外科围手术期糖尿病的治疗

目的:探讨外科手术病人伴发糖尿病的治疗及围手术期处理。方法:对1998年至2000年收治的125例外科手术伴发糖尿病病例进行回顾总结。结果:93例给予补液、降糖等处理无1例死亡。其他32例未进行有效的降糖处理,死亡5例。结论:外科手术病人伴发糖尿病时,围手术期要控制血糖,可以降低手术并发症及死亡率。     

硝普钠结合控制性再灌注预防肺缺血再灌注损伤的实验研究

目的　探讨硝普钠结合控制性再灌注在预防肺缺血再灌注损伤中的作用及其机制。方法　将 1 4只猪随机分为对照组 (Ⅰ组 )和实验组 (Ⅱ组 )。对照组在去除肺动脉阻断 ,恢复自体血流前 ,给予控制性再灌注处理 (灌注液 :去白细胞∶改良Buckberg液 =4∶1 ,灌注压 1 8mmHg ,灌注时间 1 0min ,温度 37℃± 1℃ )。实验组在去除肺动脉阻断 ,恢复自体血流前 ,给予控制性再灌注 ,后经肺动脉以每分钟 1 .0 μg kg注入硝普钠 1 0min ,余处置同对照组。 0 .5 ,1和 2h后测血氧分压、肺血管阻力、肺顺应性及肺氧合功能变化 ,实验结束后 ,取肺组织测NO含量、MDA含量及肺含水量。结果　实验组的左肺氧合功能和肺顺应性明显好于对照组 (P <0 .0 5 )。肺循环阻力、丙二醛 (MDA)值及肺含水量均低于对照组 (P <0 .0 1 )。实验组肺中NO含量较对照组明显升高 (P <0 .0 1 )。结论　硝普钠结合控制性再灌注能明显降低肺缺血再灌注损伤 ,起到了较好的移植肺保护效果     

云南省中缅边境地区疟疾血清流行病学调查分析

目的 了解中缅边境一线县、二线县、及一线三个县的一线自然村、二线自然村的疟疾流行情况,为制定边境地区疟疾防治措施提供科学依据。方法 采用IFAT对中缅边境沧源、耿马及孟连一线县与双江县、永德县二线县,边境线3县一线自然村和二线自然村进行疟血清流行病学调查,用电脑软件EPI6X2检验法进行数据分析。结果一线县抗体阳性率23.88％（568/2379）,二线县抗体阳性率1.40％（10/712）,一线县显著高于二线县（x2=180.54;P<0.01）。一线县的一线自然村抗体阳性率33.05％（467/1413）,二线自然村抗体阳性率10.46％（101/966）,一线自然村显著高于二线自然村（x2=159.92;P<0.01）。结论IFAT抗体阳性率和阳性GMRT说明靠近边境地带比远离边境的地带疟疾流行更为严重。应加强出入境人员的防治工作,才能控制边境疟病流行。     

The ontogeny of 2-[125I]iodomelatonin binding sites in chicken brain.

The characteristics of the binding sites for 2-[125I]iodomelatonin were studied in chicken brain membranes during development. Specific binding, defined using cold melatonin (1 microM), was detected as early as 8-day-old embryos. Scatchard analysis of saturation experiments showed that 2-[125I]iodomelatonin binds to a single class of site at all ages tested (8-day-old embryos to 3-month-old chicks). Binding affinity (Kd) did not change during development (18-31 pM), but the maximal number of binding sites (Bmax) increased until embryonic day 18, and then remained relatively constant until 30 days of age. A further increase in Bmax was seen at 3 months of age. Guanosine 5'-triphosphate (GTP, 1 mM) inhibited 2-[125I]iodomelatonin binding at all ages suggesting that the melatonin binding site is coupled to a guanine nucleotide binding protein at a very early stage of development. Competition experiments with a number of melatonin analogues indicated that the binding site detected in the brain at embryonic day 8 was pharmacologically identical to that observed 15 days after hatching.     

A rare case of carpal tunnel syndrome due to tenosynovial osteochondroma

A rare case of carpal tunnel syndrome due to an extra-articular synovial osteochondroma arising from the synovial sheath of the flexor pollicis longus tendon, is described. This has not been described in the literature previously. The cyst with the contained osteochondroma was excised with good relief of symptoms. The histological examination of the osteochondroma revealed another interesting and unusual feature. We would like to document a case of tenosynovial chondrometaplasia of the synovial lining of a tendon sheath. Only a few such cases have been reported in the literature.     

45例正常人听觉诱发电位P50的分析

目的 利用诱发电位技术探讨正常人听觉P50特征.方法 应用美国Nicolet Bravo脑电生理仪,采用条件刺激(S1)-测试刺激(S2)模式对45名健康受试者作了听觉P50检测.结果 分析了基本波型,提出了Cz和Pz区域P50诸指标平均值.结论 听觉P50电位具有抑制性特征,其变化可反映大脑正常感觉门的功能状态.P50较佳表达式是波幅S1-S2和100(1-S2/S1)两种结合,能直接显示感觉门的程度.此正常值可供抑郁症研究时参考.     

