脑胶质瘤经颈动脉化疗212例临床分析

目的　研究脑胶质瘤术后经颈动脉灌注化疗的临床效果 ,探讨药物选择、给药途径、化疗时机等相关问题。方法　于术后 4～30天经颈动脉灌注日本产盐酸尼莫司丁 2 5mg/kg ,每周 1次 ,3次为 1个疗程 ,4～6周后行第二疗程治疗。结果　显效 (CR) 39例 ,占18 8%;有效 (PR) 4 4例 ,占 2 0 8%;微效 (MR) 5 9例 ,占 2 7 8%;无变化 (NC) 6 1例 ,占 2 8 8%;恶化 (PD) 5例 ,占 2 4 %,中位生存期接近10 0周。结论　经颈动脉灌注治疗脑胶质瘤具有疗效好、副作用小、简便、经济、病人愿意接受等诸多优点。     

MEBO保护烧伤创面的病理观察

目的：观察使用MEBO后对烧伤早期创面病理状况的影响,以证实MEBO有保护烧伤创面的作用。方法：采用SD大鼠深Ⅱ度烧伤模型,18只鼠随机分成MEBT组和传统干燥暴露疗法组,伤后4h和3d取创面组织制作病理切片。结果：病检显示传统干燥暴露疗法组血栓形成明显,残余皮肤附件呈进行性坏死;而MEBT组无明显血栓形成,残余皮肤附件也逐步好转,结论：证实MEBO能有效地保护烧伤早期的创面。     

Population Pharmacokinetic Analysis of Mizoribine in Chinese Renal Transplant Recipients

Background

We calculated the population pharmacokinetics of mizoribine in adult Chinese patients and compared the parameters with those of Japanese patients to determine whether there are any ethnic differences in blood concentration transition between these 2 populations.

Incidence and risk factors for pulmonary mycosis in kidney transplantation

IntroductionPulmonary mycosis, a severe complication following kidney transplantation, is associated with a high rate of mortality. The incidence of and independent risk factors for its development have not been well studied.MethodsWe retrospectively reviewed 2573 kidney transplant recipients. Patients were divided into case and control groups based on a diagnosis of pulmonary mycosis. The recipient baseline characteristics, posttransplant complications, immunosuppressive regimens and antibiotic usages were analyzed to identify independent risk factors.ResultsThe total incidence of pulmonary mycosis among kidney recipients was 2.1%. Upon univariate analysis, patients in the case group differed significantly from the controls based upon: older age, higher retransplantation rate, longer dialysis time, induction with ATG or anti-CD25 monoclonal antibodies, maintenance treatment with FK506 or MMF, broad-spectrum antibiotics, higher incidences of acute rejection episodes, DGF, impaired liver function, leukopenia, cytomegalovirus infection, and delayed incisional healing (P < .05). Multivariate analysis showed that older age, retransplantation, ATG induction, FK506/MMF, broad-spectrum antibiotics, leukopenia, and delayed incisional healing were independent risk factors for pulmonary mycosis.ConclusionsThe use of more potent immunosuppressive regimens seems to increase the rate of pulmonary mycosis. Patients who have five or more independent risk factors are at high risk for developing pulmonary mycosis.     

大鼠海人酸颞叶癫痫模型及病理和致痫机制研究

目的 建立海人酸颗叶癫痫模型，观察症状、脑电图(EEG)和病理改变，探讨病理和致痫机制。方法 立体定向注射海人酸(KA)于大鼠单侧海马腹后部致痫。视频监测；深部EEG；Nissl染色、。Timm’s染色。结果 大鼠症状及EEG呈急性期、静止期和慢性期3个阶段性变化。海马结构神经元死亡主要在急性期，以实验侧CA3区最明显。齿状回(DG)出现苔藓状纤维(MF)发芽并进行性增加。结论 KA模型是模拟人类颗叶癫痫理想的动物模型。     

老年患者关节置换术后发生急性精神障碍的原因分析

目的：回顾性总结老年患者在人工髋／膝关节置换术后发生急性精神障碍的原因和防治措施。方法2006年1月至2011年12月,本组收治70岁以上老年人工关节患者1650例,出现术后精神障碍67例,发生率为4.1％。分析这67例患者精神障碍出现时间、持续时间,麻醉方式、麻醉用药、髋膝手术方式、基础疾病和电解质失衡情况与术后精神障碍的关系。结果精神障碍多发生于术后6h～5d内,主要表现有谵妄、定向力障碍、躁动、烦躁不安、神智不清、嗜睡、胡言乱语、昼夜颠倒等。术后3.77％椎管内麻醉和4.10％全身麻醉患者出现急性精神障碍,但两者无统计学差异。髋关节置换术组出现精神障碍的比例为5.09％,显著高于膝关节置换术组的2.39％。67例精神障碍患者中合并有高血压42例（62.7％）,合并糖尿病39例（58.2％）,合并酗酒18例（26.9％）。67例精神障碍患者中术后电解质检查提示低钾（50例,74.7％）、低钠（42例,62.7％）、低钙血症（37例,55.2％）,合并低氧血症52例,占77.6％。结论高龄、基础疾病、电解质紊乱、低氧血症和术后疼痛是人工髋／膝关节置换术后发生急性精神障碍的高危因素。术前应重视和纠正老年患者各种病理状态,加强围术期呼吸循环的管理,防止低血压、低氧血症、脑水肿的发生,术后给予良好的镇痛和人文关怀,尽量消除促使术后精神障碍发生的各种因素。     

医用臭氧在治疗腰椎间盘突出症中相关阼用的研究进展

医用臭氧是治疗腰椎间盘突出症常用的微创方法,已取得了良好的临床疗效,注射部位包括盘内、椎旁以及椎间孔内外等。目前的研究表明,臭氧对正常的椎间盘组织和细胞可产生氧化作用。在治疗腰椎间盘突出症中的作用主要包括对髓核的直接氧化作用、调节氧化应激、调节免疫反应、激活镇痛系统和增加氧供使炎症介质减少等。其中,有些作用机制的具体作用途径尚未完全阐明,而大量的临床证据以及明确臭氧的作用途径为其临床应用的推广起到了至关量要的作用。