在急救中心开展多发伤一体化救治分析

目的 探讨提高多发伤救治成功率的措施。方法 回顾性总结2002年6月～2003年6月间中山市急救中心开展多发伤救治的效果，分析多发伤一体化救治的模式和关键点。结果 共收治135例，抢救成功107例，成功率79．3％；死亡28例，死亡率20．7％。结论 (1)住急救中心实施多发伤一体化救治是提高其成功率的有效途径，也是多发伤救治的发展趋势，(2)在急救中心实施多发伤一体化救治的模式：急救中心设立创伤中心、建立成套的创伤急救体系，培养高素质专业人员．多发伤的诊治由急救中心医师实施或组织实施。(3)严重多发伤救治的关键点：抓好院前、院内急救——抢救生命；开展急诊手术——尽早修复损伤器官，消除致死致残因素；重视重症监护及治疗——进一步治疗原发损伤，保护各脏器功能，促进机体恢复，防止并发症。     

纤维支气管镜与间接喉钳手术治疗声带疾病

目的进一步研究声带小结与息肉的治疗手段。方法采用日本OlimpusBFp20型纤支镜和国产FF-99光电子内窥镜显示仪，配合间接万向喉钳治疗声带小结和息肉57例。结果治愈率92％，病人痛苦小。结论纤支镜配合间接喉钳手术治疗声带小结和息肉效果良好。     

合肥地区献血员感染HBV和HCV危险因素的多因素分析

用ＥＬＩＳＡ法检测了合肥地区１４４０名献血员抗ＨＣＶ和乙肝五项指标，抗ＨＣＶ阳性率为５５％；ＨＢｓＡｇ携带率为１５％，ＨＢＶ总感染率４３７％。分别以抗ＨＣＶ阳性与感染过ＨＢＶ的献血员为病例，以抗ＨＣＶ阴性与未感染ＨＢＶ的献血员为对照进行了ＨＣＶ和ＨＢＶ感染危险因素的单因素和多因素分析。结果显示，ＡＬＴ、献血次数、献血量、文化程度、献血员心理和输血史与ＨＣＶ感染有关；血型、家庭人口数和家庭子女数与ＨＢＶ感染有关。     

膜型尿LH酶联免疫试剂监测排卵

应用膜型尿促黄体激素(LH)酶联免疫试剂,对48例不育症患者60个周期进行排卵监测。结果显示基础体温双相型并有血孕酮分泌增加(48.4±20.7nmol/L)的47个周期,尿LH显色均阳性;而基础体温单相型且无孕酮分泌增加(2.6±1.5nmol/L)的13个周期,尿LH显色均阴性。提示膜型尿LH酶联免疫试剂预测排卵无假阳性及假阴性。间隔12小时收集标本,按中位数统计法,尿LH显色程度与血LH浓度呈正相关(r=0.9887,P<0.001)。尿LH显示(±)距排卵时间为32.1±3.1小时,显色加深至(+)距排卵时间为16.9±2.6小时,两组差异有极显著意义(P<0.001);而尿LH显色(++)、(+++)距排卵时间与显色(+)组比较差异无显著意义(P>0.05)。表明一次检测到尿LH显色加深,即可推测排卵反应时间。与基础体温、宫颈评分、B型超声等比较,其预测排卵的价值更为可靠,而且操作简便快速,2分钟显示结果。监测结果还提示尿LH显色阳性的47个周期中,优势卵泡在起始显色的72小时内消失的41个周期为正常排卵,72小时后仍未消失的6个周期为未破裂卵泡黄素化。     

动脉数字减影血管造影的临床应用

本文报告８０例动脉数字减影血管造影（ＩＡＤＳＡ）的初步经验，特别着重影像质量的评价。在本组病例，ＩＡＤＳＡ主要用于头颅、颈部、肺、腹部以及先天性心脏病的诊断。本组未发生重大并发症。ＩＡＤＳＡ的优点是：（１）影像质量好；（２）用于ＩＡＤＳＡ的剂量和浓度以及导管的直径均较用于常规血管造影的小得多，因此其副作用和并发症显著减少；（３）检查时间显著缩短，因此，ＩＡＤＳＡ对介入放射学治疗特别有用；（４）ＩＡＤＳＡ现已大部取代常规血管造影来诊断多种疾病。     

改良Sugiura术与青木春夫式断流术的比较

目的评价改良Sugiura术的疗效。方法回顾性分析2001年3月～2004年12月施行的改良Sugiura术50例患者的临床资料，并与随机抽取的以往施行的青木春夫式断流术50例做比较。结果改良Sugiura术：术后发生并发症10例，手术死亡5例，远期出血5例，肝性脑病3例，术后死亡4例；青木春夫式断流术：术后发生并发症7例，手术死亡2例，远期出血6例，肝性脑病2例，术后死亡4例，上述指标两者比较差异均无统计学意义，P〉0．05。改良Sugiura术手术时间和住院时间分别为（2．6±0．9）h、（27．5±10．5）d，显著短于青木春夫式断流术的（3．8±0．8）h和（53．2±34．2）d，P〈0．01。结论改良Sugiura术总体疗效肯定，是一种较好的青木春夫式断流术的替代手术，其操作简便，手术时间和住院时间短，值得临床推广。     

