关于Reed－Frost模型的研究和改进

笔者提出了对Ｒｅｅｄ－Ｆｒｏｓｔ模型的学术评论，并新建了一种Ｒｅｅｄ－Ｆｒｏｓｔ模型的改进模型。该改进模型全面考虑了隐性感染者的产生、传染作用及向免疫者的转化。应用这个模型，模拟了ＮｅｗＥｎｇｌａｎｄ的麻疹流行和中国上海市某保育院的水痘流行，结果颇为理想。该模型包括了基本的流行要因，故能用以解释流行过程，并可帮助流行病学工作者理解隐性感染在传染病流行过程中的作用。     

Serotonergic projections from the midbrain periaqueductal gray and nucleus raphe dorsalis to the nucleus parafasccicularis of the thalamus

By a double-labeling method combining the retrograde tracing of horseradish peroxidase and the immunocytochemical technique, serotonin-like immunoreactive neurons in the midbrain periaqueductal gray (PAG) and nucleus raphe dorsalis (DR) of the rat were observed to send projection fibers to the nucleus parafascicularis of the thalamus bilaterally with an ipsilateral dominance. These serotonin-containing projecting neurons were observed mainly at the middle-caudal levels of the ventrolateral subdivision of the PAG and less at the middle-rostral levels of the DR.     

孤立性左肝胆管结石并肝管狭窄的外科治疗

目的总结近２０年来孤立性左肝胆管结石并发左肝胆管狭窄的临床治疗体会．方法原发性肝胆管结石１０１８例，年龄２７～７２岁，其中孤立性左肝胆管结石１３３例，手术治疗１１２例，对其临床资料进行回顾性分析，包括各肝管狭窄并发率，术前各项检查确诊率，手术治疗方式，再狭窄率．结果左肝管狭窄的发生率为５９８％，左外肝管和左内肝管分别为８４０％和８４８％，均以重度狭窄为主．狭窄切开整形后高位胆肠吻合术是处理左肝管狭窄的常用手术方式（５２２％），远期再狭窄率为１７１％；左半肝切除术施实率为１９４％，再狭窄率为００％；狭窄整形术和狭窄扩张术的施实率分别为９０％和１９４％，再狭窄率分别为５００％和９２３％．左外肝管狭窄通常采用肝段或肝叶切除术（７８７％），而左内肝管狭窄的处理则通常采用非左半肝切除术（８４８％）．左内肝管狭窄的术前／后影像学确诊率明显低于左肝管和左外肝管，平均确诊率依次２５９％，９３３％和８７９％．结论二级肝管狭窄是孤立性左肝管结石的常见并发症，肝叶或肝段切除术是其首选治疗原则．过多依赖非肝叶／段切除术和不适当的肝段切除术是遗留狭窄和远期疗效差的重要原因     

SPECT监测移植肾功能

利用单光子发射型计算机断层显象仪监测移植肾功能２５例，计３４例次。观察表明，在肾移植早期，ＳＰＥＣＴ有利于鉴别少层原因，避免冒然切除移植肾；肾移植后期，如有肾功能减退，肾小球滤过率的降低较肌酐升高更敏感，更准确，故ＳＰＥＣＴ监测是了解肾功能及判断预后的最佳方法之一。     

成骨细胞异种移植的免疫观察

目的 探讨异种成骨细胞移植及组织工程骨构建的可能性。方法 用二步酶消化—组织块联合接种法行SD大鼠骨细胞原代培养，传代后用碱性磷酸酶(ALP)染色法进行细胞鉴定；再将28只大耳白兔分为3组：自体移植组(A组)、异种移植组(B组)、正常对照组(C组)，分别于腹直肌袋内注入自体软骨细胞悬液、SD大鼠成骨细胞及生理盐水，于1、2、4及8周行免疫学及组织形态学检测。结果 细胞原代接种后5天成单层，经鉴定为成骨细胞；实验兔各组移植后受体无明显全身及局部排异反应；B组移植后2、4周检测到特异性抗体，2周检测到细胞介导的细胞毒反应，4周达高峰，8周开始减退，HE染色见大量炎性细胞浸润，至8周无明显异位成骨现象。A、C两组移植后末见明显体液及细胞免疫反应。结论 单纯异种成骨细胞不能作为细胞移植及组织工程骨构建的可靠细胞来源。     

