人偏肺病毒研究进展

人偏肺病毒(hMPV)是一种新近发现的呼吸道致病病毒。hMPV感染主要发生在冬春季,各年龄阶段的人群都可受到感染,尤其是儿童、老年人和免疫缺陷患者。世界各国报道其感染率不径相同,感染症状可从轻微的上呼吸道病变到严重的细支气管炎和肺炎。RT-PCR技术是hMPV主要的检测手段,hMPV感染也是哮喘急性发作和慢性阻塞性肺病急性加重的诱因。     

2型糖尿病患者日内血糖波动与动脉硬度的相关性研究

目的 研究2型糖尿病患者日内血糖波动与血管硬度的相关性。方法 选取2018年5月—2019年4月该院收治的75例2型糖尿病患者,根据baPWV值是否异常分为PWV正常组（baPWV<1 400cm/s,n=25）和PWV异常组（baPWV≥1 400cm/s,n=50）。采集两组一般信息、生化指标、糖化血红蛋白、baPWV、动态血糖监测数据,进行日内血糖波动与血管硬度的相关性分析。结果 PWV异常组的年龄、糖尿病病程、SBP、MBG、SD、MAGE值与PWV正常组比较,差异有统计学意义（P<0.05）;控制年龄、糖尿病病程、血压后行偏相关分析,结果可见baPWV与MAGE呈正相关(r=0.356,P=0.004),与MBG、SD无相关性（P>0.05）;baPWV与lnMAGE进行直线回归分析,回归方程：Y=1 275.27+254.93×X(r=0.434,R2=0.189,P<0.001)。结论 2型糖尿病患者的日内血糖波动与血管硬度呈正相关。     

李显筑教授从脾论治疑难杂证经验举隅

李显筑教授临床多年,精通中医经典,不仅学有渊源,而且立足创新,临床上博采众长,大胆探索,擅长内科,对妇科、儿科亦深有造诣。李师治学,治法有宗,师古不泥。以从脾论治疑难杂证而独树一帜,临证每收佳效。     

地面传热实验的微重力修正模拟

目的 使空间飞行器地面传热实验的结果能够有效地应用到空间微重力条件下。方法 用数值模拟的方法研究了矩形空间内45度对称间隔斜进风以及垂直进风和换热情况,壁面条件为等壁温或等热流。对重力和微重力两种情况进行了对比。结果 对等壁温情况,提出了表征空间飞行器舱内换热的关系式,并且将数值计算所得数据按这些关系式进行了最小二乘拟合,得到了空间微重力工况和地面工况下的换热关系式。对等热流情况,本文列出了重力和微重力条件下的最高壁面温度值,给出了两种情况时最高壁面温度的拟合公式。结论 根据本文的内容,可以对地面模型装置的实验结果进行修正,得到空间飞行器原型内的换热情况。     

慢性硬脑膜下血肿钻孔冲洗引流的疗效观察

报告采用钻孔,冲洗,引流术治疗慢性硬脑膜下血肿42例的结果。根据颅内压增高症状,神经体征和颈动脉造影即可诊断。手术只需在血肿侧额部及顶部各钻一孔,术中进行反复冲洗,将血肿内容物排空,在顶部钻孔处向血肿腔内放一胶管作术后持续引流3～4天。本方法简单易行,老年或体弱者均可耐受。本组中有19例术前已有意识障碍,术后均清醒,无手术死亡。 42例中23例术后随访1～17年,无血肿复发及癫痫,除1例术后即有轻偏瘫,做轻工作外,均痊愈。     

大肠绒毛状腺瘤的X线诊断

绒毛状腺瘤又名乳头状息肉或苔癣样腺瘤,约占大肠各类息肉的2.5％,易恶变,常有较特征性的X线表现。国内有关本病X线诊断的报告较少,现报告经本院手术及病理证实的7例。     

