环戊硫酮治疗干眼的临床疗效评价

Objective To investigate anethol trithione therapic efficiency on dry eye. Methods It was a prospective random double-blind controlled study. Eighty cases diagnosed dry eye in Ocular Surface Out-patient Clinic of Xiamen University Affiliated Xiamen Eye Center from 2006 to 2008 were divided into two groups: anethol trithione group and control group, 40 cases in each group. Every group was then divided into two subgroups: weak dry eye subgroup, middle and severe dry eye subgroup. All groups had been added with 0.05% refresh drops. All patients had been detected and evaluated by subjective symptoms of dry eye, visual acuity,corneal fluorescent staining(F1), break-up time(BUT) and Schirmer Ⅰ test (SⅠT) at pre-therapy and 3,7,28 d of post-therapy. All groups had been compared and analyzed by F test and sample mean difference (SMD) or median difference (MD) comparison between pre-therapy and post-therapy. Results Except of tear and red eye, the other subjective symptoms of dry eye, F1, BUT and SⅠT of weak dry eye subgroup of both groups had been improved at 7 d after therapy. Only those of middle and severe dry eye subgroup of anethol trithione group had been improved at 7 d after therapy compared with those of pre-therapy: SMD=0.96 (visual tiredness), 1.26 (dry and unsmooth sensation), 0.82 (foreign body sensation), 1.28 (burning sensation), 1.05 (photophobia), 1.48 ( pain ) ; MD=0.30 (visual acuity), 4.00 (F1) ,5.00 (BUT), 5.00 (SⅠT) [F=15.30 (visual tiredness), 15.68 (dry and unsmooth sensation ), 13.56 (foreign body sensation), 20. 91 ( burning sensation ), 18.90 (photophobia), 27.22 ( pain ), 10.54 (visual acuity), 188.21 (F1) ,261.76 (BUT) ,269.05 (SⅠT) ;P<0. 05]. Those of middle and severe dry eye subgroup of control group hadn't significantly been improved at 28 d after therapy: SMD=0.10 (visual tiredness) ,0.16 (dry and unsmooth sensation) ,0.09 (foreign body sensation) ,0.38 ( burning sensation ), 0.24(photophobia) ,0.36 (pain) ,0.23 (red eye) ; MD=0.10 (visual acuity) ,0.50(F1) ,0.50(BUT), 0.50(SⅠT) [F=1.76 (visual tiredness), 1.61 (dry and unsmooth sensation), 1.02 (foreign body sensation),2.39 (burning sensation), 2.42 (photophobia), 2.73 ( pain ), 2.55 ( red eye ), 1.46 ( visual acuity) ,2.35 (F1) ,2.90 (BUT) ,2.76 (SⅠT) ; P>0.05]. SⅠT of anethol trithione group had been improved more significantly after therapy (F=13.77, P<0.05). Conclusion Anethol trithione could significantly improve middle and severe dry eye patients' symptoms and signs whose lacrimal gland function survival and it has clinical application value.     

70例晚期肺恶性肿瘤全肺切除术后的疗效分析

198 5年 8月～ 2 0 0 1年 8月我院共进行非小细胞肺癌全肺切除手术 6 9例 ,肺静脉肉瘤全肺切除 1例。现报告如下。1　临床资料1 1　一般资料 :本组男 5 1例 ,女 19例 ,年龄 16～ 71岁 ,平均 5 1岁。左全肺切除 4 9例 ,右全肺切除 2 1例。其中心包内切除 5例 ,有 2例伴部分上腔和右心房切除 ,1例伴部分左房 (包括一侧肺静脉 )切除。3例肺癌肺叶切除术后 ,同侧肺叶复发再行余肺切除。同时行部分胸壁肋骨切除 +胸改手术 3例。1 2　病理 :鳞癌 39例 ,腺癌 2 8例 (其中低分化腺癌5例 ,粘液腺癌 2例 ) ,未分化癌 2例 ,肺静脉内血管平滑肌肉瘤 1例…     

