重度烧伤患者休克期血浆B型钠尿肽含量变化及意义

Objective To study the plasma content of B-type natriuretic peptide (BNP) in patients with severe burn during shock stage and probe its clinical significance. Methods Forty-two patients aged 18-60 years, with total burn surface area ≥30%TBSA or full-thickness burn area ≥10% TBSA, hospital-ized within 4 hours after burn, were divided into A group (with total burn surface area 30% -50% TBSA or full-thickness burn area 10% -20% TBSA, n = 21 ), and B group (with total burn surface area 50% TB-SA or full-thickness burn area > 20% TBSA, n = 21 ). Twenty patients admitted during the same time for plastic surgery were enrolled as control group. The plasma levels of BNP, creatine kinase (CK), CK-MB, troponin I (Tnl) of all patients were determined on admission. The levels of BNP, Tnl and fluid resuscita-tion volume were examined at 8, 16, 24, 48 post burn hour (PBH) in A and B groups. Analysis of correla-tion between BNP and fluid resuscitation volume was performed. Results On admission: BNP level in A group (68±19 ng/L) and B group (99±38 ng/L) , respectively, was increased as compared with that in control group (17±7 ng/L, P <0.01 ). Tnl level in A group (2.13±0.67 μg/L) and B group (2.98± 0.58μg/L), respectively, was increased as compared with that in control group (0.12 ± 0.03 μg/L, P < 0.01). There was no obvious difference in CK, CK-MB levels among A, B, and control groups ( P > 0.05). BNP levels in A, B groups continuously rose during 8 - 48 PBH, and they were positively correlated with fluid resuscitation volume. TnI level peaked at 24 PBH, and decreased at 48 PBH. Conclusions The plasma level of BNP is sensitive to reflect changes in myocardial ischemia and hypoxia as a rise in level of TnI in shock stage of severe burn, and it was positively correlated with fluid resuscitation volume. BNP can be used to guide fluid resuscitation during shock stage.     

头孢噻肟钠聚合物测定实验条件的改进

目的:对中国药典收载的头孢噻肟钠聚合物测定条件进行改进。 方法 :采用高效液相色谱法 ,以Sephadex G- 10色谱柱 4 2 cm× 1.3cm对 6批样品进行分析 ,分别进样 5 0μl和 2 0 0μl,按外标法计算聚合物的量。结果:头孢噻肟钠在 10～ 6 0 μg/m l范围内线性关系良好 (r=0 .9995 ) ,高中低浓度的加样回收率分别为 10 0 .2 %、10 0 .4 %、99.7% ;RSD分别为 1.7%、1.5 %、1.9% (n =3)。该方法与药典方法比较 ,差异无统计学意义 (P >0 .0 5 )。 结论:本方法简便、快速、可行 ,具有实用价值     

经鼻蝶窦手术动物模型神经内镜手术训练

目的建立一种活体动物的神经内镜经鼻蝶手术模拟训练方法。方法选择大鼠，建立一套训练计划，完成内镜图像导引下的内镜操作，电凝止血、冲洗和吸引、活检等神经内镜经鼻蝶手术的基本技巧。结果利用大鼠颅脑进行模仿内镜经鼻蝶手术，如在内镜图像导引下操作内镜的方法；熟悉内镜系统、电凝系统、冲洗和吸引设备的使用；熟悉了神经内镜经鼻蝶手术的步骤。结论作为神经内镜实验室训练的重要组成部分，通过利用大鼠颅脑进行模拟神经内镜手术，训练者可以从中获得神经内镜操作基本技巧的练习。     

Hair transplantation. A review

Hair transplantation has developed into a refined art in the past 30 years. Refined techniques and instruments, appreciation of properly placed hairlines, better methods of harvesting donor grafts, and better cutting materials in punches have significantly improved results in one of the most frequently performed cosmetic plastic procedures.     

