输尿管镜气压弹道碎石治疗输尿管结石（附32例报告）

目的 总结输尿管镜气压弹道碎石治疗输尿管结石的临床效果。方法 回顾分析32例应用输尿管镜气压弹道碎石治疗输尿管结石患者资料。男10例，女22例；平均年龄29岁。结石位于输尿管下段24例，中段6例。上段2例。其中行原位体外冲击波碎石（ESWL）治疗后结石未能排出者8例。结果 碎石成功率90．6％（29／32）。2例因输尿管异常置镜失败，转开放性手术；1例输尿管穿孔后留置双J管，择期行ESWL治疗成功。B超显示肾积水较术前减轻或消失，KUB、IVP未发现输尿管狭窄。结论 输尿管镜气压弹道碎石治疗输尿管结石创伤小、成功率高、并发症少。     

手部关节损伤的治疗

目的 通过对手部关节损伤治疗方法的对比和随访观察，总结出各种方法的优缺点，并指出相对较好的治疗方法。方法 1980～2002年对手部关节损伤进行各种手术治疗，通过观察病人术后关节的活动度、肿胀、疼痛、畸形及捏力的改善等项目，评价哪种方法相对更好。结果 通过对各种数据的测量比较，特别是关节活动度的改善情况，认为人工关节置换是所有治疗方法中相对最好的。结论 尽管人工关节置换也有不少缺点，但随着新材料的不断应用和设计的不断改进，其治疗效果将越来越好。     

^125I放射微粒微创植入治疗前列腺癌

目的观察^125I放射微粒植入对前列腺癌的治疗效果。方法对26例临床确诊为前列腺癌患者经皮穿刺在癌组织植入^125I放射微粒，每例平均36粒，术后复查肛诊、B超、影像学及血生化指标。结果患者植入治疗经过顺利，2例少量出血，留置导尿后愈合，3个月后经肛诊、直肠B超示结节缩小，前列腺特异性抗原（PSA）降低，多普勒超声显示结节内动脉收缩期最大血流速度（VS）、阻力指数（RI）及动脉搏动指数（PI）均明显下降。结论^125I放射微粒植入对前列腺癌的治疗安全性好、效果可靠。     

下颌角截骨面下部轮廓重塑的研究

目的:下颌角截骨是面型轮廓重塑中最常见的一种手术,为了提高手术的精确性,避免不必要的损伤,我们对各种下颌角截骨术操作技巧进行探讨.方法:术前进行面部测量、下颌骨曲面断层X线和头颅正侧位定位X线片投影测量,设计截骨线和去骨量,术式选择口内切口下颌角截骨术、口内切口下颌角外板矢状劈开截骨术、耳后切口下颌角截骨术、耳后和口内联合切口下颌角截骨术;结果:面下部过宽同时下颌角肥大者单纯下颌角截骨效果往往不会很理想,需要同时进行下颌角外侧骨板部分去除,减少面下部的宽度,206例术后两侧对称,效果良好;1例面瘫;2例下颌骨骨折,术中做内固定;3例下颌骨体部成角,3个月后第二手术将突出部分磨平.结论:术前测量设计下颌角截骨的术式和截骨线是十分必要的,根据下颌角肥大的不同类型选择相适应的截骨术式.     

实时三维超声心动图定量评价左心室容量-时间曲线的可行性与准确性研究

目的:探讨实时三维超声心动图(RT-3DE)定量评价左心室容量-时间曲线的可行性及准确性。材料和方法:以心脏磁共振(CMR I)为“参考标准”,应用RT-3DE评价31例健康志愿者左心室容量-时间曲线,获得峰值排空率(PER)、峰值充盈率(PFR)等左心室功能指标。结果:30例健康志愿者获得了内膜边界清晰的三维图像和左心室容量-时间曲线;RT-3DE图像采集及分析时间明显短于CMR I;PER,PFR测值RT-3DE与CMR I间无统计学差异(P>0.05),具有良好的相关性(r分别为0.913,0.786)。结论:RT-3DE是一种定量评价左心室容量-时间曲线的可行、准确的新方法。     

提高股骨干骨折合并同侧股骨颈骨折早期诊断率的前瞻性研究

Objective To evaluate a serf-designed diagnostic protoeol which can early detect a femoral neck fracture for patients with a femoral shaft fracture. Methods From September 2005 to June 2007, a self-developed protocol was used to detect an ipsilateral femoral neck fracture for all the patients with femoral shaft fracture who had sought treatment in our department. This protocol consisted of anteroposterior plain radiography of internal rotator, intraoperative fluoroscopy of the hip, a fine (2 mm) cut computed to-mographic scan through the femoral neck, postoperative anteroposterior and lateral plain radiography of the hip in the operating room prior to awakening the patient, at the time of follow-up anteroposterior and lateral plain radiography of the hip in the presence of hip pain. The diagnostic effects of the protocol were compared with those of conventional diagnosis used for all the patients with femoral shaft fracture who had sought treatment in our department from September 2003 to August 2005. A chi-square analysis comparing the protocol group (September 2005 to June 2007) and the non-protocol group (September 2003 to August 2005) was used to assess the early and delayed diagnosis rates for an associated ipsilateral femoral neck fracture. Results The earlydiagnosis rate of an associated femoral neck fracture by the protocol was 93.8%, markedly higher than that by conventional method (46.2%), with statistically significant difference (χ2 = 4.069, P =0.044). Conclu-sion In presence of a femoral shaft fracture. this protocol consisting of plain radiography of intemal rotator, intraoperative fluoroscopy of the hip, fine cut computed tomographic scan of the femoral neck, postoperative plain radiography of the hip, and follow-up plain radiography of the hip in the presence of hip pain, may sig-nificantly improve the diagnostic rate of an associated femoral neck fracture.     

