股骨头缺血性坏死的早期治疗

自1991年6月始我们开发了多通道经皮钻孔抽髓内血减压术治疗了早期股骨头缺血性坏死并配合内收肌切断、闭孔神经切断、功能锻炼及活血生骨药物等综合性治疗方法,取得了满意效果,总结如下:1　临床资料1.1　一般资料:本组50例66髋,男44例,女6例。年龄平均42岁(28岁～66岁)。右侧29例,左侧21例,双侧16例。有长期饮烈性酒史者41例,服用过激素者8例,特发性者2例。　　Ficat期8例,12髋;Ficat期42例,54髋。所有的病例均进行了骨内压测定,骨内压平均4.9kPa。1.2　手术方法:术前用金属标记物在X线拍片下或闭路X线机下定位,并在体表上用龙胆紫标记。…     

cGMP 依赖性蛋白激酶在结直肠癌中的研究现状

在肺癌、胃癌、结直肠癌等肿瘤信号研究中发现,cGMP 依赖性蛋白激酶（cGMP －dependent pro-tein kinases,PKG）介导的抗肿瘤信号在肿瘤发生发展中发挥重要作用,异常激活的 cGMP／PKG 信号可通过促进肿瘤细胞分化、凋亡,抑制其增殖、伪足形成以及肿瘤血管生成而发挥抗肿瘤作用。因此,PKG 具有成为治疗肿瘤的信号靶点潜能。本文就 cGMP／PKG 信号抗结直肠癌的作用及其机制进行综述,为靶向 cGMP／PKG信号治疗结直肠癌提供理论依据。     

幽门螺旋杆菌是导致消化道溃疡的元凶

消化道溃疡，也称胃或十二指肠溃疡，好发于食道下端，即胃与十二指肠部位，是人类最常见的一种消化道疾病。溃疡病男性居多，发病率在10％左右。     

VEGF-C和受体VEGFR-3 mRNA在食管鳞癌中的表达及意义

目的:观察血管内皮生长因子C(VEGF-C)及其受体血管内皮生长因子受体3(VEGFR-3)在食管鳞癌组织中的表达,分析其与肿瘤淋巴结转移的关系.方法:采用RT-PCR方法检测32例食管鳞癌组织、10例正常食管粘膜中VEGF-C/VEGFR-3 mRNA的表达情况,分析其与各临床病理因素之间的关系.结果:食管鳞癌组织中VEGF-CmRNA表达阳性率为68.75%(22/32),其中18例VEGFR-3 mRNA阳性,VEGF-C和VEGFR-3的表达密切相关(P＜0.01).VEGF-C mRNA的表达与食管鳞癌的淋巴结转移、浸润深度显著相关(P＜0.01,P＜0.05),但与患者年龄、肿瘤大小及分化程度无关.正常食管粘膜中未见VEGF-C/VEGFR-3 mRNA表达.结论:VEGF-C/VEGFR-3是促进食管鳞癌经淋巴结转移的重要因素.     

七氟烷用于癫痫手术麻醉及其对脑电图的影响

Objective To assess the effects of concentration of sevoflurane on the electrocorticogram (ECoG) of intractable epileptic patients or non-epileptic patients undergoing surgery and investigate the suitable concentration of sevoflurane for epilepsy surgery. Methods Of 24 patients with intractable epilepsy and 15 patients with non-epilepsy but brain diseases, ECoG were recorded under sevoflurane anesthesia with 0.7 minimum alveolar anesthetic concentration (MAC), 1.0 MAC, 1.3 MAC, and 1.5 MAC, respectively, under similar ventilatory conditions. Spike activity and other frequency brain waves were evaluated. Results The frequencies and leads of spike waves (or spike-form waves) were similar with 0.7-1.3 MAC sevoflurane anesthesia in epileptic patients, whereas the spike waves were significantly increased at 1.5 MAC in epileptic patients and 5 of 15 non-epileptic patients (P<0.05). The change of other frequencies brain waves was similar in both group: the frequency of α and β waves decreased, δ waves increased and θ waves changed a little. Conclusion The maintenance of anesthesia with 0.7-1.3 MAC sevoflurane is safe and suitable for the craniotomy surgery of epileptic patients with ECoG monitoring. Careful attention should be paid to the higher concentration of sevoflurane (>1.5 MAC) used when intraperative ECoG is used in both epileptic patients and non-epilepsy patients.     

