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     

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。     

MRI同层动态增强对垂体微腺瘤的诊断价值

目的：分析垂体微腺瘤的MPd同层动态增强特征。方法：对40例临床怀疑为垂体微腺瘤的病人行同层动态增强MPd扫描，并绘出时间一信号强度曲线图。结果：40例病人中共检出垂体微腺瘤26例。同层动态增强后垂体微腺瘤的MPd表现为圆或椭圆形的低或稍低信号，似“充盈缺损”；垂体微腺瘤的最大信号强度多出现在注入造影剂后32～96s，以64s最明显。结论：同层MPd动态增强对垂体微腺瘤的诊断有较高价值。     

左顶叶黑色素瘤并视力受损一例

患者，女性，14岁，因视物模糊7d、头痛3d于2004年10月8日入院。查体：神志清，全身皮肤黏膜无黑色素瘤的斑痣。右眼视力50cm数指，左眼视为0.1，双眼底视神经萎缩，余颅神经检查未见异常。头颅CT及MRI：幕上下脑室系统轻度扩大。     

检测血清VEGF、CEA、TSGF在肿瘤中的临床意义

目的研究血清VEGF、CEA在肿瘤诊断中联合应用价值以及肿瘤患者中血清VEGF与TSGF相关性.方法收集结直肠癌、肺癌患者以及正常人静脉血标本,ELISA法检测血清VEGF含量,放射免疫法检测CEA,化学显色法检测TSGF.结果结直肠癌患者中,血清CEA阳性率为32.4%,VEGF阳性率为54.1%,两者联合应用时阳性率为73.0%.血清VEGF与TSCF在结直肠癌中的相关系数为r=0.355(P＜0.01),肺癌患者中为r=0.612(P＜0.05).结论联合检测CEA和VEGF可以明显提高结直肠癌患者的阳性率,肿瘤患者血清中VEGF与TSGF的含量显著相关.     

无溶剂体系合成1,3-甘油二酯用脂肪酶的筛选及其酯化性质

对不同来源的脂肪酶进行了系统的筛选,并根据位置专一性的差别将脂肪酶分为1,3 特异的、1,3 选择性和非选择性的3类.采用LipozymeRMIM在无溶剂系统中催化甘油、脂肪酸合成1,3 sn 甘油二酯.研究表明脂肪酸、底物醇种类、温度、水分活度对LipozymeRMIM的活力有明显的影响.     

护理程序在临床教学中的应用

把护理程序运用于临床教学中 ,提高护生的综合素质 ,培养实用型高素质护理人才。通过对护生社会心理状态及学习情况的评估 ,确定知识目标、技能目标、素质目标 ,然后分别组织实施 ,最后作出综合评价。结果显示 ,运用护理程序进行带教后 ,护生的专科知识、技能、服务意识都有了全面的提高 ,同时也培养了护理人员运用护理程序实施带教的能力。揭示 :护理程序在临床教学中的应用具有科学性和实用性 ,值得进一步推广。     

TAD方案治疗急性非淋巴细胞白血病疗效的评价

采用 TAD 方案治疗急性非淋巴细胞性白血病(ANLL)12例,年龄17～47岁。总有效率为66.7%,完全缓解率(CR)为41.7%。5例获 CR 的时间是26～66天,平均53天,较国内其它方案为快。CR 时间为2～9月,平均6.2月,较其它方案又较短。TAD 方案对心脏的毒性作用轻微。TAD 方案对5例获 CR 者,于诱导治疗第一疗程后,除1例外,骨髓中白血病细胞百分比下降均不明显;但于第二疗程后,白血病细胞全部减少到骨髓有核细胞总数的20%/以下,这种现象似可作为本方案预后的观察指标。     

丙泊酚对创伤家兔凝血功能的影响

目的 研究丙泊酚对创伤后家兔凝血功能的影响.方法 24只中国家兔随机分为四组.每组6只:对照组(C),创伤组(T),创伤+脂肪乳组(T+F)和创伤+丙泊酚组(T+P).观察创伤前(T0),创伤后1h(T1),3h(T2),5h(3)时的MAP、HR及RR及凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)和纤维蛋白原(FIB).结果 (1)有创组家兔在T1时MAP显著下降,T2、T3时逐渐升高,与T0间均有统计学意义(P＜0.05);有创组在不同观察点与C组间相比有差异(P＜0.05).有创组HR,T1与T0间均无差异,T2和T3与T0相比均有差异(P＜0.05);但各组间在不同观察点相比无差异.有创组RR,T1与T0间有差异,T2和T3与T0之问无差异;各组之间在不同观察点差异无统计学意义.(2)4组家兔PT,T1和T2与T0之间无差异,T3与T0间四组差异均有统计学意义(P＜0.05),组间相比,T1时有创组与C组间有差异(P＜0.05);T2、T3时组间无差异.有创组家兔APIT,T1与T0之间均有差异(P＜0.05);组间比较,T1、T2时有创三组与C组间有差异(P＜0.05).有创家兔组FIB,T1与T0间有差异(P＜0.05),组间比较,T1时有创组与C组间有差异(P＜0.05),T3时T组与其他三组之间均有差异(P＜0.05).结论 静脉持续输注丙泊酚对创伤后家兔凝血功能无显著性影响.