复发性胃癌再次手术的临床意义

[目的]探讨复发性胃癌再次行外科手术治疗的意义。[方法]回顾性分析1990年1月~2005年12月收治的103例复发性胃癌的临床资料。[结果]103例胃癌,复发局限于残胃45例,首次术后2年内复发61例。全组再手术切除54例,其中根治性切除43例,姑息性残胃切除11例,合并联合脏器切除25例。全组再次手术后1、3、5年生存率分别为71.2%、21.6%和9.5%,其中根治性残胃切除术后1、3、5年生存率分别为86.2%、49.1%和19.5%,中位生存期32.0个月;姑息性切除术后1、3、5年生存率分别为45.5%、10.0%和0,中位生存期15.0个月;未切除患者均于1年内死亡。[结论]残胃局部复发癌以残胃、吻合口局部复发及邻近器官浸润为主,具有较高的切除率,应积极行再手术治疗。     

榴莲的药用价值及综合开发利用

榴莲气味独特,营养丰富,被誉为"水果之王"。本文对榴莲国内外研究文献进行查阅整理,对其化学成分、药用价值及综合利用情况进行了归纳总结,为榴莲的深入研究及进一步开展综合开发利用提供资料参考。     

放射性直肠炎34例分析

回顾分析34例放射性直肠炎患者临床特点,该病以女性、急性患者为多,主要表现为血便、腹泻、里急后重等非特异症状,病史和结肠镜检查是诊断的主要依据.近距离放射源治疗、照射剂量大、照射前有盆腔或下腹部手术史、年龄偏高等是放射性直肠炎的影响因素.     

Tourette syndrome associated with attention deficit hyperactivity disorder: The impact of tics and psychopharmacological treatment options

Tourette syndrome (TS) is a neurodevelopmental disorder characterized by multiple chronic motor and vocal tics beginning in childhood. Several studies describe the association between TS and attention deficit hyperactivity disorder (ADHD). Fifty percent of children diagnosed with ADHD have comorbid tic disorder. ADHD related symptoms have been reported in 35% to 90% of children with TS. Since ADHD is the most prevalent comorbid condition with TS and those with concomitant TS and ADHD present with considerable psychosocial and behavioral impairments, it is essential for clinicians to be familiar with these diagnoses and their management. This paper highlights the association between treating ADHD with stimulants and the development of tic disorders. The two cases discussed underscore the fact that children with TS may present with ADHD symptomatology prior to the appearance of any TS related symptoms. Appropriate management of TS in a patient diagnosed with ADHD can lead to quality of life improvements and a reduction in psychosocial impairments.     

豚鼠耳蜗基底膜振动的测试方法

 目的  探索豚鼠耳蜗基底膜振动测试的方法。方法  用戊巴比妥钠腹腔注射麻醉豚鼠后,腹侧切口,逐层切开皮肤,分离肌肉,可见听泡位于豚鼠下颌骨内侧深面,钝性分离听泡表面的肌肉组织,暴露听泡,用电钻将听泡打开,可见螺旋形耳蜗结构,辨认基底膜所在的部位。用电钻在需要开孔的骨壁上轻磨一个环形的凹陷,待足够薄弱的时候用尖头的刀片挑开骨片。用具有微细尖端的不锈钢针蘸取少量反光微珠,放置在基底膜上。然后用激光多普勒测振仪(laser doppler vibrometer,LDV)测量基底膜在外耳道纯音激励下的振动。结果   用该方法测量了豚鼠耳蜗基底膜在不同频率声波激励下的响应曲线。结论   该方法可进行豚鼠耳蜗基底膜振动的离体实验,但活体的振动测试尚需进一步的探索。     

Oral fungal and bacterial infections in HIV-infected individuals: an overview in Africa

