以骨间前血管为蒂前臂骨膜骨瓣的临床应用

应用骨间前血管为蒂.桡、尺骨骨膜骨瓣移位治疗上肢骨不连或骨缺损38例,均获得成功。该术式与以桡、尺动脉为蒂的桡、尺骨骨膜骨瓣移位相比较,有不损伤前臂主要血管干、移位范围大、适应症较广和操作简便易推广等特点.     

EMR based telegeriatric system

INTRODUCTION: As medical services improve due to new technologies and breakthroughs, it has lead to an increasingly aging population. There has been much discussion and debate on how to solve various aspects such as psychological, socioeconomic and medical problems related to aging. Our effort is to implement a feasible telegeriatric medical service with the use of the state of the art technology to deliver medical services efficiently to remote sites where elderly homes are based. Telegeriatric system will lead to rapid decision-making in the presence of acute or subacute emergencies. This triage will also lead to a reduction of unnecessary admission. It will enable the doctors who visit these elderly homes on a once-a-week basis to improve their geriatric management skills by communication with geriatric specialist. Nursing skills in geriatric care will also benefit from this system. Integrated EMR service will be indispensable in the face of emergency admissions to hospitals. Evolution of EMR database would lead to future research in telegeriatrics and will help to identify the areas where telegeriatrics can be optimally used. METHODOLOGY: This system is based on current web browsing technology and broadband communication. EMR web based server is developed using Java Technology. EMR database was developed using Microsoft SQL server. Both are based at the Medical Informatics Programme, National University of Singapore. Two elderly homes situated in the periphery of Singapore and a leading government hospital in geriatric care has been chosen for the project. These three institutions and National University of Singapore are connected via ADSL protocol, which support high bandwidth, which is necessary for high quality videoconferencing. Each time a patient needs a teleconsultation, a nurse or doctor in the remote site sends the history to the EMR server. EMR server forwards the request to the Alexandra Hospital for consultation. Geriatrics specialists at Alexandra Hospital carry out teleward rounds twice weekly and on demand basis. SUMMARY OF RESULTS: Following the implementation of the system, a trial run has been done. This shows a high degree of coordination and cooperation between remote site and the Alexandra Hospital Also the patient compliance is very high and they prefer teleconsultation. CONCLUSION: Initial results show that telegeriatric system has definite advantages in managing geriatric patients at a remote site. As the system evolves, further research will show the areas where telegeriatrics can be used optimally.     

胃复安与下丘脑-垂体-甲状腺轴的关系及临床意义

下丘脑分泌的促甲状腺激素释放激素(Thyrotropin—releasing hormone，TRH)促进垂体促甲状腺激素(Thyrotropin，TSH)的合成和释放，而多巴胺(Dopamine，DA)和生长抑素(Somatostatin，SST)抑制TSH的合成和释放，甲状腺激素也对TSH产生反馈抑制作用。甲状腺功能减退患者，伴随多巴胺能神经元功能(Dopaminergietone)的降低和TSH基础水平升高。胃复安(Metoclopramide，MCP)是多巴胺第二受体拮抗剂，能加速提高甲低患者血TSH水平，特别是当运用于分化型甲癌(Differentiated thyroid carcinoma，DTC)病人时，能缩短停用左旋甲状腺素(L—thyroxine，L—T4)的时间和减轻甲状腺机能减退所致的症状和体征，有助于对DTC病灶的^131I显像诊断和^131I治疗。     

微创DHS内固定与传统DHS内固定治疗老年股骨粗隆间骨折比较研究

目的:对微创动力髋螺钉(dynamic hip screw,DHS)内固定和传统DHS内固定治疗老年股骨粗隆间骨折的效果进行比较.方法:将91例老年股骨粗隆间骨折患者随机分为两组,传统组46例采用传统方式置入内固定物治疗,微创组45例采用微创方式置入内固定物.对两组手术创伤大小、术后并发症、骨折愈合及功能恢复情况进行比较.主要通过考察手术切口长度、出血量、输血量、血红蛋白下降幅度、术后术区肢体肿胀情况、血沉变化等来反映手术创伤大小.结果:两组手术创伤差异有统计学意义,传统组大于微创组(P＜0.05).微创组有2例复位不良,传统组有3例复位不良,两组均无深部血肿发生.传统组围手术期死亡2例,其余患者均顺利出院,获12～30个月随访,平均17.1个月.两组各有1例在随访期间死于其它内科疾病,其余骨折均获愈合.术后平均骨折愈合时间微创组3.6个月,传统组3.8个月.术后1年髋关节功能优良率微创组84.1%,传统组79.1%,两组差异无统计学意义(P＞0.05).结论:微创DHS内固定治疗老年股骨隆间骨折,手术创伤小,有利于围手术期恢复和髋关节功能康复.     

西洋参茎叶皂甙对 CPHD病人外周淋巴细胞增强与调节作用

目的 :为了开发西洋参在临床医学方面的应用 ,提高CPHD病人的各项免疫指标。方法 :选择 4 0例CPHD病人 ,分成用药组 2 0例 ,对照组 (非用药组 ) 2 0例 ,通过流式细胞术检测病人外周血中T淋巴细胞亚群中各亚群所占的比例来反映机体的细胞免疫状态。结果 :通过两组临床研究观察 ,用药组疗效优于对照组 (P <0 0 5 )。西洋参茎叶皂甙可直接作用于淋巴细胞分化成熟过程 ,具有增强和调节CPHD病人机体免疫功能的作用。结论 :合理应用西洋参茎叶茎叶皂甙对改善CPHD病人免疫功能低下和紊乱状态 ,具有重要临床意义。     

荷瘤小鼠红细胞免疫功能观察

本实验利用小鼠可移植性组织细胞型淋巴瘤ＬⅡ接种于近交系６１５小鼠右后肢爪垫皮下，按宿主荷瘤时间以及肿瘤生长发展的不同阶段分期分批处死动物，每批动物均从眼房静脉窦取血，检测荷瘤小鼠红细胞Ｃ３ｂ受体花环率（ＲＢＣ－Ｃ３ｂＲＲ），红细胞免疫复合物花环率（ＲＢＣ－ＩＣＲ），观察荷瘤动物在肿瘤发展的几个不同时期红细胞免疫功能的变化情况。结果显示，荷瘤小鼠的ＲＢＣ－Ｃ３ｂＲＲ明显低于正常，并且随着肿瘤的发展呈下降趋势。在肿瘤侵袭早期和中期ＲＢＣ－Ｃ３ｂＲＲ下降十分迅速，而到肿瘤转移开始至转移晚期以后，其下降速度减慢。荷瘤小鼠的ＲＢＣ－ＩＣＲ高于正常，在肿瘤侵袭中期急骤增高，以后稳定在较高水平。本实验结果提示，肿瘤侵袭转移可能与宿主红细胞免疫功能有一定的关系，这些改变可作为评估肿瘤发展程度的参考指标之一，而且对于研究肿瘤转移机理有着十分重要的意义。     

一种平板流动腔重力灌流系统的力学分析

本文分析了一种采用重力灌流的平板流动腔灌流系统，并根据实验结果确定出相应的阻力系数，获得平板流动腔剪应力、雷诺数以及入口长度与流体重力灌流高度的关系。     

Transcription Factor PU.1 Promotes Conventional Dendritic Cell Identity and Function via Induction of Transcriptional Regulator DC-SCRIPT

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