桡骨颈骨折经皮撬拨复位的远期疗效

用经皮撬拨复位治疗桡骨颈骨折56例,其中复位良好46例,较好6例和不良4例;经3年7个月平均随访,复位良好和较好的44例中,后期疗效良好32例,较好11例和一般1例。骨折解剖复位、撬拨复位的手术损伤轻和石膏固定时间较短是后期疗效满意的关键。成人桡骨颈骨折伴肘内侧副韧带严重损伤比儿童多见,但儿童桡骨颈骨折严重倾斜移位和完全移位比成人多见,后期疗效更满意。     

Relationship among dosages of aminophylline, plasma levels of theophylline and variation of pulmonary arterial pressure]

The relationship among the dosages of aminophylline, plasma levels of theophylline and variations of mean pulmonary arterial pressure (mPAP) in 72 patients with COPD was investigated. The results showed that after a different loading dosage of aminophylline (6 mg/kg, 5 mg/kg and 4 mg/kg) was administered by intravenous injection, mPAP in the 6 mg/kg group was decreased more significantly (P less than 0.01) than that in the 4 mg/kg group. In the 6 mg/kg group, the decreased mPAP period sustained for 120 min, which was longer than that in the other 2 groups. The plasma levels of theophylline in the 6 mg/kg group of patients 30 to 120 min after loading dose injected were 115.54-79.04 mumol/L, which were higher than that in the others. Within the 120 min period of observation after the drug was administered no patients in any of these groups showed severe untoward effects. According to the results of this experiment, we suggest that the 6 mg/kg as a loading dose should be advised for the treatment of pulmonary hypertension in COPD. The optimum time to give the maintenance dosage should be set within 2 h after the loading dose. It is necessary to monitor the plasma levels of theophylline while aminophylline is administered, so that optimal therapeutic effects could be achieved without side effects.     

米非司酮作用于兔输卵管收缩活动与Ca^2＋关系的研究

通过“结合化学分离与原子吸收分光光度法”对Ca^2 含量测定和离体输卵管肌条收缩记录方法，研究米非司酮（Ru486)对增加假孕（4d)兔输卵管平滑肌收缩频率，而不改变其收缩张力和振幅时与Ca^2 之间的关系，结果提示：（1）Ru486对输卵管分泌液和组织内Ca^2 的含量分布无明显影响；（2）Ru486具有降低细胞外液高Ca^2 浓度促Ca^2 内流，而使收缩增强的效应，且能协同Ca^2 通道阻断剂（Verapamil)抑制细胞外Ca^2 内流，而致收缩减弱的效应。     

单用达那唑治疗慢性再生障碍性贫血19例临床观察

单用达那唑（ＤＮＺ）治疗１９例慢性再生障碍性贫血（ＣＡＡ）病人。结果表明，基本治愈１例，缓解５例，明显进步７例，有效者共１３例，总有效率为６８．４％，初治者５／７例有效，有效率为７１．４％；复治者８／１２例有效，有效率为６６．７％。治疗后与治疗前比较，血红蛋白、白细胞、血小板和网织红细胞均明显升高（Ｐ＜０．００１）；骨髓红系、粒系及巨核细胞明显增高（Ｐ＜０．０５）；Ｔ辅助细胞（ＣＤ４）明显增加、Ｔ抑制细胞（ＣＤ８）明显降低，ＣＤ４／ＣＤ８比值明显升高（Ｐ＜０．０５）。并结合文献对ＤＮＺ的作用原理进行讨论。     

Hyperoxaluria, nephrolithiasis, nephrocalcinosis and renal failure after massive resection of the small intestine: report of a case.

Hyperoxaluria is frequently seen in patients with inflammatory bowel disease, or after resection of the ileum. It is assumed to be responsible for the development of nephrolithiasis, nephrocalcinosis (oxalate nephrosis) and progressive renal impairment in these patients. Steatorrhea may aggravate the severity of hyperoxaluria. A 60-year-old male underwent massive resection of the jejunum and ileum 10 years prior to admission, due to strangulation of the small bowel, with occlusion of the superior mesenteric artery. He remained well except for steatorrhea which developed two-and-a-half years prior to admission, when microhematuria, proteinuria and oxaluria developed progressively. Since that time, the nephrolithiasis, nephrocalcinosis and renal failure have continued to worsen despite therapy with oxalate restriction and oxalate-binding agents. A renal biopsy, performed late in the clinical course, showed severe changes in the renal parenchyma. The decline in renal function proved irreversible. The unusual metabolic consequences of massive resection of the small intestine and their mechanisms are discussed.     