亚胺培南/西司他丁与头孢他啶治疗中、重度细菌感染疗效费用分析比较研究

对我院４５例确诊为中、重度细菌感染住院患者进行了亚胺培南／西司他丁与头孢他啶疗效费用分析比较研究。结果表明：２组病例有效率、死亡率无显著性差异；头孢他啶组较亚胺培南／西司他丁组疗程明显延长。亚胺培南／西司他丁每日所需费用明显高于头孢他啶；治疗结束时，前者全部费用并未超过后者；全部住院费用无明显差异。作者认为：决定２种药物全部费用的因素，除与药物单价和每日费用有关，还与药物疗程密切相关。选用药物抗菌作用越强，用药时间即相应缩短，住院时间必然缩短；最终患者住院费用降低     

The use of 6-flavor Rehmannia decoction with additives in the prevention of ototoxic deafness induced by gentamicin in guinea pigs]

The purpose of this study is to discuss the effects of the Chinese medicine six-flavor Rehmannia Decoction with additives on preventing deafness induced by gentamicin (GM) in guinea pig by means of testing the thresholds of Preyer's reflex (PR) cochlear microphonic potential (CM), action potential of the auditory nerve (N1) and scanning electron microscope of inner ear (SEM). The results showed that the medicine is effective in reducing the ototoxic effect of GM on inner ear.     

神经生长因子几丁质管修复兔面神经缺损

目的：评价神经生长因子(nerve growth factor，NGF)几丁质管在修复兔面神经缺损中的作用。方法：在16只新西兰兔的两侧面神经上颊支上分别造成8mm缺损，左侧用管腔内注入NGF的几丁质管修复，右侧用自体神经移植修复作对照。术后8周和16周分别取8只动物进行电生理和组织学检查及计算机图像分析。结果：术后8周，实验组的再生神经已通过近远中吻合口，神经纤维密集成束；术后16周，再生神经纤维的数量增加，神经纤维束增粗，形态接近于正常神经。电生理检测和图像分析显示实验组和对照组的神经传导速度和有髓神经轴突总截面积均无显著差异(P＞0．05)。结论：NGF几丁质管可为免面神经缺损提供良好的修复环境。     

Teriparatide increases bone formation in modeling and remodeling osteons and enhances IGF-II immunoreactivity in postmenopausal women with osteoporosis.

Transiliac bone biopsies were obtained from 55 women treated with teriparatide or placebo for 12-24 months. We report direct evidence that modeling bone formation at quiescent surfaces was present only in teriparatide-treated patients and bone formation at remodeling sites was higher with teriparatide than placebo. INTRODUCTION: Recombinant teriparatide [human PTH(1-34)], a bone formation agent for the treatment of osteoporosis when given once daily subcutaneously, increases biochemical markers of bone turnover and activation frequency in histomorphometry studies. MATERIALS AND METHODS: We studied the mechanisms underlying this bone-forming action of teriparatide at the basic multicellular unit by the appearance of cement lines, a method used to directly classify surfaces as modeling or remodeling osteons, and by the immunolocalization of IGF-I and IGF-II. Transiliac bone biopsies were obtained from 55 postmenopausal women treated with teriparatide 20 or 40 microg or placebo for 12-24 months (median, 19.8 months) in the Fracture Prevention Trial. RESULTS: A dose-dependent relationship was observed in modeling and mixed remodeling/modeling trabecular hemiosteons. Trabecular and endosteal hemiosteon mean wall thicknesses were significantly higher in both teriparatide groups than in placebo. There was a dose-dependent relationship in IGF-II immunoreactive staining at all bone envelopes studied. The greater local IGF-II presence after treatment with teriparatide may play a key role in stimulating bone formation. CONCLUSIONS: Direct evidence is presented that 12-24 months of teriparatide treatment induced modeling bone formation at quiescent surfaces and resulted in greater bone formation at remodeling sites, relative to placebo.     

脑血管造影及血管内治疗的全程护理

目的 探讨脑血管造影及血管内治疗的护理配合经验.方法 对34例病人脑血管造影35例次,血管内治疗17例次,进行全程护理.结果 术中发生脑血管痉挛2例,术后穿刺点出血1例,经及时处理均痊愈出院.结论 护理配合是脑血管造影及血管内治疗的重要组成部分,正确的护理方法能有效地防止并发症的发生.