机械通气并发气胸的诊断及处理

气胸是机械通气常见的并发症，在成人呼吸窘迫综合征（ＡＲＤＳ）及慢性阻塞性肺部疾病（ＣＯＰＤ）中发生率较高，分别是２９．４％和２７．８％，且多为张力性气胸。预防气胸发生的简便方法是在保证有效通气量的前提下，适当降低潮气量。机械通气过程中，患者出现血氧饱和度下降、气道压力增高、患侧呼吸音降低、心率加快及呼吸困难等临床症状均高度提示并发气胸，试穿患侧胸腔有大量气体即可诊断。安置该侧胸腔闭式引流是有效的治疗方法。     

重庆市两所高校麻疹暴发的调查

重庆市两所高校麻疹暴发的调查侯振发，谢虹，林吉群（四川省重庆市沙坪坝区卫生防疫站，重庆市，６３００３０）１９９６年３～５月，在重庆大学和西南政法学院发生麻疹暴发，现报告如下。重庆大学和西南政法学院位于重庆市沙坪坝区歌乐山脚下，两校相距２公里。重庆大学...     

皮肤病学文献数据库及其检索系统的初步研究

本文介绍了应用FOXBASE2.1中文数据库设计、建立的皮肤病文献专题数据库及其检索系统。该系统具有多种检索方式,可提供著者、分类、关键词等项目的检索,并具有数据的追加、修改、删除、查询、备份及打印等功能。     

记忆合金环抱器在复杂骨折治疗中的应用

对于一些特殊类型骨折以及严重的粉碎性骨折，传统的内、外固定方式难以固定，或固定效果不确切，不利于早期功能锻炼，影响骨折的愈合。NiTi记忆合金是近年来应用于骨折固定的新型内固定材料，自1998～2003年我们采’用记忆合金环抱器治疗各种复杂骨折17例，取得了满意的疗效。     

尿激酶溶栓治疗下肢深静脉血栓形成的剂量探讨

目的 探讨下肢深静脉血栓形成溶栓疗法的有效而安全的方案。方法 回顾性分析下肢深静脉血栓形成68例病案资料。按尿激酶每天用量分为大、中、小三个剂量组所有患者使用尿激酶后用肝素100mg/d静滴维持，疗程≤14d。观察再通时间，凝血酶原时间(PT)、国际标准化比值(INR)、血小板(plat)、纤维蛋白原(FIB)，比较组间差异。结果 再通时间比较：小剂量组长于其他两组，中等剂量组和大剂量组比较无明显差异小剂量组再通率低于另两组，而大剂量组副作用发生率则高于中、小剂量组、中等剂量组治疗前后的血凝指标变化不大(P＞0．05)。结论 中等剂量尿激酶(20～50万U／d)加肝素能有效治疗下肢深静脉血栓形成，并发症少，值得推广。     

RGD多肽接枝聚复合导管桥接神经缺损的实验研究

Objective To investigate the effect of RGD peptide conjugated poly[ LA-(Glc-Lys) ]/βTCP/PLA nerve conduit for bridging peripheral nerve regeneration defect. Methods Forty-five male Wister rots were randomly divided into 3 groups, with 15 rats each. A 10 mm defect was created in the right sciatic nerve. In group A the gap was bridged by PLA tube. In group B RGD peptide conjugated poly[ LA-(Glc-Lys) ]/β-TCP/PLA nerve conduit was used to repair the defect. Autologous nerve graft was done in group C which served as control. Twelve weeks postoperatively nerve regeneration was evaluated by gross observation,electrophysiology, muscle weight and muscle morphometry of triceps surae, and ultrastructure of the regenerating nerve. Results Twelve weeks after the operation, nerve conduction velocity and muscle weight recovery of group B were better than those of group A. The differences were statistically significant( P < 0.05). There was no significant difference between group B and group C ( P > 0. 05). The results of histology and ultrastructure showed that nerve regeneration in group B and group C was significantly superior to that in group A.Conclusion RGD peptide conjugated poly[LA-(Glc-Lys)]/β-TCP/PLA conduit can achieve similar results in repairing sciatic nerve defect to that of autogentic nerve graft. It may be an ideal material to repair nerve defect.     

空心加压螺纹钉结合钢丝治疗髌骨体部横形骨折

髌骨骨折在骨科领域属常见骨折，一般累及髌骨的中1/3，常伴有分离移位，需手术内固定治疗。由于是关节内骨折，后关节面不平整容易造成创伤性关节炎，故对复位要求较高。单纯钢丝环扎因固定欠牢靠，需辅助长时间外固定，不利于膝关节早期功能锻炼，目前逐步摒弃而被张力带取代。我院自2003年2月至2006年10月采用2枚空心加压螺纹钉结合钢丝治疗髌骨体部横形骨折25例，取得良好效果。[第一段]     

THE ACTION OF RADIX REHMANNIAE AND PLASTRUM TESTUDINIS ON BETA- ADRENERGIC RECEPTOR-cAMP SYSTEM

Mouse and rat pathological models were pro duced by injections of thyroid hormone (T3 0r T4, Model. I) or hydrocortisone (HC, Model II). A single subcutaneous dose of isoproterenol (ISO) caused plasma cAMP to peak in 5-15 min which was significantly higher in mouse Models I and II than in normal mice. Daily oral administration of a decoction of two Yin tonics-Radix Rehmanniae (RR) and Plastrum Testudinis (PT) reduced peak cAMP in both models. 3H.DHA binding assay re vealed significant elevations of the number of 3 adrenergic receptors in rat Models I and II. Decoc- tion RR and PT restored the peaks to normal range. Yang tonics Radix Aconiti praeparata (RAP) and Cortex Cinnamomi (CC) showcd contradictory effects on these models. It seems unlikely that the action of the two tonics promotes the dlearance of injected hormones, since injected hormone RIA iii plasma showed no differences between Yin tonics treated and untreated models. The therapeutic effects of these two Yin tonics on "Yin deficiency" syndrome of hyperthyroidism or hyperfunction of the adrenal cortex is very probably related to their actions on the O-adrenoreceptor-cAMP system as stated.     

353例多发伤后全身炎性反应综合征与多器官功能障碍综合征的临床研究

目的：探讨多发伤后全身炎性反应综合征（SIRS）的特点,不同程度SIRS与MODS的关系以及对进展为多器官功能障碍综合征（MODS）的防治。方法：根据SIRS的诊断标准,同时参照APACHE评分系统、创伤严重程度、全身感染等确定SIRS的严重程度,分析不同程度SIRS与MODS的关系以及由SIRS向MODS发展的渐进过程。结果：353例中轻、中、重度SIRS分别为158例、118例和77例。与轻度SIRS比较,中、重度SIRS患者MODS的发生率明显增加（P＜0．05）;受累器官中,呼吸功能障碍最多见,患病率达27．5％;随着受累器官增多,病死率显著增加（P＜0．05）。结论：多发伤后SIRS患者由于二次打击因素的存在,MODS发生率高,SIRS的程度与MODS的发病和预后密切相关。高度重视SIRS向MODS转变过程中的高危因素,阻断或削弱二次打击,早期进行脏器功能支持是防治MODS最有力的措施。