288例老年呼吸道感染患者病原菌分布特性及药敏分析

目的: 了解老年呼吸道感染患者病原菌的分布特点及药敏特性.方法: 对288例老年呼吸道感染患者痰样本(NCCLS法)进行细菌培养,K-B纸片法进行药敏测定.结果: 患者痰中共检出病原菌400株,细菌280株,其中G-杆菌147株,占36.75%, G 球菌133株,占33.25%.肺炎克雷伯菌及铜绿假单胞菌最敏感药的是头孢他啶,敏感率均为40%以上,肺炎链球菌和金黄色葡萄球菌最敏感药的是万古霉素;检出真菌120株,占30%,以白色念珠菌为主.结论: 进行病原菌跟踪监测及时的药敏试验,对及时控制老年呼吸道感染,是不可缺少的重要环节.     

经上颌窦前壁钻孔行鼻窦内窥镜术30例报告

报告经上颌窦前壁钻孔行鼻窦内窥镜手术３０例，疗效较好。与鼻腔、鼻窦内窥镜手术比较，该术式具有观察方便，出血少，反应轻，操作方便，并发症少，术后复发率低等优点。     

普通额镜下鼻内激光泪囊鼻腔造孔术治疗慢性泪囊炎

报告在普通额镜下以YAG激光经鼻腔行泪囊鼻腔造孔术，治疗慢性泪囊炎患者37例（45眼），经3～24个月的随访观察，泪道阻塞均解除，有效率为95．6％，治愈率为88．9％。本手术具有损伤小，操作简便，快捷，术后反应轻，并发症少等优点。并对手术方法及影响疗效的因素进行了探讨。     

脉冲角加速度刺激诱发豚鼠短潜伏期前庭诱发电位

以脉冲角加速度刺激在豚鼠记录出短潜伏期诱发反应，反应由发生于刺激开始后10ms以内的5～7个波组成，高强度刺激时反应振幅数微伏，I波潜伏期约2．5ms，不同动物及同一动物不同时间测试反应非常稳定。系列实验结果表明脉冲角加速度刺激诱发的豚鼠短潜伏期诱发反应系前庭诱发电位。     

Induction of apoptosis in multi-drug resistant (MDR) human glioblastoma cells by SN-38, a metabolite of the camptothecin derivative CPT-11

 The overexpression of the multidrug resistance (mdr1) gene and its product, P-glycoprotein (P-gp), is thought to limit the successful chemotherapy of human tumors. Recent studies demonstrate that SN-38, a metabolite of the camptothecin (CPT) derivative CPT-11, has antitumor effects on several tumors, but the mechanisms responsible for its cytotoxicity remain unclear. We therefore determined whether SN-38 has cytotoxic effects on MDR human glioblastoma GB-1 cells and non-MDR human glioblastoma U87-MG cells. Furthermore, we determined what role SN-38 plays in the induction of cytotoxicity in these tumor cells. In this study, we demonstrated that SN-38 had significantly stronger antitumor effects on GB-1 and U-87MG cells than did CPT (P<0.01 and P<0.05, respectively). In addition, findings obtained using a DNA fragmentation assay, Hoechst 33258 staining, in situ end-labeling and cell cycle analysis demonstrated that SN-38 induced apoptosis in these tumors. Our results suggest that SN-38 has a stronger antitumor effect on malignant glioma cells regardless of MDR expression than does CPT, and therefore can be considered a new chemotherapeutic agent potentially effective in the treatment of human primary or recurrent malignant gliomas resistant to chemotherapy. Received: 6 October 1995/Accepted 29 June 1996     

食管异物摘取术的麻醉选择

为探讨食管异物摘取术的麻醉方法，提高手术效果，对７２例食管异物患者采用强化表面麻醉法和气管内插管麻醉法进行了手术和对比观察。７２例异物均取出顺利，无严重并发症发生。资料显示：两种麻醉各具优越性，前者适用于年龄较大的儿童和成人，后者适用于食管异物并呼吸困难的小儿。     

