56例踝关节骨折的内固定治疗分析

目的总结踝关节骨折手术治疗方法及临床疗效。方法对自2004年1月～2004年12月踝关节骨折56例手术进行性回顾分析。结果56例获6～18个月随访，骨折愈合时间12～18周，疗效评定依据Baird-Jackson评分标准：本组优37例，良13例，可5例，差1例，优良率89.3％。结论合理的手术时机和内固定治疗踝关节骨折可取得满意的疗效。     

不同病理类型原发性甲状旁腺功能亢进症临床表现的比较分析

目的 分析不同病理类型甲状旁腺功能亢进（PHPT）的临床表现特点。方法 回顾性分析1958-2005年北京协和医院收治经手术病理证实的280例PHPT患者的临床资料。按病理类型分为甲状旁腺腺瘤组208例，甲状旁腺增生组52例及甲状旁腺腺癌组20例。结果 腺癌组中男性高于另外2组（P〈0．05）。增生及腺癌组中骨畸形、骨软化比例较低，增生组骨吸收、病理性骨折比例低于腺瘤组；胃肠道症状、多饮多尿及泌尿系统病变在腺癌组中高于另外2组（P均〈0．05）。血总钙（TCa）、血游离钙离子（ICa）及24h尿Ca在腺癌组显著高于腺瘤组及增生组（P均〈0．01），在腺瘤组与增生组间差异无统计学意义（P〉0．05）。出现高钙危象的比例在腺癌组显著高于另外2组（P〈0．01）。腺癌组病灶重量高于增生组，腺瘤组病灶直径小于增生组（P均〈0．05）。结论 在本组病例中，腺癌组男性比例较高，泌尿系统病变更为多见，出现高钙危象的比例显著增高，术后复发的比例较高。增生组骨骼系统病变相对较轻，其病变甲状旁腺重量低于腺癌与腺瘤组。     

后牙两段式可摘局部义齿的设计与制作

目的:改进常规可摘局部义齿设计的不足,增进固位、稳定。方法:采用两段式义齿结构、两个就位方向和插销锁连接固定。结果:义齿的固位、稳定效果明显提高。结论:插销式分段义齿是对常规可摘局部义齿的一种补充,对主基牙过度倾斜、固位要求高的患者,能够明显改善修复效果。     

Does prophylactic sotalol and magnesium decrease the incidence of atrial fibrillation following coronary artery bypass surgery: a propensity-matched analysis

Background  

Atrial fibrillation can occur in up to 40% of patients undergoing coronary surgery.     

大鼠静脉窦高压致硬膜血管变化的研究

目的探讨大鼠静脉窦高压后硬膜血管变化及其静脉窦高压在硬脑膜动静脉瘘形成中的作用。方法体重200～250g的SD雄性大鼠110只,随机分为静脉窦高压组(85只)和假手术组(25只),将静脉窦高压组85只大鼠闭塞左侧横窦和上矢状窦前1／3,并吻合右侧颈总动脉和颈外静脉,制成静脉窦高压模型。假手术组大鼠单纯解剖相应的颈部血管和硬脑膜窦,但不行吻合或闭塞。术后90d,随机取7只静脉窦高压组大鼠和5只假手术组大鼠,行硬脑膜血管明胶墨汁灌注,观察硬膜血管的状况。结果术后90d静脉窦高压组和假手术组大鼠的硬膜血管数分别为(10.7±1.5)条／mm,(10.3±0.6)条／mm,差异无显著性。在静脉窦高压组中1只大鼠有硬脑膜动静脉瘘,其形态和结构与生理性动静脉短路类似。结论大鼠静脉窦高压一段时间后,颅内硬膜血管无明显增生。颅内硬脑膜动静脉瘘的形成很可能是由动静脉间的短路发展而来。     

