缺血性脑卒中超急性期动脉内灌注尿激酶速率的动物实验研究

目的：研究兔缺血性脑卒中超急性期动脉内灌注尿激酶进行溶栓治疗的最佳速率范围。材料与方法：３０只新西兰兔分成５组，均于颈内动脉内注入由全血加凝血酶制成的新鲜血栓混悬液０．２ｍｌ。在动物脑血栓模型建立１～２小时内进行颈内动脉尿激酶灌注溶栓，剂量为４万单位／公斤体重，浓度为８０００单位／亳升。５个实验组的注射速率为Ａ组：０．０１ｍｌ／ｓ；Ｂ组：０．０２ｍｌ／ｓ；Ｃ组：０．０４ｍｌ／ｓ；Ｄ组：０．１０ｍｌ／ｓ；Ｅ组：０．５０ｍｌ／ｓ。溶栓前后分别行血管造影，溶栓术后２４小时行病理检查。结果：５组溶通率分别为Ａ组：０．０％；Ｂ组：８３．３％；Ｃ组：１００．０％；Ｄ组：８３．３％；Ｅ组：０．０％。Ｂ、Ｃ、Ｄ组的溶通率与Ａ、Ｅ组相比有显著性差异（Ｐ＜０．０２５），Ｂ、Ｃ、Ｄ组之间的溶通率无显著性差异。结论：兔脑血栓形成超急性期动脉内灌注尿激酶进行溶栓治疗的有效速率范围为１６０～８００Ｕ／ｓ，以３２０Ｕ／ｓ左右的注射速率为最佳。     

家兔注射^125I—标记重组人表皮生长因子后的药代动力学

用Ｉｏｄｏｇｅｎ法制备１２５ＩｒｈＥＧＦ，ＳＤＳＰＡＧＥ鉴定放射纯度为（９７．１±０．４５）％。家兔静脉注射１２５ＩｒｈＥＧＦ后８ｈ内血浆总放射性保持在高水平，反相高压液相色谱（ＲＨＰＬＣ）测得１２５ＩｒｈＥＧＦ分量迅速下降，亲水性１２５Ｉ标记物分量增高。１２５ＩｒｈＥＧＦ浓度时间曲线符合二室开放模型，ｔ１／２α和ｔ１／２β分别为９ｍｉｎ和１１．６ｈ。组织浓度梯度为尿＞甲状腺＞肠内容＞肾＞血浆＞胆汁＞颌下腺＞肺。８ｈ内尿排泄（２０．３±５．１）％的注入放射性。     

小剂量溶栓结合PTA和支架治疗外周动脉慢性阻塞性病变

本文报告５例６支动脉阻塞经导管使用微量泵持续灌注尿激酶（５６，０００单位／小时）溶栓治疗，灌注时间５．５￣５８（平均２６）小时。阻塞位于髂外动脉２例，其中１例伴同侧股动脉阻塞；髂总和髂外动脉联合受累１例，Ｇｕｏ动脉１例；股Ｇｕｏ动脉１例。病程１￣２４（平均９．４）个月，阻塞长度８￣２５ｃｍ（平均１５．３ｃｍ），开通率达１００％。对溶栓后残存狭窄实施ＰＴＡ３例、血管内放置支架１例；随访２￣９（平均５     

超选择性动脉内灌注尿激酶治疗急性缺血性脑卒中

目的：评价动脉内灌注尿激酶（ＵＫ）治疗急性缺血性脑卒中的安全性和疗效。材料与方法：在ＤＳＡ机下生动脉内插管灌注ＵＫ治疗２３例急性脑卒中患者。平均发病时间１８．９小时,ＵＫ用量为３－９．５×１０＾５ＩＵ,灌注时间持续３０－６０分钟。结果：１０例患者即刻完全再通,其中１例术后１天重新闭塞。９例部分再通,３例未通。１３例脑血栓形成患者中８例完全再通,而９例脑梗塞患者仅２例完全再通,前者再通率高于后者。临     

