激素替代治疗对绝经后Ⅱ型糖尿病和高血压患者肾脏微血管病变的影响

目的 :探讨激素替代治疗对绝经后Ⅱ型糖尿病和高血压患者肾脏微血管病变的影响。方法 :36例患有Ⅱ型糖尿病和高血压的绝经后妇女随机分为治疗组和安慰剂组各 18例 ,采用双盲法予口服克龄蒙或安慰剂 1片 /日 ,共 4 5个周期 ,测量用药前后各参数值并进行比较及线性相关分析。结果 :治疗组用药前后 2 4小时尿蛋白定量由 ( 0 4 45± 0 0 36 )g降到 ( 0 36 1± 0 0 32 ) g(P <0 0 1) ,内生肌酐清除率由 ( 92 0± 5 2 )ml/min增到 ( 99 1± 4 8)ml/min (P <0 0 5) ,空腹血糖由 ( 7 0 2± 0 4 3)mmol/L降到 ( 6 55± 0 31)mmol/L(P <0 0 5) ,血清总胆固醇由 ( 6 6 6±0 2 8)mmol/L降到 ( 5 71± 0 71)mmol/L(P <0 0 1) ,血压无明显改变。 2 4小时尿蛋白定量和内生肌酐清除率与其他参数间无显著相关性。安慰剂组用药前后各项指标无明显改变。结论 :激素替代治疗对绝经后Ⅱ型糖尿病和高血压患者肾脏微血管病变有改善作用     

Central venous catheter-related Rhodotorula rubra fungemia

With the increased use of indwelling central venous catheters, increasing numbers of cases of Rhodotorula fungemia have been observed in patients with neoplasia and neutropenia. In most patients with catheter-related Rhodotorula fungemia, the condition has been treated with broadspectrum antibiotics. We report two cases of central venous catheter-related Rhodotorula rubra fungemia that occurred in patients with acute myeloblastic leukemia. Both patients were in a state of neutropenia. One patient was treated with amphotericin B and his central venous catheter was removed, but he died of Klebsiella pneumoniae bacteremia. The other patient was treated with amphotericin B and discharged, with a central venous catheter, after recovery from neutropenia. Although the management of catheter-related Rhodotorula fungemia infections remains controversial, resolution of the underlying disease is more important than catheter removal for recovery from Rhodotorula rubra fungemia. Received: August 22, 2001 / Accepted: October 8, 2001     

固定桥桥体龈底形态对接触区黏膜微生态影响的研究

目的探讨烤瓷桥桥体龈端不同形态设计对牙槽嵴顶黏膜微生态的影响。方法对60例磨牙烤瓷修复的患者采用常规细菌培养和计算机鉴定的方法进行检测。结果桥体龈端接触区细菌附着量和种类与牙体预备前相比,均有增多。其中,改良鞍式和改良盖嵴式桥体龈端接触区细菌附着量和细菌种类变化的差异有统计学意义(P<0.05);而舟底式桥体龈端接触区细菌附着数量和种类的变化,均无统计学意义(P>0.05)。戴用3个月后,各组链球菌和奈瑟菌的组成比例变化与牙体预备前相比,差异有统计学意义(P<0.05);其余各类细菌组成比例的变化无统计学意义(P>0.05)。结论从对桥体底黏膜微生态的影响考虑,烤瓷桥舟底式桥体优于改良鞍式和改良盖嵴式桥体,是值得临床推广应用的磨牙桥体设计。     

CT导向下经皮射频消融术治疗肾上腺恶性肿瘤

目的对29例肾上腺肿瘤患者行射频消融（RFA）治疗，研究其近期局部治疗效果、不良反应和副作用。方法肾上腺肿瘤患者共29例，病灶总数31个，其中直径≤2．0cm的病灶共5个，2．1-4．0cm者18个，4．1-6．0cm者5个，≥6．1cm者3个，经RFA治疗1个月后行螺旋CT双期增强扫描评价肿瘤治疗效果。结果上述病灶经消融治疗后达到完全坏死者分别为5个、18个、3个、2个。患者无严重并发症出现。结论RFA治疗安全可靠，副作用小，是治疗肾上腺恶性肿瘤的有效方法之一。     

Factors influencing survival of reconstructions. Consensus report of Working Group 2

Abstract: In order to evaluate the level of evidence of factors influencing the survival of reconstructions, systematic reviews of the relevant literature were prepared by a group of rapporteurs. The review papers were circulated to the members of the group before the conference and formed the basis for group and panel discussions. Subsequently, modifications were added to the review papers, and suggestions for consensus statements concerning the following topics were prepared and again critically reviewed in the group and in the plenum: Impact of (i) periodontal disease on the survival of tooth-supported reconstructions, (ii) post-surgical factors as supportive therapy on the survival of implant supported reconstructions, (iii) technical and/or biological complications on the survival of different types of reconstructions, (iiii) material choice for reconstructions on the survival of single crowns and fixed dental prostheses.     

