腰穿后腰背部疼痛36例观察

腰椎穿刺(简称腰穿)是一种安全可靠的检查方法,对脑膜炎、脑炎等颅内疾患的诊断有决定性的意义。但其并发症有多种,据临床观察,腰穿后腰背部疼痛发生率最高。对青岛市骨伤医院5年来140例次腰穿中并发腰背疼痛的36例报告作出了分析。     

抑制素A和妊娠相关蛋白A在子痫前期中的研究

目的:探讨正常孕妇各孕周血清妊娠相关蛋白A(pregnancy-associated plasma protein-A,PAPP-A)和抑制素A(inhibin-A)的变化及其与子痫前期(pre-eclampsia)发病的关系。方法:采用时间分辩荧光免疫分析技术(DELFIA)检测孕20～41周妇女外周血PAPP-A浓度913例,其中正常孕妇880例,子痫前期孕妇33例;采用ELISA检测孕20～41周妇女外周血inhibin-A浓度724例,其中正常孕妇691例,子痫前期孕妇33例。统计分析子痫前期妇女及正常孕妇外周血清PAPP-A和inhibin-A的中位数差异。结果:正常孕妇血清PAPP-A和inhibin-A浓度值随孕周的增加而不断增高,至孕晚期达到最高水平;而子痫前期组PAPP-A和inhibin-A水平显著高于相应孕周正常孕妇组的中位数。结论:正常孕妇血清PAPP-A和inhibin-A浓度随妊娠进展而逐渐上升;子痫前期患者血清PAPP-A和inhibin-A浓度显著高于同孕周正常孕妇,但PAPP-A和inhibin-A两者间无相关性,PAPP-A和inhibin-A与子痫前期发病存在相关关系。     

无泵体外肺辅助技术对犬急性呼吸窘迫综合征血流动力学的影响

目的 探讨无泵型体外肺辅助技术（Pecla）对犬急性呼吸窘迫综合征（ARDS）模型血流动力学的影响,寻找安全的分流范围.方法 建立犬ARDS模型,连接Pecla装置,将12只杂种犬随机分为两组,A组采用心排量的25%,20%,15%,10%的分流量顺序进行分流,B组采用心排量的10%,15%,20%,25%的分流量顺序进行分流,各分流量持续1小时,分别记录Pecla模型在模型建成后稳定一小时和各分流量末时的体循环血压,心率,肺循环血压.结果 两组的体循环血压,心率,肺循环血压均有轻度变化,但无显著差异（P＞0.05）.结论 Pecla使用25%的分流量不会对血流动力学产生严重影响.     

Effect of potassium-channel openers on the release of endothelium-derived hyperpolarizing factor in porcine coronary arteries stored in cold hyperkalemic solution

Hyperkalemic solution is widely used to protect the myocardium during open-heart surgery or to preserve donor hearts during heart or heart/lung transplants. The inhibitory effects of hvperkalemic solution on the release of endothelium-derived hyperpolarizing factor (EDHF) of coronary arteries following deep hypothermic storage (4 degrees C) has been well studied. However, it has not been established whether potassium channel openers have protective effects on the coronary endothelial function after cold storage. This study was designed to examine this. Porcine coronary artery rings were studied in organ baths. Relaxation in response to the EDHF stimulus A23187 (nonreceptor-mediated stimulus calcium ionophore) in thromboxane A2 mimetic U46619 (30 nmol/L)-induced precontraction after incubation with hyperkalemic solution (20 mmol/L) with nicorandil (10 micromol/L) (either at 37 degrees C in the oxygenated organ chamber or at 4 degrees C in a refrigerator for 6 h) was compared with the control. There was significant difference between hyperkalemia group and hyperkalemia with nicorandil group under normothermia (p = .04). The difference was significant in the same solution between normothermia and hypothermia. After incubation in hyperkalemic solution without or with nicorandil, the A23187-induced relaxation was 32.8% +/- 9.1% and 72.6% +/- 16.9%, respectively (N = 8, p < .01). Potassium channel opener can attenuate the inhibitory effect of hyperkalemic solution on the release of EDHF after cold storage.     

Risperidone-induced increase in serum prolactin is correlated with positive symptom improvement in chronic schizophrenia

The elevation in serum prolactin (PRL) concentration in schizophrenic patients treated with typical antipsychotic drugs is well documented. Recently, increased prolactin levels have been reported in patients taking risperidone. The purpose of this study was to explore the effect of the atypical antipsychotic drug risperidone on serum prolactin, and to investigate the relationship between the change in PRL and the therapeutic outcome. In this study, 30 male inpatients with a diagnosis of chronic schizophrenia (DSM-III-R) were assigned to 12 weeks of treatment with risperidone after a 2-week washout period. The risperidone dose was fixed at 6 mg/day. Clinical efficacy was determined using the Positive and Negative Syndrome Scale (PANSS). Serum PRL was assayed in serum by radioimmunometric assay in schizophrenic patients before and after 12-week treatment, as compared to 30 age-matched normal male subjects. The results showed that risperidone treatment significantly increased the serum PRL. A significant and positive relationship between the change in PRL at pre- and post-treatment and the reduction rate of PANSS positive subscore was observed. Risperidone treatment significantly increased the serum PRL levels of schizophrenic patients. There was a close relationship between the improvement in positive symptoms and the change of serum PRL level before and after risperidone treatment. The serum PRL levels at baseline could be used to predict the responses of schizophrenic patients to risperidone.     

