超声探讨室间隔缺损合并动脉导管未闭的诊断方法

目的:超声探讨室间隔缺损合并动脉导管未闭(VSD PDA)患者的动脉导管未闭(PDA)显示方法.方法:超声测量41例VSD PDA和41例单纯室间隔缺损(VSD)患儿的主动脉峰值流速(Vp),平均流速(Vm),流速时间积分(VTI)和心排指数(CI).除常规在胸骨旁大动脉短轴切面探查以外,彩色多普勒超声心动图在胸骨旁肺动脉分叉切面、胸骨上主动脉弓长轴,向短轴扫查切面及剑突下主动脉短轴切面探查PDA.结果:41例VSD PDA患者检出PDA 29例,占70.73%,漏诊12例,漏诊率29.27%.VSD PDA患者的Vp、Vm、VTI和CI参数明显高于单纯VSD患者,P<0.001.4例在胸骨旁大动脉短轴切面未显示的PDA,其中2例在胸骨旁肺动脉分叉切面发现PDA,1例在胸骨上主动脉弓长轴向短轴扫查切面显示PDA,1例在剑突下主动脉短轴切面显示PDA.结论:VSD患儿主动脉Vp、Vm、VTI和CI参数增高时提示合并PDA存在.探查VSD患儿胸骨旁肺动脉分叉切面、胸骨上主动脉弓长轴向短轴扫查切面及剑突下主动脉短轴切面有助于发现PDA.     

4例急性有机锡中毒性脑病患者的护理

回顾性分析4例急性有机锡中毒性脑病患者的临床表现和护理,重点是观察其意识、情绪及行为改变.急性有机锡中毒性脑病诊断一经确立,即采取综合措施:卧床休息;纠正水电解质紊乱;积极脱水降颅内压,大剂量激素使用;有精神症状者给予适当的镇静药治疗;防止并发症;做好心理护理及出院指导等.2个月后随访,1例有轻度的智力障碍,其余3例均可从事不同程度的劳动.     

纤维结合素角膜上皮愈合作用的研究

人血浆纤维结合素对家兔刮除和板层切除后的角膜上皮愈合均有一定促进作用，角膜上皮裸区明显缩小，优于对照眼。临床治疗５类角膜上皮障碍５９例６１眼，均获得显著疗效。     

开颅术后张力性气颅

报告１９８８年１２月～１９９２年１２月开颅术后张力性气颅５例，男４，女１．５例中３例治愈，２例死亡。开颅术后张力性气颅产生的主要原因是颅内占位性病变切除后，脑脊液丢失，使颅内压降低，甚至呈负压状态，外界的气体从切口进入颅内的腔隙，ＣＴ扫描或颅骨Ｘ线平片可以确定诊断，钻孔置管排气是活疗张力性气颅的有效方法，作者探讨了预防此种并发症发生的措施。     

畸形肾结石的冲击波碎石术

畸形肾结石是当今泌尿外科的难题之一，在治疗上一直存在争议。自体外冲击波碎石术（SWL）问世以来，随着治疗例数和经验的不断积累，目前已经逐渐达成共识：畸形肾结石的冲击波碎石是一种行之有效的治疗方法，但也有较大的局限性。本在温习新近献的基础上，结合畸形肾结石的形态特点和诊断要点，概要介绍相关冲击波碎石的一些准则、观点和技术。     

影响同种异体肾移植受者勃起功能障碍的因素与治疗选择

性生活质量是肾移植受者生活质量的重要内容之一,随着肾移植受者存活率的提高,男性受者性生活质量,尤其是勃起功能已经受到医学界和移植肾受者的广泛关注。现有的资料表明男性肾移植受者勃起功能障碍(ED)的患病率为35.8%~78.3%;影响男性受者ED的因素有年龄、透析时间、手术方式、血红蛋白含量、精神心理因素、免疫抑制药物、糖尿病等。在对男性肾移植受者ED的治疗中万艾可是有效、安全的,在口服药物治疗失败后也可选择阴茎海绵体血管活性药物注射或阴茎假体植入术,但是三件套假体应该避免使用。     

人毛乳头细胞条件培养液治疗斑秃的临床观察

目的：人毛乳头细胞条件培养液治疗斑秃患者的临床观察。方法：用人毛乳头细胞条件培养液治疗100例斑秃患者，并分别选择其中53例和30例作去炎松组和空白组自身对照。结果：人毛乳头细胞条件培养液组、去炎松组和空白组治愈率分别为75％、51％、10％，有效率分别为97％、72％、30％，人毛乳头细胞条件培养液组其治愈率和有效率均明显高于去炎松组和空白组（P〈0．05）。结论：人毛乳头细胞条件培养液对斑秃患者有明显的治疗作用。     

Trehalose protects against ocular surface disorders in experimental murine dry eye through suppression of apoptosis

The disaccharide trehalose is a key element involved in anhydrobiosis (the capability of surviving almost complete dehydration) in many organisms. Its presence also confers resistance to desiccation and high osmolarity in bacterial and human cells by protecting proteins and membranes from denaturation. The present study used a novel murine dry eye model induced by controlled low-humidity air velocity to determine whether topically applied trehalose could heal ocular surface epithelial disorders caused by ocular surface desiccation. In addition, the efficacy of 87.6 mM trehalose eyedrops was compared with that of 20% serum, the efficacy of which has been well documented. Mice ocular surface epithelial disorders were induced by exposure of murine eyes to continuous controlled low-humidity air velocity in an intelligently controlled environmental system (ICES) for 21 days, which accelerated the tear evaporation. The mice were then randomized into three groups: the control group received PBS (0.01M) treatment; a second group received 87.6 mM trehalose eyedrops treatment; and the third group received mice serum eyedrops treatment. Each treatment was administered as a 10 μl dose every 6 h for 14 days. The resultant changes in corneal barrier function and histopathologic examination of cornea and conjunctiva were analyzed and the level of apoptosis on the ocular surface was assessed using active caspase-3. After 14 days of treatment, the corneal fluorescein staining area, the ruffling and desquamating cells on the apical corneal epithelium, as well as the apoptotic cells on ocular surface epithelium had significantly reduced in eyes treated with trehalose compared with those treated with serum and PBS. In contrast, after 14 days of treatment, improvements in the thickness of the corneal epithelium, the squamous metaplasia in conjunctival epithelium and the number of goblet cells of the conjunctiva were less marked in eyes treated with trehalose compared with serum. These results demonstrated that trehalose could improve the appearance of ocular surface epithelial disorders due to desiccation through suppression of apoptosis. Trehalose produces some of the same responses as serum upon topical application and can maintain corneal health.     

远隔性小脑出血

远隔性小脑出血极为罕见，可见于多种类型的神经外科手术，一般出现在手术远隔部位，多分布于单侧或双侧小脑沟、蚓部，小脑上部出血也较为多见。远隔性小脑出血总体预后良好，病死率约为10％～15％。