应用高尔夫钢板治疗胫骨平台骨折

目的:探讨高尔夫钢板治疗胫骨平台骨折的临床效果。方法:采用高尔夫钢板治疗胫骨平台骨折28例。结果:全部病例随访6个月~18个月,平均13个月,均获得骨折愈合。按Merchant标准,优21例,良5例,可2例。结论:应用高尔夫钢板治疗胫骨平台骨折,创伤小,固定牢靠,可早期功能锻炼,并发症少。     

Visual event-related potentials in progressive supranuclear palsy, corticobasal degeneration, striatonigral degeneration, and Parkinson's disease

To determine whether there are characteristic changes in event-related potentials (ERPs) in parkinsonian syndromes we studied 8 patients with progressive supranuclear palsy (PSP), 10 patients with corticobasal degeneration (CBD), 9 patients with striatonigral degeneration (SND), and 16 patients with idiopathic Parkinson's disease (PD) with a mean duration of illness shorter than 5 years in each group. A visual oddball paradigm was employed to elicit P300. P300 to the rare target and rare nontarget stimuli and reaction time (RT) to rare target stimuli in each group were compared with those in the corresponding age-matched normal control group and to each other after age correction. The correlation of P300 and RT to motor disability score was also studied. In PSP P300 amplitude was markedly reduced while in CBD P300 latency was prolonged. P300 amplitude to rare nontargets in SND and PD was attenuated. The mean RT in the PSP and the CBD group was significantly longer than in the other two groups. The mean RT in PD and P300 amplitude to rare nontargets in both CBD and PD showed significant correlation with the severity of motor disability. Simultaneous measurement of P300 and RT may yield useful supplementary information in facilitating diagnosis of parkinsonian syndromes in addition to clinical criteria. Received: 6 April 1999, Received in revised form: 5 August 1999, Accepted: 12 January 2000     

Effects of tetrandrine on phenotypic modulation of vascular smooth muscle cells and expression of p38 MAPK as well as MKP-1 after intimal injury of rabbit carotid arteries

Objective： To study the effects of tetrandrine （Tet） on phenotypic modulation of vascular smooth muscle cells （VSMCs） and expression of p38 mitogen-activated protein kinase （p38MAPK） as well as mitogen-activated protein kinase phosphatase-1 （MKP-1） after vascular intimal injury. Methods： HE staining was used to analyze vascular morphology of sham-injured group, injured group and Tet-treated group at day 28. lmmunohistochemistry, Western blot and RT-PCR were respectively used to detect the expression change of smooth muscle a-actin （SMa-actin）, proliferation cell nuclear antigen （PCNA）, p38MAPK and MKP-1 of injured group and Tet group at days 7, 14 and 28 after balloon injury. Results： ① All layers of vascular wall in sham-injured group were intact at day 28. The neointimal area was significantly increased and the lumen area notably decreased in injured group at day 28. The neointimal proliferation in Tet treated group was less than that in injured group, and the lumen area of Tet group was significantly increased than that of injured group at day 28. ②Compared with the injured group, the expression of SMa-actin, PCNA, p38MAPK and MKP-1 of vascular wall in Tet group was no difference, and the neointimal proliferation condition was also basically as same as injured group at day 7 after injury. The expression of PCNA and p38MAKP in Tet group was obviously lower than that in injured group, and the expression of MKP-1 in Tet group was obviously higher than that in injured group at days 14 and 28 after injury. The expression of SMa-actin in Tet group was slightly higher than that in injured group at days 14 and 28 after injury. Conclusions： Tet could reduce neointimal proliferation by inhibiting VSMCs phenotypic modulation and p38MAPK signaling transduction pathway as well as its down regulation.     

针药结合治疗郁病临床观察

郁病是由于情志不舒、气机郁滞所引起的一类病证.主要表现为心情抑郁、情绪不宁、胸胁胀满、或易怒善哭、多愁善感、心疑恐惧,或咽中如有异物梗阻、失眠等各种复杂症状.西医将该病归属于情感障碍,认为本类疾病多由精神创伤和长时间的精神紧张等而诱发,目前治疗以三环类抗抑郁药为首选,但有许多副作用.吕明庄教授在临床上运用针药结合治疗郁病取得较好的疗效,现报道如下.     

