儿童急性荨麻疹的心电图观察

目的 了解儿童急性荨麻疹对心脏的影响。方法 对急性荨麻疹患儿593例行常规心电图检查。结果 33例(5．6％)患儿出现心电图异常改变，主要表现为I度房室传导阻滞、室性早搏、T波低平。皮损消失后心电图亦恢复正常。结论 急性荨麻疹患儿可伴有心脏的损害，临床上应予以重视。     

A study on various symptoms of chronic hepatitis treated with radix astragali and its regulative effect to levels of serum hormone

Sixty-seven cases of chronic hepatitis were treated with Radix Astragali. After treatment (2-month course), the clinical improvement rate in 38 cases of the Stagnation of the Liver-Qi and Deficiency of the Spleen type was 92.1%, and in 26 cases of the Deficiency of Liver Yin and Kidney Yin type was 88.5%, more effective than in the control group (P<0.05). The regulative effect to the levels of serum hormone was observed in the patients of the Stagnation of the Liver-Qi and Deficiency of the Spleen type treated with this medicine. The results showed that the levels of serum triiodothyronine, estradiol (female) and testosterone (male) were increased after treatment (1.40±1.38 ng/dl, 129.30±1.23 pg/ml and 496.24±1.47 ng/dl). Pre-treatment levels were 1.22±1.49 ng/dl, 104.60±1.45 pg/ml and 398. 17±1.55 ng/dl respectively (P<0.05); however, the level of serum prolactin (2.75±4.46 ng/ml) was lower after treatment than before treatment (3.20±3.82 ng/ml,P<0.05). No obvious changes were observed in the levels of serum follicle stimulating hormone, luteinizing hormone, thyroid stimulating hormone, thyroxine, triiodothyronine uptake ratio and cortisol after treatment.     

蝮蛇抗栓酶对骨内高压降压作用实验研究

本实验随机将家兔一侧后肢于膝关节伸直位夹板外固定５周，制成固定侧胫骨上端骨内高压模型。对其全身和局部血液流变学指标进行测定，发现全血粘度，血浆粘度增大，血沉增快，血浆纤维蛋白原含量明显增高。对上述模型应用蝮蛇抗栓酶（ｓｖａｔｅ）连续治疗２１天，骨内压降低，血液流变学各项指标亦降低。本实验结果显示，蝮蛇抗栓酶通过改善骨内高压状态下的异常血液流变学状态可使骨内高压降低，从而认为血液流变学疗法可能成为临床治疗骨内高压症的一种新手段，而蝮蛇抗栓酶可能为其中高效药物之一。     

吸入一氧化氮对心瓣膜置换术后肺动脉高压患者血流动力学的影响

目的：观察吸入一氧化氮（ＮＯ）对心瓣膜置换术后肺动脉高压患者血流动力学的影响。方法：选择９例心瓣膜置换术后伴肺动脉高压的病人，吸入ＮＯ０．００３％，观察三个时象点：吸入ＮＯ前；开始吸入ＮＯ后１５分钟；停止吸入ＮＯ后１５分钟。结果：吸入ＮＯ能显著降低肺动脉压和肺循环阻力指数（Ｐ＜０．０１），停止吸入ＮＯ１５分钟后，肺动脉压和肺循环阻力指数恢复到原有水平。在整个观察过程中，心率、平均动脉压、中心静脉压、肺动脉楔压、体循环阻力指数和心脏指数均无显著变化（Ｐ＞０．０５）。结论：吸入ＮＯ具有选择性肺血管扩张作用，是治疗心瓣膜置换术后肺动脉高压的较理想药物。     

Grose-Kempf 带锁髓内钉在股骨干骨折中的应用

作者从１９８８～１９９５年末用Ｇｒｏｓｅ－ｋｅｍｐｆ钉（简称ＧＫ钉）治疗股骨干骨折４９例（５０个股骨），其中新鲜骨折２９例（３０个股骨），陈旧性骨折１６例，病理骨折４例。外伤性骨折４５例中，随访半年以上４３例，骨折全部愈合，下肢功能及关节活动良好。４例病理骨折，其中３例术后分别存活１６个月、１８个月、２４个月，另１例为成骨不全，术后患肢功能较健侧无差别。ＧＫ钉扩大了髓内钉手术适应证，可用于股骨干的粉碎性骨折、多发性骨折、陈旧性骨折不愈合及病理性骨折。对于合并脑干损伤、血管损伤、骨筋膜室综合征的股骨干骨折，用ＧＫ钉固定，获得了理想的治疗效果。     

