A method for creating an enormous medical knowledge base

Using a high-density knowledge representation method designed by us, we have developed the Enormous Knowledge Base of Disease Diagnosis Criteria (EKBDDC). It contains diagnostic criteria of 1001 diagnostic entities and describes nearly 4000 items of diagnostic indicators. It is the core of a huge medical project—Electronic Brain Medical Erudite (EBME). This enormous knowledge base was implemented initially on a low-cost popular microcomputer, which can aid in prompting of typical disease and in teaching of diagnosis. This knowledge base will be constantly expanded and adapted to the need of diagnosing of atypical diseases. By means of a software interface it will be connected with the international medical information systems. We have also explored an assembling technique of medical knowledge base. To test the behavior of EBME we performed a series of trials with a total of 815 cases. The diagnostic accordance rates were 89.7, 89.4, and 85%, respectively. It demonstrated that this system should be improved before clinical application.     

改良以聚羟基乙酸为支架同种异体组织工程化塑形软骨的构建

OBJECTIVE: To improve the method for constructing allogeneic molded cartilage by means of tissue engineering techniques. METHODS: The chondrocytes from the rib and articular cartilage of infant rabbits were harvested by type II collagenase digestion, followed by in vitro cell culture for 3 to 4 passages. The chondrocytes were then prepared into cell suspension and seeded onto C -and O -shaped pre-molded polyglycolic acid (PGA) scaffolds form chondrocyte-PGA composites, which were subsequently cultured in vitro for 7 to 10 d before implanted subcutaneously into adult rabbits. Improvement was made upon conventional shaping and implantation procedures. Morphological observation and cartilage regeneration assessment were conducted at different time points following the implantation, in comparison with the observation by conventional shaping and implantation methods. RESULTS: During in vitro cell culture, the rate of viable chondrocytes in the final cell suspension was (92+/-2)% after well-controlled prolongation of digestion trypsin, similar to the viable cell rate (93+/-2) % by traditional procedures (P>0.05). Gross observation found milk-white, newly generated cartilage which had good flexibility 4 weeks after implantation, and after 8 weeks and later, the cartilage took on the color of porcelain-white. Histological examination showed a few inflammatory cells around the newly generated immature cartilage 4 weeks after implantation, and the inflammation abated when the newly generated cartilage acquired similar histological properties to that of the original cartilage 8 weeks postoperatively and later. After 16 weeks, no blood vessel or capillaries were visible within the new cartilage. CONCLUSION: The chondrocyte viability is not affected when the cells are treated with well-controlled prolonged digestion with trypsin during in vitro cell culture. Improved PGA scaffolds shaping and the implantation procedure facilitate the regeneration of the cartilage after the implantation of the composites.     

脊椎滑脱症合并腰椎间盘突出的治疗

1987年6月至1995年1月我院共治疗脊椎滑脱55例,其中17例合并腰椎间盘突出,占31％,临床表现为顽固的腰骶痛和下肢根性放射痛。手术复位、融合不稳定脊椎的同时,均摘除突出的椎间盘髓核组织。经半年以上随访,疗效满意,作者分析了本病的病因病理,认为诊断该病必须综合性检查分析,脊髓造影或CT检查有一定影像学诊断价值,治疗宜早行探查手术。     

烧伤创面细菌分布对植皮存活率的影响

目的　通过对烧伤病人不同时间的痂下组织细菌定量培养及种类检测 ,探讨手术时间、菌量和菌种与植皮存活率的关系。方法　选择 3 65例病人于手术时取痂下组织以组织匀浆行细菌定量并鉴定菌种。结果　 45 0份标本中 3 90份为阳性 ,共培养出细菌 5 80株 ,以铜绿假单胞菌(2 7.93 %)及金黄色葡萄球菌 (16.2 0 %)为最常见种类 ;手术时间、菌量和菌种对植皮存活率均有不同程度的影响 (P <0 .0 1)。结论　手术时间越早 ,痂下组织细菌含量越少 ,菌种较单一 ,植皮存活率越高 (P <0 .0 1) ;金黄色葡萄球菌感染对植皮存活率影响较大 (P <0 .0 1)。     

