宫内外同时妊娠一例

宫内宫外同时妊娠是极为罕见的一种异位妊娠,我院于１９９７年１０月收治１例,报告如下。唐某,女,３０岁,已婚,孕２产１。因停经４３ｄ,下腹痛４ｈ于１９９７年１０月２９日下午１时急症入院。患者平时月经规则,末次月经为１９９７年９月１６日,停经４０ｄ后开始...     

β-阻滞剂治疗心衰中血浆ET,NE,ANP的变化

３０ 例心衰患者用强心利尿扩血管药物治疗２ 周,病情稳定后随机平分为Ａ,Ｂ 两组。Ａ 组加用倍他乐克治疗,Ｂ 组维持原方案治疗８ 周;Ｃ 组为正常对照组１６ 例。发现：①Ａ,Ｂ 两组血浆ＥＴ,ＮＥ 及ＡＮＰ 水平高于Ｃ 组;②治疗后Ａ 组血浆ＥＴ,ＮＥ,ＡＮＰ 水平下降程度,心机能分级,ＣＩ及ＬＶＥＦ 改善程度明显高于Ｂ 组;③血浆ＥＴ 下降值与各项指标的变化密切相关。提示：β受体阻滞剂能降低血浆ＥＴ,ＮＥ 及ＡＮＰ 水平,改善心机能;血浆ＥＴ 变化程度可作为评价心机能改善的可靠指标。     

猪油酸型急性肺损伤模型

以猪油酸型急性肺损伤模型为实验对象,观察急性发病过程中心肺功能和肺实质的病理改变。结果表明：急性肺损伤对肺功能影响主要为肺静态顺应性、氧合指数、血氧分压和pH下降。气道峰压、吸气未平台压、气道阻力明显升高。分流量明显加大。血液动力学上表现为心输出量,氧运输下降,平均肺动脉压、肺血管阻力和全身血管阻力显著升高;右心房压、肺毛细血管模压和体循环动脉压基本不变;病理形态表现为典型的急性肺损伤。结果显示,本实验成功制成急性防损伤模型,并有显著的心肺功能不良改变。     

伤寒杆菌耐药质粒pR_(ST98)介导血清杀菌作用抗性的研究

将ｐ Ｒ Ｓ Ｔ９８ 导入不含质粒且对抗菌药物敏感的大肠杆菌、伤寒杆菌,并用十二烷基硫酸钠（ Ｓ Ｄ Ｓ） 消除耐药菌株的ｐ Ｒ Ｓ Ｔ９８ ,计算接合子及 Ｒ 质粒消除前后菌株在人、兔及豚鼠的不同浓度、不同成份血清中的存活率。ｐ Ｒ Ｓ Ｔ９８ 介导其宿主菌对血清杀菌的抗性,但在不同宿主菌中抵抗力不同;补体经典途径及旁路途径均参与血清杀菌过程。ｐ Ｒ Ｓ Ｔ９ ８ 具有多效性,其广泛的宿主性在介导细菌多重耐药的同时,还赋予细菌抵抗血清的杀菌作用,使病原菌致病性增强。     

基因重组碱性成纤维细胞生长因子对急性坏死性胰腺炎犬肠道细菌移位的影响

目的探讨基因重组碱性成纤维细胞生长因子（ｂＦＧＦ）对急性坏死性胰腺炎（ＡＮＰ）犬肠道细菌移位的影响。方法杂种犬２３只,分对照组（ｎ＝７）、ＡＮＰ组（ｎ＝８）和ｂＦＧＦ组（ｎ＝８）。ｂＦＧＦ组犬复制ＡＮＰ模型后,每日静脉注射ｂＦＧＦ（５μｇ／ｋｇ）。结果ｂＦＧＦ治疗后,ＡＮＰ犬肠粘膜损伤明显减轻,脏器细菌培养阳性率下降５０％,细菌移位数量减少９３．３％－９６．７％,肠粘膜蛋白质、ＤＮＡ含量显著增加（Ｐ＜０．０５）,丙二醛含量明显减少（Ｐ＜０．０５）。结论ｂＦＧＦ可显著减少ＡＮＰ时肠道细菌移位,其机制可能是通过增加肠粘膜蛋白质合成,促进肠粘膜损伤修复。     

