慢性肾功能不全患者血管活性物质测定在血液净化中的临床研究

目的 评价血管紧张素Ⅱ、氨甲酰血红蛋白、醛固酮及甲状旁腺激素等在血液净化充分性中的意义。方法 120例慢性肾功能衰竭患者，按采用不同的透析膜分为3组：即聚砜膜、醋酸膜、铜仿膜。用放射免疫法测定其血管紧张素Ⅱ（AngⅡ）及醛固酮（ALD）浓度，化学发光法测甲状旁腺激素（PTH）。采用不同的血流量200ml／min及250ml／min比较。结果 对体内中、小分子物质清除率，聚砜膜〉醋酸膜〉铜仿膜。结论 高血流量、高通透性人工合成聚砜膜，对治疗慢性肾功能衰竭，提高肾功能不全患者的身心健康及生活质量、延长患者生命有很重要的临床意义。     

Using rare earth element tracers and neutron activation analysis to study rill erosion process.

Spatially averaged soil erosion data provide little information on the process of rill erosion. The dynamically varied data on the temporal and spatial distributions in the rill erosion process are needed to better understand the erosion process and reveal its innate characteristics. The objectives of this study were to examine the feasibility and effectiveness of rare earth element (REE) tracers and the neutron activation analysis (NAA) method on the study of the rill erosion process and to reveal quantitatively the relationships and characteristics of temporal and spatial distributions of sediment yield in rill erosion. Four REEs were used to study the changeable process of rill erosion at 4 slope positions. Four water inflow rates were applied to a 0.3 x 5 m soil bed at 3 slopes of 10.5%, 15.8% and 21.2% in scouring experiments. All of the runoff was collected in the experiment. Each sample was air-dried and well mixed. Then 20 g of each sample was sieved through 100-mesh and about a 50 mg sample was weighed for analysis of the four elemental compositions by NAA. Results indicate that the REE tracers and NAA method can be used to not only quantitatively determine soil erosion amounts on different slope segments, but also to reveal the changeable process of rill erosion amount. All of the relative errors of the experimental results were less than 25%, which is considered satisfactory on the study of rill erosion process.     

10例前置胎盘产后出血改良式宫腔纱布填塞临床分析

目的对改良式宫腔填塞治疗前置胎盘产后出血进行疗效分析。方法对我院手术室常规使用大尾纱行子宫下段胎盘附着面出血,填塞压迫止血进行回顾性分析。结果10例患者行子宫下段纱布填塞疗效明显,出血量400～600ml,均未输血,生命体征平稳,无产褥感染和晚期产后出血。结论子宫下段宫腔纱布填塞术治疗产后出血疗效显著。     

慢性多发性肌炎临床及病理分析

目的探讨慢性多发性肌炎的发病机制、临床和病理特征。方法回顾性分析95例慢性多发性肌炎患者临床表现、肌酶学和肌电图检查结果,总结肌肉病理学特征。结果慢性多发性肌炎以四肢近端肌无力、肌萎缩为主要表现,血清酶谱轻-中度增高,肌电图以肌源性损害为主,病理改变为灶性坏死、炎性细胞浸润与再生肌纤维共存。结论临床特点结合病理学检查有助于慢性多发性肌炎的诊断,多数患者激素治疗有效。     

The role of endotoxin in the pathogenesis of experimental multiple system organ failure: a preliminary report.

In this study, an animal model of multiple system organ failure (MSOF) in rabbits, engendered by feeding E. coli prior to severe hemorrhagic shock, was used for the purpose of investigating 1) the relationship between lipopolysaccharide (LPS) and MSOF, and 2) the effectiveness of Re-LPS antiserum in preventing MSOF. The results showed that endotoxemia occurred very early, and its degree correlated well with that of organ dysfunction. Re-LPS antiserum administration abated the toxic effects and lowered the incidence of MSOF. These results suggest that sequential analysis of circulating LPS levels may be useful for the early diagnosis of MSOF, and that gut-derived endotoxin might play an important role in the pathogenesis of experimental MSOF.     

日本血吸虫磷酸丙糖异构酶编码基因的克隆与序列测定

目的克隆和鉴定日本血吸虫磷酸丙糖异构酶(SjTPI)编码基因,为寻找血吸虫病的候选疫苗联合应用打基础.方法设计合成引物,抽提日本血吸虫成虫总RNA,用RT-PCR法从中扩增出SjTPI基因编码序列,将其克隆入pGEM-T载体,用双酶切、以重组质粒为模板进行PCR扩增和测序进行鉴定.结果 RT-PCR法从成虫总RNA中扩增出大小为759 bp SjTPI基因编码序列,重组质粒pGEM-SjTPI经双酶切、PCR扩增,均可获得一条与RT-PCR产物一致的DNA片段,序列测定结果表明具有一个长度为759 bp的完整开放阅读框,与日本血吸虫(菲律宾株)和曼氏血吸虫磷酸丙糖异构酶核苷酸序列有高度同源性(分别为99%和88%).结论该实验成功地克隆了SjTPI编码基因,为进一步研究提供了条件.     

