197例腰椎间盘膨出和脱出的CT分型

根据１９７例腰椎间盘病变的ＣＴ影像以及手术所见，提出腰椎间盘膨出分为均匀型、不均匀型、局限型；腰椎间盘脱出分为中央型、旁侧型、孔外型、Ｓｃｈｍｏｒｌ结节型。除Ｓｃｈｍｏｒｌ结节型外，上述椎间盘脱出可继续分为隆起型、破裂型、游离型等三个亚型。还讨论了分型的必要性、病理基础与临床关系以及鉴别诊断。     

子宫颈上皮不典型增生与宫颈癌细胞超微结构的观察比较

光镜和电镜观察慢性宫颈炎上皮不典型增生42例,宫颈癌21例,正常对照7例。上皮不典型增生之一是位于深部的储备细胞增生,细胞的核质比大,细胞器少,分化较低。鳞状上皮不典型增生细胞特点是核质比增大,核形不整,核膜内陷,细胞器增多,桥粒和张力原纤维减少。鳞癌细胞的核质比更大,核膜内褶深,细胞器更多,桥粒和张力原纤维很少或消失,分化低的癌细胞尤明显。粘液性腺癌腺上皮深部可见储备细胞转化的癌细胞。     

化学中毒与急性缺氧的双因素联合效应的实验研究

目的 研究化学中毒与急性缺氧两因素的联合效应。方法 建立常压常氧、常压缺氧和低压缺氧3种模型，以梭曼(Soman)、氰化钠(NaCN)和4-DMAP(4-dimethylaminophenol)为代表，测定大鼠、小鼠、家猫、PC12细胞、兔血红细胞等在3种模型条件下对毒物药物的行为、生化和生理指标变化。结果梭曼单独作用可导致动物协调运动下降、脑等组织含水率增加、脑组织AChE活性降低、MR下调、NE和cAMP含量增加。急性缺氧单独作用也可引起动物协调运动及自主活动的降低、脑等组织含水率的增加、外周血和脑组织AChE活性升高、MR受体上调、NE和cAMP含量增加、4-DMAP药效升高。化学中毒与急性缺氧同时作用，上述变化更加复杂。结论 化学中毒与急性缺氧两种因素同时作用于机体，对机体产生广泛而复杂的损伤作用。此种作用为两因素的联合效应。缺氧引起的机体功能下降对联合效应的增加部分贡献较大。急性缺氧既可使重要的组织成分发生质或量的变化，也会影响某些抗毒剂的作用强度。     

MRI的选购定位

对MRI若干主要参数进行总结,结合实际应用体会,对我院MRI设备选购进行讨论,以期对MRI设备的选购定位提供参考.     

Oral and dental manifestations in diabetic and nondiabetic uremic patients receiving hemodialysis.

OBJECTIVE: The aim of this study was to examine the dental condition and oral manifestations in diabetic and nondiabetic uremic patients undergoing hemodialysis. STUDY DESIGN: A total of 128 patients undergoing hemodialysis therapy were classified into the diabetic and nondiabetic groups and examined for uremic oral manifestations, dental caries, and the periodontal status. All the patients received predialytic salivary pH examination. In the diabetic group, the correlation between oral findings and glycemic controlled levels, which was collected based on Hb A1C values, were further studied. RESULTS: The diabetic group exhibited significantly higher prevalence of caries and more severe dry mouth, taste change, and mucosa pain than the nondiabetic group. The diabetic group tended to have lower predialytic salivary pH, and patients with poor glycemic control (ie, Hb A1C > 9%) showed higher incidence of dry mouth, mucosal pain, and tongue coating. However, the DMFT and CPI index were not associated with glycemic control in the diabetic group. CONCLUSIONS: This study reveals that diabetic uremic patients undergoing maintained hemodialysis exhibited a potentially higher risk for dental decay and xerostomia. Lower salivary pH and poor glycemic control may affect oral manifestations. Further research is needed to clarify the combined influence of diabetic nephropathy on oral health.     

