预防胰十二指肠切除术后并发胰胆瘘的体会

目的　探讨胰十二指肠切除术后胰胆瘘的预防。方法　对 1994年 3月 - 2 0 0 1年 11月因恶性肿瘤施行胰十二指肠切除术的 81例病人 ,统一手术方式 ,在胆肠及胰肠吻合口处肠管内置引流管减压。结果　治愈 78例 ,死亡 3例 ,术后无一例胰胆瘘发生。结论　正确而精细的手术操作 ,确保吻合口血运 ,使各吻合口处无压力、无张力 ,是保证吻合口顺利愈合的关键。完善的术前准备及术后处理 ,也是减少胰胆瘘发生的重要因素。     

老年病毒性肝炎62例临床分析

本文分析62例老年病毒性肝炎。曾查感染标志者42.4%为乙型肝炎,仅1例为甲型肝炎。重症、慢性、瘀胆性分别为24.2%,25.8%,12.9%,均显著高于其他年龄组肝炎。83.9%为黄疸性,部份病例曾疑为肝外梗阻.61.3%有并发症。发生肝昏迷、上消化道大出血、原发性腹膜炎或肝肾综合征者大多病死。病死率为19.4%,远较其他年龄组肝炎高。提示老年人原因未明的不完全梗阻性黄疸宜先进行内科治疗。老年病毒性肝炎应注意加强综合治疗、预防和及时控制并发症。     

硬脊膜动静脉瘘(附1例临床分析)

目的探讨硬脊膜动静脉瘘(SDAVF)的病因、发病机制、临床表现、诊断及治疗。方法回顾性分析了1例患者的相关临床资料。结果本例患者以双下肢渐进性麻木、无力1年余,加重伴大小便障碍9个月为主要临床表现,脊髓MRI显示T9~L1髓内以长T2长T1为主之异常信号,超选择DSA造影可见位于入LT12椎管处一硬脊膜动静脉之瘘口,成功地进行了经单侧椎板开窗夹闭瘘口术。结论SDAVF为一具有直接的动静脉交通性病变,常伴有小型畸形团,多发生于中年男性,误诊率高,主要表现为渐进性的肢体麻木、无力及大小便障碍,MRI有助于诊断,但仍须DSA确诊。阻断连接瘘口与冠状静脉丛的引流静脉是治疗SDAVF的有效方法,显微外科手术效果可靠、复发率低,尽早地确诊和治疗是取得良好疗效的根本前提。     

酵母菌2号培养最佳条件的选择

成人特发性乳糖酶缺乏症的发生率极高，这些人进食牛奶后会出现胃肠胀气、腹痛、腹泄等对牛奶不耐受的消化不良症状。为解决这一问题，自１９８９年起，国内外不少学者是主张有产替代疗法，即将人工培养制备纯化的乳糖酶直接加入牛奶中以水解其中的乳糖来弥补成人乳糖酶的缺乏。     

慢性阻塞性肺疾病的新定义及临床诊疗建议——基于2022年《柳叶刀》文件解读

慢性阻塞性肺疾病(以下简称慢阻肺)是一种常见的慢性气道异质性疾病。近年来,尽管国内外慢阻肺相关研究不断深入,管理日趋完善,但仍有许多难点亟待解决。2022年9月,《柳叶刀》杂志发布《消除慢阻肺之路》,该文件针对慢阻肺的认识、诊断、评估和个体化治疗等方面提出了新理念并提供临床诊疗指导。本文重点对该文件中慢阻肺的分类、诊断标准及诊断建议、慢阻肺的急性加重和迈向消除慢阻肺5个方面进行介绍和解读,以期为我国临床工作者开展慢阻肺相关研究和管理提供一定的参考及启示。     

Emotional reactivity and sympatho-adrenal activity in the rat (author's transl)

Using the open-field test, differences in emotional reactivity were shown in male rats of several albino strains. These behavioural differences were then investigated in relation to physiological differences. It was found that, under resting conditions, sympatho-adrenomedullary activity as estimated by urinary catecholamine excretion and adrenal catecholamine content is lower in the more emotionally reactive rats. The resting heart rate is correspondingly slower in these animals though they show the same noradrenaline cardiac concentration as the nonreactive rats. These data suggest that high defecating rats in the open-field exhibit a lower sympathetic tonus, possibly linked, however, with a higher parasympathetic tonus.     

