慢性肾衰竭患者甲状旁腺素变化的临床分析

目的：寻找降低CRF患血清TPH的有效途径，评价不同PTH水平患的营养状况，方法：应用放射免疫法测定CRF患HD，CAPD，肾移植皇血清TPH值，测定营养生化指以及用人体测量法来评价不同PTH水平患的营养状况。结果：肾移植后患较HD，CAPD患血清PTH值下降明显；务清PTH值处于65－200pg/ml的患营养指数高。结论：肾移植是清除PTH的有效治疗手段，患的血清PTH水平与营养指数密切相关。     

慢性肾衰继发甲状旁腺功能亢进的发病机制研究进展

继发性甲状旁腺功能亢进是慢性肾衰常见的严重并发症。其发病机制已引起人们极大的关注，尤其是慢性肾衰时１，２５（ＯＨ）２Ｄ３受体和钙受体异常，以及甲状旁腺腺体基因突变等对继发性甲旁亢产生的意义已引起重视。本文就此作一简要综述     

甲状旁腺素,血小板胸浆游离钙在尿毒症患者血压调节中的作用

目的 了解血透患者甲状旁腺素［ＰＴＨ（１－８４）］和血小板胞内游离钙浓度｛ｐｔ［Ｃａ＾２＋］ｉ｝在血压调节中的作用。方法 用Ｆｕｒａ－２荧光测定法和免疫放射法对２４例血透患者测定上述两面内容。结果 ＨＤ患者的静鼻ｐｔ［Ｃａ＾２＋］ｉ与ＴＰＨ（１－８４）相关。多因素逐步回归显示ＰＴＨ（１－８４）、ｐｔ［Ｃａ＾２＋］ｉ为影响ＨＤ影响平均动脉压的主要因素。结论 ＰＴＨ（１－８４）、ｐｔ［Ｃａ＾２＋］ｉ可     

血液透析患者细胞免疫功能紊乱与血浆甲状旁腺素水平的关系

目的：探讨慢性肾衰（ＣＲＦ）维持血透患者特异性细胞免疫功能状态及其与血浆甲状旁腺素（ＰＴＨ）水平的关系。方法：将３０例慢性肾衰血透患者分为两组：血浆ＰＴＨ正常组及血浆ＰＴＨ增高组。采用流式细胞分析技术检测两组患者末梢血Ｔ淋巴细胞亚群数量（ＣＤ３,ＣＤ４,ＣＤ８,ＣＤ４／ＣＤ０及表达白介素－２受体（ＩＬ－２Ｒ,ＣＤ２５）的Ｔ淋巴细胞数量。结果：两组患者ＣＤ３,ＣＤ４,ＣＤ４／ＣＤ８均较对照组下降,且     

异搏定对摘除甲状旁腺肾衰大鼠细胞免疫功能的影响

异搏定对摘除甲状旁腺肾衰大鼠细胞免疫功能的影响方文军左静南侯积寿刘秀英宋小君慢性肾功能衰竭（ＣＲＦ）患者常有细胞免疫缺陷和继发性甲旁亢，近年来，许多研究表明甲状旁腺素（ＰＴＨ）可引起Ｔ细胞功能改变。我们旨在观察预先切除甲状旁腺维持血钙正常下及异搏定治...     

甲状旁腺素、血小板胞浆游离钙在尿毒症患者血压调节中的作用

目的 了解血透患者甲状旁腺素[PTH(1～84)]和血小板胞内游离钙浓度{pt[Ca~(2 )]i}在血压调节中的作用。方法 用Fura-2荧光测定法和免疫放射法对24例血透患者测定上述两项内容。结果 HD患者的静息pt[Ca~(2 )]i和PTH(1～84)是升高的,高血压者升高更为明显。静息pt[Ca~(2 )]i与PTH(1～84)相关。多因素逐步回归显示PTH(1～84)、pt[Ca~(2 )]i为影响HD患者平均动脉压的主要因素。结论 PTH(1～84)、pt[Ca~(2 )]i可能是主要影响尿毒症患者血压的因素。     

尿毒症贫血与红细胞生成素及有关影响因素的研究

应用胎鼠肝细胞体外培养红系集落方法测定血清红细胞生成素（ＥＰＯ），８０例尿毒症患者略高于正常对照组，但显著低于再生障碍性贫血患者。凝胶过滤所得尿毒症中分子物质（ＭＭＳ）显著抑制小鼠骨髓红系集落形成单位的体内生长和正常人红细胞膜钙泵活性。尿毒症患者红细胞膜钙泵活性显著降低，红细胞内钙显著增多，透析能部分纠正上述异常。血浆甲状旁腺激素（ＰＴＨ）明显升高患者贫血较重，对重组人ＥＰＯ反应较差。表明除ＥＰＯ     

