胃癌术后膳食纤维和早期肠内营养与消化道并发症的关系

目的探讨胃癌术后膳食纤维和早期肠内营养(EN)与消化道相关并发症的关系。方法采用随机对照的方法,把56例胃癌术后患者随机分成能全素组和能全素加膳食纤维组,经鼻肠管进行早期肠内营养(EN),观察两组EN常见消化道并发症的发生情况。结果两组患者在临床资料方面具有可比性(P>0.05)。两组患者的术后腹胀、腹泻的发生率相似,均P>0.05,差异无统计学意义。1例能全素加膳食纤维组患者因吻合口水肿、输入袢不完全性梗阻而发生恶心、呕吐,其余患者均未发生恶心和呕吐。结论胃癌术后的早期膳食纤维EN并不增加EN消化道并发症的发生率。     

谷氨酰胺和生长激素对短肠综合征患者肠道代偿作用

目的探讨谷氨酰胺和生长激素对短肠综合征(SBS)患者的肠道代偿作用。方法26例短肠综合征患者残余小肠长度为0～100(中位数42.5)cm,手术后接受肠外营养(PN)支持3-52个月,联合应用生长激素(GH)(0.10±0.06)mg·kg-1·d-1和谷氨酰胺(GLN)(0.30±0.17)g·kg-1·d-1进行肠道促代偿治疗。结果26例接受GH加GLN治疗的SBS患者,其中9例(34.6%)治疗后近期内完全摆脱PN;8例(30.8%)经治疗后明显减少了PN用量,从每周需要PN(6.0±1.0)d下降至(4.2±1.0)d,每周PN需要量从(13.6±5.2)L降至(8.2±3.3)L;9例(34.6%)在治疗后仍依赖PN维持。结论经过合适的营养支持和肠道促代偿治疗,大多数短肠综合征患者残留肠道能充分代偿,完全摆脱PN或减少PN用量,长期健康生存。     

纤维素酶对玉米秸青贮营养成分及其奶牛瘤胃降解率的影响

本研究探讨了添加纤维素酶制剂对玉米秸青贮营养成分含量变化及其瘤胃内降解率的影响。以去穗玉米秸为试验材料,分别以0.00 g/1kg(C)、0.05g/1kg(Ⅰ)、0.2g/1kg(Ⅱ)、1g/1kg(Ⅲ)进行添加纤维素酶,贮藏4周后进行常规营养成分含量变化分析和饲养试验。用4头装有永久性瘘管荷斯坦乳牛,按4×4拉丁方设计进行瘤胃内降解率的试验。结果为:Ⅰ组、Ⅱ组和Ⅲ组玉米秸青贮DM含量差异不显著,但均显著低于C组;不同处理组的玉米秸青贮CP含量随纤维素添加量增加而显著提高,以1g/1kg纤维素酶添加处理的提高幅度最大;NDF和ADF含量均随着纤维素添加量增加而显著下降,其中1g/1kg纤维素酶添加处理的下降幅度最大。Ⅲ组、Ⅱ组和Ⅰ组玉米秸青贮的DM和CP奶牛瘤胃有效降解率均显著高于C组,并且Ⅲ组显著高于Ⅱ组和Ⅰ组;不同处理组的玉米秸青贮NDF有效降解率之间差异显著,Ⅲ组>Ⅱ组>Ⅰ组>C组;玉米秸青贮ADF有效降解率Ⅲ组、Ⅱ组和Ⅰ组之间无显著差异,但均显著高于C组。表明纤维素酶处理能提高青贮营养价值,且纤维素酶以1g/1kg添加量为宜。     

Long-term effectiveness and quality of life improvement in entacapone-treated Parkinson's disease patients: the effects of an early therapeutic intervention

To evaluate the long-term effects of entacapone on both mean daily 'on' time and health-related quality of life (QoL) in patients with Parkinson's disease (PD) experiencing 'end-of-dose' motor fluctuations and the benefits of an early therapeutic intervention. A prospective, multicenter, observational, 12-month study was performed with an initial 3-month intervention phase, consisting of a phone call to half of the patients from randomly selected investigators to assess if dose adjustment was necessary. Effectiveness was determined by home diaries ('on' time), subscales II and III of the Unified Parkinson's Disease Rating Scale (UPDRS), and the Parkinson's Disease Questionnaire (PDQ-8). After 3 months of treatment, 4.0% of the intervention group patients discontinued the study, versus 18.4% in the control group ( P  < 0.01). The improvement in 'on' time was significantly increased since the 3-month visit (21%, P  < 0.0001) until the end of the study (23% at 12 months, P  < 0.0001). Entacapone also induced significant reductions in the UPDRS scores for subscales II and III and in the PDQ-8 score. 11.2% of patients experienced at least one adverse reaction. This study confirms the effectiveness of entacapone in reducing motor fluctuations by increasing 'on' time, and in improving QoL of PD patients. An early adjustment of entacapone and levodopa doses reduces the number of treatment discontinuations during the first months of treatment.     