小儿病毒性脑膜炎病原诊断与临床分析

应用酶联免疫吸附（ELISA）方法，对88例临床诊断病毒性脑膜炎患儿急性期及恢复期脑脊液进行了单纯疱疹病毒（HSV－I、HSV－Ⅱ）、柯萨奇B组病毒（CoxBV）、埃可病毒（ECHO）、EB病毒（EBV）、腺病毒（AdV)及流感病毒（IFV）特异性IgM抗体检测。结果表明：HSV、CoxBV、ECHO、EBV、AdV、IFV病毒感染率分别为9．09％、18．18％、22．72％、3．41％、4．54％、5．68％；HSV及EBV感染致残率及病死率分别为87．5％（7／8）和100％（3／3）。提示脑脊液中病毒特异性IgM抗体检测可作为早期病原诊断的指标之一；CoxBV及ECH病毒是本地区小儿中枢神经系统病毒感染的主要病毒；HSV及EBV感染致残率及病死率较其它病毒高，预后不良；早期阿昔洛韦治疗，可大大降低病死率。     

阿弗菌素产生菌SIPI-AV-99081的选育

阿弗菌素链霉菌SIPI-AV-99081采用UV和NTG进行诱变处理。选育得到一高产菌株和几个典型的突变株。高产菌株AV-h-360的阿弗菌素B1的生产能力较出发菌株提高了3倍，AV-m-486和AV-m-796为阿弗菌素合成阻断突变株，它们都不能产生天然的阿弗菌素。     

离子型与非离子型MR对比剂对肝脏病变的增强效果比较

目的　对比离子型钆喷酸葡胺 (Gd -DTPA)和非离子型钆双胺MR对比剂 (Gd -DTPA -BMA)在肝脏病变手推团注多时相增强扫描中的增强效果。方法　 5 8例肝脏疾病患者 (男 3 1例 ,女 2 7例 ,年龄 3 0～ 77岁 )分 2组 ,第 1组 :3 0例 (男 16例 ,女 14例 ) ,采用Gd -DTPA -BMA。第 2组 :2 8例 (男 17例 ,女 11例 ) ,采用Gd -DTPA。行MR手推团注多时相增强扫描。结果　Gd -DTPA -BMA组 :增强效果满意者 2 3例 (77% ) ,增强效果一般者 6例 (2 0 % ) ,增强效果差者 1例 (3 % )。Gd -DTPA组 :增强效果满意者 2 2例(79% ) ,增强效果一般者 6例 (2 1% )。结论　在肝脏疾病MR手推团注多时相增强扫描中 ,Gd -DTPA -BMA和Gd -DTPA均可达到满意的增强效果 ,安全及有效性两者无显著性差异。Gd -DTPA -BMA粘滞度小 ,利于快速推注。     

Caffeic acid improves the bioavailability of l‐dopa in rabbit plasma

The impacts of caffeic acid (3,4‐dihydroxycinnamic acid, CA) on the pharmacokinetics of levodopa (L‐dopa) were studied in rabbits. A single dose of 5/1.25 mg·kg^?1 l ‐dopa/carbidopa was administered alone or was co‐administered with three different doses of caffeic acid (2.5, 5, and 10 mg·kg^?1), or a single dose of 5 mg·kg^?1 caffeic acid was administered alone via an intramuscular route to six rabbits each in a crossover treatment protocol. Plasma levels of l ‐dopa, 3‐O‐methyldopa (3‐OMD), caffeic acid, and ferulic acid were determined and subsequently used to calculate their pharmacokinetic parameters. The results indicated that caffeic acid administered at a dose of 10 mg·kg^?1 decreased about 22% of the peripheral formation of 3‐OMD and about 31% of the C_max of 3‐OMD. In addition, the metabolic ratios (MR, AUC of 3‐OMD/AUC of L‐dopa) decreased by about 22%. Results also indicated that caffeic acid significantly decreased the proportion of 3‐OMD (p < 0.05). In contrast, the parameters of neither caffeic acid nor ferulic acid were significantly affected by l ‐dopa/carbidopa. In conclusion, caffeic acid at a dose of 10 mg·kg^?1 can significantly affect the COMT metabolic pathway of L‐dopa. Copyright © 2009 John Wiley & Sons, Ltd.