武汉市儿童胰岛素依赖型糖尿病发病率调查

根据WHO DIAMOND计划,采用“捕获—再捕获”方法.对1989～ 1996年武汉市区 0～14岁儿童胰岛素依赖型糖尿病发病率进行了流行病学双向性前瞻调查。结果表明,其平均年发病率为0.4672/10万/年（男性 0.4526/10 万/年、女性 0.4828/10万/年）,按年龄构成际化后的标化率为 0.4798/10万/年（男性0.4621/10万/年、女性O.4988/10万/年）;男女性发病率比约为0.94。年度发病率呈现波动,1990和1993年最低（0.2492/10万）,1995年最高(0.8721/10万）。两个来源共同登记的确定水平为90.90％,预计年发病率为 0.4983/10万（95％CI=0.4441/10万～0.5526/10 万）。同其他国家和地区相比,武汉市儿童胰岛素依赖型糖尿病发病率较低。     

急诊多支冠状动脉搭桥术1例

冠状动脉造影及经皮冠脉腔内成形术是当前诊断及治疗冠心病安全有效的方法,但国外报道仍然有 2 %～7 % 的患者由于冠状动脉突然闭塞引起急性心肌缺血、心肌梗死及其它并发症,需行急诊冠状动脉搭桥术(CABG).由于急诊 CABG 对外科技术、组织协调等工作要求极高,国内只有为数不多的医院能够开展.笔者 2002 年 4 月为 1 例不稳定型心绞痛患者成功的施行急诊 4 支 CABG,疗效满意,现报道如下.     

氯胺酮麻醉下犬丘脑内神经递质的变化

目的:探讨氯胺酮麻醉时犬丘脑内各种神经递质的动态变化,揭示氯胺酮麻醉中枢作用的可能机制.方法:应用磁共振波谱分析(MRS)技术,选取16只犬,每只犬分别于清醒状态和麻醉后(氯胺酮2 mg/kg,静脉输入)行MRS扫描,采集丘脑内兴奋区(BOI)波谱.分析测定N-乙酰基天门冬氨酸(NAA),谷氨酸(Gh)、γ-氨基丁酸(GABA)、胆碱类化合物(Cho)和肌酸(Cr)的动态变化.结果:与清醒状态比较,静脉输入氯胺酮2 mg/ks后,丘脑区域NAA,Glu和Cho均明显降低(P<0.05);Cr,GABA在丘脑没有明显的变化.结论:氯胺酮麻醉对丘脑区域内NAA,Glu,Cho等神经递质均有影响,丘脑内递质的变化在氯胺酮的全麻机制中发挥重要作用.     

非细菌性血栓性心内膜炎

非细菌性血栓性心内膜炎(non-bacterial thrombotic endocarditis, NBTE)绝大多数发生于恶性肿瘤晚期,伴多发性动脉栓塞。我们最近遇到一例胆管细胞腺癌并发主动脉瓣的NBTE患者,在病程中出现左侧偏瘫,曾疑为逆性癌栓子或脑动脉硬化所致脑卒中。尸解证实为NBTE并发脑动脉及肢体动脉性栓塞,报道如下:     

双歧杆菌乳杆菌三联活菌片治疗婴幼儿轮状病毒性肠炎的疗效观察

目的:探讨双歧杆菌乳杆菌三联活菌片用于婴幼儿轮状病毒性肠炎治疗的临床疗效。方法:选取我院2011年8月-2014年3月收治的82例婴幼儿轮状病毒性肠炎患儿,随机分为对照组和观察组,各41例,对照组给予补液、补充电解质、合理饮食和利巴韦林治疗,观察组在对照组基础上增加双歧杆菌乳杆菌三联活菌片,比较两组治疗疗效及相关指标。结果:观察组总有效率(95.12%)高于对照组(80.49%),组间比较差异有统计学意义(P<0.05);观察组退热时间、呕吐消失时间、止泻时间及总病程均短于对照组,各项组间比较差异有显著统计学意义(P<0.01)。结论:双歧杆菌乳杆菌三联活菌片用于婴幼儿轮状病毒性肠炎治疗有助于改善临床症状,提高疗效,应在临床中推广应用。     

腹腔镜治疗输卵管妊娠60例分析

目的 探讨腹腔镜治疗输卵管妊娠的临床应用价值.方法 回顾性分析行腹腔镜手术治疗的60例异位妊娠患者的临床资料,分析腹腔镜在异位妊娠诊断和治疗中的应用价值.结果 60例输卵管妊娠患者在腹腔镜下确诊,均顺利完成手术治疗,无术后并发症及死亡.结论 腹腔镜治疗输卵管妊娠对腹腔干扰少、创伤小、术后恢复快,腹腔镜手术是输卵管妊娠首选的手术方式.     

