自发性食管破裂的护理

目的 总结自发性食管破裂患者的护理措施，提高护理水平。方法 在保守及手术治疗的同时，严密观察病情变化，做好心理护理，加强呼吸道、消化道及各种管道的护理。结果 7例患者治愈出院。结论 精心的专业化护理在治疗自发性食管破裂中起重要作用。     

Post-traumatic spontaneous recurrent hypothermia: a variant of Shapiro's syndrome

A 49-year-old man presented with episodic hypothermia many years after sustaining a contusional brain injury. Brain magnetic resonance imaging demonstrated the destruction of the anterior parts of the corpus callosum without hypothalamic lesions. Nevertheless, delayed hypothalamic dysfunction at the neurotransmitter level is the probable pathophysiological key factor. Clomipramine treatment was beneficial. This case expands the spectrum of Shapiro's syndrome.     

食管穿孔和破裂的诊断与治疗

目的 提高对食管穿孔和破裂的诊断及处理水平。方法 回顾性分析经外科处理的45例食管穿孔或破裂患的临床资料。结果 本组患经胸部平片、胸腔穿刺、上消化道造影及胃镜确诊。15例为自发性食管破裂，6例为医源性穿孔，5例为创伤性穿孔，10例为食管癌并食管支气管瘘，9例为食管憩室并食管支气管瘘。治疗予以食管修补9例；胸腔引流、空肠造瘘9例(其中1例为食管修补失败后改行此手术)；食管切除胃食管吻合术12例(其中3例为食管修补失败)；胃造瘘术4例；置入食管支架4例；食管支气管瘘切除修补3例；食管瘘口修补并肺叶切除2例；食管胃弓上短路1例，颈部引流2例；放弃治疗3例。治愈25例，好转11例，死亡6例。结论 详细了解病史和进行胸腔穿刺、上消化道造影等检查可帮助诊断。尽早手术闭合瘘口和治疗食管原发病变是治疗的关键。     

电针周围性面瘫患者地仓穴的fMRI研究

目的：采用功能性磁共振成像（fMRI）技术,研究电针周围性面瘫患者地仓穴对脑功能的影响。方法：筛选6例左侧周围性面瘫患者为研究对象,电针刺激,同时行全脑fMR I扫描,SPM软件进行图像后处理,t检验（P〈0.01）分析得出电针不同穴位的脑功能图像。结果：双侧中央前回、双侧中央后回等多个脑区信号发生变化。结论：电针刺激引起了多个脑区信号的变化,穴位治疗作用的发生可能是多个脑区互相联络,对信息进行分析、整合,共同作用的结果。     

Physiological pharmacokinetics of solutes in the isolated perfused rat hindlimb: Characterization of the physiology with changing perfusate flow,protein content,and temperature using statistical moment analysis

Distribution of Evans Blue (EB), sucrose, and water into the isolated perfused rat hindlimb was studied under various conditions using the multiple indicator dilution (MID) technique. Statistical moment analyses of the outflow profiles for the EB, sucrose, and water were used to define the vascular, extravascular, and total water spaces, respectively. The varied perfusion conditions included albumin content (2, 4.7, and 7%), temperature (25, 37, and 42 C), perfusate flow rate (2, 4, 8, and 12 ml/min) and the presence/absence of red blood cells. The range of studies undertaken were chosen to represent the variety of conditions used in the preparation of both isolated animal and human limbs, the latter being particularly important in cytotoxic therapy for recurrent malignant melanoma. The distribution volumes of EB, sucrose, and water were dependent on the flow rate and the albumin content of perfusate. The normalized variances (CV ² ) of the markers were of the following order: sucrose (2.18) > water (1.58) > EB (0.68), indicating that some disequilibrium occurs during the capillary exchange of water and sucrose. It is suggested that a Krebs-Henseleit buffer containing 2% BSA is a suitable perfusate for most studies of the isolated rat hindlimb perfusion. The effect of albumin concentration manifests itself only at higher flows.We acknowledge the support of the National Heart Foundation (Queensland) and the Mayne Bequest Foundation. This study was conducted while the investigator (Z.Y. Wu) was in receipt of a WHO Research Training Grant. Professor M. S. Roberts also acknowledges the support of the Queensland and Northern New South Wales Lions Kidney & Medical Research Foundation.     

Spontaneous reporting of adverse drug reactions in an Italian region: Six years of analysis and observations

Pharmacovigilance started in Italy in 1965, and from 1987 reporting of ADRs has been mandatory. Doctors have to send the filled forms on suspected ADRs to the Local Health Districts which transmit biannually all the reports to the Health Department. In a Northern Italian Region (Veneto) spontaneous reporting of adverse drug reactions (ADRs) has been studied during the period 1988–1993. This Region contributes a substantial percentage of the total Italian reports. The total number of reports was 3700, most of these (54 per cent) coming from GPs. A great variability in the reporting rate among the 36 districts of Veneto Region (range: 0–8.8 per 10,000 inhabitants per year) and an important under-reporting have been evident. Underreporting is also emphasized by the fact that in 1993 the Veneto doctors who sent at least one report were only 2.7 per cent. On the whole about 35 per cent of reports concerned minor reactions caused by drugs which have a well known toxicological profile. Comparison between reports coming from Veneto and the UK in some cases show a similar safety profile (omeprazole and simvastatin), whereas in other cases (e.g. terfenadine, glafenine, fluoxetine) no correspondence can be found. This article reveals the limits of the actual spontaneous reporting in Italy and suggests some possible measures for improving it.     

替代神经吻合法治疗喉返神经麻痹的解剖学研究

通过对30例人喉神经、膈神经、颈袢的解剖观测及利用图象分析仪二维重建技术对相关神经的截面积、纤维数量的测量比较分析,结合有关实验研究资料,设计了在甲状软膏板后下方开窗,于甲杓肌神经起点处切断该神经,用颈袢主支与甲杓肌神经吻合,用膈神经与喉下神经吻合,同时重建声带的内收和外展功能,并探讨了其解剖和生理学基础,认为此手术方法治疗喉返神经麻痹比较理想和可行。     

解脲脲原体与自然流产关系的探讨

采用聚合酶链反应技术对３２例自然流产患者的宫颈粘液及其中２２例清宫组织进行解脲脲原体（ＵＵ）检测，并与３０例人工流产妇女比较。结果表明：自然流产与ＵＵ寄生于宫颈无关（Ｐ＞０．０５），与宫内感染ＵＵ明显相关（Ｐ＜０．０５）。     

615系小鼠自发乳腺癌的发病率及病理形态学观察

100对615系种鼠,常规饲养繁殖,观察33个月(终生),其乳腺癌发病率为5.5%(11例全部发生于经产雌鼠),低于肺腺癌(11%,22例,雌雄各半)而居第二位,故615系小鼠仍属低乳癌品系。对615系小鼠的46例自发乳腺癌进行了病理形态学检查分析:瘤细胞可分为小、中、大三类。组织分型属A型者18例,多由小细胞及少量中细胞构成;属B型者28例,除小细胞外往往可见较多的中细胞甚或主要由大细胞与中细胞构成。B型乳腺癌的分化程度似较A型者为低。转移主要发生于肺部。7例经镜检证实属乳腺癌的肺转移瘤,其原代瘤属A型者1例,属B型者6例。肺转移瘤的组织像与原发瘤基本相同者4例;而细胞变大,呈实心排列,显示分化程度低于原发瘤者3例。