间断缺血心停搏在冠脉搭桥术中的应用

１９９２～１９９３年间为１８０例冠脉病变的病人施行冠脉搭桥术，全部病人均采用核甙抑制剂利多氟嗪预处理和低温（２８℃）间断缺血心停搏进行术中心肌保护。平均每例病人作冠状动脉端吻合３～４个，每个吻合口用９分钟，主动脉阻断累加时间约２５分钟，体外循环时间９０分钟，术后医院死亡率１．６％（３／１８０），无术后心梗发生。作者认为，冠脉搭桥术的术中心肌保护可采用核甙抑制剂和间断缺血心停搏方法，而不用心肌停搏液。     

AUGMENTATION OF ANGIOTENSIN II RELEASE FROM ISOLATED MESENTERIC ARTERIES OF WISTAR-KYOTO AND SPONTANEOUSLY HYPERTENSIVE RATS FOLLOWING NEPHRECTOMY

1. We previously reported that angiotensin II release from the mesenteric arteries of Wistar-Kyoto (WKY) and spontaneously hypertensive rats (SHR) increased in a time-dependent manner as a result of the isolation of the arteries and perfusion. This phenomenon appeared to be due to the withdrawal of circulating angiotensin II (AII). 2. The purpose of the present study was to test the hypothesis that vascular AII generation may be negatively regulated by circulating AII in WKY and SHR, and to clarify the role of this vascular angiotensin II in the sustained hypertension of SHR following nephrectomy. 3. The mesenteric arteries from kidney-intact and nephrectomized WKY and SHR were perfused and the amount of AII released into the perfusate was measured. The effects of the angiotensin converting enzyme inhibitor, captopril, and the effects of supplementation of renal renin and circulating angiotensins to nephrectomized rats, by blood exchange between kidney-intact and nephrectomized rats, on AII release were examined to clarify the pathway of vascular AII generation after nephrectomy. 4. Nephrectomy caused augmentation of vascular AII release both in WKY and SHR in spite of the abolishment of circulating renin. Captopril reduced this enhanced release of AII, but blood exchange did not affect it. There was no significant difference in these responses between WKY and SHR. 5. These results suggest that WKY and SHR have in common a potent pathway for production of vascular AII in response to the withdrawal of circulating AII, although this pathway is not responsible for the sustained hypertension of SHR after nephrectomy. The precise pathophysiological role of this pathway remains to be elucidated.     

大黄总甙、大黄素和番泻甙对小鼠离体肠管葡萄糖转运电位的影响

本实验采用记录翻转小肠和结肠囊葡萄糖转运电位的方法,来研究大黄泻下作用的有效成分大黄总甙、大黄素和番泻甙对小肠及结肠囊跨肠壁电应差的变化,发现上述成分可阻止葡萄糖和Na~+的转运,这一结果为进一步阐明大黄泻下作用的原理提供新的理论依据。     

传统腺样体切除术后腺样体残留情况调查

体统的腺样体手术为腺样体刮除术，为非直视下的手术，虽然多数患者手术后症状得得缓解，但临床上也常常看到手术后短时间内症状复发或者缓解不彻底的患儿，这类情况往往和腺样体手术切除不彻底有关。本院自2003年1月-2004年9月间对腺样体切除术后复发再次手术患者，以鼻内镜观察记录腺样体残留情况，对初次手术患者在进行传统腺样体刮除术并止血后，立即进行鼻内镜检查，了解腺样体残留情况并进行鼻内镜下处理，报告如下。     

湿润暴露疗法治疗会阴部Ⅱ度烧伤患者32例临床分析

目的：探讨湿润暴露疗法治疗会阴部Ⅱ度烧伤患者的临床效果。方法：将我院2005年6月～2006年6月间规范应用湿性医疗技术治疗的32例会阴部烧伤患者进行临床分析、总结。结果：全部病例均治愈,且烧伤创面愈合快,不形成瘢痕。结论：应用MEBT／MEBO治疗会阴部烧伤,方法简单,护理方便,临床疗效满意,值得推广。     

Comparison of histopathological characteristics of allograft biopsy between responder and non-responder to antiproteinuric effect of angiotensin-converting enzyme inhibitor (ACEI)