~(99m)Tc-ECD SPECT断层影像采血法和非采血法定量测定rCBF和CBF的对照研究

目的：应用９９ｍＴｃＥＣＤＳＰＥＣＴ断层影像采血和非采血法定量测定ｒＣＢＦ和ＣＢＦ。材料和方法：正常对照组１５例,疾病组１０例。采血法用动脉化静脉血样求得血中９９ｍＴｃＥＣＤ的浓度;非采血法用头颈平面像求得血中９９ｍＴｃＥＣＤ浓度。结果：正常对照组采血法ｒＣＢＦ２５０±４０～５９１±７６ｍｌ．ｍｉｎ－１·（１００ｇ）－１,ＣＢＦ４３０±３６ｍｌ．ｍｉｎ－１·（１００ｇ）－１;非采血法ｒＣＢＦ２６１±３２～６０３±６８ｍｌ．ｍｉｎ－１·（１００ｇ）－１,ＣＢＦ４３５±４４ｍｌ．ｍｉｎ－１·（１００ｇ）－１。和其他方法测得的正常值很接近。疾病组两法测定的结果基本一致。结论：用９９ｍＴｃ－ＥＣＤＳＰＥＣＴ断层影像测定ｒＣＢＦ和ＣＢＦ是可行的,可作为评价脑血流灌注的定量指标。     

281例腹部火器伤的诊治

目的 研究战时腹部火器伤的诊治。方法 回顾分析我院１９７９～１９８９年收治的２８１例腹部火器伤。结果 早期诊断符合率９６．８％（２７２／２８１）,一线医院误诊率３．２％（９／２８１）。严重并发症有：胃肠瘘２３例（８．２％）,腹腔脓肿３４例（１２．１％）,切口感染３２例（１１．４％）,感染性休克２６例（９．３％）,弥漫性血管内凝血（ＤＩＣ）１４例（５．０％）,成人呼吸窘迫综合征（ＡＲＤＳ）８例（２．     

^99mTc—DTPA肾动态显像在小儿肾盂积水中的应用

目的探讨９９ｍＴｃＤＴＰＡ肾动态显像诊断小儿肾盂积水的临床价值。方法常规９９ｍＴｃＤＴＰＡ肾动态显像方法，１５分钟后静脉注射速尿，共检查肾盂积水患儿４５例，其中７例作手术前后比较。定量分析指标包括：肾血流灌注率（ＢＰＲ），高峰摄取率（ＰＵＲ），半排泄时间（Ｔ１／２）。结果①ＢＰＲ随积水程度加重而明显下降，重度积水为１６８％±６８％，中度积水为３５１％±６９％，轻度积水为４０６％±９２％。ＰＵＲ在重度积水时为２１６％±１２９％。②７例患儿中６例术后ＢＰＲ明显升高。术前、术后Ｔ１／２分别为４１３±２０４和２２９±１１９分钟。术后Ｔ１／２明显改善。结论①ＢＰＲ可正确反映肾盂积水和肾功能受损程度，两者呈正相关；②术后肾功能改善情况和速尿介入能正确判断集尿系统有无梗阻存在     

国产4环／7层PET仪初试

对我国１９９６年研制成功的４环／７层ＰＥＴ仪（轴向视野８ｃｍ）进行试用。先进行模型试验和动物实验，然后对１例正常志愿者和７例患者进行１８Ｆ脱氧葡萄糖（ＦＤＧ）ＰＥＴ显像。静脉注射１８ＦＦＤＧ３７０ＭＢｑ后约１５小时显像，成人全身显像行１１个床位采集，约１５小时，心脑局部显像行２～３个床位采集，约半小时。直径１～３ｃｍ的阴模和阳模皆可显示。８例全身冠状和矢状断层影像清晰，正常志愿者（正常进食）可见脑和心肌显影，膀胱内放射性较多。２例恶性肿瘤患者的６处病变浓聚１８ＦＦＤＧ。２例恶性肿瘤患者手术和化疗后无复发征，显像阴性。２例良性病变处未见１８ＦＦＤＧ浓集。１例陈旧性心肌梗塞患者１８ＦＦＤＧ心肌断层显像与９９ｍＴｃ甲氧基异丁基异腈心肌血流灌注显像匹配良好。正常心肌显影与否受葡萄糖负荷的影响。８例脑皮质横断影像良好，基底节和丘脑影像有时尚欠清晰。初试结果表明，该ＰＥＴ仪相当于至今尚在国外广泛使用的８０年代中期４环／７层ＰＥＴ仪水平，但具有９０年代ＰＥＴ仪全身整体冠状和矢状断层显像的功能，可用于全身肿瘤显像、心肌活性判断和功能性癫痫灶术前定位，但仪器操作性能和软件功能尚需进一步完善。     

