湖南省衡阳地区STD患者病原体检测

目的 了解衡阳地区性传播疾病(STD)患者病原体感染情况。方法 对2420例可疑STD患者进行检测：淋病奈瑟菌(NG)、解脲脲原体(UU)、人型支原体(MH)采用培养法；沙眼衣原体(CT)、人乳头瘤病毒(HPV)、单纯疱疹病毒(HSV)核酸采用聚合酶链反应(PCR)法；梅毒螺旋体(TP)采用快速血浆反应素环状卡片试验(RPR)和TP-PA法。结果 STD病原体阳性检出率为38．1％(922／2420)。在922例中UU占29．6％，CT20．8％，HPV17．8％，NG17．4％，MH6．3％，HSV4．2％，TP3．9％。结论 衡阳地区STD患者中UU感染率最高，CT和HPV次之，TP感染率最低。     

Information Fusing Recognition of Traditional Chinese Medicine （TCM） Pulse State Based on Stochastic Fuzzy Neural Network

Based on the fuzzy characteristic of the pulse state and syndromes differentiation thinking mode of TCM, an information fusing recognition method of pulse states based on SFNN （Stochastic Fuzzy Neural Network） is presented in this paper. With the learning ability in parameters and structure, SFNN fuses the measurement information of three pulse-state sensors distributed in Cun, Guan, and Chi location of body for the pulse state recognition. The experimental results show that the percentage of correct recognition with new method is higher than that by single-data recognition one, with fewer off-line train numbers.     

颅脑外伤性病变的CT检查及其临床意义

目的：探讨颅脑外伤严重程度及CT征象与预后的关系，并探讨CT复查的最佳时间及临床意义。方法：回顾性分析80例颅脑外伤的严重程度与初次CT征象的关系，统计分析复查CT发现新病变的数目、程度及时间。结果：颅脑外伤的严重程度与初次CT征象符合率为92．5％(74／80)。外伤后即刻昏迷、CT显示重度复合伤、脑干损伤或弥漫性脑白质损伤的病死率达70．0％(21／30)。1～3d复查CT发现迟发性病变80个，4—7d21个，7d后8个。结论：临床病情与CT征象变化对判断预后有重要意义，颅脑外伤后3、7d是复查CT的最佳时机，出现病情变化应随时复查。     

针法微型外科解剖学基础

1针法微型外科对解剖学的要求 随着临床医学的发展，对解剖学从不同角度、不同形式提出了要求。解剖学指导和促进了医学的发展，同时又要求解剖学不断创新。早期的解剖学主要是服务于外科手术。随着外科手术的细致深入和发展，除常规的人体解剖和局部解剖外，又出现了显微外科解剖，人体皮瓣解剖，B超、CT和核磁共振等影像学解剖。     

年龄小于45岁原发性慢性闭角型青光眼的显微手术治疗

目的探讨原发性慢性闭角型青光眼年轻患者临床治疗的经验和体会。方法对临床收治的41例52眼、年龄〈45岁、临床确诊为进展期或晚期原发性慢性闭角型青光眼的病例进行抗青光眼显微手术处理的病例进行回顾性分析。结果随访时间平均（32．50±5．08）个月；男16例，女25例；进展期28眼，晚期24眼；52眼均行抗青光眼手术-复合式小梁切除手术治疗；眼轴长平均（22．40±1．63）mm，其中〈21mm占17．31％，小眼球占13．46％；前房深度平均（1．90±0．39）mm，其中〈1．9mm占61．46％；超声生物显微镜检查高褶虹膜构型占59．62％，其中睫状突位置靠前者10眼；术前平均眼压（41．73±12．26）mmHg，末次术后平均眼压（12．03±4．57）mmHg，术前后眼压差异有统计学意义（t=3．520，P〈0．001）。术后并发症主要有浅前房，恶性青光眼。恶性青光眼手术处理方式包括玻璃体抽液、前段玻璃体切割以及超声乳化白内障吸除加人工晶状体植入术治疗。4眼因眼压控制不理想，行二次抗青光眼手术治疗。结论年轻原发性慢性闭角型青光眼患者，女性多见，多伴有眼轴短、前房浅等特点，抗青光眼复合式小梁手术治疗要注意防治术后浅前房、恶性青光眼的发生。术前详细检查、手术操作精细以及有效处理术后并发症将有助于提高手术成功率和减少并发症。     

