幽门螺杆菌感染与肝硬化关系的研究

目的：研究肝硬化患者的幽门螺杆菌（HP）感染状况及其对肝性脑病和上消化道出血的影响。方法：用尿素酶快速染色和瑞一姬染色确定HP的感染,分析肝硬化与十二指肠疾病患者HP感染率的差异;HP感染对肝硬化患者血氨浓度的影响;随访HP阳性与阴性肝硬化患者肝性脑病的发生率;观察肝硬化并上消化道出血与非出血患者间HP感染的差异。结果：肝硬化与胃十二指肠疾病患者HP感染无明显差异;HP感染能使肝硬化患者血氨浓度增加,从而使肝性脑病发生率增高;肝硬化并出血与非出血组HP感染无明显差异。结论：肝硬化患者的HP感染无特异性;HP感染能促使肝性脑病的发生;HP感染在肝硬化并上消化道出血中未起主要作用。     

Role of Laryngeal Movement and Effect of Aging on Swallowing Pressure in the Pharynx and Upper Esophageal Sphincter

Objectives Describe contribution of laryngeal movement to pressure changes at the upper esophageal sphincter (UES) and the effect of aging on the swallowing function. Study Design Manofluorography on 56 nondysphagic adults divided into three age groups: the 21‐ to 31‐year‐old group (n = 32), the 61‐ to 74‐year‐old group (n = 12) and the 75‐ to 89‐year‐old group (n = 12). Analyses of the bolus transit time, the amplitudes and durations of pharyngeal pressures, the timing of a pressure fall at the UES and the laryngeal movements. Methods Intraluminal strain‐gauge sensors recorded pressure changes in the oropharynx, hypopharynx and the UES. Motion pictures of the videotapes were fed into a personal computer, and movements of the hyoid bone were measured in both the horizontal and vertical directions as an indication of laryngeal movement. Results In 26‐ and 70‐year‐old men with calcification of the thyroid cartilage, it was determined that the larynx and hyoid bone moved in consonance until the end of the rapid hyoid movements in both the superior and anterior directions. In the 21‐ to 31‐year‐old group, the magnitude of the pressure fall at the UES was maximal before or almost at the same time as the bolus arrival, in preparation for smooth passage of the bolus from the pharynx to the esophagus. The rapid superior movements of the hyoid bone started significantly early as compared with its anterior movements (P = .0001). The rapid anterior movements of the hyoid bone started simultaneously with the pressure fall at the UES. In the elderly, all segmental transit times were significantly increased. The timing of the pressure fall at the UES was significantly delayed and the UES pressure reached its minimum value after arrival of the bolus at the UES. The minimum pressure at the UES increased to a significantly positive value. The rapid anterior movements of the hyoid were significantly delayed, suggesting that this delay causes the delay in the pressure fall at the UES. Conclusions The rapid superior and anterior movements of the hyoid bone are considered to start at the same time as those of the larynx. In the young group, it is suggested that superior laryngeal movement protects the lower airway prior to the anterior laryngeal movement, causing the pressure fall at the UES to enable the passage of a bolus into the UES. In the elderly, smooth passage of the bolus from the pharynx to the esophagus is hindered and the system that prevents aspiration is rendered inefficient by changes in the swallowing pressures and laryngeal movements with aging.     

180例小儿纤维胃镜检查及68例HP感染检测分析

目的　了解小儿上消化道疾病的发病情况和儿童胃病的HP感染情况。方法　对 180例小儿纤维胃镜检查分析及 172例胃粘膜HP检测及 16 8例胃、十二指肠粘膜病理检查结果进行总结。结果　疾病检出率为 93.3% ,其中以十二指肠炎、浅表性胃炎、消化性溃疡检出率最高 ;172例HP检测者中HP阳性 6 8例 ,阳性率为 37.8% ,其中以消化道溃疡检出率为最高 ,16 8例病理活检均为轻中度炎症。结论　HP感染在儿童慢性胃炎及消化道溃疡的致病中起重要作用 ,且随年龄增长而增加 ;儿童胃炎以轻、中度为主。     

病毒唑雾化吸入治疗上呼吸道感染40例

目的　探讨病毒唑雾化吸入在上呼吸道感染中的疗效。方法　治疗组 4 0例 ,应用病毒唑 15mg/kg雾化吸入 ,15min吸完 ;。对照组 4 0例静脉滴注病毒唑。 结果　治疗组治愈率为 95% ,对照组为 6 3.2 % ,两组差异明显 (P <0 .0 5)。结论　静脉滴注到达呼吸道剂量较少 ,超声雾化可使吸入 70 %药物直接分布于呼吸道表面 ,且无副作用。     

A single technique to correct various degrees of upper lid retraction in patients with Graves' orbitopathy

