胎儿脐带缠绕253例分析

目的　探讨胎儿脐带缠绕的临床意义及处理。方法　分析 2 5 3例有脐带缠绕的孕妇的脐带长度、剖宫产率、脐动脉血流S/D的值及对围产儿的影响 ,并与 2 6 9例无脐带缠绕者作比较。结果　 2 5 3例脐带缠绕组中脐带过长者明显高于无脐带缠绕组 (P <0 .0 1)。因脐带缠绕组中脐动脉血流S/D值≥ 3.0的百分率、胎儿宫内窘迫的发生率及新生儿窒息率明显高于对照组 (P <0 .0 1) ,故临床剖宫产率也高于对照组。结论　脐带缠绕可对围产儿造成不良影响 ,临床应提高孕期监测、产程监护 ,从而减少对围产儿的影响 ,降低不必要的剖宫产     

中长跑和芭蕾舞运动中胫骨应力骨折的比较

胫骨应力骨折（ＳＦ）在芭蕾舞和中长跑运动员中均有一定发病率，作者调查某部新兵２６５人每日５０００米跑步，其胫骨应力骨折病发率为１１．６８％（３１／２６５人），骨折部位多在胫骨中段中后侧。芭蕾舞演员胫骨应力骨折病发率为８％（１５／６０人），骨折部位在胫骨下段前侧。应用新鲜尸体标本作负荷下胫骨多处的应变测定模拟跑步和足跟垫高模仿芭蕾舞时下肢负重位置的应变变化，分别于胫骨中段后侧测得有高压应力和胫骨下段前方有高张应力，此结果与调查中Ｘ线片病变部位相符。作者认为不同的运动使负重时胫骨所处姿势各不相同，而造成胫骨最大应力集中点位置各异，是造成芭蕾舞运动和中长跑运动中应力骨折部位不同的主要原因，预防和治疗工作应根据各自的应力性质和集中点部位来进行防治。     

乳舒胶囊镇痛、抗炎作用研究

目的：研究乳舒胶囊(RS)的镇痛、抗炎药效。方法：采用RS灌胃给药后，分别用甩尾法、热板法、扭体法研究RS对乳腺增生模型大鼠及小鼠的镇痛作用，分别用二甲苯法、琼脂法研究RS抑制小鼠耳廓炎症及大鼠慢性炎症性肉芽肿的作用。结果：乳舒胶囊能提高乳腺增生模型大鼠和小鼠的痛阈值、能减少醋酸致扭体疼痛小鼠的扭体次数、延长其发生扭体的潜伏期，有明显的镇痛作用；还可以抑制琼脂所致的大鼠肉芽肿和二甲苯致小鼠耳肿胀，有明显的抗炎作用。结论：乳舒胶囊镇痛、抗炎作用明显、疗效确切。     

Long QT interval syndrome with increased QT dispersion

This case report describes the anaesthetic management of a patient with sporadic-type long QT interval syndrome (LQTS), and increased QT dispersion, who presented for removal of an ovarian cyst. Beta adrenergic blockade and adequate depth of anaesthesia for successful management is emphasized. The Successful use of epidural administration of lignocaine and opioids in addition to general anaesthesia is described.     

两种术式治疗多囊卵巢综合征的远期疗效追踪比较

[目的]评价开腹卵巢楔形切除(OWR)和腹腔镜下双侧卵巢电灼开窗术(LOD)两种术式对多囊卵巢综合征(PCOS)的远期疗效.[方法]1981至2001年在我院诊断为PCOS并接受手术治疗的妇女共151例,其中行OWR 61例、LOD 90例,追踪分析两组妇女术后妊娠率、术后妊娠时间的分布及术前后月经模式变化.[结果]两组的临床特征具有可比性,OWR组累积妊娠率84%,LOD组累积妊娠率72%,两组间没有明显差异,绝大部分妊娠发生在术后18个月内;OWR组术后3个月、半年、1年、3年、5年及10年月经规律的妇女所占的比例分别是81.3%、81.3%、77.3%、77.6%、78.9%、85.2%,明显高于术前的31.1%(P值＜0.05);LOD组术后3个月、半年、1年、3年、5年及10年月经规律的妇女所占的比例分别是80.6%、63.5%、56.7%、58.0%、57.6%、42.9%,明显高于术前的35.6%(P值＜0.05);术后OWR组月经规律妇女占的比例明显高于LOD组(P均＜0.05).[结论]两种术式的术后妊娠率相似.OWR比LOD更好、更长远地改善PCOS妇女的月经异常.     

Analgesic nephropathy in Hungary: the HANS study.

