脑脊液置换术治疗蛛网膜下出血160例疗效观察

目的 观察脑脊液置换术治疗蛛网膜下腔出血(以下简称SAH)的疗效.方法 诊断成立后即行脑脊液置换术隔日1次,共置换3～5次,每次腰穿放出血性脑脊液5～10ml,以等量生理盐水进行缓慢置换,间隔5min再放出血性脑脊液5～10ml,以等量生理盐水进行置换,再间隔5min放出血性脑脊液5～10ml,以等量生理盐水进行置换,加地塞米松5mg鞘内注射.结果 160例经置换脑脊液后头痛能迅速缓解,平均为4.6d,而对照组150例头痛缓解时间平均为13.2d,P>0.05.脑血管痉挛致脑梗死的发生,置换组0例,而对照20例,置换组无脑积水的病例发生,而对照组发生脑积水25例.结论 应用脑脊液置换术治疗SAH是一种缓解头痛,减少脑血管痉挛、梗阻性脑积水的有效方法.     

人工肝支持系统治疗重症肝炎32例临床分析

目的　探讨人工肝血浆置换法治疗重症肝炎的疗效及影响疗效的因素。方法　 3 2例重症肝炎患者在内科治疗基础上给予血浆置换治疗 5 2例次 ,血浆置换量平均 3 0 0 0ml。结果　 3 2例重症肝炎患者经血浆置换后 ,临床症状都得到一定程度的改善 ,肝功能明显好转。总有效率为 62 .5 % ,其中早期为 87.5 % ,中期为 70 .5 9% ;与对照组相比 ,总胆红素由治疗前 3 77.1mmol/L降至 197.6mmol/L (P <0 .0 1)。结论　血浆置换对重症肝炎中、早期治疗效果较好     

脑脊液置换术治疗蛛网膜下腔出血25例体会

目的研究脑脊液置换术治疗蛛网膜下腔出血的临床疗效,探讨最佳方法。方法对我院收治的25例蛛网膜下腔出血(SAH)的病例行脑脊液置换术治疗,每次放脑脊液10ml,再注入等量的0.9%氯化钠溶液,反复进行3～5次,一次置换脑脊液30～50ml,并观察临床疗效。结果3次置换内头痛完全消失22例(88%),2例死于再出血,1例死于脑血管痉挛,但其头痛程度均有明显的减轻。结论腰穿脑脊液置换术是一种相对安全且效果较好的治疗方法,能够很好且及时地防治蛛网膜下腔出血并发症,如脑血管痉挛、再出血,也可以有效防止阻塞性脑积水、化学性脑膜炎、下丘脑功能紊乱等病理过程的发生。     

功能性消化不良的临床治疗探讨

目的　探讨功能性消化不良的联合药物治疗方法。方法　将确诊的FD患者随机分为治疗组及对照组 ,对照组给予多潘立酮 10mg ,3 d ;治疗组在上组基础上再加用氟西汀 2 0mg ,1次 d。结果　 1 两组总有效率的比较 :对照组总有效2 2例 (治愈 10例 ,良好 7例 ,改善 5例 ) ,无效 7例 ,总有效率为 75 9% ,治疗组总有效 2 7例 (治愈 19例 ,良好 6例 ,改善 2例 ) ,无效 2例 ,总有效率为93 1%。治疗组明显高于对照组 (P <0 0 1)。 2 不良反应 :治疗组口干 3例 ,头昏 1例。对照组大便次数增多 2例 ,口干 1例。所有病例继续用药后不良反应均消失。结…     

中药浴治疗慢性肾功能衰竭

目的 :探讨中药浴治疗慢性肾功能衰竭的疗效及其机理。方法 :治疗组 3 2例采用中药肾浴汤治疗 ,对照组 3 0例采用水浴治疗进行对比观察。结果 :治疗组显效 15例 ,有效 13例 ,无效 4例 ,总有效率87.5 0 % ;对照组显效 5例 ,有效 15例 ,无效 10例 ,总有效率 66.67%。经统计学处理两组间差异显著 (P <0 .0 5 )。两组患者经治疗后 ,肾功能、尿蛋白、血红蛋白、血浆白蛋白及血液流变学指标均有显著改善。治疗组在改善肾功能、升高血红蛋白及血浆白蛋白 ,降低血浆纤维蛋白原等方面明显优于对照组。结论 :中药浴治疗慢性肾功能衰竭具有内服药物及其他疗法不可比拟的优越性 ,具有广阔的前景。     

蛛网膜下腔出血性脑血管痉挛的早期防治

脑血管痉挛(CVS)是SAH后最主要的并发症,是十分复杂和难治的,本文应用钙通道阻断剂尼莫通治疗SAH后的脑血管痉挛,取得良好疗效,报告如下。 一、资料与方法 1.临床资料:自发性蛛网膜下腔出血病人58例(GCS 7-15分),经头颅CT扫描(部分为脑池积血)和腰椎穿刺(均为血性脑脊液)确诊,男性36例,女性22例,年龄28～67岁,平均43.8岁。     

