应用弯形麦氏接骨板治疗股骨粗隆下骨折(附28例报告)

作者应用改制的弯形麦氏接骨板内固定治疗股骨粗隆下骨折28例。经随访3～6个月,平均4个月骨折达临床愈合,14～20个月,平均16个月达骨性愈合。优良25例,优良率为89.3％。认为改制的弯形麦氏接骨板内固定牢固可靠。除严重粉碎性骨折一般不需外固定,病人可早期活动,加速骨折愈合。     

THE ROLE OF P_1-PURINERGIC RECEPTORS IN THE SPINAL MECHANISMS OF ACUPUNCTURE ANALGESIA

It has been extensively proved that electro-acupuncture elicit analgesia in bothextensive areas and local region via supraspinal structures and spinal cord.The present investigationwas to study the role of P_1-purinergic receptors in the spinal mechanisms of weak electroacupuncture-induced analgesia.Leg withdrawal latency(LWL)to noxious radiant heat focused on the ankle regionwas used to assess the effects of acupuncture and that of P_1-purinergic(adenosine)receptor antago-nists,theophylline and caffeine on the electro-acupuncture(EA)analgesia.EA prolonged the LWLby 16.7%±20.3%,with an after-effect lasting about 15 min.Both theophylline and caffeineblocked the EA-induced prolongation of LWL in a dose-dependent manner at the doses of 1.6-16 mg/kg.These results suggest that P_1-purinegic receptor is involved in the spinal mechanisms of weak EAproduced analgesia in the rat.     

黄疸出血群赖型017株钩端螺旋体外膜单克隆抗体免疫...

BALB/c mice were immunized intraperitoneally with outer envelopes of serogroup icterohaemorrhagiae lai serovar strain 017 leptospires. Monoclonal antibodies against outer envelopes (IgG, agglutinating titre 1:25,600) were produced by hybridoma technique. The monoclonal antibodies ascites (diluted 1:100) 1 ml administered intraperitoneally 1 hour before the intraperitoneal injection of 2 x 10(8) leptospires of strain 017 and the subsequent daily administration of McAb in similar doses for five days protected 80% of guinea pigs. Survival rates of three control groups which received physiological saline, ascites of BALB/c mouse myeloma cell lines SP2/0, and monoclonal antibodies against Pseudomonas aeruginosa in place of monoclonal antibodies against outer envelopes of strain 017 leptospires were 10%, 20% and 10% respectively. When killed 20 days after challenge, guinea pigs of experiment group were normal at autopsy. Old pulmonary haemorrhage were present in the animals of three control groups. Passive immunoprotection experiments have demonstrated immunoprotection of monoclonal antibodies against outer envelopes of strain 017 leptospires. It will be valuable for separating protective antigen fraction of outer envelopes and studying new vaccine of leptospira.     

Malignant external otitis: insights into pathogenesis, clinical manifestations, diagnosis, and therapy

Malignant external otitis is an infection of the external ear canal, mastoid, and base of the skull caused by Pseudomonas aeruginosa. The condition occurs primarily in elderly patients with diabetes mellitus. Current theories on pathogenesis and anatomic correlations are reviewed. Severe, unrelenting otalgia and persistent otorrhea are the symptomatic hallmarks of the disease, whereas an elevated erythrocyte sedimentation rate is the only distinctive laboratory abnormality. Iatrogenic causes such as administration of broad-spectrum antibiotics and aural irrigation may play a predisposing role in high-risk populations. The disease can result in cranial polyneuropathies (with facial nerve [VII] paralysis being the most common) and death. The mainstay of treatment is administration of antipseudomonal antibiotics for four to eight weeks. Recurrence is common, and mortality remains at about 20 percent despite antibiotic therapy. Given the increasing longevity of diabetic patients, the frequency of this disease is increasing. Internists, family practitioners, and ambulatory care physicians must now be cognizant of the presenting symptoms, while infectious disease specialists and otolaryngologists need to be appraised of strides in diagnosis and therapy. The role of surgery should be minimized. Use of new diagnostic radiologic modalities and new antipseudomonal antibiotics discussed in this review should lead to improved outcome.     