Role of intestinal bifidobacteria in the pathogenesis of gut-derived bacteria/endotoxin translocation and the effect of bifidobacterial supplement on gut barrier function following burns

Early multiple organ dysfunction syndrome appears to be facilitated with bacterial translocation in severely burn injury, yet the mechanisms of bacterial translocation remains in dispute. The aim of this study was to investigate the potential role of intestinal bifidobacteria in the pathogenesis of gut-derived bacteria/endotoxin translocation following burns and the effects of bifidobacterial supplement on gut barrier. Methods: Wistar rats were randomly divided into burn group (Burn, n=60),sham burn group (SB, n=10) in experiment Ⅰ , and burn + saline group (BS, n=30), burn + bifidobacteria group (BB, n=30), and sham-burn + saline group (SS, n= 10) in experiment Ⅱ. Animals in BB group were fed bifidobacterial preparation (5 × 109 CFU/ml) after burns, 1.5ml,twice daily. Animals in BS and SS were fed saline. Samples were taken on days 1, 3, and 5 in burn groups, and on day 3 in sham-burn groups. The incidence of bacteria/endotoxin translocation and counts of Bifidobacterium, Fungi and Escherichia coli in gut mucosa were determined with standard methods. The levels of sIgA in mucus of small intestine were measured by RIA. The positive sIgA expression in lamina propria and ileum mucosal injury was evaluated light microscopically by blinded examiners. Results: Our results showed that the incidence of bacterial translocation was increased after burns, which was accompanied by significant decrease in number of bifidobacteria but significant increase in E. coli and fungi in gut mucosa, and elevation of levels of plasma endotoxin and IL-6 (P<0. 001).The incidence of bacterial translocation was markedly reduced after 3- and 5-day supplementation of bifidobacteria compared with control group (P<0.05). The counts of mucosal bifidobacteria were increased by 4- to 40-fold,while E. coli and fungi were decreased by 2- to 30-fold and 10- to 150-fold, respectively, after bifidobacterial supplementation in contrast to control group. The damage of mucosa tended to be less pronounced after 3-day bifidobacteria-supplemented formula compared with control group [grade 2(0-6) vs. grade 4(3-6), P<0.05]. Moreover, the expression and release of sIgA was markedly augmented after 3-day bifidobacteria-supplementation formula and it returned to normal range on day 5. Conclusion: The decrease in counts and proportion of bifidobacteria in mucous membrane flora may play an important role in the development of bacteria/endotoxin translocation following thermal injury. The supplement of exogenous bifidobacteria could per se improve gut barriers, and attenuate bacteria/endotoxin translocation secondary to major burns.     

外伤性股动脉栓塞继发肾功能衰竭32例的综合治疗

目的 探讨外伤性股动脉栓塞后继发急性肾功能衰竭的临床综合治疗。方法 对32例外伤性股动脉栓塞术后继发急性肾功能衰竭病例均进行急诊手术切开取栓、血管吻合术，术后均予以综合治疗。结果住院时间7天-3个月，平均41d。最终截肢6例，死亡2例，24例修复成功。结论 术前准确判断预后，正确选择手术方式、术中筋膜减张性切开、术后及时清除坏死组织、术后利尿合剂应用和及时必要的血透是影响外伤性股动脉栓塞保肢术后急性肾功能衰竭预后的重要因素。     

神经导航下经岩骨幕上下联合入路中面神经管的解剖研究

OBJECTIVE: To study the value of neuronavigation in the transpetroal approach, and to provide anatomic data for the protection of the nerves in the facial nerve canal (FNC) during surgeries. METHODS: Simulated surgery through the transpetroal approach was performed on 16 sides of 8 adult cadaver heads with the assistance by neuronavigation. The anatomy of the facial nerve and the relationship of related structures were observed and the distances from the utmost external edge of the mastoid to different segments of the FNC were measured. RESULTS: Neuronavigation was successful with all the FNC, with the mean error of less than 0.9 mm. The FNC could be divided into 3 segments, the labyrinthine, the tympanic and the mastoid segments, stretching 3.6+/-1.2 mm, 11.2+/-2.5 mm and 16.1+/-3.6 mm respectively and with diameters of 1.2+/-0.3 mm, 1.4+/-0.1 mm and 1.7+/-0.2 mm, respectively. CONCLUSION: Neuronavigation may help protect the FNC during surgical procedures, and a thorough knowledge of the anatomic features of the FNC can be significant for preservation of the facial nerves.     

北京农村居民健康状况及卫生服务需求调查

目的了解北京农村居民健康状况及卫生服务需求特点。方法从昌平区、顺义区、大兴区、房山区随机抽取25～64岁农民1605人进行统一问卷调查。结果农民高血压自报患病率为22．4％，超重和肥胖率为56．1％；现在吸烟率为34．4％，缺乏运动率为41．6％；家庭主要经济支出为学生上学(35．3％)，建房(25．4％)和疾病(21．2％)；54．9％家庭医疗费用支出占总收入的10％以上；最关心的健康问题主要是慢性疾病防治(70．2％)；最希望获得的健康知识是慢性病预防知识(72％)；希望获得健康知识的途径是广播和电视(81％)；家庭最希望获得的医疗保健服务是方便看病和获得药物(73．8％)。结论慢性病给农民带来沉重负担，并成为农民关心的主要健康问题。