急性脑梗死诱发全身炎症反应综合征致多器官功能障碍综合征的临床研究

目的　探讨急性脑梗死 (ACI)诱发全身炎症反应综合征 (SIRS)致多器官功能障碍综合征(MODS)的发病机制 ,以及血清肿瘤坏死因子 (TNF α)、白细胞介素 (IL 1) β含量变化在ACI诱发SIRS发生、发展并向MODS转化的临床意义。方法　 6 8例ACI患者根据病情变化分为 3组 ,其中单纯性ACI(SACI组 ) 36例 ,ACI致SIRS(SIRS组 ) 32例 ,ACI致SIRS后发展为MODS(MODS组 ) 2 4例 ;应用酶联免疫吸附法 (ELISA法 )分别测定患者不同病程中血清TNF α、IL 1β值 ,并与对照组 (为 2 8名同期健康体检者 )比较。 结果　 (1) 6 8例ACI中 4 7.0 6 %发生SIRS;SIRS时 75 %发生MODS。 (2 )血清TNF α、IL 1β的含量MODS 组 >SIRS组 >SACI组 >对照组 ,各组间比较 ,差异具有极显著性 (均P <0 0 1)。MODS重症者 (积分≥ 9分 )血清TNF α、IL 1β含量高于轻症者 (积分 <9分 ) (均P <0 0 1) ;MODS死亡者血清TNF α、IL 1β含量高于存活者 (均 P <0 0 1)。结论　 (1)ACI后出现SIRS可导致MODS的发生。 (2 )患者血清TNF α、IL 1β水平异常变化可作为判断ACI致SIRS、MODS病情进展、预后及转归的一项指标     

掌背动脉逆行岛状皮瓣修复多指皮肤缺损

目的报道应用掌背动脉逆行岛状皮瓣修复多手指软组织缺损的方法。方法应用掌背动脉逆行岛状皮瓣修复手指软组织缺损16例38指。结果术后16例38块皮瓣全部存活。随访时间为4个月～1年，皮瓣外形优良，不臃肿，皮瓣两点分辨觉为5～9mm。供区植皮成活，掌背有环形瘢痕，少许色素沉着。结论掌背动脉逆行岛状皮瓣操作方便，易切取，损伤小，不牺牲主干动脉，手术可同时切取多块皮瓣修复多指软组织缺损，是修复多手指皮肤软组织缺损的良好方法。     

耳蜗血管纹上皮分泌功能的研究进展

血管纹(stria vascularis)位于蜗管外侧壁,为代谢活跃的上皮组织,具有分泌K 和吸收内淋巴液电解质的功能,并产生内淋巴正电位。内淋巴中高浓度的K 聚积及内、外淋巴     

脑内缝隙连接

缝隙连接普遍存在于动物组织中，具有重要的生理功能。近年来，由于分子生物学等技术的应用，对许多组织的缝隙连接蛋白的特性及其功能的研究取得了很大进展。本文重点介绍脑内缝隙连接蛋白的类型，分布及其生物物理学和药理学特性，并阐述胶质细胞之间、神经元之间缝隙连接的作用，以及缝隙连接与脑发育和癫痫等神经系统疾病的关系。     

谈静脉穿刺失败再次使用原针头穿刺感染问题

谈静脉穿刺失败再次使用原针头穿刺感染问题贵州省人民医院（贵阳５５０００２）王记芝观察静脉穿刺失败再次使用原针头穿刺的对照，随机将３００例一次穿刺成功；穿刺失败换针头再穿刺；穿刺失败再次使用原针头穿刺进行比较观察，结果：一次穿刺成功，局部无红肿９８例，...     

小脑梗塞的CT和MRI诊断价值

目的 分析小脑梗塞CT和MRI表现,探讨CT和MRI对小脑梗塞的诊断价值。方法对18例小脑梗塞的CT和MRI图像进行回顾分析。结果CT和MRI不同程度显示了小脑梗塞的影像学改变,各有其特点,且与病程长短和病灶大小有关。结论MRI的影像学价值较CT更胜一筹。     

Pharmacokinetic and pharmacodynamic studies with mitoxantrone in the treatment of patients with nasopharyngeal carcinoma.

The pharmacokinetics and pharmacodynamics of mitoxantrone were studied in 15 patients with advanced nasopharyngeal carcinoma (NPC) after single intravenous rapid infusion (12 to 14 mg/m2). Mitoxantrone plasma concentrations and urinary excretion were measured specifically with the use of a high-performance liquid chromatographic method with ultraviolet detection at 242 and 658 nm. The pharmacokinetic parameters are described adequately by a three-compartment model with a terminal half-life of 71.5 +/- 40.1 hours and a volume of distribution of 5037 +/- 2377 l. The total plasma clearance was 743 +/- 462 ml/minute, and the renal clearance was 18.8 +/- 8.49 ml/minute. Within 72 hours, 1.8 +/- 0.6% of the administration dose was excreted in urine as mitoxantrone parent compound. From the urinary excretion rate data, glomerular filtration and possible tubular reabsorption were the mechanisms involved in the urinary excretion of mitoxantrone. The values for unbound fraction (%) in plasma at time 0 and 5 minutes were 2.88 +/- 0.91% and 3.25 +/- 1.19%, with an average of 3.04 +/- 1.01%. The degree of protein binding of mitoxantrone was not affected by concentration (P greater than 0.05) in Chinese patients with NPC. The response rate for mitoxantrone was poor in this study. Clinical studies have demonstrated that mitoxantrone was generally well tolerated. Only very low incidences of nausea, vomiting, and alopecia were observed. The mild and rapidly reversible dose-limiting hematologic toxic effects have proven leukopenia. Although the toxicities reported here were tolerated for most patients, other combination regimens including mitoxantrone or other administration routes may be considered and need to be evaluated carefully.