24h动态血压监测评价卡维地洛对原发性高血压患者的降压效应

目的 :评价卡维地洛对原发性高血压患者的降压效应。方法 :选择我科 2 0 0 3年 7月至 2 0 0 4年 1月住院的原发性高血压患者 4 2例 ,行首次 2 4 h动态血压监测后开始服用卡维地洛 ,初始剂量为 12 .5 mg,每日口服 1次。治疗开始后每日服药前测卧位血压 1次 ,若血压控制不满意 ,可根据病情增加剂量。 4周结束时重复行 2 4 h动态血压监测。治疗前和治疗 4周结束时行血、尿常规、肝肾功能、血脂、血电解质、空腹血糖等检查。结果 :经 4周卡维地洛治疗后 ,显效 37例 (88.10 % ) ,有效 4例 (9.5 2 % ) ,无效 1例 (2 .38% ) ,总有效率 (97.6 2 % )。治疗后患者平均收缩压(SBP)、平均舒张压 (DBP)谷峰比值分别为 6 3%和 6 5 %。结论 :本观察发现卡维地洛降压疗效确切 ,有效率为 97.6 2% ,有满意的谷 /峰比值 ,副作用少 ,是一种很有前途的新型抗高血压药物。     

原发性高血压和血液流变学异常之间的关系的研究

目的探讨原发性高血压病和血液流变学异常改变之间的关系。方法对80例高血压病人进行血液流变学观察。结果原发性高血压病组血液流变学多项指标出现异常升高,与正常对照组比较差异有显著性,其主要表现为全血粘度增高,其增高程度和血压升高程度之间呈正相关趋势。其中红细胞压积增高可能是血液粘度增高的重要因素。结论高血压病患者的血液流变学异常和血压增高程度之间有密切相关性。     

The universal algorithm of maturation for secretory and excretory protein precursors.

During maturation, most proteins undergo different posttranslational modifications. In most simple cases, signal peptidases remove the signal or leader peptide from the precursors of the secretory proteins during their translocation across the ER membrane. For biologically active proteins, such as enzymes, regulatory and defense proteins, toxins, etc., additional maturation-regulating mechanisms were shown to proceed with limited proteolysis of inactive precursors by specific enzymes. A number of specific enzymes from different cell types selectively cleave proproteins at specific processing sites. In this work, we analyzed the sequences of protein precursors synthesized in the excretory glands of different animals and identified new, non-traditional processing sites. They differ from the motifs previously identified in secreted proteins' precursors and enabled us to reconstruct the sequence of events leading to the conversion of protein precursors into the final products (mature proteins). We also found that in animals, the maturation mechanism of secretory and excretory proteins and the set of enzymes involved are species specific. The processing sites identified in protein precursors in this study are useful for a more detailed genome analysis and more accurate mature protein sequence prediction.     

超声心动图诊断原发性心脏肿瘤

目的：探讨原发性心脏肿瘤超声心动图(ECG)特征。方法：利用ECG检查42例心脏肿瘤。其中粘液瘤38例，恶性肉瘤2例，均经手术病理证实。横纹肌瘤2例，经随访证实。结果：ECG对38例粘液瘤，2例横纹肌瘤全部做出正确诊断。2例恶性肿瘤提示相应部位占位病变。粘液瘤多发生在左房，有明确的瘤蒂，肿瘤回声稀疏，活动度大。恶性肿瘤回声较强、无蒂，活动度小。横纹肌瘤多发生在室壁心肌内，呈结节状，与正常心肌间有明确的界限。结论：ECG对原发心脏肿瘤的诊断具有重要意义，可初步区分良、恶性肿瘤。     

Leberresektionen wegen primärer lebermalignome Eigene ergebnisse und literaturanalyse

Zusammenfassung Im Rahmen einer retrospektiven Untersuchung wurden 50 Resektionen wegen primärer Lebermalignome, die vom 1. 6. 1979 bis zum 31. 12. 1991 an der Chirurgischen Universitätsklinik Köln durchgeführt wurden, analysiert. Die Resektionsrate betrug 28 %. Die Kliniksletalität betrug insgesamt 22 % und konnte in den letzten 5 Jahren auf 4% gesenkt werden. Die Ein-, Dreiund Fünfjahresüberlebensraten betrugen unter Einschluß der Kliniksletalität 55%, 30% und 24%. Wichtigster Prognosefaktor war die chirurgische Radikalität. In einer Literaturanalyse wurden die Ergebnisse von 8725 Leberresektionen wegen primärer Lebermalignome, die zwischen 1980 bis 1992 publiziert wurden, untersucht. Die Resektionsrate betrug im Durchschnitt 32 ± 17%. Die Kliniksletalität konnte von 15 ± 5% (Resektionen vor 1970) auf 6 ± 2% (Resektionen nach 1980) gesenkt werden. Die Ein-, Drei- und Fünfjahresüberlebensraten betrugen 66 ± 17%, 39 ± 15% und 27 ± 10%. Bis auf eine geringere Kliniksletalität asiatischer Studien (4 % vs. 7%) waren die Resektionsraten und Langzeitergebnisse von asiatischen, amerikanischen und europäischen Studien durchaus vergleichbar. Die Langzeitprognose wird in erster Linie durch die erreichte chirurgische Radikalität sowie die Größe und Ausdehnung des Tumors zum Zeitpunkt der Resektion beeinflußt. Die Effektivität adjuvanter Therapien ist noch nicht ausreichend untersucht.

