AN AUDIT OF THE USE OF SPHYGMOMANOMETERS

SUMMARY This survey assessed the measurement of blood pressure and use of sphygmomanometers by general practitioners in Humberside and Yorkshire in 1988. All registered practitioners were sent a questionnaire — 1223 (58%) returned it completed. Their responses showed that 269 (22%) had an aneroid sphygmomanometer only, and that 120 (10%) had a random zero sphygmomanometer; 700 (57%) had special cuffs for obese patients, and 558 (46%) had special cuffs for children; 228 (23.5%) had never had their sphygmomanometers serviced (‘never’ corresponding to a mean time of 5.75 years), while 23% had patients who measured their own blood pressure. These findings suggest that the British Hypertension Society's recommendations on servicing and cuff use are not always applied. A formal audit of the use of different types of sphygmomanometer in general practice may encourage and improve accuracy and uniformity in blood pressure recording.     

THE HISTOLOGICAL CHANGES IN THE THYROID GLAND OF THE RABBIT FOLLOWING LOBECTOMY

1. In a series of rabbits the changes which took place in the histology of the left lobe of the thyroid gland after excision of the right lobe have been studied at varied intervals of time. 2 days after the removal of one lobe the other lobe showed a slightly increased colloid content, an increased vacuolation of the colloid, and a slight increase in the size of the epithelial cells. At the end of a week the vesicles were greatly increased in size, distended with colloid, and the epithelial cells were flattened, while after 3 to 4 months signs of compensatory hypertrophy were present. 2. The changes observed were uninfluenced by division of the vagus or cervical sympathetic.     

CHANGES IN THE NUMBER OF SMALL LYMPHOCYTES OF THE BLOOD FOLLOWING LIGATION OF THE THORACIC DUCT

This report has attempted to analyze the changes in the absolute number of small lymphocytes in the blood stream of the cat following the intrathoracic ligation of the thoracic duct. Such a ligation produced an immediate decrease in the number of small lymphocytes to the extent of 56 per cent, but it was found that the preoperative level was again reached at about the end of 3 weeks. One is led to believe that the gradual return of the number of small lymphocytes to the preligation level took place pari passu with the establishment of the collateral circulation of the thoracic duct, although there is no absolute proof of this. Yet it is definite that the thoracic duct is an important avenue for the entrance of small lymphocytes into the blood stream, and that it is the pathway through which at least half of the small lymphocytes reach the circulating blood in the cat.     

抗癫痫药物治疗神经病理性疼痛的对照研究

目的:通过对腰椎间盘突出症患者硬膜外注射糖皮质激素疗效的回顾性分析,探讨硬膜外注射对腰椎间盘突出症的短期和中远期疗效。方法:收集我院2008年~2009年62例腰椎间盘突出症并伴有下肢疼痛患者行硬膜外注射糖皮质激素的临床资料。完整随访44例,进行治疗后1天、1月和6月疗效随访调查,并行疗效评价分析。结果:硬膜外注射糖皮质激素后1天、1月视觉模拟评分(visual ananlogue scale,VAS)及Oswestry功能障碍指数(Oswestry disability index,ODI)与治疗前相比显著性降低(P<0.05),患者治疗后6个月VAS及ODI与治疗前相比无显著性差异(P>0.05)。VAS和ODI治疗后6个月与治疗后1个月相比,显著升高。结论:硬膜外注射糖皮质激素对椎间盘突出症有较好的短期(治疗后1天和1月)临床疗效,中长期(治疗后6月)疗效欠佳,建议与其他微创治疗方法联合使用。     

阿片类药物在慢性非癌性疼痛中的应用

目的:回顾性分析卡马西平和加巴喷丁治疗原发性三叉神经痛、带状疱疹以及带状疱疹后遗神经痛的疗效、安全性和不良反应。方法:102位患者进入本研究,比较卡马西平或加巴喷丁治疗前后患者疼痛强度的改变和对睡眠影响的改善;依据药物分类,比较两种药物的副作用和不良反应。结果:卡马西平治疗原发性三叉神经痛起效较加巴喷丁快,二者长期疗效相当;加巴喷丁治疗带状疱疹和带状疱疹后神经痛的疗效优于卡马西平;疗效随治疗时间的延长而增加。卡马西平的副作用和不良反应事件发生率较加巴喷丁高。结论:抗癫痫药物卡马西平和加巴喷丁是治疗神经病理性疼痛的有效药物,可以改善患者的睡眠,但副作用和不良反应发生率高。     

红细胞电泳测定的临床应用初探

文中检测了１３例糖尿病和１３例脑梗塞患者的红细胞电泳时间和血浆粘度，以探讨血浆粘度对红细胞电泳时间的影响。结果表明：糖尿病、脑梗塞患者的红细胞电泳时间较正常人群显著延长，血浆粘度也显著高于正常人群。并就上述结果的临床意义进行了初步探讨。     

