糖尿病肾病临床研究述评

本文从中医病名、病因病机、诊断标准、临床分期、疗效评定、辨证论治、临床科研七个方面对糖尿病肾病的研究进行了述评。指出：糖尿病肾病的中医病名、诊断、分期及疗效评定标准亟待统一；立足于临床实际，参考现代医学有关认识，应用ＤＭＥ方法，开展糖尿病肾病临床和实验研究，深入探讨其病因病机和证治规律，在中医基本理论指导下，大胆创新，是提高临床疗效的关键；分期辨证论治较为符合疾病的发展规律，便于寻找防治糖尿病肾病的有效方法。     

嗜肺军团菌肺炎13例临床分析

本文报告１３例嗜肺军团菌肺炎。其中Ｌｐ１型６例；Ｌｐ６型６例；Ｌｐ１２型１例。Ｌｐ１２型国内尚未见文献报告。对临床表现，实验室检查，Ｘ线胸部征象，治疗和预后进行分析。并将部分资料与美国洛杉矶Ｗａｄｓｗｏｒｔｈ医疗中心统计资料分析对比，以探讨国人嗜肺军团菌肺炎临床特征。     

人群中病毒性肝炎的型别研究

作者于1987年2月16日～1988年2月15日在四川五个点211 639人群中监测急性病毒性肝炎。其发病率为167.74/10万,其中甲型肝炎占24.51％;乙型肝炎占38.31％;非甲非乙型肝炎占24.51％,EB病毒和巨细胞病毒所致肝炎各占3.38％;混合感染占5.92％。病毒性肝炎中有14.93％重叠感染。发病高峰在春季。发病率,男:女=1.75:1。甲型肝炎20岁以下年龄组、乙型肝炎20～39岁年龄组的发病率明显高于其他年龄组,非甲非乙型较分散,5～19岁相对多一些,其他型别年龄组间无明显差异。355例急性病毒性肝炎患者中43.9％有接触史,36.6％有注射史。     

Obsessive-compulsive disorder: admission patterns and diagnostic stability

All first-time admissions from 1970 to 1986 with obsessive-compulsive neurosis (OCD) (ICD-8 diagnosis number 300.39) or obsessive-compulsive personality disorder (OCPD) (ICD-8 diagnosis number 301.49) were analyzed based on an extract from the nationwide Psychiatric Case Register in Denmark. All patients with secondary diagnoses other than neurotic disorders or personality disorders (including “neuroses characterogenes”) were excluded from the study. A total of 284 patients were first-time admitted with a main diagnosis of OCD during the period. The sex ratio was 0.67 (males/females). A total of 126 were first-time admitted with a diagnosis of OCPD, with a sex ratio of 1.18 (males/females). Seventy-seven percent of the readmitted patients with a first-time diagnosis of OCD kept a diagnosis within the “emotional spectrum” at the last admission. About half kept OCD as a main diagnosis, whereas only 15% shifted to a severe psychiatric diagnosis such as schizophrenia or manic-depressive psychosis. Of the readmitted patients with OCPD. 13% later developed a diagnosis of manic-depressive psychosis.     

A model for estimating the potential costs and savings of osteoporosis prevention strategies

A model was developed which estimates the costs of osteoporosis risk evaluation and treatment, and the resulting savings in terms of reduced fracture frequency, for the adult female population of the United States. In the absence of treatment, the model predicts 1.44 million fractures will occur annually from non-violent causes. Treatment of all women beginning at age 50 with an agent that slows bone loss by 50% would reduce the number of these fractures by 0.59 million. Selective treatment of the 47% of women at the greatest fracture risk would reduce the number of fractures by 0.45 million, but would only cost 47% as much as treating all women. Additional data are required before the model can be used to evaluate specific treatment regimens. However, it appears that selective treatment of those at highest risk would yield the greatest benefit to cost ratio, if only benefits related to reduced fracture frequency are considered.     

