慢性肾衰竭急性加重的临床特征及相关因素分析

目的：探讨慢性肾衰竭（CRF）急性加重因素及其治疗措施对预后的影响。方法：对2001年1月～2005年6月住院治疗的CRF急性加重患者42例，按其加重原因、基础疾病、治疗方式和疗效进行回顾性总结。结果：CRF急性加重因素依次为各种感染（45．2％）、原发病加重（19．0％）、高血压未控制（14．3％）、水电解质紊乱（11．9％）、肾毒性药物（11．9％）、心功能不全（9．5％）、尿路梗阻（4．8％）、血高粘滞状态（2．4%），7例同时存在≥2种上述病因（16．7％）。CRF急性加重原发病以慢性肾小球肾炎（52．4％）和糖尿病肾病（11．9％）为主。积极治疗后肾功能恢复达到或接近原来水平者40例，死亡2例，死亡2例的年龄均在60岁以上。结论：对于CRF肾功能急剧恶化的患者，应积极寻找其加重因素，并采取非透析和透析相结合治疗，改善肾功能，降低病死率，延长患者生命。     

双柏散熏洗与外敷治疗类风湿关节炎的临床效果比较

目的 :比较双柏散熏洗与外敷治疗类风湿关节炎局部症状的疗效。方法 :观察组用双柏散熏洗联合用药 ,对照组用双柏散外敷联合用药。结果 :观察组治疗类风湿关节炎局部症状的总有效率为 92 5 % ,对照组总有效率为77 5 % (P <0 0 5 )。结论 :双柏散熏洗联合用药治疗类风湿关节炎具有消肿止痛 ,活血化瘀 ,减轻局部症状等作用 ,且护理操作简便易于观察     

Acute disseminated encephalomyelitis: the importance of early magnetic resonance imaging

The diagnosis of acute disseminated encephalomyelitis (ADEM) is frequently missed or delayed with consequent delay in instituting therapy in the crucial phase of the illness. The role of MRI in the diagnosis of ADEM is well established, however, the value of its early utilization of treatment on the outcome of patients has not been adequately stressed. Three patients with ADEM are described. Delay in the diagnosis of the first was associated with severe sequelae, while in the other two early diagnosis and institution of corticosteroid therapy which was facilitated by MRI, was associated with a better outcome. MRI should be carried out early once the diagosis of ADEM is entertained.     

Neonatal renal failure due to obstructive candidal bezoars

Acute renal failure (ARF) developed in a 7-week-old infant due to bilateral candidal bezoars (fungal balls) causing obstruction at the pelviureteric junction. The baby was born at term with an appropriate birthweight, and had been treated with broad-spectrum antibiotics for respiratory distress and septicemia during the 1st week of life. Recovery from ARF followed renal decompression with bilateral nephrostomy tube placement and parenteral administration of amphotericin B and 5-flucytosine. Received August 21, 1996; received in revised form and accepted January 3, 1997     

白血病细胞p16基因突变分析

目的探讨ｐ１６基因突变在白血病发生中的作用及基因突变的机制。方法利用点突变检测仪、水平和垂直板电泳对ｐ１６基因的外显子１、外显子２的ＰＣＲ扩增产物作缺失和点突变分析。结果在白血病３５例临床标本中有２２例发生缺失突变，６例发生点突变，突变率约８０％。在２２例缺失突变病例中，有１０例为不完全缺失突变即有低于外显子５０９ｂｐ的扩增产物。结论ｐ１６基因含有“ＧＣ”ＤＮＡ重复顺序，易发生ＤＮＡ重组及易位和重排。在白血病发生中起重要作用     

急性脑血管病患者血清髓鞘碱性蛋白含量研究

用酶联免疫吸附法对３０例急性脑血管病（ＣＶＤ）患者及３２位正常人血清髓鞘碱性蛋白（ＭＢＰ）含量进行检测。结果表明：急性ＣＶＤ组患者血清ＭＢＰ含量显著高于正常人组（Ｐ＜０．０１）；血清ＭＢＰ含量与急性ＣＶＤ的严重程度相关。提示检测血清ＭＢＰ含量对急性ＣＶＤ诊断及预后判断有重要价值     

Effects of capsaicin in temporomandibular joint arthritis in rats

Temporomandibular joint (TMJ) arthritis was induced in female Lewis rats by unilateral injection of a suspension of heat-killed Mycobacterium butyricum in paraffin oil into the TMJ. Control rats received paraffin oil by the same route. Arthritic and control rats were pretreated either with capsaicin or denervation of the mandibular branch of the trigeminal nerve. Tissues were collected for neuropeptide extraction and analysed by radioimmunoassay and reverse-phase high-performance liquid chromatography. In all groups, the levels of substance P- (SP), calcitonin gene-related peptide- (CGRP) and neuropeptide Y- (NPY) like immunoreactivity (LI) were higher in the trigeminal ganglia than in the TMJs. In control rats, capsaicin significantly lowered the levels of SP-LI in the trigeminal ganglia and TMJ, but not CGRP-LI and NPY-LI. In the arthritic rats, capsaicin pretreatment significantly lowered the SP-LI and CGRP-LI in the trigeminal ganglia and TMJ, but not the NPY-LI. In the trigeminal ganglia the unilateral denervation significantly lowered SP-LI in control rats, and in arthritic rats SP-LI and CGRP-LI. On the denervated side of the arthritic TMJ, NPY-LI, SP-LI and CGRP- LI were significantly lowered as compared to the arthritic control rats and to the contralateral side. In this rat model, pretreatment with capsaicin and surgical denervation decreased the neuropeptide content in the trigeminal ganglia and the TMJ. The results clearly demonstrate a close interaction between increased neuropeptide release from sensory and sympathetic neurones after induction of arthritis in the rat.     

尿激酶溶栓对急性心肌梗死患者单核细胞组织因子表达的影响

目的 :了解冠心病患者外周循环单核细胞组织因子 (TF)表达与冠心病病情的关系 ;观察溶栓治疗对急性心肌梗死患者单核细胞TF表达的影响。方法 :测定了 2 2例稳定型心绞痛 (SA)患者 ,2 1例不稳定型心绞痛(UA)患者 ,1 5例急性心肌梗死 (AMI)患者用尿激酶溶栓前及溶栓后 ,1 8例健康人外周循环单核细胞组织因子阳性率。单核细胞组织因子阳性率测定用免疫荧光染色及流式细胞术。结果 :SAP组 ,UAP组和AMI组单核细胞TF阳性率高于对照组 ,UAP组和AMI组单核细胞TF阳性率高于SAP组 ,单核细胞TF阳性率与冠心病病情显著相关。急性心肌梗死患者溶栓后 2h单核细胞TF阳性率升高。结论 :外周血单核细胞TF的表达与冠心病病情严重程度密切相关 ;急性心肌梗死患者溶栓治疗后单核细胞TF的表达进一步增强 ,这可能是溶栓后凝血酶活化的原因之一。