瓜蒌薤白类方与心血管系统相关的研究概况

根据近15年来有关瓜蒌薤白类方的研究文献,综述了瓜蒌薤白类方在冠心病、心绞痛、急性心肌梗塞、心律失常等心血管疾病的临床应用及相关机理研究。     

RNA干扰PPO基因抑制卵巢癌细胞生长

目的：本研究利用RNA干扰PPO基因，探索癌症的治疗的新途径。方法：利用RNA干扰技术分别从细胞水平及活体水平干扰PPO基因，用定量PCR检测PPO基因的表达量。用蛋白印迹杂交检测细胞增殖和磷酸化指标。结果：从细胞水平到活体水平均证实，利用RNA干扰PPO基因能使PCNA的表达量减少，ERK2和MEK1／2磷酸化蛋白减少，能够抑制卵巢癌细胞的生长。结论：利用RNA干扰PPO基因，从反面证实PPO与增殖和磷酸化有关，并且从细胞水平到活体水平，均证实能够抑制卵巢癌细胞的生长。     

ECG在再灌注疗效评价中的价值

判断再灌注治疗效果最直接、准确的方法是冠状动脉造影,在进行急诊冠脉介入治疗时,通过冠状动脉造影可直接观察出再灌注治疗的效果。然而,冠状动脉造影需要一定的条件,目前在很多基层医院尚无法开展。心电图检查有简单、方便、可多次重复等优点,是目前判断静脉药物溶栓效果的重     

肩胛骨骨巨细胞瘤1例

1临床资料患者男,41岁,右肩胛部肿块半年,伴隐痛3天来诊。查体见右肩胛下部稍隆起,质硬,无波动感,无红、肿、热。X线检查示(图1):右肩胛骨下部偏外侧缘处可见一大小约5cm×4cm膨胀性囊样骨破坏,偏心性生长,病灶内可见骨性分隔,呈特征性“肥皂泡”样改变,周围可见完整的骨壳,未见骨膜反应及软组织肿块影。X线诊断:右肩胛骨骨巨细胞瘤。予硬膜外麻醉下行肿瘤切除术,术中见右肩胛骨外下部5cm×4cm肿物,质硬,不易剥离,予肿物整块挖除。病理检查诊断:骨巨细胞瘤。2讨论骨巨细胞瘤是一种好发于青壮年四肢长骨骨端的原发性骨肿瘤。本例骨巨细胞瘤…     

ISO9000标准在医院数据控制管理中的应用

本文论述了医院引入ISO9000质量管理体系后,按质量管理体系要求,建立“数据分析控制程序“,“纠正和预防措施控制程序“完善了对信息数据的监督控制制度及相应管理规定,设置了质量监控记录,使医院对数据的管理、控制、分析贯穿于医护工作的全过程,成为制度化、规范化的工作,提高了医院信息数据的质量,医院管理工作不断改进、提高,促进医院全面、协调、可持续发展[1].     

中心静脉导管负压引流治疗气胸与传统方法的比较

目的 比较中心静脉导管胸腔内置管加负压引流法与传统胸腔闭式引流法治疗气胸的优缺点。方法 80例气胸患者随机分为观察组、传统组，比较二种不同治疗方法对气胸的引流效果、患侧肺组织完全复张的时间、住院天数、镇痛药使用。结果 观察组治愈率高、气胸发生率低、膜肥厚粘连发生率低。结论 新方法治疗结核性胸腔积液疗效更好。     

青壮年原发大肠癌的延误诊断

我院自1949年7月至1962年7月,共收治原发大肠癌109例,40岁以下青壮年患者57例(52%),男性44例,女性13例,最幼者18岁,平均36岁,其中直肠癌25例,乙状直肠癌8例,乙状结肠癌2例,横结肠癌1例,降结肠癌3例,盲肠癌17例,肛管癌1例。直肠癌治疗后,三年随访中健在者25例,五年随访中健在者3例;结肠癌治疗后,三年随访中健在者10例,五年随访中健在者仅3例,说明疗效不高。本病早期症状稳匿不显,且部分医生对本病缺乏足够认识,尤其对青壮年的原发大肠癌往往不大考虑,对直肠指诊、乙状结肠镜检查及活体组织检查也常不重视,因而往往延误诊断,以致失去早     