CHANGES IN THE PERCENTAGE OF CALCIUM AND PHOSPHORUS OF THE BLOOD FOLLOWING SECTION OF THE SYMPATHETIC AND VAGUS NERVES

When a splanchnic nerve or the celiac plexus was severed a definite fall in serum calcium resulted, the level falling to 6 mg. per cent and remaining low for 1 or 2 weeks. Tetany, however, did not develop. The inorganic phosphate was slightly altered. On the other hand, when the vagi nerves were severed, the serum calcium rose. The equilibrium of both calcium and phosphorus was rendered less stable by the division of the sympathetic or the parasympathetic nerves.     

使用中戊二醛碱性溶液的浓度变化状况

为了解使用中戊二醛碱性溶液的浓度变化,采用化学滴定法检测戊二醛含量。结果,浸泡眼科手术器械(1～2件/d)的溶液用至6d,浸泡普通手术器械(约10件/d)的溶液用至4d,浸泡内窥镜(约6件/d)的溶液用至5d,戊二醛含量均<18000mg/L,不能再继续使用。结果说明,戊二醛碱性溶液浓度下降速度与浸泡器械数量有一定关系。     

缺血性心脏病患者C-反应蛋白的变化及临床意义

目的 :观察缺血性心脏病 (IHD)时血清中C -反应蛋白 (CRP)的变化 ,以探讨CRP与IHD的关系及临床意义。方法 :选择体检健康者 3 0例、心绞痛患者 45例、急性心肌梗死患者 3 0例各作为正常对照 (C)组、心绞痛 (AP)组和急性心肌梗死 (AMI)组。C组于清晨、AP组于入院次日清晨取血 ,而AMI组于发病 6、12、2 4、48及 72h取血。采用散射比浊法检测CRP。结果 :AP组及AMI组各时间点CRP较C组显著增高 (P <0 0 1) ;AMI组各时间点CRP较AP组显著增高 (P <0 0 5 ) ;CRP在急性心肌梗死后的 72h内呈明显动态变化 ,6h开始升高 ,48h达高峰 ,后渐下降 ,72h时仍明显高于正常。结论 :CRP参与IHD的发病过程 ,其水平的高低与IHD的严重程度有关 ,急性心肌梗死时CRP动态演变具有判断病情发展趋势和预后的价值。     

骨髓移植患者外周血淋巴细胞亚群和免疫功能的动态变化

用免疫酶标（ＡＰＡＡＰ）法和淋巴细胞转化试验（ＬＴ）等方法对１５例骨髓移植（ＢＭＴ）患者的免疫功能变化进行动态观察。急性白血病化疗诱导缓解后即有ＣＤ＿４￣＋细胞，ＣＤ＿４／ＣＤ＿８比值和ＬＴ值异常。强化巩固治疗后上述异常进一步加重。ＢＭＴ后早期（９０天内）淋巴细胞亚群绝对值，血清ＩｇＧ、ＩｇＡ和ＩｇＭ水平以及ＬＴ值均低于正常，而激活淋巴细胞增加。ＢＭＴ后２年仍有ＣＤ＿４￣＋细胞、ＣＤ＿４／ＣＤ＿８比值和ＯＴ试验异常。ＢＭＴ的淋巴细胞亚群的百分比和绝对值的改变不是平行的，因此，应综合地评价两者的变化。     

颅脑创伤后血液表观粘度的变化

目的：观察颅脑创伤后血液粘度的变化。方法：以ＰＢⅠ—Ⅱ型损伤装置制成兔中度颅脑创伤,采集伤后１ｈ,６ｈ,２４ｈ的血样,用Ｌｏｗ Ｓｈｅａｒ３０测量表观粘度,同时测红细胞压积。比较创伤组和对照组的表观粘度、还原粘度、乘幂函数系数及计算的红细胞压积为４０％时的表观粘度。结果：乘幂函数描述血液表观粘度可有效地消除红细胞压积的影响。颅脑创伤后１ｈ其血液粘度即明显增加,伤后６ｈ持续增加,伤后２４ｈ较伤后６ｈ明显下降。与对照组相比,颅脑创伤后血液粘度的增加在低切下更为明显。结论：乘幂函数描述血液表观粘度是可行有效的方法,颅脑创伤后血液粘度的变化可能在继发性脑损伤中起一定作用,提示可用降低血液粘度的药物治疗颅脑创伤。     

