Hyperoxaluria, nephrolithiasis, nephrocalcinosis and renal failure after massive resection of the small intestine: report of a case.

Hyperoxaluria is frequently seen in patients with inflammatory bowel disease, or after resection of the ileum. It is assumed to be responsible for the development of nephrolithiasis, nephrocalcinosis (oxalate nephrosis) and progressive renal impairment in these patients. Steatorrhea may aggravate the severity of hyperoxaluria. A 60-year-old male underwent massive resection of the jejunum and ileum 10 years prior to admission, due to strangulation of the small bowel, with occlusion of the superior mesenteric artery. He remained well except for steatorrhea which developed two-and-a-half years prior to admission, when microhematuria, proteinuria and oxaluria developed progressively. Since that time, the nephrolithiasis, nephrocalcinosis and renal failure have continued to worsen despite therapy with oxalate restriction and oxalate-binding agents. A renal biopsy, performed late in the clinical course, showed severe changes in the renal parenchyma. The decline in renal function proved irreversible. The unusual metabolic consequences of massive resection of the small intestine and their mechanisms are discussed.     

Adenosine''s role in the genesis of bradyarrhythmias induced by acute myocardial hypoxia.

A close or even causal relation between myocardial adenosine and bradyarrhythmias during acute myocardial hypoxia was testified in guinea pig, rabbit and dog mainly by using specific competitive antagonist and synchronous quantitative analysis of 3 variables: intensity of myocardial hypoxia, degree of endogenous adenosine increment and severity of bradyarrhythmias. Results disclosed: A) striking resemblance of the bradyarrhythmias with hypoxic origin to those caused by exogenous adenosine, B) same locality of A-V conduction block induced by both myocardial hypoxia and exogenous adenosine, C) precise parallelism among the above-listed 3 variables with very high correlativity (r = 0.99, P < 0.01), D) frequent accompaniment of reversal of hypoxic bradyarrhythmias through resupply of 21% O2 with normalization of preexisted increase in myocardial adenosine, E) satisfactory blockade of hypoxic bradyarrhythmias by adenosine's specific antagonist--aminophylline and their augmentation by adenosine's uptake inhibitor--dipyridamole, F) close similarity of the characteristic curve representing relation among the above 3 variables to that among intensity of myocardial hypoxia, degree of endogenous adenosine increment and amount of coronary blood flow in which adenosine's role as a mediator has been well documented and G) reproducible persistence of bradyarrhythmias during myocardial hypoxia irrespective of preliminary vagotomy and atropinization, denoting independence of the occurrence of such dysarrhythmias upon vagal drive, suggestive of a mechanism other than vagotonia. We advocated that hypoxia-induced bradyarrhythmias was caused by increment in endogenous adenosine.

     

脉冲Nd：YAG激光照射对大鼠炎症牙龈组织的作用

患实验性牙龈炎的大鼠牙龈（６例）经脉冲掺钕钇铝柘榴石激光（Ｎｄ：ＹＡＧ激光）照射后进行光镜及超微结构观察。目的在于了解低能量Ｎｄ：ＹＡＧ激光照射对牙龈炎症的治疗作用。炎症牙龈经输出能量为１．５Ｗ，脉冲数为２０ＰＰＳ的激光照射后与对照组相比较，形态学上有如下变化：上皮细胞无变性；牙龈上皮层数较炎症时减少；上皮下炎细胞浸润明显减少；上皮细胞间隙变小；上皮下结缔组织内产生大量的排列致密的胶原纤维。结果提     

超声显像与膀胱镜对膀胱肿瘤的诊断价值

对经手术和病理证实的８３例膀胱肿瘤进行超声显像和膀胱镜检查的对比性分析。结果表明，膀胱镜对膀胱肿瘤的诊断符合率为９７．５％，略高于超声显像符合率的９５．２％；但对膀胱肿瘤的术前分期，膀胱镜检查尚存在局限性，而超声显像可弥补膀胱镜检查的不足。本文超声显像对膀胱肿瘤的术前分期准确率达８９．５％。超声显像对小于０．５ｃｍ的小膀胱肿瘤之检出率不如膀胱镜高。因此在常规检查以及对肿瘤的术前分期时，应以超声显像作为首选，同时结合膀胱镜检查，可进一步提高膀胱肿瘤的术前诊断正确率。     

