药线灸治疗头痛的临床体会

用多种中药制作成药线灸条，以直接灸的方式灸灼穴位来治疗头痛，尤其是对属阴，寒，虚证的难治性，顽固性头痛，疗交好，见效快，简便易行。     

36例负压刀肝切除的术后护理

为了减少肝脏手术的出血和尽量保留非病灶的肝组织,我院与成都济民医用设备有限公司合作,研制了专用于切肝的负压刀,现将负压刀切肝术围手术期的护理体会总结如下。     

40例阵发性心房颤动的昼夜分布节律

心房颤动 (ＡＦ)为常见的心律失常。阵发性ＡＦ为持续性ＡＦ的前驱表现 ,可持续数分钟至数周。此类房颤对无器质性心脏病患者的病死率无影响 ,但可增加冠状动脉硬化性心脏及瓣膜病患者的病死率。急性心血管病事件的发生存在 2 4ｈ节律变化已被确认 ,但对阵发性房颤是否存在节律性变化尚很少报道。如果能发现阵发性ＡＦ的发生规律 ,对其药物预防和复律治疗将起到一定的作用。本文将孤立性阵发性ＡＦ住院患者 40例报告如下。1　资料和方法1.1一般资料　 1996年 4月— 1999年 8月共收治有 2 4ｈ动态心电图记录和心电监护的孤立性阵发性ＡＦ患者…     

交感神经皮肤反应检测对前庭系统性眩晕的评定价值

目的 探讨交感神经皮肤反应(SSR)对不同病因所致前庭系统性眩晕的临床评定价值.方法 将120例急性前庭系统性眩晕患者分为中枢性眩晕组70例和周围性眩晕组50例,分别行SSR检测评定,并与60名健康人(正常对照组)作对照.结果 中枢性眩晕组在急性发作期SSR潜伏期延长、波幅降低,SSR总异常率为87.1%(61/70),与周围性眩晕组及正常对照组比较,差异有统计学意义(P＜0.05);周围性眩晕组SSR总异常率为18.0%(9/50),潜伏期和波幅改变与正常对照组比较,差异无统计学意义(P＞0.05).结论 前庭中枢性眩晕患者在急性发作期可出现交感神经系统功能损害,SSR检测评定可作为临床鉴别前庭中枢性眩晕和周围性眩晕的重要参考指标之一.     

成人卵巢原发Wilms瘤合并畸胎瘤成分1例并文献复习

目的 探讨成人卵巢原发Wilms瘤合并畸胎瘤成分的临床病理学特征、诊断、鉴别诊断。方法 观察成人卵巢原发Wilms瘤合并畸胎瘤成分的临床特点,采用免疫组化EnVision两步法检测WT1、PAX8、CKpan、desmin、S-100、Ki-67等的表达,分析Wilms瘤及畸胎瘤成分治疗的敏感性,并复习相关文献。结果 患者右侧卵巢大小8 cm×8 cm×7 cm,包膜较脆伴破裂。肿瘤由胚芽、上皮及间叶3种成分组成,以未分化胚芽为主,见幼稚小管及分化型腺管,局灶间质呈横纹肌形态。胚芽成分强表达WT1,而分化型上皮和间质成分均不表达。上皮表达CKpan及PAX8,横纹肌分化细胞表达desmin,软骨成分表达S-100。胚芽成分Ki-67增殖指数约60%。患者术后6、9、12个月CT示盆腹腔多发结节,右下腹壁和脐旁结节。病理诊断为转移性Wilms瘤,以胚芽成分为主;术后辅以化疗(顺铂+依托泊苷+博来霉素,长春新碱+更生霉素+环磷酰胺)。结论 成人卵巢原发Wilms瘤发生率极低,合并畸胎瘤成分的病例诊断具有复杂性及挑战性,需明确各成分占比,指导临床精准治疗。     

