食管癌围手术期死亡原因分析

目的探讨食管癌围手术期死亡原因及影响因素。方法总结1970年-2004年1858例食管癌手术患者临床资料,选择17个可能影响围手术期死亡的因素,应用Cox回归模型进行多因素分析。结果1858例食管癌手术患者围手术期死亡36例(1.94%)。呼吸系统并发症是引起围手术期死亡最常见的原因(41.7%)。Cox模型多因素分析显示严重吞咽困难、长期重度吸烟史、手术时间和手术年代是影响食管癌围手术期死亡的独立因素(P<0.05)。结论加强营养、改善肺功能、缩短手术时间是降低食管癌围手术期死亡率的重要方法。     

移动CT监测肺不张的临床应用

目的应用电子计算机体层摄影(CT)观察全身麻醉诱导前后肺不张的变化。方法8例择期行神经外科手术的患者,于麻醉前、麻醉诱导插管后行全肺CT扫描,选择肺尖、肺门、右膈顶上1cm三个层面的CT图像分析观察肺不张的变化。结果三个层面中,右膈顶上1cm层面的图像麻醉前后变化最明显,麻醉诱导插管后监测到明显的肺不张。结论全麻导致患者肺不张的面积和百分比增加,围术期肺部CT扫描能有效地监测到肺不张的发生,有助于优化术中机械通气,减少肺损伤。     

神经导航下经岩骨幕上下联合入路中面神经管的解剖研究

OBJECTIVE: To study the value of neuronavigation in the transpetroal approach, and to provide anatomic data for the protection of the nerves in the facial nerve canal (FNC) during surgeries. METHODS: Simulated surgery through the transpetroal approach was performed on 16 sides of 8 adult cadaver heads with the assistance by neuronavigation. The anatomy of the facial nerve and the relationship of related structures were observed and the distances from the utmost external edge of the mastoid to different segments of the FNC were measured. RESULTS: Neuronavigation was successful with all the FNC, with the mean error of less than 0.9 mm. The FNC could be divided into 3 segments, the labyrinthine, the tympanic and the mastoid segments, stretching 3.6+/-1.2 mm, 11.2+/-2.5 mm and 16.1+/-3.6 mm respectively and with diameters of 1.2+/-0.3 mm, 1.4+/-0.1 mm and 1.7+/-0.2 mm, respectively. CONCLUSION: Neuronavigation may help protect the FNC during surgical procedures, and a thorough knowledge of the anatomic features of the FNC can be significant for preservation of the facial nerves.     

中国急性心肌梗塞的疾病经济负担

主要通过对急性心肌梗塞疾病经济负担的研究，总体描述进行二线预防的重要性。资料主要来源于中文文献检索、政府统计报表。主要利用直接医疗费用来计算疾病经济负担，而未考虑直接非医疗费用和间接费用。中日急性心肌梗塞的发病率约为45／10万。55／10万。城市高于农村，男性高于女性。在2000年，急性心肌梗塞的死亡率在城市为32．39／10万，农村为17．99／10万，其死亡率随年龄增长而相应增长。与发病率一样，城市高于农村，男性高于女性。25岁以上人群因急性心肌梗塞而损失的DALY在2000年为3．57DALYs／千人口。怎性心肌梗塞的直接医疗费用在国家卫生部部属医院为28257元／例，省级医院为8663元／例，县级医院为5447无／例。测算2000年急性心肌梗塞的疾病经济负担为13亿元。19亿元。但由于只有10．6％的急性心肌梗塞病人得到临床床治疗，因此，本测算结果可能低估了在中国实际发生的疾病经济负担。     

盐酸吗啡普通片及硫酸吗啡控释片在不同溶剂中溶释过程的对照研究

本文采用紫外分光光度法对国产盐酸吗啡普通片及合资厂产硫酸吗啡控释片于蒸馏水、人工胃液、人工肠液中进行体外溶出度和释放度测定。结果表明，两种片剂的溶释均符合中国药典９５版标准，控释片在人工肠液中溶释参数Ｔ５０、Ｔｄ、ｍ与在蒸馏水及人工胃液中的溶释参数差异具显著性（Ｐ＜０．０１），在人工肠液中的释放过程明显缓慢。     

合理使用高张葡萄糖

临床护理工作中发现，高张葡萄糖的使用，在某些情况下存在一定的危险性，使用不当则加重病情的发展，甚至危及病人的生命。因此要掌握好高张葡萄糖对某些疾病所产生的不良影响，做到预防在先，合理使用。     

Recapitulation of fast skeletal muscle development in zebrafish by transgenic expression of GFP under the mylz2 promoter.