多媒体技术在医学生物学实验教学中的应用

本文联系医学生物学实验课程和多媒体技术的特点，探讨了多媒体技术在医学生物学实验教学中的应用。指出在基础医学实验教学中教师要利用多媒体技术的优点，结合课件制作和教学中应注意的问题，才能充分发挥多媒体技术在教学中的作用，提高教学质量。     

668颗后牙镍铬合金PFM边缘适合性的临床观察

目的：观察采用2种边缘形式的后牙烤瓷熔附金属全冠边缘适合性和对牙龈健康的影响.方法：对668颗后牙,分别采用2种边缘形式的后牙烤瓷熔附金属全冠（单冠或桥的基牙）在修复2年后进行复查,检测其边缘适合性及牙龈指数（GI）和牙周探诊深度（PD）,用统计学方法分析修复体边缘形式与牙龈病变间的关系.结果：采用羽状边缘360°金属脚边的PFM边缘适合性明显优于凹面肩台型边缘PFM,凹面肩台型边缘的PFM的牙龈病变发生率,明显高于羽状边缘360°金属脚边的PFM,而边缘适合性差者较适合性好者牙龈病变发生率显著增高.结论：后牙PFM的边缘采用羽状边缘360°金属脚边是一种好的选择.     

羟基磷灰石义眼台作为药物缓释载体减轻术后反应的临床观察

目的评价羟基磷灰石（HA）义眼台作为药物缓释载体减轻眼球摘除义眼台植入术后反应的效果。方法植入HA义眼台前，用地塞米松5mg，庆大霉素8万u，透明质酸酶1500U混合液浸泡HA义眼台15—20min后植入，手术步骤按常规。结果观察术后1周反应情况，52例中51例（98．07％）无疼痛或仅有轻度疼痛；44例（84．62％）结膜无水肿；36例（69．23％）无恶心；16例（30．77％）轻中度恶心；48例（92．31％）无呕吐。与对照组（43例）比较，术后疼痛、结膜水肿、恶心呕吐均较轻，其差别均有统计学意义（P〈0．001）。结论HA义眼台作为药物缓释载体植入眼球肌膜囊内能有效地控制术后反应，减轻患者痛苦。     

北京市农村居民医疗费用研究

了解北京市农村居民医疗费用情况。方法：分4个季度调查农村居民医疗卫生服务需要及利用情况，同时调查三级医疗机构门诊及住院病人的医疗功用。结果：农村居民年人均医疗费用80．95元，其中老年人为166．01元，居民年人均医疗费用最高的疾病为感冒及心脑血管病。结论：建议加强农村老年保健工作，发展和完善农村合作医疗制度。     

有机-无机复合型聚合物电解质的研究进展

聚合物电解质是现在锂离子电池研究领域的热点，有机－无机复合型聚合物电解质（CSPE）是现在聚合物电解质的研究主流。在聚合物电解质中添加无机添末，特别是纳米材料，大大改善了聚合物电解质的机械性能、离子导电性能以及界面稳定性能。对CSPE性能进行了评价，对在CSPE中添加无机粉末性能改善机理作了概括和探讨，并对CSPE的前景作了展望。     

99m TC-MIBI动态显像对非小细胞肺癌化疗疗效的预测价值初探

目的 探讨^99mTC-MIBI动态显像对非小细胞肺癌化疗疗效的预测价值。方法 对确诊为不能手术的非小细胞肺癌患者化疗前,静脉注射740mbq ^99mTC-MIBI后分别于30min,2h行SPECT动态扫描,计算早期/晚期肿瘤组织与对侧正常肺组织的放射活性比（T/Ne,T/Nd）,全身采用卡铂/顺铂＋VP16化疗3周期,随后复查胸部CT,评判化疗疗效及其与^99mTC-MIBI动态显像的关系。结果 78例NSCLC符合入选标准,并完成化疗方案,66例呈阳性显像,12例阴性显像,66例阳性显像中化疗有效率为90.7%,阴性显像12例中化疗全部进展,两者比较差异有显著性（P〈0.01）。结论 ^99mTC-MIBI动态显像的放射活性越高,化疗效果越好,对非小细胞肺癌化疗疗效有预测价值,可为合理制定治疗方案提供重要依据。