肿胀局麻技术的临床应用

目的探讨肿胀技术在体表外科手术中的应用价值。方法随机选择体表肿物与先天性畸形、体表瘢痕、乳房整形、脂肪抽吸、腹壁整形、除皱、隆胸、褥疮、面瘫及颅骨电烧伤等２３０例体表外科手术应用肿胀技术，成人１６４例，完全采用肿胀法局麻技术，儿童６６例，在全麻下应用肿胀技术。并与相应手术非肿胀法下施行进行了比较。结果脂肪抽吸术中利多卡因用量可达３０～６０ｍｇ／ｋｇ体重。肿胀技术具有易于进行解剖间隙的分离、减少术中失血、增强麻醉效果、增加手术安全性和术后恢复快等优点。结论肿胀技术可推广到体表外科手术中广泛应用，对儿童更为适宜，对减少输血造成的疾病具有重要意义。     

海南省第四次全国结核病流行病学抽样调查分析

目的：评价世行贷款结核病项目实施效果，掌握疫情现状，为制度2001－2010年防治规划提供理论依据。方法：按照《第四次全国结核病流行病学抽样调查工作手册》对2个随机抽样点人群进行流调。结果：活动性肺结核13例，患病率和涂阳患病率434．8／10万，33．4／10万，较1990年流设疫情分别下降了43．4％和27．3％，BCG接种率34．9％，较1996年流调提高了一倍。结论：以控制传染源为目的：以DOTS为核心的结核病控制策略是成功的，可行的，政府的行政干预及保持必要的经费投入，对结核病控制可持续发展具有重要意义。农村儿童及新生儿BCG接种工作亟待改善。     

足组织缺损的显微修复

１９８４年～１９９４年共收治各种足部组织创伤缺损２３６例，均采用显微外科技术进行组织移植修复，其中单纯皮瓣移植修复１８７例，复合皮瓣移植修复４９例。吻合血管游离移植修复９７例，带血管蒂移位修复１３９例。４例前足缺损者用带肩胛骨的复合皮瓣移植修复，６例足跟严重缺损者用带血管的腓骨复合皮瓣移植修复。经１～１０年随访，皮瓣、复合皮瓣、移植或再植的骨骨各全部成活，愈合良好，足功能基本得到恢复，可行走、负重，１８６例恢复了原工作。认为，恢复足部结构完整与重建足跟、足底的感觉是获得良好功能的关键     

乙基叔丁醚对动物局部和全身的毒性研究

为了主人乙基叔丁醚（ＥＴＢＥ）的毒性作用，探讨它的灌注溶解治疗胆固醇结石的可能性。我们做了该药物的动物毒性实验，对比ＥＴＢＥ和ＭＴＢＥ（甲基叔丁醚）对动物的局部组织和全身毒性作用。局部毒性实验是对大白兔胆囊进行灌注后，病理观察组织变化。全身毒性实验是通过对小鼠腹腔注射药物的半致死量作对比。结果发现，ＥＴＢＥ对兔的胆囊、胆部属这和十二指肠的损害较ＭＴＢＥ组动物轻。ＥＴＢＥ摇篮腔注射半致死量ＬＤ５０）     

Lethal effects of CCl4 and its metabolism by Mongolian gerbils pretreated with chlordecone, phenobarbital, or mirex.

Gerbils are much more sensitive to the hepatotoxic and lethal effects of CCl4 than rats as indicated by 48-hr LD50 values (0.08 vs 2.8 ml/kg). On the other hand, gerbils are refractory to chlordecone (CD) potentiation of CCl4 toxicity. To investigate the possible mechanism underlying the high sensitivity of gerbils to CCl4 lethality, the metabolism of CCl4 was studied in gerbils pretreated with dietary CD, phenobarbital (PB), or mirex (M) at 10, 225, and 10 ppm, respectively. The hepatic content of 14CCl4, the expiration of 14CCl4 and 14CCl4-derived 14CO2, and lipid peroxidation were measured and the results were compared with the previous data for rats. After the 15-day dietary pretreatment, male gerbils (60-80 g) received 14CCl4 (0.08 ml/kg; sp act 0.04 mCi/mmol) ip in corn oil and the radioactivity present in the expired air was collected for 6 hr. More than 80% of the parent compound as represented by the 14C-label in the toluene trap was expired in 6 hr regardless of the pretreatments. Expiration of 14CO2 measured during the 6 hr after 14CCl4 administration in control gerbils was 3.5-fold more than that in rats and was significantly increased in pretreated groups (M greater than PB greater than CD). PB and M pretreatments resulted in a significant increase of 14C-label bound to the nonlipid fraction of the liver as compared with CD-treated or control gerbils. The radiolabel present in the livers of control gerbils was 5-fold higher than that of rats. In vivo lipid peroxidation measured as diene conjugation in lipid extracts from the livers was lower in gerbils than in rats, and none of the pretreatments significantly affected lipid peroxidation. The serum alanine aminotransferase and aspartate aminotransferase were significantly elevated at 6 hr after CCl4 injection in all groups of gerbils. These data indicate that the more extensive metabolism of CCl4, as represented by 14CO2 formation and 14C-label bound to hepatic tissue, in gerbils as compared with rats, may partially explain the high sensitivity of gerbils to CCl4 toxicity. However, the enhanced metabolism of CCl4 found in CD-, PB-, or M-pretreated gerbils did not lead to amplified hepatotoxic and lethal effects of CCl4. The reason gerbils may be refractory to CD amplification of CCl4 injury might be associated with other factors yet to be investigated.     