99Tcm-MIBI心肌断层显像用于直接PTCA及静脉溶栓治疗AMI的对比研究

目的　比较直接经皮冠状动脉腔内成形术（ 直接ＰＴＣＡ） 和静脉溶栓疗法在急性心肌梗死（ＡＭＩ） 治疗中的效果。方法　１２４ 例ＡＭＩ患者（ 直接ＰＴＣＡ组６０ 例,溶栓组６４ 例） 均于发病２ 周时和１２ 周后行９９Ｔｃｍ甲氧基异丁基异腈（ＭＩＢＩ）心肌断层显像,将左室心肌分为２０ 个节段,并对心肌摄取９９ＴｃｍＭＩＢＩ的程度进行打分,分别计算发病２ 周时心肌显像的总积分（Ｓ２ＷＳ） 、发病后１２ 周心肌显像的总积分（Ｓ１２ＷＳ）和两者相减的积分（ＳＤＳ）。直接ＰＴＣＡ组和溶栓组分别有３８ 人和３５ 人于心肌显像后行平衡法门控心室显像。结果　直接ＰＴＣＡ 组与溶栓组比较：Ｓ２ＷＳ为１８－３±６－９ 和２８－６ ±７－３（ｔ＝７－３,Ｐ＜ ０－００１）,Ｓ１２ＷＳ为１１－２ ±４－２ 和２４－４ ±６－２（ｔ＝ １１－７,Ｐ＜ ０－００１）,ＳＤＳ为７－６ ±３－２ 和４－３ ±１－１（ｔ＝ ５－４,Ｐ＜ ０－００１）。直接ＰＴＣＡ组和溶栓组入院２ 周时的左室射血分数（ＬＶＥＦ） 分别为（４１－４ ±６－５） ％ 和（３９－５ ±７－２）％ （ｔ＝ １－５ ,Ｐ＞ ０－０５）,出院１２ 周后的ＬＶＥＦ 分别为（６２－６ ±７－８）％ 和（５１－４ ±     

缺血性脑卒中起急性期动脉内灌注尿激酶速率的动物实验研究

目的；研究兔缺生脑卒中超急性期动脉内水激酶进行溶栓治疗的最佳速度范围。材料与方法；３０只新西兰兔分成５组，均于颈内动脉注入由全血加凝血酶制成的新鲜血栓混液０．２ｍｌ。在动物脑血栓模型建立１－２小时内进行颈内动脉激酶灌注溶栓，剂量为４万单位／公斤体重，浓度为８０００单／毫升，５个实验组的注射速率为Ａ组；０．０１ｍｌ／ｓ；Ｂ组；０．０２ｍｌ／ｓ；Ｃ组；０．０４ｍｌ／ｓ；Ｄ组，０．１０ｍｌ／ｓ；Ｅ组；０     

Optimization of the system of medical service of students of Cadet Schools of the Ministry of Defense of the Russian Federation

One of the factors of the successful military career guidance Cadet schools students is preserving and promoting their health. Medical support of children and adolescents aged 10-17 years should include the full range of medical and preventive measures defined for this group. The state of providing outpatient care for pupils at the Cadet School in St. Petersburg was studied. These results show that full medical care in accordance with the standards can be based only on children's health clinics. It is important that the organization of medical support pupils cadet schools should be cooperate with civilian health care.     

