162例囊肿型痤疮局部护理治疗效果分析

目的：探讨局部护理治疗对囊肿型痤疮的效果。方法：将324例囊肿型痤疮随机分为两组，护理治疗组除常规治疗外并积极进行局部护理治疗。结果：护理治疗组162例的病人经过一疗程治疗痊愈128例，总有效率达94．44％，与常规治疗组对比差异有统计学意义。结论：囊肿型痤疮除常规治疗外，应积极进行局部护理治疗，以提高疗效。     

碘缺乏和甲状腺功能减退对大鼠仔鼠小脑细胞外信号调节激酶1/2蛋白表达的影响

Objective To study the effects of iodine deficiency and hypothyroidism on protein expression of extracellular signal-regulate kinase(ERK1/2) in the cerebellum of rots. Methods Twenty-eight healthy Wistar rots, female, 60 days old, were randomly divided according to their body weight into control group, iodine deficient group and hypothyroidism groups. Hypothyroidism groups in accordance with drinking water containing propylthiouracil(PTU) were divided into doses of 5 mg/L and 15 mg/L groups, 7 rats in each group. Rats after pregnancy, iodine deficient rats were administered with iodine-deficient diet and hypothyroid rats were administered with PTU in drinking water. Pup's cerebellum in each group were weighed on day 14,21,28 and 42. Cerebellum tissue was observed for cerebellar morphology using silver staining and detected for ERK1/2 protein using immunohistochemistry on day 7,14,21,28 and 42. Results On day 14,21,28 and 42, cerebellum weight of pups from iodine-deficient[(0.0945±0.0233), (0.1347±0.0046), (0.1542±0.0094), (0.1949±0.0048)g]were significantly lighter than control[(0.1856±0.0123), (0.2049±0.0098), (0.2268±0.0065), (0.2606±0.0086)g, all P < 0.05]and hypothyroidism groups [for 5 mg/L group: (0.1741±0.0172), (0.1927±0.0103), (0.2181±0.0064), (0.2583±0.0054)g, all P<0.05; for 15 mg/L group: (0.1604±0.0083), (0.1682±0.0103), (0.1996±0.0073) and (0.2579±0.0067)g, all P< 0.05]the difference had statistical significance(F=6.325,8.870, 16.191 and 21.574, all P<0.05). Compared to the controls on day 7, iodine-deficient group didn't have clear layers; on day 21, disappearance of external granule cells from iodine-deficient and 15 mg/L groups was delayed, still two or three layer external granule cells remained; on day 28 and 42, molecular layer from 5, 15 mg/L and iodine-deficient groups and became thinner. Immunohistochemistry showed that on day 7, there was no statistical difference of integrated optical density average of ERK1/2, in all the groups(F=1.102, P>0.05); on day 14,21,28 and 42, integrated optical density average of ERK1/2 in iodine-deficient group[(7.3245±0.5070), (8.3606±1.0683), (9.1217±1.0402), (12.1587±0.7581), all P<0.01]and hypothyroidism groups [for 5 mg/L group: (11.4307±1.5200), (14.919±0.8497), (16.0082±1.1130), (15.7721±0.8293), all P< 0.01; for 15 mg/L group: (7.8538±0.9775), (11.2461±0.8138),(12.78±1.3783), (13.0871±1.1450), all P < 0.01]was significantly lower than those of controls [(16.2831±0.5143), (20.2653±0.9551), (22.7485±1.0267), (22.1725±0.9939), all P < 0.01], the difference having a statistical signifieance(F=16.131,13.543,26.953,41.583, all P<0.01). Conclusions Iodine deficiency and hypothyroidism during critical periods of brain development may change eerebellar morphology and down regulate the protein expression of ERK1/2, which may result in damage of cerebellum development.     