EFFECTS OF CHRONIC EXPOSURE TO NITROUS OXIDE ON METHIONINE SYNTHASE ACTIVITY

Hepatic methionine synthase activity has been determined inrats continuously exposed (24h day^–1 and 7 day week^–1)to concentrations of nitrous oxide ranging from 500 to 50000p.p.m. for periods ranging from 24 h to 28 days. The inactivationof this enzyme was dependent upon both time and concentrationof nitrous oxide exposure, but there was no statistical evidencethat exposure continuing beyond 48 h increased the effect. However,the dose-response curve for 24 h was significantly differentfrom the curve for pooled data from exposures lasting 2–28days. These latter data indicated no significant effect with450 p.p.m. and an ED 50 of 5400 p.p.m. Significant inhibitionwas detected at 1000 p. p.m. These results suggest that thelimit of exposure of 25 p.p.m. recommended by the American NationalInstitute of Occupational Safety & Health may be undulyrestrictive.     

甲状旁腺激素和甲状旁腺激素相关蛋白在正常及骨性关节炎软骨中作用机制的研究进展

目的综述在正常和骨性关节炎(osteoarthritis,OA)的关节软骨及软骨下骨中,甲状旁腺激素(parathyroid hormone,PTH)和甲状旁腺激素相关蛋白(parathyroid hormone-related protein,PTHrP)的作用机制研究进展。方法广泛查阅近年来有关PTH和PTHrP对正常和OA关节软骨作用机制的文献,并进行总结与分析。结果 PTH和PTHrP可抑制OA软骨细胞的肥大分化及凋亡,促进其增殖,从而对OA软骨细胞起到保护作用;OA软骨下骨成骨细胞对PTH的反应下降。结论 PTH、PTHrP可能通过多种信号通路参与软骨降解和软骨下骨重塑,并对OA进展起到延缓和保护作用。     

ACUTE AND CHRONIC EFFECTS OF INTRATHECAL MORPHINE IN MONKEYS

In a double-blind study, seven Macaca fascicularis monkeys receivingintrathecal (i.t.) morphine in saline, 0.07 mgkg^–1, werecompared with a control group of four monkeys receiving eitherlumbar puncture alone (n = 1) or i.t. saline (n = 3). Neithermorphine nor saline solutions contained preservatives. Arterialblood gas tensions, respiration, arterial pressure, e.c.g.,state of consciousness and motor function were recorded for24 h. The control group was sacrificed 42 days later and thestudy group was sacrificed at 6 (n = 2) or 42 days (n = 5) afterinjection. The central nervous system, meninges, nerve rootsand dorsal root ganglia were examined macroscopically and microscopically.Respiratory depression did not occur in either the control orthe study groups. There were moderate but statistically significantdecreases in systolic and diastolic arterial pressures followingi.t. morphine. In both groups, the pathological findings werelocalized to the cauda equina region and characterized by mononuclearcell infiltration. In neither group was there evidence of demyelination,arachnoiditis or necrosis. Focal endoneurial fibrosis was foundin only one animal in the control group following multiple lumbarpunctures associated with paraesthesia. The features appearedto correlate with the physical trauma associated with lumbarpuncture rather than with the injectate.     

安信医用抗菌贴加速慢性难愈合创面愈合

目的 观察安信医用抗菌贴对慢性难愈合创面（溃疡）的促修复作用并探讨其修复机制。方法 34例共44个慢性难愈合创面,其中创伤性溃疡15例（23个创面）,压迫性溃疡9例（11个创面）,糖尿病溃疡5例,放射性溃疡5例。所有创面经清创后用安信医用抗菌贴外敷于创面,每2－3天更换一次。结果 所有经安信医用抗菌贴治疗的创面都明显愈合,其中2周内愈合26个创面,3周内愈合7个创面,4周内愈合9个创面,超过4周愈合2个创面。4周内总愈合率炎95．5％。结论 安信医用抗菌贴可以显著地加速慢性难愈合创面的愈合,其机制为广谱速效杀菌,改善局部微循环,有效激活并促进组织细胞生长。     

