无张力疝修补术治疗腹股沟嵌顿疝85例分析

目的探讨无张力疝修补术治疗腹股沟嵌顿疝的临床效果。方法对83例腹股沟嵌顿疝患者选择性施行无张力疝修补术，分析其术后效果。结果83例患者中围手术期死亡2例，伤口感染1例，其余恢复良好．平均住院时间5．1d。结论应用无张力疝修补术治疗腹股沟嵌顿疝安全可靠，效果较为满意。     

全玻璃体切割治疗玻璃体积血疗效分析

目的 探索全玻璃体切割在玻璃体积血中的应用.方法 回顾51只眼手术病例,视网膜静脉阻塞23只眼,糖尿病视网膜病变9只眼,视网膜静脉周围炎2只眼,视网膜孔源性玻璃体积2只眼.眼外伤性玻璃体积血15只眼.采用睫状体平坦部三通闭合式全玻璃体切割术,并通过巩膜压陷结合高斜镜切割基底部玻璃体.结果 术后随诊5～12月,51只眼视力均有不同程度提高,其中视力在4.5者19只眼、4.6～5.0者9只眼4.0～4.4者19只眼、指数4只眼.结论 对玻璃体积血患者掌握好适应证及手术时机,行全玻璃体切割切实有效的减少玻璃体积血残留所致的并发症提高手术效果.     

The reliability of vital sign measurements

STUDY OBJECTIVE: Vital sign measurements, specifically heart rate, respiratory rate, and blood pressure, play a fundamental role in many medical evaluations, yet little is known about the reliability of noninvasive vital sign measurements. We sought to determine whether trained observers can reproducibly assess vital signs in the clinical setting. METHODS: Two trained observers independently measured vital signs on 140 patients presenting to an urban emergency department with acute medical complaints. Heart rate and respiratory rate were each measured by auscultation of heart and breath sounds for 1 minute. Systolic and diastolic blood pressures were determined by auscultating Korotkoff sounds while viewing pressure measurements from a standard cuff and mercury manometer. The mean value of each vital sign and Bland-Altman statistics (mean difference between observers [MDO], expected range of agreement [ERA]) were used to provide absolute and relative indices of reliability. RESULTS: The observers found a mean heart rate of 78.5 beats/min, with an MDO of 0.02 beats/min (0.03%), and an ERA of +/- 10.6 beats/min (+/- 13.5%). Respiratory rate exhibited a mean of 17.5 breaths/min, an MDO of 0.04 breaths/min (0.2%), and an ERA of +/- 6.2 breaths/min (+/- 35.5%). The mean systolic blood pressure of 127.1 mm Hg was associated with an MDO of 1.3 mm Hg (1.0%), and an ERA of +/- 24.2 mm Hg (+/- 19.0%). Diastolic blood pressure exhibited a mean of 77.4 mm Hg, an MDO of 0.3 mm Hg (0.4%) with an ERA of +/- 19.9 mm Hg (+/- 25.7%). CONCLUSION: The reproducibility of vital sign measurements may be limited by significant interobserver variability. Clinicians should recognize this inherent variability and interpret vital signs with caution.     

凯西莱联用复方丹参注射液治疗酒精性肝病临床观察

目的探讨凯西莱联用复方丹参注射液治疗酒精性肝病(ALD)的临床效果。方法将160例ALD患者随机分为治疗组和对照组,每组80例,对患者治疗前后进行临床评估和检测肝功能、AFP、肝纤维化等指标变化情况。结果治疗组治疗28天后临床症状和体征除肝区疼痛明显改善外(P<0.05),其余症状与对照组比较差异无显著性(P>0.05);两组治疗后肝功能、肝纤维化四项及AFP均有明显改善,但治疗组A/G、AST以及肝纤维化四项指标改善程度均优于对照组(P<0.01)。无明显毒副作用。结论凯西莱能有效改善ALD患者的临床症状、体征及肝功能、AFP,联合应用复方丹参注射液疗效更佳,尤其是抗肝纤维化效果更为明显,且毒副作用少,具有临床应用价值。     

Extracts of Monascusus Purpureus beyond Statins——Profile of Efficacy and Safety of the Use of Extracts of Monascus Purpureus

Monascus purpureus is a fungus that has been tradi-tionally used in China for thousands of years to produce ricewine . Traditionally the fungus is used to ferment non-gluti-nous cooking of rice ,to produce a kind of famous red ricewine .Its main traditional indications consist of disordersdue to the accumulation of fats (nosologically linked withthe problems of stasis of circulation in traditional Chinesemedicine) ,liver disorders and some forms of tumor as ithelps i mprove the circulation of …     

Sexual precocity: sex incidence and aetiology

The aetiology of 197 girls and 16 boys presenting with sexual precocity was reviewed. Ninety one girls and four boys had central precocious puberty (M:F 23:1); a cause was identified in all the boys but in only six girls. All boys with precocious puberty need detailed investigation; in girls investigation should be based on clinical findings, particularly the consonance of puberty.     

显微注射后家兔转基因受精卵的体外培养和移植成活率的观察研究

目的：研究家兔受精卵经显微注射转基因过程的耐受性，建立转基因动物技术平台。方法：(1)家兔超数排卵诱导；(2)对2000个家兔受精卵进行显微注射技术操作；(3)对1280个受精卵进行显微注射后体外培养观察；(4)216个注射后受精卵向13只受体母兔输卵管进行移植．结果：(1)经显微注射后受精卵进行体外培养有68％的受精卵能够发育至桑椹胚和囊胚；(2)目前有7只受体母兔经输卵管转基因受精卵移植分别产下3，4，5，2，6，13，7只仔兔。结论：(1)受精卵能够在体外经受显微注射转基因过程的损伤，但暴露于体外的操作时间应尽可能的缩短；(2)显微注射操作技术的熟练程度是实验成功的关键。     

同种异体原位心脏移植术后心电图分析

目的：探讨同种异体原位心脏移植术后患者的心电图改变特点，方法：对3例心脏移植的患者术后分别进行体表12导联心电图跟踪观察，主要观察心率、心律、ST-T演变情况，结果：共同表现的ST段抬高系心肌再灌注后损伤性改变，不完全性右束支传导阻滞与手术中机械刺激或损伤有关，由于去神经作用心率变化较小，应用标准术式患者易出现心律失常，应用双腔静脉原位心脏移植术后心律失常发生率较少，结论：心脏移植术前、术后心电图追踪观察有助于指导治疗和评估预后。