Reversal of fulminant hepatic failure using an extracorporeal liver assist device.

Liver transplantation is currently the only effective therapy for patients with fulminant hepatic failure. The availability of an artificial liver could bridge these patients through the relatively brief crisis period and allow their own livers to regenerate, providing a more favorable outcome and sparing the trauma and expense of transplant. We have developed a device consisting of a highly differentiated human liver cell line cultured in a hollow fiber cartridge. This device is capable of supporting dogs with acetaminophen-induced fulminant hepatic failure for a period long enough for their own livers to resume function. Even though liver function tests such as albumin and prothrombin time became extremely abnormal during the course of the experiment, the dogs did not become encephalopathic. Two of the three treated animals recovered sufficient liver function after 42 to 48 hr of treatment that they could be disconnected from the device, and they survived the experiment. Histological results and serum ALT levels suggest that the device affected the course of the disease in two animals, allowing recovery of hepatocytes that would otherwise have lysed. In the third animal, regenerative nodules demonstrated that, even in the presence of severe liver injury, the device was capable of supporting total liver function.     

Bamboo joint-like appearance of stomach in Korean patients with Crohn's disease]

BACKGROUND/AIMS: Bamboo joint-like (BJL) appearance is an endoscopic finding characterized by swollen longitudinal folds transversed by erosive fissures or linear furrows on the lesser curvature side of gastric body and cardia. It has been reported to be associated with Crohn's disease (CD). This study was aimed to evaluate the incidence of BJL appearance in Korean patients with CD. METHODS: From January to December in 2005, we performed esophagogastroduodenoscopy (EGD) in patients diagnosed as CD and ulcerative colitis (UC) in our hospital. Non-inflammatory bowel disease (IBD) subjects with upper gastrointestinal symptoms who underwent EGD were consecutively enrolled during the same period. One endoscopist performed all the endoscopic examinations to avoid inter-observer variation. A dye-spraying technique with 0.4% indigocarmine was used to allow the detection of subtle changes during the endoscopic examination. RESULTS: A total of 21 patients with CD (mean age+/-SD, 40+/-15 yr; M/F, 13/8), 28 patients with UC (42+/-15 yr; 21/7), and 685 non-IBD subjects (49+/-14 yr; 354/331) were enrolled. EGD findings in CD patients were gastric erosions (11/21), chronic superficial gastritis (5/21), chronic atrophic gastritis (1/21), duodenal erosions or ulcers (2/21), and normal (2/21). Incidence of BJL appearance was significantly higher in patients with CD (47.6%, 10/21) than others (UC, 3.6%, 1/28; non-IBD, 0.1%, 1/685) (p< 0.0001). Among patients with CD, incidence of BJL appearance was not significantly different according to the sex, status of H. pylori infection, Vienna classification for phenotype, medications or EGD findings. CONCLUSIONS: BJL appearance on the gastric body and cardia can be a diagnostic clue to CD.     

异丙酚及氯胺酮靶控输注全静脉麻醉临床应用

目的　研究异丙酚复合不同镇痛剂量氯胺酮靶控输注全静脉麻醉临床应用的可行性及对血流动力学、麻醉恢复的影响。方法　择期手术患者 80例 ,分别采用异丙酚 (P组 ,n =16)及复合氯胺酮血药浓度 0 2 0mg/L(PK1组 ,n =16) ,0 40mg/L(PK2 组 ,n =16) ,0 60mg/L(PK3 组 ,n =16)和 0 80mg/L(PK4组 ,n =16)全静脉麻醉 ,采用微机控制Graseby 3 5 0 0输液泵靶控输注异丙酚或氯胺酮 ,连接Aspect-A10 0 0型脑电监护仪监测脑电变化 ,观察两组患者血流动力学改变及麻醉恢复情况。结果　单用异丙酚患者随着异丙酚血药浓度升高脑电双频指数 (BIS)值降低 ,呈明显负相关 (P <0 0 5 ) ,氯胺酮血药浓度从 0 2 0mg/L增至 0 80mg/L ,BIS值无明显变化 (P >0 0 5 )。与P组相比 ,PK1,PK2 ,PK3 ,PK4组异丙酚用量减少约 15 %～ 40 % ,PK4组停药至睁眼时间明显延长 ,其余各组无明显差异 (P >0 0 5 )。术中P ,PK1组收缩压、舒张压升高 ,PK2 ,PK3 ,PK4组无明显改变。术后无躁动、不良回忆等并发症。结论　异丙酚复合镇痛剂量的氯胺酮 (0 40～ 0 60mg/L)靶控输注全静脉麻醉具有血流动力学稳定、减少异丙酚用量、无明显术后并发症等优点。