小剂量氯胺酮咪唑安定辅助硬膜外下剖腹产手术的临床探讨

目的对比观察剖腹产选用连续硬膜外麻醉时，辅助麻醉用药镇静及对牵拉反应抑制效果。方法选择行剖腹产手术产妇60例在硬膜外麻醉效果满意后，随机分两组各30例。Ⅰ组：哌替啶50mg，异丙嗪25mg单次静注。Ⅱ组：氯胺酮28．5mg，咪达唑仑1．42mg单次静注。分组记录用药前，1min，5min，15min及术毕产妇SpO2、RR、HR、MAP值；记录手术时间、术毕苏醒例数、术中恶心躁动例数；记录术毕产妇OAA／S评分；记录新生儿娩出时Apger评分。结果两组术中镇静、抑制牵拉反应效果均满意。两组RR、BP、HR、SpO2均平稳；术毕两组OAA／S评分均为4-5分；新生儿Apger评分均正常。结论两组方法效果确切，对产妇和新生儿安全。     

急性视神经炎47例临床分析

分析了1984～1993年期间47例经治的急性视神经炎患者。治疗应用地塞米松10mg、青霉素480万u静脉点滴7天，随后减量。结果治愈35例（74．47％），好转6例（12．76％），无效2例（4．26％），转院及自动出院各2例。47例中11例治疗效果不好者行筛窦开放术后，视力逐渐恢复正常，显示筛窦开放术有其临床实用价值。     

37例传染性非典型肺炎流行病学调查与讨论

目的了解传染性非典型肺炎(SARS)流行病学的特点,提出相应的预防和控制措施.方法采取现场调查、网上电子病历审查、电话询问等方法.结果37例SARS患者的治愈率为89.2%,病死率8.1%,有接触史患者占37.8%.由于执行了严格的消毒隔离制度,医院内无任何人员感染发病.结论SARS患者在年龄上以青壮年为多,职业类以商业餐饮食人员为多.     

尿脱落细胞端粒酶检测在膀胱癌中的诊断价值

目的　利用聚合酶链反应的酶联免疫吸附试验 ,探讨检测自排尿脱落细胞端粒酶活性在膀胱癌早期诊断中的意义。方法　应用 (端粒酶重复序列扩增基础上PCR -ELISA)TRAP -PCR -ELISA方法检测 5 8例膀胱癌患者、 2 5例良性血尿患者及 30例健康体检者尿脱落细胞的端粒酶活性。结果　 (1) 5 8例膀胱癌患者尿脱落细胞阳性率为 81 0 % (4 7/ 5 8) ,2 5例良性血尿患者及健康体检者均无端粒酶活性表达。 (2 )TRAP -PCR -ELISA方法检测膀胱癌患者尿脱落细胞端粒酶活性与常规尿细胞形态学镜检间的差别有非常显著性意义 (P <0 0 1)。结论　尿脱落细胞端粒酶活性的检测法对膀胱癌患者的阳性检出率较常规尿细胞形态学方法高 ,可用于膀胱癌的早期诊断。     

振动对急性缺氧小鼠肺损伤的影响

本文观察了频率为20Hz、振幅为0．67mm和作用时间为40min的振动预处理对急性缺氧小鼠肺损伤的影响。结果发现实验组的肺组织匀浆脂质过氧化物LghdPeroxde（LPO）、支气管肺泡灌洗液（BALF）中蛋白含量和白细胞数明显低于对照组（P＜0．05）。这表明在特定率数的振动作用下能明显减轻急性缺氧小鼠肺的损伤。     

Ivermectin for the chemotherapy of bancroftian filariasis: a meta-analysis of the effect of single treatment

Summary The efficacy and safety of ivermectin in the treatment of filariasis due to Wuchereria bancrofti was assessed by a meta-analysis of the results from 15 published clinical trials. Seven hundred and forty-eight microfilaraemic patients were enrolled in 7 dose-finding and 8 comparative studies. Administered as a single dose, ivermectin induced nearly complete clearance of microfilariae from the blood from the first day to 30 days post-treatment, followed by gradual recurrence of microfilaraemia and increase in its intensity. Higher doses of ivermectin showed greater clearance effects and maintained lower microfilaraemia levels for a longer time. The adverse reactions caused by the drug were flu-like, transient, generally mild and well tolerated by patients. The frequency and intensity of adverse reactions were strongly associated with pretreatment microfilaria counts in the blood, but independent of dose. The findings of the meta-analysis suggest that ivermectin given at a single annual dose of 200 μg/kg body weight or higher, whether or not in combination with DEC, has great potential for therapeutic strategies to control bancroftian filariasis.     

