奥兰扎平治疗精神分裂症58例临床观察

目的观察奥兰扎平治疗精神分裂症的临床疗效与安全性.方法选择58例精神分裂症病人,开始给予奥兰扎平5mg*d-1,3d后根据临床疗效、副反应情况酌情增加剂量,最大剂量不超过20mg*d-1,治疗8周.治疗前及治疗后每2周用PANSS、CGI、TESS量表评定1次.结果治疗后PANSS总分、各因子分较治疗前显著下降(P<0.01),副反应主要有抗胆碱症状、过度镇静、体重增加、一过性丙氨酸氨基转移酶升高.结论奥兰扎平是一种安全、有效、副作用较轻的抗精神病药.     

先天性髋脱位骨刀模型的研究

目的：在建立先天性髋脱位（CDH）的计算机三维交互模型的基础上，建立三维骨刀模型，模拟截骨。方法：利用螺旋体积CT获得患儿髋关节扫描数据，用B＋树组织按marching cubes方法完成骨刀模型的重建。通过对B＋树的不完全遍历和回溯，定位表面模型间的交点并分割髋关节模型。结果：重建的骨刀模型与CDH三维模型之间，可进行实时交互。初步实现了对骨性三维交互模型任意位置的平面切割、球面切割、拾取和拼合。结论：此建模、切割方法可行有效，可用于计算机模拟骨性手术的研究。     

胞嘧啶脱氨酶的原核表达和多克隆抗体的制备

目的：在原核系统中表达并纯化大肠杆菌胞嘧啶脱氨酶（cytosine deaminase,CD)，制备鼠抗大肠杆菌CD多克隆抗体，方法：亚克隆CD基因到原核表达载体pMAL-c2和pBV222中，并转化入大肠杆菌DH5α内，诱导表达并纯化MBP-CD和6his-CD融合蛋白，用纯化的MBP-CD融合蛋白免疫小鼠制备多克隆抗体。结果：通过重组质粒的酶切筛选出重组阳性克隆，成功地表达和纯化出MBP-CD和6his-CD融合蛋白，用纯化的MBP-CD成功制备了鼠抗CD多克隆抗体，并用6his-CD和GST-CD重组蛋白进行Western印迹分析，证实了抗体的正确性，结论：应用多克隆抗体可以检测体内外CD基因的表达，为临床前和临床上深入开展CD基因的生物治疗研究提供重要的实验材料。     

Changes in serum amino acids in total parenteral nutrition supported patients with intra abdominal infection

Serum aminogram changes were prospectively studied in 95 patients with enteric fistula and intraabdominal infection who was under total parenteral nutrition (TPN) therapy with Anfuming 14s. In patients with sepsis and starvation, the aminogram showed remarkably low total free amino acids before TPN therapy. In 81 survivors, free amino acids increased gradually to normal in 2 weeks after use of TPN and in 14 dead cases increased rapidly to a significantly higher peak at terminal stage. Both in survivors and nonsurvivors, phenylalanine level remained high during the study. In response to infection, proline was also elevated but to a lesser degree; the ratio of branched chain amino acid (BCAA) to aromatic amino acid (AAA) was lower than normal and the decrease of arginine was parallel to the severity of infection. We conclude that the ideal amino acids preparation for the starvated and septic patients should be high in BCAA and arginine but low in phenylalanine, administration of inappropriate exogenous amino acids in decompensated metabolic septic patients may bring about more harm than benefit, and in septic patients that the levels of serum phenylalanine and proline are elevated persistently along with the decrease of arginine level is a useful prognostic indication.     

183例老年人骨密度检测分析

目的 :研究老年人不同疾病时骨密度 (BMD)的分布情况。方法 :用DXADAS 6 0 0EX型骨密度仪对183例老年患者进行左侧远程桡骨加尺骨BMD检测。结果 :内分泌疾病组、消化道疾病组和其它疾病组的患病率分别为 72 7% ,2 0 6 %和 31 4 %。T值比较 :三组差异明显 (P <0 0 0 1)。累积骨丢失率 (ABLR)比较 :前一组明显高于后两组病人 (P <0 0 1)。BMD比较中 ,内分泌和其它疾病组明显低于消化道疾病组 (P <0 0 0 1)。相关分析显示 ,内分泌和消化道疾病组的年龄变化与BMD呈正相关 (r =0 5 19P <0 0 0 1和r =0 5 89P <0 0 0 1) ,内分泌疾病组和其它疾病组的体重变化与BMD呈正相关 (r=0 918P <0 0 0 1和r =0 338P <0 0 0 1)。结论 :老年人骨质疏松 (OP)患病率以内分泌疾病组最高 ,消化道疾病组较低 ;随年龄和体重增加 ,BMD降低加重。     

