从脾胃论秋冬养阴——凌耀星教授的膏方经验一隅

冬令膏方是依据“秋冬养阴”为原则的养生和疾病防治方法。凌耀星教授在膏方辨证施治的过程中,尤重脾胃,从《内经》理论出发证实了“脾胃”在“秋冬养阴”中占有主导地位。     

胃镜取上消化道异物112例体会

我院从2000年至2005年,共用电子胃镜取上消化道异物112例,经急诊胃镜取出104例,失败2例,效果良好。胃镜取异物具有方便快捷、价廉、创伤小等优点,值得推广,现将取得的经验操作体会报告如下。1资料与方法1.1一般资料本组中男74例,女38例,年龄2岁~65岁,平均年龄42岁,10岁以下儿童为17例,112例中咽部异物17例,均为鱼刺,食道异物35例,胃内异物56例,十二指肠球部异物2例,降部异物2例,除外咽部17例鱼刺,所剩95例中难取异物44例,其中带钩义齿11例,刀片8例,玻璃片6例,铁片3例,铁钉2例,铁勺2例,戒指2例,枣核1例,牙刷4例,方便筷2例,围棋3例。1.2器械OLYMPUS电子胃镜、活检钳、鼠齿钳、网篮、胃镜套管、自制的内镜前端保护套(制作方法:将避孕套前端剪开尾端固定在镜头前方1cm并反折,用一皮圈固定外接一拉线,使用石蜡油润滑)。1.3操作方法1.3.1术前准备详细询问病史,了解异物的大小、形状、材质,并行拍片进一步了解有无气腹症及异物所处位置及性状。对锐利者准备好保护装置,胃内食物较多者嘱其平卧,禁食水,保持平静,必要时用X线透视动态了解异物是否移动。1.3.2麻醉采用利多卡因...     

环丙沙星滴耳液对内耳影响的研究

豚鼠中耳（听泡）内滴入０．５％、１％、２％环丙沙星与庆大霉素滴耳液７天或２１天，借助光镜和扫描电镜观察内耳的显微和超微结构变化。结果证明环丙沙星对内耳没有明显的毒性作用。庆大霉素则使耳蜗明显受损，以底回为重，Ｃｏｒｔｉ’ｓ器外毛细胞坏死较多，内毛细胞及支持细胞病变较轻。位觉斑耳石脱落，毛细胞纤毛粘连、脱落。壶腹嵴中央区纤毛也缺失。本实验对客观评价环丙沙星对内耳的作用及临床使用提供了形态学资料。     

内蒙古赤峰地区鼠疫现状和流行趋势预测及控制措施的研究

赤峰地区于１９４８￣１９９６年发现了１６６３２．２ｋｍ＾２鼠疫自然疫源地，分布于１１个旗（县、区）。目前达到控制鼠疫面积１３９１７．８ｋｍ＾２，占疫源地总面积的８３．６８％。选取与疫源地相关的１２种量经因子进行聚类分析，结果可分为：１．疫源性长存区；２．动物鼠疫间断流行区；３．鼠疫动物病控制区；４．疫源性基本消除区。同时对措施进行了探讨。     

医院大质量观的实践与体会

文章认为医院的质量管理不能停留在单一的医疗服务质量管理的认识上，需要有“大质量”观。培训是实施大质量现，做到全员参与的保证；大质量观注重过程化和层次化的管理。     

Intratympanic steroid therapy for inner ear diseases, a review of the literature

To evaluate the value of clinical trials on intratympanic steroid therapy in Ménière’s disease (MD), idiopathic sudden sensorineural hearing loss (ISSNHL) and rapidly progressive sensorineural hearing loss (RPSNHL). Medline and Pubmed databases from 1966 to present were searched for clinical studies on intra- or transtympanic (cortico)steroid therapy of MD, ISSNHL and RPSNHL. Results were cross-checked with additional databases to obtain a complete data set. Clinical trials were evaluated on the basis of comparability, internal and external validity. Articles were judged using the following questions: was a randomised double-blind controlled trial performed? Which criteria were used to confirm the diagnosis of MD, ISSNHL, RPSNHL? Which therapy was evaluated? How long was the follow-up? Which criteria were used to evaluate the results? Reliable evidence on the efficiency, optimum dosage and administration schedule of intratympanic steroid therapy in MD, ISSNHL and RPSNHL is lacking, therefore further investigation is required.     

464名师专生的自我厌烦感及其应对方式

目的探讨师专生自我厌烦的内容指向、体验状态和应对方式。方法开放式调查和内容分析法。结果自我厌烦内容指向出现频次由高到低为:性格、学业、身体、交往、能力、家庭、经济、就业;体验状态频次排序为:消极心境、自我否定感、自我激励感、自我逃避感;应对方式频次排序为:逃避、问题解决、合理化、求助、忍耐、发泄。结论1师专生中性格自我厌烦最多,且女生多于男生;就业厌烦随年级升高而增多。2自我厌烦感的体验状态以消极心境和自我否定感出现较多,并随年级升高而增多;在应对方式上,采用逃避策略最多。     

Effect of atrial natriuretic factor and cyclic guanosine monophosphate on water and urea transport in the inner medullary collecting duct

