突发性聋与铁代谢障碍疾病关系的临床调查

对１９７９年７月至１９９６年６月的突发性聋发病情况进行前瞻性研究与回顾性分析，探讨突聋与铁代谢障碍疾病的关系，前瞻性研究的对象分为铁代谢障碍疾病组２１８例，血液病组２１５例和正常对照组４８５０例；回顾性分析为１７年间资料完整的４２９例突聋患者史的代谢障碍疾病及其他血液病的发病情况。结果表明，铁代谢障碍疾病组的突聋调整年发病率显著高于血液病组以及正常对照组，４２９例突聋患者的无贫血缺铁，缺铁性人同血     

异丙酚的剂量与镇静和呼吸抑制作用之间的关系

研究不同剂量的异丙酚的量效关系。方法:选择50例甲状腺腺瘤切除病人,随机分为5组,Ⅰ组,0.5mg/kg、Ⅱ组0.75mg/kg、Ⅲ组1.0mg/kg、Ⅳ组1.5mg/kg、V组2.0mg/kg.采用Star呼吸机监测呼吸功能指标,同时观察其神志变化,应用Probit法分析该药量效关系。结果:Ⅱ、IV、V组随着剂量增加,潮气量降低的幅度和呼吸抑制持续时间明显增加,以给药后1～3分钟潮气量减少最为明显(P<0.01),浅睡状态ED_(50)为0.98mg/kg.深睡状态ED_(50)为1.26mg/kg,呼吸抑制ED_(50)为1.1mg/kg。结论:静注0.8～1mg/kg异丙酚可以产生适用于非全麻病人的镇静、催眠作用,而对呼吸抑制的作用较小。     

中药干预应激性溃疡大鼠模型的实验研究

【目的】初步探讨应激性溃疡的中医学病理机制。【方法】采用水浸束缚造成大鼠应激性胃溃疡模型。将60只大鼠随机分为5组，即正常空白组、造模组、心身1号组、雷尼替丁组、阿普唑仑组。观察不同药物对大鼠应激性溃疡发生的干预作用。【结果】不同给药组大鼠胃黏膜溃疡指数、pH值均存在显著差异。中药组大鼠的溃疡指数低于造模组，但中药组pH值与造模组无差异。【结论】行气活血、降逆散结的中药心身1号片可以预防应激性溃疡的发生。应激性溃疡的基本病机为气机紊乱。     

盐酸克林霉素氯化钠注射液中细菌内毒素定量检查(动态浊度法)方法的研究

应用动态浊度法鲎试验定量测定盐酸克林霉素氯化钠注射液中细菌内毒素含量.通过对样品进行干扰预试验,筛选出盐酸克林霉素氯化钠注射液最佳的检测浓度0.75mg·ml-1,进行正式干扰试验.样品中定量添加内毒素,10.00、1.00、0.10、0.01EU·ml-1,回收率为50%～200%,可用于有效的日常检查.     

激素依赖型哮喘撤减激素过程中的证候学变化及其治疗特点

探讨激素依赖型哮喘(SDA)撤减激素过程中的证候学变化及其治疗特点,认为在撤减激素的过程中,SDA患者存在着由阴虚火旺(撤前)→阴阳两虚(撤中)→肾阳亏虚(撤后)的病机演变规律,而痰瘀内阻则贯穿于整个激素撤减过程中.根据其证候学变化建立了中药三步序贯撤减激素的新方案,即撤前滋阴血,清虚热,化痰瘀;撤中滋阴养血熄风,益气温阳活血,化痰降逆平喘;撤后温肾阳,和气血,畅气机.由于三步序贯法根据SDA撤减激素过程中的动态变化规律而设计,因而较既往任何一种单一治法更能符合SDA临床发生、发展、变化的全过程,反映了其病机演变的实质特征.     

结缔组织病合并隐球菌脑膜炎的临床特点

目的：分析结缔组织病(connective tissue disease,CTD)合并隐球菌脑膜炎的临床特点及预后。方法：回顾 分析2000年1月至2017年1月期间中南大学湘雅医院风湿免疫科诊断的18例CTD合并隐球菌脑膜炎患者的临床资料。 结果：CTD合并隐球菌脑膜炎患者的常见症状为头痛、发热、恶心、呕吐,出现抽搐、意识障碍等严重临床表现的 患者均死亡。Logistic回归分析表明出现意识障碍、外周血淋巴细胞计数下降是造成CTD合并隐脑预后不良的相关因 素(P<0.05)。CTD合并隐球菌脑膜炎的病死率为61.11%,治疗有效率为38.89%。结论：CTD合并隐球菌脑膜炎患者死 亡风险高。出现意识障碍、外周血淋巴细胞计数降低与疾病预后不良相关。     

