额叶外伤后早期数字工作记忆的fMRI研究

目的:利用功能磁共振成像技术研究额叶外伤后,执行工作记忆任务时脑结构损伤与脑激活功能区的改变。材料和方法:对10例额叶外伤后早期患者(伤后平均31d,其中男性7例,女性3例;平均年龄30.1年)和12例正常志愿者作为对照组(男性7例,女性5例;平均年龄26.9年)分别进行2位和4位数字的正反序工作记忆的实验,使用single-trial设计方法;GE3.0T磁共振机扫描、采集图像,运用AFNI软件包进行数据分析。结果:①正常对照组反序4位数字任务大于正序4位数字脑区有辅助运动区SMA,双侧背外侧前额叶,左侧顶叶,右侧角回;②患者组反序4位数字任务大于正序4位数字的脑区有左侧枕叶;③正常对照组反序4位数字任务大于患者组的部位有左侧DLPFC,左侧角回;正序4位数字大于患者组的部位有左侧枕叶,右侧角回;④患者组反序4位数字任务时大于对照组的部位有楔状回,右侧Broca区;正序4位数字大于对照组的部位有右侧初级运动区MA,右侧额极区。结论:前额叶在脑工作记忆网络中处于重要节点,大脑右侧半球在工作记忆系统中起到巨大代偿作用的脑资源,fMRI提供认知功能损伤的影像学依据,应在临床上发挥更大作用。     

经皮肾镜取石和经尿道输尿管镜碎石治疗输尿管上段结石的疗效比较

目的:比较微创经皮肾镜取石术(MPCNL)与经尿道输尿管镜碎石术(URL)治疗输尿管上段结石的方法。方法:200例单侧输尿管上段结石的患者,90例采用MPCNL进行治疗;110例采用URL治疗,其中46例接受辅助ESWL治疗。结果:MPCNL组术后3天结石清除率为97.7%(88/90),术后1个月结石清除率为100%(90/90)。URL术后3天结石清除率为25.4%(28/110),术后1个月结石清除率为81.8%(90/110),均显著低于MPCNL组(P<0.05)。结论:MPCNL治疗嵌顿性输尿管上段结石有很高的结石清除率,URL手术治疗效果稍差,可以联合ESWL提高疗效。     

通过三年资料实证医院检验科常规项目全成本

目的弄清医院常规检验项目的实际成本,为医院及卫生主管部门进行科学管理和政府物价部门制订科学合理的收费价格体系提供科学依据。方法对某二级甲等医院检验科3年中所开展的全部7大类16个项目组169个检验项目的成本按耗材、设备折旧、劳务费、房屋折旧、业务费与后勤管理费共5大类进行实证分析。结果该科的成本构成比是:耗材成本34.1%、设备折旧24.3%、劳务费30.0%、房屋折旧4.0%、业务费与后勤管理费7.6%;检验项目的每项次平均成本为7.17元;成本最低的两类检验项目是生化及定性免疫,其项次成本分别为3.18元和4.25元;最高的则为微生物和血库,项次成本分别为48.63元和35.21元;项次成本过百元的有7项,多为输血项目;5至10倍于平均成本的28项,2至5倍于全科平均成本的22项,其余112项介于全科平均成本上下。结论实证研究是准确掌握检验项目成本的有效方法。     

几种花类药材的鉴别与调剂

目的:为了提高调剂水平,鉴别花类药材的调配事项。方法:对金银花、槐花、玫瑰花与月季花进行分析鉴别。结果:金银花应调配花蕾;槐花入药用花或花蕾均可,但以花蕾为好;玫瑰花与月季花主要鉴别点在花瓣和花托上。     

Expression of immune cells and their roles in the involved tissues of SARS patients]

OBJECTIVE: To study the expression of the immune cell markers and their active antigens in the involved tissues of patients with severe acute respiratory syndrome (SARS). METHODS: Specimens of the lungs, spleens and lymph nodes were obtained from autopsy of 3 SARS cases to investigate the expression of the immune cells and their activities with double immunohistochemical staining (DAB and AP) by using 14 immune cell markers and their active antigens. RESULTS: A large quantity of proliferated macrophages could be observed in the lungs, spleens and lymph nodes of the SARS patients, some of which were positive for CD25 marker (active macrophages). In the lungs of the 3 patients, localized necrosis occurred where infiltration of CD45RO (+) T lymphocytes was observed, with only scarce Ki67 (+) T lymphocytes (active T lymphocytes) and B lymphocytes. In the lymph nodes, scattered T lymphocytes positive for Ki67 and CD45RO markers (active T lymphocytes) were seen, but the T lymphocytes subpopulations were obviously decreased, which was especially so with CD4+ and CD8+ T lymphocytes and NK cells. CONCLUSION: Significantly enhanced activity of the macrophages occurs in SARS as the major reactive cells, but T lymphocyte subsets are obviously decreased, indicating the important roles of the macrophages and T lymphocytes in the pathogenesis of SARS.     

