Performance and comparison of the Cockcroft-Gault and simplified Modification of Diet in Renal Disease formulae in estimating glomerular filtration rate in a Chinese Type 2 diabetic population.

AIMS: Our aim was to assess performances of the Cockcroft-Gault and simplified Modification of Diet in Renal Disease (MDRD) formulae in estimating glomerular filtration rate (GFR) in Chinese diabetic populations and their association with vascular risks. METHODS: A total of 1009 patients with Type 2 diabetes were categorized into low estimated GFR groups (GFR < 60 ml/min/1.73 m(2)) and control groups by the two equations. The performances of these formulae were assessed at different stages of kidney function. Carotid artery intima-media thickness (IMT) and the prevalence of diabetic retinopathy or albuminuria were compared among the groups. The ability of these formulae to identify established vascular risk markers using sensitivity, specificity, positive and negative predictive values were also compared. RESULTS: The prevalence of low estimated GFR was 32.7% with the Cockcroft-Gault formula and 5.2% with the MDRD formula, respectively. In low estimated GFR subjects by the MDRD formula, IMT was significantly thicker than those by the Cockcroft-Gault formula (1.2 mm vs. 1.0 mm; P < 0.05), with a higher prevalence of albuminuria (78.4 vs. 52.8%, P < 0.05) and diabetic retinopathy (46.5 vs. 30.5%; P < 0.05). The Cockcroft-Gault formula gave a specificity of 71.7% and a sensitivity of 37.0%, and the MDRD formula gave a specificity of 96.6% and a sensitivity of 7.9% in estimating low GFR relevant for established vascular risks. CONCLUSIONS: These formulae performed differently in Chinese diabetic populations. The simplified MDRD formula is minimally superior to the Cockcroft-Gault formula for its high specificity and positive predictive values in estimating low GFR relevant for vascular risks.     

乳腺非典型增生病与血管生成关系的实验研究

目的：建立乳腺非典型增生病动物模型，探讨非典型增生与血管生成的关系。方法：采用灌服二甲基苯蒽＋颈部枷具方法复制大鼠肝郁血瘀型乳腺非典型增生动物模型，并给予中药乳复汤治疗。常规染色观察大鼠乳腺组织病理组织形态．免疫组化方法检测MVD、VEGF和bFGF的表达。结果：病证模型组乳腺非典型增生率90％．较单纯造模组高．P=0．0415；中药乳复汤治疗组非典型增生率较病证模型组低．P=0．0459；随着一般增生到非典型增生程度加重，MVD计数增多，VEGF、bFGF的表达升高，P〈0．05。结论：病证结合造模更适合中医动物实验要求，中药乳复汤具有抑制血管生成作用。     

某儿童医院10年临床报告细菌性痢疾的流行病学特征

目的探讨细菌性痢疾(以下简称菌痢)近10年流行特点。方法对10年来收集的全院各科上报的菌痢进行回顾性分析。结果1993-2002年报告菌痢10861例,占传染病报告总数的62.92%,传染科门诊量占全院门诊百分比的年变化为8.54%～4.33%;菌痢发病占传染科门诊的年比率变化为1.05%～3.45%;<1岁、1～3岁、4～6岁、7～9岁、≥10岁5个年龄组,各组之间菌痢检出率差异有统计学意义,1～3岁组检出率最高;细菌性痢疾每年4月检出率开始上升,8月达最高,11月检出率恢复到上升前水平;不同性别的儿童检出率差异有统计学意义,男童明显高于女童。结论细菌性痢疾检出年龄特点为婴幼儿最高,随年龄增长,发病逐渐减少;发病高峰季节向春秋季扩展。     

Investigation of the Effect of Neoadjuvant Chemotherapy on Stage Ⅱ Breast Cancer

OBJECTIVE To investigate the effect of neoadjuvant chemotherapy in treatment of Stage Ⅱ breast cancer. METHODS The data from 113 patients with breast cancer of the same pathologic type in Stage Ⅱ,during the period of 1995 to 2001,were analyzed retrospectively.Among the patients,47 were treated with neoadjuvant chemotherapy,and 66 received no adjuvant therapy before surgery（control group）.After the patients of the neoadjuvant chemotherapy group had received 2 courses of chemotherapy with the CMF regimen,the surgical procedure was conducted. RESULTS Complete remission（CR）was attained in 9 of the 47 cases receiving neoadjuvant chemotherapy and partial remission（PR）was reached for 22 cases.The rate of breast-conserving surgery was enhanced from 22.73%to 46.81%（P〈0.05）in the neoadjuvant treatment group. There was no difference in the 5-year overall survival（OS）and disease-free survival（DFS）rate between the two groups（P〉0.05）,but the 5-year OS and DFS of the cases with clinical tumor remission was higher compared to the control group（P〈0.05）. CONCLUSION Neoadjuvant chemotherapy can enhance the rate of breast conservation for Stage Ⅱ breast cancer and may improve the prognosis of the cases with clinical remission.     