血管紧张素Ⅱ1型受体拮抗剂与醛固酮受体拮抗剂对逆转高血压伴左室扩大患者心肌重塑的作用

目的 :探讨缬沙坦和螺内酯对高血压伴左室扩大患者心肌重塑的影响。方法 :治疗组 6 8例 ,口服缬沙坦 80～ 16 0mg/日 ,螺内酯 2 0～ 4 0mg/日 ,地高辛( 0 .2 5mg/片 ) 0 .12 5～ 0 .2 5mg/日 ,阿斯匹林 10 0mg/日。对照组 58例 ,将缬沙坦和螺内酯改为尼群地平 10～ 2 0mg(一日三次 )和双氢克尿塞 2 5mg/日或速尿 (Lasix) 2 0mg/日外 ,余药同治疗组。治疗 6个月后采用超声技术进行对比观察。结果 :治疗组反映左室形态 ,收缩功能 ,舒张功能的指标有明显改善 (P<0 .0 5～ 0 .0 1) ;上述指标对照组改善不明显。治疗组心功能改善总有效率为95.6 % ,对照组总有效率为 4 1.4 %。结论 :缬沙坦和螺内酯在强心利尿基础上可逆转扩大的左心室 ,改善左室收缩及舒张功能。     

慢性盆腔炎68例临床诊治研究

目的 分析中西医结合法治疗慢性盆腔炎的临床疗效.方法 将68例慢性盆腔炎患者随机分为治疗组(36例)、对照组(32例)进行疗效分析.对照组给予需氧菌及抗厌氧菌广谱抗生素静滴西药疗法,七天为一疗程;在西医治疗基础上加用中药口服药,1天1剂,水煎2次分服,7天为1个疗程,经期停用.结果 治疗组36例,治愈20例,总有效率97.3%.对照组32例,治愈8例,总有效率81.2%.两组痊愈率和总有效率比较差异有统计学意义(P<0.05),对照组治疗前后积分差异明显,具有统计学意义(P相似文献   

沐舒坦治疗新生儿肺炎146例疗效观察

目的 探讨沐舒坦治疗新生儿肺炎的疗效.方法 治疗组在常规治疗的基础上加用沐舒坦注射液7.5㎎静滴,2次/d,连用5～7d,对照组只给常规治疗.结果 治疗组显效56例(38.4%),有效89例(61.0%),无效1例(0.7%),总有效率99.3%.对照组显效23例(15.8%),有效82例(56.2%),无效41例(28.1%),总有效率71.9%.结论 沐舒坦治疗新生儿肺炎疗效显著,值得推广.     

松龄血脉康对高血压病患者血液流变性及甲襞微循环的影响

目的 :观察中药松龄血脉康对高血压患者血液流变性及甲皱微循环的影响。方法 :选择Ⅰ、Ⅱ期高血压病例 80例 ,治疗组 (松龄血脉康组 ) 45例 ,对照组 (得高宁组 ) 3 5例 ,观察治疗前后主要临床症状、血压、血液流变性及甲皱微循环的改变。结果 :治疗一疗程 ( 3 0天 )后 ,主要临床症状 ,治疗组总有效率为 86.7% ,对照组总有效率为 65.1% ,统计学处理有显著性差异 (P <0 .0 5) ,而血液流变学主要指标(全血粘度 ,血浆粘度 ,红细胞压积及红细胞聚集指数和变形指数 ) ,治疗组较对照组有明显改善 (P <0 .0 5～ 0 .0 1)。结论 :中药松龄血脉康治疗高血压病 (Ⅰ、Ⅱ期 ) ,疗效确切 ,能有效改善主要临床症状 ,降低血液粘度 ,改善微循环     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

What will studies of Fulani individuals naturally exposed to malaria teach us about protective immunity to malaria?

There are an estimated over 200 million yearly cases of malaria worldwide. Despite concerted international effort to combat the disease, it still causes approximately half a million deaths every year, the majority of which are young children with Plasmodium falciparum infection in sub-Saharan Africa. Successes are largely attributed to malaria prevention strategies, such as insecticide-treated mosquito nets and indoor spraying, as well as improved access to existing treatments. One important hurdle to new approaches for the treatment and prevention of malaria is our limited understanding of the biology of Plasmodium infection and its complex interaction with the immune system of its human host. Therefore, the elimination of malaria in Africa not only relies on existing tools to reduce malaria burden, but also requires fundamental research to develop innovative approaches. Here, we summarize our discoveries from investigations of ethnic groups of West Africa who have different susceptibility to malaria.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.     

The universal muscular chamber. A basic unit of the genitourinary, cardiovascular, gastro-intestinal, skeletal, cutaneous, respiratory and other systems, endocameral hypertension; and spasm, the key to their idiopathic diseases and arthropathies

Starting with the integument, we see many organs are contractile sacs or multiples thereof, which tubes or bags constitute the major part of the entire body. Recognition of this basic unit and its characteristics sheds new light, individually and collectively, on many disorders previously considered unrelated. Muscular tears and perforations develop in the walls of these chambers, being no way peculiar to those organs, wherein, hydrochloric acid occurs. So, it is not necessary to explain the absence of excessive acid from patients who exhibit holes in the gastric, uterine, aortic, duodenal, rectal, pulmonary, retina, and other walls. Muscle, not acid is the great common factor relating idiopathic disorders in the gastrointestinal tract to each other and to similar diseases in other systems. When the units are linked together, the lesions tend to appear as arthropathies, i.e. at the joints. Rephrasing common-place observations, frees us from conventional, conceptual cul-de-sacs. An observation is only as good as its interpretation, so all possibilities must be considered, otherwise, we will remain blinded by our misconceptions.