前庭水管扩大综合征患者的人工耳蜗植入术

目的 评价前庭水管扩大综合征患者人工耳蜗植入术的安全性和可行性。方法 1995年5月1日～2002年6月1日因双耳重-极重度感音神经性聋在北京协和医院接受人工耳蜗植入术的患者312例中诊断为双耳前庭水管扩大者10例(3．2％)，其中语前聋7例，语后聋3例。回顾性分析这10例患者的临床资料。结果 10例患者人工耳蜗电极植入顺利，8例耳蜗底回开窗时发生轻度井喷，迅速用颞肌筋膜牢固封闭圆窗制止井喷。全部患者术后未出现脑脊液漏、颅内感染、面瘫、中耳炎等并发症。开机6个月时8例患者具有开放性言语识别力，已进入普通学校(幼儿园、小学、大学)就读。另2例语前聋的幼儿视觉强化测听听阈达40dB HL，与其他无内耳畸形的全聋儿童术后效果差异无显著性。全聋前语言能力较好的5例患者术后语言能力明显好于语前聋的患者，语言交流基本听不出聋人特有的语音特征。另5例患者语言均有不同程度的进步。结论 尽管前庭水管扩大患者在人工耳蜗植入术中可能出现井喷，但术后未出现并发症且听力-言语康复效果好，因此重-极重度聋的前庭水管扩大综合征患者行人工耳蜗植入术是安全可行的。     

神经管发育不良患儿及其核心家庭MTHFR基因A1298C多态性分布的研究

目的　通过对神经管发育不良 (NDTs)患儿及核心家庭MTHFR基因A1 2 98位点多态性分布的研究 ,探讨该基因多态性与NDTs之间的关系。方法　 2 0 0 0年 9月～ 2 0 0 2年 3月 ,40例 3～ 1 5岁NDTs患儿 (男 2 8例 ,女 1 2例 )及其中 2 6个核心家庭进行研究。应用聚合酶链反应 限制性片段长度多态性分析 (PCR RFLP)技术 ,分析MTHFR基因第 1 2 98位核苷酸基因型 (野生型、杂合型、突变纯合型 )的分布情况 ;并对 2 6个核心家庭进行以父母为对照的病例对照研究 ,计算传递失衡指数 (TDT)及基于单体型的单体型相对危险度 (HHRR)。结果　NDTs患儿、核心家庭与正常对照中均未发现纯合突变。基因型构成比采用 χ2 检验 ,NDTs患儿及患儿母亲野生型分别占 1 7.50 % ,1 1 .54 % ,杂合型分别占 82 .50 % ,88.46 % ,与正常对照之间差异无显著性意义 (分别为P >0 .2 5 ;P>0 .90 )。患儿父亲野生型占 30 .77% ,杂合突变型占 69.2 3 % ,低于正常对照 (P <0 .0 5)。等位基因频率比较采用u检验 ,患儿为 41 .2 5 % ,与对照间差异无显著性意义 (P >0 .0 5) ;患儿父母分别为69 .2 3 % ,88.46 % ,均高于正常对照 (P <0 .0 1 )。核心家庭分析结果 :TDT(χ2 ) =0 .36 ,P >0 .0 5 ;HHRR(χ2 ) =0 .369,P >0 .0 5。结论　MTHFR基因第 1 2     

The surgical treatment for degenerative disease of the ankle

Although a variety of surgical techniques are available for the surgical treatment of early degenerative disease of the ankle, arthrodesis remains the preferred treatment for severe cases. We studied 126 ankles with an average follow up of 39 months of whom 25 with early disease underwent debridement and cheilectomy, 18 with intermediate disease underwent lower tibial osteotomy and 83 with severe disease underwent either arthrodesis (78) or total ankle replacement (5). In 96% of cases there was a satisfactory functional outcome.     

博宁霉素霜剂对牛乳头瘤病毒所致奶牛乳头瘤的疗效观察

目的 观察博宁霉素霜剂对牛乳头瘤病毒所致奶牛乳头瘤的疗效。方法 将临床患病牛随机分为2组每次将药物和基质分别涂于试验牛及对照牛乳头皮肤的肿瘤上，每日3次，连续进行10d。结果 试验组2例指状乳头状瘤分别于第6天和第9天完全脱落；4例扁平瘤虽未脱落，但瘤体表面均发生明显的剥蚀；对照组均未发生此类现象。结论 博宁霉索霜剂对奶牛乳头的皮肤无损害作用，但可选择性地使指状乳头瘤脱落，扁平瘤剥蚀、脱皮，呈现良好的治疗作用。     

The normal width of anterior hip synovial recess in children

To establish the diagnostic criteria for hip joint effusion, the normal width of the anterior hip synovial recess in children and the difference between both hips of the same child were examined in this study. Eight kindergarten schools were randomly selected for study in Kaohsiung City. The width of anterior hip synovial recess of 1,568 hips in 784 children (421 boys, 363 girls) was measured by ultrasound scanner with 7.5-MHz linear probe. The age of children ranged from 2.5 to 6.6 years old. During measurement, the children were put in supine position with hips and knees in extension and patella facing up. The results revealed that the mean width of the anterior synovial recess was 7.29+/-1.15 mm. Linear correlation of the width of synovial recess to age and height was disclosed and expressed as follows: width (millimeters) equal to 6.52+0.013x age (months), or width (millimeters) equal to 3.97+0.030x height (centimeters). The mean difference between both hips of the same child was 0.611+/-0.523 mm, and the difference was independent from the factors of age, gender, height, or weight (p>0.05). Ninety-five percent of the differences should be < or =1.46 mm, so that if the difference between hips is >1.46 mm, hip joint effusion should be suspected.     

