Irreversible drop of systemic vascular resistances in patients implanted with a Jarvik total artificial heart

Maintenance of the body's perfusion by a total artificial heart (TAH) may result in physiological alterations to the circulatory system. Little has been said about modifications to systemic vascular resistances (SVR) during TAH assistance. This paper reports on two patients implanted with a Jarvik - 70 cc TAH, who died after 1 and 3 days, both with an irreversible drop of SVR related to a complete loss of vascular tone but not related to sepsis. Activation of multiple cascades of inflammation, triggered by the extracorporeal circulation (ECC), is maintained during TAH support. Desperately sick patients might not be able to face the vaso-active situations created by the inflammatory response.     

应用低严格度—单引物聚合酶链反应对问号钩体中国参考株的…

Ｇ１、Ｇ２引物是对问号钩体具有特异性引物。分别用Ｇ１或Ｇ２单引物对问号钩体中国参考株进行前４个低严格度循环的ＰＣＲ扩增，扩增带谱显示赖型、犬型、致热型、秋季型、澳洲型、临海型、乌尔夫型、溶血型为一类，而爪哇型、拜伦型、波摩那型、七日热型、巴叶赞型塔拉索夫型、曼耗Ⅱ型是不与以上赖型等血清型本为一类，双曲钩体ａｔｏｃ型及伊利尼细丝体伊利尼型的扩增带谱与问号钩体截然不同。应用苯酚法提取的高纯度钩体ＤＮＡ     

中西医结合治疗急性胰腺炎疗效观察

目的:观察中西医结合治疗急性胰腺炎的疗效。方法:西药组23例用西药治疗,中西医结合组19例在用西药治疗的基础上加用柴芍承气汤及丹参注射液治疗。结果:中西医结合组疗效明显优于西药组(P<0.05)。结论:中西医结合治疗急性胰腺炎可明显改善急性期症状,减少并发症,改善预后。     

健康和病变人声带振动特性声门图

本文用多功能声门图仪测定了健康受试者(男46名,女34名)和不同喉病患者(男134名,女87名)声门图的波形及其特征参数。根据测出的正常声门图及其参数分布研究了恶性喉病变、声带麻痹、喉内关节病变、功能性声门发声障碍、声带息肉、声带小结、喉炎和早期喉病的临床声门图表现及其与声带振动模式变异之间的关系,并探讨了上述病变声门图的鉴别诊断指标和用声门图对喉病手术治疗、药物治疗和功能治疗的疗效进行定性和定量评价。研究结果证实:声门图方法能准确、定量、灵敏地反映声带振动模式及其变异;在喉病诊治中具有重要的应用价值。     

Practice of orthokeratology by a group of contact lens practitioners in Hong Kong

Purpose: The aim of the study was to provide information about the characteristics of three main types of orthokeratology (ortho‐k) lenses used in Hong Kong and to report on their performance based on the clinical impressions of a group of ortho‐k practitioners. Method: Twelve ortho‐k practitioners were interviewed between 1 March and 30 June 2001. Results: Most ortho‐k lenses were ordered from three manufacturers: DreimLens, Fargo and Contex. The median maximum myopia reduction reported for DreimLens, Contex and Fargo lenses were 6.25 D, 6.00 D and 4.50 D respectively. The time to reduce myopia by up to 4.00 D could be up to three weeks for Contex and DreimLens and up to four weeks for Fargo. For reduction of myopia by up to 4.00 D, the treatment usually required only one or two lenses per eye for all three types of lenses. The incidence of lens binding and lens tightening after achieving the optimal reduction was reported to be higher with the DreimLens design. Good centration, less lens binding, relatively lower incidence of complications and lens tightening after achieving the optimal reduction were reported with the Fargo lenses. Conclusions: DreimLens tended to be more effective for myopia reduction. However, some practitioners were concerned with the aggressiveness of myopia reduction using this lens design and the higher potential for ocular complications. Selection of the lens design is dependent on various factors, in particular, practitioners need to be comfortable with the design they choose and to consider the needs of their patients and the final goal of the treatment.     

