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目的总结胰岛素瘤的外科治疗经验。方法回顾性分析1983～2002年收治的128例胰岛素瘤的临床资料。结果肿瘤局部摘除术适用于75.8％的病人；胰瘘是胰岛素瘤手术后最常见的并发症。结论胰岛素瘤的手术方式应该根据病变的性质、部位、数量等因素决定；必要的术前定位检查有助于术中选择合理的手术方式。     

颈动脉血管重建术对颈动脉狭窄患者认知功能的影响

颈动脉狭窄会导致患者远期认知功能下降，而既往研究表明颈动脉内膜剥脱术和支架
置入术作为治疗颈动脉狭窄的主要术式，可以改善患者的认知功能，尤其是执行能力等特定领域的
认知水平。进一步研究发现颈动脉血管重建术中栓子的形成，术后脑血流灌注提高，以及神经代谢
水平等改变可能在机制上解释颈动脉重建术后认知功能的变化；此外，围术期炎症反应，血脂水平，
以及基因易感性等都是术后远期认知功能结局的临床预测因素，以上因素对于提高颈动脉狭窄患者
的生活质量、治疗术式的优化具有重要临床意义。     

胃肠道肿瘤术后复发与肠粘连引起的肠梗阻临床分析

目的：探讨胃肠道肿瘤复发和粘连性肠梗阻的临床区别和治疗特点。方法：回顾性复习了经手术治疗的86例胃肠道肿瘤术后出现肠梗阻的临床资料，并分析其在临床上区别和治疗特点。结果：86例中粘连性肠梗阻39例，肿瘤复发47例，在复发组胃癌术后复发最为多见(P＜0．05)，原发性肿瘤分化差的其复发引起肠道梗阻明显高于分化好引起的粘连性肠梗阻(P＜0．01)。症状上肿瘤复发组出现的恶心、呕吐及肛门停止排便排气低于粘连性肠梗阻(P＜0．01)。肿瘤复发的肠梗阻表现为不全性梗阻，口服泛影葡胺治疗多能缓解，但大部分患者部分症状仍存在，粘连性肠梗阻多为完全性肠梗阻(P＜0．005)，多需要手术。结论：低分化原发肿瘤、不全性肠梗阻、低发生率的恶心和呕吐及肛门停止排便排气的肠梗阻，多提示为肿瘤的复发，泛影葡胺治疗后梗阻缓解但仍有症状存在应首先考虑是肿瘤复发。     

通心络对实验性大脑中动脉闭塞大鼠脑缺血微血管的保护作用

目的 观察通心络胶囊对大脑中动脉闭塞(MCAO)模型大鼠脑缺血后微血管的保护作用.方法 清洁级雄性SD大鼠200只随机分为5组:假手术组只做颈总和颈内动脉分离和生理盐水灌胃;其余4组制备MCAO模型,其中MK-801组在造模成功后腹腔注射MK-801;通心络大、小剂量组均在造模成功后分别给予1.0 g·kg-1·d-1和0.5 g·kg-1·d-1通心络原粉水溶液灌胃;模型组给予等体积生理盐水灌胃.各组动物分别于术后6、12、24、48和72 h电镜观察皮质微血管超微结构改变、检测缺血脑皮质毛细血管通透性、免疫组化法测定大脑皮质Ⅷ因子和脑微血管周围IL-6、IL-1β蛋白表达.结果 电镜下观察,治疗组均能显著改善缺血后脑皮质微血管超微结构;模型组脑内伊文蓝含量明显增加(P＜0.01),通心络大剂量组在脑缺血12 h能显著降低其含量(P＜0.01),并且在24 h后较小剂量组、MK-801组降低明显(P＜0.01);模型组皮质中微血管数急剧减少(P＜0.01),治疗组各时间皮质中血管数均明显多于模型组(P＜0.01),其中通心络大剂量组的微血管数多于其他治疗组(P＜0.01,P＜0.05);模型组脑皮质微血管周围IL-6及IL-1β表达升高(P＜0.01),分别于缺血后24和12 h达到高峰,各治疗组与模型组相比,IL-6表达明显升高(P＜0.01),而IL-1β表达明显降低(P＜0.01),其中通心络大剂量组最为明显(P＜0.01).结论 通心络胶囊可从多角度对大脑中动脉闭塞(MCAO)模型大鼠脑缺血微血管损伤进行保护.     

Evaluating therapeutic outcome in epileptic patients using the changes of interval and duration