碘缺乏和甲状腺功能减退对大鼠仔鼠小脑细胞外信号调节激酶1/2蛋白表达的影响

Objective To study the effects of iodine deficiency and hypothyroidism on protein expression of extracellular signal-regulate kinase(ERK1/2) in the cerebellum of rots. Methods Twenty-eight healthy Wistar rots, female, 60 days old, were randomly divided according to their body weight into control group, iodine deficient group and hypothyroidism groups. Hypothyroidism groups in accordance with drinking water containing propylthiouracil(PTU) were divided into doses of 5 mg/L and 15 mg/L groups, 7 rats in each group. Rats after pregnancy, iodine deficient rats were administered with iodine-deficient diet and hypothyroid rats were administered with PTU in drinking water. Pup's cerebellum in each group were weighed on day 14,21,28 and 42. Cerebellum tissue was observed for cerebellar morphology using silver staining and detected for ERK1/2 protein using immunohistochemistry on day 7,14,21,28 and 42. Results On day 14,21,28 and 42, cerebellum weight of pups from iodine-deficient[(0.0945±0.0233), (0.1347±0.0046), (0.1542±0.0094), (0.1949±0.0048)g]were significantly lighter than control[(0.1856±0.0123), (0.2049±0.0098), (0.2268±0.0065), (0.2606±0.0086)g, all P < 0.05]and hypothyroidism groups [for 5 mg/L group: (0.1741±0.0172), (0.1927±0.0103), (0.2181±0.0064), (0.2583±0.0054)g, all P<0.05; for 15 mg/L group: (0.1604±0.0083), (0.1682±0.0103), (0.1996±0.0073) and (0.2579±0.0067)g, all P< 0.05]the difference had statistical significance(F=6.325,8.870, 16.191 and 21.574, all P<0.05). Compared to the controls on day 7, iodine-deficient group didn't have clear layers; on day 21, disappearance of external granule cells from iodine-deficient and 15 mg/L groups was delayed, still two or three layer external granule cells remained; on day 28 and 42, molecular layer from 5, 15 mg/L and iodine-deficient groups and became thinner. Immunohistochemistry showed that on day 7, there was no statistical difference of integrated optical density average of ERK1/2, in all the groups(F=1.102, P>0.05); on day 14,21,28 and 42, integrated optical density average of ERK1/2 in iodine-deficient group[(7.3245±0.5070), (8.3606±1.0683), (9.1217±1.0402), (12.1587±0.7581), all P<0.01]and hypothyroidism groups [for 5 mg/L group: (11.4307±1.5200), (14.919±0.8497), (16.0082±1.1130), (15.7721±0.8293), all P< 0.01; for 15 mg/L group: (7.8538±0.9775), (11.2461±0.8138),(12.78±1.3783), (13.0871±1.1450), all P < 0.01]was significantly lower than those of controls [(16.2831±0.5143), (20.2653±0.9551), (22.7485±1.0267), (22.1725±0.9939), all P < 0.01], the difference having a statistical signifieance(F=16.131,13.543,26.953,41.583, all P<0.01). Conclusions Iodine deficiency and hypothyroidism during critical periods of brain development may change eerebellar morphology and down regulate the protein expression of ERK1/2, which may result in damage of cerebellum development.     

