烧伤患者吸入性损伤和肺部感染的发生特点及其对死亡的影响

为了评价吸入性损伤和肺部感染的发生特点及其对死亡的影响，总结了我科近１４年住院治疗的热力烧伤患者９４０例，其中吸入性损伤７５例，轻度１５例，全部治愈，中度２５例，死亡１３例，死亡率为５２．０％，重度３５例，死亡３１例，死亡率为８８．６％。统计分析表明，合并吸入性损伤者６９．３％在密闭空间发生，同时伴有面部烧伤者达９６．０％。随着烧伤面积的增加，吸入性损伤发生率和肺部感染的发生率相应增加。有吸入性损伤肺部感染较无吸入性损伤肺部感染率为高（Ｐ＜０．０１），发生时间早。两组同等烧伤面积、深度、年龄患者，有吸入性损伤组发生死亡的危险比无吸入性损伤组大１７．２倍（Ｐ＜０．００１）。烧伤面积、深度和年龄相近，合并肺部感染者明显增加了死亡的机会（Ｐ＜０．００１）。     

Coexistence of autonomic and somatic mechanisms in the pressor areas of medulla in cats.

The effects of electrical stimulation and microinjection of sodium glutamate (0.5 M) in the sympathetic pressor areas of the dorsal medulla (DM), ventrolateral medulla (VLM), and parvocellular nucleus (PVC) on the knee jerk, crossed extension, and evoked potential of the L5 ventral root produced by intermittent electrical stimulation were studied in 98 adult cats anesthetized with chloralose and urethane. During electrical and glutamate stimulation of these pressor areas, in addition to the rise of systemic arterial blood pressure marked inhibition of the spinal reflex was produced, indicating presence of neuronal perikarya responsible for these actions. Mild to moderate augmentation of spinal reflexes was also observed during brain stimulation but only in a few cases. The magnitude of the somatic effects among the pressor areas of the VLM, DM, and PVC subsequent to glutamate activation was about the same. Induced spinal reflex inhibition, independent from the baroreceptor and vagal influence, remained essentially unaltered after acute midcollicular decerebration. The inhibition was also observed in cats decerebellated 8-10 days in advance. The inhibition was not affected after bilateral electrolytic- or kainic-acid-induced lesions in the paramedian reticular nucleus (PRN). On the contrary, PRN-induced spinal reflex inhibition was attenuated after bilateral lesions in the DM or VLM. Data suggest that there coexists neuronal subpopulations in the VLM, DM, and PVC that can affect both the sympathetic pressor systems and spinal reflexes.     

颈部神经鞘瘤34例临床分析

对３４例颈部神经鞘瘤进行了临床分析，均以颈部无痛性包块为主诉。１６例压迫肿瘤可引起肢端麻木、放射性疼痛或压气、呛咳等症状，１０例肿块穿刺抽出囊液，８２．２％来诊时诊断不清楚，需与颈部其他肿瘤相鉴别，Ｂ超对诊断有帮助。本组手术行肿瘤核除术１３例，肿瘤切除术１９例，取病理２例。应争取做保留神经功能的肿瘤核除术。     

根除幽门螺杆菌5种治疗方案的药物经济学评价

目的 探讨不同的方案根除幽门螺杆菌(Hp)所产生的经济效果。方法 151例幽门螺杆菌阳性感染的消化性渍疡和胃炎患者，随机分为5组，给予不同的短程三联治疗方案：A组(胶体次枸橼酸铋 阿莫西林 甲硝唑)、B组(胶体次枸橼酸铋 克拉霉素 甲硝唑)、C组(奥美拉唑 阿莫西林 克拉霉素)、D组(奥关拉唑 阿莫西林 甲硝唑)、E组(奥美拉唑 克拉霉素 甲硝唑)，运用药物经济学的成本-效果分析方法进行评价。结果A、B、C、D、E5组治疗胃炎Hp根除率分别为63．2％、70．9％、89．1％、77．6％、86．8％，治疗消化性溃疡Hp根除率分别为65．1％、73．0％、96．2％、80．4％、93．2％，5组方案对胃炎／消化性溃疡的成本-效果比(C／E)分别为3．14／3.05、4．10／3．98、4．25／3．94、2．91／2.81、2．78／2．59，增长的成本-效果比(△C／△E)分别为-／-、12．00／11．70、6．96／5．80、1．93／1．81、1．83／1．53。结论 E方案为根除Hp的最佳方案。     

Cytotoxic activity of cardenolides from Beaumontia brevituba stems.

Five known cardenolides, digitoxigenin (1), oleandrigenin (2), digitoxigenin alpha-L-cymaroside (3), digitoxigenin beta-gentiobiosyl-alpha-L-cymaroside (4), and delta 16-digitoxigenin beta-D-glucosyl-alpha-L-cymaroside (5), were isolated from the stems of Beaumontia brevituba Oliver by cytotoxicity-directed fractionation monitored by a cultured human lung cancer cell line. The cytotoxic activity of these compounds was evaluated with a panel of twelve human and murine cancer cell lines. The lignan glycoside, syringaresinol beta-D-glucoside, was obtained for the first time in the form of its levo-enantiomer.     

FasL启动子调控的报告基因表达质粒的构建及活性分析

目的扩增FasL启动子并构建带有FasL启动子的荧光素酶报告质粒,并评价在皮质酮(啮齿类动物体内的糖皮质激素)作用的睾丸Leydig细胞中,由FasL启动子调控的荧光素酶的表达活性。本研究将为进一步分析Leydig细胞中FasL启动子转录调控的作用机制奠定基础。方法采用DNA重组技术构建由FasL启动子调控的荧光素酶报告基因的表达质粒。此重组质粒经阳离子脂质体LipofectAMINE介导,瞬时转染入Leydig细胞中,36h后细胞经皮质酮处理,并于48h时收集细胞。测定荧光素酶的相对表达活性。结果(1)酶切及测序证实成功扩增FasL基因启动子并构建了带有FasL基因启动子的报告基因表达质粒；(2)皮质酮处理的Leydig细胞中FasL启动子调控的荧光素酶表达质粒的表达活性显著增高。结论构建成功的带有FasL启动子的荧光素酶报告质粒可准确地评价FasL启动子在凋亡过程中的作用。     

Ultrastructural investigation of granulation tissues on the osteoarthritic femoral head. A scanning electron microscopic and transmission electron microscopic study.

From the femoral heads of nine cases of advanced osteoarthritis of hip joint, three categories of granulation tissues with different colors (bright red, dark-red and white granulation tissues) and texture were obtained. After processing, the specimens were observed under scanning electron microscope and transmission electron microscope. With transformation of the granulation tissues from bright red to white, the collagen fibers therein contained gradually changed from fine to thick ones. Nevertheless, the cellular components in these three types of granulation tissues always possessed the characteristics of both fibroblasts and chondrocytes, i.e., fibroblastic configuration with pericellular Type I collagen fibrils bearing 64 nm periodicity; and chondrocytic scallop-shaped cytoplasmic membrane with intracytoplasmic fat droplets and glycogen granules and pericellular Type II collagen fibrils. All these indicated that in osteoarthritis of hip joints, the granulation tissues of the femoral heads transformed eventually into fibrocartilage, irrespective of their color and texture.

     

骨原发性恶性纤维组织细胞瘤11例

骨的原发性恶性纤维组织细胞瘤少见而诊断困难。本文通过11例临床、X 线和病理分析,确认用三结合方法是正确诊断的依据,而病理检查方能确诊。其特点是同时存在组织细胞样细胞及成纤维细胞样细胞。截肢仍为治疗的主要方法。