p27、Survivin在乳腺癌中的表达及相关性

目的：探讨p27、Survivin在乳腺癌中表达的意义及相关性。方法：用免疫组化S-P法检测48例乳腺癌中p27、Survivin的表达情况，并与29例乳腺良性病变检测结果进行对照分析。结果：（1）乳腺良性病变p27、Sur-vivin的阳性率分别是79．3％（23／29）、24．1％（7／29）；乳腺癌p27、Survivin的阳性率分别是42％（20／48）、72．9％（35／48）。p27、Survivin的阳性表达率在乳腺良、恶性病变中差异具有统计学意义（P〈0．01）。（2）乳腺癌p27与Survivin的表达呈负相关（P〈0．05）。（3）乳腺癌p27的表达与患者的年龄、族别无关（P〉0．05）．与乳腺癌组织学分级相关（P〈0．01）；Survivin的表达与患者的年龄、族别、乳腺癌的组织学分级均无关（P〉0．05）。结论：p27、Survivin表达异常可能在乳腺癌的发生、发展中具有重要的作用，二者在乳腺癌的发生、发展中可能具有相互作用。p27、Survivin表达异常可用于良、恶性乳腺疾病的鉴别．对乳腺良性病变的恶性转化有一定的预兆性。     

康斯特保护液对未成熟心肌保护效果的临床观察

目的探讨康斯特保护液(HTK液)在婴幼儿心内直视手术中心肌的保护作用。方法36例择期行心内直视手术的婴幼儿随机分为两组。实验组灌注HTK液,对照组灌注ST.Thom as液。两组分别于阻断升主动脉前,开放升主动脉后3 m in由冠状静脉窦取血,行肌酸激酶同工酶(CK-MB),乳酸脱氢酶(LDH),心肌肌钙蛋白(cT-nI)检测。开放升主动脉前自右室流出道取心肌组织0.3 cm×0.3 cm两块,行超微结构观察。结果血清CK-MB、LDH和cTnI浓度变化:开放升主动脉后较缺血前两组均明显升高。心肌结构改变:对照组可见心肌细胞水肿,片状肌浆凝聚,心肌纤维呈波纹状改变,线粒体轻度肿胀,部分嵴断裂,空泡形成。实验组超微结构改变较对照组轻。结论HTK心脏停搏液对未成熟心肌有良好的保护作用。可减轻心肌细胞及间质水肿,肌原纤维结构破坏轻,线粒体损伤轻。单次灌注避免多次灌注所致的心肌细胞水肿和冠脉血管内皮的损伤。     

改进手术方法治疗额颞部重型颅脑损伤

目的 探讨高原额颞部重型颅脑损伤的改进手术方法及效果。方法 采用改良式Keuy问号形切口，沿前额发际内正中旁3era，向后呈弧形在顶骨结节前转向颞部到达乳突上缘，从耳后发际边缘拐向前缘止于颧弓上。从颞骨鳞部开窗，颅骨钻孔取下扩大骨瓣，切开硬脑膜，清除血肿及挫碎脑组织。同时去骨瓣减压，将骨瓣浸泡在55％酒精瓶内密封低温冷藏。结果 本组46例患者经手术治疗后存活36例，良好28例，中度残废6例，重度残废2例；死亡10例。结论 46例患者采用改进手术方法扩大入路硬脑膜成形术治疗额颞部重型颅脑损伤，存活36例，取得了较好的效果。     

综合康复训练对军队慢性精神分裂症患者阴性症状的影响

目的：探讨综合康复训练对改善军队慢性精神分裂症患者阴性症状的效果。方法：将符合入组标准的86例慢性精神分裂症患者随机分为研究组和对照组，对照组行常规抗精神病药治疗，研究组在此基础上实施2个月的综合康复训练。以阳性和阴性症状量表（PASS）、住院精神病人康复疗效评定量表（IPROS）作为评定效果的工具。结果：综合康复训练前PANSS、IPROS总分及各凶子分间无明显差异。与综合康复训练前比较，研究组PANSS量表阴性．反应缺乏及抑郁因子分明显下降（P〈0．05～0．01），与对照组比差异有显著性（P〈0．05～0．01）；IPROS量表总分及各因子分均明显下降（P〈0．05～0．01），与对照组比差异也有显著性（P〈0．05～0．01）；对照组PANSS量表的抑郁因子分明显升高（P〈0．05）。结论：综合康复训练能够有效地改善恢复期精神分裂症患者的阴性症状及提高康复疗效。