贲门癌患者围手术期上消化道动力学观察

目的观察贲门癌对食管运动功能的影响以及手术后残余食管、残胃的运动功能改变。方法　用低顺应性三腔聚乙烯液压毛细管灌注导管对22例正常人和31例中晚期贲门癌患者进行了食管压力测定。所有受检者均仰卧位,每次吞咽5ml水,采用定点牵拉法。计算机自动计算出各部位的静息压、收缩压、收缩及松弛时间、传播速度。结果贲门癌患者手术前与正常人的各项指标(除下括约肌外)相比较,贲门癌患者食管下段收缩时间明显长于正常人。贲门癌患者手术前后的数据比较:①手术后上括约肌收缩压明显高于手术前。②手术后食管上段静息压和收缩压均明显高于手术前。③手术后食管中段收缩压明显低于手术前。④手术后胃的压力明显低于手术前。⑤手术后食管中段静息压明显低于胃的压力。结论①贲门癌这一疾病并未改变食管运动功能。②手术后近期吻合口处有一高压带,可起到阻止胃腔正压向食管腔传递的压力屏障作用。③手术使食管中段收缩运动功能减弱。④术后反射性引起食管上段收缩增强,从功能上讲似能阻止可能发生的食管咽返流。     

QT Dispersion Level and Its Clinical Significance.in Dilated Cardiomyopathy

［1］Richardson CP, Mckenna RM, Bristow CM, et al.Report of the 1995 Word Health Organization/International Society and Federation of Cardiology Task Force on the definition and classification of cardiomyopathies. Circulation, 1996,93: 841 ［2］Barr CS, Naas A, Freeman M, et al. QT dispersion and sudden unexpected death in chronic heart failure. Lancet, 1994,343:327 ［3］Martin AB, Garson A, Perry JC, et al. Prolonged QT interval in hypertropic and dilated cardiomyopathy in children. Am Heart J, 1994,127(1):64 ［4］Pye M, Quinn AC, Cobble SM. QT dispersion: a non-invasive marker of susceptibility to arrhythmia in patients with sustained ventricular arrhythmias?Br Heart J, 1994,71(5):51 ［5］Berger RD, Kasper EK, Baughman KL, et al. Beat to beat QT interval variability: novel evidence for repolarization lability in ischemic and non ischemic dilated cardiomyopathy. Circulation, 1997, 96 (5):1557 ［6］Wolfram G, Ulrike S, Volker M, et al. QT dispersion and arrhythmic events in idiopathic dilated cardiomyopathy. Am J Cardiol, 1997,78: 458 ［7］Fei L, Goldman JH, Prasal K, et al. QT dispersion and RR variations on 12-lead ECGs in patients with congestive heart failure secondary to idiopathic dilated cardiomyopathy. Eur Heart J, 1996,17: 258 ［8］Pan YZ, Guo NS, Xing ZF, et al. The relation between QT dispersion and ventricular arrhythmia of dilated cardiomyopathy. Chin J Inter Medi, 1996,35(11):73 ［9］Galinier M, Vialette JC, Fourcade J, et al. QT interval dispersion as a predictor of arrhythmic events in congestive heart failure. Importance of aetiology. Eur Heart J, 1998,19(7) :1054     

Efficacy and Mechanism of Intravenous Sotalol for Termination of Paroxysmal Supraventricular Tachycardia

ＳＶＴ ,ｉｎｃｌｕｄｉｎｇＡＶＲＴａｎｄＡＶＮＲＴ ,ｉｓａｋｉｎｄｏｆａｒｒｈｙｔｈｍｉａｏｆｔｅｎｓｅｅｎｉｎｃｌｉｎｉｃａｌｐｒａｃ ｔｉｃｅ .Ｓｏｔａｌｏｌ,ａｃｌａｓｓⅢａｎｔｉ ａｒｒｈｙｔｈｍｉｃｄｒｕｇｗｉｔｈａｄｄｉｔｉｏｎａｌβ ｂｌｏｃｋｉｎｇａｇｅｎｔｐｒｏｐｅｒｔｉｅｓ ,ｈａｓｂｅｅｎｗｉｄｅｌｙｕｓｅｄｔｏｔｒｅａｔｖａｒｉｏｕｓａｒｒｈｙｔｈｍｉａ(ｓｕｐｒａ ｖｅｎｔｒｉｃｕｌａｒａｎｄｖｅｎｔｒｉｃｕｌａｒ)ｅｆｆｉｃｉｅｎｔｌｙｉｎｗｅｓｔｅｒｎｃｏｕｎｔｒｉｅｓ[1 9]…     

影响鼻窦显微手术疗效因素的分析

目的 分析影响鼻窦显微手术疗效的因素。方法 鼻内筛窦手术,经上颌窦手术,上颌窦窦口扩大,中鼻道开窗。结果 ３５９侧鼻窦显微手术,术后１～４年（平均３６．４个月）,随访２８８侧,治愈１０８例（３７．５％）,显著进步８７例（３０．２％）,好转６５侧（２２．６％）,无效２８侧（９．７％）,良好率６７．７％,鼻内筛窦手术良好率６０．６％,经上颌窦手术良好率７２％,上颌窦窦口扩大未闭良好率６０．１％,中鼻开     

