两种常用加力方式对种植钉压低上前牙力学行为影响的三维有限元分析

目的：使用三维有限元法分析种植钉压低上前牙时两种常用加力方式对上前牙力学行为的影响，为正畸临床提供生物力学依据。方法：建立含有托槽、弓丝、上前牙、牙周膜和牙槽骨的三维有限元模型。设定加力方式：方式1：起点为弓丝中点，终点为前鼻棘下。方式2：起点为中切牙与侧切牙间弓丝的中点，终点为与前鼻棘等高的中切牙与侧切牙间牙槽骨。分析牙周膜的主应力分布及牙齿的初始位移。结果：方式2的牙周膜应力分布更均匀。两种加力方式下，上切牙均发生唇倾。加力点两侧的牙齿向加力点倾斜。结论：将种植钉植入中切牙与侧切牙之间施加压低力更为合理。压低过程中需注意前牙转矩的控制，并使用较粗的不锈钢丝作为主弓丝。     

以DNA拓扑异构酶Ⅱ为靶点的一种抗癌药筛选的新方法

借鉴文献方法,我们以小鼠L_(1210)白血病细胞为村料,提取DNA拓扑异构酶Ⅱ,鉴别了其生物学特性,并观察了十多种已知及未知的抗癌药物对其活性的影响,初步建立了以DNA拓扑异构酶Ⅱ为靶点的新抗癌药筛选方法。实验表明DNA拓扑异构酶Ⅱ对DNA链切割反应是可逆的,并且高浓度的氯化钠对其活性有抑制作用。许多药物能促进拓扑酶Ⅱ引起的DNA链断裂如ADM、DNR、Vp16及ACM—B等,而另一些药物如萜类化合物BC_1、BC_4等则能抑制链断裂反应。     

奎硫平与利培酮治疗老年期精神分裂症的对照研究

目的　比较奎硫平与利培酮治疗老年期精神分裂症的临床疗效与安全性。方法　将68 例住院老年期精神分裂症患者,随机分成两组,分别给予奎硫平与利培酮治疗,疗程8 周。采用阳性症状量表和阴性症状量表(PANSS)评定疗效,用副反应量表(TESS)评定不良反应。结果　治疗8 周后PANSS总分较治疗前显著下降奎硫平组有效率91.2%,显效率为76.5%,利培酮组分别为88.2%和73.5%,两组比较差异无显著性(P>0.05)。奎硫平组不良反应少而轻。结论　奎硫平与利培酮治疗老年期精神分裂症患者疗效相当,奎硫平不良反应较轻,安全性好。     

Pre-operative serum levels of tissue polypeptide antigen in patients with gastric cancer

Abstract Pre-operative serum tissue polypeptide antigen (TPA) levels were measured in cases of gastric cancer from December 1987 to December 1992. All 351 cases received gastrectomies. The clinicopathological factors were analysed. The significant factors that correlated with the elevation of pre-operative serum TPA levels included tumour size (> 7 cm), Borrmann-type cancers, late stages (III and IV), lymph node metastasis, hepatic metastasis and Ming's expanding type cancers. Multivariate analysis showed that the tumour size (> 7 cm) and the presence of hepatic metastasis are significant factors. To clarify the relationships between gastric cancer per se and the pre-operative serum TPA levels, we selected cases without evidence of metastasis (n = 139). The tumour size was the only significant factor when multivariate analysis was applied. Possibilities of hepatic recurrence were found in cases with high pre-operative serum TPA levels (> 220 U/L), even radical gastrectomies were performed. A high pre-operative serum TPA level did not display a poor survival prognosis, if the radical gastrectomy was possible. We thus concluded that: (i) elevated pre-operative serum levels of TPA are associated with either a large size tumour (> 7 cm) or the presence of hepatic metastasis and the tumour size is the most important factor relating to the serum TPA levels; (ii) high pre-operative serum TPA levels (> 220 U/L) may serve as indicators of later hepatic recurrence; and (iii) elevated serum TPA levels were not indicators of survival prognosis.     