External Application of Chinese Drugs on Acupoint Shenque Combined with Salpingostomy for Treatment of Sterility Caused by Obstruction of the Fallopian Tube——A Clinical Report of 45 Cases

Objective： To observe the therapeutic effect of external application of Chinese drugs on acupoint Shenque （CV 8） combined with salpingostomy for treatment of sterility caused by obstruction of the fallopian tube. Method： 75 cases were randomly divided into the following 2 groups. Forty-five patients in the treatment group were treated with external application of Chinese drugs on acupoint Sbenque （CV 8） combined with salpingostomy, while 30 patients in the control group were treated with salpingostomy only. Results： The results showed that in the treatment group, 26 cases were cured, 11 cases improved, and 8 cases failed, with a total effective rate of 82.22%; while in the control group, 14 cases were cured, 7 cases improved, and 9 cases failed, with a total effective rate of 70.00%. There is a significant difference in the total effective rate between the two groups （P〈0.05）. Conclusion： The therapeutic effect of external application of Chinese drugs on acupoint Shenque combined with salpingostomy is better than that of salpingostomy only.     

糖皮质激素在川崎病治疗中作用的循证医学研究

目的 通过循证医学方法研究肾上腺皮质激素在川崎病治疗中的作用.方法 采用循证医学方法,检索国内外5种大型专业数据库,筛选出随机或半随机对照研究的文献,再人工筛查确定适宜文献.通过Meta分析,比较激素与丙种球蛋白治疗川崎病在退热时间和冠状动脉病变发生率方面的差异.结果 初筛得到443篇文献.经过人工检索,8篇文献符合要求而被纳入标准.其中,3篇文献共有49例川崎病患儿接受甲基强的松龙治疗,5篇文献共有406例患儿接受强的松治疗.对照组共有33例接受静脉丙种球蛋白治疗,435例接受阿司匹林治疗.各组间患儿性别、年龄、病程差异无显著意义.①甲基强的松龙组(3篇文献):24例发生冠状动脉病变,对照组18例发生,两组病变发生率差异无显著意义.在退热方面,1篇文献显示甲基强的松龙组发热时间明显较丙种球蛋白组缩短,差异有显著意义;2篇文献显示差异无显著意义.②强的松组(8篇文献):28例发生冠状动脉瘤,阿司匹林对照组11例发生,3篇文献提示强的松组冠状动脉瘤发生率明显高于对照组.强的松组76例发生冠状动脉扩张,对照组75例发生,3篇文献提示强的松组冠状动脉扩张发生率明显高于对照组,2篇文献提示强的松组冠状动脉扩张发生率略低于对照组,但差异无显著意义.结论 目前的研究资料显示,激素治疗与丙种球蛋白治疗川崎病在冠状动脉病变发生率方面尚无差异或增高.在缩短热程上两者差异也不显著.尚可进一步通过更大数量病例的随机对照研究来证实本结果.目前治疗川崎病不主张单独应用激素.     

不同光凝接触镜填充液对中央角膜厚度的影响

目的　比较在行氩激光全视网膜光凝治疗中使用不同接触镜填充液对中央角膜厚度的影响 ,以寻找最适用于该治疗的填充液。方法　对 4 6例 (5 2眼 )患者进行氩激光全视网膜光凝治疗 ,每次分别随机使用 0 2 5 %氯霉素、1%羧甲基纤维素及医用透明质酸钠组作为安放全眼底激光角膜接触镜填充液 ,在治疗前及治疗后均用角膜测厚仪测量患者中央角膜厚度。结果　治疗后使用 0 2 5 %氯霉素组中央角膜平均增厚 (31 4± 10 2 ) μm ,1%羧甲基纤维素组中央角膜平均增厚 (10 6± 4 3) μm ,医用透明质酸钠组中央角膜平均增厚 (8 0± 3 5 ) μm。方差分析显示 :氯霉素组与另两组差异有极显著性意义 (P <0 0 1) ,羧甲基纤维素组与透明质酸钠组差异无显著性意义 (P >0 0 5 )。结论　 1%羧甲基纤维素及医用透明质酸钠作为安放全眼底激光角膜接触镜的填充液对角膜水肿程度的影响明显小于0 2 5 %氯霉素 ,是可供选用的优良填充液