再生医学技术在烧伤传统治疗无效病人中的应用(附38例报告)

目的：总结重度烧伤传统疗法无效改为再生医学(MEBT/MEB0)技术治疗变化规律和临床验．方法：将我科l995年5月至2002年5月收治的院外采用传统疗法无效改用MEBT/MEBO技术治疗的38例重度烧伤病人临床资料进行回顾性总结，病人一旦入院创面均改用MEBT/MEBO治疗，初始予以彻底清创，规范用药、规范操作，规范认识；全身实行系统综合治疗措施．以临床观察和病人感觉评价治疗效果。结果：本组38例全部治愈，末植皮自行愈合者21例．占55.26％．深Ⅲ度创面自愿要求植皮者17例，占44.74％。经随访多数无增生性瘢痕，部分愈后有局限性瘢癌，质软无残废。结论：重度烧伤经传统疗法久治不愈或疗效欠佳病人．病情复杂，并发症较多治疗难度也较大，再生医学可有效改善以上缺陷和病症．是重度烧伤病人传统治疗无效时的理想疗法。     

白芥子散穴位贴药治疗哮喘经验

目的:观察穴位贴药治疗哮喘发作状态及远期疗效.方法:用纯中药白芥子散配六神丸和生姜汁贴敷于定喘穴(双)、肺俞穴(双)、膏肓穴(双)、膻中穴,在每年三伏天和三九天外贴.结果:临床50例哮喘患者治疗1个疗程,治愈率达98.90%,较纯西药治疗效果明显提高.结论:说明该药具有明显的止咳平喘、固本益气功效,达到了冬病夏治的目的.     

妊高征孕妇压力反射功能的改变

目的研究妊高征孕妇心率变异性(HRV)、血压变异性(BPV)和压力反射敏感性(BRS)的改变.方法用无创伤测定和频谱分析方法,检测31名正常妊娠孕妇和19名中、重度妊高征孕妇的HRV、BPV和自发性BRS,数据用SPSS 10.0软件分析.结果妊高征组和正常妊娠组相比,HRV各指标有下降趋势,但无统计学意义(P>0.05).妊高征孕妇BPV的低频成分显著高于正常妊娠孕妇(P<0.05),BRS较正常妊娠孕妇降低(P<0.05).结论妊高征孕妇交感神经对血压调节的活动性较正常妊娠孕妇增强;压力反射功能受损可能是妊高征发病过程中一重要环节.     

前列腺素E1对大鼠肝脏缺血再灌注损伤的保护作用

目的 探讨前列腺素E1（PGE1）对肝脏 因再灌注损伤的保护作用。方法 制作常温下大鼠部分肝叶缺血再灌注模型，于缺血前经门静脉给予PGE1，45min后恢复血流灌注，并于1h后取门静脉血测定血清谷草转氨酶（GOT）、谷丙转氨酶（GPT）、乳酸脱氢酶（LDH）、肿瘤坏死因子－α（TNF－α）及内皮素1（ET－1），同时取缺血肝叶行病理组织学检查。结果 缺血再灌注组GOT、GPT、LDH及TNF－α和ET－1均明显高于正常对照组，PGE1组则明显低于缺血再灌注组。PGE1组的肝脏病理组织学改变明显轻于缺血再灌注组，并接近正常对照组。结论 PGE1对肝缺血再灌注具有保护作用。     

MRI顺磁性造影剂增强及护理

目的 :进一步探讨 MRI增强前后的准备与护理方法。材料与方法 :共增强 833例 ,男 5 85例 ,女 2 4 8例。使用顺磁性造影剂 Gd- DTPA,按 0 .2 m L/kg体重给药。其中双倍量增强 110例 ,增强前认真履行告知义务和签署同意书。发生造影剂外漏者给予鲜马铃薯片外敷。结果 :增强效果达良好以上共 82 5例 ,占 99% ,未发生严重负反应。 3例造影剂外漏 ,鲜马铃薯片外敷后 3h痊愈。结论 :增强前充分细致的准备是保证增强效果的重要因素。认真履行告知义务和签置同意书 ,不仅尊重了病人的权利 ,也是依法行医 ,保证医疗安全的需要     

BIOEQUIVALENCE BETWEEN rhGH FOR RECONSTITUTION AND READY-TO-USE rhGH IN TWO LIQUID FORMULATIONS

Objective To evaluate the bioequivalence between recombinant human growth hormone （rhGH） for reconstitution, and two dosages of liquid formulation of rhGH [ （151U） 5mg or （301U） lOmg per 3ml ]. Methods The study drugs were tested in a randomized, single-blind and three-period crossover studies in 24 healthy male subjects. The three drugs were administered by subcutaneous injection at a dose of O. 21U/kg body weight. A continuous somatostatin infusion was given in order to suppress the secretion of endogenous GH. The ve- nous blood samples were drawn at different time points to test the serum concentration of GH. The pharmacokinetic parameters were analyzed by statistical methods. Results 90% confidence intervals （CI） of AUC0-24h among three products were all within 80% - 125% interval （ 103. 4% - 116. 5%, 105. 7% - 119. 6% and 91.9% - 103. 7%, respectively）, and the Cls of C,~ among three products were all within 70% - 143% interval （91.9% - 114. 0%, 103. 7% -127. 2% and 81.6% -97. 4%, respectively）. There was no statisitical difference of tmax among all the three products. Conclusion These data demonstrate that there is bioequivalence between rhGH for reconstitution and two liquid formulations of rhGH.     

骨盆骨折合并出血性休克的救治

目的探讨骨盆骨折合并出血性休克的救治方法。方法回顾性分析2001年1月-2006年2月收治的85例骨盆骨折合并出血性休克患者的临床资料,根据AIS-ISS创伤评级标准评定伤情。结果本组患者ISS评分均大于16分,平均(33．3±15．5)分,成活60例,死亡25例,抢救成功率70．6％。结论骨盆骨折合并出血性休克的死亡率较高,死亡患者大部分发生在急诊抢救过程中,早期应用合理的抢救措施是降低死亡率的关键。     

Developmental changes of glutamate acid decarboxylase 67 in mouse brain after hypoxia ischemia

Objective To study the developmental changes of glutamic acid decarboxylase-67 (GAD-67, a GABA synthetic enzyme) in normal and hypoxic ischemic (HI) brain. Methods C57/BL6 mice on postnatal day (P) 5, 9, 21 and 60, corresponding developmentally to premature, term, juvenile and adult human brain were investigated by using both Western blot and immunohistochemistry methods either in normal condition or after hypoxic ischemic insult. Results The immunoreactivity of GAD67 was up regulated with brain development and significant difference was seen between mature (P21, P60) and immature (P5, P9) brain. GAD67 immunoreactivity decreased in the ipsilateral hemisphere in all the ages after hypoxia ischemia (HI) insult, but, significant decrease was only seen in the immature brain. Double labeling of GAD67 and cell death marker, TUNEL, in the cortex at 8h post-HI in the P9 mice showed that (15.6±7.0)% TUNEL positive cells were GAD67 positive which was higher than that of P60 mice. Conclusion These data suggest that GABAergic neurons in immature brain were more vulnerable to HI insult than that of mature brain.     

做好当前临床外科教学工作的思考

应从提高教师队伍素质、提倡主动式教学、专科教育、指导学生处理好医患关系、提高法律意识和自我保护意识、制定统一的教学内容和目标等方面，做好临床教学工作。