青少年非骨化性纤维瘤误诊分析

目的探讨非骨化性纤维瘤的本质,提高非骨化性纤维瘤的临床诊治准确率。方法对15例曾被误诊为其他疾病的非骨化性纤维瘤的临床资料进行回顾分析。结果(1)青少年是疾病高发人群,以男性、四肢长骨多见;(2)影像学检查有特征性改变,特别是X线结合CT检查可明显提高非骨化性纤维瘤的检出率;(3)病理检查是最终确诊的方法。结论提高对可疑病例重视,合理应用影像学检查手段,早期病理检查可对非骨化性纤维瘤做出正确诊断。     

外周神经复发性神经鞘瘤的显微外科治疗

目的　探索复发性神经鞘瘤的显微手术方法并观察其疗效。方法　本组 2 1例均采用显微外科切除方法 ,以瘤体远、近端正常神经束为线索 ,用窄而锐利的刀片纵向锐性切割快速切除肿瘤。结果　 2例术后 2周内有手麻痛 ,很快恢复。无 1例产生新的神经损伤并发症。随访 10个月至 5年 ,无 1例复发。结论　采用显微外科方法可以快速、彻底地切除复发性神经鞘瘤 ,而且能很好地保存神经功能 ,并可使肿瘤不再复发。     

A randomized prospective comparison of oral versus intraperitoneal ofloxacin as the primary treatment of CAPD peritonitis

Summary: Oral ofloxacin has been successfully used in our centres for the primary treatment of peritonitis complicating continous ambulatory peritoneal dialysis (CAPD). In view of the progressive rise in the resistance rate to ofloxacin among peritoneal bacterial isolates, a study was conducted to determine if oral ofloxacin remains a viable first line treatment for CAPD peritonitis in our centres and if the result can be improved by changing from an oral to an intraperitoneal (i.p.) route. In patients on three 2 L daily CAPD exchanges, ofloxacin given at the i.p. dosage of 200 mg loading followed by 25 mg/L of peritoneal dialysate achieved overnight trough peritoneal levels which are at least four times the minimal 90% inhibitory concentration (MIC90) of most bacterial pathogens without significant accumulation in the systemic circulation. This i.p. dosage was therefore chosen for the clinical study and the result was compared to that using ofloxacin given in the oral dosage of 400 mg loading followed by 300 mg once daily as maintenance. of all the recruited episodes, 35 were eligible for analysis. the overall primary cure rate including primary failures and relapses was 55.6% (10/18) in the oral treatment group and 70.6% (12/17) in the i.p. treatment group. the corresponding figures for gram positive bacterial (g +) infections were 36.4% and 50%, for gram negative bacterial (g -) infections were 66.7 and 80% and for culture negative infections were 75 and 80%. In culture positive cases, all treatment failures were due to resistant infections which were observed in 42.3% of all bacterial isolates, 47.1% of g + isolates and 33.3% of g - isolates. Due to the high background level of bacterial resistance among our CAPD population, ofloxacin monotherapy given either by the oral or the i.p. route can no longer be recommended for the primary treatment of CAPD peritonitis.     

术后硬膜外镇痛泵的临床应用与疗效观察

目的：本文观察术后病人使用硬膜外自控镇痛泵(PCEA)和持续镇痛泵(CEA)的方法和临床效果。方法：60例ASAⅠ～Ⅱ级腹部手术患者，随机分为二组：A组(PCEA组)30例，吗啡15mg、氟哌利多5mg、布比卡因150mg 0．9％NS至100ml。持续量1ml／h，PCA量0．5ml／次，安全锁定时间15min。B组(CEA组)30例，吗啡10mg、氟哌利多5mg、布比卡因150mg、 0．9％NS至100ml。持续量2ml／h。均于手术结束时将镇痛泵于硬膜外导管连接，观察并记录疼痛评分、SpO2、呼吸频率、血压、镇静状态及恶心呕吐等指标。结果和结论：二组病人上述观察指标无显著性差异，疼痛控制率均达98％。总之我们认为两种给药方法均为较好的术后止痛法。     

旅店业预防艾滋病健康教育工作现状分析

目的了解旅店业艾滋病防治宣传材料、安全套分发使用情况,为指导旅店业有效开展预防艾滋病健康教育工作的提供参考。方法选择AIDS流行率及高危因素各具不同特点的皖北、皖中、皖南的各1个市,随机抽取各档次宾馆、旅社、招待所共36个调查单位,采用问卷调查的方式,进行旅店业预防艾滋病健康教育工作情况,安全套、宣传材料来源、分发使用及其需求的调查,同时调查612名服务员和206旅客艾滋病防治相关知识、态度。结果36家单位中,1/3的宾旅馆没有艾滋病防治宣传材料;有安全套供应/销售的旅店占47.2%。旅店业服务人员核心信息完全知晓率只有10.95%;入住旅客艾滋病核心信息完全知晓率为10.19%;多数旅店服务人员持有艾滋病防治积极态度;48.50%的旅客对旅店放置安全套持积极态度。结论旅店业开展艾滋病防治工作具有可行性和有效性。建立由政府多部门合作的旅店业艾滋病防治工作保障机制,动员旅店业服务人员参与预防艾滋病活动,有利于艾滋病防治政策和措施的落实。