电位滴定法测定胰激肽释放酶活力测试条件探讨

本文用ＦＩＰ推荐的方法，以具有国际单位的参照品为标样，滴定液为０．０１ｍｏｌ／ＬＮａＯＨ标准溶液，考查了以ＢＡＥＥ为底物的电位滴定法测定胰激肽释放酶活力的实验条件，通过正交试验得出直观和方差分析的结果，依据酶活力单位高、ＳＤ和ＲＳＤ％较小的原则，求出酶活力测定的最适条件是：酶反应温度为２５℃；缓冲液为０．００１５ｍｏｌ／ＬＮａ２Ｂ４Ｏ７－０．２５ｍｏｌ／ＬＮａＣＬ－２×１０（－４）ｍｏｌ／ＬＥＤＴＡ，ｐＨ为８．００；反应液中酶浓度为０．４８ＩＵ／ｍｌ；底物浓度为５×１０（－３）ｍｏｌ／Ｌ；胰蛋白酶抑制剂浓度为１２５μｇ／ｍｌ。胰激肽释放酶活力测定的实验数据的相对标准偏差小于５％。     

双光气对大鼠肺损伤的研究

研究了双光气染毒后不同时间大鼠支气管肺泡灌洗液（ＢＡＬＦ）成分及肺形态学改变。结果表明，双光气染毒后，ＢＡＬＦ成分的变化程度与肺形态改变密切相关ＢＡＬＦ成分分析可作为动物实验中探测双光气所致肺损伤的有力手段。     

MRI诊断腰椎间盘术后粘连和突出复发

失败的下腰椎手术是个复杂的问题，由于其症状和体征不典型，单靠临床检查很难明确诊断，而脊髓造影和常规ＣＴ等检查也很难区别突出复发和硬膜外粘连。本文分析了３２例再手术患者ＭＲＩ图象，并与第二次手术所见对比，发现２７例ＭＲＩ诊断准确，３例假阳性，２例因信号缺失不能明确诊断。     

水飞蓟素对脑缺血性损伤的影响

目的：探讨水飞蓟素对脑缺血性损伤保护作用的机制。方法：采用四血管阻断法造成大鼠全脑缺血模型．观察水飞蓟素对脑匀浆液一氧化氮(NO)和一氧化氮合成酶(NOS)的表达量。结果：水飞蓟素在显降低缺血大鼠脑组织中NO、NOS含量的同时，明显缩小了梗死面积。结论：水飞蓟素能提高机体抗氧化能力，对脑缺血损伤有显的保护作用。     

Calcification and ossification of chronic encapsulated intracerebral haematoma: case report.

We report a case of calcified chronic encapsulated intracerebral haematoma (ICH) in a 29-year-old female who presented with progressive left sided weakness and intermittent seizures since childhood. The preoperative magnetic resonance (MR) imaging of the head initially suggested that a partially thrombosed aneurysm or vascular malformation was present. However, no vascular stain was found on the digital subtraction angiography (DSA) of both the carotid and vertebral arteries. The excised mass was histologically diagnosed as a chronic ICH. We traced the patient's medical history and found that at the age of one she sustained a head injury after a fall. So far, to our knowledge, no case of epilepsy secondary to a calcified chronic encapsulated ICH occurring 28 years after head injury has been reported. Calcified chronic encapsulated ICH concomitant with new bone formation within is even rarer. The possible pathogenesis of this case is discussed.     

口服谷氨酰胺颗粒对烧创伤患者的疗效及安全性分析

目的观察口服谷氨酰胺(Gln)颗粒对烧(创)伤及大手术患者的疗效及可能发生的不良反应.方法采用随机双盲、安慰剂对照法,将受试患者分为Gln组和对照组,每组60例,两组患者采用等氮、等热量的营养支持.Gln组口服或管饲Gln 0.5 g·kg-1·d-1,对照组使用同等剂量的安慰剂甘氨酸,疗程均为7 d.比较用药前后两组患者肠黏膜屏障功能、蛋白代谢、免疫功能、肝和肾功能的变化及不良反应等. 结果伤后两组患者血浆Gln浓度明显低于正常值,而血浆二胺氧化酶(DAO)活性、内毒素含量、肠黏膜通透性[尿乳果糖/甘露醇(L/M)]及尿氮排量均明显增高;但Gln组用药7 d后血浆Gln浓度与用药前比较增加38.04%(P＜0.01).Gln组血浆前白蛋白、转铁蛋白及白细胞介素2(IL-2)含量均显著高于对照组(P＜0.01),升幅分别为21.19%、51.11%、57.54%.血浆DAO活性、L/M比值、内毒素含量及尿氮排量明显低于对照组,降幅分别为47.26%、52.18%、22.22%、27.78%(P＜0.05或0.01).两组患者的血浆总蛋白、白蛋白、血尿常规及肝、肾功能在用约前后变化不明显(P＞0.05).用药后有少数患者出现轻微不良反应如恶心、腹泻和便秘等,2～3 d后自行缓解,两组间比较,差异无显著性意义(P＞0.05).结论口服Gln能显著提高患者血浆Gln浓度,明显减轻伤后肠黏膜受损程度,并能促进机体蛋白合成,降低蛋白分解,提高机体免疫功能,且临床应用无明显不良反应.     

SURGICAL TREATMENT OF GYNECOLOGIC MALIGNANCES IN PATIENTS 70 YEARS OF AGE AND OLDER

Accordingtothedatafromepidemiology,thein-cidenceofcancerrisessteadilywithadvancingage.Age?specificincidenceratesfromtheThirdNationalCancerSurveyoftheUnitedStatesrevealedthattheriskofcancerdevelopmentinthe6thdecadeoflifeisapproximately1%,whichincreasesto2%inthe81styearoflife(1).Theincidencesofmostgyneco-logiccancersincludingcervicalcancer,endometrialcancer,ovariancancerandvulvarcancerpeakaftertheageof60years(2-4).Surgeryisoneofthemaintreatmentoptionsforgynecologiccancerandmaybringaboutsomeeff…     

小儿急性肺损伤的短期肺功能随访

Objective To study the pulmonary functions of pediatric ALI/ARDS(acute lung injury/acute respiratory distress syndrome) survivors. Method A prospective cohort study of all survivors of ALI/ARDS in the PICU of Beijing Children's Hospital was performed. Patients were divided into three groups(0-3 years of age,3 ～ 7 years of age, and over 7 years of age) and followed up three months after diagnosis. Results There were 36 survivors in total of 44 ALl patients, three patients lost follow-up, 12 died and 21 survived. Five survivors refused to participate in the study because of asymptomatic, and one was unable to participate because of lymphoma com-bined with sepsis. A total of 15 children completed the whole survey (11 patients were less than 3 years old, andfour were over 7 years of age). Twelve patients had no discomfort in their respiratory tracts. Three months after be-ing enrolled, the pulmonary functions of all children improved, especially in terms of tidal volume and respiratory compliance (P<0.05). Conclusions The abnormal respiratory symptoms and signs in most children disap-peared three months after discharge. Most survivors still have pulmonary dysfunction at 3 monthes after discharge, but better than discharge.     

以人为本理念在全程护理服务中的实践

为了探索既符合中国国情又能满足病人需求的护理服务新模式，浙江省台州市中心医院自2002年开始试行全程护理服务。在实施护理中以病人为中心，从理念上、环境上、权益上、细节上为病人提供全面、全员、全程的人本服务；在管理实践中，提倡“尊、理、信、谐、通、创”六字理念，将管理视为服务，实行人本管理。通过3年的实践，整体护理质量、病人满意度、护士对工作满意度均有显著提高。