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Liver resection for primary liver tumors. Our own results and an analysis of the literature

In a retrospective study we analysed 50 resections for primary liver tumors performed between 1 July 1979 and 31 December 1991 at the Department of Surgery of the University of Cologne. The mean resectability rate was 28 %. Hospital mortality after resection was 22% and could be reduced to 4% during the last 4 years. The overall survival rates after 1, 3 and 5 years were 55%, 30% and 24% respectively. The surgical radicality is the most important prognostic factor. In a review of the literature the results of 8,725 resections for primary liver malignancies published between 1980 and 1992 were analyzed. The mean resectability rate was 32 ± 17%. The hospital mortality after resection could be reduced from 15 ± 5% (resections before 1970) to 6 ± 2 % (resections after 1980). The overall survival rates after 1, 3 and 5 years were 66 ± 17%, 39 ± 15% and 27 ± 10%, respectively. Apart from a lower hospital mortality in Asian studies (4 % vs. 7 %) the resection rates and long-term results of Asian, American and European studies were similar. Long-term prognosis predominantly depended on the surgical radicality and on the size and extension of the tumor at the point of resection. The effectivity of an adjuvant tumor therapy is not analyzed sufficiently.

     

Primary cemented total hip arthroplasty—an Indian experience

We report outcome of 9-year follow-up of 50 Charnley cemented primary arthroplasties in 47 patients performed between 1996 and 1999. The minimum follow-up period was 5 years with a mean of 7 years. All hip joints were thoroughly assessed preoperatively to document patients’ functional level and Harris hip score was calculated. All the patients were disabled because of pain in hip and 45 (90%) had used walking aids. At follow-up all patients were living. The radiographs of all patients were available for the entire follow-up period. Of the 50 operated hips, only 2 patients (4%) complained of pain while all the rest were free of pain. Postoperatively only 10 (20%) patients used support for walking. At follow-up none of the hips were revised. Two patients (4%) had dislocation in postoperative period in which reduction was done under anesthesia. In one patient (2%) prosthesis and cement was removed because of deep infection. In two patients (4%) radiolucent clear zone was seen at bone cement interface on acetabular side and three (6%) patients had it on femoral component. None of the patients developed deep vein thrombosis or heterotopic bone. In postoperative period the Harris hip score was calculated in each case and compared with the preoperative score to evaluate the outcome. Significant improvement was found in Harris hip score after surgery.     

高强度聚焦超声治疗原发性肝癌的疗效

目的探讨高强度聚焦超声（HIFU）对原发性肝癌的治疗效果。方法对我科自2005年5月至2006年8月使用高强度聚焦超声治疗的35例原发性肝癌进行回顾性分析。结果本组术后疼痛症状缓解率为69.6%,术后3月生存率94.29%,6月生存率65.59%,1年生存率57.39%;术后生存期较其自然病程延长。结论高强度聚焦超声治疗原发性肝癌可在一定程度上减轻患者症状、改善患者生存质量、延长患者生存时间。     

原发性小肠肿瘤诊断治疗的临床分析(附58例报告)

目的探讨原发性小肠肿瘤临床特型、病理分型及诊治经验。方法回顾性分析1993年10月。2003年10月收治的有完整资料的58例原发性小肠肿瘤病例。结果本组包括13例(22．4％)良性肿瘤，45例(77．6％)。小肠良性肿瘤均行局部肠段切除，除2例死于其它疾患外，余11例健在；小肠恶性肿瘤患者中，院内死亡6例，仅11例能行根治性肠切除，37例行化疗(总有效率83．4％)，随访33例(随访率89．5％)，存活5年以上者14例(5年生存率42．4％)，多为T细胞性非何杰金淋巴瘤。结论原发性小肠肿瘤恶性所占比例较高，缺乏特征性的临床表现及有效的诊断手段，易致长期延误诊治，预后甚差；对原因不明的腹痛、消化道出血及定位不明的腹部包块患者及早行剖腹探查是避免小肠肿瘤长期误诊、改善患者预后的可靠手段。     

中西医结合治疗原发性痛风性关节炎30例总结

目的:观察中西医结合治疗原发性痛风性关节炎的临床疗效。方法:对照组采用西医常规治疗,治疗组采用中西医结合治疗,主要观察两组治疗前后血尿酸、血肌酐水平以及血清K 、Na 、Cl-、Ca2 水平、体重等指标变化情况。结果:治疗组血尿酸指标的下降程度明显优于对照组(P<0.05);但两组血清K 、Na 、Cl-、Ca2 水平及体重等指标比较无明显改变(均P>0.05);治疗组痛风发作次数也明显少于对照组(P<0.05)。结论:中西医结合治疗本病疗效满意。     

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目的　探讨一种更精确而行之有效的测量甲状腺残留量的方法。方法　自 1996～ 2 0 0 1年对 15例原发性甲状腺功能亢进症病人于术前经CT对甲状腺进行体积测量 ,于双侧甲状腺次全切除术后 ,再用增强CT对上述病人残留甲状腺进行体积测量 ,并与术中测得残留量比较。结果　术中测得残留量 2 8～ 13 0 g ,术后CT测量为 3 4～ 16 6g ,二者之间有一定误差 (P =0 0 6 7) ,产生原因主要为术者对残留甲状腺背面气管旁沟处的不规则腺体测量不准确。体积切除率 83 1%～ 97 9% ,体积残留率 2 1%～ 17 9% ,活体组织相对体积质量 (1 0 5 4 8± 0 0 2 0 5 ) g/cm3 ,离体组织相对体积质量 (1 0 6 4 8± 0 0 188) g/cm3 。结论　CT测量更接近实际残留量 ,可重复性强 ,可比性强。体积残留率比腺体残留重量、手术切除率更具有个性化参考意义。