慢性肾功能不全98例患者血清胱氨素C检测分析

目的:观察慢性肾功能不全时血清胱氨素C(Cyst.C)的变化与血清肌酐(Creatinine Cr)、内生肌酐清除率(Creatinine clearance,Ccr)的相关性,并将免疫比浊法与EL ISA法进行比较性评价。方法:分别以放射免疫比浊法、EL ISA法测定的各种肾脏患者的血清胱氨素C,同时测定血清肌酐、内生肌酐清除率;并以健康成人检测结果为对照组。结果:放射免疫比浊法肾病组5 1例Cyst.C4 .10±3.17mg/ L,正常对照组4 4例0 .84±0 .14 mg/ L,两组间差异有显著性(t=- 6 .771,P<0 .0 5 ) ;相关分析表明Cyst.C与Ccr呈负相关(r=- 0 .84 3,P<0 .0 1) ,与Cr呈正相关(r=0 .775 ,P<0 .0 1)。Cyst.C与Cr非参数ROC曲线的曲线下面积(AU Ccyst.C=0 .96 1,SE=0 .0 18;AU Ccr=0 .732 ,SE=0 .0 5 3)之间差异有显著性(P<0 .0 1)。EL ISA法肾病组4 7例Cyst.C 3.32±3.14 mg/ L ,对照组30例0 .77±0 .11mg/ L,两组间差异有显著性(t=- 4 .4 2 4 ,P<0 .0 5 ) ;相关分析表明Cyst.C与Ccr呈负相关(r=- 0 .76 7,P<0 .0 1) ,与Cr呈正相关(r=0 .910 ,P<0 .0 1) .Cyst.C与Cr非参数ROC曲线的曲线下面积(AUCcyst.C=0 .92 6 ,SE=0 .0 33,AU Ccr=0 .787,SE=0 .0 5 3)有显著性差异(P<0 .0 1)。结论:两种测定Cyst.C的方法均可作为判断肾小球功能的指标,但放射免疫比浊法操作简便、快速,值得临床推广应用。     

三种内固定方式固定治疗股骨粗隆间骨折

自2003年2月至2006年7月我院采用DHS、PFN、DCS治疗粗隆间骨折137例，现将治疗效果分析报告如下。     

锁骨钩钢板治疗锁骨远端骨折及肩锁关节脱位

2005年4月～2007年12月,我院应用锁骨钩钢板治疗锁骨远端骨折38例,取得满意疗效。1材料与方法1.1病例资料本组38例,男30例,女8例,年龄16～63岁。左侧11例,右侧27例。单纯锁骨远端骨折30例,单纯肩锁关节脱位8例。脱位合并骨折18例。致伤原因：交通伤20例,跌伤9例,打击伤9例。骨折类型：横断骨折6例,斜形骨折9例,粉碎骨折15例。     

黄芪注射液佐治成人原发性肾病综合征疗效观察

为探讨成人原发性肾病综合征(PNS)低白蛋白血症的有效疗法，近年来我院采用黄芪注射液静脉滴注，取得了较满意近期疗效，现报告如下。     

高热 偏瘫 意识障碍 紫癜 贫血

高热偏瘫意识障碍紫癜贫血江苏省通州市人民医院内科（２２６３００）王立松张鸿民蒋国成病历摘要患者，男性，３１岁，农民。因发热、头痛４天伴右侧肢体活动障碍、神志不清１６小时于１９９６年６月２９日入院。患者４天前无诱因突然发热、体温３９℃伴头痛，当地乡卫生...     

