高危新生儿脑干听觉诱发电位的近期观察

目的 为了解高危新生儿脑干及听觉功能障碍情况.方法 于1995年8月～1996年1月对128例高危新生儿进行脑干听觉诱发电位(Anditory Brainstem Responses—ABR)测定.结果 急性期高危新生儿ABR异常率为51.4%,其中高胆红素血症,低体重儿,窒息和丁胺卡那霉素应用组ABR异常率分别为61.1%、66.7%、53.8%和 2.8%.血清胆红素(Sb)值>290.7μmol/L和重度窒息儿ABR异常率明显高于Sb<290.7μmol/L和轻度窒息儿.早产儿和足月小样儿ABR异常率无明显差异.丁卡组对听阀的近期影响不大.结论 高危新生儿是脑干和听觉功能障碍的高危人群,应当密切随防和早期干预.     

光照疗法对新生儿红细胞谷胱甘肽还原酶活性的影响

作者对光照疗法（光疗）前及光疗后于口服维生素Ｂ＿２（４３例）和不予口服维生素Ｂ＿２（１７例）的黄疸新生儿的红细胞谷胱甘肽还原酶（ＧＲ）的活性进行了动态观察。结果显示，接受短期光疗的黄疸新生儿其红细胞ＧＲ活性较光疗前的ＧＲ活性有显著下降，光疗后予口服维生素Ｂ＿２可使下降的红细胞ＧＲ活性回升，而不予补充维生素Ｂ＿２者的红细胞ＧＲ活性继续下降。光疗的时间越长，红细胞ＧＲ活性的下降越明显，补充维生素Ｂ＿２使红细胞ＧＲ活性回复到正常水平所需的时间也越长。短期光疗也可引起体内维生素Ｂ＿２的降解，导致红细胞ＧＲ活性的下降，为避免因红细胞ＧＲ活性下降引起的红细胞额外破坏，对接受光疗的黄疸新生儿常规补充维生素Ｂ＿２的是必要的。     

小儿腭裂修复术后麻醉恢复期的观察与护理

腭裂是口腔颌面外科常见的先天畸形，手术修复是唯一有效的治疗方法，术后护理直接关系到手术的成功与否，特别是全身麻醉恢复期，患儿易出现各种意外，故应加强护理，采取有效预防措施，以确保麻醉恢复期平稳度过，保证手术成功。我科2001年3月-2006年4月收治腭裂患儿396例，全部安全度过麻醉恢复期。现将护理体会总结如下。     

Synthesis and cholinergic properties of bis[[(dimethylamino)methyl]furanyl] analogues of ranitidine.

The histaminergic H2 antagonist, ranitidine, has also been found to significantly inhibit acetylcholinesterase (AChE) in vitro. In an effort to develop novel, nonquaternary AChE inhibitors capable of penetrating into the CNS and alleviating the cholinergic deficit characteristic of Alzheimer's disease, a series of bis[[(dimethylamino)methyl]furanyl] analogues of ranitidine has been synthesized. All compounds were evaluated for human erythrocyte AChE inhibitory activity and compared to ranitidine, physostigmine, and tetrahydro-9-aminoacridine (THA). The most active AChE inhibitors were N,N'-disubstituted derivatives of 2-nitro-1,1-ethenediamine and 4,6-dinitro-1,3-benzenediamine, with compound 8 demonstrating activity greater than physostigmine. Deletion of the diaminonitroethene group in a series of alkyl and aryl bis-thioethers, yielded a number of slightly less active compounds, comparable in potency to THA. The 13 most active AChE inhibitors all demonstrated a more selective inhibition of AChE, as opposed to butyrylcholinesterase inhibition, than did THA. Compounds 3 and 22 were equally active to THA in potentiating rat ileal contractions. Binding studies demonstrated M1 and M2 cholinergic receptor affinities slightly greater than or equal to THA. Differential receptor binding studies showed compound 12 resembled THA in agonist/antagonist activity. Compounds 11-13 significantly elevated mouse brain acetylcholine levels, when administered at 80% of their approximate lethal doses, but were less active than THA or physostigmine.     

Extraction, purification and ascertainment of anti-hepatoma active principles for targeted preparation of radix Aconiti Kusnezoffii]

The extraction, purification, pharmacological experiments and chemical analysis of anti-hepatoma active principles of Radix Aconiti Kusnezoffii have been studied. The results show that the medicinal material Radix Aconiti Kusnezoffii is efficacious in inhibiting hepatoma, and the active principles are mainly made up of poisonous ester alkaloids. The liver targeting delivery system will be the first choice for its anti-hepatoma preparation, and the effective component AY3a is fit for the preparation of targeted microspheres.     

医械时代

曾几何时,一个小药箱,一个听诊器,就是一个医生的全部家当。但今天这也许意味着医疗事故官司和失去患者信任度的双重危险。在科学日益昌明的现在,医者和患者都越来越仰仗更昂贵、更先进的仪器,而在这现象之后,是各种医疗仪器设备的迅速普及,是诊疗过程的快速、高效和缜密,是更多科技新发明对人体的近距离关照,当然随之衍生出来的,还有过度医疗服务的不当取利,和种种难见阳光的幕后交易。     

直视下经尿道内切开术治疗尿道狭窄

目的：探讨直视下经尿道内次切开术治疗尿道狭窄的有效性和安全性。方法：总结直视下经尿道内切开术治疗68例尿道狭窄和闭锁患者的疗效和经验，63例1次手术成功；3例行2次、2例行3次成功。结果：68例中，57例术后随访3～71个月，平均28．3个月，43例(75％)均排尿通畅；2例暂时性尿失禁者分别于术后3～6月内恢复。结论：直视下经尿道内切开术创伤小，并发症少，疗效确切，是尿道狭窄和闭锁的首选治疗方法。     

人血浆三尖杉酯碱高效液相色谱测定法

本文建立了在常温常速离心条件下进行样品预处理的人血浆三尖杉酯碱高效液相色谱荧光测定法。本法批内CV%为3.08～3.47%,批间CV%为4.36～5.28%,回收率范围为93.6～95%,标准曲线在12.5～500ng/ml范围内线性良好(r=0.998)。方法简单、快速、准确,适于临床应用。     

前锯肌下部肌皮瓣移植的应用解剖

目的：为前锯肌下部肌皮瓣移植提供解剖学基础。方法：在２５具（５０侧）成人尸体标本上，对前锯肌下部的形态、血供和神经支配进行了应用解剖学观测。结果：前锯肌下部的血供主要来自胸背动脉的前锯肌支，外径１．３±０．２ｍｍ，伴行静脉外径１．５±０．２ｍｍ，长４．９±１．１ｃｍ；由胸长神经支配，其横径为１．７±０．４ｍｍ，神经干长７．７±１．４ｃｍ。结论：以胸背血管及前锯肌支为血管蒂和胸长神经为蒂可切取前锯肌下部１２．０ｃｍ×９．０ｃｍ的肌皮瓣，修复较大创面或重建肌动力