内镜下套扎与硬化夹心联合法治疗食管静脉曲张出血的研究

目的　了解套扎与硬化夹心联合法 (套扎 硬化 套扎 )能否获得优于单纯内镜下食管静脉曲张结扎 (EVL)的疗效。方法　对 98例肝硬化食管静脉曲张伴活动性出血或近期出血的患者随机采用单纯EVL或夹心法治疗 (EVL组 5 0例 ,夹心法组 4 8例 )。EVL组每条曲张静脉结扎皮圈不超过 3个 ,夹心法组每条曲张静脉结扎 2个皮圈 ,并在两个结扎点之间的曲张静脉内注射 1～ 3ml硬化剂。夹心法组 7例在首次内镜治疗时接受食管静脉造影检查。 7～ 10d重复 1次内镜治疗 ,直至静脉曲张消除。结果　 7例行静脉造影检查 ,其中 6例硬化剂在曲张静脉内滞留时间超过 4 5min。两种方法控制活动性食管静脉曲张出血 (EVB)的止血成功率相同 (10 0 .0 % ) ;两组间静脉曲张消除率相似 (夹心法组 93.8% ,EVL组 90 .2 % ,P >0 .0 5 ) ,但夹心法组一次治疗后静脉曲张消除率明显高于EVL组 (6 6 .7%比10 .0 % ,P <0 .0 0 1) ,达到消除的平均治疗次数明显减少 (1.2± 0 .4比 3.8± 1.5 ,P <0 .0 1) ,所需时间显著缩短 [(13.1± 4 .3)d比 (42 .5± 16 .7)d ,P <0 .0 1];与EVL组相比 ,夹心法组再出血率较低 (8.3%比2 8.0 % ,P <0 .0 5 ) ,随访期内静脉曲张复发率明显下降 (8.3%比 4 4 .0 % ,P <0 .0 0 5 ) ;两组间并发症发生率相似 (夹心法组 1     

骨盆骨折合并阴道损伤（附5例报告）

报告5例女性骨盆骨折合并阴道损伤，占骨盆骨折41例中的12.2%,均为交通事故伤，都合并有失血性休克，开放伤3例，闭合伤2例，治疗作阴道修补术2例，用碘仿纱条填塞阴道2例。未作处理1例，均治愈，阴道损伤表现为四型；横行撕裂伤，纵行撕裂伤，斜行撕裂伤和刺伤，强调早期诊断，及时治疗以防止合并症。     

胃镜检查与幽门螺杆菌感染关系的初步探讨

本文用前瞻性连续检测方法，对２６９例患者作胃粘膜ＨＰ检测，且同步对消毒前后的胃镜、有关器械和操作者手套采样，作ＨＰ检测。结果发现，消毒前镜端（含弯曲部）、活检钳、清洁刷、器械管道插口和操作者手套采样标本的ＨＰ阳性率分别达６９．５１％、７３．６０％、８１．６２％、８７．７３％和９７．７２％。目前常规的清洗消毒虽能清除ＨＰ对胃镜的大部分污染，但还存在一些易忽视的环节，这可能在检查中引起医源性感染，应予高度重视。     

尼莫地平控制性降压对犬血流动力学的影响

在健康杂种犬10只中,分别以15、30、45μg/kg 尼莫地平静注行控制性降压,监测平均动脉压和其它血流动力学指标。结果表明,15μg/kg、30μg/kg 和 45μg/kg 静注后,平均动脉压1min 时分别下降19.44％、29.93％和33.60％,45min 恢复对照水平。降压期间除心输出量指数、每搏量指数和总外周阻力指数外,其它各项指标无显著性改变。因此,我们认为尼莫地平可试用于临床控制性降压,其效果有待临床进一步观察。     

DNA限制性内切酶分析应用于伴放线放线杆菌的鉴定和分型

本文用限制性内切酶分析(REA)作伴放线放线杆菌(Aa)的鉴定和分型研究,提取Aa染色体DNA,井分别用BamHI、HindⅢ,Sal Ⅰ和Xho Ⅰ消化,作琼脂糖凝胶电泳。结果显示,Aa和嗜沫嗜血杆菌的DNA片段图谱明显不同;分属于两种不同血清型的两株Aa菌株,其DNA片段图谱也明显不同。这表明,REA可用于Aa菌的鉴定和分型,在所用的4种酶中,以Sal Ⅰ和Xho Ⅰ消化的DNA片段图谱差异最明显。     

Arterial effects of salt restriction in hypertensive patients. A 9-week, randomized, double-blind, crossover study.

