针刺取穴与骨折愈合疗效关系初探

目的:初步探讨针刺取穴与骨折愈合疗效的关系,为临床研究和应用提供参考,方法选用48只体重2.0～2.5 kg的雄性纯种大耳白家兔,手术造成新鲜桡骨骨折模型,用区组随机法分为局部和邻近取穴组(A组)、远道和辨证取穴组(B组)、局部和邻近取穴加远道和辨证取穴组(C组)、空白对照组(D组)共四组,术后第一天开始对治疗组分别做电针治疗,于术后7 d、14 d、28 d取材做血液生化学、生物力学、放射学、组织学的观测.比较各组间上述指标的差别.结果:血清碱性磷酸酶含量14 d时A组和C组明显高于B组和D组(P＜0.01),骨折标本抗弯强度在28 d时A组和C组明显高于B组和D组(P＜0.01),X线量化评分14 d和28d时A组和C组明显高于B组和D组(P＜0.05),在各个时段各个指标A组与C组、B组与D组比较均无显著差异(P>0.05).结论:局部和邻近取穴能明显促进骨折愈合,而且具有操作简便,易于推广等优点,远道和辨证取穴则效果不明显,与前者合用也没有明显增强前者的疗效.     

选择性激光小梁成形术治疗各类型开角型青光眼临床疗效的研究

目的观察选择性激光小梁成形术(selectlasertrabecularplasty,SLT)治疗各类型开角型青光眼(openangleglaucoma,OAG)降低眼内压的临床疗效和临床反应。方法对27例(52眼)多种类型开角型青光眼进行SLT治疗。所用设备为CoherentSelecta7000倍频Q-开关NdYAG双频激光仪。80个非重叠激光斑打击在颞侧180°范围小梁网,能量0.4～1.0mJ,激光斑400μm。术后观察眼内压和前房反应,时间为1d,1,6mo,1a。全部患者定期检查视力、裂隙灯、眼底镜、房角镜、视野(Octopus视野仪)、海德堡共焦激光断层扫描仪,(HRT-ⅡONH)和眼前节生物超声(UBM)检查。结果患者术前眼压平均(26.87±2.6)mmHg,不同时期的眼压大部分改善,术后1a为(20.21±3.4)mmHg,下降幅度为(6.66±2.8)mmHg,相当于下降24.78%,有3眼为高眼压症,没有明显降压效果出现。2眼为发育性青光眼,术后5d内降眼压效果明显,但10d左右眼压回升到接近术前水平转为手术治疗。部分病例仍需配合局部降眼压药。视力、C/D比、房角镜无明显改变。1a视野检查,9眼有改善。结论SLT治疗多种类型开角型青光眼安全有效,没有明显副作用和并发症,是治疗开角型青光眼的有效方法之一。     

Latex rubber (Penrose drain) is detrimental to esophagogastric anastomotic healing in rats

BACKGROUND: Surgeons commonly drain cervical esophagogastric anastomoses, but there is little objective evidence to support this practice. Studies in other areas of gastrointestinal surgery have shown that routine drainage is unnecessary, and even detrimental to anastomotic healing. We conducted an animal experiment to see if a drain had a negative effect on esophagogastric anastomotic healing. METHODS: Esophagogastric anastomoses were done in 40 rats. In the experimental group (20 rats) a portion of latex rubber Penrose drain was placed over the anastomosis. This was not done in the control group (20 rats). Rats were sacrificed 7 days after surgery. The anastomoses were inspected for leaks, distracted in a tensiometer to measure breaking strength, and subjected to hydroxyproline analysis (an indicator of wound collagen). RESULTS: There were 4 contained leaks in the experimental group (drain) and no leaks in the control rats (p=0.033). Anastomotic breaking strength was 3.80+/-0.81 N in the experimental rats and 3.46+/-0.64 N in the control rats (p=0.18, not significant). Anastomotic tissue hydroxyproline concentration was 615.9+/-52 nmol/mg in the experimental rats and 609.4+/-195 nmol/mg in the control rats (p=0.13, not significant). CONCLUSIONS: The presence of drain material predisposed to esophagogastric anastomotic leakage in this rat model.     

双氢麦角碱对脑卒中恢复期患者的疗效观察

目的：评估双氢麦角碱(商品名：喜德镇)对脑卒中后功能恢复的疗效。方法：采用随机、对照研究。脑卒中后1周患者，随机服用双氢麦角碱3片/d，服用3个月，以神经功能缺损量表(NFDS)和简易智能量表(MMSE)作为疗效评估指标。结果：神经功能缺损量表分两组无显著性差异；简易智能量表分药物组优于对照组。结论：双氢麦角碱可以改善卒中后的认知功能障碍，在一定程度上促进脑卒中患者神经功能恢复。     

923份住院病历抗菌药使用情况调查分析

目的：调查住院患者抗菌药使用情况，提高临床合理使用抗菌药水平。方法：抽取深圳市属某综合医院2004年4月1、4、7、10、13、16、19、22、25、28日共10d34个临床科室的所有出院病历923份，对其抗菌药使用情况进行统计分析。结果：75．1％的患者(693／923)使用了一共86种抗菌药(其中头孢菌素类27种)，其中514例患者使用了2种以上的抗菌药，34例患者使用了6种以上的抗菌药，最多者使用了17种抗菌药。手术科室抗菌药使用率和联合用药率均明显高于非手术科室。仅87例进行了微生物学检查和药敏实验。没有一例进行血药浓度监测。结论：抗菌药使用广泛，比例偏高；多凭经验用药，缺少药敏实验依据。用药方案不尽合理，存在滥用现象。     

