支气管结核在纤维支气管镜下治疗方法的探讨

目的 :探讨支气管结核在纤维支气管镜下治疗的方法及价值。方法 :对 2 5例支气管结核病人 ,在全身抗结核治疗的同时分别实施镜下注药治疗、微波接触式辐射治疗和球囊扩张术 局部注药治疗。结果 :在全身抗结核治疗的同时运用上述几种镜下治疗方法 ,支气管局部病灶较镜下治疗前均有明显好转。结论 :利用纤维支气管镜对支气管结核病人进行局部治疗 ,可加快病灶的吸收和症状的改善 ,值得推广应用     

Comparative effects of dietary wheat bran and its morphological components (aleurone and pericarp-seed coat) on volatile fatty acid concentrations in the rat

Adult male rats were fed on diets containing 100 g dietary fibre/kg either as alpha-cellulose or wheat bran or the pericarp-seed coat or aleurone layers prepared from that bran by sequential milling and air elutriation and electrostatic separation. After 10 d, concentrations of total volatile fatty acids (VFA) in caecal fluid were significantly different between groups and fell in the order: aleurone greater than wheat bran greater than pericarp-seed coat greater than cellulose. This ranking probably reflected the ease of fermentation of fibre polysaccharides by colonic bacteria which also resulted in a considerably higher faecal bacterial mass in the aleurone group. Because of the differences in the volume of caecal digesta, the mass of caecal VFA was considerably the highest in the aleurone group, intermediate with wheat bran and equally low in the pericarp-seed coat and cellulose groups. The diet based on aleurone gave a relatively higher proportion of propionate but with both pericarp-seed coat and wheat bran the contribution of butyrate was raised. VFA concentrations in hepatic portal venous plasma were proportional to caecal concentrations with very high (greater than 3 mM) values being recorded in the aleurone group. The findings are discussed in relation to the apparent susceptibility of the morphological components of wheat bran to fermentation by large bowel bacteria.     

4-Aminopyridine induces the release of neuropeptide Y (NPY) to produce an atropine- and tetrodotoxin-resistant contraction in rabbit isolated jejunum

4-Aminopyridine (4-AP) induced an atropine- and tetrodotoxin (TTX)-insensitive contraction (resistant contraction), in a concentration-dependent manner, in the isolated jejunum of rabbits. The failure of specific antagonists of histamine, serotonin and substance P to affect this resistant contraction ruled out the participation of histamine, serotonin and/or substance P. Antiserum against neuropeptide Y (NPY) reduced this resistant contraction in a concentration-dependent manner and inhibited the action of 4-AP totally at a high concentration (1.25% dilution) whereas normal serum lacked this ability. This suggested that the release of NPY was involved in this 4-AP-induced resistant contraction. Radioimmunoassay of NPY-like immunoreactivity in isolated synaptosomal preparations indicated that 4-AP possessed the ability to induce the release of NPY. However, guanethidine did not affect the actions of 4-AP, indicating that NPY is released mainly from non-adrenergic nerves. Our results indicate that 4-AP induces the release of NPY from non-adrenergic nerves to produce an atropine- and TTX-resistant contraction in the isolated jejunum of rabbits.     

Monokines produced by macrophages stimulate the growth of osteoblasts

We have previously reported that the J774A.1 macrophage-like tumor cell line produces two potent monokines which stimulate the growth of osteoblasts and chondrocytes. These growth factors, which have an affinity for heparin-agarose, have been termed HEP I (a 30 Kd PDGF-like molecule) and HEP II (an approximately 20 Kd molecule), respectively, based on their elution profile. Unlike HEP I, HEP II does not stimulate the growth of fibroblasts. Extensive biological and chromatographic studies disclosed that HEP II appears to be a unique bone cell mitogen unlike any known growth factor, including the FGFs, IL-1s, and TNFs, EGF, IGF-I and -II, TGF-beta, beta 2 microglobulin, G-CSF, CSF-1 and GM-CSF. To characterize more fully the effects of the macrophage-derived monokines on osteoblast growth and function, clones were derived from calvaria explant cultures. Two clones, SDFRC-2.05 and SDFRC-3, were developed and found to exhibit osteoblastic characteristics, including high levels of alkaline phosphatase, synthesis of type I but not type III collagen, and an increased intracellular cAMP production in response to PTH. The SDFRC-3 cells exhibited a polygonal morphology like that of the explant-derived cells while SDFRC-2.05 cells exhibited a more fibroblastic morphology. When tested on the explant cultures and clones, HEP I and HEP II were found to stimulate DNA synthesis and increase protein per culture, but decreased alkaline phosphatase activity. Clone SDFRC-3 was found to be more responsive to HEP II than clone SDFRC-2.05. Both monokines were found to be more potent mitogens for bone cells than TGF-beta. HEP II, but not HEP I or TGF-beta, induced a transformation of bone cells from a polygonal to a fibroblastic morphology, suggesting the induction of migration prior to proliferation. Thus, macrophages may be responsible not only for bone repair but also for ensuring the linkage of bone formation to resorption during physiological remodeling.     