C-反应蛋白在感染性肺炎治疗中的应用

目的探讨血清CRP水平变化在感染性肺炎治疗中的应用。方法对160例确诊为感染性肺炎的住院患者和同期门诊上呼吸道感染80例以及87例健康人分别进行CRP、白细胞总数和白细胞分类测定。结果门诊患者的CRP(73.3±3.6)mg/L显著低于我院患者(132±11.3)mg/L;住院患者治疗前为(132±11.3)mg/L,治疗后降低到(33.7±28.8)mg/L,差异有显著性(P<0.001)。结论血清C-反应蛋白增高可作为诊断感染性肺炎时判断其愈后及疗效判定的一项指标。     

自身免疫性疾病——红斑狼疮

红斑狼疮是自身免疫性疾病,这一疾病的命名,最初指的是局限性盘状红斑狼疮,患者的两侧面颊、鼻梁和前额部的皮肤除了红斑之外,在其基础上还伴有患处皮肤萎缩、瘢痕、鳞屑和色素增深,使本来的面容变形,如同被狼咬过一样,因此得名红斑狼疮。除局限性盘状红斑狼疮之外,该病还会侵犯心脏、肾脏、肝脏和中枢神经系统,凡是发生脏器改变的称为系统性红斑狼疮。     

七氟烷用于癫痫手术麻醉及其对脑电图的影响

Objective To assess the effects of concentration of sevoflurane on the electrocorticogram (ECoG) of intractable epileptic patients or non-epileptic patients undergoing surgery and investigate the suitable concentration of sevoflurane for epilepsy surgery. Methods Of 24 patients with intractable epilepsy and 15 patients with non-epilepsy but brain diseases, ECoG were recorded under sevoflurane anesthesia with 0.7 minimum alveolar anesthetic concentration (MAC), 1.0 MAC, 1.3 MAC, and 1.5 MAC, respectively, under similar ventilatory conditions. Spike activity and other frequency brain waves were evaluated. Results The frequencies and leads of spike waves (or spike-form waves) were similar with 0.7-1.3 MAC sevoflurane anesthesia in epileptic patients, whereas the spike waves were significantly increased at 1.5 MAC in epileptic patients and 5 of 15 non-epileptic patients (P<0.05). The change of other frequencies brain waves was similar in both group: the frequency of α and β waves decreased, δ waves increased and θ waves changed a little. Conclusion The maintenance of anesthesia with 0.7-1.3 MAC sevoflurane is safe and suitable for the craniotomy surgery of epileptic patients with ECoG monitoring. Careful attention should be paid to the higher concentration of sevoflurane (>1.5 MAC) used when intraperative ECoG is used in both epileptic patients and non-epilepsy patients.     

肾移植患者带状疱疹神经痛综合治疗12例临床观察

目的 观察肾移植术后并发带状疱疹的综合治疗的疗效.方法 12例患者予静脉点滴阿昔洛韦,紫外线皮损区体表照射和超短波神经节区照射,曲安奈德、甲钴铵和利多卡因混合注射液神经阻滞.结果 患者平均视觉模拟疼痛评分(VAS)从治疗前9.3分降到治疗后2.1分(P<0.01),总有效率达到100%.结论 肾移植术后并发带状疱疹患者采用抗病毒药物、理疗复合神经阻滞的综合治疗方法 安全、有效.     

神经阻滞联合口服药物治疗带状疱疹后遗神经痛临床观察

目的 比较单纯口服药物和联合神经阻滞两种方法治疗带状疱疹后遗肋间神经痛(PHN)的效果.方法 40例病程超过6个月的PHN患者,分成两组,每组各20例.A组口服卡马西平、多寨平、双氯芬酸钠、B族维生素,B组在口服上述药物的基础上应用醋酸曲安奈德、弥可保、0.4%利多卡因行肋间神经阻滞.比较两组患者治疗前、治疗后3周和治疗后6个月的视觉模拟评分(VAS).结果 B组患者在治疗后3周和6个月VAS均较治疗前明显降低(P<0.01),A组在治疗后3周VAS低于治疗前,6个月后与治疗前无显著作差异.组间比较:B组治疗后3周和6个月VAS均明显低于A组(P<0.01).结论 神经阻滞联合口服药物治疗顽固PHN止痛作用强,疗效持久.