碘缺乏和甲状腺功能减退对大鼠仔鼠小脑细胞外信号调节激酶1/2蛋白表达的影响

Objective To study the effects of iodine deficiency and hypothyroidism on protein expression of extracellular signal-regulate kinase(ERK1/2) in the cerebellum of rots. Methods Twenty-eight healthy Wistar rots, female, 60 days old, were randomly divided according to their body weight into control group, iodine deficient group and hypothyroidism groups. Hypothyroidism groups in accordance with drinking water containing propylthiouracil(PTU) were divided into doses of 5 mg/L and 15 mg/L groups, 7 rats in each group. Rats after pregnancy, iodine deficient rats were administered with iodine-deficient diet and hypothyroid rats were administered with PTU in drinking water. Pup's cerebellum in each group were weighed on day 14,21,28 and 42. Cerebellum tissue was observed for cerebellar morphology using silver staining and detected for ERK1/2 protein using immunohistochemistry on day 7,14,21,28 and 42. Results On day 14,21,28 and 42, cerebellum weight of pups from iodine-deficient[(0.0945±0.0233), (0.1347±0.0046), (0.1542±0.0094), (0.1949±0.0048)g]were significantly lighter than control[(0.1856±0.0123), (0.2049±0.0098), (0.2268±0.0065), (0.2606±0.0086)g, all P < 0.05]and hypothyroidism groups [for 5 mg/L group: (0.1741±0.0172), (0.1927±0.0103), (0.2181±0.0064), (0.2583±0.0054)g, all P<0.05; for 15 mg/L group: (0.1604±0.0083), (0.1682±0.0103), (0.1996±0.0073) and (0.2579±0.0067)g, all P< 0.05]the difference had statistical significance(F=6.325,8.870, 16.191 and 21.574, all P<0.05). Compared to the controls on day 7, iodine-deficient group didn't have clear layers; on day 21, disappearance of external granule cells from iodine-deficient and 15 mg/L groups was delayed, still two or three layer external granule cells remained; on day 28 and 42, molecular layer from 5, 15 mg/L and iodine-deficient groups and became thinner. Immunohistochemistry showed that on day 7, there was no statistical difference of integrated optical density average of ERK1/2, in all the groups(F=1.102, P>0.05); on day 14,21,28 and 42, integrated optical density average of ERK1/2 in iodine-deficient group[(7.3245±0.5070), (8.3606±1.0683), (9.1217±1.0402), (12.1587±0.7581), all P<0.01]and hypothyroidism groups [for 5 mg/L group: (11.4307±1.5200), (14.919±0.8497), (16.0082±1.1130), (15.7721±0.8293), all P< 0.01; for 15 mg/L group: (7.8538±0.9775), (11.2461±0.8138),(12.78±1.3783), (13.0871±1.1450), all P < 0.01]was significantly lower than those of controls [(16.2831±0.5143), (20.2653±0.9551), (22.7485±1.0267), (22.1725±0.9939), all P < 0.01], the difference having a statistical signifieance(F=16.131,13.543,26.953,41.583, all P<0.01). Conclusions Iodine deficiency and hypothyroidism during critical periods of brain development may change eerebellar morphology and down regulate the protein expression of ERK1/2, which may result in damage of cerebellum development.     

咪达唑仑复合瑞芬太尼丙泊酚在小儿斜视矫正术中麻醉效果观察

目的:比较咪达唑仑复合瑞芬太尼丙泊酚麻醉与单纯瑞芬太尼丙泊酚麻醉在小儿斜视矫正术中的麻醉效果.方法:将70例择期行斜视矫正术患儿随机分为两组:Ⅰ组为咪达唑仑复合瑞芬太尼丙泊酚麻醉组,Ⅱ组为瑞芬太尼丙泊酚麻醉组,每组各35例.比较两组麻醉各时段血流动力学变化、瑞芬太尼丙泊酚使用剂量及苏醒情况,记录术中和术后不良反应的发生情况,记录麻醉诱导前、气管插管后、术中30min、术中60min及拔管后的收缩压、舒张压、心率、脉搏血氧饱和度及脑电双频指数.结果:两组在术中维持血压及心率较基础值均显著降低(均P<0.05);Ⅱ组在插管时血压与心率升高明显,与Ⅰ组相比差异显著(P<0.05).Ⅱ组使用丙泊酚量较Ⅰ组显著增加(P<0.05),瑞芬太尼用量也有增加.Ⅰ组拔管期躁动的患儿比例与Ⅱ组相比显著降低(P<0.05).两组拔管时间无显著性差异(P>0.05).结论:瑞芬太尼丙泊酚麻醉用于小儿斜视矫正术中安全、有效,复合咪达唑仑后更为安全经济.     

碘缺乏和甲状腺功能减退对大鼠仔鼠小脑CaM和CaN表达的影响

目的观察碘缺乏及甲状腺功能减退对大鼠仔鼠小脑发育的影响,以及对CaM、CaN表达的影响。方法W istar大鼠交配妊娠后,取孕鼠28只按体重随机分成对照组、甲状腺功能减退-1组、甲状腺功能减退-2组和碘缺乏组。自妊娠第6日起,对照组继续饲以普通饲料;甲减-1组、甲减-2组分别给予5 ppm、15 ppm丙基硫尿嘧啶饮水,饲以普通饲料;碘缺乏组饲以缺碘地区粮食配制的饲料,至仔鼠生后第28 d（PN28）。PN7、PN14、PN21、PN28、PN42取仔鼠小脑皮质进行CaM、CaN蛋白免疫组化染色。结果PN14、PN21、PN28及PN42时,甲减-2组和碘缺乏组仔鼠小脑皮质CaM的平均积分光密度值显著低于对照组和甲减-1组,具有统计学意义（P〈0.05）;碘缺乏组仔鼠小脑皮质CaN表达均显著高于对照组,具有统计学意义（P〈0.05）。结论碘缺乏和甲状腺功能减退可影响大鼠仔鼠小脑CaM、CaN蛋白的表达,从而损害仔鼠小脑,导致脑神经发育障碍。     