BACKGROUND: The diagnosis of analgesic nephropathy has improved significantly with modern imaging techniques. We reviewed a large portion of the Hungarian dialysis population to obtain additional insight into the problem. METHODS: Twenty-two participating dialysis units enrolled 1400 patients on renal replacement therapy between 1 January 1995 and 1 January 1998. Patients with no known aetiology (n = 284) were interviewed and studied with renal imaging. We assessed the presence of decreased renal mass combined with either bumpy contours, papillary calcification, or both. The subjects studied were interrogated extensively. RESULTS: Our survey suggested analgesic nephropathy in 47 of 1400 patients (3.3%), 3-fold higher than the EDTA database estimate for Hungary. The analgesics most commonly abused were phenacetin-containing mixtures. The driving symptoms were mainly headache and joint pain. Cardiovascular complications were more common than in the rest of the dialysis population, independent of smoking and lipid values (P<0.01). CONCLUSIONS: Phenacetin should be banned. Our study results support the need for longitudinal cohort and case-control studies in Hungary.     

The effect of supplementation with fish oil during pregnancy on breast milk immunoglobulin A, soluble CD14, cytokine levels and fatty acid composition

BACKGROUND: Breast milk contains many immunomodulatory factors (soluble CD14 (sCD14), IgA and cytokines) with the potential to influence infant immune development. OBJECTIVE: To determine if changes in breast milk omega-3 polyunsaturated fatty acid (n-3 PUFA) composition as a result of maternal dietary fish oil supplementation during pregnancy can modify levels of these immunological parameters in breast milk. METHOD: In a randomized controlled trial, 83 atopic women received either 4 g fish oil capsules (containing 3.7 g n-3 PUFA) (n = 40) or 4 g olive oil capsules (n = 43) from 20 weeks gestation until delivery. Breast milk was collected 3 days post-partum and fatty acids were analysed by gas liquid chromatography and IgA, sCD14 and cytokines (IL-5, IL-6, IL-10, TNF-alpha and IFN-gamma) were quantitated by ELISA or time resolved fluorescence (TRF). RESULTS: Omega-3 docosahexaenoic acid (DHA; 22:6n-3) and eicosapentaenoic acid (EPA; 20:5n-3) levels were significantly higher (P < 0.001) in breast milk from women supplemented with fish oil (n = 33, DHA mean 1.15%, SD 0.47% and EPA mean 0.16%, SD 0.07%) than in samples from the control group (n = 40, DHA mean 0.50%, SD 0.17% and EPA mean 0.05%, SD 0.02%). Breast milk arachidonic acid (AA; 20:4n-6) levels were significantly lower (P = 0.045) in the fish oil group (mean 0.55%, SD 0.12%) compared with the control group (mean 0.61%, SD 0.14%). Breast milk IgA was positively correlated with DHA (P = 0.046) and 22:5n-3 (P = 0.003), but inversely correlated with linoleic acid (LA; 18:2n-6) (P=0.034). Levels of sCD14 were also positively correlated with 22:5n-3 (P=0.009). Cytokines involved in IgA synthesis (IL-10 and IL-6) were also significantly correlated with both IgA and n-3 PUFA levels, although there were no differences in the levels of breast milk IgA, sCD14 or cytokines between study groups. CONCLUSION: Supplementation with fish oil during pregnancy significantly alters early post-partum breast milk fatty acid composition. omega-3 PUFA levels were positively associated with IgA and sCD14 levels, suggesting a relationship between fatty acid status and mucosal immune function.     

LONG‐TERM OUTCOME OF ENDOSCOPIC BALLOON DILATION IN OBSTRUCTIVE GASTROINTESTINAL CROHN's DISEASE

Background: Gastrointestinal strictures are the most often and serious complication in Crohn's disease. Because of the frequent postoperative recurrence in Crohn's disease, endoscopic therapy of gastrointestinal stricture is one of the best therapeutic options. Method: The present study sets out the results from a prospective study of endoscopic dilation therapy on 48 Crohn's disease patients with severe gastrointestinal stenoses. All patients who could not undergo endoscopic balloon dilation therapy (EBD) were operated on. Results: Long‐term success was attained in 32 of the 48 patients; cumulative avoidance of surgery after EBD was 86% at one year and 71% at three. Second, the most hazardous factor was recurrent inflammation causing restenosis. Patients who had strictures with oral luminal dilatation and patients with frequent recurrence had a tendency to be operated on. As a complication, perforation occurred in two cases (3.3%). Conclusions: EBD therapy for Crohn's stricture in the gastrointestinal tract is recommended before surgical intervention.     

田径运动员心缩间期的研究

<正> 近年来在运动医学领域中,心缩间期(STI)被认为是评定运动员心脏功能状况的指标之一。为了进一步探讨STI对于评定田径运动员的心脏功能状况的意义,我们进行了下列研究。