肺部肿块影116例，阻塞性肺炎表现为主27例，以局限性肺不张表现为主19例，片状模糊的阴影12例，两肺多发结节影3例。结论 纤支镜和影像学征象对肺癌的诊断各有特点，两者联合应用，可取长补短，提高肺癌的诊断。     

氟西汀对2型糖尿病合并抑郁症患者下丘脑-垂体肾上腺轴功能及临床疗效的影响

目的探讨氟西汀对 2型糖尿病合并抑郁症患者的下丘脑 垂体 肾上腺轴 (HPA)功能的影响及其临床意义。方法测定 98例 2型糖尿病患者和 3 4例正常对照组基础血皮质醇 (F ,0 8:0 0am、16:0 0pm)、小剂量地塞米松抑制试验 (DST)后血F、2 4h尿游离皮质醇 (UFC)。将 64例 2型糖尿病伴发抑郁症患者随机分成A组 (服用氟西汀组 ,3 2例 )和B组 (未服用氟西汀组 ,3 2例 )。予 6周治疗。分别于治疗前、后进行HAMD评分及代谢控制水平评估。结果 ( 1)血F( 0 8:0 0am、16:0 0pm)、2 4h尿UFC、DST脱抑制例数2型糖尿病患者较正常对照组增高 (P <0 .0 1) ,2型糖尿病伴抑郁症组 (DD组 )较无抑郁症组 (DM组 )增高(P <0 .0 5 ,P <0 .0 1)。 ( 2 )经 6周治疗后 ,服用氟西汀组 (A组 )较未服用氟西汀组 (B组 )糖皮质激素水平降低 (P <0 .0 1)、HAMD评分降低 (P <0 .0 1) ,糖脂代谢改善 (P <0 .0 5 ,P <0 .0 1)。 ( 3 ) 2 4h尿UFC与HbA1C呈正相关性 (r =0 .5 69,P <0 .0 1)、IR呈正相关 (r =0 .65 3 ,P <0 .0 1)、与HAMD评分呈正相关性 (r =0 .3 5 2 ,P <0 .0 5 )。结论 2型糖尿病及合并抑郁症患者HPA轴功能紊乱 ,加重了糖代谢紊乱和胰岛素抵抗 ;氟西汀干预治疗抑郁症可改善抑郁症和糖脂代谢。     

The Lipid-regulating Effects of Atorvastatin on Type 2 Elder Diabetes Patients with Hyperlipidemia

Inthisstudy,theeffectofatorvastatinonlipidmetabolism ,especiallysLDL ,intype 2elderdiabetespatientswithhyperlipidemiawasstudy .Theresultswerepresentedasfollows.1　SUBJECTSANDMETHODS1 1　SubjectsThesubjectsincluded 2 6patientswithtype 2elderdiabetesandhyp…     

无创性缺血预处理延迟相心肌保护作用及其机制的研究

目的　通过建立大鼠在体缺血再灌注模型 ,探索无创性缺血预处理 (NIPC)延迟心肌保护作用 ,以及核因子κB (NF κB)在此过程中所起的作用。方法　将SD雄性大鼠随机分成 4组 ,Ⅰ组 (I/R组 ) ;Ⅱ组 (NIPC组 ) ;Ⅲ组 (PDTC NIPC组 ) ;Ⅳ组 (PDTC组 )。PDTC为NF κB特异性抑制剂。建立体内大鼠缺血再灌注模型 ,分别结扎前降支 4 5min ,复灌 30min ,观察大鼠心肌超微结构、心律失常发生率 ,并测量超氧化物歧化酶 (SOD)、丙二醛(MDA)、热休克蛋白 70 (HSP70 )、NF κB的值 ;复灌 2h测定心肌梗死面积。其中NIPC为I/R前 2 4h采用止血带阻断双下肢血流 5min ,复灌 5min ,反复 3个循环。结果　Ⅱ组心功能恢复优于其它 3组、心梗面积小于其它 3组(P <0 0 5 ,P <0 0 1) ;心律失常发生率较其他 3组低 (均P <0 0 5 )。Ⅲ组的各项结果与另外 3组比较均有统计学意义 ,Ⅰ和Ⅳ组的结果差别没有统计学意义。结论　无创性缺血预处理可以起到延迟相心肌保护作用 ;NF κB在预处理过程中可以诱导产生心肌保护蛋白 ,但在心肌持续缺血过程中作为一种重要炎症因子可加重心肌损伤。     