重症急性胰腺炎早期治疗的探讨及分析

目的 探讨重症急性胰腺炎（SAP）早期治疗体会及外科手术治疗时机和手术方式的选择。方法 对比分析1989—1995年以早期手术为主的36例SAP（A组）与1996—2003年7年中非手术治疗为主的44例SAP（B组）的治愈率和死亡率。结果 B组的死亡率明显低于A组，A组的治愈率低于B组。结论 SAP早期的急性炎症反应期，手术只能加重对机体的打击，加重SAP全身炎症反应，增加手术死亡率。故SAP早期治疗应以非手术疗法为主。当内科治疗无效，手术治疗是唯一的选择，而手术时机的掌握和手术方式的选择更为重要，直接影响手术结果。     

Increased prevalence of undernutrition in Parkinson's disease and its relationship to clinical disease parameters

Summary An anthropometric study was performed in 95 subjects (53 male, 42 female) with Parkinson's disease. Weight, height, triceps and biceps skin-fold thicknesses, and mid-arm circumference were recorded. A high incidence of undernutrition was found (23.6% of males and 22.5% of females, as defined by recent British guidelines). A subgroup of severely disabled patients with Parkinson's disease had a significantly lower mean body mass index than a similarly disabled control group with chronic pyramidal upper motor neuron lesions (males 20.6v 23.2 kg/m² p<0.05; females 20.6v 26.6 kg/m² p<0.01), suggesting that the undernutrition is not due to chronic illness or immobility alone. Correlation between anthropometric indices and clinical features of disease demonstrated that the presence of moderate or severe dyskinetic movements was the clinical parameter most strongly related to undernutrition. The reduction in anthropometric indices was most marked for skin fold thickness (related to percentage body fat) and least for arm muscle circumference (related to lean body mass); therefore the weight loss seen in Parkinson's disease is primarily due to fat loss rather than muscle loss.     

上海城乡儿童智力发育调查

为探索着力低下早期发现的途径和方法，对上海城乡4546名0～12岁）儿童进行了智力发育测查。首先用DDST或绘人测验进行智力筛查，筛查阳性者按不同年龄用儿——心量表、WPPSI或WISC—R进行测试。DQ或IQ低于70者以婴幼儿一初中生社会生活量表进行社会适应能力评估。测查结果共发现智力低下42例，占调查儿童总数的9．24％。城乡相比，农村智力低下现患率（16．13‰）明显高于城市（4．19‰），P＜0．01。从性别来分，男孩现患率（11．36‰）高于女孩（6．91‰）。智力低下患病率有随年龄增加而上升的趋势。因素分析与配对研究显示智力低下与父母文化素质有密切关系，父母文化程度小学以下者其子女智力低下患病率高。智力低下的发生还与高危因素有关。     

Disorders in early embryonal cellular proliferative properties distort the postnatal formation of nervous, immune, and endocrine regulation systems in a newborn

Disorders in the postnatal nervous, immune, and endocrine regulation systems were revealed in the progeny of rats irradiated during the preimplantation period of embryogenesis. These disorders persist till adult age. The direction of disorders confirms the hypothesis about memorization of changed proliferative properties of embryonal cells during the development of the (pro)endocrine system of a new organism. Memorization results in distortion of postnatal nervous immunoendocrine regulation: hypertrophy of the endocrine component and coadaptive underdevelopment of the nervous and immune components. Translated fromByulleten' Eksperimental'noi Biologii i Meditsiny, Vol. 126, No. 8, pp. 164–166, August, 1998     

腹腔镜在异位妊娠中的诊断和治疗价值

本文分析1982～1987年间收治的544例异位妊娠,其中270例行腹腔镜检查、274例未作腹腔镜检查。两组资料相比提示:腹腔镜检查组诊断符合率高达97.40％;由于能及早明确诊断,故该组腹腔内出血量比未作腹腔镜检查组少,平均为241m1/372ml(P<0.05),需输血例数明显减少30例(11.11％)/134例(48.90％)(P<0.01),输卵管未破裂者增高222例(82.22％)/194例(70.80％)(P<0.01)。270例无术后并发症发生。上述给年轻不孕患者作非手术治疗或输卵管保守手术以保留生育功能提供良好条件。