rdxA基因在幽门螺杆菌对甲硝唑耐药机制中的作用

目的 探讨rdxA基因变异与幽门螺杆菌(Hp)对甲硝唑耐药之间的关系。方法 随机收集快速尿素酶试验(RUT)阳性的病人(5l例)，取胃窦部黏膜l块，在体外微需氧培养。甲硝唑耐药率检测分别用E试验和临界点药敏法。PCR扩增HA的rdxA基因片断(886bp)并测序。对耐药株和敏感株的rdxA基因序列与标准菌株HA26695相应序列进行同源性分析。结果共分离出Hp临床分离菌47株。甲硝唑用E试验法检测耐药率为34％(16／47)，临界点药敏法为31．9％(15／47)，其中15株两种方法均耐药。测序15株Hp耐药株和8株敏感株的rdxA基因片断，与标准菌株HA26695相应序列对比，15株耐药株(MtzR)的rdxA基因核酸序列相似性范围在90％-95％之间，平均为92．5％，而8株敏感株(Mtzs)相似性范围在94％—95％之间，平均为94．5％。大多数耐药株rdxA基因的变异为点变异、单个碱基插入或缺失，未发现大片段序列的插入和缺失，且突变位点是不固定的。结论 在耐甲硝唑的大多数Hp临床分离株中，rdxA基因发生多处点变异，单个碱基插入或缺失，但未发现大片段序列的插入和缺失，且变异位点是不固定的。     

部分体外循环胸骨旁小切口心脏不停跳二尖瓣置换术的研究

目的探讨部分体外循环胸骨旁小切口心脏不停跳二尖瓣置换术的临床意义和价值。方法 2007-10～2012-03将风湿性心脏病二尖瓣病变需行二尖瓣置换的80例患者随机分为研究组(A组)和对照组(B组),各40例。A组采用经右前胸小切口(6～8 cm)第四肋间进胸,行右股动、静脉插管建立部分体外循环,无须显露和阻断升主动脉。B组采用常规经右胸前外侧切口(12～18 cm)第四肋间进胸,显露并插升主动脉灌注管和上、下腔静脉引流管建立体外循环,不阻断升主动脉。两组均在心脏不停跳下完成二尖瓣置换手术。结果切口长度:A组(6.7±0.61)cm,B组(16.51±1.52)cm(P0.05);心脏血管手术时间:A组(74±12.00)min,B组(71±11.00)min(P0.05);体外循环时间:A组(58±13.30)min,B组(56±11.60)min(P0.05);出血量:A组(183±56)ml,B组(196±43)ml(P0.05);ICU停留时间:A组(36±8.5)h,B组(37±7.8)h(P0.05);术后住院时间:A组(12±2.3)d,B组(13±2.9)d(P0.05)。全组元伤口感染,元气栓栓塞和神经系统并发症,无主动脉、股动脉和静脉损伤并发症,均恢复顺利。心功能恢复两组差异无统计学意义(P0.05)。结论部分体外循环胸骨旁小切口心脏不停跳二尖瓣置换术能进一步缩小胸部切口的长度、减少创伤、减轻疼痛和降低并发症发生率,达到恢复快和切口美观的效果,为临床多提供一种微创的手术方法,而且容易推广。     

颅骨缺损早期修补83例治疗体会

目的探讨颅骨缺损早期修补的意义、时机及临床经验。方法对83例颅骨缺损早期三维动态钛网修补术患者进行回顾性分析。结果所有患者三维动态钛网固定可靠、无浮动,外观对称美观。无头皮感染及排斥反应,无咀嚼功能受限。结论三维动态钛网是目前较为理想的颅骨缺损修补材料,应用其早期颅骨修补是可行的,可明显改善病人的生活质量。     

Protective effects of pretreatment with Radix Paeoniae Rubra on acute lung injury induced by intestinal ischemia/reperfusion in rats

