曼陀罗药酒中毒患者的急救护理

对43例鼻咽癌患者放疗前行导管动脉灌注化疗，结果获得理想疗效，未发生严重并发症。其重点为密切观察生命体征，严格限制体位，做好穿刺处伤口护理，预防血栓、胃肠道反应及口腔炎，加强心理护理和健康教育是治疗成功的关键。     

Novel Strategy to Engineer Trachea Cartilage Graft With Marrow Mesenchymal Stem Cell Macroaggregate and Hydrolyzable Scaffold

Limited donor sites of cartilage and dedifferentiation of chondrocytes during expansion, low tissue reconstruction efficiency, and uncontrollable immune reactions to foreign materials are the main obstacles to overcome before cartilage tissue engineering can be widely used in the clinic. In the current study, we developed a novel strategy to fabricate tissue‐engineered trachea cartilage grafts using marrow mesenchymal stem cell (MSC) macroaggregates and hydrolyzable scaffold of polylactic acid–polyglycolic acid copolymer (PLGA). Rabbit MSCs were continuously cultured to prepare macroaggregates in sheet form. The macroaggregates were studied for their potential for chondrogenesis. The macroaggregates were wrapped against the PLGA scaffold to make a tubular composite. The composites were incubated in spinner flasks for 4 weeks to fabricate trachea cartilage grafts. Histological observation and polymerase chain reaction array showed that MSC macroaggregates could obtain the optimal chondrogenic capacity under the induction of transforming growth factor‐β. Engineered trachea cartilage consisted of evenly spaced lacunae embedded in a matrix rich in proteoglycans. PLGA scaffold degraded totally during in vitro incubation and the engineered cartilage graft was composed of autologous tissue. Based on this novel, MSC macroaggregate and hydrolyzable scaffold composite strategy, ready‐to‐implant autologous trachea cartilage grafts could be successfully fabricated. The strategy also had the advantages of high efficiency in cell seeding and tissue regeneration, and could possibly be used in future in vivo experiments.     

高压氧治疗对阿尔茨海默病大鼠海马内神经元凋亡及p38丝裂原蛋白激酶表达的影响

目的 评价高压氧治疗对阿尔茨海默病(alzheimer's disease,AD)大鼠海马内神经元凋亡及p38丝裂原蛋白激酶(p38 mitogenactivated protein kinases,p38MAPK)表达的影响. 方法 18只雄性SD大鼠,体重260 g～290 g,采用随机数字表法分为3组(每组6只):生理盐水组(NS组),海马区注射生理盐水;阿尔茨海默病组(AD组),海马区注射Aβ1-40;高压氧组(HBO组),海马区注射Aβ1-40,并于术后1 d～7d行每天1次的高压氧治疗.应用脑立体定位仪于大鼠海马区注射Aβ1-40制备AD模型.于术前1d和术后1、7、14、21 d行水迷宫行为学测试.于术后21 d水迷宫行为学测试结束后处死大鼠,采用苏木精-伊红染色(hematoxylin-eosin,HE)方法染色海马组织病理结构,TUNEL法标记检测凋亡细胞,免疫印迹法(Western bolt)法测定海马内p38MAPK蛋白磷酸化水平. 结果 术后21 d时,与NS组比较,AD组大鼠上台前路程和逃避潜伏期增加[(379±41)、(1 978±120) cm,(16.0±2.8)、(78.4±10.8)s](P＜0.05);与AD组比较,HBO组大鼠上台前路程和逃避潜伏期减少[(1978±120)、(1 246±96) cm,(78.4±10.8)、(51.7±6.2)s](P＜0.05).与NS组比较,AD组和HBO组大鼠海马组织细胞凋亡率[(6.3±13)％,(45.2±5.1)％]及p38MAPK蛋白磷酸化表达升高(0.16±0.06),(0.54±0.10)(P＜0.05);与AD组比较,HBO组海马组织细胞凋亡率[(45.2±5.1)％,(22.5±3.7)％]及p38 MAPK蛋白磷酸化表达下降[(0.54±0.10),(0.31±0.08)](P＜0.05).结论 高压氧治疗可有效缓解AD大鼠认知功能障碍,且能够抑制海马内神经元凋亡,其机制与降低p38MAPK的磷酸化水平有关.     

仝小林运用石膏、知母、川黄连清胃热经验

胃热证常见于糖尿病等代谢性疾病、口腔炎症、急性胃炎、消化性溃疡、上消化道出血等多种疾病的发病过程中.仝小林院士临床常以石膏、知母、川黄连三药合用以直折胃热,石膏配知母清热而不伤阴液,黄连尤善清中焦之郁热,方中石膏常用剂量为15～30 g,知母为15～45 g,川黄连为9～30 g,若胃热伤阴,可加人参益气生津,津液伤甚者,可加石斛、麦冬、玉竹、沙参.临床应用中应中病即止,不可久服.     