丹参及血管内皮生长因子对动物肢体缺血模型侧支循环建立的作用

目的 :建立兔左后肢无主干及分支动脉供血的缺血模型 ,并观察丹参及血管内皮生长因子 ( VEGF)对兔后肢缺血模型侧支循环建立的作用。方法 :通过手术方法在兔后肢大腿段建立一个无主干及分支动脉供血的严重缺血模型。动物随机分为 5组 :未治疗组、丹参组、VEGF组、丹参加VEGF组及生理盐水对照治疗组。在解剖及生理水平上观察各组动物缺血肢体缺血及侧支循环建立情况。结果 :术后第 1天未治疗组动物左 /右小腿血压比为 0 ;动脉造影显示左侧只有髂外动脉中段以上显影、以下主干及分支均未显影。对侧后肢主干及分支动脉显影良好 ,即左侧毛细血管密度( 4 9.8± 1 7.6)个 /mm2 ,右侧为 ( 385 .7± 36.7)个 /mm2 ,P<0 .0 0 1 ;毛细血管数 /肌束数比值 :左侧( 0 .2 1± 0 .0 7) ,右侧 ( 0 .98± 0 .0 5 ) ,P<0 .0 0 1。治疗结束时 ,丹参加 VEGF组动物小腿血压比最高( 0 .74± 0 .1 7) ,它显著高于对照组、丹参组和 VEGF组 ;毛细血管密度与毛细血管数 /肌束数比值亦以丹参加 VEGF组为最高 ;动脉造影显示 ,丹参加 VEGF组中缺血组织处具有治疗意义的粗大的侧支循环形成。结论 :丹参与 VEGF联合应用具有强大的促进缺血模型侧支循环建立的作用     

反应停抗Lewis肺癌小鼠肿瘤血管生成的作用

目的 :研究具有抗血管生成作用的药物反应停对 Lewis肺癌小鼠皮下移植瘤和肺转移瘤的作用 ,并探讨其与肿瘤细胞凋亡的关系。方法 :2 4只皮下接种 Lewis肺癌肿瘤细胞 ( 1×1 0 6cell/mouse)的 C57BL/6小鼠随机分为两组 ,治疗组每日反应停 77.5 mg· kg-1灌胃 ,对照组每日生理盐水灌胃。第 2 1天处死动物 ,秤取瘤重、肺重 ,计数肺转移结节数 ,免疫组化染色后计数肿瘤组织微血管密度 ,流氏细胞仪测定分析肿瘤细胞凋亡率及细胞周期。结果 :反应停治疗组皮下移植瘤重量与对照组间差异无显著性 ( P>0 .0 5 ) ,但是肿瘤平均体积有下降趋势 ;反应停治疗组肺重、肺转移结节数目、肿瘤微血管密度低于对照组 ( P<0 .0 5 )。反应停治疗组肿瘤细胞凋亡率及 G1、S、G2 期肿瘤细胞百分数与对照组比较差异无显著性 ( P>0 .0 5 )。结论 :反应停有明显地抑制肿瘤细胞转移的作用 ,移植瘤体积有缩小的趋势 ,但不影响细胞的增殖周期     

The synchronization of respiration and swallow sounds with videofluoroscopy during swallowing

Simultaneous recording of adult subjects sipping small amounts of fluid from a cup have been obtained by videofluoroscopy together with feeding respiratory patterns and swallow sounds from the Exeter Dysphagia Assessment Technique (EDAT). These allowed visual representations of respiration and swallow sounds to be superimposed on a videofluoroscopy recording using a split-screen technique. Sequentially numbered, 1/50 sec, half-frame photographic prints were examined and schematic drawings of the relevant radiographs were made. These were superimposed on to the actual EDAT printed chart of the same swallow event, theri exact time relationship with respiration and cervical swallow sounds being preserved. The results allow events in the barium videofluoroscopy to be related to events in the feeding respiratory pattern and swallow sounds recorded by EDAT.     

龈沟液隐血试验与牙龈出血指数、龈下菌群的关系

目的 探索一种无创性的牙龈出血检测方法－－龈沟液隐血试验（GCFobt），并分析牙龈出血与微生物之间的内在联系。方法 用隐血试纸进行102例唾液标本的唾液隐血（Sobt）检查，1600个位点的GCFobt、牙龈出血指数（SBI）、探诊深度（PD）检测，分别对79、32个龈下细菌标本作涂片检查和厌氧培养，分析临床指数与龈下细菌的关系。结果 GCFobt具较高灵敏度（68.05）和特异度（80.5%），较Sobt更能说明局部牙周炎症状况，与SBI有非常显著相关关系（P＜0.001）；GCFobt阳性与阴性部位螺旋体、杆菌、球菌百分含量有非常显著差异（P＜0.001）；在0与3之间黑色菌检出率有非常显著差异（P＜0.01），在0与2、3之间梭杆菌检出率有显著差异（P＜0.05）。结论 GCFobt是一种快速、简便、无创伤的检测牙龈出血新方法，可以作为牙周病临床检查的一项客观指标。     

慢性非特异性溃疡性结肠炎中医研究述评

本文通过对古典医籍及近１０年文献有关慢性非特异性溃疡性结肠炎的资料分析，认为本病的证候特点与中医病名“休息痢”相符，病机归纳为脾虚为发病之本，湿热为致病之标，血瘀为局部病理变化，治疗方面得出了健脾益气化湿、活血化瘀解毒、托疮祛腐生肌等方法是治疗本病之关键的结论，提出分期治疗本病的思想，认为提高近期治愈率、降低复发率及做好癌前监测是今后研究的努力方向。