伴严重增殖性玻璃体视网膜病变视网膜脱离的玻璃体手术及失败原因探讨

本文报导采用现代玻璃体手术结合巩膜扣带、空气或硅油填塞治疗81例伴严重增殖性玻璃体视网膜病变(PVR)视网膜脱离的手术效果.经过6～28个月(平均14个月)的随访,视网膜完全平伏者54例,成功率66.7%,对极严重的PVR D(?)(闭斗状脱离)也取得50%的成功率.硅油填塞初步应用于极严重病例尤其是巨大裂孔的治疗,取得明显的效果.本文病例术后视力提高者50例,不变19例,下降12例,术后视力在0.05以上者共34例.认为玻璃体手术结合其它技术是伴严重PVR手术治疗的有效方法,提出进一步提高PVR治疗成功率的方法:彻底清除增殖膜及寻找一种有效抑制膜增殖而对眼内其它组织无毒性的药物。指出旧的PVR分级法存在的不足,推荐用于硅油研究的PVR新的分级法.     

病毒性肝炎病人血浆VitE水平及其临床意义

观测了急性肝炎和重症肝炎病人血浆ＶｉｔＥ及Ｌｐｏ水平及其动态变化。急性肝炎和重症肝炎病人血浆ＶｉｔＥ低于对照组，Ｌｐｏ高于对照组，均以重症肝炎更明显，且死亡病例血浆ＶｉｔＥ低于存活者。部份病人口服ＶｉｔＥ不能提高其血浆水平，并随病情加重而逐渐降低。讨论了病毒性肝炎病人血浆ＶｉｔＥ降低与Ｌｐｏ升高的关系及其临床意义，认为动态观测血浆ＶｉｔＥ可作为判断重症肝炎病情进展及预后的参考。     

格林—巴利综合症血清唾液酸、磷脂、胆固醇的测定及其临床意义

本文应用硫代巴比妥酸(TBA)法对34例格林—巴利综合征(GBS)患者51次血清唾液酸(SA)测定。结果显示:患者血清SA含量显著高于50例对照组,血清SA阳性率亦显著高于对照组;GBS患者四肢肌力与血清SA呈负相关;以重型GBS血清SA含量显著高于轻型,病程初期高于患病后期;血清磷脂含量GBS明显高于对照组,而血清胆固醇两组变化无显著性意义。本文提示GBS血清SA含量变化能够反映周围神经损伤的程度。     

A study on effects of parents age, birth order and mental retardation of unknown etiology]

On this report 461 matched cases of mental retardation of unknown aetiology were analysed on the relationship between the diseases and the parents age, birth orders with conditional Logistic regression. These cases were accurately diagnosed and selected from the Epidemiologic Survey of genetic diseases of Sichuan, China. The results found that mental retardation of unknown aetiology is related to the age of parents and birth order. The paternal age is the main factor while the maternal age in not a significant effect and birth order also in not a significant effect after readjusting the other factors. Compared to paternal age group of under 25. There are significant increase of relative risks of age group 30-34 and 45 above, about 1.8 and 2.7 fold increase in univariate analysis and 1.9 and 3.3 fold increase in controlling the maternal age and birth order, a chi-square test for trend of distribution of paternal age also indicates a significant dose response relationship between increasing risk with age. The significance of result and methods of analysis were discussed.     

Stimulation of the fastigial nucleus enhances EEG recovery and reduces tissue damage after focal cerebral ischemia.

Stimulation of the cerebellar fastigial nucleus (FN) increases CBF but not metabolism and reduces the tissue damage resulting from focal cerebral ischemia. This effect may result from enhancing CBF in the ischemic tissue without increasing local metabolic demands. To test this hypothesis, we studied whether the reduction in tissue damage is restricted to the neocortex, a region in which the CBF increase is independent of metabolism, and whether stimulation of the dorsal medullary reticular formation (DMRF), a treatment that increases both cerebral metabolism and CBF, also protects the brain from ischemia. In halothane-anesthetized Sprague-Dawley rats, the middle cerebral artery (MCA) was occluded either proximally or distally to the lenticulostriate branches. The FN or DMRF were then stimulated for 1 h (50-100 microA; 50 Hz; 1 s on/l s off). Twenty-four hours later, the infarct volume was determined. FN stimulation substantially reduced the size of the infarct, an effect that was greater with distal (-69 +/- 8%; n = 6; p < 0.001; mean +/- SD) than with proximal (-38 +/- 8%; n = 8; p < 0.001) MCA occlusion. The reduction occurred only in neocortex (-43 +/- 9%; p < 0.001) and not in striatum (-16 +/- 21%; p > 0.05). Stimulation of the FN also enhanced recovery of EEG amplitude in the ischemic cortex (+48%; p < 0.003). DMRF stimulation (n = 7) did not affect the stroke size or EEG recovery (p > 0.05). Thus, stimulation of the FN, but not the DMRF, attenuates the damage resulting from focal ischemia.(ABSTRACT TRUNCATED AT 250 WORDS)     

论医学生和谐就业伦理观的培养

结合目前医学生在就业过程中出现的不和谐伦理现象,分析了其主客观原因,提出了医学生和谐就业伦理观培养的现实途径.     

胰岛素样生长因子-Ⅰ对软骨细胞凋亡的抑制

目的:探讨胰岛素样生长因子-Ⅰ(IGF-Ⅰ)对软骨细胞增殖及白细胞介素-1(IL-1)诱导软骨细胞凋亡的影响,揭示其抗损伤作用机制,为关节软骨损伤治疗提供理论依据。方法:分离培养人胚胎关节软骨细胞,采用四氮甲基唑蓝(MTT)法测定不同含量软骨细胞增殖活性的变化,利用光镜、电镜、DNA电泳及流式细胞仪测定作为凋亡检测指标。结果:IGF-Ⅰ呈剂量依赖式促软骨细胞增殖,当IGF-Ⅰ含量达50μg/L时,促软骨细胞增殖作用达最大值。IL-1组光镜、电镜下可见典型的细胞凋亡形态学改变,琼脂糖凝胶电泳示特征性的DNA梯状条带,IGF-Ⅰ处理组未见明显凋亡征象。流式细胞仪检测发现,IGF-Ⅰ处理后软骨细胞凋亡率显著降低。结论:IGF-Ⅰ能促进软骨细胞增殖,对IL-1诱导的软骨细胞凋亡具有保护作用。     

新生儿听力筛查研究及其评价

我国每年有两千万新生儿出生，约有2万～6万新生儿患有听力障碍，远高于目前已开展的两病筛查（先天性甲状腺功能低下1：7000，苯丙酮尿症1：16500）。开展新生儿听力筛查，是一项社会意义重大的优生工程。本院已将新生儿听力筛查作为重点工作，由专职听力筛查的儿科医生和主管护师共同承担此项工作，并对患儿进行追踪随访，为早诊断、早干预提供帮助，同时调查家长对筛查结果的评价。现介绍如下。