急性心肌缺血期大鼠丘脑束旁核神经元μ1-阿片受体mRNA表达变化的研究

目的:观察急性心肌缺血期大鼠丘脑束旁核神经元μ1-阿片受体mRNA不同时间点表达的变化,以探讨μ1-阿片受体在丘脑束旁核痛觉整合和调制中的作用.方法:体重260～280g的健康成年雄性SD大鼠36只,随机分为两大组:对照组,即非冠状动脉扎闭(non-coronary artery occlusion、C组)组和扎闭冠脉(coronary artery occlusion,CAO组)组.每组又分为T1(CAO1h)、T2(CAO3h)、T3(CAO6h)三个时点.对照组仅在开胸后冠状动脉左前降支下穿线不予结扎;CAO各组则扎闭冠状动脉左前降支.在预定的时点处死动物,取含有大鼠丘脑束旁核的脑片行原位杂交.杂交结果检测采用IDA-2000数码显微图像分析系统进行半定量分析.结果:CAO后1h、3h、6h大鼠丘脑束旁核神经元μ1-阿片受体mRNA的表达均较对照组各时点明显增强(P＜0.05),对照组各时点表达无明显差异,而CAO组则随着缺血时间的延长表达有逐渐增加的趋势,在CAO后6h表达最强(P＜0.05).结论:急性心肌缺血可诱发大鼠丘脑束旁核神经元μ1-阿片受体mRNA表达增强,μ1-阿片受体参与急性心肌缺血伤害性刺激在丘脑束旁核的调制.     

CHANGES IN THE TITRE OF SERUM OPSONINS AND PHAGOCYTIC PROPERTIES OF MOUSE PERITONEAL MACROPHAGES FOLLOWING INJECTION OF ENDOTOXIN

A study has been made of the changes in the opsonic properties of mouse serum and bactericidal activity of mouse peritoneal macrophages at different times following the injection of various doses of lipopolysaccharide. It has been found that changes in the percentage of bacteria phagocytosed and killed within the mouse peritoneal cavity in a given time could be correlated with changes in the opsonic titre of the serum. Macrophages harvested from the peritoneal cavities of mice injected with endotoxin appear to be more efficient in phagocytosing bacteria in the presence of serum opsonins than macrophages obtained from normal mice. The relative importance of these changes in determining an animal's resistance to infection is discussed.     

EXPERIMENTAL DEHYDRATION: CHEMICAL CHANGES IN THE BLOOD OF THE DOG CONTRASTED WITH THOSE FOLLOWING OBSTRUCTION OF THE CARDIAC END OF THE STOMACH

A comparative chemical study of the blood and the urine of the dog with experimental dehydration and with obstruction of the cardiac end of the stomach is reported. The average duration of life is slightly longer with dehydration than with obstruction. The urine output per kilo of body weight is almost twice as great in dehydration as with obstruction. The increase in non-protein nitrogen and urea nitrogen is much the same in the two groups although somewhat more marked with obstruction. The chlorides of the blood are markedly increased with dehydration and slightly decreased with obstruction. The increase in fibrinogen and total protein is twice as great with obstruction as with dehydration. These findings indicate that there must be some factor or factors in addition to dehydration producing the toxemia of cardiac obstruction.     

科玛嘉念珠菌显色培养基的临床应用

科玛嘉（CHROMagar）念珠菌显色培养基是通过菌落的不同颜色和不同形态来进行快速鉴定的培养基。在CHR显色培养基上生长为翠绿色菌落为白色假丝酵母菌，蓝灰色菌落为热带念珠菌，紫红色边缘模糊有微毛为克柔念珠菌，整个菌落为紫红色为光滑球拟假丝酵母菌，白色至粉色为其他念珠菌。而沙保罗琼脂培养基只是念珠菌的初步分离培养基，菌落均为乳白色，不能鉴别念珠菌的类型。随着免疫抑制剂、激素、广谱抗生素、抗癌药物的广泛使用，器官移植、骨髓移植等技术应用增多，以及恶性肿瘤发病率的增多，念珠菌的感染率逐年呈上升趋势。临床分离的真菌主要以白色假丝酵菌为主（占42．3％）。自2004年9月～2005年12月，我院共分离506份临床标本，共检出229份真菌阳性标本，同时接种CHR显色培养基和VITEK32-YBC鉴定卡对比进行念珠菌分离培养，CHR显色培养基阳性报告169例，占总株数的73．8％；而VITEK32与CHROMagar直接鉴定法鉴定符合百分率为95．3％（见表1）。现报告如下。     

国产TiNi合金食管支架临床应用(附108例报告)

该文应用国产(TiNi)合金支架治疗食管良恶性狭窄108例,支架在内镜和X光透视定位下置入,均一次获得成功。为食管恶性狭窄的治疗提供了一种安全有效的方法,对良性狭窄的应用尚待进一步探讨。价格约为进口同类支架的1/10,适合国情,便于临床推广应用。