基层医院开展腹腔镜筋膜内子宫切除术58例分析

目的:探讨基层医院开展腹腔镜筋膜内子宫切除术(LISH)的安全性、可行性。方法:回顾分析LISH术58例的临床资料。结果:58例中2例中转手术,无1例脏器损伤,术中出血平均(146±72)m l,无1例输血,术后3d体温平均(37.3±1.5)℃,术后排气时间平均(20.2±4.1)h,平均住院(6.2±1.2)d。结论:根据基层医院特点,开展LISH术简单易行、安全,患者痛苦少、康复快,效果良好。     

Nicastrin基因新选择性剪接与阿尔茨海默病的相关性研究

目的 探讨Nicastrin基因转录产物的选择性剪接与阿尔茨海默病的相关性.方法 通过使用RT-PCR法分别在病理确诊的10例AD患者与13例非AD对照中检测了海马区Nicastrin基因转录产物的选择性剪接,同时PCR-RFLP法进行apoE基因分型,对比分析Nicastrin基因、apoE基因与AD的相关性.结果 我们发现Nicastrin基因上的一个新的选择性剪接转录产物-NCSTN△E16,该转录产物导致其跨膜结构域上游71个氨基酸缺失,在apoEε4携带者伴外显子16缺失阳性组中AD患病率明显增加,但这一相关性没有统计学意义.结论 Nicastrin基因转录产物的选择性剪接-NCSTN△E16与AD没有明显相关性.     

聚丙烯酰胺水凝胶取出同期假体隆乳术分析

目的:介绍一种聚丙烯酰胺水凝胶注射隆乳后取出同时置入假体隆乳的新方法。方法:18例聚丙烯酰胺水凝胶注射隆乳术患者在取出注射物后同期于胸大肌下置入硅凝胶假体。结果:18例患者均取得了良好的效果,外观形态好,无1例出现血肿和感染。结论:聚丙烯酰胺水凝胶注射隆乳后取出注射物同期胸大肌下置入硅凝胶假体是一种可行且效果良好的隆乳矫治方法。     

固相板酶免法测定人血清游离三碘甲状腺原氨酸

目的 :探讨游离三碘甲状腺原氨酸 (FT3)的酶免疫测定法对于诊断甲状腺功能亢进和监测甲状腺激素补充治疗效果及预后情况的重要意义。方法 :采用聚苯乙烯96孔板作为固相载体 ,利用亲和纯化的兔抗T3 抗体和T3 - β-半乳糖苷酶标记物 ,建立了固相板竞争法。结果 :可测范围为0.48～45.0ng/L ,灵敏度0.13ng/L ,平均批内变异系数为 (n=20)6.4 % ,平均批间变异系数为 (n=8)12.4% ,正常参考范围4.14±0.97ng/L。正常人与甲亢病人能明显分开。结论 :酶免法测定血清FT3,其灵敏度、精密度均达到放免水平 ,且可避免同位素污染     

SPM5软件分析癫痫患者脑PET图像的应用研究

Objective To investigate the value of statistical parametric mapping 5 (SPM5) and its parameter settings in analysis of PET imaging for epilepsy patients. Methods Seventeen epilepsy patients and seventeen controls were scanned with PET. The datns were analyzed using PET and SPM5 with qualitative and semiquantitative analysis, statistical analysis of the percentage (numbers of agent distribution decreasing in focus to brain) for different parameters combinations, which were value adjustment to contral-p and voxels-k. Results There was decreasing of agent distribution at temporal lobe in epilepsy patients detecting with PET; the T/NT of focus to cerebellum was 1.07±0.24, the T/NT of normal tissue in opposite side to cerebellum was 1.27±0.18, there was a significant difference (t=1.87, P<0.05). Dealing with SPM5, there was more significant decreasing of agent in regions 19, 21, 39 of temporal lobe, regions 7, 19, 31, 40, 47 of parietal lobe and occipital lobe in epilepsy patients. With different value of k, the percentage was (27±22)%, (29±24)%, (32±23)%, (35±27)%, (39±31)%respectively, there was not significant difference (F=0.59, P>0.05) ; for different value of p, the percentage was (42±30) %, (29±25) %, (26±21) % respectively, with a significant difference (F=3.60, P<0.05); there was linear regression in value adjustment to contral-p and the percentage(b=-18.24, t=2.57, P<0.05). Conclusions Semiquantitative analysis by SPM5, the setting of value adjustment to contral-p would affect the results, the smaller of value adjustment to contral-p, the better of the result. SPM5 would be more objective and accurate to locate the focuses.     

