自发性食管破裂治疗16例

1 临床资料 1989-08／2004-05，我院共诊治自发性食管破裂患16(男15，女1)例，年龄12-62(平均37)岁，饮酒后呕吐引起10例，饱餐后呕吐引起3例，妊娠呕吐引起1例，重体力劳动后引起2例．主要临床表现：上腹部及下胸部剧烈疼痛．呼吸急促和发热；查体：上腹部腹肌紧张、压痛12例，颈部皮下气肿8例；X线摄片提示纵隔增宽13例，     

人甲胎蛋白时间分辨免疫荧光分析试剂盒的研制

目的研制人甲胎蛋白(hAFP)时间分辨免疫荧光分析(TRFIA)试剂盒.方法采用双抗体夹心法建立AFP TRFIA 试剂盒,对试剂盒的各项指标进行评价.结果试剂盒的可测范围为l～1 000 U/ml,灵敏度为0.17 U/ml,精密度良好,批内和批间的精密度分别为3.3%～5.9%,3.7%～6.5%.与CEA、CA12-5、CA19-9、CA15-3、白蛋白无交叉反应.稳定性试验表明试剂可以在4℃稳定1年,37℃稳定7 d.426份正常血清标本测试该试剂盒的正常参考值范围是0～12 U/ml.用本试剂盒与国外同类试剂盒同时检测60份血清标本,其相关系数为0.995.结论试剂盒各项指标(灵敏度、精密度、特异性、稳定性、准确度)均达到临床检测要求,可替代国外同类产品试剂盒.     

Prof. Shan Zhaowei＇s Experience in Treating Atrophic Gastritis

Prof. Shan Zhaowei （ 单兆伟 ）, the author＇s teacher, has been engaged in TCM for more than 30 years, with profound knowledge in the treatment of diseases of the spleen and stomach, which are introduced in the following.     

The prevalence of LRRK2 Gly2385Arg variant in Chinese Han population with Parkinson's disease.

We conducted a case-control study to determine the prevalence of the LRRK2 Gly2385Arg variant in patients with Parkinson's disease in Han population in mainland China. Heterozygous LRRK2 Gly2385Arg variant was identified in 14 of 235 patients with Parkinson's disease (5.69%), but not in 214 unrelated healthy controls. Multivariate analysis indicated the frequency of Gly2385Arg variant in the female patients with early age at onset is higher than their male counterparts. The founder haplotype analysis showed the variant carriers shared the same founder. Clinically, the LRRK2 Gly2385Arg carriers presented with classical Parkinson's disease symptoms. Our study indicates that the LRRK2 Gly2385Arg variant is a potential ethnic-specific genetic risk factor of Parkinson's disease within Chinese Han ethnicity.     

经胸小切口在食管癌切除手术中的应用

目的探讨经胸小切口治疗食管癌手术的地位和可行性。方法对132例不同分期的食管癌行经胸小切口根治性手术,全部采用颈部吻合。结果切口平均长度13.0±2.0 cm,开关胸时间、开胸时出血量、术后伤口疼痛、呼吸功能受限及患肢活动等方面有显著差异,在手术时间、淋巴结清扫、术中出血及术后胸腔引流和常规手术无差异。结论经胸小切口食管癌根治手术安全、可行,并且有创伤小、恢复快等优点,便于推广应用。     

小剂量氯胺酮咪唑安定辅助硬膜外下剖腹产手术的临床探讨

目的对比观察剖腹产选用连续硬膜外麻醉时，辅助麻醉用药镇静及对牵拉反应抑制效果。方法选择行剖腹产手术产妇60例在硬膜外麻醉效果满意后，随机分两组各30例。Ⅰ组：哌替啶50mg，异丙嗪25mg单次静注。Ⅱ组：氯胺酮28．5mg，咪达唑仑1．42mg单次静注。分组记录用药前，1min，5min，15min及术毕产妇SpO2、RR、HR、MAP值；记录手术时间、术毕苏醒例数、术中恶心躁动例数；记录术毕产妇OAA／S评分；记录新生儿娩出时Apger评分。结果两组术中镇静、抑制牵拉反应效果均满意。两组RR、BP、HR、SpO2均平稳；术毕两组OAA／S评分均为4-5分；新生儿Apger评分均正常。结论两组方法效果确切，对产妇和新生儿安全。     

大豆皂甙和神经肽Y在下丘脑后核引起的心血管效应中的关系

微量注射大豆皂甙（Ｔｓ）到下丘脑后核（ＰＨＮ）能引起平均动脉压（ＭＡＰ）升高，心率加快，其效应与向ＰＨＮ内注入神经肽Ｙ（ＮＰＹ）相似。分别注入不能引起血压、心率发生明显变化的微量Ｔｓ、ＮＰＹ，如果合并注入ＰＨＮ则可引起血压、心率的显著变化，表明二者互有加强作用。Ａｔｒｏｐｉｎｅ可以对抗Ｔｓ、ＮＰＹ或Ｔｓ＋ＮＰＹ同时注入ＰＨＮ的升压效应，提示ＮＰＹ是通过激活脑内Ｍ受体而实现升压效应的，而Ｔｓ的心血管效应又可能是经过脑内ＮＰＹ介导和加强的。     

Clinical Observation on the Method of Supplementing Qi, Clearing away Heat and Promoting Blood Circulation for Treating 53 Cases of Gastritis Related to Pyrolic Helicobacterium

According to the clinical experience of professor Shan Zhaowei (单兆伟), the author has successfully developed Qingyou Yangwei Capsule (清幽养胃胶囊capsules for eliminating pyrolic Helicobacterium and nourishing the stomach) for treating the gastritis. Clinical research has shown that the capsule has a good curative effect on chronic gastritis related to pyrolic Helicobacterium. Among the 53 cases in the treatment group, clinical observation showed cure in 6 cases, obvious effect in 18 cases, effect in 24 cases, no effect on 5 cases, with a total effective rate of 90.5%. Of the 50 cases in the control group, cure was found in 5 cases, obvious effect in 13 cases, effect in 20 cases, no effect in 12 cases, the total effective rate being 76%. The total effective rate in the treatment group was higher than that in the control group. The rate of eliminating pyrolic Helicobacterium in the treatment group was 66.04%, similar to that in the control group. In a follow-up visit 6 months later, the recurrence rate in the treatment group was 13.33%, obviously lower than that of 41.66% in the control group.     

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。     

波纹龙虱捕食蚊幼功能反应研究

作者于1991年7～9月,对波纹龙虱捕食淡色库蚊幼虫功能反应进行了研究。结果表明。在实验室条件下,波纹龙虱的捕食量随着蚊幼密度的增加而增大,其曲线符合Holling Ⅱ型功能反应,即其捕食量与猎物密度呈负加速曲线型。并根据Holling圆盘方程,建立了波纹龙虱捕食功能反应数学模型。波纹龙虱的寻找效应随着猜物密度的增加而降低。