我院成本管理系统方案概述

医院成本管理,标志着医院的发展水平.成本管理的好坏,直接影响着医院的经济效益.全面支持医院经济核算的计算机信息系统,是医院建设和发展的重要内容之一,是医院参与市场竞争,创造良好社会效益和经济效益的重要手段.本文对我院成本管理系统的设计思想,工作原理,系统特点等作一概述,以供参考.     

Adenosine''s role in the genesis of bradyarrhythmias induced by acute myocardial hypoxia.

A close or even causal relation between myocardial adenosine and bradyarrhythmias during acute myocardial hypoxia was testified in guinea pig, rabbit and dog mainly by using specific competitive antagonist and synchronous quantitative analysis of 3 variables: intensity of myocardial hypoxia, degree of endogenous adenosine increment and severity of bradyarrhythmias. Results disclosed: A) striking resemblance of the bradyarrhythmias with hypoxic origin to those caused by exogenous adenosine, B) same locality of A-V conduction block induced by both myocardial hypoxia and exogenous adenosine, C) precise parallelism among the above-listed 3 variables with very high correlativity (r = 0.99, P < 0.01), D) frequent accompaniment of reversal of hypoxic bradyarrhythmias through resupply of 21% O2 with normalization of preexisted increase in myocardial adenosine, E) satisfactory blockade of hypoxic bradyarrhythmias by adenosine's specific antagonist--aminophylline and their augmentation by adenosine's uptake inhibitor--dipyridamole, F) close similarity of the characteristic curve representing relation among the above 3 variables to that among intensity of myocardial hypoxia, degree of endogenous adenosine increment and amount of coronary blood flow in which adenosine's role as a mediator has been well documented and G) reproducible persistence of bradyarrhythmias during myocardial hypoxia irrespective of preliminary vagotomy and atropinization, denoting independence of the occurrence of such dysarrhythmias upon vagal drive, suggestive of a mechanism other than vagotonia. We advocated that hypoxia-induced bradyarrhythmias was caused by increment in endogenous adenosine.

     

脉冲Nd：YAG激光照射对大鼠炎症牙龈组织的作用

患实验性牙龈炎的大鼠牙龈（６例）经脉冲掺钕钇铝柘榴石激光（Ｎｄ：ＹＡＧ激光）照射后进行光镜及超微结构观察。目的在于了解低能量Ｎｄ：ＹＡＧ激光照射对牙龈炎症的治疗作用。炎症牙龈经输出能量为１．５Ｗ，脉冲数为２０ＰＰＳ的激光照射后与对照组相比较，形态学上有如下变化：上皮细胞无变性；牙龈上皮层数较炎症时减少；上皮下炎细胞浸润明显减少；上皮细胞间隙变小；上皮下结缔组织内产生大量的排列致密的胶原纤维。结果提     

超声显像与膀胱镜对膀胱肿瘤的诊断价值

对经手术和病理证实的８３例膀胱肿瘤进行超声显像和膀胱镜检查的对比性分析。结果表明，膀胱镜对膀胱肿瘤的诊断符合率为９７．５％，略高于超声显像符合率的９５．２％；但对膀胱肿瘤的术前分期，膀胱镜检查尚存在局限性，而超声显像可弥补膀胱镜检查的不足。本文超声显像对膀胱肿瘤的术前分期准确率达８９．５％。超声显像对小于０．５ｃｍ的小膀胱肿瘤之检出率不如膀胱镜高。因此在常规检查以及对肿瘤的术前分期时，应以超声显像作为首选，同时结合膀胱镜检查，可进一步提高膀胱肿瘤的术前诊断正确率。     

妇癌患者的社会心理因素调查

本文以自编病前负性情绪调查表、ＬＳＥ─Ｒ及ＥＰＱ对５６例妇癌住院病人进行了调查，并以５６例内科病住院病人作对照。结果显示，６９．６％的妇癌病人在病前有负性情绪，而内科病病人只有１６．１％；８５．７％的妇癌病人病前经历了负性生活事件，而内科病组则为５８．９％；ＥＰＱ评定结果神经质分亦为前者高于后者，均提示社会心理因素与妇癌的发生密切相关。