Remote-controlled catheter ablation of accessory pathways: results from the magnetic laboratory.

AIMS: This study evaluates feasibility, safety, and efficacy of magnetic remote-controlled accessory pathway (AP) ablation. METHODS AND RESULTS: The novel magnetic navigation system (MNS) (Niobe, Stereotaxis) creates a steerable magnetic field (0.08 T) controlling the distal magnetic tip of an ablation catheter. In conjunction with a catheter advancer system (Cardiodrive, Stereotaxis) remote catheter ablation is enabled. Conventional electrophysiology study identified AP conduction in 59 patients (37 males, 36+/-14 years, 60 APs). First generation 1-magnet tip (1-M) (group I, n=18), second generation bipolar 3-magnet tip (3-M) (group II, n=27), and third generation quadripolar 3-magnet tip catheters (3-M quad.) (group III, n=14) were used for magnetic remote-controlled ablation. Successful AP ablation was achieved in 67% (group I), 85% (group II), and 92% (group III). A significant decrease of median [IQR: Q1-Q3] fluoroscopy time and dosage was observed: 21.2 [12.1-33.8] min, 1110 [395-3234] microGym2 (group I); 6.5 [4.4-15.4] min, 290 [129-489] microGym2 (group II), and 4.9 [3.4-8.0] min, 129 [74-270] microGym2 (group III). Mean procedure time (217+/-67 min; 182+/-68 min, and 172+/-90 min) significantly decreased in group III. Median number [Q1-Q3] of radiofrequency current applications in groups I, II, and III was 4 [2-9], 4 [2-6], and 2 [2-4], respectively. No complications occurred. CONCLUSION: Remote AP ablation is safe and feasible using the novel MNS. Introduction of the 3-magnet quadripolar ablation catheter significantly improved the efficacy of the procedure.     

急性肢体动脉栓塞26例诊断与治疗

目的 探讨急性肢体动脉栓塞的诊断、治疗与预后。方法回顾性分析2002年5月至2005年7月大连大学附属中山医院血管外科收治的26例急性肢体动脉栓塞病人的病例资料，26例均急诊行动脉切开Fogarty导管取栓并配合药物治疗。结果无死亡病例，26条肢体均获保存，术后肢体变暖，24例病人肢体远端动脉搏动恢复。2例肢体远端动脉搏动未恢复。结论早期诊断、及时动脉切开Fogarty导管取栓，是保存缺血肢体的关键因素。     

国产血管内介入治疗导管的临床应用

目的：探讨国产导管在血管内介入治疗中的价值。方法：应用60条国产血管内介入治疗导管行脑血管造影17例、盆腔动脉造影及栓塞6例、肝动脉造影及栓塞37例。结果：所有血管造影及治疗均成功完成。结论：国产血管内介入治疗导管能够满足介入治疗的需要。     

Functional adaptation to full‐arch fixed prosthesis supported by osseointegrated implants in the edentulous mandible

The objective of the present study was to assess possible adaptive functional changes in the masticatory system after insertion of fixed prostheses supported by osseointegrated implants in the edentulous mandible. Registrations of mandibular movement characteristics and maximal biteforce were performed at insertion and after 1 week, 3 months and 1 year after connection. The duration of the opening and closing phase decreased and maximal biteforce increased significantly (p < or = 0.05-0.001) from connection of the prostheses to the annual check-up. However, the process of functional adaptation implied 2 identified stages. An immediate phase that occurred within the 1st week, probably due to altered impact from mechano-sensitive receptors and a later more time-dependent phase, based on learning and new cortical engrams. Accordingly, the process of adaptation will continue over a long period of time.     

多孔陶瓷板固定床生物反应器设计及模拟

设计了一种结构新型的多孔陶瓷固定床生物反应器，与传统的固定床相比，该反应器具有氧传递性能好，能够均匀接种等优点，通过模拟，考察了反应器内的流体流动和气液传递性质，计算证明反应器的供氧能力能够满足链霉菌发酵过程对氧的需求。