A 1,934-bp muscle-specific promoter from the zebrafish mylz2 gene was isolated and characterized by transgenic analysis. By using a series of 5' promoter deletions linked to the green fluorescent protein (gfp) reporter gene, transient transgenic analysis indicated that the strength of promoter activity appeared to correlate to the number of muscle cis-elements in the promoter and that a minimal -77-bp region was sufficient for a relatively strong promoter activity in muscle cells. Stable transgenic lines were obtained from several mylz2-gfp constructs. GFP expression in the 1,934-bp promoter transgenic lines mimicked well the expression pattern of endogenous mylz2 mRNA in both somitic muscle and nonsomitic muscles, including fin, eye, jaw, and gill muscles. An identical pattern of GFP expression, although at a much lower level, was observed from a transgenic line with a shorter 871-bp promoter. Our observation indicates that there is no distinct cis-element for activation of mylz2 in different skeletal muscles. Furthermore, RNA encoding a dominant negative form of cAMP-dependent protein kinase A was injected into mylz2-gfp transgenic embryos and GFP expression was significantly reduced due to an expanded slow muscle development at the expense of GFP-expressing fast muscle. The mylz2-gfp transgene was also transferred into two zebrafish mutants, spadetail and chordino, and several novel phenotypes in muscle development in these mutants were discovered.     

Norplant皮下埋植避孕剂与Vcu200宫内节育器5年临床对比观察

为指导育龄妇女选用适宜的避孕方法 ,采用统一的接受标准 ,共接收Norplant使用者 3 1 5例 ,Vcu2 0 0使用者 3 2 0例 ,每 6个月随访 1次 ,直至 5年使用期满或终止使用。用生命表法统计 2组间各种事件率 ,使用WHO的MDS软件统计月经日记卡并分析出血类型 ,对 2组间的差异行统计学检验。结果显示 :Norplant使用者 5年持续使用率和因妊娠、月经问题、医学问题、避孕器反应的终止率分别为 80 .0 7%、0 .3 5 %、1 3 .3 7%、6.1 2 %和 0 .46% ;Vcu2 0 0组分别为 84.42 %、9.5 0 %、1 .71 %、0 .3 7%和 4.40 %。阴道出血类型分析显示 ,Norplant组不规则出血者占 43 .1 %～5 7.6% ,使用 6个月后阴道出血基本正常者占 1 2 .9%～ 3 2 .7% ;Vcu2 0 0组出血基本正常者可达 5 4.8%～ 60 .2 %。结果表明 :Norplant埋植剂和Vcu2 0 0节育器具有相同的持续使用率 ,使用Norplant埋植剂后的妊娠率和脱出率明显低于Vcu2 0 0节育器 ,而阴道出血类型中不规则出血明显高于Vcu2 0 0节育器。提示 :2种避孕方法各有优缺点     

特异性DNA倍增技术检测t-PA cDNA基因在表达细胞中的稳定性

利用特异性DNA倍增技术(polymerase chain Reaction,PCR)检测t-PA cDNA基因在表达细胞基因组中的稳定性,并对所得的PCR反应产物进行了限制性内切酶片段、分子杂交和核苷酸顺序分析等方面的研究,证实了t-PA cDNA基因已插入到表达细胞染色体中。这种方法快速、简便、灵敏度和特异性高,是检测基因工程表达细胞中cDNA基因稳定整合状况的好方法。     

Role of endothelin in the pathogenesis of hypertension in spontaneously hypertensive and 2 kidneys 1 clip rats.

The plasma endothelin (ET) level in spontaneously hypertensive rats (SHR) and 2K1C hypertension animal models and its vasoconstrictive effect on renal and tail arteries were studied. The results demonstrated that there was no difference in plasma ET level between the hypertensive groups SHR, 2K1C, normotensive control groups Wistar Kyot (WKY) and Sprague Dawley (SD), while the vasoconstrictive effect of ET in SHR was more dominant than in WKY. The EC50 of the renal and tail arteries in SHR (0.8912 +/- 0.1662 x 10(-8) M, 0.6103 +/- 0.0878 x 10(-8) M) was apparently lower than that in WKY (1.77 +/- 0.2991 x 10(-8) M, 1.2267 +/- 0.2502 x 10(-8) M, P less than 0.05), but no difference was found in 2K1C and SD rats. The four groups of animals exhibited no difference of such effects as response to norepine-phrine (NA). The findings suggested that the increased arteriole sensitivity to ET be an important factor in the pathogenesis of hypertension in SHR.