山东农村511名高中生伤害的现况调查

目的 调查高中生伤害的情况、危险因素及其影响，为制定高中生伤害的预防措施提供依据。方法 以整群抽样的方法在山东省利津县某高中9个班的511名高中生中进行调查和描述性分析。结果 在过去一年里所调查的高中生8种伤害(车祸、中毒、跌落、烧烫伤、电击伤、钝／锐器伤、动物昆虫叮咬伤、溺水)的总发生率为15．5％，男、女生发生率分别为18．5％、11．9％。发生率最高的前4位伤害依次是跌落伤(7．6％)、中毒(4．3％)、车辆伤(3．3％)和钝／锐器伤(3.1％)。家中常发生中毒、烧烫伤，学校常发生跌落伤和钝／锐器伤。平均每人次伤害花费最大的是车辆伤，其次为跌落伤；平均影响学习时间最长的是车辆伤，其次为烧烫伤和跌落伤。伤害发生率在性别和父亲健康状况上有显著性差异。结论 针对不同伤害特点采取相应预防措施，以降低伤害发生率，促进青少年健康，减少社会健康损失和经济损失。     

妇癌患者的社会心理因素调查

本文以自编病前负性情绪调查表、ＬＳＥ─Ｒ及ＥＰＱ对５６例妇癌住院病人进行了调查，并以５６例内科病住院病人作对照。结果显示，６９．６％的妇癌病人在病前有负性情绪，而内科病病人只有１６．１％；８５．７％的妇癌病人病前经历了负性生活事件，而内科病组则为５８．９％；ＥＰＱ评定结果神经质分亦为前者高于后者，均提示社会心理因素与妇癌的发生密切相关。     

流行性出血热患者骨髓细胞超微结构的研究

8例流行性出血热患者骨髓细胞的超微结构研究结果发现骨髓细胞出现变性、空泡、粗面内质网及高尔基体扩张。并在胞浆中发现颗粒-丝状病毒包涵体及直径为100nm的病毒颗粒。同时胶体金免疫电镜发现骨髓细胞EHF抗原阳性,说明骨髓细胞是其繁殖、复制的场所。     

多巴酚丁胺负荷对缺血性扩张型心肌病患者左心室充盈的影响：病理生理学及预后意义

目的：本研究旨在探讨多巴酚丁胺对缺血性心肌病（ICM）患者左心室（LV）充盈功能的影响，并确定峰值负荷时限制性充盈型（RFP）是否具有预后预测价值。背景：ICM患者峰值负荷时RFP的预后价值尚属未知。方法：在静息和负荷情况下，采用多普勒超声心动检查研究了69例ICM患者；RFP定义为跨二尖瓣E／A比≥1．0、等容舒张时间（IVRT）〈80ms及E波减速时间（EDT）〈120ms。结果：69例患者中有42例静息时出现RFP，其中有24例患者负荷情况下转变为非RFP（EA），18例患者RFP持续存在（EE）；69例患者中27例静息和峰值负荷时均无RFP（AA）。     

脑动脉瘤手术麻醉处理体会

我院自2002年2月至2003年10月期间施行脑动脉瘤手术18例。现将麻醉处理体会，并结合文献总结如下。     

经肝动脉介入治疗并发胆囊坏死(2例报告并文献复习)

目的 :探讨经肝动脉介入治疗并发胆囊坏死的发生原因和防治措施。方法 :报告 2例经肝动脉介入治疗并发胆囊坏死的病例 ,均经手术病理证实。并结合文献资料分析这一并发症发生的机率、原因 ,以及为了减少并发症的发生需要注意的一些问题。结果 :近 8年来我院共做经肝动脉介入治疗 6 80例次 ,并发胆囊坏死 2例 (0 3% )。其发生原因是多方面的。超选择插管不到位是该并发症发生的主要原因。结论 :胆囊坏死是经肝动脉介入治疗比较常见的严重并发症之一 ,在今后工作中应引起足够的重视 ,尤其对肝血管瘤的介入治疗更应慎重 ,使这一并发症的发生率降至最低限度。