小儿手烧伤瘢痕畸形的整形外科治疗

Background: Cicatricial deformation in child burn of hand often leads to severe squaelae. According to different causes of disease , different plastic surgery were adopted .The key of operation lies in skin repairing , articulation dealing, and thumb correcting, which aim is to resume normal longitudinal and transverse arcs ,holding and clenching ability.     

肝细胞癌p21蛋白与增殖细胞核抗原的表达

应用免疫且化的方法对59例肝细胞癌p21蛋白及增殖细胞核抗原的表达进行研究，并对两者在肝细胞癌中的表达关系进行比较。结果显示：p21在癌周肝组织的表达水平高于癌组织，在癌组织中的表达与肝细胞癌的分化程度有关，癌组织的分化降低，p21表达水平也随之降低p21的表达与PCNA的表达呈负相关关系（r＝－0．327，P＜0．01）。提示：p21的缺失表达可能促进PCNA合成的增加，对肝癌的发生发展起重要作用。     

病人信息与影像处理系统的设计与实现

本文介绍了病人信息与影像处理系统的网络结构、体系结构设计;功能设计及实现方法.系统运行后性能稳定,达到了预期目的.     

寒冷干燥地区平时火器伤的早期处理

目的　探讨寒冷干燥地区平时火器伤伤情特点与早期救治方法。方法　对 1991年 1月— 2 0 0 2年 12月间 40例火器伤病人的临床救治进行回顾分析。结果　 2 4例枪伤中 ,2 0例一期缝合伤口 ,均一期愈合 ,另外 4例只清创未一期缝合的伤口 ,3例愈合 ,1例感染 ;4例骨折内固定均愈合良好 ,无骨髓炎发生。 16例炸伤病人局部软组织损伤及污染比枪弹伤重 ,14例一期缝合伤口中 ,10例一期愈合 ,4例感染 ,骨折内固定 2例 ,均愈合良好 ,无骨髓炎发生。结论　寒冷干燥地区火器伤早期伤道清创时限可适当延长 ,在平时火器伤的救治中 ,对软组织条件较好的创面 ,早期清创后可一期闭合伤口和骨折内固定 ,这样可减少感染和伤残 ,促进康复     

靶控输注异丙酚意识消失时血浆和效应室浓度的EC50与脑电双频谱指数的关系多中心大样本临床研究

目的 研究择期手术患者靶控输注（TCI）异丙酚意识消失时血浆、效应室靶浓度的50%患者意识消失时的药物浓度（EC50）与脑电双频谱指数（BIS）的关系。方法 5家医疗中心405例择期手术患者（国人）,ASAⅠ或Ⅱ级。靶控输注异丙酚,以血浆靶浓度1．2μg/ml为起点,到达预期血浆靶浓度后每30秒递增0．3μg/ml,直至患者意识消失。采用概率单位回归分析计算患者意识消失时异丙酚血浆靶浓度、效应室靶浓度的EC05、EC50和EC95及其所对应的BIS。结果 择期手术患者TCI异丙酚意识消失时异丙酚血浆靶浓度EC05、EC50和EC95分别是2．9μg/ml、3．8μg/ml和4．8μg/ml,效应室靶浓度EC05、EC50和EC95分别是1．3μg/ml、2．2μg/ml和3．2μg/ml,50%患者意识消失的BIS是58,5%和95%患者意识消失的BIS分别是77和40。结论 择期手术患者TCI异丙酚意识消失时血浆靶浓度和效应室靶浓度EC50及95%置信区间分别是3．8μg/ml（3．8～3．9μg/ml）和2．2μg/ml（2．2～2．3μg/ml）, 50%患者意识消失的BIS用95%置信区间是58（58～59）。     

老年腰椎间盘突出症的手术治疗

目的 探讨老年腰椎间盘突出症的特点与手术治疗效果.方法 对62例老人腰椎间盘突出症患者的临床与病理特点进行分析.均行腰椎后路椎板减压髓核摘除术,其中小切口开窗35例,半椎板切除20例,全椎板切除7例,根据手术前后JOA评分评价手术疗效.结果 老年腰椎间盘突出症病理以髓核组织的脱水,纤维环的破裂,小关节囊、周围韧带及软骨终板退变为主要特点.临床特点为下肢疼痛多发,腰部活动受限较多;双下肢神经系统检查肌力下降明显,生理反射改变明显.62例平均随访1.9年,JOA评分术后平均改善率为68.9%,手术前后JOA评分比较差异有显著性意义(P＜0.05).结论 老年腰椎间盘突出症患者病程长,体征多,病理改变明显,行腰椎后路椎板减压髓核摘除术,手术效果满意.     

Autonomic dysregulation as a basis of cardiovascular, endocrine, and inflammatory disturbances associated with obstructive sleep apnea and other conditions of chronic hypoxia, hypercapnia, and acidosis

Obstructive sleep apnea has traditionally been viewed as a structural disease. A multitude of systemic endocrine and cardiovascular abnormalities have been previously attributed to the prevalence of obesity in these patients. A growing body of clinical evidence, however, points to a relationship between sleep apnea and its systemic abnormalities independent of obesity. We hypothesize that this association is based on a maladaptive autonomic response of chemoreceptors, reacting to the hypoxia, hypercapnia, and acidosis of sleep apnea. The elevated sympathetic response triggers an inflammatory cascade that results in a myriad of downstream consequences including insulin resistance, hypertension, diabetes, atherosclerosis and metabolic syndrome. The sympathetic bias and endocrine disturbances may further exacerbate sleep disturbance in a potentially pernicious cycle. Our proposal may extend to any chronic respiratory or metabolic conditions that manifest hypoxia, hypercapnia, and acidosis and elicit a maladaptive autonomic and inflammatory response.     

Rapid leukocyte integrin activation by chemokines

Summary: Chemokines control selective targeting of circulating leukocytes to the microvasculature by triggering inside-out signal transduction pathways leading to integrin-dependent adhesion. Integrin activation by chemokines is very rapid, is downmodulated within minutes and appears to involve both enhanced heterodimer lateral mobility on the plasma membrane, facilitating encounters with dispersed ligand, as well as induction of a high-affinity state. These two modalities of integrin activation by chemokines involve distinct signaling pathways in the cell, yet complement each other functionally, allowing binding of rolling cells under conditions of low as well as high ligand density. Recent data show that chemokines generate both pro- and anti-adhesive intracellular signaling events, whose equilibrium is likely to be relevant to the kinetics of adhesion and de-adhesion, and to cell movement during diapedesis and chemotaxis. Importantly, chemokines utilize different signaling mechanisms to modulate the activity of distinct integrin subtypes. These recent advances suggest that chemokines may regulate adhesive responses of immune cells based not only on patterns of chemokine receptor expression, but also on variable signaling pathways that can modulate the pro-adhesive responses of leukocytes as a function of their differentiated state, and of the local microenvironment.     

Map location of the kanamycin resistance determinant in P1Km0.

The kanamycin resistance determinant in P1Km lies between am33 and gene 2 on the P1 genetic map. This is within the invertible region (C loop) of P1 DNA.     

心音信号的分形研究

本文通过引入分形概念,首次为描述心音信号的复杂程度给出了一个定量的指标——分数维数。研究结果表明:心音信号确实存在着“无标度区”,具有典型的分形特性;心音信号的分维值能显著性地区分正常心音、二尖瓣病变心音(包括二尖瓣狭窄、二尖瓣关闭不全及二尖瓣狭窄加关闭不全)和主动脉瓣病变心音(主动脉瓣狭窄、主动脉瓣关闭不全及主动脉瓣狭窄加关闭不全)。