缩窄性心包炎的外科治疗

报告12例缩窄性心包炎外科治疗的体会，本组病例的特点是病史长，入院前误诊率高（41.6%)，心增厚达0.5-2cm，龟壳样变。结果：12例手术资料随访1-6a，手术疗效满意，认为对诊断明确者应及早手术治疗，尽可能彻底剥脱缩窄的心包是手术疗效的关键。     

全去带乙状结肠原位可控膀胱术25例随访报告

目的：探讨全去带乙状结肠原位可控膀胱术的临床效果。方法：对25例施行该术式术后患者的可控性、尿动力、血清电解质、肾功能、生活质量等进行随访观察。结果：25例随访2－15个月，平均11．3个月。白天完全自控排尿25例（100％）；夜间完全自控排尿24例（96．0％），1例偶有遗尿；贮尿囊容量220－370ml，平均320ml；贮尿囊内压力1．86－3．92kPa，平均2.44kPa。IVU及贮尿囊造影示单侧贮尿囊输尿管反流2例（8．0％），无肾积水；膀胱镜检查2例（8．0％）贮尿囊内出现细沙样结石，1例（4．0％）贮尿囊后尿道吻合口狭窄，经尿道直视内切开术治愈。15例（60．0％）男性患者保留性功能，肾功能正常，1例（4．0％）出现一过性高氯血症。结论：全去带乙状结肠原位可控膀胱术手术成功率高，疗效可靠，患者生活质量高，是一种较理想的尿路分流术，值得推广。     

大肠肿瘤组织中EB病毒的原位杂交检测

目的：探讨EB病毒感染与人大肠癌发生的关系。方法：用原位分子杂交法对130例人大肠癌标本中EB病毒小分子RNA片段进行检测。结果：130例标本中有6例（4.48％）癌组织呈阳性反应，其中4例为男性，4例有明显淋巴细胞浸润。结论：EB病毒感染可能与我国部分大肠腺癌的发生有关，肿瘤细胞间质中大量淋巴细胞浸润可能是EB病毒感染的重要病理学特征。     

No impact of repeated endoscopic screens on gastric cancer mortality in a prospectively followed Chinese population at high risk.

BACKGROUND: Gastric cancer (GC) is the leading cause of cancer deaths in China. Our study prospectively evaluated the impact of repeated endoscopic screens on GC mortality in a high-risk population in China. METHODS: Between 1989 and 1999, a population-based gastroscopic screening was conducted in 4,394 residents of Linqu County, China, a region with the highest rates of GC worldwide. Residents ages 35 to 64 years received initial gastroscopies with biopsies in 1989. Repeated endoscopies were performed in 1994 and 1999. Cancer occurrences and deaths were actively monitored throughout the entire period until July 2000. Mortality from GC was compared with expected values based on mortality rates obtained for Linqu in the 1990-1992 Chinese Cancer Mortality Survey. RESULTS: Between March 1989 and July 2000, 39,303 person-years were accumulated; 85 new GCs occurred, 29 (34.5%) were in early stage. Fifty-eight cases (68%) were identified at one of the screens. The number of observed deaths from GC (37) was close to the expected (36.8). The standardized mortality ratio was 1.01 (95% CI 0.72-1.37) for the entire cohort, 1.13 (95% CI 0.77-1.57) for males, and 0.65 (95% CI 0.26-1.32) for females. CONCLUSIONS: Despite high population coverage with repeated screens, no reduction in GC mortality was observed in this high-risk population in China.     

蒙药制剂中毒性药物的应用分析

蒙医学在长期的临床实践中总结和探索出较为科学的毒性药物炮制、制剂配伍和应用方法，使毒性药物在临床得到极为广泛的应用。特别是蒙药一般选用生药、多复方、用量小、服用方法简便、起效迅速，其作用较等量中药制剂强而有力，其中重要原因之一就是蒙医学擅长使用毒性药物及峻烈药材，以毒攻毒，多有奇效。成方中含有毒药物的方剂比率较高，据《蒙医成方选》一书记载：解痉镇痛药全部8个配方，白喉肿毒治疗药配方24个中有20个，