病毒性肝炎患者内源性一氧化氮产生水平及其临床意义

近年来有关一氧化氮(NO)与肝病关系的研究日益增多。认为NO可能在肝病中起重要作用。我们对29例各型病毒性肝炎及对照组(5例献血员)进行内源性NO含量检测，并对其临床意义进行探讨。     

鞍区梭形细胞嗜酸细胞瘤2例临床病理分析

目的探讨鞍区梭形细胞嗜酸细胞瘤(spindle cell oncocytoma, SCO)的临床病理特征、诊断、鉴别诊断、治疗及预后。方法回顾性分析2例SCO的临床资料、组织学形态和免疫表型,并复习相关文献。结果肿瘤主要由梭形细胞混合多少不等的上皮样细胞构成,多呈巢状、束状排列,局部可呈腺样或菊形团样排列,瘤细胞胞质丰富,嗜酸性细颗粒状、淡红染,核呈短梭形、圆形或卵圆形,核仁不清,具有轻～中度异型性,未见核分裂象及坏死。部分上皮样细胞胞质空淡或呈空泡状,散在分布于梭形细胞之间,部分呈片状分布,与梭形细胞存在移形过渡。间质见较多成熟淋巴细胞及少许嗜酸性粒细胞浸润,局部可见黏液变性。免疫表型:vimentin、S-100蛋白、EMA、Galetin-3和TTF-1均弥漫阳性,CK灶阳性,GFAP、Syn、CgA、p63、PR、ACTH、PRL、GH、TSH、FSH和LH均阴性,Ki-67增殖指数3%～5%。术后分别随访9、10个月,未见复发。结论 SCO临床少见,其病理特征及影像学检查无明显特异性,易误、漏诊,确诊主要依靠病理学检查,该肿瘤虽属WHOⅠ级,但可复发,应对其进行长期密切随访。     

脑脊液置换联合尼莫地平治疗蛛网膜下腔出血的临床研究

目的 研究脑脊液置换联合尼莫地平治疗蛛网膜下腔出血（SAH）的疗效及临床应用价值。方法将本院2000年1月至2006年12月收治的72例SAH患者作为治疗组应用脑脊液置换联合尼莫平治疗。逆时选取2000年1月以前采用传统保守治疗的66例SAH病人作为对照组,应用尼莫地平治疗。结果治疗组病人头痛持续时间较对照组明显缩短（P〈0、01）,治疗组病死率较对照组明显下降（P〈0.05）。但采用脑脊液置换并不能有效防止再出血并发症的发生,亦不增加发生再出血的几率。结论脑脊液置换联合尼莫地平治疗蛛网膜下腔出血有较高的临床应用价值,适合临床普及应用。     

临床指南结合TBL教学在眼科住院医师规范化培训中的应用

目的:探讨眼科临床指南结合团队式学习(team-based learning,TBL)教学课程在眼科住院医师规范化培训中的应用及教学效果。方法:本研究选取2022年1月—2023年6月在广州医科大学附属第一医院眼科进行住院医师规范化培训的15名住院医师作为研究对象,先后交替使用自学讲课、TBL教学这两种教学模式进行眼科临床指南学习,通过填写满意度调查问卷及评估出科考通过率、学业水平测试成绩、结业考通过率,从主观及客观角度探讨临床指南结合TBL学习模式的教学效果。结果:住院医师对增加眼科临床指南学习具有较高评价,且不认为会增加其学习负担。开展指南学习后,住院医师出科考试及格率、学业水平测试通过率、结业考通过率均为100%。在培养团队合作能力、改善学习氛围两方面,TBL讲课的满意度均高于自学讲课(均P<0.001)。93.3%(14/15)的住院医师更喜欢TBL教学模式。结论:眼科临床指南结合TBL教学是一种有效的教学模式,住院医师在主观满意度调查问卷及客观考试成绩的评估中,均达到满意的教学效果。