全麻快诱导期非加压通气的可行性

目的观察丙泊酚-爱可松-瑞芬太尼快诱导期非正压通气的可行性及对急性胃扩张的预防效果。方法20例择期全麻病人入手术室即作动脉血气分析,高流量(8~10L/m in)吸氧5m in后静注丙泊酚(2mg/kg)-爱可松(0.8mg/kg)-瑞芬太尼(1μg/kg)序贯快诱导(60 s内注射完毕),60 s后气管插管。插管成功即刻再进行动脉血气分析。诱导插管期间任由患者进入无呼吸状态而不给予正压辅助通气。结果各病人诱导后插管条件满意,平均插管耗时27.45 s。诱导插管后患者的PaO2、PaCO2均上升,与基础值相比分别为(242±111)Vs(93±10)mm Hg(P<0.01)和(45±8)Vs(39±4)mm Hg(P<0.01),无急性胃扩张发生。结论经5m in的高流量纯氧预吸后,丙泊酚-爱可松-瑞芬太尼快诱导插管期无通气并无低氧、高碳酸血症的发生,且可有效防止诱导期急性胃扩张发生。     

Association between Cardiac Changes and Stress,and the Effect of Peroxisome Proliferator-activated Receptor-γ on Stress-induced Myocardial Injury in Mice

This study was aimed to investigate the effect of stress induced by high-intensity exercises on the cardiovascular system. In the epidemiological investigation, 200 subjects(test group) engaged in special high-intensity exercises, and 97 who lived and worked in the same environment and conditions as those in the test group, but did not participate in the exercises served as controls. In the second part of the study, 50 mice were randomly divided into control group, exhaustive swimming group, white noise group, exhaustive swimming plus white noise group, and pioglitazone intervention group. The results showed that the plasma concentrations of the myocardial injury markers heart fatty acid-binding protein(H-FABP), C-reactive protein(CRP), β-endorphin(β-EP) and levels of psychological stress were significantly increased in test group as compared with control group; special high-intensity exercises resulted in a significant elevation of the incidence of cardiac arrhythmias. Animal experiments showed that the plasma levels of corticosterone(CORT) and troponin I(Tn I) were raised while the level of SOD was reduced in exhaustive swimming group, white noise group, and exhaustive swimming plus white noise group. The expression levels of PPARγ m RNA and protein were decreased in myocardial tissues in these groups as well. HE staining showed no remarkable change in myocardial tissues in all the groups. Treatment with pioglitazone significantly decreased the plasma levels of Tn I and CORT, while increased the level of SOD and the expression levels of PPARγ m RNA and protein. It was concluded that the high-intensity exercises may induce a heavy physical and psychological stress and predispose the subjects to accumulated fatigue and sleep deprivation; high-intensity exercises also increases the incidence of arrhythmias and myocardial injury. PPARγ may be involved in the physical and psychological changes induced by high-intensity exercises.     

浙江省赛艇运动员的膳食调查

作者以３０名年龄１９～２５岁的浙江省赛艇运动员为对象，进行为期５天的膳食调查。结果表明，不同级别运动员总热量摄入都是充足的，但三大供能营养素的比例值得商榷，均存在脂肪摄入量过多，约占总热量的２８％～３９％，碳水化物摄入量偏低，约占总热量的４５％～５６％的情况。蛋白质供给良好。水溶性维生素和无机盐摄入量充裕，而维生素Ａ摄入不足，只占标准供给量的５４％～６９％。     

从心胆气虚论治神经症

探讨从心胆气虚论治神经症的理论依据和临床应用。认为胆虚体质为神经症的病理基础,不良情志刺激为其诱发因素,两者互为因果。益气镇惊、安神定志是从心胆气虚论治神经症的治疗大法。同时心胆气虚常与心脾两虚、心肾阴虚复合为证,亦可与痰热扰神、肝郁伤神兼夹,故以安神定志丸为主方进行辨证加减治疗神经症。