比照西医:中医特殊认识的实践要素论纲

实践决定认识,认识的差异也便决定于实践差异。中医学和西医的认识差异巨大,其中存在诸多因素,但是实践差异必定是决定性因素之一。本文从多方面分析了中医的实践特点,并基于中医的实践特点论证了其对中医特殊认识的决定作用。为说明问题,同时与西医实践进行了比较。     

周围型肺腺癌CT、病理征象与肿瘤淋巴管密度及淋巴转移相关基因表达关系的研究

目的研究周围型肺腺癌的CT、病理征象与肿瘤组织VEGF-C、VEGFR-3表达及淋巴管生成的相关性。方法搜集40例经手术病理证实的肺腺癌,术前均行CT平扫及增强扫描,对肿瘤标本行SP免疫组化染色,根据其阳性表达计数阳性细胞数及淋巴管密度(LMVD),分析肺腺癌某些CT、病理征象与VEGF-C、VEGFR-3表达,LMVD值间的关系。结果淋巴结增大、转移及其它一些CT表现与VEGF-C、VEGFR-3过表达及LMVD值有密切相关性;肿瘤组织的VEGF-C、VEGFR-3表达与LMVD值亦有相关性。结论肺腺癌淋巴结增大等CT征象与VEGF-C、VEGFR-3表达及淋巴管生成具有相关性。     

毛囊性扁平苔藓

患者男，56岁。 主诉：左腰部丘疹伴瘙痒1个月。[第一段]     

TARP钢板系统在难复型寰枢椎脱位手术中的临床应用

目的探讨经口咽前路寰枢椎复位钢板系统（TARP）在难复型寰枢椎脱位的临床应用。方法自2003年4月-2004年9月，对13例陈旧性的难复型寰枢椎脱位患者行经口咽前路松解减压，应用TARP系统复位和固定，两侧寰枢关节间植入自体髂骨融合。结果除1例因跌倒引起螺钉松动再次脱位外，均固定牢固，融合理想，脊髓减压满意。结论经口咽前路寰枢椎复位钢板系统一次完成寰枢椎脱位的复位和固定是治疗陈旧性难复型寰枢椎脱位较为理想的手术方法。     

3种肠道清洁方法效果比较

目的 探讨顺产儿脐部护理中修剪法配合Orem自理模式的应用效果。方法 将100名顺产新生儿随机分为对照组和观察组各50名。对照组按常规进行脐部护理；观察组择期行脐部修剪，同时根据Orem自理模式进行全补偿、部分补偿及支持一教育护理模式进行护理。观察两组脐带出血、脱落及疑似感染情况。结果 两组均未出现脐带出血情况；两组出生后9d回访时脐带脱落比较，差异有显著性意义（P〈0．05）。结论 修剪法配合Orem自理模式进行脐部护理，能促进新生儿脐带早脱落。     

Antibodies against dengue virus E protein peptide bind to human plasminogen and inhibit plasmin activity

Both mice and rabbits immunized with dengue virus E protein peptide spanning amino acids 100–119 (D4E) produced antibodies that reacted not only with the D4E peptide itself but also with human plasminogen, as shown by ELISA and Western blot. Sera from dengue virus-hyperimmunized mice and dengue patients also contained antibodies against D4E and plasminogen. Furthermore, such sera all contained plasmin inhibitory activity. Using affinity-purified anti-D4E antibodies and free D4E peptide for competitive inhibition, we demonstrated that the inhibition of plasmin activity was due to anti-D4E antibodies rather than other substances in the sera. Taken together, these results suggest dengue virus E protein amino acids 100–119 are a cross-reactive immunogenic region, and antibodies against this region may interfere with human fibrinolysis.     

氨甲喋呤配伍中药治疗未破裂型输卵管妊娠(附86例报告)

目的：探讨用氨甲喋呤（Methotraxate,MTX)配伍中药治疗条件适宜的输卵管妊娠的可行性及疗效。方法：对MTX配伍中治疗的输卵管妊娠86例临床资料进行分析。结果：82例治疗成功，成功率为95．35％，其中，治疗1个疗程69例，2个疗程13例，随访16例妊娠，1例2年后对侧输卵管妊娠，4例治疗失败者改手术治疗，病理见不同程度的滋养细胞溶解，绒毛坏死，出血，结论：使用MTX配伍中药治疗输卵管异位妊娠，方法简便易行，安全有效，副作用少，特别适合于基层医院。     

移植肾血管痉挛原因探讨

通过对临床37例肾移植的观察，发现术中移植肾开放血流后肾血管痉挛现象与当时血压明显相关。收缩压大于24kPa者，移植肾血管痉挛率为53．33％，收缩压低于24kPa者，移植肾血管痉挛率为9．09％。两组有显著性差异（P＜0．01）．发生血管痉挛的肾脏排尿时间较未痉挛者明显延长，分别为23±6．35min．3．8±0．86min，两组差异极显著（P＜0．01）．从而认为肾移植术中提升血压应适度，并针对移植肾血管痉挛的原因进行了讨论。     

阿片受体在异氟醚延迟预处理减轻兔心肌缺血再灌注损伤中的作用

Objective To investigate the role of opioid receptors in the protective effects of isoflurane-induced delayed preconditioning against myocardial ischemia-reperfusion (I/R) injury in rabbits. Methods Forty male New Zealand white rabbits weighing 2.0-2.5 kg were randomly assigned into 4 groups ( n = 10 each) : group I sham operation (S); group II I/R; group Ⅲ isoflurane + I/R (Iso) and group IV Iso + naloxone + I/R (Nal). Myocardial I/R was induced by 40 min occlusion of left anterior descending branch (LAD) of coronary artery followed by 120 min reperfusion. In group Ⅲ (Iso) 2% isoflurane in 100% O2 was inhaled for 2 h and I/R was produced 24 h later. In group IV (Nal) naloxone 6 mg/kg was given iv 10 min before 2 h of 2% isoflurane inhalation and I/R was produced 24 h later. At the end of 120 min reperfusion, infarct size (IS) and area at risk (AAR) were determined by Evan's blue and TTC staining. Myocardial ultrastructure was examined by electron microscopy. The phosphorylated p38MAPK protein expression in myocardium was determined by Western blot. Results The IS was significantly smaller in group Iso ( Ⅲ ) ( 19.7% ± 2.8%) than in I/R group ( II ) (37.8% ±1.7%) (P<0.05). The phosphorylated p38MAPK protein expression in myocardium was significantly lower in group Iso than in group I/R. Microscopic examination showed less myocardial damage in Iso group than in group I/R. The protective effects of delayed preconditioning by isoflurane was prevented by naloxone pretreatment. ConclusionOpioid receptors may be involved in the protective effects of delayed preconditioning by isoflurane against myocardial I/R injury.