Catatonic features: differential diagnosis and treatments at an emergency unit

During a 2-year period, 34 patients of catatonic features in Chinese ethnic background Taiwanese were brought to the emergency unit of Chang Gung Memorial Hospital at Linkou. The ratios of the causes of catatonic features by schizophrenic disorders, mood disorders, neuroleptic-induced disorders, and general medical conditions were 26, 9, 24 and 41%, respectively. After the treatments of antipsychotics, benzodiazepam, or electroconvulsive therapy (ECT), 24 patients (70.6%) showed complete remission, seven patients (20.6%) showed partial remission, and three patients (8.8%) showed no response (two died). Additionally, a suggestive period is proposed in order to distinguish acute and insidious onset catatonic conditions to help clinicians in deciding on probability immediately. The patients were grouped into four diagnostic categories; namely, schizophrenic disorders, mood disorders, neuroleptic-induced disorders, and general medical conditions for comparison. One-way ANOVA and Duncan's multiple-range test were used for continuous variables, and the Chi-squared test was used for categorical variables. The mean duration of 'insidious onset catatonic condition' (including schizophrenic disorders and general medical conditions) before seeking medical help was longer than 3.33 weeks, while the mean duration of 'acute catatonic condition' (including mood disorders and neuroleptic-induced disorders) was shorter than 1.83 weeks. These findings suggest that 2-3 weeks would be a cut-off point for acute or insidious onsets of catatonic conditions.     

Intestinal cytokine response after gut ischemia: role of gut barrier failure

OBJECTIVE: To investigate the effect of intestinal ischemia with and without a reperfusion injury on intestinal cytokine production and gut permeability. SUMMARY BACKGROUND DATA: In humans and in animal models, the gut has been implicated as a cytokine-producing organ after ischemia/reperfusion (I/R)-type injuries. Because of the limitations of in vivo models, it has been difficult to demonstrate directly that the gut releases cytokines after an I/R injury or whether there is a relation between the magnitude of the ischemic process and the cytokine response. METHODS: Ileal mucosal membranes from rats subjected to sham or 45 or 75 min of superior mesenteric occlusion (SMAO) or 45 minutes of SMAO and 30 minutes of reperfusion (SMAO 45/30) were mounted in the Ussing chamber system. Levels of tumor necrosis factor-alpha and interleukin-6 were serially measured in the mucosal and serosal reservoirs of the Ussing system, as was mucosal permeability as reflected by the passage of bacteria or phenol red across the ileal membrane. In a second group of experiments, Escherichia coli C25 was added to the mucosal reservoir to determine if the cytokine response would be increased. RESULTS: Mucosal and serosal levels of tumor necrosis factor-alpha were equally increased after SMAO, with the highest levels in the 75-minute SMAO group. The highest levels of interleukin-6 were found in rats subjected to 75 minutes of SMAO or SMAO 45/30; the serosal levels of interleukin-6 were four to sixfold higher than the mucosal levels. The addition of E. coli C25 resulted in a significant increase in the amount of interleukin-6 or tumor necrosis factor-alpha recovered from the mucosal reservoir. Increased ileal membrane permeability was observed only in rats subjected to 75 minutes of SMAO or SMAO 45/30. CONCLUSION: These results directly document that the levels of tumor necrosis factor-alpha and interleukin-6 released from the gut increase after an ischemic or I/R injury, such as SMAO, and that there is a relation between the magnitude of the gut ischemic or I/R insult and the cytokine response.     