Effects of Integrative Chinese and Western Medicine on Arterial Oxygen Saturation in Patients with Severe Acute Respiratory Syndrome

Objective: To evaluate the effects of treatment of integrative Chinese and Western medicine (ICWM) on arterial oxygen saturation (SaO2) in patients with severe acute respiratory syndrome (SARS). Methods:The non-randomized, controlled trial was conducted on 447 SARS patients treated synchronously with western conventional treatment (WM group, n = 171) alone and ICWM (ICWM group, n = 276). The changes of the cases with normal level (≥95% ) or abnormal level (<95% ) SaO2 were observed dynamically. Results: In the 3rd-14th day of the therapeutic course, the percentage of patients with normal SaO2 in the ICWM group was higher than that in the WM group (OR = 0.5178, P = 0.0038), and this tendency was more evident in patients of the severe type (OR = 0. 18, P = 0. 0001). However, the statistical significance of difference was only shown in patients for whom the ICWM treatment started in the early period after the onset (≤7 days after it, OR = 0.3803, P = 0.006), but not shown in those who received ICWM treat     

可注射型骨修复材料对兔MSC增殖及分化的影响

目的：观察以纤维蛋白胶为载体的骨修复材料对兔骨髓基质细胞（marrow stromal cell,MSC)增殖及分化的影响。方法；采用细胞培养及组织化学等方法对各材料组兔MSC的增殖、碱性磷酸酶（alkaline phosphase,ALP)的活性和染色、细胞贴壁率及I型胶原表达进行研究。结果：（1）各组材料对细胞贴壁率及促增殖作用的影响总体上由强到弱依次是：对照组2→实验组→对照组1[纤维蛋白胶（fibrin sealant,FS)]→对照组3→单纯对照组，差异有显著性（P＜0．05）。（2）各组细胞的I型胶原表达水平和ALP活性由强到弱依次是：实验组→对照组3→对照组1→对照组2→单纯对照组，差异有显著性（P＜0．05）。结论：以纤维蛋白胶为载体的注射型骨修复材料可显著保进MSC贴壁率和向成骨细胞方向的分化水平。     

2－氯－4－溴－α－甲基肉桂酸可能为一种新型钠通道阻断剂

用细胞内记录方法检测２－氯－４－溴－α－甲基肉桂酸钠盐（ＳＣ１００１Ｎａ）和通道阻断剂四乙铵、氯化锰及河豚毒素对中华大蟾蜍离体缝匠肌动作电位和静息电位的影响。１０ｍｍｏｌ／Ｌ四乙铵及氯化锰对静息电位和动作电位幅度无影响，１μｍｏｌ／Ｌ河豚毒素完全阻断动作电位。２ｍｍｏｌ／ＬＳＣ１００１Ｎａ显著降低动作电位幅度并延长其持续时程（Ｐ＜０．０５），而对静息电位无影响，但其作用可逆。经四乙铵１０ｍｍｏｌ／Ｌ预处理后，２ｍｍｏｌ／ＬＳＣ１００１Ｎａ仍能延长动作电位持续时程，同时降低其幅度，而１０ｍｍｏ１／ＬＳＣ１００１Ｎａ完全阻断动作电泣，并使静息电位去极化（Ｐ＜０．０５）。且药物效应为不可逆。本研究结果提示：ＳＣ１００１Ｎａ可能是一种新型钠通道阻断剂。     

Clinical evaluation of manual and ultrasonic subgingival scaling using image analysis]

The objective of this study was to compare the effect of hand and ultrasonic instrumentation in removing subgingival plaque and calculus.In experiment one,forty-eight teeth from patients were randomly assigned to be scaled with curettes or ultrasonic scaler.Probing depth,clinical attachment level and bleeding index were reexamined 2 months latter.The results demonstrated that no significant differences between the two mehtods.In experiment two,seventeen teeth from six patient were also randomly scaled manualty ultrasonic or uninstrumented as a control.All these teeth were extracted immediately after subgingival scaling.The proportion of tooth surfaces covered by residual plaque and calculus(relative to the total surface area of the side of the tooth)was analysed on each tooth using computerized graphic processing.The findings showed the proportional areas of residual plaque and calculus in teeth.But the hand scaled root surface were much smoother than those treated with ultrasonic scaler.     

离体兔输尿管及膀胱组织的光学特性

采用标准积分球系统测量了离体兔输尿管及膀胱组织的激光漫反射比及透射比，所用激光为：He-Cd(441.6nm),Ar (465nm,488nm,496.5nm,514.5nm),He-Ne(632.8nm)和YAG（1060nm)，对组织的吸收比和吸收系统进行了分析计算，结果表明：（1）输尿管组织和膀胱组织的光学特性类似。（2）组织的激光漫反射比在可见光范围（441.6nm-632.8nm)内变化幅度不大，但在465nm处最小，514.5nm处有一峰值。（3）组织的透射比在所测波段（441．6nm-1060nm)内随波长的增加而增加，（4）组织的吸收系数在465nm处有一峰值。