模式翻转视觉诱发电位快速提取的可行性再研究

目的把模式翻转视觉诱发电位快速提取法应用于视神经病变的病人,探讨其临床应用价值。方法应用Galileo视觉诱发电位检测系统对30例正常健康人和17例视神经疾病病人分别进行全视野的PRVEP检测熏每一结果重复检测3次。所得结果应用少次提取法进行处理而得VEP波形。然后将正常对照组3次重复结果两两间分别进行配对t检验,探讨其可重性,并计算出正常值范围,最后参照正常值,分析视神经疾病组的检测结果。结果3次重复结果两两间配对t检验,得P1=0.425>0.05,P2=0.179>0.05,P3=0.110>0.05;参照本研究得出的正常值范围,对病人组的检测结果进行分析,得出这种少次提取法对视神经疾病检测的敏感度90.0%(18/20),特异度92.5%(13/14),准确度91.1%(31/34)。结论用这种少次提取法提取PRVEP,可重性好,稳定可靠。很有临床应用价值。     

GK型机械瓣空化可视化研究

对国产GK27型机械二尖瓣进行了单次关闭方式的离体空化实验，采用数码相机拍摄了空泡照片。机械瓣阻塞体关闭后，云状空泡出现在挡座周围，呈放射状向外运动，空化原因是机械瓣关闭时阻塞体与挡座的撞击形成的局部挤压射流，挤压缝隙出口射流速度高达9m/s，局部低压造成空化，在机理上，这是附壁射流引起的旋涡空化。关闭速度是衡量机械瓣空化趋势的重要指标之一。空化历时随心室载荷率的增加而增加，在载荷率为2750mmHg/s时，最大空化历时达440μs。机械瓣空化临界载荷率为420mmHg/s，这比动物实验所得的正常生理条件750mmHg/s低，因此在人体正常生理条件下，机械二尖瓣存在空化的可能。     

不同机制大动脉粥样硬化型脑卒中基线特征和血管内治疗后结局比较

目的 本研究旨在比较颅内大血管伴/不伴同侧颈内动脉闭塞的大动脉粥样硬化型脑卒中患者基线特征以及行血管内治疗后结局的差异。方法 对DIRECT-MT亚组进行回顾性分析,以比较前循环大动脉粥样硬化（large-artery atherosclerosis,LAA）型卒中串联闭塞和颅内闭塞接受血管内治疗（endovascular treatment,EVT）的患者的基线特征和预后,分析不同机制学特征（动脉粥样硬化或动脉-动脉栓塞）对临床结局的影响。结果 LAA型卒中患者共108例,其中串联闭塞63例,颅内闭塞45例。颅内闭塞组患者高血压史率高于串联闭塞组（77.8% vs. 52.4%, P=0.007）。颅内闭塞组闭塞部位最常见于大脑中动脉M1段（88.6%）,而串联闭塞组颅内闭塞主要位于颈内动脉颅内段（49.2%）和大脑中动脉M1段（49.2%）（P＜0.001）。两组患者在年龄、性别、术前抗栓、他汀类药物的使用,卒中、房颤、吸烟史,基线mRS、NIHSS评分,是否静脉溶栓,侧枝循环,以及救治流程时间差异均无统计学意义（P均＞0.05）。90天mRS 0-2分的患者比例两组差异无统计学意义（53.3% vs. 41.9%, P=0.243）。颅内闭塞组术后成功再灌注率高于串联闭塞组（93.3% vs. 77.4%, P=0.026）,但术后24-72小时血管再通的比例前组低于后组（57.1% vs. 77.2%, P=0.034）。最终梗死体积,颅内闭塞组小于串联闭塞组（20.1 vs. 34.5, P=0.025）。术后NIHSS评分,90天EQ-5D-5L评分和BI指数等其他次要结局,两组间差异无统计学意义（P均＞0.05）。两组在90天内的死亡率,发生的无症状性和症状性颅内出血率,5-7天时在另外的血管区域新发脑梗死,以及新流域栓塞的患者百分比相似,差异无统计学意义（P均＞0.05）。结论 动脉粥样硬化导致的串联闭塞相较于孤立颅内闭塞,末次造影成功再灌注率较低,梗死体积更大,但术后24-72小时再通率更高,且神经功能良好预后率以及不良事件发生率均与颅内闭塞相仿。     

Clinicopathologic features and survival of patients with colorectal mucinous, signet-ring cell or non-mucinous adenocarcinoma:experience at an institution in southern China

Background Previous studies have shown conflicting results on the relation between clinicopathologic features and prognosis of patients with colorectal mucinous, signet-ring cell, or non-mucinous adenocarcinoma; only few such studies have been performed in China. This retrospective study analyzed data from our department to investigate clinicopathologic characteristics, prognosis and possible correlations of three histologic types -- colorectal mucinous,signet-ring cell, and non-mucinous adenocarcinoma, to clarity the bases for observed differences which may lead to development of targeted therapies Methods Of 2079 patients diagnosed with colorectal cancer between 1994 and 2007, 144 had mucinous, 25 had signet-ring cell, and 1837 had non-mucinous adenocarcinoma. Their clinicopathologic parameters and survival were analyzed using established statistical methodologies.Results Mucinous and signet-ring cell adenocarcinomas were common in younger patients (P <0.001). Location, size and disease stage differed significantly among the three types. Signet-ring cell tumors were more commonly found in the rectum than mucinous and non-mucinous adenocarcinoma (P <0.001). Mucinous and signet-ring cell tumors presented in a later stage in life more often than non-mucinous adenocarcinoma, with lymph node involvement, serosal infiltration, peritoneal dissemination, and adjacent organ invasion (P <0.01). The rate of radical resection, hepatic metastasis and local recurrence did not differ among types (P ＞0.05). Compared with patients with non-mucinous adenocarcinoma, patients with mucinous and signet-ring cell tumors who underwent potentially curative resections or stage Ⅱ/Ⅲ disease had poorer long-term overall survival. Survival did not differ by type for patients with either stage Ⅰor Ⅳ disease (P ＞0.05). Conclusions Mucinous and signet-ring cell adenocarcinoma have unique carcinogenesis and similar biologic behavior.Our study confirms that both histologic types, especially signet-ring cell tumors, are independent, negative prognostic factors for patients with colorectal cancer. Type does not appear to have a significant effect on survival when disease is either stage Ⅰ or Ⅳ at presentation.     