妊高征患者合体滋养细胞质膜部分生化指标的变化

目的：研究妊高征（ＰＩＨＳ）患者胎盘合体滋养细胞质膜（ＳＴＣＰＭ）中生化指标的变化及原因。方法：ＰＩＨＳ２４例，其中轻度８例、中度７例、重度９例，以正常孕妇１８例作对照，用Ｗｈｉｔｓｅｔ等法制备ＳＴＣＰＭ，以孔雀石绿无机磷法（ＭＧＩｏＰＡ）测定ＡＴＰａｓｅ的活性，用ＤＰＨ荧光探针测定膜的微粘度来推断膜的流动性，用硫代巴比妥酸荧光微量测定法测丙二醛酸（ＭＤＡ）以代表脂质过氧化物（ＬＰＯ）。结果：ＰＩＨＳ组Ｎａ＋、Ｋ＋－ＡＴＰａｓｅ、Ｃａ２＋、Ｍｇ２＋－ＡＴＰａｓｅ活性均显著低于对照组（Ｐ＜０．０５），且随病情加重而降低，膜的流动性亦显著降低（Ｐ＜０．０５），ＭＤＡ则显著增高，且随病情加重而增高；ＭＤＡ与两种ＡＴＰ酸呈负相关关系（Ｐ＜０．０５）。结论：ＰＩＨＳ的ＳＴＣＰＭ生化指标发生变化，其变化的原因之一是脂质过氧化作用增强     

三七、茜草复方对置铜宫内节育器家兔子宫局部t-PA活性的影响

目的 探讨三七、茜草(SQ)复方治疗置铜宫内节育器(Cu-IUD)所致子宫异常出血的作用机理。方法 制 作家兔置Cu-IUD动物模型,以吲哚美辛作对照,观察SQ复方对置Cu-IUD家兔模型子宫匀浆中组织型纤溶酶原激 活物(t-PA)活性的影响。结果 置Cu-IUD家兔模型子宫匀浆中t-PA的含量增高(P<0．01),经SQ复方治疗后与模 型组比较有显著性差异(P<0．01),说明SQ复方能减少家兔子宫匀浆中t-PA的含量,降低t-PA的活性。结论 SQ 复方通过降低置Cu-IUD家兔子宫内膜局部的纤溶活性而达到止血的目的。     

The effect of nerve-root injections on the need for operative treatment of lumbar radicular pain. A prospective, randomized, controlled, double-blind study

BACKGROUND: The purpose of the present study was to determine the effectiveness of selective nerve-root injections in obviating the need for an operation in patients with lumbar radicular pain who were otherwise considered to be operative candidates. Although selective nerve-root injections are used widely, we are not aware of any prospective, randomized, controlled, double-blind studies demonstrating their efficacy. METHODS: Fifty-five patients who were referred to four spine surgeons because of lumbar radicular pain and who had radiographic confirmation of nerve-root compression were prospectively randomized into the study. All of the patients had to have requested operative intervention and had to be considered operative candidates by the treating surgeon. They then were randomized and referred to a radiologist who performed a selective nerve-root injection with either bupivacaine alone or bupivacaine with betamethasone. The treating physicians and the patients were blinded to the medication. The patients were allowed to choose to receive as many as four injections. The treatment was considered to have failed if the patient proceeded to have the operation, which he or she could opt to do at any point in the study. RESULTS: Twenty-nine of the fifty-five patients, all of whom had initially requested operative treatment, decided not to have the operation during the follow-up period (range, thirteen to twenty-eight months) after the nerve-root injections. Of the twenty-seven patients who had received bupivacaine alone, nine elected not to have the operation. Of the twenty-eight patients who had received bupivacaine and betamethasone, twenty decided not to have the operation. The difference in the operative rates between the two groups was highly significant (p < 0.004). CONCLUSIONS: Our data demonstrate that selective nerve-root injections of corticosteroids are significantly more effective than those of bupivacaine alone in obviating the need for a decompression for up to thirteen to twenty-eight months following the injections in operative candidates. This finding suggests that patients who have lumbar radicular pain at one or two levels should be considered for treatment with selective nerve-root injections of corticosteroids prior to being considered for operative intervention.