Abstract:  Angiotensin-converting enzyme inhibitor (ACEI) has become recognized as agents that have renoprotective effects in the treatment of progressive renal diseases including post-transplant kidneys. Previously we demonstrated the safety and effectiveness of ACEI treatment on the hypertensive proteinuric post-transplant patients ( N  = 10) who had been followed up for 12 months. However, not all patients show good response in urinary protein reduction. We aimed to analyse the histopathological factor(s) affecting the responsiveness of proteinuria to ACEI treatment. Fourteen post-transplant patients with proteinuria who were treated with ACEI and underwent allograft biopsy were analysed. Eight patients showed 50% or more reduction in proteinuria (responder). The other 6 patients showed less (< 50%) reduction in proteinuria (non-responder). There was no difference in clinical characteristics (BP, renal function, donor age, recipient body mass index), dietary sodium or protein intake, and diuretic use between the two groups. As a histopathological characteristic, glomerular size in responder group was significantly larger than that in non-responder group. This suggests that the large glomerular size at least partly contributes to the responsiveness in urinary protein reduction to ACEI treatment in kidney allograft recipients with proteinuria.     

肺结核病人健康教育现状调查与影响因素分析

目的　调查活动性肺结核病人在诊断前接受结核病知识的教育现状 ,分析病人接受结核病知识与社会经济因素的影响。方法　对 2 0 0 0年全国结核病流行病学抽样调查中的 1 2 78名活动性肺结核病人进行社会经济个案调查 ,调查以问卷的形式进行。结果　 1 2 78例肺结核病人在诊断前有 5 1 4例接受过不同形式的健康教育 ,占 40 2 % ,男性接受健康教育比例为 41 8% ,女性为 3 6 9%。各年龄组接受健康教育比例 <1 5岁组最低为2 5 9% ,其次是 65～年龄组为 3 0 9%。随着病人文化程度的增高和家庭人均年收入的增高 ,接受健康教育比例增高。肺结核病人各种职业的分类中 ,无工作者接受健康教育比例最低为 3 5 5 % ,其次为农林牧渔劳动者。按照病人是否有症状、有症状后是否就诊及最后诊断为肺结核病人的 3个过程接受不同形式的健康教育的频率 ,均以广播电视、健康教育和亲友教育为主。结论　在开展健康教育活动中 ,应注意对儿童和老年人群 ,对于文化程度低、家庭经济收入低、无工作者和农林牧渔劳动者等重点人群的教育     

小儿乙状结肠冗长症病理特点分析

目的 探讨小儿乙状结肠冗长症的病理特点，以提高对该症病理特点的认识。方法 分析我科1993～2002年间经手术治疗12例小儿乙状结肠冗长症的临床病理资料。结果 小儿乙状结肠冗长症病理特点与先天性巨结肠同源病相似。主要表现为乙状结肠肠壁肥厚，部分肌纤维变性。结肠黏膜萎缩，黏膜下充血水肿；肌间神经丛减少，均可见神经节细胞发育幼稚，且数量减少或体积变小，呈固缩或空泡变性。结论 小儿乙状结肠冗长症大多有肠神经元发育异常。     

Ⅰ、Ⅲ型前胶原基因第2外显子核酶对靶RNA的体外切割活性的研究

目的 体外研究锤头型α1Ⅰ型及Ⅲ型前胶原基因第2外显子片段核酶对各自靶RNA分子的切割活性及反应条件。同时观察两反义核酶对瘢痕中成纤维细胞胶原合成的影响。方法 将含α1Ⅰ型及Ⅲ型前胶原基因第2外显子片段的重组质粒(pT-Ⅰ、pT-Ⅲ)，经体外^32P标记转录后形成产物靶RNA。同时将含特异性核酶基因的重组质粒(pT-gⅠ、pT-gⅢ)进行非标记的体外转录，产物(核酶)与各自的^32P-靶RNA按不同的条件混和反应，电泳后放射自显影观察结果。将构建好的核酶以脂质体包裹后导入培养的成纤维细胞内，采用图像分析法观察核酶对成纤维细胞Ⅰ型、Ⅲ型胶原蛋白mRNA合成的影响。结果 两种核酶在37℃、42℃均能有效切割各自的靶RNA，对Mg^2 浓度的要求范围较宽(10～20mmol／L)；反应温度从65℃逐渐降至并维持在37℃的条件下核酶切割活性显提高。Ⅰ、Ⅲ型胶原蛋白mRNA的表达明显降低，胶原蛋白生成降低，胶原生成明显受抑制。结论 针对α1Ⅰ型及Ⅲ型前胶原基因第2外显子片段的核酶能有效地在体外对靶RNA进行切割并能有效地抑制瘢痕中成纤维细胞胶原的合成。