胆道残余结石39例分析

目的总结胆道残余结石原因及预防目的.方法对39例胆道残余结石的临床资料进行回顾性分析.结果本组除1例老年病人,因严重胆道感染死亡外, 其余38例均经再次手术治愈.结论完善的术前检查,术中胆道造影及B超,选择适宜的术式是预防结石残留的关键.     

股动脉插管选择性全脑血管造影50例体会

1 一般资料本组共50例,男32例,女18例。年龄6—67岁。30～40岁占本组病例数63%。脑血管造影145条次,其中1次完成4条1例,3条(包括两侧颈内动脉,1侧推动脉)44例。病例选择:蛛网膜下腔出血33例,占66%;颅神经损害5例,占10%;锥体束征4例,占8%;颅内压增高4例占8%;间脑癫痫病2例占4%;共济失调2例占4%。2 造影方法采用上海医用诊察仪器厂生产F_6脑血管造影针,经皮穿刺股动脉,导管插入所需动脉分别注入60%泛影葡胺10ml,注药1次摄片1张,摄正侧位片,必要时个别摄斜位片。用日本产500mAX 线机,自配高压注射器。条件正斜位片90kV、0.5秒、200mA;侧位91kV、0.4秒、     

细节管理决定临床护理工作的成与败

护理工作平凡而琐碎,日常工作中很多是由一个个看似不起眼的细节组成的,而护理质量的优劣恰恰就包含在这众多琐碎的、不起眼的工作细节当中;加强细节管理能使整体工作有质的改变,细节管理应该渗透在每一项工作中,因为优质的服务、品牌的打造就隐藏在细节当中。     

老年脊髓亚急性联合变性的临床诊断经验(附56例分析)

近来在临床上屡屡见到一些老年亚急性联合变性（SCD）病人，长期得不到诊断或误诊，延误了治疗时机。为此我们将老年SCD诊断经验报告如下。     

血脂康治疗脂肪肝的临床观察

目前肝组织学检验是诊断脂肪肝的金标准，但由于系创伤检查，推广应用受到限制。临床上多采用B超诊断，其优点是无创伤，重复性强。治疗可在调整膳食的基础上，采用中西医结合治疗，但疗效欠佳。我们在3年多临床工作中，应用血脂康治疗脂肪肝，取得满意效果，经B超动态观察，发现脂肪肝减轻或消失，总结报告如下。     

补阳还五汤治疗脱疽及臁疮2例

补阳还五汤是清代王清任为治疗中风而设,治气虚血瘀,意在补气促进血液循环,达到祛瘀的目的,临床上广泛用于治疗脑血管疾病.但从组方来看,补阳还五汤是活血化瘀的良方,不仅只用于治疗脑血管疾病,加以化裁可广泛用于一切瘀血性疾病.脱疽(血栓闭塞性脉管炎)和臁疮(下肢溃疡)均为瘀血阻于脉络引起,应用补阳还五汤加减治疗往往收到满意的效果.现将我们收治的2例报告如下.     

口服泰尔登致心源性休克1例

患者男，38岁，有睡眠障碍5年。临床表现：以脑力易兴奋和头都有轻微紧箍感。查体：意识清楚，四大生命体征正常。四肢脊柱正常。神经系统无病理反射，生理反射存在，血、尿常规、肝功、心电、脑电检查均正常。以药物与心理治疗相结合之原则。开始用安定7．smp，晚口服，治疗效果不佳，试用泰尔登12．sing治疗，江流效果好，次日服泰尔登12sing，业后，发现患者意识不清，皮温下降，血压巴e／s·vxna，ECG带有大小不等、形态各异、间隔不规则的亚波，QRS综合波之间距离绝对不规则。心电图诊断为“心房问动”。立即吸氧，25％葡萄糖500ml…     

Zona Pellucida Induces Activation of Phospholipase A2 During Acrosomal Exocytosis in Guinea PigSpermatozoa

Objective To investigate whether PLA2 is involved in ZP-stimulated acrosomal exocytosis,if Ca^2 is required for activation of PLA2,and sigal transduction pathways modulating PLA2. Methods Guinea-pig spermatozoa were capacitated and labeled in low Ca^2 medium with [^14C]choline chloride or [^14C] arachidonic acid,and were then exposed to millimolar Ca^2 and various reagents and stimulated with ZP. Results Precapacitated spermatozoa exposed to millimolar Ca^2 and stimulated with ZP experienced increases in arachidonic acid(AA)and lysophosphatidylcholine (lysoPC) and a parallel decrease in phosphatidylcholine (PC);these chages are indicative of PLA2 activation.Simulation with ZP also led to acrosomal exocytosis in a high proportion of spermatozoa. Lipid changes and exocytosis were prevented if spermatozoa were exposed to aristolochic acid,a PLA2 inhibitor, before treatment with ZP.Stimulation with ZP in medium without added Ca^2 ,or in medium with millimolar Ca^2 and EGTA or La^3 resulted in no lipid changes or exocytosis. Pretreatment with pertussis toxin,a G1 protein inhibitor, before stimulation with ZP,blocked the release of AA and lysoPC and acrosomal exocytosis.Exposure of spermatozoa to the DAG kinase inhibitor R59022 before ZP stimulation led to a significant increase in the generation of lysoPC and exocytosis.Conclusion These results indicate very strongly that PLA2 plays an essential role in ZP-induced exocytosis in spermatozoa, that PLA2 activation requires Ca^2 internalization,and that it is regulated by signal transduction pathways involving G proteins and DAG.     

冠心病与血清微量元素变化的探讨

本文检测76例广州地区冠心病者血清10种微量元素(锌、锶、钼、锰、镁、铁、铜、铬、钡、硼)与健康人对照,结果显示冠心病者血清钼、镁、铜、铬、硼含量增高,其中铬、硼增高尤为显著。锌、锶、锰无显著差异。急性心肌梗塞组与其余冠心病组比较,10种微量元素血清水平均无显著性差异(P>0.05)。