279例耳闷胀感的病因分析

目的 探讨产生耳闷胀感的部位和原因。方法 收集耳闷胀感为主诉的279例362耳,对患耳的临床表现、鼓室导抗图、纯音测听和咽鼓管功能进行分析。结果 362耳中鼓室导抗图A型203耳、B型111耳、C型33耳以及鼓膜穿孔15耳。纯音测听表现为传导性聋、感音神经性聋、混合性聋以及正常者分别是83耳、8l耳、105耳和93耳。在362耳中,咽鼓管功能异常208耳,在A型鼓室导抗图203耳中,咽鼓管功能异常67耳。结论 产生耳闷胀感的病变部位包括外、中、内耳和面神经的病变,其中以分泌性中耳炎、各种原因引起的感音神经性聋和“咽鼓管狭窄症”为多。     

针刺与硬膜外腔复合麻醉用于胆囊切除术的临床研究

81例胆囊切除术分为 3组 : 组针刺与单纯硬膜外低浓度局麻药复合麻醉 ; 组单纯硬膜外低浓度局麻药麻醉 ; 组硬膜外常规浓度局麻药麻醉。临床观察麻醉效果 , 、 组进行同位素放射免疫测定进行比较研究 ,其结果显示针刺与硬膜外复合麻醉既减少麻醉药用量又对机体有调整作用 ,对手术刺激反应具有保护性抑制作用 ,使循环系统更稳定。     

荧光定量PCR与ELISA法检测HBV-DNA结果分析

目的 :应用荧光定量PCR方法精确检测HBV -DNA的拷贝数 ,为临床判断病毒复制程度提供指标 ;对比分析荧光定量PCR方法和ELISA方法检测HBV -DNA的结果。方法 :用荧光定量PCR法检测 10 14例用ELISA法诊断为乙型肝炎病人的血清HBV -DNA拷贝数。结果 :10 14例病人中 ,病毒拷贝数≥ 1× 10 5的 4 99例 ,阳性率4 9.2 % ;HBeAg阳性患者的HBV -DNA拷贝数≥ 1× 10 5的阳性率显著高于HBeAg阴性患者。结论 :荧光定量PCR检测HBV病毒复制情况结果准确 ,对临床工作指导意义更大 ;HBeAg是一项重要指标。     

实验性大鼠肺血栓栓塞血浆TXA2,PGI2的变化及意义

目的探讨实验性大鼠肺血栓栓塞血浆TXA2,PGI2浓度和TXA2,PGI2比值的变化及意义。方法健康Wistar大鼠60只,随机分为栓塞前组,栓塞1h,3h,5h,7h组,每组12只,栓塞组自颈外静脉注入自体血栓混悬液2ml建立肺血栓栓塞模型,栓塞前和注栓后1h,3h,5h,7h各时点收集动脉血,进行动脉血气分析和用放免法检测TXB2,6-Keto～PGF,n及TXA2,PGI2比值。结果组织病理符合肺血栓栓塞的改变;栓塞组注栓后PO2较栓塞前组比较差异显著（P〈0．01）;血浆TX＆3h达高峰值,6-Keto—PGF1a从基线逐渐上升至7h时点达高峰值,二者各时点与栓塞前比较差异有显著性（P〈0．01）,TXA2,PGI2比值失衡,1h时点达高峰值。结论建立大鼠自体肺栓塞模型成功;缩血管因子TXA2和TXA2,PGI2比值失衡在PTE的初始和早期病理生理过程中发挥重要作用。PGI2对PTE后期病理生理过程有重要影响。     

织纹螺麻痹性贝类毒素毒力测定

目的测定引起食物中毒的织纹螺麻痹性贝类毒素的毒力。方法根据出口贝类麻痹性贝类毒素检验方法,小白鼠下腹腔注射织纹螺麻痹性贝类肉质提取液,测定鼠单位(MU)。结果市场水产摊位采集的织纹螺毒力为100g肉中9300MU;食物中毒者家中食用剩余的织纹螺的毒力为100g肉中8370MU,而作为对照的血蛤螺的毒力<400 MU/100g肉。结论引起食物中毒的织纹螺的毒力是国际上规定的安全限值的20.9-23.3倍。     

