病毒性脑炎患者S-100b蛋白浓度与临床的相关性

目的 观察病毒性脑炎急性和恢复期患者血液和脑脊液的S-100b蛋白浓度变化，探讨其与异常脑电图和影像学低密度灶体积等方面的相关性。方法 42例病毒性脑炎住院患者为观察组，25例与观察组相匹配的阑尾或胆囊摘除手术病人以及健康体检者为对照组，采用双抗体夹心ELISA法，检测其血液及脑脊液100b蛋白浓度；并应用SPSS10．0统计软件包进行统计学分析。结果病毒性脑炎急性期患者血液和脑脊液S-100b蛋白显著高于恢复期患者和对照组（P〈0．01）；血液和脑脊液S-100b蛋白浓度与低密度灶体积均呈显著正相关（rCSF=0．756，P〈0．01；r血液=0．685，P〈0．01）；轻度、中度及重度异常脑电图患者脑脊液S-100b蛋白浓度均高于血液（P〈0．01）；重度、中度异常脑电图患者血液及脑脊液S-100b蛋白浓度均高于轻度（P〈0．01）。结论脑脊液或血液中的S-100b蛋白浓度反映了神经胶质细胞的损害程度，也是脑组织破坏后较合适的生化标记物，对监测病毒性脑炎患者的病情变化和疗效观察具有重要价值。     

Demonstration of Right and Left Atrial Dissociation by Atrial Rapid Pacing or Extrastimulation During Fast-Slow (Uncommon) Form of Atrioventricular Nodal Reentrant Tachycardia

Some recent works suggest that extranodal atrial fibers may form part of the reenlry circuit in the atrioventricular (AV) nodal reentrant tachycardia (AVNRT). This hypothesis is based on the fact that the perinodal dissection successfully abolished AVNRT while preserving intact AV conduction. Apart from the surgical success, the electrophysiological evidence supporting this hypothesis has not been demonstrated, especially in the uncommon (fast-slow) form of AVNRT. We present some electrophysiological evidence suggesting atrial participation in eight patients with the fast-slow form of AVNRT. During the tachycardia, rapid pacing or extrastimulation was done from the orifice of the coronary sinus (CS) and the right atrium (RA), while recording the electrograms of the CS and the low septal RA. In seven patients, right and left atrial dissociation was demonstrated during pacing from the RA, while in the remaining one this was demonstrated from the CS. The interatrial dissociation will be unlikely if the intranodal reentry circuit connects with the atria via a single upper common pathway. This suggests that the upper turnaround of the reentry circuit involves atrial tissue and that the extranodal accessory pathway with long conduction times may form the ascending limb of the circuit (atrionodal reentry). Alternatively, the reentry circuit is entirely intranodal and two or more connecting pathways are present between the atria and the circuit.     

Regulation of fluid intake in dogs following water deprivation

Whereas water loss in land living animals occurs continuously, water intake takes place discontinuously. At the normal operating set point of plasma osmolality, urine is more concentrated than plasma due to secretion of vasopressin. Thus animals operate around a state of mild dehydration. As water loss occurs, the severity of dehydration and thirst increase in intensity and at some point water intake occurs. Sufficient water is consumed to return plasma osmolality to the normal operating set point. Food intake and water balance are interdependent as food provides the osmoles which determine obligatory renal solute excretion. When dry food with the same osmotic content was substituted for canned food (water content 74%), dogs increased water intake from 24.2 +/- 4.3 to 62.2 +/- 8.8 ml/kg. Urine output and urine osmolality were unchanged, as under conditions of normal hydration, near maximal urine concentration is achieved. Changing water intake is the only available variable to maintain water balance. During water deprivation, the major renal mechanism appears to be natriuresis. In rehydration, satiety mechanisms ensure appropriate water intake and renal sodium conservation restores sodium balance.     

雌激素及雄激素对去睾丸大鼠骨质疏松 形成的干预研究

目的　研究雌、雄激素对去睾丸大鼠腰椎、股骨颈、粗隆部、股骨近端的骨密度及股骨颈骨微结构的变化。方法　选用 39只 3～ 4月龄的Wistar雄性大鼠 ,随机分成假去睾丸组 (Sham)、去睾丸组 (Orch)、去睾丸 +雌激素组 (Orch +E2 )和去睾丸 +雄激素组 (Orch +T) ,同条件下饲养 1 8w。处死前用HologicQDR 2 0 0 0 +DEXA测量大鼠腰椎、股骨颈、粗隆部、股骨近端的骨密度。处死前第 1 4 ,1 3d和第 3 ,2d行骨荧光标记 ,大鼠处死时收集血清行T和E2 放免检测 ,同时取左侧股骨近端行塑料包埋的骨组织切片及组织形态计量学分析。结果　Orch组大鼠 1 8w后腰椎、股骨颈、粗隆部、股骨近端的骨密度均下降 ,与Sham组比较差异有显著性 (P <0 0 1 )。Orch +E2 组大鼠的 4个部位骨密度均最高 ,但与Sham组比较无差异 ,Orch组股骨颈的骨小梁面积百分率和骨小梁数目与Sham组比较均减少 (P<0 0 1 ) ,骨小梁分离度增加 (P <0 0 1 ) ;Orch +E2 和Orch +T组大鼠的各静态参数维持在Sham组水平 ;Orch组的骨荧光标记周长百分率、骨形成率BFR/BS、BFR/BV和BFR/TV均增加 (P <0 0 1 ) ,代表骨吸收的骨小梁面积破骨细胞数和骨小梁周长破骨细胞数均增加 (P <0 0 1 ) ;Orch +E2 和Orch +T组大鼠的各动态参数维持在Sham组水平。结论　     