方格星虫酶解物成分分析及其抗氧化作用

用木瓜蛋白酶对方格星虫（Sipunculus nudus）进行酶促水解,并对酶解物冻干粉的成分进行了分析,其中粗蛋白质量分数为69.02%,多肽质量分数为60.60%,肽的平均链长为3.73个氨基酸残基,肽分子的平均相对分子质量为447.6;游离氨基酸占5.27%。氨基酸分析结果显示,方格星虫酶解物含有17种氨基酸（色氨酸未测）,其中人体必需氨基酸含量较高,占总氨基酸数的30.62%。方格星虫酶解物中还含有P、Fe、Mg、Mn、Zn、Cu、Se等至少12种矿质元素,以及含有抗氧化作用的营养成分,并通过动物试验证明了方格星虫酶解物具有显著的抗氧化作用。方格星虫酶解物可用于食品添加或用作功能性食品。     

Electrophysiological study on differentiation of rat bone marrow stromal stem cells into neuron-like cells in vitro by edaravone

To explore the electrophysiological proper-ties of differentiation of rat bone marrow-derived stromal stem cells (rBMSCs) to neuron-like cells in vitro by edaravone, a new type of free radical scavenger. Methods: Stromal stem cells were separated from rat bone marrow with Ficoll-Paque reagent and expanded in different culture medium in vitro, rBMSCs were induced by edaravone containing serum-free L-DMEM. Morphologic observation and Western blot analysis including the ex-pression of Nav1.6, Kv1.2, Kv1.3, Cav1.2 were performed, and whole patch-clamp technique was used. Results: Cyton contraction and long processes were shown in differentiated stromal stem cells. Nav1.6, Kv1.2, Kv1.3 and Cav1.2 were expressed in both differentiated and undifferentiated cells. However, the expression of channel proteins in differentiated cells was up-regulated. Consistently, their resting potential and outward currents were also enhanced in the differentiated cells, which was especially significant in the outward rectifier potassium current. Conclusion: In vitro, neuron-like cells derived from rBMSCs, induced by edaravone, possess electrophysiologi-cal properties of neurons.     

后腹腔镜与经腰背途径输尿管切开取石手术疗效比较

目的 对后腹腔镜和经腰背部途径治疗输尿管上段结石的疗效指标进行比较,探讨两种术式的技术要点.方法 收治98例上尿路结石病例,其中42例行后腹腔镜输尿管切开取石术,56例行经腰背部直切口输尿管切开取石术.腹腔镜术式采用气管插管全麻,经腰背部途径采用腰硬联合麻.两组术中均留置双J管.结果 98例手术全部成功,两组术中均无需输血.两组在手术时间、术中出血及住院时间有统计学差异,术后复查未见结石残留,随访无并发症发生.结论 对输尿管上段结石的治疗,后腹腔镜输尿管切开取石术微创、安全、有效,较经腰背部途径术中出血少、术后恢复快.但它需要较长的手术时间和一定的腹腔镜外科训练.     

Treatment of severe subglottic laryngotracheal stenosis using hyoid graft with sternohyoid muscle flap]

OBJECTIVE: To evaluate the possibility and reliability of the hyoid-sternohyoid graft transfer in the correction of server subglottic laryngotracheal stenosis, and delineate the operation skills and clinical results. METHODS: Seven patients with severe subglottic stenosis underwent laryngotracheal reconstruction using the hyoid grafts with sternohyoid muscle flaps (HG-SHMF). Five of these patients had traumatic subglottic stenosis, one with scar tissue of unknown etiology arising in the subglottic region, another with tracheal narrowing caused by inhalation of hydrochloric acid. RESULTS: All seven patients were successfully decannulated with moderate good voice. The average time from reconstruction to decannulation was 15.4 months. The stent was endoscopically removed with a range of 3 to 22 months; the mean time required for stenting was 9.6 months. Two patients who received additional salvage reconstruction procedures because of graft or stent displacement were extubated with improved voices and satisfactory airway. CONCLUSIONS: The HG-SHMF transfer was a single-stage reconstruction, relatively simple procedure that can restore an adequate airway and a good voice. Patients undergoing laryngotracheal reconstruction with HG-SHMF must have regular, long-term follow-up since graft displacement and recurrent granulation tissue or scar reformation can cause restenosis after an initially successful surgery. This procedure should be used in a large number of patients to further test its reliability.