Recurrent lens binding and central island formations in a fast-responding orthokeratology lens wearer.

A 12-year-old girl with a history of fast myopia progression underwent advanced orthokeratology (ortho-k) treatment and suffered from recurrent lens binding and central corneal staining. The problem could not be fixed by lens fenestration and refitting with a less aggressive lens (three-zone ortho-k) design. After refitting with a lower target advanced ortho-k lens, these complications were no longer occurring, and the amount of power reduction was greater than expected considering the target designed for the refitted lenses. During the following 15 months of ortho-k lens wear, there was no clinically significant change to her refractive error. The patient and her parents were happy with the outcome, although the refractive error was not totally eliminated and she still needed to wear spectacles for clear vision. Possible etiologies of the complications are discussed.     

Efficacy of minor analgesics in primary dysmenorrhoea: a systematic review

Objective To quantify the efficacy and safety of naproxen, ibuprofen, mefenamic acid, aspirin and acetaminophen (paracetamol) in the treatment of primary dysmenorrhoea through a systemic overview of randomised controlled trials.
Methods MEDLINE, EMBASE and the Science Citation Index were searched for randomised controlled trials. Efficacy was assessed by measurement of pain relief, requirement for rescue analgesics, restriction of daily life and absence from work or school. The rate ratios of side effects were used to assess safety.
Results Fifty-six trials describing 55 comparisons of analgesics with placebo and 12 direct comparisons with other analgesics met our inclusion criteria. Women taking naproxen were over three times more likely to have at least moderate pain relief than those taking placebo. Ibuprofen, mefenamic acid and aspirin were also superior to placebo but acetaminophen was not. The requirement for rescue analgesics, restriction of daily life and absence from work or school were less frequent with naproxen and ibuprofen than placebo but not with aspirin or acetaminophen. Direct comparisons did not show any difference between naproxen and ibuprofen. Side effects occurred more frequently only with naproxen when compared with placebo.
Conclusion Naproxen, ibuprofen, mefenamic acid and aspirin are all effective in primary dysmenorrhoea. Ibuprofen appears to have the most favourable risk-benefit ratio. Acetaminophen appears to be less effective than nonsteroidal anti-inflammatory drugs, but there was only one trial meeting our inclusion criteria and further studies are required.     

视盘血管炎——关于混合型的研讨

对６０例（６３眼）视盘血管炎的临床分型进行了探讨，结果表明，除分为Ⅰ、Ⅱ两型外，尚存在混合型，当视盘睫状血管炎性病变波及中央静脉，或两个血管系统同时受炎症侵犯时，即可再现混合型的临床表现，视盘明显水肿，视网膜静脉迂张，散在渗出，出血，动脉狭细。眼底荧光血管造影可见视盘荧光早期充盈明显迟缓，后期渗漏面积〉２．０ＰＤ，视网膜循环时间延长，混合型兼有Ⅰ，Ⅱ两型的临床特征，应作为一个独立类型存在，同时观察     

人脐静脉内皮细胞清除补体攻膜复合物的机制

目的：探讨内皮细胞清除补体攻膜复合物（MAC）的途径及其清除动力学，方法：原代培养的人脐静脉内皮细胞以RH414荧光标记质膜双层，0℃组装亚溶剂量的MAC，37℃复苏后，LSCM实时监MAC沉积诱导的质膜囊泡化形成和胞吞，胞吐情况,流式细胞仪定量检测内皮细胞表面MAC抗原的清除情况，结果：MAC沉积后，内皮细胞有的质膜囊泡化形成，囊泡以胞吞和胞吐2种方式离开细胞，并以前者占优，37度条件下，内皮细胞清除表面MAC的半衰期约为5min。结论：内皮细胞可通过胞吞和胞吐2种机制清除细胞表面沉积的MAC，并以胞吞方式为主。