胆绿素改善大鼠脑缺血再灌注损伤的作用机制

  目的  探讨胆绿素对大鼠脑缺血再灌注损伤的保护作用以及机制。  方法  采用线栓法建立大鼠大脑中动脉栓塞模型（middle cerebral artery occlusion model，MCAO），给予胆绿素治疗后，采用改良版神经功能缺损评分评价大鼠神经功能缺损情况，干湿重法测定脑组织含水量，TTC染色测定脑梗死面积，Iba-1/DAPI染色标记缺血侧脑组织小胶质细胞活化情况，免疫荧光染色检测脑组织炎症因子TNF-α表达，Western blot测定脑组织Iba-1/CD68的蛋白表达。  结果  和IR组比较，胆绿素治疗可改善MCAO大鼠的神经功能缺损（P < 0.05），同时，还能减轻脑组织含水量（P < 0.05），降低大脑梗死面积（P < 0.05），以及降低缺血侧脑组织中小胶质细胞的表达和Iba-1/CD68蛋白的表达（P < 0.05）。此外，胆绿素治疗还能减少缺血侧脑组织中炎症因子TNF-α的表达（P < 0.05）。  结论  胆绿素在MCAO大鼠中可能通过抑制小胶质细胞活化而减轻大鼠脑缺血再灌注损伤。     

超声心动图诊断动脉导管未闭合并重度肺动脉高压的临床应用价值

目的探讨动脉导管未闭(PDA)合并重度肺动脉高压(PH)的超声心动图特点及诊断技巧。方法回顾性分析42例PDA合并重度PH患者的心脏二维超声改变、多普勒血流特点以及显示PDA切面。结果超声心动图诊断PDA合并重度PH符合率61.5%,误诊16例;二维超声的主要改变是肺动脉扩张、右心增大;彩色多普勒分流束及分流频谱是诊断的主要依据;左高位切面是诊断PDA合并重度PH的最易显示切面。结论 PDA合并重度PH的临床及超声特点与单纯PDA不一致,注重超声心动图检查思维与技巧有助于诊断及鉴别诊断。     

药物洗脱支架直接置入治疗A型和B_1型病变的临床观察

目的　评价直接置入药物洗脱支架 (CYPHERTM,codis)在A或B1 型病变的冠心病患者治疗中的安全性、可行性。方法　 6 2例接受CYPHERTM 支架直接置入的患者 (直接支架组 )和一般情况匹配的 5 1例球囊扩张后行冠脉支架术的患者 (常规支架组 ) ,比较两组的一般情况 ,冠脉造影及介入治疗即刻和临床随访结果。结果　直接支架组介入操作时间明显短于常规支架组 [(17.2± 8.6 )比 (2 6 .3± 7.1)min ,P <0 .0 1],直接支架组平均扩张压明显高于常规支架组 [(14± 3)比 (12± 1.9)atm ,P<0 .0 1],两组无一例发生介入治疗相关的严重心脏事件。随访期间两组严重心脏不良事件发生率无显著差异。结论　A或B1 型病变的冠心病患者CYPHERTM 支架直接置入术可缩短介入操作时间 ,即刻效果、并发症及中期临床随访与常规支架组差异无显著性意义     

复方金荞麦颗粒治疗肺癌1000例临床疗效观察

目的 总结复方金荞麦颗粒治疗肺癌的疗效。方法 对1000例各种类型的肺癌患者采用复方金荞麦颗粒5g，3次·d^-1 口服，同时辅以中药汤剂治疗，3mo为1疗程，病情稳定后逐渐减量维持。结果本组1000例患者经3mo～15a以上治疗，基本治愈181例（18．1％），显效518例（51．8％），有效204例（20．4％），无效97例（9．7％），总有效率为90．3％。结论 复方金荞麦颗粒为抗肿瘤的纯中药制剂，具有明显抑制肿瘤细胞生长、增强免疫功能、提高患者生存质量等功效，尤其是对失去手术治疗机会、不能接受化疗和放疗的肺癌患者具有较好疗效。     

大剂量甲基强的松龙冲击治疗急性脊髓损伤疗效分析

目的研究大剂量甲基强的松龙(MP)治疗急性脊髓损伤的临床效果.方法对87例急性脊髓损伤患者进行回顾性研究,根据伤后时间并按自愿选择用药原则分为应用MP治疗组(MP组,45例)和未应用MP治疗组(对照组,42例),以ASIA分级标准进行分级,并比较疗效和并发症.结果两组患者在治疗前后感觉及运动功能均有明显改善(P＜0.05).但MP组的感觉及运动功能恢复均优于对照组(P＜0.05).MP治疗组中24h治疗组(A组)与48h治疗组(B组)并发症发生率比较无显著性差异(P＞0.05),而MP组与对照组比较并发症的发生率明显增加,有显著性差异(P＜0.05).结论早期应用MP大剂量冲击治疗急性脊髓损伤是一项有效措施,但会显著增加患者治疗中并发症的发生率.     

Mind-Refreshing Acupuncture Therapy for Facial Spasm, TrigeminalNeuralgia and Stubborn Facial Paralysis

Facial spasm, trigeminal neuralgia and stubborn facial paralysis are commonly seen in clinic. The authors have obtained quite good therapeutic results for the above diseases by using the mind-refreshing acupuncture therapy. These are introduced in the following.     