Rhenium-188-Labeled DTPA: a new radiopharmaceutical for intravascular radiation therapy

Balloon angioplasty is a standard treatment for artherosclerotic coronary artery disease. However, its clinical value is reduced by a high restenosis rate. A new concept in preventing restenosis is the use of a liquid-filled balloon containing a beta-emitting radioisotope. In this study, we performed biodistribution studies of Re-188 perrhenate and Re-188 diethylenetriaminopentaacetate (DTPA) to assess the resulting organ dose values in the event of balloon rupture if these agents are used for the clinical inhibition of restenosis after percutaneous transluminal coronary angioplasty (PTCA). After injecting Re-188 preparations intravenously, rats were killed at 10 min, 30 min, 60 min, 2 h, and 6 h ( n =5 per group). Tissue concentrations were calculated and expressed as percent injected dose per gram or per milliliter (%ID/g or %ID/mL). In addition, urine excretion and thyroid gland uptake were evaluated in rats ( n=5 per group) with a gamma camera after administration of 37 MBq (1 mCi) of each agent. Our data showed that both agents were excreted primarily via urine. However, the excretion of Re-188 DTPA was much faster than that of Re-188 perrhenate via the urinary system. The biodistribution data revealed that radioactivity levels in the stomach and the thyroid gland were high in the perrhenate group but low in the Re-188 DTPA group. The concentration levels in other tissues including lung, liver, testis, muscle, and blood were low throughout this study for both agents. The thyroid radiation value in the Re-188 perrhenate group was 0.163 mGy/MBq, which was much higher than that of the Re-188 DTPA group (0.0167 mGy/MBq). The stomach radiation value was as high as 0.127 mGy/MBq for Re-188 perrhenate, compared with 0.013 mGy/MBq for Re-188 DTPA. In conclusion, in the event of balloon rupture, the release of Re-188 DTPA results in lower radiation doses than Re-188 perrhenate, especially to the thyroid gland and the stomach. Our data suggest that Re-188 DTPA is a useful radiopharmaceutical for endovascular irradiation.     

Changes in hemodynamics of the carotid and middle cerebral arteries before and after endoscopic sympathectomy in patients with palmar hyperhidrosis: preliminary results

OBJECT: The purpose of this study was to analyze the change in carotid and middle cerebral artery (MCA) hemodynamics before and after endoscopic upper thoracic sympathectomy in patients with palmar hyperhidrosis (PH). METHODS: Sixty-eight patients with PH (35 males and 33 females) for whom the average age was 24.5+/-10.7 years (+/- standard deviation) were recruited into this study. These patients all underwent routine upper T-2 sympathectomy to treat their PH. Ultrasonography studies of the carotid arteries (CAs) and MCA were obtained in each patient before and after T-2 sympathectomy. The blood flow volume, flow velocity, and resistivity index (RI) in the bilateral common CAs (CCAs), internal CAs (ICAs), and external CAs (ECAs) were evaluated using duplex ultrasonography. The systolic peak velocity, mean velocity, diastolic peak velocity, pulsatility index, and RI of the bilateral MCAs were evaluated using transcranial Doppler ultrasonography. Blood pressure and heart rate were also recorded during this study. The Student paired t-test was used to analyze the differences between studies before and after bilateral T-2 sympathectomy. There was a significant reduction in diastolic pressure after T-2 sympathectomy (p = 0.003), but not in systolic pressure or heart rate. The vessel diameter was increased after sympathectomy in the left CAs and right CCA. The T-2 sympathectomy led to significant elevation of blood flow volume and RI in the left CCA, ICA, and ECA (p < 0.05). The authors found significant increases in maximum flow velocity and RI in the left MCA (p < 0.05). CONCLUSIONS: Patients who underwent T-2 sympathectomy demonstrated a significant increase in blood flow volume and flow velocities of the CAs and MCA, especially on the left side. Asymmetry of sympathetic influence on the hemodynamics of the CAs and MCA was noted. The usefulness of sympathectomy for the treatment of ischemic cardiovascular and cerebrovascular disease deserves further investigation.