24例病毒性、15例化脓性脑炎患者脑脊液中乳酸脱氢酶及同功酶分析

目的 :观察病毒性、化脓性脑炎脑脊液(csf)中乳酸脱氢酶 (LDH)活性及其各同功酶活性百分率的变化。方法:病毒性脑炎24例 ,化脓性脑炎15例 ,酶动力学法检测脑脊液总乳酸脱氢酶 (TLDH)活性 ,琼脂糖凝胶电泳法检测脑脊液中LDH各同功酶活性百分率。结果:病毒性脑炎与对照组比较 ,脑脊液总乳酸脱氢酶 (TLDH)明显降低 (P<0.01) ,LDH1同功酶显著降低 (P<0.01) ,LDH5显著升高 (P<0.01) ;化脓性脑炎与对照组比较脑脊液TLDH明显升高 (P<0.01) ,LDH1同功酶明显降低 (P<0.01) ,LDH5明显升高 (P<0.01)。结论:脑脊液TLDH值的测定可以鉴别病毒性、化脓性脑膜炎 ,检测脑脊液LDH各同功酶活性 (LDH1和LDH5)的变化程度对脑炎的进展及预后有一定的价值。     

保留胸背神经的背阔肌皮瓣游离移植

目的 为减少背阔肌皮瓣切取时供区的代价，尽可能保留肌皮瓣切取后背阔肌的功能。方法 通过了解胸背神经、血管的解剖特点，切取肌皮瓣时不将胸背神经完全切断，保留部分或全部神经的支配。手术前后对背阔肌的神经肌肉动作电位进行检查，了解术后保留的背阔肌功能。临床应用20例修复下肢或前臂软组织缺损或伴骨外露。结果 19例移植皮瓣成活良好，保留的背阔肌有收缩功能存在。结论 在切取一定大小的背阔肌皮瓣时，保留胸背神经的支配，可减小背阔肌的功能损失，使供区的代价降低，符合皮瓣切取原则。     

炎性肠梗阻15例诊治体会

目的探讨炎性肠梗阻的诊断和治疗。方法分析15例炎性肠梗阻的临床特点和治疗。结果15例经保守治疗,其中1例因肠扭转缺血损伤严重,出现全身性炎症反应综合征致多脏器衰竭死亡外,其他病例均痊愈,平均治愈时间为12.6d。结论炎症性肠梗阻由无菌性炎症致广泛肠粘连引起,应用小剂量激素减缓炎症反应,抗生素防止肠道菌群易位,经内镜逆行置入肠减压管及营养支持治疗,多数病例可保守治愈。     

5名电离辐射事故患者外周血T细胞T细胞抗原受体、T细胞分化抗原决定簇－3效应的研究

文中报道了５名事故性急性骨髓型放射病患者照后２．５和３．５年外周血Ｔ淋巴细胞Ｔ细胞受体（ＴＣＲ）基因，ＴＣＲ、Ｔ细胞分化抗原决定簇－３（ＣＤ_３）表达与ＴＣＲ／ＣＤ_３复合物功能的辐射效应．发现５名患者于照后２．５年，２名（５．２Ｇｙ和２．４Ｇｙ，５５岁）于照后３．５年外周血Ｔ细胞应答抗ＣＤ３单抗刺激而增殖的能力尚未完全恢复；经同时用ＩＬ－２和抗ＣＤ_３单抗刺激，增殖能力比单用抗ＣＤ_３单抗刺激有所增强；后２名的外周血ＴＣＲ、ＣＤ_３阳性细胞百分率一直低于正常对照和其他患者；并见一患者出现ＤＮＡ重排杂交带型．本文并从ＴＣＲ／ＣＤ_３在介导Ｔ细胞抗原刺激反应中的作用，电离辐射对ＴＣＲ／ＣＤ_３复合物的影响，后果和意义等方面进行了讨论．     

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.

     

椎管内肿瘤磁共振成像增强扫描初步观察

对１１例手术病理证实的椎管内肿瘤进行磁共振成像（ＭＲＩ）增强扫描的前、后分析，并对肿瘤定位、定性和鉴别诊断作了初步探讨。根据肿瘤形态、边界、强化程度，及与脊髓、硬脊膜、神经根等关系，ＭＲＩ的增强扫描对提高其定位、定性诊断均有较大的帮助。     

Intracapsular tonsillar reduction (partial tonsillectomy): reviving a historical procedure for obstructive sleep disordered breathing in children.

OBJECTIVE: We sought to reintroduce a historical procedure-intracapsular tonsillar reduction (partial tonsillectomy or tonsillotomy)-for tonsillar hypertrophy causing obstructive sleep disordered breathing (OSDB) in children, as well as to determine whether partial tonsillectomy, compared with conventional (total) tonsillectomy when performed by more than one surgeon, is equally effective for the relief of OSDB while resulting in less pain and more rapid recovery. STUDY DESIGN: We conducted a retrospective case series at a tertiary children's hospital. The charts of children who underwent partial tonsillectomy and total tonsillectomy (1998 through 2002) for postoperative complications were reviewed. The caregivers were surveyed to assess postoperative pain, rapidity of recovery, and effectiveness of surgery for relieving symptoms of OSDB. RESULTS: Two hundred forty-three children underwent partial tonsillectomy and 107 children underwent total tonsillectomy. There were no significant differences in immediate and delayed complications between the groups. Both operations were equally effective in relieving OSDB. Children who had partial tonsillectomy had significantly less postoperative pain and significantly more rapid recovery. CONCLUSION: Intracapsular tonsillar reduction with an endoscopic microdebrider relieves OSDB as effectively as conventional tonsillectomy, but results in less postoperative pain and a more rapid recovery.     

广西毛南族农村妇女铁营养状况调查

对450名广西环江县毛南族农村育龄妇女进行血清铁蛋白(SF)、红细胞游离原卟啉(FEP)及血红蛋白(Hb)3项铁指标测定.结果发现:铁缺乏症患病率为27.8%(其中ID4.2%,IDE 7.8%,IDA 15.8%).随着孕次或产次的增加,血红蛋白水平逐渐下降,铁缺乏症患病率逐渐增高.有妊娠或分娩史的妇女与未孕或未生育的妇女血红蛋白水平与铁缺乏症患病率比较均有显著性差异(P<0.05).     

叶内型肺隔离症致咯血的栓塞治疗

目的探讨叶内型肺隔离症患者咯血的栓塞治疗效果。方法结合文献复习，回顾性分析6例叶内型肺隔离症患者血管造影表现，并对畸形动脉行栓塞治疗。结果6例叶内型肺隔离症患者血管造影显示畸形动脉7支，表现为粗大、迂曲的体循环血管影；在毛细血管期可见隔离肺叶染色及引流静脉早显；静脉期显示引流静脉（肺静脉）。6例患者均进行畸形血管栓塞治疗，临床止血总有效率100％，随访1a均未复发。结论畸形血管栓塞术对叶内型肺隔离症致咯血的治疗，安全有效。     

HPLC法测定七味清咽气雾剂中苦参碱的含量

目的：用HPLC测定七味清咽气雾荆中苦参碱的含量。方法：采用高效液相法，使用Shim-pack VP-ODS色谱柱，以乙腈珈．2％三乙胺溶液（1．4：98．6）用磷酸调至pH为2．5，柱温为55℃，流速为0．7mL／min，检测波长为214mn。结果：苦参碱在64．4～1030μg范围内呈良好的线性关系（r=0．9997），回收率为98．6％，RSD为0．9％。结论：方法灵敏、准确、专属性强，回收率高，重现性好，可作为七味清咽气雾剂的质量标准。