抽动障碍中医证型与血清单胺类物质的相关性研究

目的 观察抽动障碍不同中医证型患者血清多巴胺、去甲肾上腺素等单胺类神经递质的水平,并探讨各证型之间血清神经递质的水平是否存在差别.方法 采用化学荧光法测定46例抽动障碍患者(病例组)血清多巴胺、去甲肾上腺素水平,并与40例正常儿童(对照组)进行比较.结果 病例组血清多巴胺为0.449μg/ml,对照组为0.210μg/ml;病例组血清去甲肾上腺素为0.227μg/ml,对照组为0.127μg/ml,两组各均值比较,病例组血清多巴胺和去甲肾上腺素均显著高于对照组.病例组外风侵袭、肝风内动型,或兼气郁化火型,或兼脾虚痰聚型,或兼阴虚风动型血清多巴胺水平分别为0.316、0.400、0.235、0.247μg/ml,四者比较有显著性差异;病例组符证型血清去甲.肾上腺素水平分别为0.203、0.224、0.144、0.154μg/ml,四者比较差异有显著性.结论 抽动障碍患者存在多巴胺和去甲肾上腺素水平异常,且各证型血清多巴胺、去甲肾上腺素水平有明显差异,而尤其以外风侵袭、肝风内动兼气郁化火型水平最高.     

综合实践教学模式的实施与护生综合能力的培养

目的在《护理学基础》教学中，运用整体护理思维，探讨课堂综合实践教学模式的实效性，以提高护生的职业素质和能力。方法随机确定实验班和对照班，对照班采取传统的实践教学模式授课，实验班采取小群体综合实践模式教学。结果实验班护生的规范操作能力、沟通能力和知识运用能力与对照班比较有显著提高。结论小群体综合实践教学模式对护生综合能力的培养具有实际意义。     

The Application of Topical Anesthesia Combined with Subconjunctival Anesthesia for Glaucoma Surgery

Purpose: To evaluate the feasibility, reliability and analgesia effect of topical anesthesia combined with subconjunctival anesthesia in anti-glaucomatous surgery.Methods: Two hundred and four cases (357 eyes) underwent anti-glaucomatous surgeries under topical anesthesia with 0.5％ Alcaine eye drops combined with subconjunctival anesthesia with 2％ Lidocaine. The analgesic effect was analysed with visual analogue pain scale.Results: Among all of 357 eyes, 62 eyes underwent peripheral iridectomy, 67 eyes underwent simple trabeculectomy, 167 eyes underwent compound brabeculectomy and 12 eyes nonpenetrating trabecular surgery. The effects of anesthesia were as follows: 304 eyes (85.2％) were painless (Grade Ⅰ), 50 eyes (14.0％) were slight painful (Grade Ⅱ), and 3 eyes (0.8％) were more painful (Grade Ⅲ) during surgery. And no severe complications were observed in all the cases during surgery and postoperatively. Amaurosis fugax was not observed in the glaucoma patients at the late stage with narrow vi     

高度近视的病因学研究进展

高度近视发生的内因、外因，包括遗传倾向，相关基因定位，巩膜胶原白体免疫学说，视网膜生物活性物质失调学说，环境因素等，本研究就这些因素对高度近视发病的影响做一综述。现统一的认识有：①高度近视具有明显的遗传倾向。②迄今为止，已找到4个高度近视相关基因，它们的遗传方式均为常染色体显性遗传。③高度近视的巩膜组织病理改变和胶原代谢障碍引发了人们对高度近视免疫相关基因的深入研究。已发现HLAⅡ类基因与部分高度近视具有相关性。④视网膜中存在的生物活性物质直接或间接参与了形觉剥夺性近视的形成。⑤环境因素并非高度近视发病的决定因素，它仅起一定程度的促进作用。将今后的工作重点放在高度近视基因定位的研究，基因表达的调控及巩膜胶原代谢、网膜生物活性物质之间的关系研究上，无疑会进一步揭示高度近视的病因，为防治高度近视开辟新途径。     

超声引导下VacoraTM旋切系统的实验研究

目的探讨VacoraTM真空辅助活检系统的准确性和安全性,为临床应用奠定基础。方法选用里脊肉和鱼丸作为实验材料,根据鱼丸大小将实验分为5组:0.5、0.8、1.0、1.5及2.0cm组,每组鱼丸3~5个。采用VacoraTM活检系统,先行灰阶超声扫查肌肉后将鱼丸置入肌肉中,超声扫查置入的鱼丸,同轴套管针在超声引导下插入鱼丸底部,在套管针引导和超声监视下行旋切真空抽吸术;旋切后取出采样腔内的组织标本,用超声检查肌肉内的残腔,确定无鱼丸残留声像图。结果每次旋切组织条比较完整,其大小为20.0mm×0.6mm,旋切次数随鱼丸大小的增加而增加;0.5、0.8、1.0、1.5及2.0cm组里脊肉内鱼丸全部切除的平均旋切次数分别为12、15、19、26和31。所用的平均时间分别为15、18、23、27和34min。结论VacoraTM真空辅助活检系统定位准确、取样完整、操作简便。可为良恶性病变的诊断提供足够量的病理检查标本,为良性病变的完全切除提供具有潜在价值的手段。     