氨气敏电极法快速测定血氨

本文介绍使用氨气敏电极,采用标准曲线法简便、快速、准确测定血氨的方法。取空腹血1ml,用1M HClO_4沉淀蛋白,以0.1M NH_4Cl—0.6MNa_2SO_4作内充液,碱化后的上清液可在2～3min内测试完毕。40例正常成人血氨的测定结果:■=31.4μmol/L N;S=6.4μmol/L N;■±2S(正常值范围)为18.6～44.2μmol/L N。10份血样的平均回收率为100.4％。该法用血少、简便、快速;结果较稳定、准确,适用于临床检验。     

内镜辅助肋骨-软骨移植重建髁突与同期正颌手术的临床研究

目的 探讨内镜辅助肋骨-软骨移植重建髁突与同期正颌手术治疗严重颞下颌关节病变及牙颌面畸形的效果. 方法 于术前对患者进行临床检查和治疗设计,术中行Le Fort Ⅰ型截骨术、下颌支矢状骨劈开术、髁突等关节区病变的处理、内镜辅助下肋骨-软骨移植和颏成形术,术后进行随访. 结果 2003年9月至2005年12月,于临床应用15例,所有患者同期手术均顺利完成.术中、术后均无严重出血、神经损伤、受区感染等严重并发症发生.术后随访29～52个月,平均31.8个月,所有患者面容均显著改善,关节功能良好,且无关节区疼痛等主观症状,患者对手术疗效满意.术后张口度平均为33.6 mm,侧向运动度为0～6 mm. 结论 选择合适的适应证、设计合理的手术方案,内镜辅助髁突重建同期正颌手术效果较好.     

胶质细胞活化对慢性前列腺炎/慢性盆腔疼痛综合征(CP/CPPS)大鼠脊髓背角P物质的影响

目的探讨胶质细胞活化对慢性前列腺炎/慢性盆腔疼痛综合征（chronic prostatitis/chronic pelvic pain syndromes,CP/CPPS）大鼠脊髓背角P物质的影响。方法完全福氏佐剂和3%角叉菜胶前列腺内注射造成CP/CPPS模型,脊髓插管给药胶质细胞活化抑制剂Propentofylline干扰CP/CPPS模型大鼠,免疫组织化学方法观察正常组、疼痛模型组、药物干扰组脊髓节段（L6和S1）背角的胶质细胞的活化和P物质的定性定位,并用放射免疫的方法观察三组脊髓背角P物质的变化。结果脊髓背角胶质细胞活化阳性细胞数疼痛组明显增加,药物干扰组明显减少;P物质主要表达于脊髓背角且疼痛模型组明显增多,药物干扰组明显减少。结论胶质细胞活化是CP/CPPS大鼠脊髓背角P物质变化的重要原因,胶质细胞活化抑制剂的应用将是治疗CP/CPPS的新亮点。     

Early outcomes of surgery for small bowel obstruction: analysis of risk factors

OBJECTIVES: The study aimed to review the etiologies of patients who underwent surgery for small bowel obstruction (SBO) and to evaluate the risk factors affecting the early postoperative outcomes. MATERIALS AND METHODS: A case series of 430 patients (252 men) with a mean age of 64.5 years, who underwent 437 operations for SBO, were retrospectively reviewed. RESULTS: Peritoneal adhesions and hernia were the most common causes of SBO, contributing 42.3 and 26.8% of all cases, respectively. Strangulation occurred in 27.7% and caused nonviable bowel in 13.0% of obstructing episodes. Old age (age >/= 70 years), female patient, nonadhesive obstruction, and hernia were the independent significant factors associated with bowel strangulation. The 30-day mortality was 6.5%, and the median postoperative hospital stay was 8 days. Old age, the presence of premorbid pulmonary disease, and malignant obstruction were the independent factors associated with operative mortality. The overall complication rate was 35.5%, and old age was the only significant factor associated with postoperative complications. CONCLUSIONS: Surgery for SBO is still associated with significant mortality and morbidity. As old age is significantly associated with an increased incidence of strangulation, operative mortality, and complications, this group of patients should be managed with extra cautions to avoid unfavorable outcome of surgery.     

一种适合正颌外科的成人个体化头影测量颅颌关系的方法

目的本研究选择在判断矢状向和垂直向颅颌关系中最常用的5项X线头影测量项目并以此为基础,运用多元回归的方法探讨并建立我国成都地区成人个体化颅颌关系浮动正常值,并探讨其应用方法.方法搜集符合纳入标准的未接受过正畸治疗的成都地区18岁至45岁正常(牙合)97例,其中男性48例,女性49例.测量各样本上颌突度(SNA),下颌突度(SNB),上颌相对颅底倾角(NL-NSL),下颌相对颅底倾角(ML-NSL),颅底角(NSBa).对测量项目进行多元统计分析并建立成都地区成人个体化头影测量颅颌关系浮动正常值.结果(1)5个测量项目之间均存在显著相关关系,其中SNB与其余4个测量项目的相关强度最大;(2)以SNB为自变量建立成都地区成人个体化头影测量颅颌关系浮动正常值.结论本研究为成人正畸患者,特别是拟进行正颌外科治疗的成人患者提供了一种辅助性的头影测量诊断方法.     

急性脑梗死88例临床分析

[背景 ]比较分析 88例不同年龄组急性脑梗死患者的病因、症状、体征及头部CT所见 .[病例报告 ]将 88例急性脑梗死患者分为老年组和非老年组 ,对发病因素、症状、体征和头部CT特点进行对比分析 ,发病因素中有高血压者占 6 4 % ,心脏病者占 2 3% ,糖尿病者占 2 5 % ,有短暂性脑缺血发作病史者占 30 % ,高脂血症者占 4 5 % ,吸烟者占 5 2 % ,有家族史者占 33% .非老年组中初发者多见 ,有头痛、头晕及偏身感觉障碍等症状者比老年组多见 ,而偏瘫、四肢瘫、构音障碍及意识障碍者则老年组多见 .头部CT示单梗塞灶者在非老年组多见 ,多梗塞灶、脑白质脱髓鞘及脑萎缩者在老年组多见 .[讨论 ]脑梗死病人因年龄不同 ,其发病因素、临床表现及头部CT所见有所不同