原发性三叉神经痛的LEKSELL-C伽玛刀治疗

目的 探讨伽玛刀治疗原发性三叉神经痛的方法和效果.方法 对28例原发性三叉神经痛采用LEKSELL-C型伽玛刀治疗,均沿三叉神经走行在三叉神经根近桥脑处选择双靶点治疗.中心剂量75～85Gy,50%等剂量线限定靶点.结果 随访3～11个月,疼痛消失时间平均在术后3.5个月.按疼痛缓解评分,在随访时点,总有效率为96%.结论 LEKSELL-C型伽玛刀是治疗原发性三叉神经痛安全和有效的方法之一.     

实时双平面超声心动图初步临床应用研究

目的　探讨实时双平面超声心动图的临床应用价值。方法　对 83例受检者进行实时双平面超声 (BP)检查 ,其中男 46例 ,女 3 7例 ,平均年龄 2 0 92± 19 16岁。正常人 10例 ,先天性心脏病 44例 ,心瓣膜病 2 6例 ,其他心脏病变3例。结果　实时双平面超声有助于理解心脏立体解剖 ;能通过有限的声窗获得更多的切面 ,并可显示常规经胸超声不易得到的切面 ;多切面显示心脏瓣膜及其病变 ,有利于获得瓣膜狭窄或关闭不全的最佳观察平面 ;多切面显示房、室间隔缺损 ,便于寻找缺损的最佳显示切面以及与毗邻结构的关系。房、室间隔缺损BP、2DE测值与手术测值均有良好相关性 ;室间隔缺损BP测值与手术测值无显著性差异 ;BP、2DE均有低估房间隔缺损大小的倾向。实时双平面超声能同时显示复杂先心病的多种解剖畸形 ,有利于确定房室连接 ;辨认主、肺动脉。结论　实时双平面超声有其独特的优势 ,可为心血管疾病的准确诊断提供更多的信息。     

爱宝疗液敷贴治疗宫颈糜烂临床分析

介绍了采用爱宝疗液敷贻治疗宫颈糜烂的疗效情况,肯定了其应用价值。     

复发性鼻腔及鼻窦恶性肿瘤的挽救性治疗

目的 探讨鼻腔及鼻窦恶性肿瘤复发后的临床表现、与复发有关的因素、再手术的意义及缺损组织的修复。方法 排除原发性鼻腔鼻窦恶性肿瘤，仅收集治疗后复发并且有再手术意义的病例。应用乘积极限法估计生存率，Stata7．0统计软件进行统计运算。结果 1993～2002年共有25例患者符合要求。男19例，女6例，年龄13～66岁，平均46．1岁。所有患者均有至少1次手术或放射治疗史。末次治疗至复发的时间2周～46个月，中位时间18个月，80％的患者肿瘤复发出现于末次治疗后2年内。术后随访1～65个月。再手术中无死亡病例。5例健在无肿瘤复发；局部复发2例，颈部淋巴结转移1例，经过1刀或手术治疗后2例健在、1例带瘤生存；死于局部复发13例，死于肺转移1例，死于无关疾病1例，失访2例。1年生存率62．5%，2年生存率43．7％，3年生存率29．1％，中位生存时间18个月。术后发生脑脊液漏3例次，中枢性尿崩症1例次，皮瓣部分坏死1例次。手术修补脑脊液漏l例。结论 鼻腔及鼻窦恶性肿瘤局部复发多发生于末次治疗后2年之内，主要症状是头痛及局部隆起。肿瘤的类型和分化程度与复发密切相关。合理、及时的综合治疗有助于减少复发。运用有效修复手段的再手术可改善晚期患者的生活质量，延长生命。并发症主要是脑脊液漏，多数可通过保守方法治愈。     

两种不同方法测定低水平压力支持通气时气道阻断压与自主呼吸时常规方法测定值的相关性分析

目的 拟比较以两种不同方法测定低水平压力支持通气（pressure support ventilation，PSV）病人的气道阻断压（P0．1）与自主呼吸时常规方法测定值的相关性。方法 12例机械通气病人，断开呼吸机自主呼吸时以常规方法测定P0．1得到P0．1-SB：在PSV水平为5cmH20，以常规方法和按压呼气末暂停键测定P0．1分别得到P0．1-PSV5和P0．1-PSV5eeo．分析后二者与前者之间的相关性。结果 P0．1-SB与P0．1-PSV5之间差异无显著性，P0．1-PSV5ee0分别小于P0．1-SB与P0．1-PSV5，差异有显著性；P0．1-PSV5eeo与P0．1-PSV5和P0．1-SB之间的相关系数均为0．97。结论 按压呼气末暂停键测定PSV水平为5cmH2O的P0．1值与常规方法测定的PSV水平为5cmH2O以及自主呼吸时的测定值相比，其值偏小,但前者与后二者之间具有良好的相关性。     

Serial peritoneal macrophage function studies in new and established continuous ambulatory peritoneal dialysis patients

