碘海醇重度过敏反应1例抢救体会

1临床资料患者男性,71岁,B超提示肝癌。拟行CT平扫增强检查。增强检查前,询问患者有无过敏史,观察碘过敏试验阴性15分钟后行CT平扫,发现占位病变再定位增强。采用人工推注碘海醇(扬子江药业集团有限公司,国药准字H10970326,产品批号07010701 NO 035,有效期2008/12)50ml×2瓶。当碘海醇注入到80ml时患者出现四肢躁动、恶心、呕吐,呼吸困难、口唇、面色青紫,心跳减慢,血压骤减等重度过敏症状。发现问题后立即停止推药并迅速静脉注入20mg地塞米松,皮下给予肾上腺素0·3mg,即刻用5%的葡萄糖溶液静滴,(既能扩容、维持动脉压、保证重要器官的…     

伊文氏蓝染色对大鼠脑内肿瘤生物学标记方法的研究

目的研究在大鼠脑内肿瘤模型中生物学染色标记脑内肿瘤的方法。方法选择F344大鼠,移植体外培养的RG2胶质瘤细胞制作脑内肿瘤模型,移植18d后经大腿静脉注射伊文氏蓝(Evans blue,EB)染色肿瘤组织,探讨生物学染色对脑内肿瘤的标示作用和手术中对肿瘤和周围正常脑组织鉴别的意义。结果EB浓度在100mg/kg时,肿瘤组织染色成鲜明蓝色,同时大鼠的皮肤和所有器官都被染色成蓝色;当浓度低于10mg/kg时,仅染色肿瘤组织而皮肤和其他器官不被染色;肉眼可鉴别的最低静注浓度为1.25mg/kg。肿瘤组织的染色效果持续到静注后96h。血清中EB浓度在静注后3h内迅速减少,之后呈缓慢代谢过程,静注后24h减少到静注浓度的38%,静注后24h EB在血清和肿瘤组织中的浓度差达到最大值。染色后在手术显微镜下进行肿瘤切除手术操作较未染色对照组明显容易,手术后切片组织学观察肿瘤被完全切除。结论EB生物学染色标记脑内肿瘤效果可靠,手术中作为肿瘤的标示鉴别肿瘤和周围正常脑组织的界限有效。     

胸痹通胶囊对高脂血症大鼠脂质过氧化的影响

目的：探讨胸痹通胶囊对高脂血症大鼠血脂及脂质过氧化作用的影响。方法：选取健康成年wistar大鼠60只，随机分为正常对照组、高脂对照组和实验观察组，分别饲以基础饲料、高脂饲料和高脂饲料加胸痹通胶囊，12周后取大鼠血清及多脏器组织，观察胸痹通胶囊对高脂血症大鼠血脂及脂质过氧化的影响。结果：与正常对照组比较，高脂对照组血清胆固醇、三酰甘油明显升高为(1.83&;#177;0.49)和(1.09&;#177;0.35)mmol／L，高密度脂蛋白(high-density lipopro-tein HDL)则明显降低至(2.06&;#177;0.45)mmol／L，差异均有显著性意义(t=3.070～4.589，P&;lt;0.05)，血清和心肌超氧化物歧化酶(superoxide dismutase，SOD)活性显著降低为(2.71&;#177;0.79)mkat／L和(0.68&;#177;0.20)mkat／g，血清和肝脏的过氧化氢酶(catalase，CAT)、谷胱苷肽过氧化物酶(dutatllione peroxidase，GSH-Px)活性分别降至(0.04&;#177;0.01)mkat／L (0.64&;#177;0.13)和(0.74&;#177;0.15)mkat／g 差异均有显著性意义(t=2.148～4.145，P&;lt;0.05)，经胸痹通胶囊干预后血脂异常得以纠正，血清胆固醇、三酰甘油分别降低为(1.42&;#177;0.41)和(0.70&;#177;0.36)mmol／L并使血清和心肌组织SOD活性以及肝脏GSH-Px活性显著升高至(3.50&;#177;1.05)mkat／L，(0.84&;#177;0.17)mkat／g和(0.87&;#177;0.15)mkat／g，同时明显降低血清及心肌组织的脂质过氧化物丙二醛的含量，与高脂对照组比较，差异均具有显著性(P&;lt;0.05)。结论：降血脂、抗脂质过氧化可能是胸痹通胶囊心肌保护作用的机制之一。     

Poststroke DNA immunization against neurite growth inhibitors is beneficial to the recovery from local cerebral ischemia in rats

