男性病人冠状动脉病变与吸烟关系的研究

[目的]探讨吸烟对病人冠状动脉病变的影响。[方法]对吸烟组(5 0例)与不吸烟组(3 0例)进行冠状动脉造影,观察记录冠状动脉病变情况并进行统计学分析。[结果]两组冠状动脉病变记分、每日不同吸烟量与冠状动脉病变记分、不同的吸烟年限与冠状动脉病变记分比较均有统计学意义(P <0 .0 1)。[结论]长期吸烟可使冠状动脉病变程度加重,应加强对长期吸烟及冠状动脉介入术后病人的健康教育,有效预防和控制冠心病,提高人群的健康水平。     

三康胶囊对高原移居者运动后NO乳酸及血氨的影响

目的探讨三康胶囊对高原人体运动后一氧化氮(NO)及其合酶(NOS)、乳酸(BLA)、血氨(Ammo)的影响.方法选择进驻海拔3 700 m高原1年的10名健康青年,口服三康胶囊15 d,在服药前后分别采用功量自行车进行渐增负荷运动,测定其血清 NO、NOS、BLA及Ammo含量.结果服药后较服药前运动后NO水平[(101.02±6.49) Vs (77.10±8.11)]和NOS活性[(71.40±7.23) Vs (56.29±6.28)]均增高, BLA[(7.58±0.79)Vs (6.13±0.74)]和Ammo[(80.11±9.44)Vs (69.38±8.86)]降低,有非常显著性差异(P＜0.01).结论 三康胶囊能增强高原移居者运动后NOS活性,加速乳酸清除,减缓运动疲劳的发生.     

血管移植搭桥治疗巨大动脉瘤

目的探讨中、高流量血管搭桥方法对颅内巨大颅内动脉瘤的治疗。方法8例巨大和颅底复杂动脉瘤患者,主要表现头痛发病者5例,视力减退者2例,面部麻木者1例。未破裂动脉瘤6例,2例患者发生动脉瘤破裂,Hunt-Hess分级分别为Ⅰ级和Ⅱ级。血管造影证实：动脉瘤体位于颈内动脉海绵窦段（C4段）4例、床突上段（C1段）2例、大脑中动脉M2～M1段者2例动脉瘤大小为2．5～6．0cm,平均直径3．7cm。其中6例动脉瘤为梭形,2例为宽颈动脉瘤。8例患者均采用额颞开颅,骨瓣要尽可能低到颅底,以缩短搭桥移植血管在颅外走行长度。通常用7-0显微缝线吻合移植血管与颈外动脉,用8-0缝线吻合移植血管与颅内段颈内动脉和大脑中动脉。4例患者利用大隐静脉移植搭桥,4例患者利用桡动脉移植搭桥。颅内、外搭桥完毕后将动脉瘤近心端和远端的供血动脉结扎和夹闭,阻断动脉瘤的全部血供。对3例有压迫脑神经或颅内占位引起颅压高的患者,将动脉瘤切除。结果5例术后头痛消失,1例视力减退者明显改善,1例动眼神经麻痹恢复。5例术后行脑血管造影检查,3例行CT血管造影检查,7例搭桥吻合血管全部畅通,动脉瘤消失。2例术后出现暂时性一侧肢体力弱,肌力在Ⅱ～Ⅲ级之间,术后1个月完全恢复。结论中、高流量颅内外血管搭桥可作为治疗颅内巨大动脉瘤的有效方法。     

延迟一期修复外周神经损伤38例报告

目的 探讨应用显微外科技术延迟一期修复四肢外周神经损伤的治疗体会。方法 应用显微外科技术延迟一期修复各种原因所致的四肢外周神经损伤38例41条，手术方法包括神经瘢痕松解、神经直接缝合术等。结果 术后随访6个月～7年，平均33个月，优良率为81．6％。结论 对失去一期修复手术治疗机会的周围神经损伤患者应尽早行延迟一期手术，可取得较好疗效。     

试论七情发生和脑主神明与抑郁症病机证治的关系

抑郁症是一组以抑郁心境自我体验为中心的临床症状群或状态.中医多将其归在郁证之类,对其理论解释的重点多是在心主神明论指导下的以五脏为中心的肝,临床治疗亦多遵疏肝解郁这一基本大法,并取得了一定成效.     

复发性鼻腔及鼻窦恶性肿瘤的挽救性治疗

目的 探讨鼻腔及鼻窦恶性肿瘤复发后的临床表现、与复发有关的因素、再手术的意义及缺损组织的修复。方法 排除原发性鼻腔鼻窦恶性肿瘤，仅收集治疗后复发并且有再手术意义的病例。应用乘积极限法估计生存率，Stata7．0统计软件进行统计运算。结果 1993～2002年共有25例患者符合要求。男19例，女6例，年龄13～66岁，平均46．1岁。所有患者均有至少1次手术或放射治疗史。末次治疗至复发的时间2周～46个月，中位时间18个月，80％的患者肿瘤复发出现于末次治疗后2年内。术后随访1～65个月。再手术中无死亡病例。5例健在无肿瘤复发；局部复发2例，颈部淋巴结转移1例，经过1刀或手术治疗后2例健在、1例带瘤生存；死于局部复发13例，死于肺转移1例，死于无关疾病1例，失访2例。1年生存率62．5%，2年生存率43．7％，3年生存率29．1％，中位生存时间18个月。术后发生脑脊液漏3例次，中枢性尿崩症1例次，皮瓣部分坏死1例次。手术修补脑脊液漏l例。结论 鼻腔及鼻窦恶性肿瘤局部复发多发生于末次治疗后2年之内，主要症状是头痛及局部隆起。肿瘤的类型和分化程度与复发密切相关。合理、及时的综合治疗有助于减少复发。运用有效修复手段的再手术可改善晚期患者的生活质量，延长生命。并发症主要是脑脊液漏，多数可通过保守方法治愈。     

