外伤性延迟性脾破裂的诊断和治疗（附21例报告）

目的探讨外伤性延迟性脾破裂的发病规律、临床特点、诊断和治疗方法。方法结合国内外资料及本组病例进行回顾性分析。结果明确诊断16例，误诊为肝破裂2例，宫外孕破裂2例，脾肿瘤1例。21例均手术治疗，行脾切除14例，其中保留副脾2例；脾切除加自体脾组织网膜内移植术3例；脾缝合修补术3例；脾部分切除术1例。死亡1例，原因有就诊晚、失血性休克。结论本病由于腹腔内出血与受伤时间间隔长，容易误诊。诊断除依靠病史、临床表现外，应及时进行腹腔穿刺、B超及CT检查。治疗以脾切除为主，可根据病情、脾破裂的程度以及是否有合并伤等情况采取保脾手术。     

心脏起搏器安置术后电极脱位的预防护理

介绍了心脏起搏器安置术后电极脱位的类型、发生率、发生原因及处理,重点综述了安置心脏起搏器术后预防电极脱位的护理。     

In vivo kinetics and displacement study of a carbon-11-labeled hallucinogen,N,N-[11C]dimethyltryptamine

The endogenous hallucinogen, N,N-dimethyltryptamine (DMT), was labeled with carbon-11 and its regional distribution in rat brain studied. [¹¹C]DMT showed higher accumulation in the cerebral cortex, caudate putamen, and amygdaloid nuclei. Studies of the subcellular distribution of [¹¹C]DMT revealed the specific localization in the fractions enriched with serotonin receptors only when a very low dose was injected into rats. The proportions of the radioactivity in receptor-rich fractions were greatly enhanced by pretreatment with the monoamine oxidase inhibitor, pargyline. Specific binding of [¹¹C]DMT to serotonin receptors in dog brain was demonstrated by a positron emission tomographic study in which 5-methoxy-N,N-dimethyltryptamine caused approximately 20% displacement of the radioligand from the receptors.     

益气活血法治疗脑梗死恢复期50例临床观察

目的 观察益气活血法治疗脑梗死恢复期气虚血瘀证的临床疗效.方法 将99例脑梗死恢复期病人随机分为观察组和对照组,对照组采用西医规范化治疗,观察组在对照组用药的基础上,加用补阳还五汤加味治疗.两组疗程均为15天.结果 观察组总有效率为92.00%,对照组为83.67%,两组比较有显著性差异(P＜0.05);两组治疗后神疲乏力、肢麻沉重、面色(白光)白等疗效有显著性差异(P＜0.05).结论 益气活血法治疗脑梗死恢复期有较好的疗效,未见明显不良反应.     

多部位采血快速血糖仪的临床应用

目的:探讨多部位采血快速血糖仪检测大鱼际毛细血管葡萄糖用于糖尿病患者血糖监测的准确性及优缺点。方法:对我科47例住院糖尿病患者在知情同意后进行血糖检测。行正常餐实验,在空腹时和正常餐后2h分别采静脉血用葡萄糖氧化酶法测定血糖、采手指血用乐康全血糖仪测定血糖、采手掌大鱼际血用Free- style多部位采血血糖仪检测血糖;同时进行采血疼痛感和使用方便性的主观调查,分最好、好、一般和差4级,转换为数字1、2、3、4进行评价。结果:3组的空腹血糖值差异无显著性(P>0.05);餐后2h血糖差异有显著性(P<0.05)。3组的空腹血糖及餐后2h血糖均有良好的线性相关(r=0.759～0.795,P<0.001)。3个部位的测试结果间均呈良好的线性相关,决定系数(R~2)=0.576～0.651(P<0.001)。两种血糖仪的使用方便性无明显差异.指尖采血的疼痛性要强于手掌大鱼际采血(P<0.05)。结论:多部位快速血糖仪(Freestyle)手掌大鱼际采血检测血糖的结果可靠,是糖尿病患者长期监测血糖的一种较为准确、方便、痛苦较少的方法。     