安妥明对高胆固醇血症大鼠血脂、LCAT及过氧化酯质的影响

本实验探讨安妥明对实验性高胆固醇血症大鼠脂质代谢紊乱的影响。实验结果表明安妥明除具有已知的降低血清T—C、LDL—C和VLDL—C作用外,还可明显升高高胆固醇血症大鼠的血清HDL—C水平和LCAT活性,同时能明显降低血清及肝脏IPO的形成。进一步观察表明,安妥明对高密度脂蛋白亚组份的作用是使HDL_2-C升高,而对HDL_3-C无明显影响。     

The synchronization of respiration and swallow sounds with videofluoroscopy during swallowing

Simultaneous recording of adult subjects sipping small amounts of fluid from a cup have been obtained by videofluoroscopy together with feeding respiratory patterns and swallow sounds from the Exeter Dysphagia Assessment Technique (EDAT). These allowed visual representations of respiration and swallow sounds to be superimposed on a videofluoroscopy recording using a split-screen technique. Sequentially numbered, 1/50 sec, half-frame photographic prints were examined and schematic drawings of the relevant radiographs were made. These were superimposed on to the actual EDAT printed chart of the same swallow event, theri exact time relationship with respiration and cervical swallow sounds being preserved. The results allow events in the barium videofluoroscopy to be related to events in the feeding respiratory pattern and swallow sounds recorded by EDAT.     

肿瘤三项标记物在良性和恶性胸液鉴别诊断中的价值

作者测定了44例良恶性胸腔积液患者胸液及血清甲胎蛋白(AFP)、癌胚抗原(CEA)和铁蛋白(Ft)三项肿瘤标记物水平。结果表明:恶性胸腔积液患者的胸液和血清的CEA均明显高于良性胸腔积液。若胸液和血清的CEA以>15ng/ml为诊断界值,其敏感性为55.6％和43.8％,特异性均为100％。恶性胸腔积液患者胸液的Ft高于良性胸腔积液。若胸液的Ft分别以男>480 ng/ml、女>264 ng/ml为诊断界值,其敏感性为70％,特异性为66.7％。故可认为CEA及Ft在良恶性胸液的鉴别诊断中具有一定意义,而AFP在鉴别诊断中则无显著意义。     

彩色多普勒超声血流图在心脏手术中的应用(附19例病例分析)

在心脏手术中应用多普勒彩色超声心动仪直接探测和观察19例患者,其中风湿性心瓣膜病11例、先天性心脏病7例、左心房粘液瘤1例。风心病及左房粘液瘤患者手术前、中检查的结果基本一致;先心病术前诊断符合率为84.2％(5/7),术中诊断符合率为100％。本文对检查结果作了分析讨论,并提出符合我国情况的有关检查设想。     

医疗纠纷的非诉讼解决方式-医疗纠纷ADR

由于在纠纷解决方面所表现出来的简便，经济，快捷，专业性及保密性强等优点，非诉讼纠纷解决方式（又可译为代替性纠纷解决方式）ADR（Alternative Dispute Resolution）逐渐成为许多国家和地区解决民事纠纷的一大趋势，我国现行医疗纠纷解决机制存在着较多的问题，有待于进一步的改善与完善，根据我国所面临的现实情况，将ADR引入医疗纠纷领域是一条快速，有效地解决医疗纠纷的途径，医疗纠纷的非诉讼纠纷解决方式主要包括仲裁，调解与和解，这3种纠纷解决方式各具特点，适用于不同情况下医疗纠纷的解决。     

Electrocatalytic dehalogenation of organohalides on a nickel(II) tetraazamacrocyclic complex-modified graphite felt electrode

Electrocatalytic dehalogenation of organohalides was studied using a nickel(II) tetraazamacrocyclic complex-modified graphite felt electrode. The nickel(II) tetraazamacrocyclic complex-modified graphite felt electrode was prepared by attaching nickel(II) (6-(2′-hydroxyethyl)-1,4,8,11-tetraazacyclotetradecane)perchlorate chemically to the carboxyl groups of a thin poly(acrylic acid) layer coated on the graphite felt. The modified electrode gave a reversible electron transfer for the nickel(II)/nickel(I) redox couple in cyclic voltammetry at ?0.95 V versus Ag/AgCl. A preparative electrocatalytic dehalogenation of organohalides was successfully achieved on the modified electrode with an adequate current efficiency (55.6–94.8%), conversion (34.2–100%) and turnover number of the Ni catalyst (667–3333).