关木通引起慢性间质性肾炎7例报告

目的　观察关木通所致慢性肾损伤的临床和病理改变特点。方法　本组 7例中 ,男 5例 ,女 2例。 3例服关木通汤药 ,4例服含关木通成药。分析服用时间、累积总量与肾损害首发症状及症状出现时间、肾功能和肾病理改变的关系。结果　汤药组 :服药时间平均 3 3 3个月 ,累积总量平均 82 9 3 g ,首发症状为乏力 3例 ,夜尿增多 2例 ,平均时间为 8 3个月 ,Cr平均 40 2 μmol/L。肾病理 :3例均为重度寡细胞性肾间质纤维化 ,肾小管广泛萎缩。成药组 :服药时间平均 7 5个月 ,累积总量平均 13 6g ,乏力 3例 ,夜尿增多 1例 ,恶心呕吐、头痛头晕 1例 ,平均18 8个月 ,Cr 3 62 8μmol/L。肾病理为重度寡细胞性间质纤维化和灶状纤维化各 2例 ,肾小管灶状萎缩 3例 ,广泛萎缩 1例。结论　汤药组关木通积累大 ,发病时间早 ,肾病理改变重。提示关木通所致肾损其临床表现、病理改变与服用关木通时间、剂量相关。     

1例乙酸钙不动杆菌致角膜溃疡病人的护理

不动杆菌为条件致病菌,致病力不强,一般情况下很少引起感染,但当机体抵抗力降低或正常免疫屏障被破坏时可引发疾病,确切的致病因子目前尚无定论[1].我院于2005年8月24日收治1例因乙酸钙不动杆菌所致角膜溃疡病人,经过及时、有效的治疗及精心护理,取得了较好的疗效,现将其护理总结如下.     

豚鼠内耳磁微粒栓塞缺血模型初探

OBJECTIVE: To set up an inner ear ischemic model in guinea pig with ferromagnetic embolism. METHODS: A magnet was fitted in the external auditory canal and carbonyl iron filings (1%, 1 ml/kg) was injected into jugular, then the inner ear vessels were obstructed by ferromagnetic spheres. Cochlear blood flow (CBF) and number of red blood cells in the stria vessels were used to detect the model's ischemia of cochleae. The slice of temple bone and basal membrane stained by silver nitrate were used for inner ear's histopathological observations. RESULTS: The iron spheres were amassed in the one and two-day-later's model of inner ear vessels, which resulted in embolism. The number of red blood cells in the stria vessels decreased and then recovered to normal level after 4 days, but the CBF decreased to 50% +/- 10% of basic level immediately and recovered to 99% +/- 41% 4 days later. Scattered lesion of out hair cell cilium could be seen in cochleae in eight-day-later's model, and degenerations in different degree were found in vascular stria. CONCLUSION: The methods of inner ear ischemic model with ferromagnetic embolism could be practical and the decrease of CBF was reversible, so it may be an ideal model for studying some ischemic inner ear diseases and evaluating the effects of therapeutic drugs.     

PRENATAL DIAGNOSIS Ⅰ. EARLY DIAGNOSIS OF OPEN NEURAL TUBE DEFECTS BY QUALITATIVE ACETYLCHOLINESTERASE ISOENZYME IN AMNIOTIC FLUID

The measurement of amniotic fluid (AF) acetylcholinesterase isoenzyme (AChEI) is a relatively new method for early diagnosis of open neural tube defects (NTDs). As quantitative methods are of unproven reliability at present, the authors used a high resolving power qualitative method-vertical slab polyaerylamide gel electrophoresis. The benefits of this technique are: simplicity of operation, accuracy, unsophisticated equipment, and easily available reagents. Combined results of 9 NTDs studies revealed that samples from early pregnancy gave more accurate results than those from late pregnancy.     