Oral opportunistic infections developing secondary to human immunodeficiency virus (HIV) infection have been reported from the early days of the epidemic and have been classified by both the EC-Clearinghouse and the World Health Organisation (WHO). Among the fungal infections, oral candidiasis, presenting in African HIV-infected patients has been sporadically documented. We review the literature with respect to candidal carriage, oral candidiasis prevalence and the predictive value of oral candidiasis for a diagnosis of underlying HIV disease in African HIV-infected patients. The use of oral candidiasis as a marker of disease progression, the species of yeasts isolated from the oral cavity in Africa and the resistance of the yeasts to antifungal agents and treatment regimens are discussed. Orofacial lesions as manifestations of the systemic mycoses are rarely seen in isolation and few cases are reported in the literature from Africa. In spite of the high incidence of noma, tuberculosis, chronic osteomyelitis and syphilis in Africa, surprisingly there have been very few reported cases of the oral manifestations of these diseases in HIV-positive individuals. Orofacial disease in HIV-infected patients is associated with marked morbidity, which is compounded by malnutrition. The authors indicate specific research areas, initially directed at the most effective management strategies, which would complete data in this important area.     

CYP2C19基因多态性及与其代谢相关药物的研究

细胞色素P450酶系(CYP450)是人体内参与药物代谢的主要酶,CYP2C19是细胞色素P450酶系中的一种。临床上多种药物在体内代谢时,均需要CYP2C19酶的参与。许多研究显示,CYP2C19酶的活性受CYP2C19基因多态性的影响。本文就CYP2C19基因多态性及其在体内参与几种药物的代谢情况进行分析与总结。     

未通过听力筛查的新生儿诊断测听结果分析

目的通过分析未通过听力筛查的新生儿诊断测听结果,全面了解这些幼儿的听力状况,以便更好地采取应对措施。方法对102例未通过新生儿听力筛查的幼儿进行畸变产物耳声发射（DPOAE）和听性脑干反应（ABR）测试,并参考声导抗测试结果进行听力学诊断。结果双耳听力正常33例（33。7％）;双耳听力异常47例（48％）,其中轻中度听力损失26例（26．5％）、重度以上听力损失21例（21．4％）;单耳听力正常18例（18．4％）。4例只进行了DPOAE测试者未记入最后统计数据。结论在未通过新生儿听力筛查的幼儿中,听力损失表现出一定程度的多样性,部分幼儿的听力有一定的波动。在临床工作中。应根据不同的听力损失情况做出相应处理。     

Left Atrial Voltage during Atrial Fibrillation in Paroxysmal and Persistent Atrial Fibrillation Patients

Background: Left atrial (LA) endocardial voltage characteristics assessed during atrial fibrillation (AF) have not been previously compared in different AF types. This study was aimed at investigating the LA voltages and volumes in patients with paroxysmal and persistent AF. Methods: LA electroanatomic voltage maps acquired during AF were compared between consecutive patients without major structural heart disease undergoing first catheter ablation for paroxysmal AF (n = 100) or persistent AF (n = 100). The groups were comparable in baseline clinical characteristics. Results: Patients with persistent AF presented with lower median LA voltage (median 0.41, interquartile range [IQR] 0.31–0.51 mV versus median 0.99, IQR 0.47–1.56 mV; P < 0.001), and maximum LA voltage (4.07 ± 1.76 vs 6.42 ± 2.16 mV; P < 0.001). They also had a higher proportion of the LA points exhibiting voltage <0.2 mV (30 ± 20 vs 12 ± 11%; P < 0.001) and voltage 0.2–1.0 mV (55 ± 15 vs 42 ± 19%; P < 0.001). They further displayed higher LA volume/body surface area (75 ± 16 vs 58 ± 13 mL/m²; P < 0.001). In the multivariate regression model, both LA voltage (P < 10^?9) and LA volume (P < 10^?5) were significant determinants of AF type. Conclusion: Patients with persistent AF had significantly lower LA voltage compared with patients with paroxysmal AF even after adjustment for differences in indexed LA volume. LA voltage represents an independent covariate of clinical manifestation of AF. (PACE 2010; 541–548)