关于社区卫生服务人力资源开发的思考与探讨

基于北京市朝阳区大力发展社区卫生服务３年多的实践,就发展社区卫生服务的关键所在－人力资源开发,在配置卫生资源,实施全科医学培训工程,制定相应政策保障,充分展示社区卫生服务功能等方面的现状及其对策进行了充分的论述和有益的探讨。     

鼠源性单克隆抗体F(ab′)2片段制备工艺

目的制备符合临床应用质量标准的鼠源性mAb F(ab′)2片段.方法采用胃蛋白酶消化小鼠腹水抗体,疏水作用色谱法纯化F(ab′)2片段的新工艺,替代原有的木瓜蛋白酶消化IgG,阴离子交换色谱法纯化的旧工艺.结果新工艺所制备的F(ab′)2 片段经SDS-PAGE检测纯度达98%以上,ABC免疫组化法测定免疫活性为1∶8000,回收率大于 50%,核酸含量及热原均合格,整个工艺流程可在48 h内完成.结论新工艺制备人用鼠源性mAb F(ab′)2片段更简便高效、安全实用,能够适应中试放大及大规模生产的要求.     

肝素与糖皮质激素在急性肺损伤中的治疗对比

目的 :了解急性肺损伤 (AL I)常见治疗中肝素与糖皮质激素对炎细胞的影响。方法 :用油酸尾静脉注射制作小鼠AL I损伤模型 ,观察其周围血白细胞及肺组织病理改变。结果 :AL I时肺系数损伤组明显高于除肝素组的其他组 ,周围血中性粒细胞 /淋巴细胞 (N/L)比率在 AL I时明显增加 ;肝素组在损伤 6 h后可见 N/L 降低 ,糖皮质激素则使其增高。组织切片见激素治疗组中每高倍视野内的多形核细胞数 (PMN)、肺水肿程度明显低于肝素组与损伤组 ;肝素治疗组中虽然肺水肿程度与损伤组无差异 ,但微小血栓明显少于损伤组与激素组。结论 :激素通过抑制 PMN在肺内的聚集而减少肺损伤 ;肝素则通过调节凝血机制保护肺脏     

羊水过少的B超诊断性试验分析

目的 探讨产前Ｂ超测定羊水平段诊断羊水过少的最佳界值。方法 对妊娠≥３６周的孕妇进行Ｂ超测定羊水最大平段,剖宫产时实际测定羊水量,确定２．０ｃｍ、２．３ｃｍ、２．６ｃｍ、３．０ｃｍ、３．３ｃｍ、３．８ｃｍ等７个界点,分别计算其敏感性、特异性、阳性预测值和阴性预测值,对各界点的敏感性和（１－特异性）作受试者工作特性曲线。结果 当Ｂ超测定羊水平段界点为３．３ｃｍ,可获得较高的诊断敏感性和特异性,其值为８０．５６％和７８．７９％。结论 Ｂ超测定羊水平段界点值为３．３ｃｍ时,可产前诊断为羊水过少。     

广东地区GBV-C/HGV5'NCR区序列变异的研究

目的 了解广东地区ＧＢＶ－Ｃ／ＨＧＶ５＇ＮＣＲ区的序列变异情况。方法 以ＧＢＶ－Ｃ和ＨＧＶ的５＇ＮＣＲ区安全同源的序列设计合成引物用于套式ＲＴ－ＰＣＲ。从广东地区的１０例ＧＢＶ－Ｃ／ＨＧＶ感染者血中扩增了１０个充列,分别克隆对ｐＵＣ１９、ｐＴ－Ａｄｖ载体。以３５Ｓ标记的双脱氧链末端终止法对这１０个序列分别进行正反两个方向的序列测定。结果 １０株充列相互间同源性最大为１００％,最小为８４．４％。与Ｇ     

Transcriptome analysis of Armillaria gallica 012 m in response to auxin

Gastrodia elata is an achlorophyllous and fully mycoheterotrophic orchid which obtains carbon and other nutrients from Armillaria species in its life cycle. Many researchers suggested that plant hormones, as signing molecules, play a central role in the plant–fungi interaction. In the process of Armillaria gallica 012 m cultivation, both exogenous indole-3-acetic acid (IAA) and indole-3-butyric acid (IBA) distinctly stimulated the growth of mycelia in solid media. The differential expression genes (DEGs) of A. gallica 012 m with IAA versus blank control (BK) and IBA versus BK were investigated. The results showed that more than 80% of DEGs of the IAA group were coincident with the DEGs of the IBA group, and more than half of upregulated DEGs and most of the downregulated DEGs of the IAA group coincided with those DEGs of the IBA group. Above research implied that A. gallica 012 m could perceive IAA and IBA, and possess similar responses and signaling pathways to IAA and IBA. The overlapping differential genes of the IAA group and IBA group were analyzed by GO term, and the results showed that several DEGs identified were related to biological processes including positive regulation of the biological process and biological process. The downregulated NmrA-like and FKBP_C genes might be benefit to the growth of mycelia. Those results can explain that exiguous IAA and IBA improved the growth of A. gallica to some extent. We speculate that IAA and IBA are signaling molecules, and regulate the expression of growth-related genes of A. gallica 012 m by the same signaling pathway.