输尿管镜下气压弹道碎石治疗输尿管结石失败原因探讨(附36例报告)

目的:探讨输尿管镜下气压弹道碎石(URSL)治疗输尿管结石失败原因及防治措施.方法:回顾分析36例气压弹道碎石治疗输尿管结石手术失败的临床资料.结果:17例手术中结石移位进入肾盂,无法碎石;8例因输尿管走行迂曲或输尿管狭窄置镜未成功;5例因局部出血或引流不畅导致视野不清终止手术;6例因输尿管穿孔而改开放手术.结论:结石移位、输尿管走行迂曲或狭窄、术中视野不清、输尿管穿孔是手术失败的主要原因.合理选择病例,保持液适当的灌注速度和压力,保持视野的清晰和在直视下推进输尿管镜是手术成功的关键.     

P17 Pharmacology in the integrated course ＂Basic Medical Sciences＂ in Zhejiang University School of Medicine

According to traditional teaching mode, the courses in preclinical medicine including pharmacology are separately run. This mode causes a series of disadvantages including loose connection between knowledge in different disciplines and weak ability to bridge basic preclinical knowledge and clinical practice. In order to overcome the disadvantages and promote the teaching efficiency, we constructed a new integrated course-Course of Basic Medical Sciences, which includes 6 traditional courses, anatomy, histology and embryology, physiology, pathology, pathophysiology and pharmacology. We integrated these courses based on the human organ systems and according to the principle-＂ From macro to micro, From morphological to functional, From normal to abnormal and From disease to drug therapy＂ and published the series of textbook in 2004. The contents of pharmacology are taught just after pathology and pathophysiology in every organ system. In comparison with the traditional teaching mode, teachers of pharmacology need not spend a lot of time to review preceding knowledge of anatomy and histology, physiology, pathophysiology and pathology. This is helpful in saving time and improving the teaching efficiency.     

对大肠癌术后早期炎性肠梗阻诊治的探讨

目的：探讨大肠癌术后早期炎性肠梗阻的特点及治疗方法；方法：分析10例大肠癌术后出现早期炎性肠梗阻的临床表现并进行综合保守治疗；结果：10例患者保守治疗全部成功；结论：术后早期炎性肠梗阻是一种非细菌性炎性肠梗阻，以发生在术后早期，腹胀、呕吐明显，腹痛轻或无为主要临床特点，治疗应采用保守治疗。     

脑创伤致迟发性脑梗死临床分析

目的探讨脑创伤后迟发脑梗死的发生机制,临床诊断及救治措施。方法对32例经影像学证实为颅脑创伤后迟发脑梗死患者的临床资料进行回顾分析。结果出院时按GOS标准评价:恢复良好12例、中残5例、重残4例、植物生存3例,死亡8例,其中非手术治疗20例,存活14例,死亡6例,死亡率30%;手术治疗12例,存活10例,死亡2例,死亡率17%。结论及时诊断与合理有效的治疗是提高脑创伤后迟发性脑梗死的治愈率及提高患者生存质量的关键。     

A computerized system for image cephalometrics]

This system is composed of: (1) a perspective table, (2) TV camera, (3) a high-resolution image displayer, (4) a computer, (5) a laser printer The functions of this system are as follows: (1) It can perform cephalometries directly from image of X-ray film, (2) it can diagnose and analyse the deformity and provide treatment plan. This system is valuable for orthodontics and surgical orthodontics.     

不良生活方式与高血压病的流行病学调查分析

目的:调查不良生活方式对高血压发病的影响。方法:以国际通用血压测量方法对全区15 384人进行整群随机抽样调查,着重对有、无不良生活方式的两组人群进行高血压患病率调查,及相对危险度(RR)、归因危险度(AR)、人群归因危险度(ARp)、U检验等的检测,以及相关及多元回归分析。结果:食盐量≥12 g/d高血压患病率31.6％,<12 g/d的为 4.4％(P<0.001,RR 7.3,AR 27.3,ARp 57.2％,r=0.8517);BMI>24高血压患病率 23.2％,<24者 6.4％(P<0.001,RR 3.7,AR 16.9,ARp 37.2％,r=0.3215);肥胖患病率 34.7％,无肥胖8.1％(P<0.001,RR 4.3,AR 26.6％,ARp 19.7％,r=0.3529);油腻饮食高血压患病率14.8％,非油腻饮食8.7％(P<0.001,RR1.7,AR 6.1,ARp 13.9％,r=0.3853);吸烟高血压患病率 12.5％,非吸烟 9.2％(P<0.001,RR1.4,AR 3.3,ARp 8.3％,r=0.8403);饮酒患病率 12.7％,非饮酒 9.4％(P<0.001,RR1.35,AR 3.3,ARp6.7％,r=0.4650)。为进一步了解各危险因子与高血压患病率之间的数量关系和对高血压影响作用的大小,对所有对象用年龄(15～80岁)进行了分组,龄差1岁,共66组,多元回归结果为:偏相关系数0.3775～0.0809,建立的统计模型达到极显著水平(P<0.001),复相关系数0.9525。6个回归因子中按对高血压患病率影响(偏相关系数)大小排序:     

特异性DNA倍增技术检测t-PA cDNA基因在表达细胞中的稳定性

利用特异性DNA倍增技术(polymerase chain Reaction,PCR)检测t-PA cDNA基因在表达细胞基因组中的稳定性,并对所得的PCR反应产物进行了限制性内切酶片段、分子杂交和核苷酸顺序分析等方面的研究,证实了t-PA cDNA基因已插入到表达细胞染色体中。这种方法快速、简便、灵敏度和特异性高,是检测基因工程表达细胞中cDNA基因稳定整合状况的好方法。     

药物浓度和病因对三磷酸腺苷治疗阵发性室上性心动过速的影响

本文报告23例次ATP治疗PSVT的效果,总有效率56.5％,9例次高浓度快速注射者8例转复。器质性心脏病者副作用较多,1例冠心速注高浓度ATP后,发生心室颤动和阿-斯氏综合征。这一结果提示:药物浓度和注射速度是影响疗效的主要因素,PSVT伴AVB者疗效也很低;病因和药物浓度是决定副作用的因素。因此,对于器质性心脏病者,尤其冠心病人,应避免高浓度快速静脉注射ATP。     

子宫颈癌手术前放疗28例临床分析

我院１９８９年至１９９４年共行子宫颈癌广泛切除术和盆腔淋巴结清扫术３９例，其中２８例行术前放射治疗，１９例临床诊断为Ⅱｂ，随着手术技术的提高和术前放射治疗的配合，子宫颈癌的手术适应症的选择，可以扩大至Ⅱｂ，不增加手术的并发症，并具有一定的优点。