中药饮片煎煮法改革的研究

目的 对传统中药煎煮法进行改革,为高温浸泡法提供相应的理论依据.方法 选用6种不同质地的中药材,分别采用传统煎煮法和高温浸泡法煎煮,以水中溶出物干重和有效成分含量为检测指标,比较两种煎煮中药方法的差异.结果 传统煎煮法和高温浸泡法煎出液水中溶出物干重值比较无明显差异(P＞0.05),表明两种方法汤剂总的煎出物基本一致.而高温浸泡法煎出液有效成分含量测定结果均高于传统中药煎煮液(P＜0.05),有显著性差异.结论 高温浸泡法有效成分含量高于传统中药煎煮法,可进一步推广运用于临床.     

比格犬严重多发伤上气道堵塞窒息模型建立

目的:建立比格犬严重多发伤上呼吸道窒息动物模型,探讨模型制作方法,评价效果的可行性。方法:普通级比格犬13只,按气道全梗阻时间随机分为窒息≤6 min组(A组,n=4),7～8 min组(B组,n=4)和≥9 min组(C组,n=5)。观察各组动物的存活率、生理指标、血常规、动脉血气各项参数的变异。结果:动物急救复苏后A组全部存活,B、C组动物存活率分别是75%、60%。建模后各组多项指标差异频现,建模后WBC上升,HGB、PLT、PaO2下降并有显著性差异(P<0.05),C组PaCO2先升高后下降,均有显著性差异(P<0.05)。结论:本模型建模方法量化可行,稳定性好,重复性强,有助于现场一线生命救护技术与装备研究和实践标准化评价。     

125I粒子永久性组织间植入治疗浅表恶性转移肿瘤

目的 探讨125I粒子术中组织间植入治疗浅表恶性转移肿瘤的临床效果.方法 在B超引导下将125I粒子植入24例恶性肿瘤切除后28处浅表转移病灶肿瘤组织内,治疗1个月后观察疼痛缓解情况和瘤灶大小等变化,并定期随访.结果 24例患者术后均恢复良好,未因植入125I粒子而导致严重并发症,随访1～14个月,中位随访8个月,均无不良反应发生.125I粒子植入1个月后,肿瘤病灶疼痛症状完全缓解23处,部分缓解5处;肿瘤病灶体积部分缓解25处,3处无改变.结论 125I粒子组织间植入治疗浅表恶性转移肿瘤,方法简便,近期疗效确切,能缓解癌性疼痛及局部压迫等症状,提高患者的生存质量.     

模糊控制在射频消融温度与阻抗监测系统中的应用

为了提高射频消融系统中肿瘤组织温度和阻抗的控制精度,设计了基于模糊控制的温度与阻抗监测系统。系统采用光纤光栅温度传感器测量组织温度,运用电阻采样、互感器隔离的方式测量组织阻抗;选用模糊控制算法对温度和阻抗进行控制,并通过建立分层多规则集结构模糊控制器,降低了控制复杂度。经过实验验证,治疗温度上升速度快、过渡时间短,最大超调量为1℃,稳态精度为±0.4℃,控制算法适应性强,可以实现对肿瘤组织均匀、平稳的加热治疗,对临床治疗肿瘤具有较高的实用价值。     

消石汤配合体外冲击波碎石术治疗泌尿系结石50例

目的观察消石汤配合体外冲击波碎石术治疗泌尿系结石的临床疗效。方法对泌尿系结石患者50例施行体外冲击波碎石术,术后口服消石汤治疗。结果本组50例泌尿系结石患者48例结石完全排除,复查B超无结石残留,肾积水消除。结石清除率96%。结论口服消石汤配合体外冲击波碎石术后排石,效果确切。     

市售炮制辅料醋中5-羟甲基糠醛含量的比较

目的 比较不同品种市售炮制辅料醋中5-羟甲基糠醛的含量。方法 采用高效液相色谱法测定5-羟甲基糠醛的含量,色谱条件为流动相甲醇-0.05%磷酸（8:92）,流速1.0 mL·min^-1,检测波长284 nm,进样量20 mL。结果 3批白醋中未检测到5-羟甲基糠醛,以黑糯米、小米等优质粮食为原料酿造的米醋中5-羟甲基糠醛含量相对较高,天立老醋、水塔老陈醋和恒顺镇江陈醋等有陈酿工艺的米醋中5-羟甲基糠醛含量高。结论 5-羟甲基糠醛含量的高低反映了米醋质量的优劣,5-羟甲基糠醛可作为米醋的质量控制指标。     

慢性乙型肝炎核苷（酸）类似物抗病毒治疗与基因分型测序的相关性研究

目的探讨慢性乙型肝炎核苷（酸）类似物（拉米夫定、替比夫定、恩替卡韦、阿德福韦酯）抗病毒治疗与HBV基因分型间的相关性。方法收集2008年1月—2010年12月就诊的慢性HBV感染者541例,随机分为4组：（1）拉米夫定组（136例）100mg口服,每日1次;（2）替比夫定组（135例）600mg口服,每日1次;（3）恩替卡韦组（135例）0.5mg口服,每日1次;（4）阿德福韦酯组（135例）10mg口服,每日1次,疗程均为48周。治疗前进行基因测序确定基因型,并于治疗前及治疗后48周时分别检测肝功能、HBV DNA、HBeAg、HBeAb等肝炎病毒标记物。结果 （1）HBV基因型B型占17.38%（94/541）;C型占75.78%（410/541）,B/C混合型占6.84%（37/541）,未检出其他基因型。（2）拉米夫定组、恩替卡韦组、替比夫定组,B型、C型、B/C基因型疗效（包括HBV DNA阴转率、有效率、ALT复常率、HBeAg血清转换率等）比较,差异有统计学意义（P〈0.05）,而阿德福韦酯组,B型、C型、B/C基因型比较,差异无统计学意义（P〉0.05）。结论 HBV基因型与核苷类抗病毒药物治疗的疗效密切相关。     