两种不同方法测定低水平压力支持通气时气道阻断压与自主呼吸时常规方法测定值的相关性分析

目的 拟比较以两种不同方法测定低水平压力支持通气（pressure support ventilation，PSV）病人的气道阻断压（P0．1）与自主呼吸时常规方法测定值的相关性。方法 12例机械通气病人，断开呼吸机自主呼吸时以常规方法测定P0．1得到P0．1-SB：在PSV水平为5cmH20，以常规方法和按压呼气末暂停键测定P0．1分别得到P0．1-PSV5和P0．1-PSV5eeo．分析后二者与前者之间的相关性。结果 P0．1-SB与P0．1-PSV5之间差异无显著性，P0．1-PSV5ee0分别小于P0．1-SB与P0．1-PSV5，差异有显著性；P0．1-PSV5eeo与P0．1-PSV5和P0．1-SB之间的相关系数均为0．97。结论 按压呼气末暂停键测定PSV水平为5cmH2O的P0．1值与常规方法测定的PSV水平为5cmH2O以及自主呼吸时的测定值相比，其值偏小,但前者与后二者之间具有良好的相关性。     

Serial peritoneal macrophage function studies in new and established continuous ambulatory peritoneal dialysis patients

Peritoneal macrophages (PM) perform first-line defense activity against peritonitis, the most important complication in continuous ambulatory peritoneal dialysis (CAPD) therapy. Our longitudinal study has compared the PM function in 20 uremic patients during periods free of peritonitis since they started CAPD therapy in January 1987. The results showed that at the initiation of CAPD, there was a higher bactericidal activity, phagocytosis index, H2O2 production and interleukin-1 (IL-1), gamma-interferon (IFN-gamma) and tumor necrosis factor (TNF) production ability and MHC expression. As time went on, these progressively decreased, and by 9 months after CAPD therapy had started they were significantly lower than at the beginning. During the 1.5-year follow-up period, there was a significantly increased peritonitis rate in the period 6 months after the beginning of CAPD than in the period before the 6th month (88.3 vs. 11.7% respectively; p less than 0.001). These results indicate that PM of new CAPD patients have a more active function than those of established patients. The established patients had a greater risk of peritonitis. A comparison of the immunological profiles of PM from patients who had a peritonitis history shows that phagocytosis index, bactericidal activity and IL-1 and TNF production of PM were significantly decreased during the period free of peritonitis. This result suggests that these parameters may serve as an indicator in developing peritonitis.     

脂肪族聚酯与高氯酸锂络合物的结构与导电性

本文通过酯交换反应合成了一系列脂肪族聚丁二酸酯,对他们的结构和性能作了表征。发现聚酯存在多晶现象,其熔点有奇偶性变化规律。探索了由此系列聚酯与高氯酸锂形成的固体电解质的结构和离子导电性。无机盐的加入提高了电解质的玻璃化温度但降低了聚酯的熔点及结晶度。聚酯电解质的晶体类似于聚酯,其无机盐主要溶解于聚酯的无定形区域。聚酯系列电解质的导电率也有偶奇效应,与熔点变化相反;熔点高的电解质导电率低,熔点低的电解质导电率高。电解质的导电率随温度改变而变化,在室温下电解质的导电率可达10~(-6)s/cm。高分子链上侧基的引入将大大降低电解质的导电性。     

Behavioral, biochemical and neurotoxicological actions of the alpha-ethyl homologue of p-chloroamphetamine

The present set of experiments was designed to examine the effects of extension of the alpha-methyl of p-chloroamphetamine (PCA) to an alpha-ethyl. Therefore, the alpha-ethyl homologue of PCA, 1-(4-chlorophenyl)-2-aminobutane (CAB), was compared to PCA in a number of pharmacological assays. CAB was 2-fold less potent than PCA at inhibiting synaptosomal uptake of [3H]5-hydroxytryptamine ([3H]5-HT), and 5-fold less potent at inhibiting uptake of [3H]dopamine ([3H]DA). In drug discrimination assays, CAB was approximately 3-fold less potent than PCA in animals trained to discriminate 3,4-methylenedioxymethamphetamine (MDMA) or its alpha-ethyl homologue, S-(+)-N-methyl-1-(1,3-benzodioxol-5-yl)-2-butanamine (S-(+)-MBDB), from saline. Monitoring with in vivo microdialysis, 10 mg/kg of PCA caused a large increase in extracellular DA and a significant decrease in 3,4-dihydroxyphenylacetic acid (DOPAC) in the striatum. In contrast, 11 mg/kg CAB caused no increase and 22 mg/kg CAB caused only a slight increase in extracellular DA. Both doses of CAB caused a decrease in extracellular DOPAC. The potential 5-HT neurotoxicity of CAB was examined by measuring monoamine and metabolite levels and [3H]paroxetine binding at one week following acute doses. A 10 mg/kg dose of PCA caused an 80% decrease in cortical and hippocampal serotonergic markers, while an equimolar dose of CAB decreased only hippocampal 5-HT and 5-hydroxyindoleacetic acid (5-HIAA) levels. However, 22 mg/kg of CAB produced a 20-40% decrease in all serotonergic markers. Thus, extension of the alpha-alkyl significantly decreases the dopaminergic effects of PCA. The similar decrease in relative 5-HT neurotoxicity and the decreased ability to alter dopaminergic systems in vivo and in vitro supports the involvement of DA in the neurotoxicity of PCA.