Early operation for fulminant acute pancreatitis: a possible way to decrease mortality

Background Although the indication and the timing for surgery in fulminant acute pancreatitis (FAP) are still controversial, our experience of surgical treatment for fulminant acute pancreaUtis may help improve the outcome for patients.Methods The clinical data of twenty-six patients with FAP from January 1, 2001 to October 1,2005 were analyzed. The diagnostic criteria fitted the 2007 Guidelines for the Management of Severe Acute Pancreatitis by the Chinese Medical Association.Results Twenty-six patients with FAP received surgical debridement, with a mortality rate of 42.3% (11/26). The postoperative mortalities in the ＞72 hour operation group and the <72 hour operation group were highly significantly different (7/8 vs 22.2% (4/18), respectively).Conclusions Early surgery may reduce the intraabdominal pressure and prevent the deterioration of FAP. An operation within 72 hours from the onset of symptoms might decrease the mortality of the disease.     

Policy making and organization in managing tropical diseases in China

China have a vast territory and a large population. It is situated between north latitude 2°-58° and east longitude 74°-135°. Most of China is lacated in the temperate and subtropical zones, with a small part in the tropical zone. Due to the influence of monsoons from the Pacific Ocean during the summer season, rainfall is plentful, and the weather can be hot and humid. The natural conditions create a good environment for the rise and spread of most tropical diseases (infectious and parasitic diseases), especially in South-eastern China, where about 80% of the population lives.     

胃肠道间质瘤的免疫组化诊断及P53和P21表达

目的：探讨胃肠道间质瘤（GIST）的诊断及鉴别诊断。方法：GIST患50例,进行常规检查及P^53/P^21,HHF－35,vimentin,CD34免疫组化检测。结果：本组50例GIST,恶性34例,交界性10例,良性6例,以胃及小肠为多发（68％）。免疫组化以平滑肌细胞分化为主型占46％,神经源分化型占18％,平滑肌和神经双向分化型18％,未分化型24％。肌肉共同蛋白HHF－35为平滑肌细胞分化最敏感的标志物。未分化型间质瘤的免疫表型为vimentin和CD34阳性。P^53蛋白和P^21蛋白对GIST的良恶性可资鉴别。结论：尽管胃肠道间质瘤光镜下形态相似,但其免疫表型呈异源性,需要做免疫组化准确定性。     

三味中药配伍应用对改善烫伤小鼠受损免疫功能的作用

目的　观察对烫伤小鼠受损免疫功能具有调理作用的单味中草药 ,经过配伍应用后的协同作用。方法　采用 1 .0 3 4× 1 0 5 Pa的蒸气烫伤 1 0s ,烫伤面积 1 6% ,深度为Ⅲ度的致伤模型烫伤动物。通过观察MΦ的吞噬功能、枯否细胞清除能力、MΦ抗原提呈功能、血清TNF量、淋巴细胞增殖反应及IL 2产生能力、小鼠抗体产生能力、PMNH2 O2 释放量及PMN溶菌酶释放量、血清补体的趋化作用和聚集作用等指标 ,籍以了解单味中药与配伍中药对烧 (烫 )伤小鼠受损免疫功能的调理作用。结果　单味中药三七(PP) ,金银花 (LJ)和虎杖 (PC)对小鼠受损免疫功能有一定的改善作用。PC +LJ、PP +PC、PP +LJ等二味配伍的中药 ,除少数指标外 ,均比单味药的作用好。而PP +LJ+PC三味配伍药的调理作用 ,比单味药和二味配伍药的调理作用更佳。结论　单味中药经配伍应用后对烧 (烫 )伤小鼠严重受损的免疫系统功能 ,具有比单味药更好的协同调理作用。     

导赤散加味治疗慢性前列腺炎110例

目的 了解导赤散加味对慢性前列腺炎的疗效。方法 应用导赤散为主组方,结合直肠指诊、化验检查进行综合分析,辨证加减用药、治疗慢性前列腺炎110例,并与口服环丙沙星片、回通淋丹组40例作对照。结果 治疗组近期治愈率36.4%,总有效率为91.0％,对照组近期治愈率仅15.0%,总有效率为72.5%,两组的有效率比较差异有显性（P＜0．05）。结论 导赤散加味治疗慢性前列腺炎有明显改善作用。     

直视下行大鼠气管插管的改良方法

目的 提高大鼠气管插管的成功率;方法 对比传统闭式法与改良直视法的成功率;结果传统闭式法的成功率为50％,改良直视法的成功率为100％。结论 改良直视法优于传统闭式法,值得推广应用。