OBJECTIVE: To investigate the hemodynamic effects of a moderately low-salt diet in a 9-week, randomized, double-blind, crossover study in 20 hypertensive, ambulatory patients. METHODS: All subjects followed a 9-week, low-salt diet. During this period, they received capsules containing either lactose or salt in 4-week treatment periods, separated by a 1-week washout period. Hemodynamic and biological parameters were evaluated on the day of randomization and at the end of weeks 4 and 9. We defined a low-sodium diet (LSD) as a salt-restriction period with lactose capsules, and a normal-sodium diet (NSD) as a salt-restriction period with capsular salt supplementation. RESULTS: Blood pressure was significantly lower during LSD compared with NSD. This fall in blood pressure was associated with a decrease in peripheral resistance in carotid and forearm circulation. Brachial artery diameter was larger during LSD whereas carotid artery diameter remained unchanged. The changes in brachial artery were: (1) not related to blood pressure changes; (2) positively related to age, and (3) negatively correlated with baseline intracellular sodium content. CONCLUSIONS: These results suggest that moderate low-salt restriction is capable of decreasing blood pressure and peripheral resistance in carotid and forearm circulation. The increase in brachial, but not carotid, artery diameter following salt restriction suggests a difference in salt dependence among different arteries.     

寰椎变异的观测 Ⅰ.中国人寰椎后桥和侧桥的观测

本文对300个寰椎的后桥和侧桥的存在情况作了观察。其中129个寰椎(43.0％)有后部分桥,22个寰椎(7.3％)有后完整桥;34个寰椎有侧部分桥(11.3％),16个寰椎(5.3％)有侧完整桥。经统计学检验,在左右侧后完整桥及左右侧侧完整桥间均无显著性差异。对寰椎横突孔、后弧孔及侧弧孔内径的测量显示,绝大部分后弧孔(92.0％)较同侧横突孔小,且右横突孔与右后弧孔间存在高度显著性差异(P<0.01)。此外,还测量了两种完整骨桥的宽度,探讨了狭小后弧孔对正常椎动脉机能的可能影响,分析了文献中关于寰椎桥的起源。     

儿科用药的一些新观念

1背景资料自从1928年弗来明发明了青霉素,治愈了千百万各种细菌性感染的病人,使人类社会欣喜若狂,然而随着这个代表医学界里程碑式革命的发明的延续,以及随后产生的各式各样抗生素,而且品种规格愈来愈高级,每年要耗费数百亿美元,使应用抗生素成了许多医生第一本领,很难想象离开了抗生素,医生将如何工作。应用抗生素已有50多年历史,其结果是带来人菌大战,新的抗生素不断产生,细菌为了求生存对抗生素产生了耐药性,这种耐药性可以质粒遗传给细菌后代。细菌产生耐药性的速度是惊人的,有时超过抗生素的发展。人菌大战胜者是谁,尚难定论。抗生素的…     

大鼠摄入铝,氟及其不同比例混合物后血和骨中铝氟含量分析

Wistar rats were divided into 8 groups:control, 300 ppm F, 130 ppm F, 300 ppm Al, 1200 ppm Al, 130 ppm Al + 130 ppm F. 300 ppm Al + 300 ppm F and 1200 ppm Al + 300 ppm F. The chemicals were mixed into the standard diet. The animals were fed on the diets for 12 weeks. Contents of F, Al, Ca and P in the blood (or serum) and humerus were determined at the end of 12 weeks. The results showed that the level of F in the blood and bone in the unadulterated F group was increased, especially F in the bone reached a level more than 10 times that of the control. In the 3 mixture groups, blood F and bone F were lowered, while blood F was restored to normal level, but bone F was not nevertheless, the results showed that Al was in antagonism to the absorption of F. In the unadulterated Al groups, blood and bone Al did not parallel with the amount of Al administered. The level of Al in the median Al group was higher than that of the high Al group. Taking the level of blood and bone Al as a measure, when different doses of Al were administered with F, in the low and median dosage of Al, F was in antagonism to Al absorption, but in case of high dosage of Al, F was in potentiation to Al absorption. In all the experimental groups serum P was elevated, but serum Ca was not disturbed. Bone Ca and P were decreased only in the 3 groups with unadulterated F as well as unadulterated and adulterated high dosage of Al. Mechanism of the nonlinearity of Al absorption vs Al dosage, as well as the dual effect of F on the absorption of Al was proposed.