鞍区肿瘤手术入路临床分析

目的:对鞍区肿瘤手术切除的入路进行评价.讨论额下、翼点、经蝶、纵裂等手术入路的缺点.方法:鞍区肿瘤103例,经额下入路42例;经翼点入路22例;经纵裂入路11例;经蝶入路23例;胼胝体入路3例;经侧脑室入路2例.结果:本组病例肿瘤全部切除76例,全切除率73.79%.结论:正确的手术入路选择对于肿瘤切除有着决定作用,全切肿瘤以适当的并发症为代价是值得的.视神经减压效果以及手术创伤,经蝶以及内窥镜垂体瘤切除手术十分具有优势.在鞍区巨大肿瘤操作中,切除彻底与否,下丘脑以及垂体的保护,翼点入路具备优势.在侵入三脑室内的鞍区肿瘤,纵裂入路给我们提供可开阔的操作术野.     

脑卒中患者对负性情绪及心理治疗认知状况的调查

目的：调查甘肃省脑卒中患者对负性情绪是否影响肢体功能以及心理治疗的认知。方法：采用问卷调查方式,对甘肃省10家不同级别的省市县级医院神经内、外科2010年收治的脑卒中住院患者1 100例进行调查。结果：负性情绪对肢体功能恢复的影响占69.80%,脑卒中后心理治疗的需要占76.99%。结论：负性情绪对脑卒中患者肢体功能恢复有影响,并且非常需要心理治疗。     

硼替佐米作用不同时间对K562耐药细胞株核因子-κB途径的影响

 目的　观察硼替佐米（商品名：万珂,PS-341）对柔红霉素（DNR）诱导的K562耐药细胞株（K562／DNR）核因子-κB（NF-κB）、抑制蛋白κB（IκB）及P-糖蛋白（P-gp）表达的影响,探讨PS-341逆转耐药的分子机制。方法　以100 μg／ml DNR单用或联合应用4 μg／L PS-341分别作用于K562／DNR 12、24及36 h,检测不同时间点各组NF-κB、IκB及P-gp表达情况,同时测定NF-κB p65活性,检测各组细胞凋亡率。结果　Western blot结果显示：与阴性对照组相比,DNR可诱导NF-κB表达上调及活性增强、IκB表达下调、P-gp表达上调;加用PS-341可显著抑制 DNR诱导的NF-κB及P-gp表达,使IκB表达增加。加用PS-341后,NF-κB活性12 h为（15.3±1.87）%[DNR组为（23.8±2.27）%],24 h为（10.2±1.69）%[DNR组为（25.4±1.98）%],36 h为（6.08±2.53）%[DNR组为（26.9±2.58）%],与相应单用DNR组相比均有明显下降,差异有统计学意义（P值均＜0.05）。DNR与PS-341联用后,细胞凋亡率12 h为（35.23±5.15）%[DNR组为（15.56±4.12）%],24 h为（40.26±6.89）%[DNR组为（17.25±2.89）%],36 h为（43.58±7.69）%[DNR组为（22.47±4.58）%],与DNR组相比,细胞凋亡率均明显增加,差异具有统计学意义（P值均＜0.05）。上述作用呈时间依赖性。结论　PS-341可减少K562／DNR细胞NF-κB的活化,降低P-gp表达,逆转细胞耐药,促进细胞凋亡。     

Radiography in acute ankle injuries: the Ottawa Ankle Rules versus local diagnostic decision rules