德生丹治疗排卵障碍性不孕症肾虚肝郁证患者临床研究

目的?观察中原门氏验方德生丹对排卵障碍性不孕症肾虚肝郁证患者的临床疗效。方法?将120例排卵障碍性不孕症肾虚肝郁证患者随机分为中药组（采用中药德生丹）、联合组（采用中药德生丹+克罗米芬）、西药组（单纯使用克罗米芬）。治疗12周后观察3组患者优势卵泡直径、子宫内膜厚度、宫颈黏液（Insler）评分及排卵率、妊娠率及血清雌二醇（E₂）、孕酮（P）水平的变化等。结果?治疗后3组优势卵泡直径与治疗前比较均显著增长（P<0.05~0.01）,联合组与西药组优于中药组（P<0.01）;3组中医证候积分均显著下降（P<0.01）,联合组与中药组优于西药组（P<0.01）;中药组、联合组子宫内膜厚度、Insle评分均有所增加（P<0.01）,优于西药组（P<0.05~0.01）;排卵日3组血清E₂水平均有所增长（P<0.01）,联合组与中药组优于西药组（P<0.05）;中药组、联合组黄体期血清P水平增长明显（P<0.01）,优于西药组（P<0.05~0.01）;3组排卵率比较,联合组与西药组均优于纯中药组（P<0.05~0.01）;3组妊娠率比较,联合组优于中药组、西药组（P<0.05~0.01）,中药组优于西药组（P<0.05）。结论?德生丹能改善排卵障碍性不孕症肾虚肝郁证患者临床症状,减少单纯克罗米芬抑制子宫内膜的不良作用,提高临床排卵及妊娠率。      

Screening for Trauma-Related Sleep Disturbance in Women Admitted for Specialized Inpatient Treatment

Abstract

The authors designed a Sleep Disturbance Screening questionnaire to assist clinicians in disentangling trauma-related factors that contribute to sleep disturbance from other common factors, such as depression. They administered the questionnaire to 129 female psychiatric inpatients, most of whom were treated in a specialty program for trauma-related disorders. Confirmatory and exploratory factor analyses distinguished four sleep disturbance scales, two pertaining to sleep disturbance generally (Insomnia, Hypersomnia) and two pertaining to sleep-related fear (Intrusive, Phobic). Correlations of the sleep disturbance scales with the Childhood Trauma Questionnaire (Bernstein et al., 1994), Impact of Event Scale-Revised (Weiss & Marmar, 1997), Dissociative Experiences Scale (Bernstein & Putnam, 1986), Beck Depression Inventory (Beck & Steer, 1993), and selected scales of the Millon Clinical Multiaxial Inventory (MCMI-III; Millon, 1994) show evidence of convergent and discriminant validity for the Sleep Disturbance Screening. The findings point to the potential diagnostic value of screening for trauma-related sleep disturbance, with the Sleep Disturbance Screening providing a small set of key questions that may be used in psychometric form or incorporated into routine diagnostic clinical interviews.     

The Role Of Electro-Physiological Tests in the Diagnosis of Non-Organic Hearing Loss

Today it is possible, by the use of newly developed tests, to diagnose cases of non-organic hearing loss with reasonable certainty. Having once decided that there may be non-organic elements, it is useful to supplement routine pure-tone and speech audiometry with a neurophysiological test like an ERA by means of which the auditory threshold can be established without the patients subjective judgement. A hearing loss which is apparent by routine pure-tone audiometry, but which is not evident after ERA is almost certainly non-organic, although confirmation of this state of affairs by other reliable tests is advisable. Measurement of the acoustic reflex thresholds and delayed speech feedback tests are both useful in this respect and rarely cause any confusion, except in some cases of true hearing loss in strongly recruiting ears.     

From the Cover: Gut bacteria facilitate adaptation to crop rotation in the western corn rootworm

Insects are constantly adapting to human-driven landscape changes; however, the roles of their gut microbiota in these processes remain largely unknown. The western corn rootworm (WCR, Diabrotica virgifera virgifera LeConte) (Coleoptera: Chrysomelidae) is a major corn pest that has been controlled via annual rotation between corn (Zea mays) and nonhost soybean (Glycine max) in the United States. This practice selected for a “rotation-resistant” variant (RR-WCR) with reduced ovipositional fidelity to cornfields. When in soybean fields, RR-WCRs also exhibit an elevated tolerance of antiherbivory defenses (i.e., cysteine protease inhibitors) expressed in soybean foliage. Here we show that gut bacterial microbiota is an important factor facilitating this corn specialist’s (WCR''s) physiological adaptation to brief soybean herbivory. Comparisons of gut microbiota between RR- and wild-type WCR (WT-WCR) revealed concomitant shifts in bacterial community structure with host adaptation to soybean diets. Antibiotic suppression of gut bacteria significantly reduced RR-WCR tolerance of soybean herbivory to the level of WT-WCR, whereas WT-WCR were unaffected. Our findings demonstrate that gut bacteria help to facilitate rapid adaptation of insects in managed ecosystems.