急性重度眼烧伤135例临床分析

目的了解急性重度眼烧伤的临床特点、预后及并发症发生情况。方法对笔者单位病案室保存的1977--2002年住院眼烧伤患者135例（155只眼）的病历进行回顾性统计分析。分析不同深度、原因眼烧伤的眼表修复率、修复时间、致盲情况及并发症。结果治疗后Ⅲ度眼烧伤的修复时间短于Ⅳ度眼烧伤，其修复率也明显高于Ⅳ度眼烧伤（P〈0．01）；在不能修复的Ⅳ度眼烧伤中，酸烧伤致角膜穿孔6只眼，显著高于碱烧伤（1只眼，P〈0．05）。Ⅲ度眼烧伤视力≥0．05者有38只眼，〈0．05者51只眼；Ⅳ度眼烧伤视力≥0．05者0只眼，〈0．05着66只眼。78只酸、碱烧伤眼中，52只眼致盲，致盲率为66．7％；77只热烧伤眼中，65只眼致盲，致盲率为84．4％。Ⅲ度眼烧伤的并发症发生率低于Ⅳ度眼烧伤。其中Ⅲ度眼烧伤角膜穿孔、睑球粘连的发生率（1．1％、36．O％）均显著低于Ⅳ度眼烧伤（27．3％、59．1％，P〈0．01）。在酸烧伤患者中，角膜穿孔及睑外翻的发生率（29．2％、37．5％）较高。而热烧伤患者中眼睑球粘连的发生率（53．2％）较高。结论Ⅳ度眼烧伤伤后的预后差，致盲率高。目前的治疗方法尚不能完全改善其视功能及预后，有待进一步研究。     

不同钉位布局影响股骨颈骨折内固定效应的生物力学研究

目的:观察应用多枚钉内固定治疗股骨颈骨折时采取不同钉位布局对骨折断端固定效应的影响,为临床操作中寻求最佳钉位布局奠定基础。方法:通过特制壮年人体尸骨股骨颈骨折模型,进行直视下解剖复位后,分别应用3钉倒三角形、3钉正三角形和双钉平行3种不同钉位布局内固定方法完成内固定。在生物力学万能试验机上进行轴向压缩和扭转实验,观察不同生物应力下断端相对的位移距离、轴向刚度、水平剪切刚度和扭转强度等项目,取得试验数据后经统计学处理,进行组间对比,观察其差异的显著性。结果:在3种钉位布局的内固定方法之中,以股骨矩核心下2～3mm处进钉位为下位顶点的倒三角形钉位布局能获得最坚强的固定效应,相同应力下其位移距离最小而各项刚度最大;而股骨矩核心上位和中下位双钉固定法固定效应最差,表现为相同应力下位移距离最大和各项刚度最小。结论:尽可能选择以股骨矩核心下2～3mm处进钉位为下位顶点的倒三角钉位布局法,尽可能减少应用双钉位布局法。     

立体定向开放显微手术治疗脑内致痫小病灶

目的脑内致癫痫小病灶术前、术中的精确定位和病灶切除,是手术治疗效果的关键。探讨立体定向开放微创手术,皮层电极监测下切除脑内致痫小病灶的手术方法。方法53例症状性癫痫病例,CT、MR I检查有脑内小病灶(直径在0.5~3.0 cm),24 h视频脑电图确认致痫灶为脑内单发病灶。ASA 601S型立体定向仪CT引导辅助全麻环钻开颅,导针穿刺放置导管引导,显微镜下手术分离、切除病灶,皮层脑电图确认将致痫灶切除。结果病灶全切率达96.2%,术后50例得到随访,随访时间5~12个月,平均6.3个月,癫痫消失45例,脑电图检查记录到癫痫波11例,临床癫痫发作5例。因肺癌死亡3例。结论CT立体定向引导,显微手术切除颅内致痫小病灶,术中皮层电极确认将致痫灶切除,是一种定位精确、微创、安全、有效的治疗方法。     

Quick White美白胶漂白氟斑牙的临床效果

目的:临床观察QuickWhite美白胶对氟斑牙患者的漂白治疗效果。方法:选取63例I￣III级不同程度的氟斑牙患者,采用QuickWhite美白胶进行漂白治疗,分别于治疗前及治疗后用Vita比色板对牙齿比色并记录,评价治疗效果。评价标准:治疗后无改变为无效,变白2个色阶为有效,变白3个色阶以上为显效。结果:使用QuickWhite美白胶治疗后,I级患者显效率为95.6%,II级患者显效率为50%。结论:QuickWhite美白胶可为氟斑牙患者提供可靠的漂白治疗效果。     

Effects of Ageing on the Oral Absorption of d-Xylose in Rats: Analysis of Gastrointestinal Disposition

The effects of ageing on the oral (gastrointestinal) absorption of d -xylose were investigated by analysing the gastrointestinal disposition after oral administration to young (9 weeks) and old (53 weeks) rats. A linear model assuming first-order gastric emptying followed by first-order intestinal absorption was fitted to remaining fraction vs time profiles for the stomach and small intestine to estimate the gastric emptying rate constant (k_g) and the intestinal absorption rate constant (k_a). In young and old rats, k_g values were 0·087 ± 0·008 and 0·070 ± 0·007 min^?1, respectively, and k_a values were 0·020 ± 0·002 and 0·018 ± 0·002 min^?1 suggesting an insignificant effect on ageing on the rate of oral absorption. The average intestinal lumen volume (V_av) was unchanged with ageing, and so was the apparent intestinal membrane permeability clearance (CL_app) as the product of k_a and V_av. However, the small intestinal transit time (T_si) was suggested to be twice that in older rats (171 min) than in young rats (78 min) by the analysis of gastrointestinal disposition of inulin, a non-absorbable marker. It was also shown that our preceding finding of an increase in the fraction absorbed of D-xylose with ageing can be solely ascribable to the delay in intestinal transit. Thus, among various determinants of oral absorption, only T_si was found to be altered with ageing. The CL_a,app and k_a of passively absorbed drugs such as D-xylose may be generally unchanged, and the fraction absorbed may increase with ageing by the delay in intestinal transit.