We examined the action of high (2×10^–8M) and low (6×10^–9M) concentrations of atrial natriuretic factor (ANF) on water and urea transport in the rat inner medullary collecting duct (IMCD) using the in vitro microperfusion technique. We measured the hydraulic conductivity (Lp ×10^–6 cm/atm per second) and both lumen-to-bath (P _u(lb)) and bath-to-lumen (P _u(bl)) ¹⁴C-urea permeabilities (P _u× 10^–5 cm/s) in the absence and in the presence of vasopressin (VP). High concentrations of ANF were able to inhibit the maximum activity of (50 U/ml) VP-stimulated L _p but physiological concentration of ANF inhibit only submaximum activity (10 U/ml) of VP-stimulated L _p. The hydrosmotic effect of dibutyryl-cyclic 3,5 adenosine monophosphate (cAMP) (10^–4M) was unchanged by high concentrations of ANF (2×10^–8M). Also we found that high (10^–4M) and low (10^–6M) concentrations of exogenous cyclic 3,5-guanosine monophosphate (GMP) while unable to change the Lp in the absence of VP, decreased the maximum activity of VP-stimulated Lp significantly. We also found that ANF inhibits partially and in a reversible manner the VP-stimulated P _u(lb) but not the VP-stimulated P _u(bl). These results demonstrated that plasma concentrations of ANF observed during volume expansion (10^–10M) are able to inhibit submaximum activity of VP-stimulated (10 U/ml) L _p in the rat IMCD, this effect seems to occur before cAMP formation and it appears to be mediated by cGMP. ANF (6× 10^–9M) also reduced the VP-stimulated urea outflux. Therefore, the increase in water excretion produced by ANF could be explained, at least in part, by the inhibition by ANF of vasopressin effects on water and urea transport in the IMCD.This study was presented in part at the VI Latin American Congress of Nephrology, Brazil, October 1985 and at the X^th International Congress of Nephrology, London, July 1987.     

Anatomic and physiologic development of the photoreceptor of the kitten

Summary The postnatal development of the photoreceptor of the cat was studied using physiological and anatomical methods. The late receptor potential (LRP) was recorded in vitro and the threshold and maximum amplitude determined. The same specimens used in the electrophysiological studies were then prepared for microscopy, and rod cell outer and inner segment length and diameter, photoreceptor density, and inter-receptor distance were determined. A small LRP was first recorded at 9–10 days, but only at very high stimulus intensities. Thereafter, there was a rapid decrease in the threshold and an increase in the amplitude of the LRP. The threshold reached adult values at 17–18 days, while the amplitude of the LRP was adultlike at 23–26 days. Of the anatomical parameters examined, inter-receptor spacing and rod cell diameters seem to be most clearly associated, respectively, with the attainment of adult LRP threshold and amplitude. Outer segment length was adult-like at 35–43 days of age and thus postdated physiological maturity of the photoreceptor. These observations suggest that the surface area of the rod cell outer segment tips is more critical in the development of the adult LRP than is the number of discs in the outer segment. In addition, changes over time in the mean diameter and length of rod cell inner segments follows the pattern of ontogenetic changes in LRP amplitude. These findings imply a close relationship during ontogeny between the metabolic functions of the inner segment and phototransduction at the outer segment disc.This study was supported by the Florida Lions Eye Bank (GST) and by a grant, 2-RO1-EY00376-08, from the National Eye Institute, National Institutes of Health, Bethesda, Maryland (DIH)Andrew Labbie and Joseph Muroff were participants in the Community Laboratory Research Programm sponsored by the Dade County Public School System, Miami, Florida     

The SLC14 gene family of urea transporters

Carrier-mediated urea transport allows rapid urea movement across the cell membrane, which is particularly important in the process of urinary concentration and for rapid urea equilibrium in non-renal tissues. Urea transporters mediate passive urea uptake that is inhibited by phloretin and urea analogues. Facilitated urea transporters are divided into two classes: (1) the renal tubular/testicular type of urea transporter, UT-A1 to -A5, encoded by alternative splicing of the SLC14A2 gene, and (2) the erythrocyte urea transporter UT-B1 encoded by the SLC14A1 gene. The primary structure of urea transporters is unique, consisting of two extended, hydrophobic, membrane-spanning domains and an extracellular glycosylated-connecting loop. UT-A1 is the result of a gene duplication of this two-halves-structure, and the duplicated portions are linked together by a large intracellular hydrophilic loop, carrying several putative protein kinase A (PKA) and -C (PKC) phosphorylation sites. UT-A1 is located in the apical membrane of the kidney inner medullary collecting duct cells, where it is stimulated acutely by cAMP-mediated phosphorylation in response to the antidiuretic hormone vasopressin. Vasopressin also up-regulates UT-A2 mRNA/protein expression in the descending thin limb of the loops of Henle. UT-A1 and UT-A2 are regulated independently and respond differently to changes in dietary protein content. UT-A3 and UT-A4 are located in the rat kidney medulla and UT-A5 in the mouse testis. The widely expressed UT-B participates in urea recycling in the descending vasa recta, as demonstrated by a relatively mild "urea-selective" urinary concentrating defect in transgenic UT-B null mice and individuals with the Jk_null blood group.