2005-2007年某科研单位人员高血糖变化趋势分析

目的了解近年来某科研单位人员血糖异常情况及其变化趋势,为采取有效预防措施提供依据。方法对本单位人员3年健康检查中高血糖检出率检测结果进行分析。结果2005、2006、2007年高血糖检出率分别为9.31%、7.02%、4.40%,变化趋势差异有统计学意义(χ2=7.707,P<0.05),不同年龄、不同职业人员高血糖检出率差异有统计学意义(P<0.01)。结论该研究机构人员高血糖检出率有逐年下降的趋势,但仍高于国内的文献报道,须进一步加强预防保健工作。     

切开复位内固定治疗Gartland Ⅲ型肱骨髁上骨折

目的探讨切开复位内固定治疗Gartland Ⅲ型肱骨髁上骨折的疗效。方法1999年10月-2005年4月，对62例平均年龄7．5岁的患儿，应用切开复位克氏针固定治疗Gartland Ⅲ型肱骨髁上骨折。其中伸直尺偏型41例，伸直桡偏型18例，伸直中间型3例；无伴发血管、神经损伤和筋膜室间隔综合征。闭合性骨折47例，开放性骨折15例。结果术后56例获得随访，随访时间为6～15个月，平均11．5个月。所有骨折均获得愈合。根据Flynn标准进行疗效评价，其中优22例（占39．3％），良21例（37．5％），可9例（16．1％），差4例（7．1％）。伤后8h内手术的优良率为89．7％，伤后8h后手术的优良率为63．0％。直接手术治疗的优良率为90．1％，曾接受手法复位的优良率为67．7％。结论切开复位内固定治疗Gartland Ⅲ型肱骨髁上骨折可取得满意的疗效，是安全、有效的治疗方法。     

骨样骨瘤的影像学诊断:X线平片与CT常规横断位及MPR比较

目的:比较常规X线平片、多层螺旋CT常规横断位及多平面重组(multi-planar reformation,MPR)在骨样骨瘤诊断中的价值。方法:回顾性分析41例骨样骨瘤病人在X线平片、CT常规横断位及MPR图像上的表现及其对瘤巢及瘤巢内钙化显示能力。结果:41例病灶均表现为一圆形或卵圆形的透亮区,其周围有不同程度的骨质硬化。41例中仅8例在X线平片上能显示瘤巢,瘤巢显示率为19.5%(8/41);所有检查者均清楚显示瘤巢周围骨质硬化,但均不能显示瘤巢内钙化;41例CT横断位图像及MPR图像均能清楚显示瘤巢,18例CT横断位图像能显示瘤巢内钙化,30例病人在MPR图像能显示瘤巢内钙化;横断位CT图像和MPR对瘤巢内钙化显示率分别为43.9%(18/41)和73.2%(30/41)。结论:瘤巢是确诊骨样骨瘤的关键,CT是显示瘤巢的重要检查方法,MPR图像是显示瘤巢内钙化的最佳方法,有助于做出准确诊断。     

后路减压植骨融合3D脊柱内固定系统治疗腰椎滑脱症

[目的]观察3D脊柱内固定系统对腰椎滑脱症的固定及治疗效果。[方法]2004年1月～2005年7月,对42例腰椎滑脱症患者(其中,男28例,女14例)运用椎板减压、椎管后外侧植骨融合、3D椎弓根螺钉内固定系统治疗,随访13～32个月(平均25.3个月)。[结果]术前JOA评分平均4.48分的42例患者,随访时14.5分(P<0.01),术后15个月内动态X线检查显示3D椎弓根螺钉固定患者植骨融合率100%,融合节段稳定,临床症状改善优良率92.8%。[结论]后路运用3D内固定系统行椎管后外侧植骨融合内固定对腰椎滑脱症患者是一种安全、有效的术式,近期疗效满意。     

1例海洛因白质脑病患者行血液净化治疗的护理

对1例巨大甲状腺肿瘤患者在体外膜肺氧合辅助下行肿瘤切除术，手术顺利，历时12．0h，切除肿瘤500g，住院23d患者康复出院。提出术前充分评估患者状况、做好心理护理和器械物品准备，术中熟悉体外膜肺氧合的操作方法、积极配合手术、密切观察病情等，是获得良好手术效果的重要环节。