BACKGROUND： Inhibitory signals, i.e. neurite growth inhibitors （NGIs）, presenting on central nervous system （CNS） myelin have been shown to play a crucial role in inhibiting lesioned axonal sprouting and leading to less functional recovery. Vaccines targeting NGIs may provide multifactorial protection against brain insults by overcoming the inhibitory effects of these NGIs and boosting the body＇s immune repair mechanisms. OBJECTIVE： To evaluate the effect of poststroke DNA immunization against NGIs on the rehabilitation for sensorimotor function of rat models of local cerebral ischemia. DESIGN： Completely randomized grouping design, and controlled experiment. SETTING： Brain Injury Research Laboratory, Department of Neurosurgery, National Neuroscience Institute, Singapore. MATERIALS： Sixty adult male Sprague-Dawley rats ranging in age from 45 to 120 days and in weight from 180 to 250 grams were provided by Animal Center of Department of Anatomy, Faculty of Medicine, National University of Singapore. pcDNA3.1（＋）-neurite growth inhibitors （pcDNA-NGIs） a gift was provided by Dr. Xiao from Department of Clinical Research, Singapore General Hospital, Singapore. METHODS： The experiment was carried out at Brain Injury Research Laboratory, Department of Neurosurgery, National Neuroscience Institute, Singapore from August 2003 to April 2005. （1）The involved rats were randomized into 3 groups： pcDNA-NGIs group （group A）, pcDNA3.1 （＋） group （group B） and model group （group C）, with 20 rats in each group. Left focal cerebral ischemia （FCI） was permanently induced through middle cerebral artery occlusion （MCAO） with the assistance of an operating microscope. Successful MCAO was determined by a 20% decrease to baseline in the ipsilateral cerebral blood flow. 100 μg of pcDNA-NGIs eluted in phosphate-buffered saline （PBS） was intramuscularly injected into the tibial muscle once a week after MCAO for 6 weeks in group A. As control, pcDNA3.1 （＋） was also administrated in the same way in group B and nothing was administrated in group C. （2） The modified neurological severity score （mNSS）, a composite of motor, sensory, reflex and balance tests, was used to test the sensorimotor deficit. The mNSS was graded on a scale of 0 - 18, i.e. normal score was 0, maximal deficit score was 18, and 1 point was warded for the inability to perform the tasks or the lack of a tested reflex. （3） The newly generated axons of corticorubral projection were traced by stereotaxic guided injection of 100 g/L biotinylated dextran amine. Rats were sacrificed two weeks after tracing, and cryostat coronal sections of midbrains （30μm） were reacted to BDA according to the manufacturer＇s instruction by the free-floating method. Images were captured on a DM RXA2 LEICA Microscope with a Spot Digital Camera system （Germany）, and the numbers of labeled axons on the denervated side in four standard coronal sections including the red nucleus were manually quantified. MAIN OUTCOME MEASURES： （1） The number of newly generated axons of corticorubral projection. （2）The improvement in sensorimotor deficit. RESULTS： All the involved 60 rats entered the stage of final analysis. （1） The number of newly generated axons of corticorubral projection of rats： Only ipsilateral axons of CRP were noted with little evidence of fibers crossing to the contralateral red nucleus in rats of groups B and C. More BDA-positive fibers crossing the midline and terminating in the contralateral red nucleus in appropriate target areas mirroring the non-differentiated red nucleus were found in rats of group A. Quantitative analysis showed that BDA-labeled axons in the denervated side of rats in group A were more than those in group B （P 〈 0.05）. （2） Improvement in sensorimotor deficit of rats： At 2 weeks after immunization, significant improvement in sensorimotor deficit was found in rats of group A. There were significant differences of improvement in sensorimotor deficit of rats between group A and group B or group C at 12 and 14 weeks after immunization （P 〈 0.05）. CONCLUSION： （1） Poststroke DNA immunization against NGIs leads to increased sensorimotor recovery following FCI and compensatory newly growth of axons from corticorubral projection.     

抑郁症受体机制研究进展

本文综述了谷氨酸受体、促肾上腺皮质激素释放激素受体、神经激肽受体、糖皮质激素受体在抑郁症发病机制中所起作用的研究进展。     

吗啡、可乐定、新斯的明相互配伍用于硬膜外腔术后镇痛的比较

1临床资料 1．1一般资料 45例胆囊切除术患者，男32例，女13例，年龄20-55岁，ASAI-Ⅱ级，随机分为三组，每组15例。硬膜外手术结束时双盲法硬膜外腔注入以下三组药物中的一组：吗啡2mg＋可乐定4μg（M＋C组），吗啡2mg＋新斯的明lmg（M＋N组），吗啡2mg＋新斯的明lmg＋可乐定4μg/kg（M＋N组）。以上各组容积均为10ml，以生理盐水作溶剂。     

嗜酸性粒细胞性胃肠炎三例临床分析

嗜酸性粒细胞性胃肠炎是一种消化道组织中嗜酸性粒细胞浸润的少见疾病,其病因及发病机制尚不清楚.该病于1937年由Kaijser首次报道,至1997年文献报道仅300余例 [1].由于其临床表现多样且尤特异性,误诊率很高.我们于2003年9月至2008年9月共收治嗜酸性粒细胞性胃肠炎患者3例,对其临床资料分析如下.     

塑化液治疗牙本质过敏症的对照疗效观察

目的：探讨塑化液治疗牙本质过敏症的疗效。方法：采用自身配对对照法，用塑化液和氟化钠局部涂搽治疗牙龄磨损所致的牙本质过敏症。结果：平均疗效分别为100％、62．5％，经统计学处理P＜0．01。结论：用塑化剂治疗牙本质的敏感症优于氟化钠脱敏法。