BACKGROUND: Seizure frequency is in abnormal distribution, and it is not enough to express the trend of concentration using means, and its median loses a lot of information, thus it lacks of a standard for evaluating the therapeutic effects based on seizure frequency. OBJECTIVE: To establish a method for evaluating the therapeutic effects on anti-epileptic drugs using changes of interval and duration of seizure. DESIGN: A prospective cohort study. SETTING: Zhumadian Psychiatric Hospital. PARTICIPANTS: Outpatients and inpatients suffering from epilepsy attending firstly visited Zhumadian Psychiatric Hospital from June 2001 to June 2002 were enrolled. They were diagnosed as epileptic according to the International Classification of Epileptic Seizure by International League Against Epilepsy (1981) based on the clinical history, physical examination, and investigations. The interval time was no more than 6 months. Informed consent was obtained from all the subjects, and the study was approved by the hospital ethical committee. METHODS: ① For the first visit and each follow-up, the following data were recorded, including general demographic information, seizure type, the date and time of ictus, the duration of ictus, and inducement or situation related, according to which the following indexes could be calculated, including seizure styles, interval, duration, cluster frequency and cluster duration. The information from the first review was noted as annals A. The second interview was taken at the end of the evaluating period; the information from the second review was noted as annals B. The third interview was taken within two weeks after the second one; the information from the third review was noted as annals C. The annals B or the annals C were respectively compared with the annals A in the light of the same types or the same styles of the same patient. Summation of the scores of interval change and duration change of the same type or the same style and 5 of basic score was the score of a corresponding seizure type or a corresponding style of one patient. In order to test its reliability and validity, the score of change of frequency or duration plus 5 scores respectively was the score of frequency or duration. ② Reliability and validity were tested by calculating corresponding correlation coefficient with SPSS 11.0. ROC curve was used for developing diagnostic criterion of predicting therapeutic effects with SPSS 11.0. MAIN OUTCOME MEASURES: ① Reliability and validity; ② Diagnostic criterion for predicting therapeutic effects one year later. RESULTS: Totally 28 patients were involved in the final analysis of results. ① Reliability and validity were high: rinter-rater=0.98, rtest-retest=0.99, rconstruct validity=0.83. ② A total score > 6 was the optimal diagnostic criteria for predicting therapeutic effects one year later, in other words, a patient who scored more than 6 at the evaluating period may be seizure-free one year later. CONCLUSION: It is a potential tool for evaluating epileptic therapeutic outcome, and it can be diffusely used in interrelated fields after being further validated.     

月桂氮(艹卓)酮的抑菌作用观察

月桂氮Ｚｈｕｏ酮（氮酮）作为一种高效透皮吸收促进剂，已广泛应用于医药化妆品等领域，本实验中发现，氮酮在２０μｇ／ｍｌ浓度下，对Ｇ＾＋细菌及芽孢具有显著的抑制作用。     

聚合酶链反应检测实验动物弓形虫核酸的研究

建立弓形虫动物模型，常规方法提取肝、脾、肾、肺等组织DNA，应用聚合酶链反应（PCR）扩增，产物经电泳检测显示199bp的弓形虫特异带谱。并以γ－32p标记克隆的弓形虫特异DNA片段为探针，对扩增产物行Southern印迹分析，结果上述4种标本均出现阳性杂交带，进一步证实扩增条带是弓形虫特异DNA顺序。同时用酶标法检测显示鼠血清弓形虫抗体IgG；阳性。组织病理学检查结果，肝组织损伤较严重，肝细胞肿大，肝窦消失，脾、肾、肺组织可见轻微的病理改变。另外本文介绍一种简单PCR方法[1]，取鼠尾静脉血2μl直接进行扩增，结果与酚-氯仿法提取的DNA扩增结果一致。     

已婚育龄妇女避孕措施变化趋势分析

目的:了解已婚育龄妇女避孕措施的变化趋势,为指导计划生育服务工作提供科学依据。方法:收集1983~2005年苏州市已婚育龄妇女避孕方法的资料,并用统计软件对其变化趋势进行了分析。结果:已婚育龄妇女节育率在88.38%~92.94%范围波动,长效避孕措施现用率从75.19%下降至71.27%,而短效避孕措施从12.86%上升至17.11%。宫内节育器的现用率从50.09%上升到66.50%;避孕套从1.94%上升到14.21%;其他避孕方法的现用率均呈下降趋势,其中女性绝育现用率从24.42%下降到4.50%。结论:节育率维持在较高水平;长效避孕措施现用率下降而短效避孕措施现用率上升;避孕方法使用趋于多样化,需要提供满足个性化需求的指导和服务。     

高碘摄入对SD大鼠钠/碘同向转运体蛋白表达影响的免疫组化研究

目的:动态观察长期高碘摄入对SD大鼠甲状腺细胞钠/碘同向转运体(NIS)蛋白表达的影响.方法:SD大鼠分别饲以去离子水及不同碘浓度的碘化钾水,给碘后1 d及1,2,4,8周处死.测定尿碘、组织碘含量,免疫组织化学方法观察甲状腺细胞NIS蛋白表达水平.结果:高碘摄入可引起甲状腺滤泡细胞膜表面NIS蛋白表达的下降.短期较低浓度的高碘摄入对NiS蛋白的表达无明显影响,而较高浓度的碘摄入则引起NIS蛋白表达的明显减少;长期高碘摄入对NIS蛋白表达的抑制作用,可在机体自我调节机制作用下得以部分恢复,但NIS蛋白表达仍处较低水平.结论:高碘摄入可导致甲状腺细胞表面NIS蛋白表达下降,随摄碘浓度的增加抑制作用增强;不同浓度的碘摄入对NIS蛋白表达的抑制作用表达时间不同.     

宣肺清热颗粒剂稳定性研究

目的:研究宣肺清热颗粒剂中橙皮甙热稳定性变化,为该颗粒剂有效期的确定、制剂生产、贮存条什提供实验参考依据。方法:采用加速实验法对橙皮甙热稳定性进行研究,用甲醇超声提取样品,HPLC进行含量测定。根据Arrhenius公式处理数据。结果:Arrhenius公式得室温下的速度常数K298=3.38×10-5/h,得出常温下该颗粒剂以橙皮甙为指标的有效期为3.6年。结论:宣肺清热颗粒剂稳定性好,初步符合中药稳定性要求。