Objective： To investigate the effect of pretreatment with Radix Paeoniae Rubra （RPR） on acute lung injury induced by intestinal ischemia/reperfusion in rats and its protective mechanism.
Methods： Thirty-two Wistar rats were randomly divided into four groups： Sham-operation group, ischemla/ reperfusion group （I/R group ）, RPR-pretreatment group and hemin group. The model of intestinal ischemia/ reperfusion was established by clamping the superior mesenteric artery for 1 hour followed by 2-hour reperfusion. The effect of RPR on the expression of heme oxygenase-1 （HO-1） in lung tissues was detected by immunohistochemistry and morphometry computer image analysis. Arterial blood gas analysis, lung permeability index, malondialdehyde （MDA） and superoxide dismutase （SOD） contents in lungs were measured. The histological changes of lung tissue were observed under light microscope.
Resalts： The expression of HO-1 in RPR-pretreatment group and hemin group was obviously higher than that in sham-operation group and I/R group （ P 〈 0.01 ）. The level of MDA and lung permeability index in RPR-pretreatment and hemin group were significantly lower than those in I/R group （P〈0.01 or P〈0.05）, while the activity of SOD in RPR-pretreatment and hemin group was obviously higher than that in I/R group （P〈0.01）. Under light microscope, the pathologic changes induced by I/R were significantly attenuated by RPR.
Conclusion： Intestinal ischemia/reperfusion may result in acute lung injury and pretreatment with RPR injection can attenuate the injury. The protective effect of RPR on the acute lung injury is related to its property of inducing HO-1 expression and inhibiting lipid peroxidation.     

右胸小切口心脏不停跳心内直视手术15例经验

1997年1月至1997年12月，我们采用右胸小切口行常温心脏不停跳心内直视手术15例，效果良好，现报告如下：1资料和方法一般资料：男性8例，女性7例，年龄12～35（平均20．5）岁；心胸比率0．54～0．68（平均0．58）；心功能（NYHA）I级4例，I级5例，1级5例，N级1例。其中二尖瓣替换7例，心房间隔缺损修补5例，心室间隔缺损修补2例，左心房粘液瘤切除1例。手术方法：取右胸腋下“L”切口长8～12cm，于前锯肌与胸大肌之间钝性分开，经第3肋间进胸（除1例干下型心室间隔缺损需横断胸骨外，其余均能完成手术），于隔神经前纵切心包，暴露心脏…     

急性心肌梗死静脉应用潘南金与氯化钾临床疗效对照分析

目的探讨潘南金对急性心肌梗死的疗效。方法48例AMI病人应用潘南金,56例病人单纯应用氯化钾。结果室速发生率、窦缓、房颤、室上速发生率、急性左心衰竭发生率及死亡率,治疗组与对照组分别为8.3%对21.4%,24.2%对14.3%,14.6%对28.6%,4.2%对7.1%。结论AMI应用潘南金疗效优于氯化钾。     

呼吸之门--从胸腹呼吸、丹田呼吸到体呼吸

人人皆知,呼吸支撑着生命。因此,中国古代养生家极重视呼吸的训练。他们认为,善养生者,应当首先调节好日常呼吸,让大自然的清新之气透达全身。然而这还远远不够,真正的养生家还应当开启丹田呼吸、开启体呼吸,由此而呼吸真气,超越自然寿命的局限。最被现代人忽视的呼吸,在古人那里,发展成了一门调息导气的大学问。 古人认为,呼吸的气息有四种形态:一为风,二为喘,三为气,四为息。有声为风,无音为气,出入为息,气不畅为喘。在入静时,“守风则散,守喘则结,守气则劳,     

不同年代铜绿假单胞菌1型整合子结构比较

目的研究1992-1996年和2003-2005年两个时间段90份铜绿假单胞菌1型整合子结构，比较其结构差异，以了解不同年代1型整合子变化趋势。方法用常规和长片段PCR方法扩增1型整合子及耐药基因，并对PCR产物进行测序和GenBank比对分析。结果41份1992—1996年间样本有13份检出1型整合子结构，长片段PCR扩增1型整合子DNA平均长度为1868bp，平均包含2个耐药基因，包括qaeE△1（n=6）、sul1（n=14）、aadA1（n=2）、aadB（n=1）、PSE-1（n=2）和tetA（n=1）等6种耐药基因，形成5种耐药基因盒组合。49份2003-2005年间样本中有19份检出1型整合子结构，长片段PCR扩增产物平均长度为3383bp，平均包含3．6个耐药基因，包括qaeE△1（n=18）、sul1（n：25）、aadA1（n=6）、aadB（n=7）、aaeA4（n=2）、PSE-1（n=3）、VEB-1（n=4）、OXA10（n=1）、cm1A（n=1）和tetA（n=2）10种耐药基因，形成9种耐药基因盒组合。结论根据整合子碱基数量和所携带耐药基因盒数量，发现2003--2005年间检出的1型整合子结构比1992—1996间检出的复杂程度增加。