中耳炎导致硬脑膜动静脉瘘1例报告

<正>硬脑膜动静脉瘘(dural arteriovenous fistula,DAVF)是指硬脑膜动脉、静脉及静脉窦之间形成的异常交通的血管性疾病,占颅内血管畸形的10%～15%^[1-3]。目前其发病机制仍不清楚,可能与静脉窦的闭塞导致引流不畅,进一步导致动静脉之间的潜在血管吻合开放有关。     

儿童脓毒性休克的激素与PS联合治疗效果及对患儿心功能的影响分析

目的:分析儿童脓毒性休克接受激素与肺表面活性物质(PS)联合治疗的效果.方法:以我院2018年06月01日～2018年12月31日收治的100例脓毒性休克儿童为对象,按照治疗方法将患儿分为2组,1组接受激素治疗,视作对照组,1组接受激素与肺表面活性物质联合治疗,视作观察组,比较两组休克治愈率、疾病转归、心功能改善情况....     

COMBINED INTRAOPERATIVE ILIAC ARTERY STENTS AND FEMORO-POPLITEAL BYPASS FOR MULTILEVEL ATHEROSCLEROTIC OCCLUSIVE DISEASE

Objective. To review our preliminary experience and evaluate our early results of a combined intraopemtive iliac angioplasty and stenting with infrainguinal revascularization in multilevel atherosclerotic occlusive disease. Methods. From July 1999 to April 2000, intraoperative iliac angiOplasty and stenting combined with simultaneous femoro-pepliteal bypass were pedormed on 12 lower extremities of 10 patients suffering from multilevel athemsclemtic occlusive disease. There were 8 men and 2 women, average 72 years. The indicationsf or procedures included disabling claudication in 3 and rest pain in 7 patients. Results. Eleven iliac angioplasty and stem procedures combined with simultaneous 9 femoro-popliteal by-pass and 3 femoro-femoral-popliteal bypass were performed in 12 limbs of 10 patients. Angioplasty and stem placement was technically successful in all patients. One contralateral femoral-popliteal bypass was failure after femoro-femoral-popliteal bypass. There were no additional instances of procedural or postoperative morbidity or mortality. Mean follow-up was 5 months (range 1 -10 months). During the follow-up period, one femoro-infrapoplitealgraft became occluded after 7 months and above-knee amputation was required. The cumulative primary patencyrate of stented iliac arteries, femoro-femoral bypass grafts and femoro-popliteal bypass grafts were 100% (11/11), 100% (3/3) and 90. 9% (10/11) in the follow-up period, respectivdy. The amputation rate was 8. 3%(1/12). Conclusions. Intraoperative iliac artery PTA and stent placement can be safely and effectively pedormed simultaneously with infrainguinal revascularization for multilevel atherosclerotic occlusive disease by skilled vascular surgeon, using a portable C ann fluoroscopy in the operating room. Furthermore, iliac artery PTA and stenting was valuable adjunct to distal bypass either to improve inflow and outflow, or to reduce the extent of traditionalsurgical intervention, and also, any angioplasty and stenting-related complications can be immediately corrected as well.     

Metabolic changes in rats with photochemically induced cerebral infarction and the effects of batroxobin: a study by magnetic resonance imaging, 1H- and 31P-magnetic resonance spectroscopy.

Metabolic changes in rats with photochemically induced cerebral infarction and the effects of batroxobin were investigated 1, 3, 5 and 7 days after infarction by means of magnetic resonance imaging (MRI), 1H- and 31P-magnetic resonance spectroscopy (MRS). A region of T2 hyperintensity was observed in left temporal neocortex in infarction group and batroxobin group 1, 3, 5 and 7 days after infarction. The volume of the region gradually decreased from 1 day to 7 days after infarction. The ratio of NAA/Cho + Cr in the region of T2 hyperintensity in the infarction group was significantly lower than that in the corresponding region in the sham-operated group 3, 5 and 7 days after infarction respectively (P < 0.05). Lac appeared in the region of T2 hyperintensity in the infarction group 1, 3, 5 and 7 days after infarction, but it was not observed in the corresponding region in sham-operated group at all time points. Compared with the sham-operated group, the ratios of beta ATP/PME + PDE and PCr/PME + PDE of the whole brain in the infarction group were significantly lower 1, 3 and 5 days after infarction respectively (P < 0.05), and the ratio of beta ATP/PCr also was significantly lower 1 day after infarction (P < 0.05). Batroxobin significantly decreased the volume of the region of T2 hyperintensity 1 and 3 days after infarction (P < 0.05), significantly increased the ratio of NAA/Cho + Cr in the region 5 and 7 days after infarction (P < 0.05), significantly decreased the ratios of Lac/Cho + Cr and Lac/NAA in the region 5 and 7 days after infarction (P < 0.05), and significantly increased the ratios of beta ATP/PME + PDE and beta ATP/PCr in the whole brain 1 day after infarction (P < 0.05). The results indicated that the infracted region had severe edema, increased Lac and apparent neuronal dysfunction and death, and energy metabolism of the whole brain decreased after focal infarction, and that batroxobin effectively ameliorated the above-mentioned abnormal changes.     

