异体脱细胞组织补片置入拔牙创预防术后并发症

目的 评价异体脱细胞组织补片局部应用对阻生牙拔除术后并发症的预防作用.方法 将300例拔除阻生牙的患者随机分成甲、乙两组,牙拔除术后,甲组向拔牙窝置入异体脱细胞组织补片,乙组为空白对照,术后观察两组并发症的发生率.结果 甲乙两组干槽症发生率分别为1.3%和8.7%,甲乙两组术后出血率分别为0.7%和6.0%,差异都有统计学意义;甲乙两组术后肿胀发生率分别为8%和10%,差异无统计学意义.结论 异体脱细胞组织补片局部应用对阻生牙拔除后干槽症和出血有一定的预防作用,但对预防术后肿胀无作用.     

复杂性尿路感染的病因1分析及治疗

在我国一组人群普查中,尿路感染(urinary tractinfection,UTI)的发生率为0.9%,尤以女性多见(2.37%)[1].临床上尚无有效的预防UTI的方法[2].因此.UTI的发病率、复发率并无明显下降,研究UTI的复杂因素,合理治疗以降低复发率,保护肾功能乃是临床工作中值得探讨的重要课题.现将我院收治的UTI患者,对其复杂因素,治疗及预后关系作一讨论. 6.Easthan J.et al. Xanthogranulomatous pyelonephritis:Clinical findings and surgical consideratins. Urology, 1994,43: 295     

局部阻滞治疗红斑性肢痛病25例

局部阻滞治疗红斑性肢痛病２５例冯力张德仁（广东省深圳市南山人民医院，深圳５１８０５２）红斑性肢痛病是一种肢端血管异常过度扩张性疼痛疾病，罕见报告。我们自１９９３年以来门诊共诊治２５例，疗效满意，现报告如下。１资料与方法１．１一般资料男７例、女１８例。...     

17β-雌二醇对雌兔腹主动脉损伤后内膜增殖的抑制作用

研究雌激素对雌兔动脉球囊损伤后动脉内膜增生的抑制作用。将50只雌兔随机分成5组，A、B、C、D4组雌兔行卵巢切除术，E组为假手术组。1个月后，各级雌兔均行腹主动脉球囊扩张损伤术。A组和E组肌注对照液。B、C、D肌注不同剂量的雌激素。用药3d后，每组各取5只雌兔处死，取出腹主动脉，行体外腹主动脉3H－TdR掺入观察血管平滑肌增殖的情况。每组的其余5只雌兔于用药后第3周处死，取腹主动脉用图像分析仪测定内膜厚度。结果表明，雌二醇显著抑制兔主动脉片段3H-TdR掺入量，并显著抑制雌兔动脉球囊损伤后内膜的增厚。     

Prevention of No-flow With Distal Protection Device in Patients Underwent Percutaneous Coronary Intervention

Objectives To evaluate the feasibility and safety of distal protection device (PercuSurge) during percutaneous coronary intervention (PCI) in patients with acute coronary syndrome. Methods From October 2004 to August 2007, 40 patients with high risk acute coronary syndrome who received primary coronary intervention were included in this study. Patients were divided into two groups according to whether PercuSurge was attempted during PCI. The basic clinical characteristics, angiographic results, and follow-up data before discharge were compared. Coronary arteries blood flow thrombolysis in myocardial infarction (TIMI) grade, TIMI myocardial perfusion (TMP) grade and the rate of no-reflow were performed in all cases after PCI. Results There was no significant difference between the two groups in basic clinical characteristics and angiography before PCI (P>0.05). All patients underwent PCI successfully in both groups. In the PercuSurge group, PCI with PercuSurge guardwire protection was performed successfully in 18 patients. There was significant difference between the two groups in TIMI 3 flows gained in target vessels after PCI. Better percentage of TMP grade 3 of target vessels was achieved in PercuSurge group. Less no-reflow were found in PercuSurge group. There were lower peak troponin I and serum MB isoenzyme of creatine kinase levels, higher left ventricular ejection fraction and smaller left ventricular end-diastolic dimension in the PercuSurge group after PCI at the date before discharge (P<0.05). There was no major adverse cardiac events in PercuSurge group, only one patient died in the control group. Conclusions This study demonstrates that using the PercuSurge Guardwire system during PCI in high risk acute coronary syndrome patients to prevent no-reflow is feasibility and safety.     