车前子苷的提取分离

目的 :从中药车前子寻找特异性有效成分。方法 :在药理筛选和高效液相色谱指纹图谱识别的基础上进行色谱层析。结果 :确定车前子的醋酸乙酯部位具有镇咳、祛痰的作用 ,并从中分离出具有该作用的化合物 车前子苷。结论 :采用药理实验和高效液相色谱指纹图谱指导下的提取分离对寻找有效成分有重要意义     

肝舒乐片对非酒精性脂肪肝大鼠肝细胞线粒体能量代谢的影响

目的研究肝舒乐片对非酒精性脂肪肝(NAFL)大鼠肝细胞线粒体能量代谢的影响。方法用高脂饲料诱发大鼠NAFL模型,同时给予肝舒乐片干预,光镜下观察大鼠肝组织病理形态和琥珀酸脱氢酶(SDHase)的表达,电镜下观察肝细胞超微结构并行立体计量学分析,检测肝组织甘油三酯(TG)、总胆固醇(TC)、游离脂肪酸(FFA)含量,并与对照组比较。结果肝舒乐组的肝组织脂肪变性与肝细胞超微结构明显改善,免疫组化表明其显著促进脂肪肝肝细胞SDHase的表达,同时肝组织TG、TC、FFA含量降低,与模型组相比差异均有统计学意义(P0.05)。结论肝舒乐片能有效防治NAFL,其机理可能与增强肝细胞线粒体能量代谢有关。     

过表达 mimecan对人脐静脉内皮细胞增殖和凋亡的作用初探

目的 应用反转录病毒载体技术构建稳定过表达mimecan的人脐静脉内皮细胞株（HUVEC）,并观察过表达mime-can后HUVEC增殖及凋亡的变化.方法 应用反转录病毒载体构建稳定过表达mimecan的HUVEC细胞株,real-time PCR和Western blot法检测mRNA和蛋白水平的表达.应用CCK-8方法检测过表达mimecan后HUVEC增殖的变化,应用Annexin V-PE染色观察过表达mimecan后HUVEC凋亡的变化.结果 构建了稳定过表达mimecan的HUVEC细胞株.过表达mimecan后,HUVEC增殖能力降低,凋亡率增加.结论 过表达mimecan抑制HUVEC的增殖,促进其凋亡.     

前列腺导管腺癌临床病理和诊治特点分析

Objective To discuss the pathological and clinical features, diagnosis and treatment of prostatic duct adenocareinoma. Methods The clinical data of nine cases of prostatic duct adeno-carcinoma were retrospectively analyzed, with the average age of 76 (59-106) years. Six cases were presented with dysuresia and/or nocturia, and two of them had the painless gross hematuria. Two pa-tients presented painless gross hematuria as the first symptom. One case was detected the elevated ser-um PSA in a routine healthy examination. Radical prostatectomy (RP) was performed in 1 case;RP and bilateral orchidectomy and external beam radiotherapy (EBRT) were performed in 1 case;5 cases underwent transurethral resection of the prostate (TURP) combined with photoselective vaporization of the prostate (PVP) by green laser and bilateral orchidectomy;1 case underwent TURP combined with PVP;1 case underwent bilateral orchidectomy combined with EBRT. Eight cases took flutamide for 3-45 months. All patients were followed-up according to the scheduled time. Results The op-erations were successfully performed in all 9 patients. The papillary or cauliflower-like tumors infiltra-ted colli culus seminalis and prostate duct nearby. The glands were coated with tall pseudostratified columnar cells. The nuclei were large, dark stained with more frequent mitoses. The positive rates of immunolabelling antibody PSA, AR, PAP were found to be 89%(8/9), 100%(5/5), 100%(5/5) re-spectively. The distribution of Gleason score was 6-7(3 cases), and≥8(6 cases), and a coexisting acinar carcinoma component was identified in 5 cases of the group. Nine cases had a mean follow up for 20(3-48) months. Five cases have developed biochemical recurrence, of whom 3 died of bone metas-tasis and multiple organ failure, and 1 developed lung and bone metastasis. Three cases remained alive without recurrence. The remaining 1 case survives during the follow-up survey for 6 months until now, without examinations due to the old age. Conclusions Duct adenocarcinoma of the prostate presents the low incidence and lacks of typical symptoms in the early stage. Diagnosis was confirmed mainly on the basis of pathology. The tumors tend to have a more advanced stage and a very short term survival rate. The treatment options and management are similar to that of high-grade adenocar-cinoma of the prostate;meanwhile, close follow-up survey should be performed.