Studies on the chemical constituents of the roots of Rhododendron molle G. don

Summary The compounds from the root ofRhododendron molle G. Don were isolated, purified by various chromatographic techniques, and their structures were identified according to the physical and chemical features and spectral data. Three compounds were separated from the root ofRhododendron molle G. Don and identified as Rhodojaponin-III,taraxerol, β-sitosterol for the first time. XIANG Yanni, female, born in 1976, Postgraduate student     

生物型人工硬脑膜应用的实验研究

OBJECTIVE: To evaluate the safety and efficacy of a dural graft prepared using porcine membrane in duraplasty. METHODS: Eighteen New Zealand rabbits were randomly divided into groups A (n=4), B (n=4), C (n=5), and D (n=5) sacrificed 3, 14, 30 and 90 d after duraplasty, respectively. Each animal underwent bilateral parietal craniectomy behind the coronal suture and beside the midline to expose the dura, which was cut on the right side and substituted with the dural graft. The exposed dura on the left was kept intact as control. The rabbits were observed for WBC counts before the operation and before sacrifice by transcardiac formalin perfusion, respectively. The meninges and brain tissues were histologically examined after sacrifice. RESULTS: The WBC count varied little after the operation (P>0.05). Microscopic examination demonstrated tissue repair on both the implantation side and control side, without graft adhesion to the cortical surface. In group A, a large number of leukocytes were seen gathering on the lateral dura, suggesting acute tissue repair. In group B, endothelial cells covering the inner surface of the graft could be seen. Fibroblasts and fibrocytes were seen in the grafts between collagen fibers in group C, and in group D, fibroblasts and fibrocytes increased between the collagen fibers and the suture healed. CONCLUSION: The dura graft is safe and applicable for dural defect repair.     

SA、F/TPSA及PSAD在前列腺癌诊断中的作用

目的 :探讨血清前列腺特异抗原 (PSA) ,血清总PSA及游离PSA比值 (F/TPSA)及前列腺特异性抗原密度(PSAD)在前列腺癌诊断中的作用。方法 :对 5 1例前列腺癌患者及 14 5例良性前列腺增生症患者PSA、F/TPSA及PSAD值的差异进行分析、比较。结果 :前列腺癌组血清PSA及PSAD高于良性前列腺增生组 ;而F/TPSA值低于良性前列腺增生组 ,差异均有显著性。结论 :PSA >4ng·ml-1作为筛选前列腺癌的临界值存在一定缺陷 ;当PSA <10ng·ml-1,F/T值有助于鉴别前列腺癌和良性前列腺增生 ;而PSAD对于筛选前列腺活检病例亦有一定价值。     

丙型肝炎病毒感染对肾移植术后影响的临床研究

OBJECTIVE: To study the influence of hepatitis C virus (HCV) infection on the clinical outcome of kidney transplantation. METHODS: The recipient/graft survival, the incidence of acute/chronic rejection and cause of death in 86 HCV-infected recipients of renal transplantation were compared with those in another 86 recipients without HCV infection. RESULTS: HCV-infected recipients had significantly shorter 5-year survival (74.4%) than those without HCV infection (87.2%, P<0.01). The 1-year (94.2%/90.7% vs 96.8%/96.0%) and 3-year recipient/graft survival rates (88.4%/79.1% vs 90.7%/87.2%), the incidence of acute/chronic rejection (31.3% vs 21.2%, and 12.5% vs 6.5%) and the 5-year graft survival (73.3%/81.4%) were comparable between the two groups (P>0.05). Hepatic disease was identified as the primary cause of mortality. CONCLUSIONS: HCV infection may affect the long-term survival of the recipients with kidney transplantation, and therefore should be considered as a relative contraindication of kidney transplantation.