重症急性胰腺炎33例临床分析

目的　加强对重症急性胰腺炎的认识 ,探讨重症急性胰腺炎的有效治疗方法。方法　对我院 1997～ 2 0 0 3年收治的 3 3例重症急性胰腺炎作回顾性分析。结果　 3 3例病人中 ,治愈 2 8例 ,死亡 5例。行手术治疗 12例 ,死亡 2例 ;行非手术治疗 2 1例 ,死亡 3例。休克和MOF是主要死亡原因。结论　重症急性胰腺炎治疗宜采用手术治疗与非手术治疗并存在的双轨制体系 ,早期以非手治疗为主 ,应严格掌握手术指征。     

传染性非典型肺炎患者泪液和血液中特异性抗体检测的对比研究

目的：通过传染性非典型肺炎(SARS)患者泪液病毒特异性抗体的检测，寻找SARS病毒是否通过泪液或眼结膜传播的理论依据，了解泪液和血液中SARS病毒特异性抗体检测结果的一致性程度。方法：用酶联免疫吸附法(ELISA)检测18例不同病程的SARS患者泪波及血清SARS病毒特异性抗体。结果：18例SARS患者泪液中的特异性IgM类和IgG类抗体均为阴性，而同组患者有13例其血液中的特异性IgM类和IgG类抗体呈阳性。结论：SARS病毒可能不通过泪液或结膜传播。     

老年牙周组织疾病216例证候分析

目的 探讨老年牙周组织疾病的证候特点。方法 对 1998 年 1 月-2003 年 12 月门诊接诊的 216 例老年牙周组织疾病进行回顾性分析。结果 阴虚火旺型 124 例(57.4%),气血不足型 51 例(23.6%),胃火炽盛型 16 例(7.5%),气滞血瘀型 14 例(6.4%),痰湿阻络型 11 例(5.1%)。结论 老年牙周组织疾病证候表现以虚为主、虚中夹实,阴虚火旺型和气血不足型是其主要证候类型。     

综合疗法和加用人胎肝细胞悬液治疗重症肝炎30例疗效比较

重症肝炎30例随机分为两组,采用综合疗法治疗15例;另15例在综合疗法基础上加用人胎肝细胞悬液。综合治疗组病死比例为9/15例;胎肝组病死比例为4/15例,较综合疗法组明显为低。胎肝组存活11例平均退黄时间为55.4±25.4天;综合疗法组存活6例,平均退黄时间为119.7±54.9天,前者明显短于后者(P<0.01)。对胎肝组12例患者作输注前后凝血酶元时间活动度对比观察,输注后48h凝血酶元时间活动度可提高18.9％。     

Inhibitory effect of activated protein C on platelet aggregation induced by the prothrombin-converting reaction

The present study was undertaken to elucidate the effect on platelet aggregation of the prothrombin-converting reaction on platelets with or without activated protein C (APC). A reaction mixture of washed platelets from human individuals, Factor Xa and prothrombin markedly induced platelet aggregation; maximum aggregation rates, 31.3–92.5%, and times to reach to maximum aggregation, 11.6 to 20.1 min. This aggregation was inhibited by the addition of APC with 50% inhibition concentration (IC₅₀) value of 14.4 U/ml. APC also inhibited thrombin generation in the reaction mixture in a dose-dependent manner with IC50 value of 0.96 U/ml. However, APC did not inhibit the thrombin (0.1 CU/ml)-induced platelet aggregation at concentrations of up to 30 U/ml. These findings suggest that APC has no direct inhibitory effect on platelet aggregation and that APC inhibits platelet aggregation through inhibition of thrombin generation.     