Comparison of the effects of three different combinations of general anesthetics on the electroretinogram of dogs

The objective of this study is to compare the effects of three different anesthetic combinations on the electroretinogram in the same animals under similar laboratory conditions. Thiopental–isoflurane (TI), medetomidine–ketamine (MK), and xylazine–ketamine (XK) were used on each of 12 healthy miniature schnauzer dogs (MS) with a period of at least 3 weeks in between subsequent anesthesia protocols, using the Dog Standard Protocol. The scotopic ERGs consisted of scotopic low stimulus strength (S) responses designated S1, S2, S3, S4, and S5, at 1, 5, 10, 15, and 20 min after dark adaptation, respectively, and scotopic standard stimulus strength (S-ST) responses. The photopic ERGs consisted of a photopic single flash (P) response and 31 Hz flicker (P-FL) responses. For S-ST (2.5 cd s/m²), the amplitude of the a-wave using TI was significantly lower than that using MK (adjusted P = 0.05) and XK (adjusted P = 0.03), and the implicit time of the a-wave was significantly shorter than that using MK (adjusted P = 0.04). For P (2.5 cd s/m²), the amplitude of the b-wave using XK was significantly higher than that using MK (adjusted P = 0.01). The implicit times of the b-wave using TI was significantly longer and shorter than that of MK for S1, S2 and P-FL and for S4 and S-ST, respectively, and than that of XK for S2 and P-FL and for S5 and S-ST, respectively. The results of the present study showed that TI affected both the amplitude and the implicit time of the a-wave for S-ST and the implicit time of the b-wave relatively more so than was the case when using XK or MK. Therefore, it appears that either XK or MK could be advantageous to use rather than TI for clinical studies.     

王成荣治疗子宫内膜异位症“火热致瘀”理论探讨

王成荣研究员长于以中医药诊治子宫内膜异位症（EMT），根据其临床经验认为“火热致瘀”是EMT的基本病因、病机，且火热与瘀血互为因果、恶性循环，致使EMT病程缠绵不愈、反复复发。王老据此提出“清热解毒、化瘀散结”的治疗法则，为治疗EMT开辟了另一思路和理论。     

两种单静脉法与传统Amplatzer法治疗动脉导管未闭

目的探讨两种单静脉入路法和动静脉双入路法治疗PDA各自的优缺点及最佳适应症,为PDA患者选择合理介入治疗方法提供依据。方法103例PDA患者经三种不同介入方法治疗,其中单静脉入路超声法37例,单静脉入路造影法14例,动静脉双入路法52例。PDA的位置、形态、大小经不同方法观察,单静脉超声法经超声观察,单静脉造影法在PDA内或降主动脉近PDA口外造影观察,动静脉双入路在主动脉弓降部侧位造影观察。选择合适型号的Amplatzer伞经股静脉建立的轨道进行封堵。术后15 min经胸超声及心脏听诊判断有无分流。术前、术后均行血流动力学测定,术后3 d、1个月复查超声心动图,观察大动脉水平有无分流及动脉导管未闭再通。结果103例患者全部一次封堵成功,技术成功率100%。术中操作平均透视时间(10.45±4.35)min,心导管检查测肺动脉收缩压由术前轻度增高[(33.2±3.11)mmHg]降为正常[(22.03±5.3)mmHg]。术后即刻所有患者心前区双期连续性杂音消失,术后无残余分流,无任何并发症发生,随访1个月未发生动脉水平分流及动脉导管再通。结论单静脉入路Amplatzer封堵器治疗动脉导管未闭简化了手术程序,不用或减少造影剂用量,缩短了操作透视时间,手术成功率高,疗效可靠,值得推广应用。     

术中即时扩张皮肤面积增加与压力和时间的量效关系

目的探讨术中即时扩张皮肤面积增加与压力、时间的量效关系。方法用6头小型猪，压力参数分别为15、20、25kPa，时间参数为60、90min，配对组成6个实验组，1个对照组，36个实验部位。在每只猪背部皮下均匀埋置100ml圆形扩张器6个，术中即时扩张皮肤，观察扩张皮肤各径线移位特点，计算面积变化。结果扩张区周边皮肤向中心蠕动和扩张器表面皮肤伸展同时存在。扩张皮肤面积扩大在一定范围内与压力、时间增加成正比，20kPa、60min组合增幅最大，此后增幅明显减少，并逐渐引发皮肤病理性改变。结论皮肤可在一定范围内通过术中即时扩张获得面积有效增加。     

尿干化学法检测阴性不可偏废沉渣镜检

通过对 5 0 0例经尿 11项试纸检查阴性的标本 ,沉渣镜检发现尚有 6 7例阳性 ,阳性率为 13.4 %。提示尿沉渣镜检 ,不失为泌尿系统疾病检查的必要手段不应忽视及偏废