育龄妇女月经周期中心血管功能的变化

本研究采用先进的三维超声成像技术及多普勒技术对正常育龄妇女月经周期中心血管功能进行研究。结果：月经周期中ＨＲ、ＢＰ无变化；血清Ｅ２是周期性变化，排卵前达高峰。ＳＶ、ＣＯ、ＥＦ在排卵前期升高达峰值，显著高于月经期和黄体期；ＳＶＲ排卵前期最低，而Ｖｅｄ、Ｖｅｓ无变化。Ｖｍａｘ、Ａ、Ｅ在内源性Ｅ２高峰时明显加快，而Ｅ／Ａ比值无明显变化。结果提示：月经周期中随内源性Ｅ２的周期性变化，心脏功能也发生周期性变化。Ｅ２高峰时，心输出量、心搏量和射血分数达最高。外周阻力最低，心脏内血流速度加快。     

海南文昌汉族人群中两种葡萄糖-6-磷酸脱氢酶基因突变的研究

目的:分析海南文昌人群中葡萄糖-6-磷酸脱氢酶基因1376G→T、95A→G突变。方法:应用硝基四氮唑蓝定量法进行G6PD缺乏症的筛查,用等位基因特异PCR检测1376G→T、95A→G突变。结果:在358位海南文昌汉族人中,发现G6PD缺乏症患者20例,其中9例患者有1376G→T突变,3例患者有95A→G突变。结论:1376G→T、95A→G突变是文昌人群中常见的突变。     

异体甲状旁腺脑室内移植治疗甲状旁腺机能减退症

应用异体甲状旁腺进行脑室内移植治疗甲状旁腺机能减退症６例，疗效满意，术后临床症状消失或明显减轻，连续监测血清钙、血清磷和尿钙、尿磷均证实移植物在脑室内存活并有正常的生理功能。随访７－２２个月病情均无复发。本文对脑室内组织移植的手术方法，胎儿甲状旁腺的取材及术后可能发生的并发症进行了讨论。     

胫骨延长后骨痂直径与新生骨预后关系的临床分析

目的探讨胫骨延长后骨痂直径与新生骨预后的关系.方法 1996年1月～2001年12月,对68例胫骨延长者测量达所需延长长度时的骨痂直径,计算骨痂直径率(callus diameter ratios,CDR);统计拆除外固定架后2～4周时新生骨发生骨折例数及畸形角度,比较骨折和成角畸形与CDR的关系.结果拆除外固定架前胫骨前屈角度5度以上畸形19例,其中11例发生骨折;拆除外固定架后胫骨出现5度以上畸形6例,其中2例骨折;其余43例胫骨延长骨痂正常愈合.计算CDR值:CDR值小于80% 23例,其中发生新生骨骨折13例,成角畸形5度以上者21例;CDR在81%～85%之间6例,成角畸形5度以上4例;CDR值超过86% 39例,无畸形或新生骨骨折.结论胫骨延长时CDR小于80%时,容易发生新生骨骨折和畸形;CDR大于85%时,无新生骨骨折和畸形发生;两组间具有统计学意义(P＜0.05).CDR是判断骨痂能否正常愈合较为理想的检测指标.     

急性重型颅脑损伤ET和CGRP含量变化及其临床意义

目的　探讨急性重型颅脑损伤 (ASBI)患者血浆中内皮素 (ET)和降钙素基因相关肽 (CGRP)的含量变化及其临床意义。方法　用放免法测定 2 8例ASBI患者伤后 6～ 2 4h血浆中ET及CGRP含量。结果　ASBI患者ET含量明显增多 ,差别有显著性 (P <0 .0 5 ) ;CGRP也有一定的增多 ,但无显著性差异。结论　ET和CGRP共同参与ASBI病理生理反应过程 ,ET释放增加是加重脑继发性损害的重要因素