环磷酰胺冲击治疗狼疮性肾炎近期疗效观察

本文观察了大剂量环磷酰胺静脉冲击疗法联合强的松治疗狼疮性肾炎的近期疗效，并与单纯口服强的松进行比较，结果冲击组总有效率明显高于对照组，尿蛋白量减少，冲击组较对照组有显著差异（Ｐ＜０．００１），并能有效地改善肾功能及中枢神经系统病变。     

颈椎管内、外木筷贯穿并存留致不全瘫1例报道

患者女性,25岁,自述1d前遭遇抢劫,搏斗时被木筷自颈部左前方刺伤,出现颈部疼痛、出血,左侧肢体活动受限,固定颈部后急诊入院。入院查体:颈椎活动受限,左侧胸锁乳突肌外侧缘中段可见一0.8cm皮     

可吸收螺钉内固定治疗PipkinⅡ型股骨头骨折

目的探讨应用可吸收螺钉内固定治疗PipkinⅡ型股骨头骨折的效果。方法对13例PipkinⅡ型股骨头骨折患者采用Smith-Peterson入路切开复位、可吸收螺钉内固定进行治疗。结果患者均获随访,时间18～36（25&#177;4.1）个月。按Thompson-Epstein评分法评定疗效：优8例,良4例,中1例。未出现可吸收螺钉断裂及异物反应现象,无深部感染、股骨头缺血性坏死及创伤性关节炎等并发症发生。结论采用Smith-Peterson入路、可吸收螺钉内固定治疗PipkinⅡ型股骨头骨折效果显著,该方法手术简单,是一种可推荐的治疗方法。     

老年人糖尿病肾病肾功能不全26例临床分析

老年人糖尿病并发糖尿病肾病 (ＤＮ)时较易进展至肾功能不全。本文探讨其影响因素 ,从而采取有效对策。我院伴肾功能不全的老年人ＤＮ患者 2 6例 ,现分析报告如下。临　床　资　料1　一般资料　 1 992年 3月— 1 999年 3月我院内科住院老年ＤＮ病人 (均为Ⅱ型糖尿病 ) 74例中伴肾功不全 2 6例 ,男 1 6例 ,女 1 0例 ,平均年龄 69.4(60～ 82 )岁。糖尿病诊断按ＷＨＯ1 980年标准 ,ＤＮ符合Ｍｏｇｅｓｅｎ分期Ⅳ～Ⅴ期。 2 6例中氮质血症 2 0例 ,尿毒症 6例。入院时空腹血糖 (1 7.43± 5 .93 )ｍｍｏｌ/Ｌ ,尿素氮 (1 7.2 0±6.1 7)ｍｍｏｌ/Ｌ…     

可控微结构电子束熔化成形钛合金支架作为成骨细胞载体修复兔骨缺损的研究

Objective To evaluate effects of titanium alloy scaffolds with controlled internal architecture as an osteoblast carrier on bone response in models of rabbit defects. Methods Electron beam melting process was utilized to fabricate porous titanium alloy scaffolds with fully interconnected and controlled internal pore architecture. After osteoblasts were seeded on the scaffolds and cultured for up to 7 days, the growth of rabbit osteoblasts on the scaffolds was observed by scanning electron microscopy. The experiment was conducted in 4 groups to evaluate the bone formation in vivo: group A (cell/scaffold composite), group B (scaffold only), group C (left empty) and group D (autogenous bone implant) . The scaffolds were transplanted into the rabbit defects after cultured in vitro for 7 days. The animals were sacrificed at 4, 8, and 12 weeks after implantation. Bone formation in the scaffolds was investigated by gross observation, histology and histomorphometry of non-decalcified sections and fluorochrome markers. Results Confluent cell layers could be observed on the scaffold surface and in the internal pores after 7 days of incubation in vitro. New bone growth and revascularization could be observed not only at the margins of the scaffolds, but also inside the central pores of the scaffolds after 12 weeks. New bone formed along the controlled internal channels of the scaffolds. The scaffolds were filled fully with the new bone tissue and blood vessels. More extensive new bone formation was found to originate from the host bone towards the implant in group A than in group B (P ＜0. 05) . Conclusions The controlled scaffolds are well biocompatible enough to accelerate healing of rabbit defects and new bone formation. The controlled honeycomb-like architecture may guide and promote the formation of mineralized tissue.