玉溪市农村室内鼠类及其体外寄生蚤类调查

笔者于１９９２年２月至１９９３年１月，在玉溪市两个自然村室内进行了鼠类及体外寄生蚤类调查研究。鼠类年均捕获率７．２５％；褐家鼠为优势种，占７３．４９％，捕获率高峰期在９月；黄胸鼠和小家鼠为常见种，捕获率高峰期分别在３和４月。３种家鼠年龄孕鼠率为１４．５７％，平均胎仔数为７．３只，１０月为全年生殖高峰。     

Poststroke DNA immunization against neurite growth inhibitors is beneficial to the recovery from local cerebral ischemia in rats

BACKGROUND： Inhibitory signals, i.e. neurite growth inhibitors （NGIs）, presenting on central nervous system （CNS） myelin have been shown to play a crucial role in inhibiting lesioned axonal sprouting and leading to less functional recovery. Vaccines targeting NGIs may provide multifactorial protection against brain insults by overcoming the inhibitory effects of these NGIs and boosting the body＇s immune repair mechanisms. OBJECTIVE： To evaluate the effect of poststroke DNA immunization against NGIs on the rehabilitation for sensorimotor function of rat models of local cerebral ischemia. DESIGN： Completely randomized grouping design, and controlled experiment. SETTING： Brain Injury Research Laboratory, Department of Neurosurgery, National Neuroscience Institute, Singapore. MATERIALS： Sixty adult male Sprague-Dawley rats ranging in age from 45 to 120 days and in weight from 180 to 250 grams were provided by Animal Center of Department of Anatomy, Faculty of Medicine, National University of Singapore. pcDNA3.1（＋）-neurite growth inhibitors （pcDNA-NGIs） a gift was provided by Dr. Xiao from Department of Clinical Research, Singapore General Hospital, Singapore. METHODS： The experiment was carried out at Brain Injury Research Laboratory, Department of Neurosurgery, National Neuroscience Institute, Singapore from August 2003 to April 2005. （1）The involved rats were randomized into 3 groups： pcDNA-NGIs group （group A）, pcDNA3.1 （＋） group （group B） and model group （group C）, with 20 rats in each group. Left focal cerebral ischemia （FCI） was permanently induced through middle cerebral artery occlusion （MCAO） with the assistance of an operating microscope. Successful MCAO was determined by a 20% decrease to baseline in the ipsilateral cerebral blood flow. 100 μg of pcDNA-NGIs eluted in phosphate-buffered saline （PBS） was intramuscularly injected into the tibial muscle once a week after MCAO for 6 weeks in group A. As control, pcDNA3.1 （＋） was also administrated in the same way in group B and nothing was administrated in group C. （2） The modified neurological severity score （mNSS）, a composite of motor, sensory, reflex and balance tests, was used to test the sensorimotor deficit. The mNSS was graded on a scale of 0 - 18, i.e. normal score was 0, maximal deficit score was 18, and 1 point was warded for the inability to perform the tasks or the lack of a tested reflex. （3） The newly generated axons of corticorubral projection were traced by stereotaxic guided injection of 100 g/L biotinylated dextran amine. Rats were sacrificed two weeks after tracing, and cryostat coronal sections of midbrains （30μm） were reacted to BDA according to the manufacturer＇s instruction by the free-floating method. Images were captured on a DM RXA2 LEICA Microscope with a Spot Digital Camera system （Germany）, and the numbers of labeled axons on the denervated side in four standard coronal sections including the red nucleus were manually quantified. MAIN OUTCOME MEASURES： （1） The number of newly generated axons of corticorubral projection. （2）The improvement in sensorimotor deficit. RESULTS： All the involved 60 rats entered the stage of final analysis. （1） The number of newly generated axons of corticorubral projection of rats： Only ipsilateral axons of CRP were noted with little evidence of fibers crossing to the contralateral red nucleus in rats of groups B and C. More BDA-positive fibers crossing the midline and terminating in the contralateral red nucleus in appropriate target areas mirroring the non-differentiated red nucleus were found in rats of group A. Quantitative analysis showed that BDA-labeled axons in the denervated side of rats in group A were more than those in group B （P 〈 0.05）. （2） Improvement in sensorimotor deficit of rats： At 2 weeks after immunization, significant improvement in sensorimotor deficit was found in rats of group A. There were significant differences of improvement in sensorimotor deficit of rats between group A and group B or group C at 12 and 14 weeks after immunization （P 〈 0.05）. CONCLUSION： （1） Poststroke DNA immunization against NGIs leads to increased sensorimotor recovery following FCI and compensatory newly growth of axons from corticorubral projection.     

火器伤后胸心异物存留

目的：探讨火器伤后胸心异物存留摘除的指征、时机、方法及结果。方法：回顾性分析了３９例火器伤后胸心异物存留摘除者的一般资料、临床表现、不同处理方法的选择及效果。结果：１９例患者早期因凝固性血胸及肺持续漏气伴异物存留或异物存留伴胸腔及心包腔化脓性感染，在开胸清创时做了异物摘除；另２０例患者为胸伤伤情恢复后单纯异物存留，因异物位于肺门、心脏及大血管旁或远期并发症等，而后期开胸异物摘除。结论：火器性胸部穿透伤后，因异物本身或其他原因所致早期并发症者，应在开胸清创的同时摘除异物；胸伤伤情恢复而单纯胸心异物存留，应选择性摘除或因并发远期并发症而摘除。