Benzylpenicillin preparations can evoke a systemic anaphylactic reaction in guinea pigs

All of the five commercially available benzylpenicillin preparations obtained from different sources and a PcG preparation prepared by filtration of a commercial PcG on Sephadex G10 elicited the systemic anaphylactic reactions in guinea pigs which had been immunized with benzylpenicilloyl (BPO)-Ascaris extract conjugate (BPO-As) mixed with aluminum hydroxide gel. These preparations could evoke no such reactions in guinea pigs immunized with BPO-bovine gamma globulin conjugate (BPO-BGG) emulsified with complete Freund's adjuvant. The severity of the systemic anaphylactic reactions correlated significantly with the titers of either 8-day passive cutaneous anaphylactic (8-day PCA) reactions or 4-hr PCA reactions evoked with the same benzylpenicillin preparations. In vitro benzylpenicillin preparation contracted the tracheas of the guinea pigs immunized with BPO-As. These results indicated that the commercially available benzylpenicillin preparations have enough antigenicity to evoke systemic anaphylactic reactions in guinea pigs immunized with BPO-As mixed with aluminum hydroxide gel. Such guinea pigs represent an animal model for investigation of penicillin allergy.     

Development of a non-invasive treatment system for urinary incontinence using a functional continuous magnetic stimulator (FCMS)

A system composed of a functional continuous magnetic stimulator (FCMS) and a saddle-type coil has been developed for non-invasive treatment of urinary incontinence, especially stress incontinence and urge incontinence. The FCMS conditions were as follows: 2 kW maximum electrical power consumption, 800 V maximum capacitor voltage, 720 μs pulsewidth (180 μs rise time), and 5–30 Hz frequency. A frequency between 5 and 10 Hz is used to treat urge incontinence and a frequency between 25 Hz and 30 Hz is used to treat urge incontinence. The coil (120 mm long, 90 mm wide and 50 mm thick) fits the most suitable region for this treatment, the region from the anus to the perineum. The coil is cooled to maintain a coil temperature between 20 and 25°C so that it can be used efficiently and safely. In experiments with anaesthetised dogs, it was confirmed that the urethral pressure increased when the circumference of the perineum received continuous magnetic stimulation of 720 μs pulsewidth (180 μs rise time), 10Hz frequency and about 520 V capacitor voltage. This result suggests that magnetic stimulation can be effective as a urinary incontinence therapy.     

社区人群癫癎患者抗癫癎治疗现状及效果分析

目的：研究社区人群癫痫患者药物治疗现状及影响其效果的主要因素。方法：于2000年在上海市金山朱泾镇采用分层整群抽样完成5万人群的癫痫普查，并对癫痫患者进行药物治疗现状调查和对服药者的血药浓度进行测定。结果：癫痫患病率为3.11%，标化患病率为3.62%。癫痫患者中从未服药者33.1%，曾服药者66.9%，目前正在服药者占35.6%，以单药治疗为主。治疗后显效者51.5%，有效者40.6%，无效或恶化者7.9%。服用单药者显效和有效的比例明显高于服用二种药或三种药的效果。服药者血药浓度在有效范围者，仅占36.1%，其中服用苯巴比妥者血药浓度达标的比例（71.4%），明显高于其他药物。血药浓度在有效范围内的显效率为53.3%，明显高于未达有效范围者的显效率（23.8%）。非条件Logistic回归分析显示与治疗效果有关的主要因素为病程、发作年龄、现年龄、发作频率、教育程度、服药类型、血药浓度等。结论：社区人群癫痫患者接受治疗的比例和服药后血药浓度达有效范围的比例都降低。治疗效果受多种因素影响。