An etiological study on fulminant viral hepatitis]

Viral markers were studied in 79 cases of viral hepatitis with hepatic failure. The results were shown as follows: 8 cases were positive for anti-HAV IgM (10.12%); 76 cases positive for HBsAg or anti-HBc IgM (96.20%) and 41 cases positive for anti-HCV antibodies (51.89%). Among those with anti-HCV positive, 35 cases were co-infected with HBV, 5 cases with HAV and/or HCV, only one was infected with HCV alone 2 cases were HD-Ag positive (2.52%) and one not identified (1.27%). With the reference of clinical findings, patients co-infected with HBV/HCV or anti-HBc IgM positive were more critical and usually entail higher mortality. In cases with HCV co-infections, the positive HBV replication markers seems to be reduced. Hepatic failure without HBV replicative markers had a high rate of hepatic coma as well as poor outcome.     

钙拮抗药及烧伤血浆对大鼠PBMC内NF-κB活化和炎症介质产生的影响

目的 :探讨外周血单个核细胞 (PBMC)内上游信号分子及核因子 κB(NF κB)在烧伤后炎症级联反应中的作用。　方法 :体外检测在烧伤血浆作用下的PBMC内游离Ca2 及NF κB活化的变化 ,观察钙通道阻断药对NF κB活化及IL 6、NO表达水平的调控作用。　结果 :不同时相点的烧伤血浆可使体外PBMC内Ca2 明显增加 ,培养的PBMC核内NF κB的积聚明显增加 ,培养上清中NO和IL 6高表达。应用尼莫通 (Nimodipine)和丹曲林 (Dantrium)对NF κB的活化有调节作用 ,对IL 6和NO亦有下调作用。　结论 :烧伤血浆可使PBMC内信号分子浓度明显增高 ,NF κB过度活化 ,并易位进入细胞核内 ,NF κB介导的促炎性细胞因子和NO过度表达。两种钙通道阻断药有调控细胞内信号转导的作用 ,对烧伤后全身炎症反应综合征 (SIRS)可能有防治作用     

PTCA及支架植入术治疗心肌梗死并重症泵功能衰竭近期效果观察

OBJECTIVE: To evaluate the short-term therapeutic effect of percutaneous transluminal coronary angioplasty (PTCA) with stent implantation in the treatment of myocardial infarction with severe pump failure. METHODS: The clinical data of 73 patients receiving PTCA and stent implantation for myocardial infarction with severity pump failure were analyzed and grouped according the occurrence of complications, degree of the vascular lesions and the complexity of the surgical procedures. Preoperative and postoperative ventricular ejection fractions (LVEF) were compared in each case. RESULTS: The degree of vascular lesions and surgical complexity were not shown to relate to the occurrence of the complications. Except in cases complicated by chronic renal dysfunction, significant improvement was achieved in the patients 7 d after the operation (P<0.05), regardless of different degrees of vascular lesions and surgical complexity. CONCLUSION: PTCA with stent implantation is effective to improve the short-term cardiac function of patients with myocardial infarction and severe pump failure.     

浅谈基因治疗的现状及其面临的困境

基因治疗将在未来的疾病治疗中扮演重要的角色，然而这一新颖的技术却面临着诸多问题，本文论述了基因治疗的发展现状及其所面临的技术难题。     

医院档案综合管理的意义及对策

对我国医院目前档案管理的现状,档案信息资源在医院现代化建设中的作用以及实行医院档案综合管理的重要意义及对策进行了全面系统地分析,强调了实现医院档案规范化、科学化和现代化管理的重要性和紧迫性。     

PRENATAL DIAGNOSIS Ⅰ. EARLY DIAGNOSIS OF OPEN NEURAL TUBE DEFECTS BY QUALITATIVE ACETYLCHOLINESTERASE ISOENZYME IN AMNIOTIC FLUID

The measurement of amniotic fluid (AF) acetylcholinesterase isoenzyme (AChEI) is a relatively new method for early diagnosis of open neural tube defects (NTDs). As quantitative methods are of unproven reliability at present, the authors used a high resolving power qualitative method-vertical slab polyaerylamide gel electrophoresis. The benefits of this technique are: simplicity of operation, accuracy, unsophisticated equipment, and easily available reagents. Combined results of 9 NTDs studies revealed that samples from early pregnancy gave more accurate results than those from late pregnancy.     

关于癌症患者"坚强"的概念分析

全文以Walker和Avant概念分析格式介绍坚强（hardiness）的定义和特征,说明案例,分析前置因子和后果,列举坚强的评估方法和在不同人群中的运用.希望通过对坚强的全面分析加深医务人员对此概念的理解,从而有助于激发患者的坚强特质.     

我们对发生在急诊科的死亡病例了解多少？

目的：通过尸体解剖检查结果来观测临床死亡诊断与实际死凶之间的差异，本研究中的死亡病例均发生在急诊科并向苏格兰地方检查院上报，随后进行尸检。方法：这是在格拉斯哥某医院急诊科进行的一个为期1年的前瞻性研究，所有入选病例系来院前死亡和在急诊科死亡的患者。由有经验的急诊科医师在场判断死亡原因，然后与尸枪结果确定的真正死因进行对照，比较两者之间的差异。     

Epidural hematoma following use of a three-point skull clamp.

We report an unusual case of epidural hematoma secondary to the use of a three-point skull-fixation device. Initially, a posterior-fossa brain tumor with hydrocephalus was diagnosed in a 15-year-old boy. Midline suboccipital craniectomy was performed with the patient placed in the prone position. A Mayfield (Ohio Medical Instrument Co., Cincinnati, OH, USA) skull clamp was used for fixation of the head during the surgical procedure, following which, a huge epidural hematoma developed within 6 hours of surgery, due to skull penetration and fracture at one of the clamp's pin sites located proximate to the coronal suture.     

NADPH-Diaphorase-Positive Neurons in Primate Cerebral Cortex Colocalize with GABA and Calcium-Binding Proteins

Neurons in the monkey cerebral cortex containing nicotinamideadenine dinucleotide phosphate-diaphorase (NADPH-d) can he dividedinto two distinct types, both nonpyramidal. Type I neurons havea large soma (diameter 20–50 µm), a dense NADPH-dhistochemical reaction. and are distributed throughout the cortex,but mainly in the subcortical white matter, and are mostly aspiny.Type II cells have a small soma (< 20 µm) with lightNADPH-d reactivity and are distributed primarily in the supragranularlayers, particularly layers II and upper III. The numericaldensity of type II cells is much greater than that of type I.Type I neurons also stain for GABA and a few intracortical typeI cells contain calbindin. All type II cells found here arecolocalized with both GABA and calbindin. Neither type I nortype II cells are stained for parvalbumin. Together with previous observations that almost all corticalNADPH-d cells in various subprimates are like type I cells,we suggest that type II cells may form a group of NADPH-d-richneurons differentiated in higher mammalian cortex from a subpopulationof calbindin-containing GABAergic interneurons, and these nitricoxide-synthesizing cells may play a role in control of intracorticalneuronal activity characteristic of higher cerebral functionsin advanced mammals.