放射性碘在大鼠甲状腺内的滞留模式及剂量估算

为确定放射性碘在甲状腺内滞留模式，观察甲状腺吸收放射性碘后的生物效应，进而评价其辐射危害。方法利用活体测量方法，直接测量两个不同年龄组大鼠甲状腺内１３１Ⅰ的代谢参数。对测量数据进行处理后得到了大鼠甲状腺内１３１Ⅰ的滞留函数为三指数项函数。结果利用所得三指数项滞留函数的准确方法进行剂量估算，所得的两组动物的甲状腺平均累积吸收剂量分别为７．７Ｇｙ和１１．５Ｇｙ，而一般方法算得的大鼠甲状腺的平均累积吸收剂量比用准确方法高估了６６％～９１％。结论由于准确方法考虑到影响估算甲状腺所受剂量的一些因素，故可相对准确地反映了１３１Ⅰ所致不同年龄大鼠甲状腺的吸收剂量。     

吉林192Ir放射事故患者局部急性放射损伤病理改变

目的观察一例大剂量全身极不均匀照射急性放射损伤患者数处局部病理改变。方法病理常规切片染色，光镜检查。结果吸收剂量右下肢为３７３８Ｇｙ，左手掌为８３０Ｇｙ，于照射后第８天行右下肢、左前臂截肢术。右手、左膝照射剂量相对较小但难以准确估计，红斑、水肿、水疱、溃疡出现相对较晚，于第５５天行右手指、左膝清创植皮术。镜下：右小腿局部皮肤和皮肤附属器官、皮下组织和骨胳肌广泛地坏死和弥漫性出血，但真皮中的立毛肌尚存；左手指、手掌皮肤表皮细胞空泡变性、坏死，并形成大小不一的囊泡，致使表皮与真皮分离，真皮弥漫性出血、中性粒细胞浸润，汗腺上皮细胞变性、坏死，皮下组织内弥漫性出血，少数脂肪细胞坏死。胫骨、腓骨上端和股骨、桡骨、尺骨下端处骨髓腔内造血组织各系细胞均消失。左膝、右手拇指、食指、中指皮肤示急性放射性溃疡。结论大剂量照射导致的急性放射损伤造成大面积、深达肌肉的软组织坏死及骨髓造血细胞消失。     

Brain neurons and glial cells express Neu differentiation factor/heregulin: a survival factor for astrocytes.

Neu differentiation factor (NDF, also called heregulin) was isolated from mesenchymal cells on the basis of its ability to elevate phosphorylation of ErbB proteins. Earlier in situ hybridization analysis showed that NDF was transcribed predominantly in the central nervous system during embryonic development. To gain insights into the role of NDF in brain we analyzed its distribution by immunohistochemistry and in situ hybridization. Late-gestation (day 17) rat embryos displayed high NDF immunoreactivity in both motor (e.g., putamen) and limbic (e.g., septum) regions. Lower levels of the factor were exhibited by adult brain, except for the cerebellum, where NDF expression was increased postnatally. Both neurons and glial cells were identified by immunohistochemistry as NDF-producing cells (e.g., pyramidal neurons in the cerebral cortex and glial cells in the corpus callosum). By establishment of primary cultures of rat brain cells we confirmed that NDF was expressed in neurons as well as in astrocytes. In addition, by using such primary cultures we observed that NDF treatment exerted only a limited mitogenic effect, which was accompanied by significant acceleration of astrocyte maturation. Furthermore, long-term incubation with the factor specifically protected astrocytes from apoptosis, implying that NDF functions in brain as a survival and maturation factor for astrocytes.     

声音振动刺激试验在临床上的应用

应用声振仪对１９９２年２个月～１９９３年６个月单胎３６～４３周妊娠孕妇１５０例进行了声音振动刺激试验（ＶＡＳ－Ｔ）并与无负荷试验（ＮＳＴ）对照。对此结果ＶＡＳ－Ｔ（＋）１４６例，（－）４例，ＮＳＴ反应型９６例，无反应型５４例。ＮＳＴ无反应型预测价值８％，假阴性率９２％。ＮＳＴ无反应型经声音刺激后５０例成ＶＡＳ－Ｔ（＋）。ＶＡＳ－Ｔ预测价值９９．３％。ＮＳＴ有效率６６％，ＶＡＳ－Ｔ有效率９９％。ＮＳＴ至少需做２０ｍｉｎ，ＶＡＳ－Ｔ９５％在３ｍｉｎ内达到标准，最长１５ｍｉｎ。为避免ＮＳＴ假无反应型，应进行ＶＡＳ－Ｔ。     

肝尾叶切除

肝尾叶深藏于肝门结构与下腔静脉之间，具有独立的管道系统，手术切除风险较大，作者结合２例肝尾叶切除的体会，复习文献，对肝尾叶的解剖、影像学特征、切除指征及手术方法进行了讨论。