BACKGROUND: Several lengthening techniques have been proposed for upper eyelid retraction in patients with Graves' orbitopathy and variable rates of success have been reported. Most authors recommend different procedures for different degrees of retraction, but cannot prevent residual temporal retraction in a significant number of cases. The modified levator aponeurosis recession described by Harvey and colleagues, in which the lateral horn is cut completely, seems to be an exception to this rule, but was evaluated in a limited number of cases only. METHOD: The authors further modified Harvey's technique by dissecting the aponeurosis together with Müller's muscle of the tarsus and the conjunctiva medially only to the extent necessary to achieve an acceptable position and contour of the eyelid in upright position. They also used an Ethilon 6.0 suture, instead of Vicryl, on a loop. It is placed between the tarsal plate and the detached aponeurosis to prevent spontaneous disinsertion. This modification was used in 50 Graves' patients (78 eyelids) with a upper lid margin-limbus distance ranging from 1 to 7 mm and evaluated using strict criteria. RESULTS: A perfect or acceptable result was obtained in 23 of 28 patients (82%) with bilateral retraction and in 18 of 22 patients (82%) with unilateral retraction. Seven eyelids were overcorrected (too low) and three undercorrected, necessitating reoperation. All other eyelids had an almond-like contour and a lid crease of 10 mm or less. No complications except subcutaneous haematomas were seen. Two patients showed a recurrence of lid retraction 9 months after the operation. CONCLUSION: This technique is safe and efficacious and can be used for all degrees of eyelid retraction.     

Abnormal single motor unit behavior in the upper motor neuron syndrome

We studied the discharge pattern of single motor units (SMUs) in the left and right biceps muscles from a patient with nonspastic weakness of the left arm. Detailed statistical analysis of the behavior of discharge patterns of 4 of 4 single motor units on the affected side showed abnormalities with characteristic features of an upper motor neuron lesion. Five out of 5 single motor units recorded from the right biceps were normal. An upper motor neuron lesion affecting the left arm, predicted by our results, was confirmed by magnetic resonance imaging (MRI), which showed a lesion in the right precentral gyrus. It appears that changes in single motor unit firing characteristics, caused by an upper motor neuron lesion, can be detected at a time when there is no evidence of increased "tone" and/or hyperreflexia (spasticity) in the affected extremity.     

Esophageal pressure and apnea hypopnea index in sleep-disordered breathing

Severity of negative esophageal pressure (Pes) and apnea hypopnea index (AHI) were investigated in six cases of upper airway resistance syndrome (UARS) and 11 cases of obstructive sleep apnea syndrome (OSAS). The severity of negative Pes was represented by the highest peak (Pes Max) and the number of increased episodes (more than 13.5 cmH2O) per h (NPesI13.5). There was no significant correlation between Pes indices and AHI. Pes Max and NPesI13.5 were not different among severe OSAS (AHI > 30), mild OSAS (AHI < 30) and UARS. Apnea hypopnea index failed to represent the severity of negative Pes, which is an important aspect of the pathophysiology of sleep-disordered breathing.     

凝血酶治疗新生儿上消化道出血的研究

目的　探讨凝血酶治疗新生儿上消化道出血的临床效果。方法　对 2 0 0 0年至今收住院的新生儿上消化道出血患儿 17例 ,除常规综合疗法外 ,静脉滴注维生素K1 10mg/d ,连用 4～ 7d。结果　治疗组 17例 ,显效 16例 ,显效率 97% ,对照组 15例 ,显效 7例 ,显效率 40 % ,两组比较有明显差异性 (P <0 0 0 1)。治疗组止血时间 1 3 5± 0 6d ,对照组平均止血时间 3 2±0 5d ,两组比较有明显差异性 (P <0 0 0 1)。结论　凝血酶治疗新生儿上消化道出血为一种安全、方便 ,无副作用的首选止血药物     

喜炎平和利巴韦林治疗急性上呼吸道感染的比较

目的 比较喜类平注射液(主要成份:穿心莲内酯)和利巴韦林注射液治疗急性上呼吸道感染的临床疗效。方法 将204例急性上呼吸道感染患儿随机分成两组,治疗组133例,给予喜炎平注射液0.2～0.4m/(kg·d)。对照组71例,给予利巴韦林注射液10～15mg/(kg·d),两组均加苯唑青霉素50mg/kg·d,静滴。结果 治疗组治愈时间5.14±1.50d,对照组5.55±1.46d,两组平均治愈时间无显著差异(P>0.05),但治疗组平均退热时间与对照组比较有显著差异(P<0.05)。结论 喜炎平注射液具有抗病毒,抗菌作用,副作用小,是治疗小儿急性上呼吸道感染较理想的药物。