川芎挥发油化学成分研究

采取闪蒸气相毛细管色谱法和气相毛细管色谱—质谱法研究了宁夏六盘山区产川芎的挥发油化学成分,色谱分离出50多个峰,质谱鉴定了24个成分,主要是川芎酜内酯(46.37％)、丁基酞内酯(13.87％)、新蛇床内酯(6.98％)和丁烯基酜酯(4.8％)。红外光谱图中有较强的内酯特征吸收峰,为质谱所鉴定的以上主要成分提供了佐证。将闪蒸气相色谱法与蒸气蒸馏提取气相色谱法进行对照,二者的色谱图基本相符,前者是分析天然产物挥发性成分更加简便、迅速的微量方法。     

血液透析中尿毒素两室模型实验验证的研究

为了揭示血液透析过程中溶质在体液中的传递规律，我们制做了尿毒症实验动物犬模型进行血液透析实验，采用肌肉活体组织活检测定组织细胞内尿素氮（BUN）和肌酐（Cr）的浓度，同时取血样测定其血浆水平，发现组织细胞内BUN和Cr的浓度与其血浆浓度随时间变化具有明显的差异。因此，从实验上直接证实了人体体液两室模型理论的假设，提示人体细胞内代谢物质的传递与排他是不均一的，细胞内的物质进入血液需要克服一定的传质阻力。实验结果为合理地评价透析的充分性提供了理论根据。     

Gadolinium ring enhancement and mass effect in acute disseminated encephalomyelitis

A 9-year-old boy presented with a subacute history of optic neuritis followed by brainstem involvement, with fever and a lymphocytic pleocytosis in the cerebrospinal fluid. Gadolinium-enhancing ring lesions were demonstrate in the white matter of the cerebrum, brainstem and cerebellum on day 17 of the illness, all appearing simultaneously as part of a monophasic illness. A parietal lesion exerted mass effect. Needling and biopsy yielded no evidence of a pyogenic lesion, tumour or tuberculosis and showed vasculitis. There was insufficient material for myelin staining. Dexamethasone therapy lead to rapid improvement of the radiological lesions: MRI and CT on day 34 of the illness showed complete clearing of the lesions except for residual abnormality at the biopsy site.     

5～14岁男性体格发育水平与性器官发育关系的研究

目的：探讨男性青少年体格发育水平与性器官发育关系。方法：收集4854例5—14岁男性青少年的身高、体重并计算出体质指数，测量阴茎的长度、周长和睾丸的纵径、横径，观察二者之间的关系。结果与结论：身高与阴茎的长度、周长和睾丸的纵径均呈二次方程曲线关联，而与睾丸横径无明显关联。体重和体质指数与阴茎有长度、周长和睾丸的纵径、横径无明显关联。     

Comparison of the APACHE III, APACHE II and Glasgow Coma Scale in acute head injury for prediction of mortality and functional outcome

Objectives: This study examines the efficacy of the predicting power for hospital mortality and functional outcome of three different scoring systems for head injury in a neurosurgical intensive care unit (NICU). Design: On the day of admission, data were collected from each patient to compute the Acute Physiology, Age, and Chronic Health Evaluation (APACHE) II and III, and Glasgow Coma Scale (GCS) scores. Hospital mortality was defined as the deaths of patients before discharge from hospital. Early mortality was defined as death before the 14th day after admission. Late mortality was defined as death after the 15th day from admission. Functional outcome was evaluated by Index of Independence in Activities of Daily Living (Index of ADL). Setting: An 8-bed NICU in a 1270-bed medical center in Taichung Veterans General Hospital. Patients and participants: Two hundred non-selected patients with acute head injury were included in our study in a consecutive period of 2 years. Patients less than 14 years old were not included. Interventions: None. Measurements and results: Sensitivity, specificity and correct prediction outcome were measured by the chi-square method in three scoring systems. The Youden index was also obtained. The best cut-off point in each scoring system was determined by the Youden index. The difference in Youden index was calculated by Z score. A difference was also considered if the probability value was less than 0.05. The area under Receiver Operating Characteristic (ROC) curve was computed. Then the area under ROC of each scoring system was compared by Z score. There was statistical significance if p was less than 0.05. For prediction of hospital mortality, the best cut-off points are 55 for APACHE III, 17 for APACHE II and 5 for GCS. The correct prediction outcome is 82.4% in APACHE III, 78.4% in APACHE II and 81.9% in the GCS. The Youden index has best cut-off points at 0.68 for APACHE III, 0.59 for APACHE II, and 0.56 for GCS. The area under Receiver Operating Characteristic (ROC) curve is 0.90 in the APACHE III, 0.84 in the APACHE II and 0.86 in the GCS. There are no statistical differences among APACHE III and II, and GCS in terms of correct prediction outcome, Youden Index and the area under the ROC curve. Other physiological variables excluding GCS in APACHE III and II (AP III-GCS, AP II-GCS) have less statistical value in the determination of mortality for acute head injury. For the prediction of late mortality, APACHE III and II yield significantly better results in the area under the ROC curve, correct prediction and Youden index than those of GCS. Other physiological variables (AP III-GCS and AP II-GCS) play an important role in the prediction of late mortality in APACHE scores. For prediction of the functional outcome of surviving patients with acute head injury, the APACHE III yields the best results of correct prediction outcome, Youden index and the area under the ROC curve. Conclusion: The APACHE III and II may not replace the role of GCS in cases of acute head injury for hospital or early mortality assessment. But for prediction of the late mortality, the APACHE III and II have better accuracy than GCS. Other physiological variables excluding GCS in the APACHE system play a crucial contribution for late mortality. GCS is simple, less time-consuming and economical for patients with acute head injury for the prediction of hospital and early mortality. The APACHE III provides better prediction for severe morbidity than GCS and APACHE II. Therefore, the APACHE III provides a good assessment not only for hospital and late mortality, but also for functional outcome. Received: 22 May 1995 Accepted: 2 September 1996     