氨茶碱治疗房室传导阻滞的疗效观察

房室传导阻滞是下壁心肌梗死后常见的并发症 ,阿托品治疗常能恢复正常 ,但若因心肌缺血后代谢产物所致的传导阻滞 ,阿托品多无效。本文观察腺苷拮抗物氨茶碱对阿托品治疗无效的下壁心肌梗死高度传导阻滞的疗效。1　资料与方法收集本院 4年来心肌梗死患者共 2 4例 ,其中伴二度或高度房室传导阻滞的急性下壁心肌梗死患者 6例 ,年龄 45～75岁 ,男性 4例 ,女性 2例。房室传导阻滞一般于心肌梗死后 3～ 5ｄ发生。首先予阿托品 1ｍｇ静注 ,1ｈ后有 1例患者心率升至 60次 ｍｉｎ以上 ,房室传导阻滞也恢复正常。余 5例阿托品无疗效 ,立即给予氨茶碱 …     

表现为瘙痒的带状疱疹2例

1 病历资料 例一,40岁女性.3月24日月经来潮,月经前二天自觉乏力,无发热及咳嗽.月经第二天自觉右肩背部发痒,当时未与特殊处理,第三天上述部位瘙痒明显,局部皮肤无红肿,自行服用扑尔敏、外涂皮炎平不见好转,第四天见右侧肩胛岗区及锁骨上、下区分别出现片状红斑,约0.5×1.0cm2大小,压之褪色,仍给予上述抗过敏治疗不见好转,第五天片状红斑中央区出现少许粟粒状丘疹,考虑带状疱疹,给予苷泰250mg ivgtt q8h,口服维生素B1、B2,Vc,于第7天部分片状红斑中央区出现粟粒状至绿豆大的水泡,局部瘙痒明显减轻,继续用药10天后水疱基本消失,局部皮损残留轻度色素沉着.     

去铁敏对大鼠脑室出血后慢性脑积水与脑组织Wnt1、Wnt3a表达的影响

目的 观察去铁敏对大鼠脑室出血(IVH)后脑积水的干预效果及脑组织Wnt1、Wnt3a的表达影响.方法 雄性SD大鼠130只随机分为正常组、假性IVH组、IVH组及IVH加去铁敏组.采用脑室出血后慢性脑积水大鼠模型,于术后1 d、7 d及28 d处死大鼠,观察脑积水的发生率和脑组织中Wnt基因及蛋白表达情况.结果 正常组、假性IVH组未见脑积水发生,IVH组28 d脑积水发生率80%(12/15),显著高于IVH加去铁敏组28 d脑积水发生率20%(3/15).IVH后Wnt1、Wnt3amRNA及蛋白表达在7 d及28 d均显著高于假性IVH组,而去铁敏治疗组Wnt1、Wnt3a mRNA及蛋白表达在28 d较IVH组均显著降低.结论 去铁敏治疗可降低大鼠IVH后慢性脑积水发生率,Wnt信号通路参与了IVH后脑积水发生及去铁敏干预机制.

Abstract：

Objective To observe the effect of deferoxamine on chronic hydrocephalus after intraventricular hemorrhage (IVH) and the role of Wnt (Wnt1 and Wnt3a). Methods A total of 130Sprague Dawley male rats were randomly assigned into 4 groups: normal control group, sham - IVH group,IVH group and deferoxamine - treated group. The rats of subgroups except normal control group received an injection of autologous blood or saline into right lateral cerebral ventricles. Deferoxamine or vehicle was administered 3 hours after IVH and then every 12 hours up to 7 days in IVH group and deferoxaminetreated group. Rats were euthanized at 1, 7, 28 days for measurement, and the transverse diameter of the lateral ventricles were observed for evaluation of hydrocephalus. The expression of Wnt1 and Wnt3a were measured by RT -PCR and Western Blot. Results At 28 days, there was no hydrocephalus in the normal control group and sham - IVH group. 80 %(12/15) of the rats in IVH group developed hydrocephalus. The rate was only 20 % ( 3/15 ) in deferoxamine - treated group, which was much lower than that in IVH group. The expression of Wnt1 mRNA was normal in normal control group and shame - IVH group, and upregulated in IVH group. The peak expression was detected at 28 days. The expression was significantly higher than that in shame - IVH group at 7 days and 28 days, after deferoxamine treatment, downregulation of Wnt1 mRNA were observed and were significantly lower than that in IVH group. The Wnt3a mRNA had similar trends, while the expressed level was normal in normal control group and shame - IVH group, and upregulated following IVH. The peak expression was detected at 28 days, and was significantly higher than that in shame - IVH group at 7 days and 28 days. After deferoxamine treatment, the downregulation of Wnt3a mRNA was observed and was significantly lower than that in IVH group. Accordingly, Wnt1 protein expression was normal in normal control group and shame - IVH group, and increased after IVH. At 7 days and 28 days, the Wnt1 protein expression of IVH group was markedly higher than shame - IVH group. After deferoxamine treatment, the expression of Wnt1 protein was reduced and significantly lower than that of IVH group. The expression of Wnt3a protein was also normal in normal control group and shame - IVH group. The up-regulation of the protein expression was observed following IVH at 28 days, while down - regulation was observed after deferoxamine treatment at 28 days. Conclusions Deferoxamine could reduce hydrocephalus after IVH, and Wnt pathway may play an important role in the development of IVH and therapeutic effect of deferoxamine.