Effects of acylation and glycation treatments on physicochemical and gelation properties of rapeseed protein isolate

The aim of this study was to improve the gelation property of rapeseed protein isolates (RPI) by means of acylation and glycation. The results showed that acylation and glycation within RPI occurred at Lys, and Lys, Met, Ile, Leu and Pro, respectively. Acylation and glycation both increased the surface hydrophobicity (So) and molecular weight of RPI, and decreased the free sulfhydryl (SH) content of RPI, while acylation resulted in a lower change of So and SH. The conformational structure of modified RPIs was changed, and acylated RPI (acylation degree, 38 ± 0.2%) possessed the highest ordered structure content among the modified RPIs. The thermal stability of the protein was improved after either acylation or glycation treatments. Furthermore, native RPI with moderate modification (low degree of acylation, 38 ± 0.2%) showed an overall improvement in the gelation and gel properties as evidenced by the reduced least gelation concentration and surface roughness, increased water-holding capacity, and better textural properties.

Acylated and glycated RPI gels were prepared, but the moderate acylation was more favorable to improve the gelation property of RPI.     

髂骨复合瓣与前臂皮瓣串联重建大型下颌骨复合缺损

由于恶性肿瘤的根治性切除致下颌骨大型复合缺损３例，采用髂骨复合瓣与前臂皮瓣串联重建，其中１例切取双侧髂骨复合瓣。３例病人７块皮瓣全部成活，随访３～１２月，供受区外形及功能结果较满意，经Ｘ摄片随访观察显示移植骨愈合改建过程迅速，骨吸收量少。结果表明，前臂皮瓣可弥补髂骨复合瓣携带皮岛的不足，两者串联应用是重建下颌骨大型复合缺损的一种理想方法。     

左氧氟沙星联合阿奇霉素治疗高龄难治性呼吸道感染的临床研究

目的评价左氧氟沙星联合阿奇霉素治疗高龄人群难治性呼吸道感染的疗效与安全性。方法对68例难治性细菌性呼吸道感染的高龄患者随机分为治疗组和对照组,治疗组34例给予左氧氟沙星联合阿奇霉素治疗;对照组34例给予左氧氟沙星治疗,两组总疗程皆为15 d。结果治疗组与对照组的有效率分别为64.71%和32.35%,呼吸道细菌清除率分别为76.19%和36.36%,差异均有统计学意义（P〈0.05）。两组不良反应发生率皆低。结论左氧氟沙星联合阿奇霉素治疗高龄人群难治性呼吸道感染临床疗效优于单用可乐必妥,疗效确切而且安全。     

电子束CT增强容积扫描检测早期实验性心肌缺血的方法及初步结果

目的：探讨电子束ＣＴ增强容积扫描检测早期实验性心肌缺血的方法，并报告初步结果。材料和方法：用Ｉｍａ－ｔｒｏｎＣ－１５０型电子束ＣＴ机对冠状动脉结扎后１．５ｈ的５例实验犬进行心脏的碘造影剂增强容积扫描。仔细观察左心室心肌缺血在电子束ＣＴ图像上的形态学表现，测定并对比分析心肌缺血区和正常区的ＣＴ值及两者与左心室腔ＣＴ值的比值（Ｍ／Ｌ值）。结果：电子束ＣＴ增强容积扫描能清晰地显示心肌低密度缺血区的部位、范围、形态、密度等；缺血区的ＣＴ值及Ｍ／Ｌ值显著低于正常心肌区。结论：电子束ＣＴ可作为检测、分析心肌缺血早期形态学表现和定量分析其ＣＴ值变化的一种高敏感性的非创伤性方法。     

桥小脑角区MRI解剖研究

目的：研究桥小脑角区ＭＲＩ正常解剖。材料与方法：５具头颅标本磁共振成像（ＭＲＩ）与解剖断面对照，并与１０例正常人增强前后头颅ＭＲＩ配对比较。结果：桥小脑角区主要解剖结构为内听道及三叉神经，表现为：（１）内听道各壁在Ｔ１、Ｔ２加权像均为极低信号，宜用Ｔ２加权像观察内听道的大小和形态；（２）在Ｔ１加权像上可显示内听道内面神经、耳蜗神经、前庭上下神经等，且第Ⅶ、Ⅷ神经束粗细为３．０ｍｍ；（３）三叉神经粗细为２．０ｍｍ，在横断面Ｔ１加权像上显示最清楚。结论：ＭＲＩ能显示桥小脑角区细微的解剖结构，横断面和冠状面ＭＲＩ是显示结构的最佳断面。     

正常国人MRI横断面脑沟回定位的研究

探讨定位中央沟和邻近脑回的各种MRI证象及其显示率和临床应用价值。材料和方法：收集50例（100个半球）的正常人群，均经SE序列横断面MRI扫描T1、T2加权成像，两位医生双盲法阅片并记录脑沟回的解剖特点。结果：额上沟、中央前沟、中央沟、边缘支、中央后沟及顶内沟在MRI上的显示率分别为100％、97％、10o％、94％、96％、和98％；额上沟－中央前沟征、边缘支括弧征、钩形征、薄中央后回征及顶内沟－中央后沟征的临床应用价值分别为0．87、0．90、0．98、0．98和0．92而中央沟征、分叉中央后沟征、边缘支偏斜征、脑白质指样征的应用价值仅为0．70、0．74、0．68和0．69；后二者的准确度为100％；但显示率低。结论：单一征象都不是100％的有效；多征象的结合有助于脑沟回及病变区的准确定位。