内脏高敏感与功能性胃肠病

功能性胃肠病(functional gastrointestinal disorders,FGIDs)是指一组以慢性或反复发作的消化道症状就诊,但无明确胃肠黏膜结构改变或生化异常可查的症候群。心理、社会因素可加重FGIDs患者症状,患者可同时伴有躯体症状[1]。其发病机制目前尚不明确,最初该类疾病被认为是胃肠神经官能症,大量的流行病学资料表明,尽管精神压力与患者症状发作有关,但主要还是决定于患者的就医行为。此后,FGIDs发病机制的研究又集中在胃肠动力改变方面,肠易激综合征患者(IBS)、功能性消化不良患者(FD)、非心源性胸痛患者(NCCP)均发现了各种胃肠动力异…     

荷移分光光度法测定诺氟沙星含量

本文研究了诺氟沙星与P-苯醌荷移反应条件,确定在乙醇介质中,在室温下反应50min可获得稳定的络合物,其λ_(max)=490nm;组成比为1:1表观摩尔吸光系数ε=4.13×10~3。应用拟定的方法测定制剂中诺氟沙星含量,获得满意的结果。     

国产氟康唑对小鼠隐球菌病的疗效

以５×１０３ｃｆｕ／鼠的新型隐球菌给小鼠脑室感染（ｉｃ）１ｈ后，分别口服氟康唑（Ｆｌｕ）５和１０ｍｇ／（ｋｇ·ｄ）或酮康唑（Ｋｅｔ）５０和１００ｍｇ／（ｋｇ·ｄ），ｂｉｄ×９ｄ。对ｉｃ小鼠连续观察４０天的存活率和平均存活时间，Ｆｕｌ分别为５０％～７０％和８～１５天，Ｋｅｔ是３０％～４０％和５～９天。由小鼠侧尾静脉注射１０６ｃｆｕ／鼠新型隐球菌３天后产生的全身感染，分别给小鼠口服Ｆｌｕ２．５～１０ｍｇ／（ｋｇ·ｄ）或Ｋｅｔ２５～１００ｍｇ／（ｋｇ·ｄ），ｂｉｄ×９ｄ。感染２４、２８和３２天的ＰＤ５０Ｆｌｕ是２．７、３．５和６．７ｍｇ／ｋｇ，Ｋｅｔ为２８．４、７０．４和８３ｍｇ／ｋｇ；Ｆｌｕ和Ｋｅｔ的平均存活时间分别是２３～３４天和２０～３１天。在上述两种实验模型中分离脑和肺做细菌培养，Ｆｌｕ均与对照和５０ｍｇ／（ｋｇ·ｄ）的Ｋｅｔ比较，对ｉｃ１０天及静脉注射感染１３天的小鼠，口服５和１０ｍｇ／（ｋｇ·ｄ）或２．５～１０ｍｇ／（ｋｇ·ｄ）Ｆｌｕ均显著抑制新型隐球菌生长。     

脾萎缩伴暴发性肺炎球菌败血症

本文报告1例脾萎缩伴暴发性肺炎球菌败血症、脑膜炎、播散性血管内凝血(DIC)及华-弗氏综合征。血培养分离出肺炎球菌。尸体解剖发现脾萎缩、双侧肾上腺出血及坏死。显微镜检查有肺炎、脑膜炎、DIC及华-弗氏综合征的组织学证据。对本病的发病机理和防治进行讨论     

Intraoperative coronary venography for portal hemodynamic observation in the procedure of combined portozygos disconnection

Since 1986, intraoperative coronary venography was performed on 24 patients before and after undergoing portoazygos disconnection for portal hypertension. Before the disconnection the portal vein was found to be communicated with cardial and esophageal veins by two pathways, i.e. from the esophageal branches of the coronary vein to the esophageal varices, and from the gastric branches of the coronary vein to the esophageal varices by way of the gastric intramural venula. The portal blood flow was postulated to be hepatofugal because the portal trunk could not be seen on the venography. Coronary venography done after the disconnection found no pericardial and esophageal varices but the portal vein with hepatoportal blood flow. The authors come to the conclusion that the operation has the advantage of both complete disconnection between the portal vein and the cardio-esophageal varices, thus preventing the varices bleeding, and increasing hepatic blood flow.