不同针刺手法调节体温效应机制研究概况

目的:介绍近年不同的针刺手法对体表温度调节效应的研究,并探讨其产生体温效应的机制。方法:从临床研究、实验研究等方面进行综述。结论:针刺穴位的作用及其疗效,随着手法引起的温度变化而不同,针刺补法引起体温升高,而泻法则引起体温下降。体表温度是由血液循环状态、交感神经兴奋程度和组织新陈代谢状态等多方面决定的,不同的针刺手法引起的皮肤温度变化与影响上述3个环节状态有关。     

盐酸帕罗西汀治疗躯体疾病伴发焦虑的疗效观察

目的：评价盐酸帕罗西汀治疗躯体疾病伴发焦虑的疗效。方法：对我院2002年1月-2003年．3月内外科躯体疾患伴发焦虑患者进行开放性平行对照研究，对照组用多虑平治疗，为期六周，采用HAMA、CGI量表评定临床效果，以TESS评定不良反应。结果：共65例(帕罗西汀31例，多虑平组34例)，临床判断帕罗西汀与多虑平的显效率分别为66．7％和69．4％，无显著差异，治疗后一周，多虑平组HAMA减分率优于帕罗西汀组，治疗二周后无显著差异。副反应的发生率，帕罗西汀组为17．6％，远低于多虑平组的34．6％。结论：帕罗西汀是一种疗效好，安全性高的治疗躯体疾病伴发焦虑的首选药物。     

体重对腰椎后路开窗减压手术疗效的影响

目的对不同体重老年腰椎管狭窄患者行单纯腰椎后路开窗减压手术,并评价其治疗效果。方法回顾性分析1996年12月～2002年12月间145例因老年腰椎管狭窄而采用单纯腰椎后路开窗减压手术治疗患者的病例资料,结合问卷调查患者对手术的满意程度,比较不同体重患者住院期间及术后症状改善情况,评估手术疗效。结果不同体重患者术后腰腿疼痛明显缓解、日常生活质量改善,患者对手术的满意率达67.59%。而且患者的各种统计数据表明,不同体重组之间差异无显著性意义(P>0.05)。结论体重在一定程度上影响老年腰椎管狭窄患者的手术治疗结果。单纯腰椎后路开窗减压手术,可以达到较为理想的治疗效果。     

Correlations between bone mineral density and demographic, lifestyle, and biochemical variables in community-dwelling Japanese women 69 years of age and over

Introduction A few epidemiologic studies have comprehensively attempted to identify risk factors for low bone mineral density (BMD) in elderly Asian women. The purpose of this study was to identify demographic, lifestyle, and biochemical factors correlated with BMD in elderly Japanese women 69 years of age and over.Methods The study design was cross-sectional. The subjects were 583 ambulatory women aged 69 years and over, and their average age was 74.3 (SD 4.4) years. Predictor variables were age, reproductive history, anthropometric indices, grip strength, calcium intake, lifestyle information, and serum 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D (1,25(OH)₂D), osteocalcin (OC), and undercarboxylated osteocalcin (ucOC) values. The outcome variable was forearm BMD measured with a DTX-200 osteometer.Results Simple linear regression analyses showed that BMD was significantly positively associated with body height, weight, body mass index, grip strength, serum albumin concentration, and “housework,” and negatively associated with age, years since menopause, age at menarche, number of children, serum 1,25(OH)₂D concentration, serum OC concentration, and ucOC concentration. The stepwise multiple regression analysis showed that weight (β=0.00316, SE=0.00028, R²=0.180), age (β=−0.00321, SE=0.00050, R²=0.108), log-transformed serum OC (β=−0.0445, SE=0.0064, R²=0.053), log-transformed serum 1,25(OH)₂D (β=−0.0401, SE=0.0074, R²=0.050), “farmwork” (β=0.00904, SE=0.00426, R²=0.005), and serum 25(OH)D concentration (β=0.000281, SE=0.000120, R²=0.003) were significantly associated with BMD.Conclusion It was concluded that body weight is a major predictor of forearm BMD among the factors measured in this study in independent Japanese women 69 years of age and over and that serum 1,25(OH)₂D concentration may be associated with cortical BMD. Maintenance of body weight is very important for maintaining BMD in this population, unless a large weight aggravates obesity-related diseases. A follow-up study is needed to confirm these findings.     

易误诊为神经肿瘤的一种疾病——肿块型中枢神经系统原发性血管炎

背景与目的：由于缺乏特异性临床和影像表现，肿块型中枢神经系统原发性血管炎（primary angiitris of central nervous system，PACNS）常被误诊为胶质瘤．本文旨在探讨肿块型PACNS的诊断与鉴别诊断。方法：回顾性分析手术治疗的37例肿块型PACNS患者的临床及影像表现。结果：85．3％的患者出现局灶性神经功能减退，55．9％患者有不同程度皮层高级功能减退症状。70．6％的颅内病变累及脑皮层：73．5％患者的正常区域脑血管周围间隙增宽，其中76％出现血管强化；病变出现特征性的“C”形强化。结论：局灶性神经功能和高级功能减退、病变累及皮层和“C”形强化等特征．有助于诊断肿块型PACNS。