电脑比配色仪与比色板之间的相近性分析

目的：通过对比色记录的分析，比较Vita比色板、松风Vintage Halo比色板和电脑比配色仪之间的相近性和差异性。方法：随机抽取100名年龄在21～24岁的本地在校大学生，由男女两位测试者使用电脑比配色仪、Vita比色板和松风Vintage Halo比色板对被测试者的左上中切牙进行比色分析。结果：三种比色方法均以A色调最为集中，占总数的55％以上。其次是D色调占总数20％以上。男女测试者的选色在A、R、VR．系列中无明显差异。结论：电脑比配色仪、Vita比色板、松风Vintage Halo比色板均不能完全覆盖本地区青年天然中切牙的色度特征，只在A色调系列中重复率较高。     

Surgical treatment of carcinoma of the hypopharynx and cervical esophagus: substitution by the colon and stomach]

Thirty-one cases with hypopharyngeal carcinoma and 4 cases with esophageal carcinoma in cervical segment were treated surgically from April 1984 to April 1989. In 6 cases, while preserving the larynx, the hypopharynx and the esophagus were resected and reestablished by the colon. In 29 cases, total laryngectomy was also performed and 4 had their hypopharynx and esophagus substituted by the colon and 25 by the stomach. According to UICC (1982), there were 11 cases in stage II, 15 in stage III and 9 in stage IV. The mean 3-year and 5-year survival rates were 62% and 32% respectively. In fatal cases, 4 cases had recurrences at the site of pharyngeal anastomoses and 11 had metastases in the neck.     

Foley尿管气囊压迫治疗骶前静脉丛大出血的评价(附6例报告)

目的:评价直肠癌根治术中用Foley尿管气囊压迫治疗骶前静脉丛大出血(MPVP)的临床价值。方法:分析1995~2005年用Foley尿管气囊压迫治疗骶前静脉丛大出血6例的临床资料。结果:6例骶前大出血中全部用Foley尿管气囊压迫控制出血,术中出血量为800~1700mL,Foley尿管于术后4d拔除3例,5d1例,6d2例,均无再出血,会阴切口均一期愈合。结论:Foley尿管气囊压迫治疗骶前静脉丛大出血是一种简单安全有效的治疗方法。     

大鼠自体异体表皮细胞悬液混合移植的实验研究

目的　探讨自、异体表皮细胞悬液混合移植技术在创面修复中的应用。　方法　 30只大鼠随机配成 15对后 ,分成细胞悬液移植组 (A组 ,10对 )和细胞膜片移植组 (B组 ,5对 )。取每只大鼠全厚皮 ,分离表皮细胞 ,并根据配对情况按 1∶1的细胞比例混合 ,体外常规培养。 4d后收获A组混合细胞悬液 ,14d后收获B组混合细胞膜片。将此细胞悬液和膜片分别转移至A、B组相应供体大鼠的去全厚皮创面。随后A组每对大鼠的创面交叉覆盖配对方的异体全厚皮 ;B组创面覆盖胶原膜及“优妥”敷料。比较移植后 2～ 3周两组的创面修复情况。　结果　术后 2～ 3周 ,A组创面大多愈合 ,表面光滑 ,与皮下连接紧密。术后第 5天 ,B组创面部分细胞膜片脱落 ,部分成活 ,膜片成活的创面后期再次出现小创面 ,经久不愈。　结论　自、异体表皮细胞悬液混合移植是一种可行的、体内构建皮肤、修复创面的方法。     

老年人食道病变呈心绞痛样胸痛13例分析

13例有心绞痛样胸痛的住院病人入院均诊有冠心病心绞痛,后均经ECG、8例心脏“B”超、核素心肌灌注及24小时动态ECG各2例,确诊冠心病5例,不支持冠心病8例;后均行GI,并同时行胃镜、食管24小时pH测定及压力测定各2例,确诊有胃食管反流疾病(GERD),本组自胸痛症状出现至GERD确诊病程平均29.5个月(0.5～120个月),报告2例典型病例,讨论了误漏诊原因,探讨了老年人食管性胸痛的诊疗程序。     

大型垂体瘤不同手术入路治疗的比较研究

本文回顾性比较106例大型垂体瘤的开颅和经蝶手术治疗的比较。开颅组58例,经蝶组48例。开颅组肿瘤次全切除9例,大部切除48例,部分切除1例;经蝶组全切除35例,大部切除12例,部分切除1例。开颅组术后视力好转率71%,无变化12例,恶化3例。手术后偏盲好转率67%;经蝶组手术后视力好转率77%,无变化者11例,无1例恶化。手术后偏盲好转率93%。开颅组20例有额叶挫伤,其中1例并发脑内血肿,死亡4例。作者认为垂体腺瘤不长向鞍旁、海绵窦、前颅窝底和脚间池和肿瘤不呈瓶颈样生长者,都应优先考虑经蝶窦入路手术。