An experimental study on systemic inflammatory response syndrome induced by subeschar tissue fluid

OBJECTIVE: To investigate the biological activity of subeschar tissue fluid (STF) and its probable mechanism in the genesis of systemic inflammatory response syndrome(SIRS). METHODS: The changes of heart rate (HR), respiratory rate (RR), white blood cell count (WBCC) as well as the major organ function were observed in the animals injected with STF. The inflammatory mediators TNF-alpha and IL-1 in the supernatants of macrophages cultured with STF were assayed. RESULTS: The HR, RR and WBCC were elevated in animals after injection with STF. STF showed a deleterious effect on function and structure of the major visceral organs. Macrophages were activated to produce excessive TNF-alpha and IL-1. CONCLUSION: The findings suggest that STF may be one of the inducing factors involved in the genesis of SIRS and the development of MODS in the early postburn stage.     

腹腔镜手术治疗特殊部位异位妊娠11例报告

目的 探讨特殊部位异位妊娠的临床特点与腹腔镜手术治疗的可行性与安全性。方法 回顾分析1998年1月至2003年1月间经腹腔镜手术治疗的特殊部位异位妊娠的临床资料,包括输卵管间质部妊娠4例,卵巢妊娠4例,腹腔妊娠3例。结果 11例特殊部位异位妊娠的临床特点:平均停经时间以卵巢妊娠较短,而间质部妊娠时间较长;血β-HCG值以卵巢妊娠和腹腔妊娠较低,而间质部妊娠较高;腹腔镜手术治疗特殊部位异位妊娠效果:平均手术时间为(45.0±13.8)min,平均术中失血为(81.0±80.6)mL,平均住院时间为(3.0±0.6)d,腹腔镜手术成功率为91％。结论 腹腔镜手术治疗特殊部位异位妊娠是可行且安全的,但是应根据其特点选择术式并预防并发症。     

雌激素受体亚型mRNA在子宫内膜癌组织中的表达

目的比较雌激素受体两种亚型α和β在子宫内膜癌中的表达,探讨雌激素受体亚型在子宫内膜癌发生和发展中的作用.方法用RT - PCR法检测子宫内膜癌和正常子宫内膜组织雌激素受体mRNA的表达.结果①与正常子宫内膜组织比较,子宫内膜癌中ER α mRNA、ER β mRNA表达和ER β/ER α mRNA比值都明显上升;②早期、内膜样子宫内膜癌ER α mRNA明显上升.结论子宫内膜癌的发生与ER α和ER β的表达有关,ER α mRNA表达升高可能提示子宫内膜癌预后较好.     

Development of multifocal duodenal erosions after anti-Helicobacter pylori triple therapy.

BACKGROUND AND PURPOSE: Anti-Helicobacter pylori triple therapy is effective for healing duodenal ulcer (DU) diseases and reducing disease recurrence. However, multifocal duodenal erosions or shallow ulcers may develop after triple therapy. The purpose of this study was to investigate the incidence and outcome of duodenal erosions that developed after triple therapy. METHODS: A total of 106 Taiwanese with active DU and with H. pylori infection were enrolled in this study. All patients received anti-H. pylori triple therapy (i.e., 2 weeks of antimicrobial agents combined with treatment for 4 to 6 weeks with acid suppression agents). Follow-up endoscopy was performed immediately after stopping treatment. The incidence of multifocal erosions or shallow ulcers over the bulb and/or second portion of the duodenum was studied. Additional acid suppression agent was given for 4 weeks whenever duodenal erosions or shallow ulcers were found. RESULTS: Out of 106 patients, 11 (10.4%) were found to have multifocal duodenal erosions and/or shallow ulcers on the duodenal bulb and/or second portion of the duodenum at the end of treatment. Ten of the 11 patients with newly developed erosions had healed DU in the S1 or S2 stage, and all 11 had successful H. pylori eradication. The duodenal erosions and/or shallow ulcers of these 11 patients were healed after an additional 4 weeks of histamine-2-receptor antagonist therapy. CONCLUSIONS: Multifocal duodenal erosions and/or shallow ulcers were noted in around 10% of Taiwanese DU patients who received anti-H. pylori triple therapy. An additional 4 weeks therapy with acid suppression agents healed these lesions.