我国农村地区实施大病统筹合作医疗或医疗保险方案的技术缺陷

在我国中等发达及上农村地区,大病统筹合作医疗或医疗保险以其可缓解农村居民的就医经济风险而受到欢迎,但是在方案的拟订过程中尚存在一些明显的技术缺陷,比如,“大病”的技术定义、农村居民就医经济风险分析、风险临界线界定、保险经付比测算和保险费率厘定等,这些技术的缺乏,已严重影响农村合作医疗或医疗保险的推广和实施效果。     

氯地滴眼液对家兔眼压及房角组织影响的研究

目的 观察氯地滴眼液对家兔眼压及房角组织影响。方法 用６０只家兔设实验和对照组,以含０．１７５％氯霉素和０．１５％地塞米松的氯地跟液滴眼,每日４次,生理盐水对照。于１／２、１、２、３月测眼压后处死家兔以电镜观察房角组织变化。结果 眼压和房角组织结构与对照组无明显差异。结论 临床应用氯地眼液３月内是安全的。     

Poisoning by Datura leaves used as edible wild vegetables.

The causes of Datura intoxication include medication overdose, misuse of edible vegetables, deliberate abuse as a hallucinogen, homicidal or robbery and accidental intoxication from contaminated food. We report an incident of 14 people with Datura intoxication caused by ingesting wild Datura suaveolans for food. The incubation period was 15 to 30 min. The symptoms/signs were dizziness, dry mouth, flushed skin, palpitation, nausea, drowsiness, tachycardia, blurred vision, mydriasis, hyperthermia, disorientation, vomiting, agitation, delirium, urine retention, hypertension and coma. Three patients were hospitalized for 2-3 days. Thirteen persons received supportive fluid therapy. One patient did not receive medical therapy, he induced vomiting and drank a lot of water. Four patients presented with delirium/coma and 3 received physostigmine therapy with good response. One patient was intubated because of coma and respiratory depression. Three persons needed Foley catheterization for urine retention or coma status. One patient had a complication of urinary tract infection and antibiotic management. All patients recovered with no sequelae.     

Renal vein thrombosis and selective arterial or venous thrombolytic therapy

Summary Background: Renal vein thrombosis (RVT) complicating the nephrotic syndrome is associated with a poor prognosis. Methods/Results: RVT was diagnosed in 12 of 60 patients with a diagnosis of nephrotic syndrome suggested by computed tomography (CT) and subsequently confirmed by selective renal angiography. Fifty patients carried a diagnosis of primary glomerulonephritis with various pathological findings, and 10 patients had lupus nephritis. Renal vein and peripheral vein blood samples were collected in the 12 patients with RVT and were assayed for fibrin(ogen) degradation products (FDP), antithrombin III (AT III), VIIIR:AG, and fibrinogen. The results suggested a state of hypercoagulation. Of these 12 patients, 7 were given 200,000 units of urokinase (UK) over 60 minutes in divided doses selectively via the renal vein. Five patients were given 200,000 units UK selectively into the renal artery. All patients also received 2.5 mg/day warfarin and 75 mg/day persantine. Except for three patients with focal glomerulosclerosis, all patients received 40 mg/day prednisone. After 1 month, the CT scan and blood samples for FDP, AT III, VIIIR:AG, and fibrinogen were repeated. Patients receiving intra-arterial UK had complete resolution of their thrombi. Complete resolution was also suggested in 2 of the 7 patients receiving UK by renal vein, and there was partial resolution in the other five. The hypercoagulation state decreased in all patients. Conclusions: We conclude that RVT is not an uncommon event in patients with nephrotic syndrome. The diagnosis can be supported reliably using abdominal CT scanning. Although a small number of patients were included in this nonrandomized study, it appeared that intra-arterial thrombolytic therapy yielded better results. The patients with minimal change disease have a good prognosis.     

.MYCOLOGIC IDENTIFICATION OF EMERICELLA NIDULANS AND ASPERGILLUS FLAVUS CAUSED PULMONARY INFECTION

A rare case of pulmonary infection caused by Emericella nidulans and Aspergillus flavus is reported for the first time in our country. "This diagnosis is of significance mycologically. :Direct microscopic examination and histopatho- logic cross section of expectorated mass show numerolus cleistoithecia of varying size, filled by asci and ascospores. Outside the cleistothecia 'were numerous thickwalled Hulle cells. The pa- tient was treated satisfactorily with antimyco- tics.     

注射用鹿茸生长素对肾阳虚型骨质疏松症的临床研究

目的：探讨鹿茸生长素肾阳虚型骨质疏松的治疗作用。方法：将阳虚型骨质疏松症随机分为两组分别用鹿茸生长素与蛙降钙素治疗，测量治疗前后骨密度、骨代谢生化指标分析，以及观察临床症状和体征结果：经注射用鹿茸生长素治疗后，治疗组临床症状明显改善，骨密度较治疗前提高。     

口腔愈疡颗粒质量标准的建立

目的：建立口腔愈疡颗粒的质量标准。方法：采用高效液相色谱法对成品中芍药苷进行含量测定。结果：芍药香浓度线性范围为：0．104—0．520μg/ml,γ=0.9993。样品平均回收率为98．85％，RSD为1．27％(n＝5)。结论：该方法适用于口腔愈疡颗粒的质量控制。     

电位滴定法的计算原理及Excel软件应用

阐述了电位滴定法的计算原理以及Excel软件在电位滴定数据处理中的应用。     

经迷路进路听神经瘤术后脑脊液漏的预防及处理

目的　探讨经迷路进路听神经瘤切除术后脑脊液漏发生的影响因素及处理方法。方法1999年以来采用迷路进路或扩大迷路进路听神经瘤切除术 85例 ,前 4 1例采用传统关闭术腔技术 ,后4 4例对关闭技术进行改良 ,分析其脑脊液漏的发生率。发生脑脊液漏者行保守或手术治疗。结果传统关闭技术组中脑脊液漏的发生率为 19 5 % ( 8 4 1) ,改良关闭技术组中脑脊液漏的发生率为 2 3%( 1 4 4 ) ,两组差异有显著性意义 (P =0 0 13)。传统关闭技术组中脑脊液漏多数发生在大型听神经瘤中 ,其发生率随肿瘤增大有上升的趋势。 9例脑脊液漏的患者中 ,3例经保守治疗 ;6例经手术修补成功 ,其中 5例 1次修补成功。结论　改良关闭术腔技术可显著降低经迷路进路听神经瘤切除术后脑脊液漏的发生率 ,手术修补为终止脑脊液漏的有效措施     

Expression of nm23 protein in human osteosarcoma in relationship with early metastasis

Nm23 protein expression was analyzed by immunohistochemical staining using formalin-fixed, paraffin-embedded sections from 39 cases with osteosarcomas and compared with the histologic findings and early metastasis for the purpose of detecting nm23 expression in osteosarcoma and elucidating the clinical significance of its expression. Immunoreactivity of nm23 protein was detected in 48.7% of the total cases. There was no statistical difference between nm23 expression and early metastasis, but there was a trend for cases with nm23 expression to progress to early metastasis within 1 year after operation. The role of nm23 as a tumor metastasis suppressor in osteosarcomas appeared less prominent.