3405例产前诊断的指证及其结果评价

目的:分析产前诊断指证与胎儿染色体检测结果的关系。方法:3405例有产前诊断指证的孕妇,进行羊膜腔穿刺或脐静脉穿刺术,取羊水细胞或脐血细胞培养,作胎儿染色体核型分析。结果:3405例孕妇共检出胎儿染色体异常88例,染色体异常率为2.6%,显著高于一般人群的异常率(P<0.01)。其中夫妇一方为染色体平衡易位携带者组的胎儿染色体异常率达25.9%(7/27),产前胎儿超声异常标记组、孕母血清唐氏筛查阳性组和高龄孕妇组的异常率分别为6.2%(49/778)、1.7%(22/1283)和1.1%(7/664)。18-或21-三体儿妊娠史组、体外受精组、本次妊娠有先兆流产史组和孕期不良因素接触组,均未检出胎儿染色体异常。结论:出现胎儿染色体异常率最高的指证,依次为夫妇一方染色体平衡易位携带者、产前超声发现胎儿异常标记、孕母血清唐氏筛查阳性和高龄孕妇。有针对性地进行产前诊断,可有效地控制和减少出生缺陷的发生。     

肝部分切除与肝十二指肠韧带骨髂化治疗肝门部胆管癌

Objective To summarize the surgical experience of partial hepatectomy with skeletonization of the hepatoduodenal ligament in the treatment of hilar cholangiocarcinoma.Methods Between Jan.1999 and Dec,2001,67 consecutive patients with hilar cholangiocarcinoma underwent surgical exploration at the Second Military Medical University,Eastern Hepatobiliary Surgery Hospital.The clinical data of these patients were reviewed.Results Of the 67 patients,65(97%) underwent surgical resection.Fourty-nine patients(73%) received curative resection:22 skeletonization resection(SR) and 27 SR combined with partial hepatectomy.In 16 patients(9%) with curative resection the tumor margin was histologically postive and the resection was therefore considered palliative.The tumors were classified according to Bismuth with SR was type Ⅱ(17cases),various types of partial hepatectomy with SR was type Ⅲ and type IV.Right lobectomy with right caudate lobectomy was indicated in type Ⅲ(6cases),left lobectomy with complete caudate lobectomy in type Ⅲb(15cases),right loobectomy with complete caudate lobectomy(3 cases),left lobectomy with complete caudate lobectomy(9 cases) and quadrate lobectomy(2 cases)in type IV.SR and left lobectomy with complete caudate lobectomy was successfully performed in 2 patients(3%) who had undergone palliative biliary resection and cholangiojejunostomy before.Eight patients(12%) had local resecton of the tumor with Roux-en-Y hepaticojejunostomy reconstruction using intrahepatic stents.Two patients(3%) had palliative biliary drainage.Combined portal vein resection was performed in 13 patients(20%) and hepatic artery resection in 27 patients(40%) .Twenty-four atients(36%) had no postoperative complication,23 patients(34%) had minor complications only ,and the remaining 20 patients(30%) had major complications.Of the 20 patients with major complications,14 recovered,the remaining 6 patients died from hepatorenal failure with other organ failures,from myocardial infarction or from intraabdominal or gastrointestianl bleeding 7,12,14,42,57 or 89 days after surgery.The 30-day operative mortality was 4.5%.The mean survival of the patient with curative resecton was 16 months(range 1-32 months);for those undergong palliative resection mean survival was 7 months(range 1-14months).Conlusion Partial hepatectomy with SR for hilar cholangiocarcinoma can be performed with acceptable morbidity and mortality.For curative treatmet of hilar cholangiocarcinoma,caudate lobectomy is always recommended in Bismuth Ⅲ/IV.     

熏洗配服药治疗膝关节风湿痛

膝关节风湿痛是临床常见病之一,主要表现为患者膝关节疼痛但外形及功能正常,不发热,且遇风寒加重,x线检查无骨和关节的病理改变。笔者运用熏洗配服药治疗40例患者,其中男性29例,女性11例;年龄最大60岁,最小16岁。结果治愈19例,显效14例,有效5例,无效2例。熏洗方组成牛膝15克,威灵仙15克,续断15克,麻黄15克,桂枝15克,当归12克,红花12克,川乌12克,草乌12克,木鳖子12克,川芎12克,乳