STUDY OBJECTIVE: We validate the Ottawa Ankle Rules and 2 Dutch ankle rules in distinguishing clinically significant fractures from insignificant fractures and other injuries in patients with a painful ankle presenting to the emergency department. METHODS: This prospective comparison of 3 ankle rules was conducted in the ED of a 580-bed community teaching hospital in Amsterdam from January 1998 to April 1999. Participants included 647 consecutive patients aged 18 years or older presenting with a painful ankle after trauma. All physicians received extensive and pictorial training on how to correctly score the respective items of the rules. The physician on call recorded these items derived from history and physical examination on a standardized data sheet. All patients subsequently underwent standard radiographic assessment. A radiologist and a trauma surgeon evaluated the radiographs blinded from the results of the data sheet form and the treatment given. The diagnostic performance of the 3 rules was measured in terms of sensitivity, specificity, and the reduction of radiographs. Receiver operating characteristic (ROC) curves were constructed, and the area under the ROC curves was calculated and compared. RESULTS: Seventy-four fractures were seen, of which 41 were clinically significant. The Ottawa Ankle Rules had a sensitivity of 98% for identifying clinically significant fractures; the local rules scored 88% and 59%, respectively. The potential savings in radiographs for the 3 decision rules were 24%, 54%, and 82%, respectively. The area under the ROC curve was better for both the local rules (0.84 and 0.83) compared with the Ottawa Ankle Rules (0.76). CONCLUSION: Because the identification of all relevant fractures is more important than a reduction in radiographs, the higher sensitivity of the Ottawa Ankle Rules makes these most suitable for implementation in The Netherlands.     

经尿道等离子双极电切术治疗良性前列腺增生(附80例报告)

目的 探讨经尿道前列腺等离子双极电切术(PKRP)治疗前列腺增生(BPH)的疗效.方法 采用PKRP治疗BPH80例,随访1～10个月.结果 80例BPH患者均成功手术.术中止血效果满意,无前列腺电切综合征(TURS).国际前列症状评分(I-PSS)由(27.4±3.2)分降至(8.1±4.2)分.最大尿流率(Qmax)由(6.1±1.9)ml/s升至(23.7±3.1)ml/s.结论 PKRP治疗BPH具有创伤小、安全、恢复快、并发症少,是一种治疗BPH的理想方式.     

自拟中药方浴足治疗老年闭塞性下肢动脉硬化症

【目的】探讨中药浴足治疗闭塞性下肢动脉硬化症的临床疗效。【方法】120例患者随机分为治疗组和对照组,对照组给予丁咯地尔10mg,每日一次静滴,治疗组在此基础上加用自拟中药方煎煮浴足,每日一次,于治疗前后,第1、2周末对足疼痛发作频次、持续时间、疼痛程度和踝肱指数（ABI）进行测评。【结果】加用中药浴足组在减少足静息痛发作频次、缩短每次发作持续时间、减轻疼痛程度、改善ABI及降低复发方面,均明显优于单用丁咯地尔组。【结论】中药浴足加丁咯地尔治疗闭塞性下肢动脉硬化症有较好疗效。     

舒平烧伤膏治疗烧烫伤1358例

目的：观察舒平烧伤膏治疗烧烫伤的,临床疗效。方法：应用局部涂摸、暴露或弹力绷带加压包扎的方法,治疗各种烧烫伤患者1358人。结果：伤口愈合率100％,烧伤创面平均愈合时间浅II度（9．30±5．28）天,深II度为（16．87±6．63）天,III度为（33．80±17．46）天。烧伤深度越深、程度越重、住院应用抗生素的患者平均医疗费用和每1％面积医疗费用越高。结论：舒平烧伤膏治疗烧烫伤效果显著。     

Effect of Gardenia extract ZG on the adsorption quantity of herpes simplex virus type 1 （HSV-1）

To observe the effect of Gardenia extract ZG on the adsorption quantity of herpes simplex virus type 1 (HSV-1) so as to explore the mechanism of its antiviral activity, fluorescein isothiocyanate (FITC) was used as the fluorescent probe to label viruses and heparin sodium was used as control. Meanwhile , the effect of Gardenia extract ZG on the adsorption quantity on the surface of Hep-2 cells was determined by flow cytometry. It was demonstrated that adsorption of HSV-1 on the surface of Hep-2 cells exhibited the character of saturation and specificity and heparin sodium could prevent attachment of viruses on these cells. These results are in accord with those reported previously. It was also proved that the manner of drug-use prior to adsorption or simultaneous use of drug and adsorption was better than adsorption prior to drug-use, and the inhibition rates of the former and latter manner were 84. 76% and 82.92% respectively. Three manners of drug-use with Gardenia extract ZG were all effective to reduce the adsorption quantity of viruses, especially the manner of simultaneous use of drug and adsorption with an adsorption inhibition rate of 68.46% . From the above observation, it is apparent that the mechanism of anti-viral activity of Gardenia extract ZG may be via several steps involved in the HSV-1 adsorption.