宫颈癌Ⅱ期术前介入治疗的临床价值

目的 探讨Ⅱ期宫颈癌患者术前介入化疗栓塞的临床价值.方法 31例宫颈癌Ⅱ期患者,术前行超选择性插管化疗栓塞,10～14 d后行宫颈癌根治术,分析其手术切除率、术中出血量及疗效,并与27例单纯手术病人进行对照.结果 化疗栓塞组临床症状均有不同程度的缓解,术中平均出血量340 mL,明显低于单纯手术组(560 mL);术中见瘤体有不同程度的坏死、缩小,分界变清,容易分离;病理示部分瘤细胞变性、坏死,瘤细胞数量减少,宫旁转移灶消失.术前化疗栓塞组3年和5年生存率分别为90.32%和75.86%,明显高于对照组(66.67%和46.15%).结论 子宫动脉化疗栓塞是Ⅱ期宫颈癌术前有效的辅助治疗手段.     

离子印迹交联壳聚糖的制备及其对Zn2+的吸附作用

目的 合成交联壳聚糖的离子印迹聚合物并用于对Zn2 的吸附. 方法 用交联剂环氧氯丙烷交联壳聚糖-Zn2 的配合物,并用0.5 mol/L HCl洗脱Zn2 得到Zn2 印迹聚合物. 结果 红外光谱和X射线光电子能谱的分析表明,在离子印迹过程和离子印迹聚合物对Zn2 的吸收中,壳聚糖氨基上的N原子和仲羟基O原子同时参与Zn2 的配位反应.该离子印迹聚合物对Zn2 的吸附达56.3 mg/g,与非印迹交联壳聚糖相比,其对Zn2 的吸附能力提高1倍以上,同时该印迹聚合物在弱酸中有较好的稳定性,可重复使用. 结论 离子印迹交联壳聚糖是一种新型高效的金属离子吸附剂.     

唾液斑口腔上皮细胞端粒长度变化在法医学实践中的应用研究

目的：探讨人类唾液斑中口腔上皮细胞端粒长度变化与年龄的相关性及其稳定性,探讨2种方式提取的检材及其不同放置时间后口腔上皮细胞端粒长度是否有差异,拟为法医学通过微量易得检材推断年龄提供依据。方法：选取40例不同年龄段健康人唾液,分为童年组（0～6岁）、少年组（7～17岁）、青年组（18～40岁）、中年组（41～65岁）、老年组（>66岁）5个年龄组,每组8人,分别制成新鲜口腔拭子和不同时间段（1、7、14、28 d）的唾液斑,用磁珠法提取样本中的DNA,通过荧光PCR（聚合酶链反应）相对定量法检测端粒DNA限制性酶切段长度变化。结果：不同组间端粒长度有明显差异（F=7.138,P=0.018）,年龄回归方程：Y=-75.006X+101.193,端粒TRF平均长度随年龄增加而逐渐缩短,并呈不均衡趋势。检材提取方式及检材新旧程度对检测到的TRF结果没有显著影响（P=0.740,P=0.740,P=0.958,P=0.324）。结论：唾液斑中口腔上皮细胞端粒长度随年龄增加而缩短,并且呈规律性改变;2种方式采集的样本及其不同放置时间后的样本端粒长度无明显差异,说明唾液斑中口腔上皮细胞端粒长度具有一定的稳定性,故可通过唾液斑中口腔上皮细胞端粒长度推断个体年龄。     

《医学免疫学》课程实施翻转课堂与形成性评价的实践及思考

翻转课堂的教学理念是以学生为中心,将传统的“先教后学”变为“先学后教”,具有提高学生自主学习能力,促进学生知识掌握与能力提升等优点。在此,介绍了《医学免疫学》课程中翻转课堂的应用实践,包括课程内容选择、课前建立QQ 群学习平台、自主学习资源制作与发布、任务单与学习要求制定、课堂教学活动设计与实施等环节;并开展形成性评价及回顾。通过对教学中出现问题的反思,以期为翻转课堂的推广奠定基础。     

Squamous cell carcinoma of the pancreas with liver metastasis: a case report

Squamous cell carcinoma of the pancreas is an unusual cancer of ductal cell origin. In a review of 6668 cases of exocrine pancreatic cancer from various registries reported from 1950 through 1985, the incidence of squamous carcinoma and adenosquamous carcinoma was 0.005% and 0.01%, respectively） We report a case of squamous cell carcinoma of the pancreas with liver metastasis.     

胶原酶溶解术治疗腰椎间盘突出症1600例

目的 通过1600例临床观察,总结分析胶原酶化学溶解术治疗腰椎间盘突出症的临床应用价值。方法 1994－10／1999－10采用硬膜外注射,部分采用盘内注射胶原酶300U治疗腰椎间盘突出症1600例。结果 1200例患者术后3－48mo随访,总有效率96.67％,优良率90.58%。结论 硬膜外注射胶原酶治疗腰椎间盘突出症,安全创伤小、疗效满意。