Peritoneal macrophages (PM) perform first-line defense activity against peritonitis, the most important complication in continuous ambulatory peritoneal dialysis (CAPD) therapy. Our longitudinal study has compared the PM function in 20 uremic patients during periods free of peritonitis since they started CAPD therapy in January 1987. The results showed that at the initiation of CAPD, there was a higher bactericidal activity, phagocytosis index, H2O2 production and interleukin-1 (IL-1), gamma-interferon (IFN-gamma) and tumor necrosis factor (TNF) production ability and MHC expression. As time went on, these progressively decreased, and by 9 months after CAPD therapy had started they were significantly lower than at the beginning. During the 1.5-year follow-up period, there was a significantly increased peritonitis rate in the period 6 months after the beginning of CAPD than in the period before the 6th month (88.3 vs. 11.7% respectively; p less than 0.001). These results indicate that PM of new CAPD patients have a more active function than those of established patients. The established patients had a greater risk of peritonitis. A comparison of the immunological profiles of PM from patients who had a peritonitis history shows that phagocytosis index, bactericidal activity and IL-1 and TNF production of PM were significantly decreased during the period free of peritonitis. This result suggests that these parameters may serve as an indicator in developing peritonitis.     

脂肪族聚酯与高氯酸锂络合物的结构与导电性

本文通过酯交换反应合成了一系列脂肪族聚丁二酸酯,对他们的结构和性能作了表征。发现聚酯存在多晶现象,其熔点有奇偶性变化规律。探索了由此系列聚酯与高氯酸锂形成的固体电解质的结构和离子导电性。无机盐的加入提高了电解质的玻璃化温度但降低了聚酯的熔点及结晶度。聚酯电解质的晶体类似于聚酯,其无机盐主要溶解于聚酯的无定形区域。聚酯系列电解质的导电率也有偶奇效应,与熔点变化相反;熔点高的电解质导电率低,熔点低的电解质导电率高。电解质的导电率随温度改变而变化,在室温下电解质的导电率可达10~(-6)s/cm。高分子链上侧基的引入将大大降低电解质的导电性。     

Behavioral, biochemical and neurotoxicological actions of the alpha-ethyl homologue of p-chloroamphetamine

The present set of experiments was designed to examine the effects of extension of the alpha-methyl of p-chloroamphetamine (PCA) to an alpha-ethyl. Therefore, the alpha-ethyl homologue of PCA, 1-(4-chlorophenyl)-2-aminobutane (CAB), was compared to PCA in a number of pharmacological assays. CAB was 2-fold less potent than PCA at inhibiting synaptosomal uptake of [3H]5-hydroxytryptamine ([3H]5-HT), and 5-fold less potent at inhibiting uptake of [3H]dopamine ([3H]DA). In drug discrimination assays, CAB was approximately 3-fold less potent than PCA in animals trained to discriminate 3,4-methylenedioxymethamphetamine (MDMA) or its alpha-ethyl homologue, S-(+)-N-methyl-1-(1,3-benzodioxol-5-yl)-2-butanamine (S-(+)-MBDB), from saline. Monitoring with in vivo microdialysis, 10 mg/kg of PCA caused a large increase in extracellular DA and a significant decrease in 3,4-dihydroxyphenylacetic acid (DOPAC) in the striatum. In contrast, 11 mg/kg CAB caused no increase and 22 mg/kg CAB caused only a slight increase in extracellular DA. Both doses of CAB caused a decrease in extracellular DOPAC. The potential 5-HT neurotoxicity of CAB was examined by measuring monoamine and metabolite levels and [3H]paroxetine binding at one week following acute doses. A 10 mg/kg dose of PCA caused an 80% decrease in cortical and hippocampal serotonergic markers, while an equimolar dose of CAB decreased only hippocampal 5-HT and 5-hydroxyindoleacetic acid (5-HIAA) levels. However, 22 mg/kg of CAB produced a 20-40% decrease in all serotonergic markers. Thus, extension of the alpha-alkyl significantly decreases the dopaminergic effects of PCA. The similar decrease in relative 5-HT neurotoxicity and the decreased ability to alter dopaminergic systems in vivo and in vitro supports the involvement of DA in the neurotoxicity of PCA.     

~(125)Ⅰ眼镜蛇毒及抗眼镜蛇毒血清在小白鼠体内分布的比较观察

用氯胺-T法125I标记眼镜蛇毒示踪液及抗眼镜蛇毒血清。小白鼠分二组，用125I-眼镜蛇毒、125I-抗眼镜蛇毒血清分别给小白鼠尾静脉注射，于注射后的不同时间测定血、颈部肌肉、肝、肺、肾、心等脏器放射性分布。结果发现：125I-眼镜蛇毒在肌肉及肝、肺等器官中于注射后2小时过高峰，在肾脏中浓度高，在脑未见放射性分布，抗眼镜蛇毒血清与眼镜蛇毒分布相似但在肌肉及肺脏有更高的分布。证明抗眼镜蛇毒血清能跟踪分布眼镜蛇毒。     

核桃仁泥外敷治疗肌肉注射后皮下硬结的疗效观察

采用核桃仁泥外敷治疗１３８例（实验组）肌肉注射后皮下硬结，并与４０例（对照组）采用新鲜土豆片外敷硬结法比较。结果表明：实验组患者治疗１５天后Ⅰ度和Ⅱ度硬结治愈率分别为８１．１３％和４２．２５％，总有效率达９２．０３％，明显优于对照组（Ｐ＜０．００１）。