鞘内注射吗啡加可乐定对切口痛大鼠脊髓背角蛋白激酶A催化亚单位表达的影响

Objective To observe the effect of intrathecal clonidine plus morphine on expression of protein kinase A (PKA) catalytic subunit in the spinal dorsal horn in a rat model of incisional pain. Methods Eighty male Sprague-Dawley rats were divided randomly into five groups: sham group, control group, pre-incisional morphine 2.5 μg group, pro-incisional clonidine 5 μg group and preincisional morphine 2.5 μg plus clonidine 5 lag group (n=16). lntrathecal catheter and the model of incisional pain were pro-duced according to Yaksh and Brennan's described method respectively. Changes of pain behavior were assessed by mechanical with-drawal threshold (MWT) and thermal withdrawal latency(TWL). The expressions of PKA catalytic subunit in the spinal dorsal horn were assessed by immunohistochemical method and western blotting analysis. Results Compared with sham group, MWT and TWL in control group were decreased significantly at 2 h after incision (P<0.01) and the number of positive cells and protein expression of PKA catalytic subunit in the spinal dorsal horn were increased significantly in control group (P<0.01). Compared with control group, MWT and TWL in pre-incision morphine 2 μg plus clonidine 5 lag group were increased significantly at 2 h after incision (P<0.01) and the number of positive cells and protein expression of PKA catalytic subunit in the spinal dorsal horn were decreased significantly in pre-incision morphine 2 μg plus clonidine 5 μg group (P<0.01). However, MWT, TWL and the number of positive cells and pro-tein expression of PKA catalytic subunit in the spinal dorsal horn changed with no statistical significance in pre-incisional morphine 2.5 μg group and pre-incisional clonidine 5 μg group compared with control group. Conclusion lntrathecal clonidine significantly enhances the antinociceptive effect of intrathecal morphine in a rat model of incisional pain, which might be associated with inhibi-tion of the increased expression of PKA catalytic subunit in spinal cord.     

格林——巴利氏综合征血液流变学观察

血液流变学已用于许多疾病的研究,对某些疾病的诊断和治疗起到有益的指导作用。格林—巴利氏综合征(GBS)的血液流变学观察尚未见正式报道。今将我院1988～1990年收治的42例GBS患者血液流变学8项指标的对照观察结果报告如下。 1 临床资料与方法 1.1 临床资料 42例中男25例,女17例,     

腱鞘内脂肪瘤误诊为腱鞘囊肿一例报告

患者,女,36岁,发现右踝前肿物15年,加速生长1年入院。患者于15年前发现右踝前方长出一肿物,较小,无疼痛,不影响日常生活而未就诊,此后肿物未长大。一年前患者发现肿物生长加速,至今已有核桃大小,有压痛。查体:右     

发挥远程教育优势推进医学继续教育发展

《教育部关于加强高校网络教育学院管理提高教学质量的若干意见》中强调指出：高校网络教育学院要以在职人员的继续教育为主，要充分发挥网络教育的优势，为在职人员更新知识、增强技能、不断学习、不断提高提供良好的服务。然而，要使医学院校在开展继续教育中发挥更大的作用，推进医学继续教育的发展，远程教育不仅是解决这一问题的有效途径，而且将成为开展医学继续教育的强大动力。     

以能力为本位的专科护理教学课程体系的构建

针对专科护理教学课程在培养应用型护理人才方面存在的问题，如忽视学生主体作用和能力培养、课程间缺乏有机联系、课程开发与护理职业需求缺乏有机联系、实践教学环节薄弱等，建议在以能力培养为本位原则、三接轨原则、开放性原则和整合性原则的基础上，改革传统的学科型护理课程体系，从放学内容、课程设置、教学手段和方法、考核制度等方面构建以能力为本位的专科护理教学课程体系。     

甘肃省武威市胃癌发病率对比分析

目的:探讨甘肃省武威市胃癌发病特征及其流行趋势。方法:通过建立恶性肿瘤登记报告获取胃癌发病资料。结果:武威市胃癌发病率1991 ~ 1995 年为 61 62/10 万,1996~ 2000 年为 55 .96/10 万,后期低于前期。年龄组发病率前后两期均随年龄的增高而上升,65 岁以前各组前期高于后期,65岁及以后各组后期明显高于前期。结论:武威市胃癌发病呈下降趋势。     

老年患者鲍氏不动杆菌感染的情况及耐药性

随着广谱抗菌药物及免疫抑制剂在临床上的广泛应用,导致鲍氏不动杆菌(ABA)对多种抗菌药物出现了耐药性.为此,对我院临床标本分离到的135株ABA分布及耐药现状进行分析,为合理使用抗菌药物提供参考.     

脾破裂保守治疗20例的体会

目的探讨脾破裂在临床上保守治疗的价值。方法回顾性收集并分析20例脾破裂患者的临床资料。分析临床脾破裂保守治疗的价值。结果20例脾破裂患者保守治疗治愈出院。结论脾破裂在一定程度上可保守治疗，从而避免脾切除手术及影响免疫功能。     

尼尔雌醇和利多卡因在绝经后妇女取环中联合应用

目的分析绝经后妇女取环宫口扩张，取环的难易程度。方法回顾分析2004年7月-2006年7月我院绝经后妇女取环术120例临床资料，随机分为2组。A组采用术前2～3d口服尼尔雌醇1mg和术时利多卡因5mL宫旁神经阻滞麻醉，B组采用单一术前2～3d口服尼尔雌醇1mg对照2组效果。结果A组宫口大小4．5～5，5号，取环困难率15％；而B组宫口大小2.5～3．5号，取环困难率82％，2组有极显著性差异（P〈0.01）。结论尼尔雌醇和利多卡因联合应用在绝经后妇女取环中能减轻疼痛，扩张宫口，提高取环成功率。     

腹膜转移瘤的影像学诊断

目的探讨腹膜转移瘤的影像学表现特点。方法回顾性分析经手术及穿刺活检证实的35例腹膜转移瘤的影像学表现,并与手术结果对照,35例做CT平扫及增强扫描,5例行MR I检查。结果(1)腹膜转移瘤常表现为大量腹水(22/35);(2)腹膜结节状增厚(23/35);(3)大网膜饼形增厚(16/35)和大网膜污垢样改变(12/35);(4)肠系膜污垢样改变(12/35)及结节状改变(9/35);(5)腹腔单发或多发囊性改变,有占位效应(4/35)。结论CT/MR I是发现腹膜转移灶的重要影像学方法。