Children's dental fluorosis and estrogen receptor α gene Xba I polymorphism

Objectives To explore the relationship between polymorphism in estrogen receptor alpha (ERα)gene Xba I and child dental fluorosis.Methods Qiulou township of Kaifeng and Sunying township of Tongxu counties of Henan province were chosen as the investigation spots in 2006.An area of water drinking endemic fluorosis(high fluoride area)and a non-endemic area(control area)were chosen in every spot,where dental fluorosis of children aged 8 to 12 years old were examined and diagnosed by using the Dean method.The children in the high fluoride areas were divided into dental fluorosis group and control group of the endemic areas according to dental fluorosis status,and the children in the control areas as control gruop of non-endemic areas.The Xba I polymorphism in the ERα gene was genotyped using the PCR-RFLP procedure.The fluoride levels in the urine samples from the three groups were detected by fluoride ion selective electrode and over standard rate of the urine was counted.Results The prevalence rate of dental fluorosis in high fluoride areas was 51.7%(74/143)and the community fluorosis index was 1.310.No dental fluorosis case was checked out in the control and the community fluorosis index was 0.021.The over standard rate of urine fluoride in dental fluorosis group[84.6%(121/143)]was significantly higher than that of control in non-endemic area[9.6%(9/94);χ2=125.95,P<0.01].The frequency distribution of ERα Xba I genotype was XX 6.8%(5/74),xx 36.5%(27/74),xx 56.8%(42/74)in dental fluorosis group;XX 15.9%(11/69),Xx 37.7%(26/69),xx 46.4%(32/69)in the eontrol of the endemic areas;XX 14.9%(14/94),Xx 43.6%(41/94),xx 41.5%(39/94)in children from the control in non-endemic area,respectively.No significant difference was found among the three groups(χ2= 3.450, P > 0.05). Allele frequency of ERα Xba I genotypes was X 22.7%(30/132), x 77.3%(102/132) in dental fluorosis group and X 35.5%(39/110),x 64.5% (71/110) in the control in endemic area when urine fluorosis of children was exceeding standard and significant difference was found in this two groups(χ2 = 4.768, P < 0.05; OR = 0.535,95% CI:0.305 - 0.941). Conclusion Children who carried X allele frequency of ERα Xba I genotypes have a lower risk of dental fluorosis when children with high-loaded fluoride status.     

黄泛区浅层地下水中砷氟含量及相关性研究

近5年来,国家对饮水型地方性砷中毒的防治力度不断加大。从河南省筛查情况来看,筛查出来的高砷水源多分布在黄河故道,黄泛区与黄河故道居民的取水方式及水埋深相似,且与高氟区有重叠,故选择黄泛区杞县作为研究对象。     

药物对临床诊断的干扰及其对策

临床对疾病的诊断往往通过询问病史、体格检查、实验室检查和器械检查来分析判定,但其检查结果的准确性对疾病诊断的正确性有着十分重要的意义,没有正确的诊断,就没有正确的治疗,也无法准确的进行疗效观察与不良反应监测。为使诊断结果更客观、真实、可靠,必须排除药物对临床诊断的干扰,这既是药物治疗临床思维的要点内容,也是临床合理用药的重要部分。     

河南省农村饮水氟含量调查结果分析

目的:掌握河南省高氟饮水暴露人群分布情况,为实施改水降氟防治措施提供可靠依据。方法:在全省农村,采集每个自然村饮水水源水样,集中供水采集2份水样,分散供水采集3份水样,测定水氟含量,以水氟平均值代表自然村饮水氟含量。结果:共调查水源453701个,覆盖全省158个县(市、区)、174425个自然村;水氟含量≤1.0mg/L的自然村154017个,占调查自然村的88.30%(154017/174425);水氟含量>1.0mg/L的自然村20408个,占调查自然村的11.70%(20408/174425)。其中,水氟1.1～2.0mg/L、2.1～4.0mg/L、≥4.1mg/L的自然村分别占被调查村的8.00%(13949/174425)、3.44%(6007/174425)和0.26%(452/174425);高氟饮水人群分布在17个省辖市的122县(市、区),覆盖人口1240.9万人,占全省农业人口的19.2%;河南省东部、东南部和东北部的商丘、周口、开封和濮阳4个相邻的省辖市,水氟>1.0mg/L村数、水氟>2.0mg/L村数在全省相应的构成比分别为74.92%(15289/20408)、和87.60%(5658/6459)。结论:河南省高氟饮水人群分布范围广,仍是我国受高氟危害最为严重的省份之一;河南省农村水氟超标水源以轻度超标为主;饮水高氟暴露人群主要分布在河南省东部、东南部和东北部大范围的黄河冲击平原。