糖耐量试验对评价肝癌患者肝脏储备功能的价值

绝大多数肝细胞性肝癌患者合并肝硬变，为预测其对肝切除的耐受性，给正确选择切肝患者提供依据，作者对６２例切肝者和４９例未切肝者手术前后的糖耐量试验（ＯＧＴＴ）和肝组织病理学进行了对比研究。结果：术前ＯＧＴＴ曲地Ｐ型者切肝后恢复顺利；Ｌ型者对肝切的耐受性差，术后易发生肝功能衰竭等并发症，其肝硬化和蔼多为ＣⅢ或ＣⅣ级，曲线形态界于Ｐ和Ｌ型之间的Ｉ型患者２９例用肝门区域血管阻断法切肝，并在阻断血管前使用预     

神经肽Y标记神经元在大鼠脑桥的分布

目的:观察了神经肽Y（NPY）样神经元在大鼠脑桥的分布,为探讨脑桥NPY样神经元的功能提供实验形态学依据。方法:免疫组织化学方法（PAP法）。结果:在脑桥可见到前庭神经上核、耳蜗神经腹侧核及脑桥尾侧网状核NPY样免疫反应胞体。前庭神经上核的NPY样胞体较多且密集,细胞大小均匀,呈梭形或椭圆形,有明显突起;耳蜗神经腹侧核内的NPY样胞体呈大小均匀分布,圆形且较小,突起不明显;脑桥尾侧网状核内的NPY样胞体分布较稀疏,且大小不一,呈菱形或梭形,有明显较长的突起。结论:NPY样神经元不仅广泛存在于端脑和下丘脑,在脑桥也同样有着广泛的分布。     

Effects of Platelet Factor 4 on Expression of Bone Marrow Heparan Sulfate in Syngenic Bone Marrow Transplantation Mice

Platelet factor 4 ( PF4) is a negativehematopoietic factor.It can inhibit the prolifera-tion of endothelial cells and hematopoietic stem/progenitor cells,particularly megakaryoryocyticcells,reversibly[1] ,inhibit DNA synthesis,blockcell cycle progression during S phase and reducethe sensibility of normal hematopoietic stem/pro-genitor cells,but not some cancer or leukemia celllines,to cytotoxic drugs and ionizing radia-tion[2 - 3] ,and it also can cause a population in-crease of the stem cel…     

初诊T2DM短期胰岛素强化治疗40例分析

目的观察初诊T2DM短期胰岛素强化治疗的疗效。方法对40例初诊T2DM患者采用三餐前皮下注射短效胰岛素和睡前注射中效胰岛素2wk，并检测治疗2wk前后FPG、PPG、GHbA1C及血脂等值进行比较。结果两组治疗后FPG、PPG、GHbA1C及血脂各值均显著低于治疗前p〈0．05（x^2=4．940—11．544）。结论胰岛13细胞功能异常和（或）胰岛素抵抗是T2DM发病的基本环节，早期强化胰岛素治疗能获得血糖的有效控制，减少或延缓并发症的发生。     

Severe odontogenic infections

Background : Severe odontogenic infections are serious potentially lethal conditions. Following the death of a patient in the authors' institution this study was initiated to determine the risk factors, management and outcome of a consecutive series of patients.
Methods : All patients admitted to the Royal Adelaide Hospital under the care of the Oral and Maxillofacial Surgery Unit with odontogenic infections in calendar year 2003 were investigated. Detailed information relative to their pre-presentation history, surgical and anaesthetic management and outcome was obtained and analysed.
Results : Forty-eight patients, 32M, 16F, average age 34.5, range 19 to 88 years were treated. All presented with pain and swelling, with 21 (44 per cent) having trismus. Forty-four (92 per cent) were as a result of dental neglect and four (8 per cent) were regular dental patients having endodontic treatment which failed. Of those known to have been treated prior to presentation, most had been on antibiotics. Most patients had aggressive surgical treatment with extraction, surgical drainage, high dose intravenous antibiotics and rehydration. The hospital stay was 3.3 (range 1–16) days. Patients requiring prolonged intubation and high dependency or intensive care (40 per cent) had longer hospitalization. No patient died and all fully recovered.
Conclusion : Severe odontogenic infections are a serious risk to the patient's health and life. Management is primarily surgical with skilled anaesthetic airway management. Antibiotics are required in high intravenous doses as an adjunct and not as a primary treatment.