采用修正正交分段线性函数求解时滞系统和卷积的方法

应用修正正交分段线性函数的时滞和反向特性，推导出求解时滞系统和卷积的公式。数字仿真表明，它具有计算简单，精度高的优点。     

糖皮质激素受体高、低亲和力位点在急性淋巴细胞性白血病治疗中的意义

研究了１０例正常人和２９例急性淋巴细胞性白血病（急淋）患者外周血糖皮质激素受体高、低亲和力结合位，或（ＧＣＲＨ、ＧＣＲＬ），利用Ｒｕ３８４８６对ＧＣＲＬ进行封闭，对部分患者ＧＣＲＨ、ＧＣＲＬ在激素联合化疗前后水平的变化进行了动态观察。结果表明，正常对照组ＧＣＲＨ、ＧＣＲＬ分别为４６０８±１８８９位点／细胞和１３５２３８±８８５０９位点／细胞，两者相关良好。急淋患者ＧＣＲＨ、ＧＣＲＬ分别为６０５２±３８８８位点／细胞和１２６４０５±１０２１３３位点／细胞，经过糖皮质激素药物联合化疗后，其水平分别为３６１６±１９６２位点／细胞和１４３５９７±１１２２８９位点／细胞，ＧＣＲＨ下降明显（Ｐ＜０．０１），下降率为４０．３％；而ＧＣＲＬ化疗前后差异不显著（Ｐ＞０．０５）。提示ＧＣＲＬ在介导糖皮质激素联合化疗疗效的维持中起重要的作用。     

EVALUATION OF INDOCYANINE GREEN RETENTION AND AMINOPYRINE BREATH TESTS IN PATIENTS WITH MALIGNANT BILIARY OBSTRUCTION

Impaired hepatic function is a major contributory factor to the high incidence of postoperative morbidity and mortality in patients with malignant biliary obstruction. Dynamic hepatic function tests such as indocyanine green (ICG) retention and aminopyrine breath tests were evaluated in such patients to define whether they were clinically useful for prediction of postoperative morbidity and mortality. Forty-four patients with malignant biliary obstruction undergoing surgery for relief of obstructive jaundice were recruited into the study. Indocyanine green retention and aminopyrine breath tests were carried out in all patients pre-operatively and repeated in 36 patients postoperatively. The ICG retention was abnormal in all patients before surgery and there was significant improvement 2 weeks after surgery (32.8 ± 2.5%vs 18.3 ± 2.8%, P= 0.001). The change in ICG retention levels correlated with the serum bilirubin levels but the pre-operative ICG retention value could not predict postoperative morbidity and mortality. The aminopyrine breath test was abnormal in all but one patient. It correlated with pre-operative prothrombin time of the patients before surgery but it did not improve significantly after surgery and was not predictive of postoperative outcome. It is concluded that both ICG retention and aminopyrine breath tests have limited clinical value in the pre-operative evaluation of patients with malignant biliary obstruction.     

Comparison of purified indium-111 granulocytes and indium-111 mixed leukocytes for imaging of infections

Several methods have been proposed for the separation and labeling of white blood cells for the diagnosis of suspected infection. We retrospectively compared 105 patients imaged with 111In purified granulocytes (GRAN) to 106 patients imaged with 111In mixed leukocytes (MIX). We found that in acute infection the sensitivity of GRAN and MIX were both high and not statistically different. In chronic infections the sensitivities were lower than for acute infections. Again, there was no significant difference between GRAN and MIX with the borderline significant exception of MIX being superior to GRAN in chronic soft tissue infections (p = 0.06). We then had independent observers blindly grade the degree of lesion visualization. We found that delayed images visualized the lesions better than early images (p = 0.0001) and acute infection was better visualized than chronic infection (p = 0.03). We concluded that, in routine clinical practice, MIX is probably the agent of choice for three reasons: (a) easier preparation, (b) comparable sensitivity in acute infection and, (c) borderline superior sensitivity in chronic infection.     

肛肠肌电图对盆底疾病的诊断价值(附360例报告)

对3组患者均检查耻骨直肠肌,肛门内,外括约肌共1098块肉,共检测67880个运动单位电位。结果表明:便秘组肌电异常占82.2％(226/275),肿瘤术后组异常率为66.7％(14/24),脊髓病变组肌电异常率为98.4％(60/61),亦初步探讨肌电图对盆底疾病的诊断价值。