内外兼治治疗耳鸣耳聋

耳鸣、耳聋在临床属于多发病之一。肾开窍于耳,心也寄于耳,胆络于耳,所以体虚失聪的施治就在于心肾;邪干窍闭,则治在胆经。因耳是空灵之窍,为清阳交会之所在,凡是外因感受风热火郁,与内因水衰火实,肾虚气厥者都能失聪。因此,治疗方法,就不外乎通阳镇阴和益肾补心清胆等,使宁静清明之气可上达清窍,耳听就能聪明了。肾是肝之母,肝是肾之子,肝藏血、肾藏精,肝血有赖肾精的滋养,肾精得肝血化生之精填养,故精血同源、肝肾同源。在病理上,肾精肝血的病变亦相互影响,精亏肝血不足;反之肝血不足可导致肾精亏损,肾阴不足可引起肝阴不足,而导致肝阳亢…     

CBN对脑反复缺血再灌注小鼠的保护作用研究

目的:观察CBN对脑缺血再灌注小鼠的保护作用.方法:采用小鼠脑反复缺血再灌注模型,从形态学、SOD活性、MDA含量、ATPase含量等方面观察了CBN对脑保护作用.结果:CBN可显著增加缺血再灌注脑海马区存活锥体细胞数,保护SOD活性,减少MDA的生成,减轻ATP酶活性的降低.结论:CBN对脑反复缺血再灌注小鼠具有脑保护作用.     

CBN对拟缺血再灌注神经细胞损伤的保护作用

目的:观察CBN对拟缺血再灌注神经细胞的保护作用.方法:采用"缺糖-复糖"结合"缺氧-复氧"的方法,在体外用小鼠胎鼠神经细胞模拟"缺血再灌注"损伤,观察了在LDH、SOD活性、MDA含量方面CBN对神经细胞的保护作用.结果:CBN可显著减少拟缺血再灌注神经细胞LDH的释放,保护SOD活性,减少MDA的生成.结论:CBN对拟缺血再灌注样神经细胞具有保护作用.     

婴儿围手术期静脉输液护理管理措施探讨

目的 探究婴儿围手术期静脉输液护理管理措施,提高护理质量.方法 选取我院2013年2月至2013年5月收治的婴幼儿患者100例,随机分为实验组和对照组.实验组婴幼儿患者50例,采取全新的护理方式,对照组婴幼儿患者50例,采取传统的护理方式.实验结束后,对这两组的临床疗效进行对比.结果 实验结束后发现,实验组患者一次性输液成功46例,成功率为92.0％；对照组患者一次性输液成功30例,成功率为60.0％.经对比,两组患者临床疗效差异显著,P＜0.05,具有统计学意义.结论 加强婴儿围手术期静脉输液护理管理,提高护理人员基本功,有助于提高护理质量,对手术成功有很重要的作用.     

“临床早期接触”对医学生关怀能力养成的效果分析——以汕头大学医学院“医者之心（HEART）”课程为例

目的探讨医者之心（HEART）课程中“临床早期接触社会实践环节”对关怀能力养成的效果，对该课程纳入“临床早期接触”的教学设计做小结。方法编纂临床早期接触中的“隐性课程”体验问卷，对参加医者之心（HEART）课程的临床早期接触社会实践环节的学生进行事后访问及问卷调查，以此评估“隐形课程”对医学生关怀能力养成的初步情况。 结果医学实习生对各种具有隐性课程内涵举措的各个维度对其关怀能力培育的帮助，均呈偏正向的态度。“带教教师教学示范”“关怀展现”“专业胜任能力对学生关怀能力影响”这3个构面的强弱程度，会因“学生临床早期接触时长”“带教教师年资”“临床早期接触过程满意程度”的不同而呈现显著差异。结论“临床早期接触各类组织形式”对第一次进入临床体验的医学生关怀能力认知有重要影响，典范学习及同伴影响对医学生关怀能力认知有正向影响。     

Characteristic Echocardiographic Manifestations of Behçet's Disease

The objective of this study was to determine the characteristic echocardiographic manifestations of Behçet's disease. Ninety-seven Behçet's patients admitted to our hospital from January 2002 to December 2016 were retrospectively analyzed. There were 63 patients (64.9%) with cardiac involvement; these included 47 men (74.6%) and 16 women (25.4%). Of these 63 patients, most (74.6%) exhibited valvular lesions, especially aortic regurgitation. The primary characteristic manifestations of valves were cusp prolapse with aneurysmal changes, vegetation-like lesions and echo-free spaces within the annulus. Second (30.0%) were aortic lesions, including aortic dilation or aneurysm formation, aortic pseudoaneurysm and coronary sinus aneurysm. Other manifestations, such as cardiac thrombosis, coronary arterial pseudoaneurysm, pulmonary aneurysm and pericardial effusion, were rare. Cardiac involvement is not uncommon in Behçet's patients, especially in males, and it is characterized by valvular disease, especially aortic regurgitation. The diagnosis of Behçet's disease should be considered when evaluating patients with these characteristic echocardiographic manifestations.