Anatomic and spiral computed tomographic study of the genial tubercles for genioglossus advancement.

OBJECTIVE: To measure and compare Chinese mandibular genial tubercles measured anatomically and with computed tomography (CT). STUDY DESIGN AND SETTING: Spiral CT scans were taken of 40 adult human skulls; the superior genial spines were measured using anatomic and CT methods. RESULTS: The height and width of the superior genial spines, mandible thickness, and distance from the menton to the inferior and superior margins of the superior genial spines were 5.82 +/- 0.71, 6.98 +/- 1.35, 11.95 +/- 1.59, 11.08 +/- 2.05, and 16.91 +/- 2.30 mm from anatomic measurements and 6.17 +/- 0.71, 7.01 +/- 1.13, 12.19 +/- 1.64, 10.41 +/- 1.55, and 15.73 +/- 2.12 mm using spiral CT, respectively. The anatomic and CT measurements were correlated. CONCLUSION: Spiral CT of the genial tubercles can help locate the osteotomy in genioglossus advancement. SIGNIFICANCE: This study acquired reference data on Chinese genial tubercles demonstrating that CT measurements of the genial tubercles reflect their anatomy, which should allow accurately locate the osteotomy.     

肝内HBcAg与血清学指标的关系及慢性乙型肝炎发病机理的探讨

We detected the presence and distribution of HBcAg in the liver by immunohistochemistry (ABC method) and the presence of HBV-DNA in serum (spot hybridization) and anti-HBe in serum (ELISA) from 59 cases of hepatitis B hospitalized in our hospital, including 47 cases of CAH, 5 cases of CPH, and 7 cases of subacute fulminant hepatitis. 1. HBcAg in the liver was detected in 25 out of 47 cases (53%) of CAH, in 2 out of 5 cases of CPH and in 4 out of 7 cases of subacute fulminant hepatitis. The total percentage was 53% (31/59). 2. There was no positive correlation between HBV replication activity and liver disease activity (P greater than 0.05). Our results did not support the hypothesis that suggests a direct cytopathic effect of HBV. Oppositely, the fact was that the presence, the amount and the patterns of HBcAg in the liver, and the presence of HBV-DNA in serum were predominant in mild CAH compared with those in severe CAH, predominant in CAH without cirrhosis compared with those in CAH with cirrhosis. There was a tendency of inverse correlation between HBV replication activity and liver disease activity. The results above were in line with the concept that HBcAg expressed on the surface of infected hepatocytes may be relevant target for T lymphocyte cytotoxicity. The results have suggested that an immune response to HBV is present, leading to the destruction of most infected cells. 3. There was a positive correlation between HBV-DNA in serum and HBcAg in the liver (P less than 0.005), indicating that HBV-DNA in serum can represent HBV replication.(ABSTRACT TRUNCATED AT 250 WORDS)     

肝动脉化疗,栓塞与肝静脉暂时闭塞治疗肝癌

本文报道在10例肝癌患者中运用肝静脉暂时闭塞和肝动脉内灌注化疗、栓塞的方法治疗取得较好疗效。7例甲胎蛋白阳性患者5例下降大于50%,2例转阴。4例肿瘤缩小>50%。2例合并肝动-静脉瘘者成功实行碘油栓塞,1例经治疗后肝动-静脉瘘消失。对肝功能的影响与普通介入治疗相同。消化道反应相对较轻。并可提高肿瘤局部药物浓度,延长药物作用时间。配合肝段动脉或靶血管的插管可进一步提高疗效,减少并发症。     

子宫外蜕膜结节的病理学观察

采用ＰＡＳ、波形蛋白（ｖｉｍｅｎｔｉｎ）、上皮膜抗原（ＥＭＡ）、雌激素抗体（ＥＲ）和孕酮抗体（ＰＲ），对３例卵巢蜕膜结节（其中２例伴有腹膜结节），进行了免疫组织化学染色和光镜观察。结果３例均表达波形蛋白，而上皮膜呈阴性，支持蜕膜样细胞来源于体腔上皮。雌激素受体和孕激素受体显强阳性。说明妊娠期间，雌激素和孕激素的大量存在对异位蜕膜的形成和生长具有决定性的作用。