A case report of deficiency in an inhibitor of calcium-dependent association of protein S with C4B-binding protein suggested by a modified crossed immunoelectrophoresis

We have experienced a coagulation factor VIII-deficient patient whose plasma has normal protein S (PS) activity and masses of free PS and its bound form in complex with C4b-binding protein (C4BP). Although the patient's plasma showed a normal ratio of free PS to PS-C4BP complex in the presence of 5 mM EDTA, the plasma gave an abnormally retarding major C4BP peak together with a major PS peak in the crossed immunoelectrophoresis (CIE) in the presence of 2 mM CaCl₂. It was revealed that the major peak was formed by a mixture of PS-C4BP complex and free form. The addition of normal human plasma (NHP) to the patient's plasma inhibited the retardation of the major PS-C4BP complex. These suggest that the patient's plasma lacks some component(s) to inhibit Ca²⁺-dependent association of PS with C4BP.     

Relationship between plantar pressure distribution under the foot and insole comfort

In this paper, four pairs of insoles with different comfort characteristics were used to investigate the relationship between the pressure distribution under the foot and running shoe comfort. Fourteen male subjects were tested in four insole conditions by walking and running on a treadmill. The pressure at the plantar surface of the foot was measured by using an EMED pressure-measuring insole. For walking there were significantly higher pressures and forces in the midfoot area and significantly lower pressures in the medial forefoot and hallux area by wearing the most comfortable insole compared with wearing the least comfortable insole. The shift of the pressure from forefoot to midfoot for the most comfortable insole provided an even distribution of the pressure at the plantar surface of the foot. The results also demonstrated that the path of centre of force at the plantar surface of the foot moved to the lateral aspect of the foot for the most comfortable insole. For running, only the pressure in the medial forefoot area was found significantly lower for the most comfortable insole than for the least comfortable insole. The results of this study indicated that the pressure distribution between the plantar surface of the foot and the shoe could detect the change of shoe comfort. Thus it is a suggestion that pressure measurement may be related to understand factors important for shoe comfort.

Comfort of sport shoes is important for the appropriate execution of sport activities. Additionally, comfort may influence fatigue and possibly the development of injuries. The quantification of comfort of sport shoes and the understanding of mechanical and/or biological functions related to it may be enhanced with the use of pressure measurements between the plantar surface of the foot and the shoe sole.     

亚低温治疗高温高湿环境下重型颅脑损伤的临床护理

目的 探讨亚低温治疗高温高湿环境下重型颅脑损伤的护理方法。方法 高温高湿环境下的重型颅脑损伤患者60例，随机分为亚低温治疗组和对照组。规范护理程序，严密观察病人生命体征变化，采取积极护理措施，减少并发症。结果 亚低温治疗24h后颅内压逐渐下降，脑组织PO2逐渐上升，伤后3个月亚低温治疗组的良好率明显高于对照组（P〈0.05），而死亡率明显低于对照组（P〈0．01）。结论 精心护理有助于改善亚低温治疗的高温高湿环境下重型颅脑损伤病人的预后。     

双侧同时开颅治疗重型颅脑损伤随机对照临床研究

目的探讨双侧同时开颅手术治疗重型颅脑损伤（sTBI）的疗效。方法49例sTBI患者，分为双侧同时开颅手术（治疗组）和传统手术方式（对照组）并于3个月后进行COS评定。结果治疗组27例，恢复良好9例，中度残疾5例，重残4例，植物生存2例，死亡7例。对照组22例，恢复良好3例，中度残疾0例，重残3例，植物生存6例，死亡10例，（P〈0．05）。结论采用双侧同时开颅手术治疗sTBI疗效优于传统手术方式。     

应用两种评分系统对409 例肝硬化和重型肝炎病例的评估分析

目的应用两种评分方法对409名肝硬化及重型肝炎患者进行评估比较，对两种评估结果及有关的上消化道出血及死亡等因素进行相关性分析。方法统计409名肝硬化及重型肝炎患者的相关资料，应用Child和MELD评分法分别计算后应用Chiss软件进行统计学分析。结果各种计算比较结果见表格。结论Child-Pugh分级法和MELD评分系统各有特点，将两种评分方式与多因素分析与经验有机结合，才是符合临床实际的判断严重肝病预后的较科学手段。