血管紧张素Ⅱ对血管平滑肌细胞内游离钙的作用机制

本研究用５７０型粘附式细胞仪（ＡＣＡＳ－５７０）动态观察了血管紧张素Ⅱ（ＡｎｇⅡ）对单个平滑肌细胞（ＳＭＣ）内游离钙的影响，探讨了ＡｎｇⅡ调节ＳＭＣ内游离钙的改变的机制。分离兔主动脉中层平滑肌，用含１０％小牛血清的ＤＭＥＭ培养，第３～５代细胞用于实验，并于实验前两天去除血清使细胞处于静止期。结果发现：ＡｎｇⅡ可引起细胞内一个快的、短暂的、剂量依赖性的游离钙升高，ＡｎｇⅡ的拮抗剂沙拉斯（ｓａｒａｌａｓｉｎ）可抑制这种作用，而钙离子通道阻滞剂硝苯地平或维拉帕米则没有影响。提示：ＡｎｇⅡ调节ＳＭＣ内游离钙升高的机制主要是通过促进细胞内贮存钙的释放。     

比索洛尔对高血压合并舒张性心力衰竭患者左心室舒张功能的影响

目的探讨比索洛尔对高血压合并舒张性心力衰竭患者治疗前后左心室舒张功能及血清氨基末端脑钠尿肽前体(NT-proBNP)、C反应蛋白(CRP)、肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)水平的影响。方法选取高血压合并舒张性心力衰竭患者216例,随机分为对照组(n=105)和试验组(n=111)。试验组在常规治疗基础上给予富马酸比索洛尔2.5mg/d,每3天增加2.5mg,最大剂量增至10mg/d。两组患者均在治疗前、治疗后3月采用超声心动图检测E/A、IVRT、EDT及E/E’,采用电化学发光分析仪检测血清NT-proBNP浓度。采用酶联免疫吸附试验测定各组患者用药前后血清CRP、TNF-α和IL-6的含量。结果试验组富马酸比索洛尔平均用量6.3mg。治疗3月后,对照组及试验组患者的E/A、IVRT、EDT均明显上升(P<0.05),与对照组相比,试验组E/A、IVRT、EDT上升更明显(P<0.05)。对照组及试验组患者E/E’、NT-proBNP均明显下降;与对照组相比,试验组E/E’、NT-proBNP降低更明显(E/E’下降值:5.35±1.67比4.15±1.28,lgNT-proBNP下降值:2.58±0.78比1.84±0.64;均P<0.05)。治疗3月后,两组血清CRP、TNF-α、IL-6水平较治疗前明显下降(P<0.05)。但两组间下降幅度差异无统计学意义(P>0.05)。结论在常规治疗的基础上加用比索洛尔能进一步改善高血压合并左心室舒张功能不全患者的心功能,可能与调节NT-proBNP的表达有关。     

环状钢丝电极在紧急心脏起搏中的临床应用

目的:观察环状钢丝电极在经皮穿刺紧急心脏起搏中的临床应用情况并与钩状钢丝电极进行对比分析,总结环状钢丝电极的特点。方法:46例住院期间发生心脏骤停的患者,在心肺复苏时,随机使用环状钢丝电极和钩状钢丝电极进行紧急心脏起搏治疗。依所用电极种类,归入相应组。比较2组建立有效起搏的时间、起搏参数和起搏并发症。结果:2组紧急心脏起搏的成功率均为100%;建立有效起搏操作时间差异无统计学意义;均未发生心包压塞等严重并发症;2例钩状电极在拔出体外后头端钩状钢丝折断于体内。环状钢丝电极操作简化。结论:环状钢丝电极操作性能良好,有助于建立迅速、有效的紧急心脏起搏,并减少对心肌的损伤,达到抢救心脏骤停的目的。     

脑外科急诊瞳孔散大固定患者的预后分析

目的　提高急诊瞳孔散大患者的诊治效果并进行预后分析。方法　将 90例发生瞳孔散大固定的患者根据病因分成 2组 :4 9例外伤患者 ,4 1例高血压脑出血患者。治疗结果以Glasgow评分归类。对其进行临床调查和预后分析。结果　总死亡率 6 6 .7% ,2 4 .4 %Glasgow评分 2～ 3分 ,8.9%Glasgow评分 4～ 5分 ,脑外伤和脑出血组间没有统计学差别。单侧瞳孔散大患者生存率 (5 3.1% )比双侧 (2 2 .4 % )者高 (P <0 .0 1)。年龄和生存率无相关 ,但是年轻存活者功能恢复更好。治疗是否迅速、及时与预后关系密切。治疗后瞳孔散大未改善者预后极差。治疗后双侧瞳孔均恢复 ,生存率为 6 4 %。结论　治疗后瞳孔的恢复情况与存活率关系密切。治疗及时、单侧瞳孔散大、年纪轻的患者生存和康复的机会更大。