间日疟原虫深圳株红内期SSUrDNA基因片段的克隆与序列分析

目的 体外扩增间日疟原虫深圳株红内期小亚单位核糖体核糖核酸编码基因(SSUrDNA)片段，研究其结构与功能。方法 设计一对特异性引物，采用聚合酶链反应(PCR)从间日疟原虫患者血样中扩增出间日疟原虫SSUrDNA片段，以PUC19质粒T载体构建重组子导入大肠杆菌JM109；阳性克隆双酶切鉴定后，双脱氧末端终止法测定序列。结果 间日疟原虫SSUrDNA扩增片段大小为341bp；阳性克隆双酶切及PCR扩增均得到预期大小的片段；序列测定插入片段为341bp，与Sal I株顺序相比，仅在第151位处缺失一个碱基C。结论 成功克隆了间日疟原虫SSUrDNA片段．该序列在间日疟原虫虫株间高度保守。     

阿米替林合并认知疗法治疗精神分裂症后抑郁的对照研究

目的　评价阿米替林合并认知疗法对精神分裂症后抑郁的治疗效果。方法　将符合CCMD 3诊断标准的 86例精神分裂症后抑郁患者随机分为治疗组和对照组 ,治疗组给予阿米替林合并认知治疗 ,对照组织给予阿米替林治疗 ,疗程 12周。采用汉密尔顿抑郁量表 (HAMD)、简明精神病量表(BPRS)、阴性症状量表 (SANS)评定临床疗效 ,采用副反应量表 (TESS)评定副反应。结果　在治疗的 4、8、12周末 ,HAMD评分治疗组优于对照组 ,显效率分别为 83 95 %和 6 1 90 % (u =5 .83,P <0 0 5 )。结论　阿米替林与认知治疗组结合治疗精神分裂症后抑郁疗效好于单用阿米替林治疗。     

In vitro reversal MDR of human carcinoma cell line by an antisense oligodeoxynucleotide-doxorubicin conjugate.

A conjugate of antisense oligodeoxynucleotide (AS ODN) covalently linked with deoxorubicin (DOX) was synthesized. Its properties and antitumour activity in human carcinoma DOX resistant cells (KB-A-1) were investigated in vitro. The results showed that the conjugate was strongly stable both in Dulbecco's Phosphate-Buffered Saline (PBS) and in culture medium. The intracellular concentration of the conjugate was higher than that of the AS DON by HPLC analysis. The conjugate showed potent dose-dependent inhibition to the growth of KB-A-1 cells. Chemosensitivity of KB-A-1 cells to DOX was also investigated in vitro. When the cells were first exposed to the conjugate (0.5 microM) and then exposed to DOX for 24 h, the IC50 value of DOX decreased from 21.5 to 2.2 microM. In contrast, when treated with the mixture of the same concentration of the AS ODN with equivalent DOX, the IC50 value of DOX was 16.8 microM. Intracellular DOX concentration was detected in KB-A-1 treatment with the conjugate in vitro by HPLC. The results showed that the intracellular DOX concentration was 6.4-fold increased in KB-A-1 cells treated with the conjugate compared to treatment with DOX alone. In contrast, 1.8-fold increasing was observed when treated with the AS ODN. Western blot analysis showed a significantly decrease in the amount of P-glycoprotein in KB-A-1 cells. These results suggest that the conjugate is effective in reversing multidrug resistance. Certainly, further studies are conducting to explore the antitumour effect of the conjugate in vivo.     

国产唑来膦酸治疗肿瘤高钙血症多中心Ⅱ期临床观察

Objective： To evaluate the effect and safety of clinical use of zoledronic acid in the treatment of malignant hypercalcemia. Methods： A multi-center, open phase II clinical trial was conducted in 15 cases with malignant hypercalcemia who received zoledronic acid intravenously for 15 min. The level of blood calcium and side effects were recorded regularly within 28 days after injection. Results： One case was dropped out due to bad compliance. The complete response rate （the corrected serum calcium was reduced to normal level） was 100.00% （14/14）. The medium time of complete response rate was 5.07 days. The medium maintain time was 22.30 days. Slight, or moderate fever was observed. Conclusion： Zoledronic acid can effectively reduce the malignant hypercalcemia. The use of zoledronic acid appears to be safety and convenient.