西咪替丁对血浆氨茶碱浓度的影响

在１６例呼吸系疾病患者观察了西咪替丁对氨茶碱血浆浓度的影响。结果表明加服西咪替丁４００ｍｇ，３次／日，３天后血浆氨茶碱谷浓度和峰浓度均明显增高（ｐ＜０．０１），其中谷浓度升高４３．０±５１．１％，峰浓度升高２７．０±２９．０％。提示二者合用时，应适当减少氨茶碱用量，以避免氢茶碱中毒的发生。     

烧伤患者吸入性损伤和肺部感染的发生特点及其对死亡的影响

为了评价吸入性损伤和肺部感染的发生特点及其对死亡的影响，总结了我科近１４年住院治疗的热力烧伤患者９４０例，其中吸入性损伤７５例，轻度１５例，全部治愈，中度２５例，死亡１３例，死亡率为５２．０％，重度３５例，死亡３１例，死亡率为８８．６％。统计分析表明，合并吸入性损伤者６９．３％在密闭空间发生，同时伴有面部烧伤者达９６．０％。随着烧伤面积的增加，吸入性损伤发生率和肺部感染的发生率相应增加。有吸入性损伤肺部感染较无吸入性损伤肺部感染率为高（Ｐ＜０．０１），发生时间早。两组同等烧伤面积、深度、年龄患者，有吸入性损伤组发生死亡的危险比无吸入性损伤组大１７．２倍（Ｐ＜０．００１）。烧伤面积、深度和年龄相近，合并肺部感染者明显增加了死亡的机会（Ｐ＜０．００１）。     

慢性丙型肝炎患者丙型肝炎病毒核酸与IgM抗体关系的研究

本文检测了１４０例丙型肝炎病毒（ＨＣＶ）抗体（抗－ＨＣＶ）阳性的慢性丙型肝炎（ＣＨＣ）的ＨＣＶ核酸（ＨＣＶＲＮＡ）和ＩｇＭ抗体（抗－ＨＣＶＩｇＭ）两项指标。结果表明，原始诊断为不同临床型的肝炎（ＨＣ）患者，８年随访时，ＨＣＶＲＮＡ和抗－ＨＣＶＩｇＭ阳性率分别为８０．７％和９０．７％（ｕ＝２．３９Ｐ＜０．０５）．在原始诊断不同临床型ＨＣ转慢者中，上述两项指标均未发现统计学上的差别（均为Ｐ＞０．０５）。ＨＣＶＲＮＡ与抗－ＨＣＶＩｇＭ配对比较，符合率为７８．６％。基因分型初步结果表明，河北省固安ＨＣＶ以基因Ⅱ型为主。本研究提示，随访８年的ＣＨＣ患者绝大多数仍有传染性；本文方法检测的抗－ＨＣＶＩｇＭ不能代表早期感染标志，但代表慢性感染活动化或带毒，所以，在不具备检测ＨＣＶＲＮＡ的地方更具有实用价值．     

缩泉丸治疗氯氮平所致流涎的临床观察

采用双盲法观察缩泉丸治疗氯氮平所致流涎的疗效。缩泉丸治疗组21例,治疗后流涎症状较19例对照组明显减少(P<0.01)。中医辨证分型与缩泉丸治疗关系分析,表明痰湿内阻型和阳虚亏损型疗效最佳。氯氮平血浓度与流涎两者间无相关性(P>0.05)。     

通过原生质体融合获得青霉素高产菌株

采用两株分别带有不同抗药性标记的产黄青霉原生质体以1:1相混合,用30％的聚乙二醇(MW6000)原生质体融合处理。将混和物涂布在补给有两种药物同时存在的高渗性分离培养基上,培养后获得异核体菌落。洗下异核体分生孢于继续分离在补给有两种药物同时存在的分离培养基上,得到了同时带有两种抗性标记的重组体。纯化后,进行抗性稳定性和摇瓶效价的测定,将一株具有双重抗性、摇瓶发酵效价较高的菌株作出发菌株,经诱变因子处理后,获得了一株43u7c—57菌株,在摇瓶中效价比生产菌株平均提高4.94％,该菌株在40吨发酵罐试生产后,发酵效价平均提高4.4％,产量则平均增加12.15％。     

Saponins from the roots ofPulsatilla koreana

From the roots ofPulsatilla koreana, three monodesmosides(pulsatilla saponins A, B and D) and two bisdesmosides(pulsatilla saponins F and H) were isolated. The structure of these saponins have been determined as hederagenin 3-O-α-L-rhamnopyranosyl(1→2)-α-L-arabinopyranoside(A), hederagenin 3-O-β-D-glucopyranosyl(1→4)-α-L-arabinopyranoside(B), hederagenin 3-O-α-L-rhamnopyranosyl (1→2)-[β-D-glucopyranosyl(1→4)]-α-L-arabinopyranoside(D), 3-O-α-L-rhamnopyranosyl(1→2)-α-L-arabinopyranosyl hederagenin 28-O-α-L-rhamnopyranosyl(1→4)-β-D-glucopyranosyl(1→6)-β-D-glucopyranosyl ester (F) and 3-O-α-L-rhamnopyranosyl(1→2)-[β-D-glucopyranosyl(1→4)]-α-L-arabinopyranosyl hederagenin 28-O-α-L-rhamnopyranosyl(1→4)-β-D-glucopyranosyl(1→6)-β-D-glucopyranosyl ester(H) on the basis of chemical and spectral studies. Pulsatilla saponin B is the first report of its presence in plants but saponins A, D, F, and H have recently been isolated from the same genusP. cernua.     