MMP-2与TIMP-2在神经胶质瘤侵袭中的作用及其意义

目的分析MMP-2、TIMP-2的表达与神经胶质瘤恶性程度和侵袭性之间的关系。方法采用免疫组化S-P法,测定76例不同级别神经胶质瘤和10例正常脑组织中,MMP-2和TIMP-2蛋白表达。结果MMP-2蛋白表达水平与神经胶质瘤的恶性程度呈正相关系(P<0.01);在神经胶质瘤中MMP-2与TIMP-2蛋白表达水平之间呈明显的负相关系。结论MMP-2的表达与神经胶质瘤的恶性程度正相关系;MMP-2与TIMP-2之间的平衡失调与神经胶质瘤的恶性程度和侵袭性密切相关,两者之间协同作用在神经胶质瘤的侵袭中有重要的意义。     

Laparoscopic management of common bile duct stones

Background While laparoscopic cholecystectomy is widely accepted for therapy of cholecystolithiasis, controversy still exists concerning the management of common bile duct stones. Besides preoperative endoscopic papillotomy followed by laparoscopic cholecystectomy and open common bile duct surgery, management of common bile duct stones can be conducted by laparoscopy, if respective experience is available.Method During laparoscopic cholecystectomy a cholangiography via the cystic duct is routinely performed. If bile duct stones are detected they are retrieved via the cystic duct or via incision of the common bile duct by insertion of a Fogarty catheter or Dormia basket. Exclusion criteria against simultaneous laparoscopic management include suspicion of malignancy, severe pancreatitis, or cholangitis.Results From November 1991 to March 2002, 200 patients primarily underwent laparoscopic therapy of bile duct stones. Retrieval was performed via cystic duct and common bile duct incision in 115 and 85 cases, respectively. Complete removal was achieved in 91%; complication rate and mortality was 7% and 0.5%, respectively. During the same period primary endoscopic papillotomy was necessary in 40 patients because of the above contraindications.Conclusions When correct indications and surgical expertise are observed, simultaneous laparoscopic management of common bile duct stones represents a safe and minimally invasive alternative to a two-procedure approach.     

羟基磷灰石配合自体红骨髓移植修复骨缺损的临床初步应用

本文报告采用人工合成的羟基磷灰石配合自体红骨髓移植修复5例良性骨肿瘤引起的骨缺损。本法优点是材料来源广,使用便利、安全,无不良反应,手术创伤小,功能恢复良好。     

Diabetes distress,but not depressive symptoms,is associated with glycaemic control among Japanese patients with Type 2 diabetes: Diabetes Distress and Care Registry at Tenri (DDCRT 1)

Aims To investigate the association between glycaemic control, diabetes distress and depressive symptoms among Japanese patients with Type 2 diabetes. Methods Cross‐sectional data from 3305 patients with Type 2 diabetes were obtained from a baseline assessment of a diabetes registry at a general hospital in Japan. The Centre for Epidemiologic Studies Depression scale and Problem Areas in Diabetes scale were used to measure depressive symptoms and diabetes‐related distress, respectively. Modified Poisson regression analysis was used to estimate the relative risks for poor glycaemic control across the quartiles of Centre for Epidemiologic Studies Depression scale and Problem Areas in Diabetes scale scores. Results The average age of the participants was 64.9 years and the average HbA_1c level was 58.1 mmol/mol (7.5%). Clinically significant levels of depressive symptoms (Centre for Epidemiologic Studies Depression scale scores ≥ 16) were reported by 27.8% of participants. These scores significantly correlated with Problem Areas in Diabetes scale scores (r = 0.4354, P < 0.0001). Diabetes distress, but not depressive symptoms, was significantly associated with higher HbA_1c levels. The relative risks for poor glycaemic control (HbA_1c≥ 64 mmol/mol; 8.0%), when adjusted for age, sex, BMI, type of diabetes therapy and duration of diabetes, was 67% higher among patients with Problem Areas in Diabetes scale scores in the highest quartile (≥ 26.25) compared with those in the lowest quartile (0–3.75). Conclusion A significant association between glycaemic control and diabetes‐related distress, but not depressive symptoms, was observed in Japanese patients with Type 2 diabetes.