离体肺冷冻后顺应性的变化

目的:观察家兔离体肺冷冻后顺应性的变化.方法:将32只家兔肺随机均分为对照组、冷冻(0℃)24h组、120h组和240h组.对照组:测定室温条件下的肺顺应性.冷冻组:在相应时间取出冷冻肺,室温条件下复温后,置入生理盐水中,测定注气(或注入生理盐水)和抽气(或抽生理盐水)过程中,肺容积在10ml、20ml、30ml时的顺应性变化.结果:同对照组比较,冷冻24h组向肺内注气10ml,注或抽生理盐水20ml、30ml;冷冻120h组向肺内注气10ml、20ml、30ml,抽气30ml,注生理盐水30ml,抽生理盐水20ml、30ml;冷冻240h组向肺内注生理盐水10ml、20ml、30ml,抽生理盐水20ml、30ml时,差异具有显著性(P＜0.05).其余各组、项与对照组比较差异无显著性(P＞0.05).结论:冷冻不会使肺顺应性发生明显变化,肺顺应性降低与冷冻的时间无明显关系.     

Early markers of neuronal differentiation in DRG: islet-1 expression precedes that of Hu

The Hu and Islet-1 proteins are early markers of neuronal differentiation in the avian embryo. We here examine which of these markers is expressed first in avian dorsal root ganglia (DRG). Recently we showed that neural tube and DRG cells express Islet-1 after leaving the cell cycle, while sympathetic ganglion cells express Islet-1 while still dividing. Others have shown that Hu is found in cells that take up BrDU in the DRG, suggesting that it is expressed even earlier in the differentiation process than Islet-1. In this study we double-label sections for Hu and Islet-1 at several stages of embryonic development, using a simple antigen retrieval method in paraffin sections. At early stages many more cells are Islet-1(+) than Hu(+). In addition, although many cells express both markers, some Islet-1(+)/Hu(-) cells are observed but the converse is never found. At later stages, almost all DRG neurons express both markers, although a few Islet-1(+)/Hu(-) cells are still observed. Staining for Hu and Islet-1 at a later stage than previously reported shows that neither marker is expressed in DRG satellite cells. Our results suggest that Islet-1 is a useful marker for DRG neurons at earliest embryonic stages, and is likely to be expressed in DRG neurons before the Hu antigen.     

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目的 探讨先天性心脏病(CHD)患儿肺动脉高压(PH)形成的影响因素.方法 研究对象均为2003-06-2005-02于北京大学深圳医院收集病例,以健康者30名为对照组(A组),以肺动脉压正常和并发PH的左向右分流的CHD患儿各30例为观察组(B组、C组).以高效液相色谱法、硝酸还原法及放射免疫法测定其血清精氨酸(L-Arg)、一氧化氮(NO)、血浆内皮素(ET-1)的浓度.结果 血清L-Arg浓度对照组(A组)为(72.00±18.01)nmol/mL,肺动脉压正常的患儿(B组)为(30.74±8.97)nmol/mL,伴PH的患儿(C组)为(23.51±12.37)nmol/mL.血清NO浓度A组为(76.10±17.10)nmol/mL,B组(90.55±26.57)nmol/mL,C组(60.05±17.60)nmol/mL.血浆ET-1浓度A组(50.82±7.58)pg/mL,B组(64.90±16.28)pg/mL,C组(69.64±10.66)pg/mL.结论 血清NO浓度和血浆ET-1浓度及其之间的平衡关系共同影响PH的形成及其程度.血浆ET-1浓度的升高是肺动脉压升高的直接因素,血清NO浓度的降低是间接因素,而血清NO浓度降低是由血清L-Arg浓度的降低引起.     

血液透析与血液透析滤过急性肾衰竭患儿治疗前后血清P2微球蛋白下降率对比

目的探讨血液透析（HD）及血液透析滤过（HDF）治疗急性肾衰竭患儿前后血清陉微球蛋白（β2-MG）及下降率的影响。方法对各种原因导致的急性肾衰竭需行血液净化治疗38例患儿随机分成2组。HD组20例，HDF组18例。透析前后分别测血清β2-MG水平。结果HDF与HD前后血清陉．MG变化经统计学处理。HDF组治疗前后血清β2-MG水平差异有显著性意SL（P〈0．01）；HD组治疗前后血清β2-MG水平差异无显著性意义（P〉0．05）；HDF和HD组治疗后比较血清β2-MG水平差异、下降率差异均有显著性意义（P均〈0．01）。结论HDF清除血β2-MG明显优于HD。     

岗梅根清喉颗粒的制备及临床疗效观察

目的研究岗梅根清喉颗粒的制备方法,并观察其临床疗效。方法与草珊瑚含片对照比较,观察其治疗咽喉炎症的临床疗效,并进行动物急性毒性试验。结果符合颗粒的质量要求。动物试验LD50>1208g生药/kg。治疗组与对照组总有效率均在85%以上,两者对咽喉炎症均具有明显的治疗作用。结论本颗粒组方合理,工艺可行,无毒性;临床疗效满意。