血管内覆膜支架置入治疗降主动脉夹层动脉瘤

目的 :介绍血管内覆膜支架置入治疗降主动脉夹层动脉瘤的初步经验。材料与方法 :本组 6例 Debakey 型的慢性降主动脉夹层动脉瘤患者行血管内覆膜支架置入治疗。经股动脉将 Talent覆膜支架置于夹层动脉瘤裂口处 ,支架张开使覆膜支架固定于裂口附近的主动脉壁上将裂口封闭并阻断血流。结果 :6例病人均获得成功 ,手术和临床成功率 10 0 %。 1例患者术中出现内漏 ,置入第二枚支架后漏口封闭。平均随访 7个月 ,所有患者内膜裂口全部完全封闭 ,假腔内血栓形成无内漏 ,假腔均明显缩小。结论 :血管内覆膜支架置入治疗主动脉夹层动脉瘤具有安全可靠 ,患者术后恢复快的优点     

男性慢性胃炎患者人格特征初探

本文采用卡氏十六种人格因素量表，对纤维胃十二肠镜和活体组织病理检查确诊，剔除可能影响调查的疾患之后的５６例慢性胃炎患者做了测查，结果与中国男性成人常模对照，提示男性慢性胃炎患者的主要人格特征有：严谨、保守、忧郁、紧张、顺从、依赖、有焦虑倾向，非内向个性，不属于心理不健康人群，而与消化性溃疡个性特征有所不同，但是，矫治其人格缺损及属必要。     

5种拟钉螺酯酶同工酶酶谱的比较研究

采用聚丙烯酰胺凝胶垂直平板电泳技术，对湖北和四川两省５种拟钉螺的酯酶同工酶酶谱进行比较研究，并以湖北钉螺作对照，５种拟钉螺酯酶同工酶共分离出８条酶带，酶谱可分成３区，即ＥＳＴ－１、ＥＳＴ－２、ＥＳＴ－３，其基本特征与钉螺显著不同，很容易通过酶谱将拟钉螺与钉螺区分开，同时，５种拟钉螺的酯酶同工酶酶谱之间均存在一定的差异，说明拟钉螺种间酯酶同工酶存在多态，而种间差异程度似与地域隔离的远近有关。结果提示拟钉螺酯酶同工酶的酶谱特征既有助于拟钉螺属的鉴定，又有助于拟钉螺近缘种的区分，从而对拟钉螺的分类有较大的参考价值。     

Prospective clinical outcomes of revision fusion surgery in patients with pseudarthrosis after posterior lumbar interbody fusions using stand-alone metallic cages.

BACKGROUND CONTEXT: Posterior lumbar interbody fusion (PLIF) is a popular method of arthrodesis for surgical treatment of instabilities and degenerative conditions of the spine. With the introduction of threaded titanium cage devices, surgeons began performing PLIF procedures using these cages as stand-alone devices. Complications have been reported, however, including pseudarthrosis with persistent pain. Outcomes after revision surgical treatment for these patients with failed PLIF are not known. PURPOSE: To prospectively evaluate clinical outcomes of revision fusion surgery in patients who previously underwent posterior lumbar interbody fusion with stand-alone metallic cages resulting in pseudarthrosis. STUDY DESIGN/SETTING: Prospective case series. METHODS: Nineteen patients referred to the senior author were evaluated and diagnosed with pseudoarthrosis having previously undergone a PLIF procedure with stand-alone metallic cages. History, physical exam, and imaging studies were performed preoperatively and postoperatively. All underwent revision posterolateral fusion with iliac crest graft and pedicle screw instrumentation. Patient demographics, SF-36, and Oswestry Disability Index (ODI) data were collected prior to surgery and two years postoperatively. RESULTS: Patients undergoing revision fusion surgery were found to have had extensive facetectomies and pseudarthrosis intraoperatively. Outcomes data was collected on eighteen of nineteen patients (95%). Mean clinical follow up was 3.2 years (range 2.5-3.5 years). Seventeen patients (94%) achieved a solid fusion. Improvement was noted in seven of eight SF-36 sub-categories, but was significant only in two (Physical Function and Role Emotional). There was no significant difference in ODI scores. CONCLUSIONS: Pseudarthrosis should be considered in the differential diagnosis if severe symptoms persist in patients who undergo PLIF with stand-alone metallic cages. Successful revision fusion did not always correlate with improved clinical outcomes in these challenging patients undergoing further surgery. Performing PLIF using stand-alone metallic cages, especially after total resection of the facet joints, is not advocated unless supplemental instrumentation is utilized.