Effects of Electro-Acupuncture on Immune Function After Chemotherapy in 28 Cases

PURPOSE: To observe the effects of electroacupuncture therapy on T cells and activity of NK cell in the patient of Chemotherapy. METHOD: Electro-acupuncture therapy was simultaneously applied during chemotherapy, T cells and activity of NK cell of patients were determined before electroacupuncture treatment (before chemotherapy) and after 4-course electro-acupuncture treatments. RESULTS: Before chemotherapy, CD3 was low within the normal range, CD4 was much lower than the normal range, and CD8, CD4/CD8 and activity of NK cell were within the normal range. After one month of chemotherapy combined with electro-acupuncture, no decline of all the indices was found (P > 0.05). CONCLUSION: Electro-acupuncture can really increase the immune function of patients of chemotherapy.     

浙江省在鼠中检测到埃立克体及无形体DNA片段并测序分析

目的:了解鼠中自然感染埃立克体及无形体的状况。方法:用巢式PCR扩增鼠中埃立克体属及嗜粒细胞无形体属16S rDNA的5′末端片段,对阳性产物克隆后测序。结果:在浙江省金华市金东区捕到鼠128只。在黄毛鼠中检到阳性4份,阳性率为3.125%,并对其进行克隆后测序。与Genbank上比对分析,三份与牛埃立克体相同基因区最为接近,属无形体科,无形体属。一份与反刍动物埃立克体相同基因区最为接近,属无形体科,埃立克体属。均为国内首次报道。结论:初步认为浙江省存在埃立克体及无形体病原。黄毛鼠可能为埃立克体及无形体宿主,尚需进一步调查。     

Investigation of the anti-complement agents, FUT-175 and K76COOH, in discordant xenotransplantation

Abstract: We examined whether hyperacute rejection (HAR) of a discordant xenograft in a nonhuman primate model could be inhibited by the anticomplement agents, FUT-175 (FUT) and K76COOH (K76). The inhibitory effect of FUT and K76 on baboon sera was studied in vitro by i) complement-mediated hemolysis of sheep erythrocytes (by measuring serum CH50) and ii) cytotoxicity to cultured pig kidney (PK15) cells. The in vivo administration of FUT (at 0.2–25 mg/kg/h i.v. continuously) and K76 (50 mg/kg i.v. bolus) allowed evaluation of the serum levels of these drugs. Both FUT and K76 inhibited serum CH50 in a concentration-dependent manner. An enhanced effect was obtained by combining K76 with FUT therapy. High concentrations of FUT (>10^-4 M) and K76 (>10³ μxg/ml) were necessary to suppress serum CH50 to <5% of the normal level. However, PK15 cytotoxicity remained at >50% in the presence of i) 10^-4 M of FUT, ii) 10³ μg/ml of K76, and iii) 10^-6 M of FUT + 10³ μg/ml of K76. Pig heart transplantation (HTX) was performed in two baboons receiving FUT (1 mg/kg/h i.v. continuously) and K76 (at 200 mg/kg ×1 or 400 mg/kg + 200 mg/kg × 2 i.v, respectively). Cytotoxicity of the serum to PK15 cells at the time of HTX showed 39% and 1% cell death, respectively, in these two baboons, and the CH50 level was 1% (of control level) and 0%, respectively. Graft survival was 4.5 hours and 10 hours (with death of the baboon), respectively (compared with a mean of 29 minutes in control experiments). Both excised grafts showed typical features of hyperacute rejection. Immunopathological studies revealed deposition of C1q, C3d, C6, properdin, and Factor B, demonstrating that complement activation was not fully inhibited by FUT and K76. We conclude that i) FUT and K76 are indeed potent complement inhibitors, ii) the dosages of FUT and K76 necessary to suppress complement-mediated injury cannot be extrapolated from previously reported data obtained from serum CH50 levels, and iii) higher (possibly toxic) dosages will be required to inhibit complement activation completely. It seems unlikely that HAR will be prevented by these drugs alone, although they may be beneficial when combined with other forms of therapy.     

家兔肝的神经支配

本实验共用家兔17只,将20%的HRP溶液100μl,经肝门多点注入,其中10只家兔出现标记细胞.两侧T_(2-12)背根节内共270个,左侧占51.11±3.04%,右侧为48.89±3.04%,左、右侧差异无显著性(P>0.05).在T_(5-8)背根节内的标记细胞较多,占总数的59.26±2.99%,中、小型细胞共占94.53±1.60%.两侧结状神经节内的标记细胞共143个.左侧占53.15±4.17%,右侧占46.85±4.17%.两侧差异无显著性.中、小型细胞共占93.01±2.13%.两侧腹腔神经节内的标记细胞较多,计数其中2例,共582个,左侧占59.79±2.03%,右侧为40.21±2.03%.在迷走神经背核内仅发现2个标记细胞.