EFFECTS OF ALFENTANIL ON THE PRESSOR AND CATECHOLAMINE RESPONSES TO TRACHEAL INTUBATION

The effects of alfentanil (given during induction of anaesthesia)on the haemodynamic and catecholamine responses to trachealintubation were studied in 44 adult patients who received alfentanil10 µg kg^–1 or 40 µg kg^–1, or salineplacebo. Alfentanil 10 µg kg^–1 and 40 fig kg^–1prevented any increase in heart rate and arterial pressure aftertracheal intubation. Alfentanil 40 µg kg^–1 producedprofound hypotension and bradycardia. The use of alfentanilin both doses was associated with a decrease in plasma adrenalineconcentrations after tracheal intubation.     

碱性成纤维细胞生长因子加速慢性难愈合创面愈合

目的　观察碱性成纤维细胞生长因子（ｂ Ｆ Ｇ Ｆ）对慢性难愈合创面（溃疡）的促修复作用并探讨其促修复机制。方法　２８ 例共３３ 个慢性难愈合创面,其中创伤性溃疡１２ 例（１４ 个创面）,压迫性溃疡 ９ 例（１２ 个创面）,糖尿病溃疡 ４ 例,放射性溃疡 ３ 例。所有创面经清创后用ｂ Ｆ Ｇ Ｆ 治疗（１５０ Ｕ／ｃｍ ２ 创面,每天１ 次）。结果　所有经ｂ Ｆ Ｇ Ｆ治疗的创面都产生了明显的愈合,其中２ 周内愈合者２０ 个创面,３ 周内愈合者 ３ 个创面,４ 周内愈合者８ 个创面,超过４ 周愈合者２个创面。４ 周内总愈合率为９３．９％ 。结论　ｂ Ｆ Ｇ Ｆ可以显著地加速慢性难愈合创面愈合,其可能的机制涉及外源性ｂ Ｆ Ｇ Ｆ能够补充内源性ｂ Ｆ Ｇ Ｆ 的不足或调控内源性ｂ Ｆ Ｇ Ｆ活性。     

EFFECTS OF TRANSCUTANEOUS NERVE STIMULATION ON THE MICROCIRCULATION IN CHRONIC LEG ULCERS

The purpose of this study was to find out to what extent transcutaneous electrical nerve stimulation (TENS) affects the blood flow in and around chronic lower leg ulcers, as measured with a new technique, laser Doppler imaging (LDI). Fifteen patients, mean age 73 years (range 38-85) with chronic leg ulcers of various causes participated in the study. The duration of the ulcers ranged from 3 months to 16 years. Low-frequency (2 Hz; 10-45 mA) TENS was given for 60 minutes. The changes in blood flow were measured every 5 minutes by LDI. After 60 minutes, mean blood flow had increased in the ulcer by 35%, and in the intact skin surrounding the ulcer by 15%. Even 15 minutes after the TENS had finished there was still a mean blood flow increase of 29% in the ulcer and 9% in the skin. The present results show that TENS has a stimulating effect on local blood circulation in and around chronic ulcers.     

EFFECTS OF TWO DIFFERING HALOTHANE CONCENTRATIONS ON THE METABOLIC AND ENDOCRINE RESPONSES TO SURGERY

The effects of two differing concentrations of halothane, 2.1MAC or 1.2 MAC, on the metabolic and endocrine responses toabdominal hysterectomy were investigated. The changes in bloodglucose and lactate values, and plasma glycerol, cortisol, insulinand catecholamine concentrations were similar in both groups.We conclude that high concentrations of halothane do not suppressthe responses to pelvic surgery, and that accurate quantificationof the dose of halothane, within the concentration range of1.2 to 2.1 MAC, is not essential in studies of metabolic changesassociated with surgery.     

EFFECTS OF EXTRADURAL ANALGESIA AND VAGAL BLOCKADE ON THE METABOLIC AND ENDOCRINE RESPONSE TO UPPER ABDOMINAL SURGERY

The effect of thoracic extradural analgesia and vagal blockadeon the metabolic t -1 endocrine responses to cholecystectomywas investigated. In comparison with a control grjf patients,extradural analgesia and vagal blockade abolished the glycaemicresponse to surgr jut had no effect on the increase in plasmacortisol. Circulating insulin values were significantly decreasedm the extradural group of patients, confirming the importanceof autonomic innervatir in maintaining basal insulin output.There is, at present, no satisfactory local analgesic techniquefor controlling the endocrine response to upper abdominal surgery.