带状疱疹83例误诊原因分析

带状疱疹是由水痘—带状疱疾病毒引起的皮肤科常见疾病。其主要的病理损害,一是受累神经的严重炎症性浸润,继而导致受侵犯神经节内神经细胞变性、坏死;二是皮肤的水泡。迅速抑制神经节和相应的感觉神经纤维的充血、水肿和坏死,防止粘连形成,达到迅速镇痛、改善皮损,缩短病程及防止后遗症的发生是治疗的关键。因而,尽早明确诊断,     

Estimation of accumulated dose of radiation by method of ESR-spectrometry of dental enamel of mammals

ESR-spectrometry was used to investigate radiation-induced paramagnetic centers in enamel of mammals: carnivores (polar bear and fox), ungulates (reindeer, European bison, moose), and man. Values at half the microwave power saturation of the radiation signal, P_1/2, evaluated at room temperature, was found to range from 16 to 26 mW for animals and man. A new approach to discrimination of the radiation induced signal from the total ESR spectrum of reindeer enamel is proposed. ‘Dose-response’ dependencies of enamel of different species mammals were measured within the dose range from 0.48 up to 10.08 Gy. Estimations of ‘radiosensitivity’ enamel of carnivores and ungulates showed good agreement with radiosensitivity enamel of man by ESR method.     

Analysis of the results of the international comparison of activity measurements of a solution of Fe

The results of an international comparison of activity measurements of a solution of ⁵⁵Fe organized by the BIPM in 2005 are reported and analysed. This exercise, which follows the procedures of the CIPM mutual recognition arrangement to update older comparisons, is a renewal of the comparison organized by the BIPM that took place in 1978. A EUROMET comparison was organized in 1996 specifically to compare activity measurements of a ⁵⁵Fe solution by means of liquid-scintillation techniques. Results of these three comparisons are presented and discussed in this paper.

The radionuclide solution was provided by the NPL, which also distributed the samples to the participants. The activity of the ampoules was measured by 16 laboratories using 12 methods producing 25 results. Some general considerations on uncertainty assessments pertaining to the different techniques used are drawn. The outcome of four different estimators is compared from which the presence of at least one outlier can be confirmed. Further measurements should be made to try to reduce the discrepancy between the results. To date the outcome of the present comparison does not show an improvement to that of the 1996 comparison.     

Evaluation of the results of various technics of non-surgical therapy of varicocele

A new method of non-surgical treatment of varicocele syndrome is described: it consists in sclerotherapy of spermatic vein by trans-femoral percutaneous catheterization with balloon-catheters. In 8 cases venous thrombosis has been induced by direct electric clotting. The techniques and a 6 months follow-up are discussed. It is pointed out that this procedure should be considered as the method of choice for tubular lesions and sub-fertility prophylaxis in young people and in childhood.     

延迟性脾破裂误漏诊原因分析

目的探讨延迟性脾破裂误漏诊原因和预防措施.方法回顾性分析总结12例延迟性脾破裂中的诊断和误漏诊的经验与教训.结果本组延迟性脾破裂的误漏诊5例(41.66%).对多发伤与脾破裂并存可能认识不足,外伤史轻微或伤员隐瞒外伤史,缺乏腹痛-缓解-突然再腹痛的典型病史,缺乏“对冲性脾破裂”力学分析和整体化诊断思路等为其误漏诊的主要原因.结论详细的外伤史和全面系统检查,重视腹以外多发伤掩盖腹内脏器伤及延迟性脾破裂可能.确立外伤-腹内脏器伤-脾破裂整体化诊断思路.不间断地辅以B超检查脾形态学变化和腹内有无积液,腹腔穿刺确定有无血腹、X线胸腹部检查观察左侧胸肋角和膈肌运动情况、必要时CT检查以尽早发现脾包膜下血肿,降低延迟性脾破裂误漏诊率.