烧伤后检测血儿茶酚胺类、血糖及血胰岛素的临床意义

我们对３０例住院病人用荧光分光光度法测定了不同烧伤时间、不同烧伤指数（ＢＩ）血儿茶酚胺类（ＣＡ）释放量，以期了解病人的应激状况，同时测血糖（ＢＳ）和用放射免疫法测血胰岛素（ＳＩ）。结果表明烧伤后ＣＡ类释放是持续性的，且有休克和感染两个高峰（Ｐ＜０．０５，Ｐ＜０．０１）；ＣＡ类释放主要是去甲肾上腺素（ＮＥ）的持续性增加，是正常量的两倍以上。休克期ＣＡ类释放如不增加，脓毒症阶段肾上腺素（Ｅ）与去甲肾上腺素从高值骤然下降，且低于休克期。提示：交感－肾上腺系统已处于衰竭状态，死亡似不可避免，而胰岛素分泌正常或相对不足。因此我们认为，ＣＡ类释放增加、糖原异生、胰岛β细胞分泌受抑制，是烧伤后全过程内分泌变化的主要原因。扩容纠酸、早期切痂预防感染以及使用抗ＣＡ类药物是防治的主要措施。     

Microvascular corrosion casting of normal tissue, transitional mucosa and adenocarcinoma in the human colon.

The microcirculatory architecture of normal tissue, transitional mucosa and adenocarcinoma of the human colon was investigated with microvascular corrosion casting (MVCC) combined with scanning electron microscopy (SEM). The study showed that the capillaries within the normal mucosa were arranged in a regular hexagonal pattern around the mucosal glands and that the microvessels of transitional mucosa mostly had lost the typical hexagonal pattern and become slightly wider in diameter. The microvessels in the tumor periphery were increased in number and disorganized, and presented large variation in morphology with claw-like formations, widened sinuses, diverticula and appendixoid patterns. Microvessels were lacking in the central areas of tumors. These morphological alterations may serve as additional indicators of tumor development.     

Bronchial stenosis due to endobronchial tuberculosis: successful treatment with self-expanding metallic stent.

Endobronchial tuberculosis is present in 10-40% of patients with active pulmonary tuberculosis, and more than 90% of the patients with endobronchial tuberculosis have some degree of bronchial stenosis. The primary treatment for tuberculous bronchial stenosis is antituberculous chemotherapy combined with steroids, but some patients do not respond well, and more aggressive treatment is needed to restore the patency of the involved bronchus. Balloon dilatation of tuberculous bronchial stenosis has been reported to be successful. However, in our experience, balloon dilatation of the stenotic segment has not significantly improved patients' clinical symptoms except in those with very short segmental stenosis. We describe a case of tuberculous bronchial stenosis that was successfully treated with Gianturco self-expanding metallic stents.     

华蟾蜍毒素对离体豚鼠输精管的作用

华蟾蜍毒素(华蟾素)使离体豚鼠输精管产生剂量依赖性收缩反应,利血平化豚鼠输精管及冷藏输精管对华蟾素反应减弱。给酚妥拉明、维拉帕米后,输精管对华蟾素反应均受抑制,溴苄胺可使反应潜伏期缩短。结果提示华蟾素收缩输精管反应可能与其促进肾上腺素能神经末稍NA释放有关。     

The value of hysteroscopy in the diagnosis of infertility and habitual abortion.

Ninety cases of infertility and habitual abortion were analyzed by hysteroscopy between April 1983 and July 1990 in PUMC hospital. Abnormal changes of the uterine cavity were seen in 74.4%. The result of hysterosalpingography corresponded with that of hysteroscopy in 62.5%, and the result of B-ultrasound corresponded to that of hysteroscopy in 52.5%. The diagnosis of adhesion and polyps of the uterine cavity was made accurately by hysteroscopy, and both could be operated under hysteroscopy. After operative removal of the adhesion, an IUD should be put into the uterine cavity for 3 months. In 60 cases operations were performed during or after hysteroscopy. Of the 45 patients followed, 19 achieved pregnancy. Five patients achieved pregnancy after operative removal of the adhesion. It is concluded that hysteroscopy is more important than B-ultrasound and hysterosalpingography in the examination and treatment of infertility.     

The use of 6-flavor Rehmannia decoction with additives in the prevention of ototoxic deafness induced by gentamicin in guinea pigs]

The purpose of this study is to discuss the effects of the Chinese medicine six-flavor Rehmannia Decoction with additives on preventing deafness induced by gentamicin (GM) in guinea pig by means of testing the thresholds of Preyer's reflex (PR) cochlear microphonic potential (CM), action potential of the auditory nerve (N1) and scanning electron microscope of inner ear (SEM). The results showed that the medicine is effective in reducing the ototoxic effect of GM on inner ear.     

癌旁组织CD44vmRNA的表达对原发性肝癌术后复发的影响

研究原发性肝癌癌旁组织ＣＤ４４ｖｍＲＮＡ表达的意义。应用ＲＴ－ＰＣＲ检测原发性肝癌癌旁组织ＣＤ４４ｖｍＲＮＡ的表达并结合术后近２年的随访结果进行综合分析。癌旁组织ＣＤ４４ｖｍＲＮＡ表达高于癌组织者的肿瘤包膜缺如、门静脉癌栓和瘤周卫星结节等与转移相 关的病理指标高于癌旁组织ＣＤ４４ｖｍＲＮＡ表达低于癌组织的病例，前者复发率亦高于后者。结论：癌旁组织ＣＤ４４ｖｍＲＮＡ的表达肝癌侵袭潜能以及预测其复发等     

三磷酸腺苷对蟾蜍交感神经节细胞的作用及机制分析

应用光化学诱导法建立免局灶性脑梗塞模型,为临床治疗人的脑梗塞疾病提供有效的实验研究手段。结果显示,模型制作成功率98%,梗塞灶面积为0.465±0.012 cm2,体积为0.268±0.009 cm3,梗塞灶呈典型的损伤、渗出和炎症反应病理过程。结果提示,光化学诱导法建立免局灶性脑梗塞模型方便、快速、稳定。     

开放手术观察腰椎间盘突出症溶核失败45例分析

目的 通过开放手术观察分析椎间盘髓核化学溶解术治疗腰椎间盘突出症失败原因。方法 收集溶核失败的腰椎间盘突出症45例行开放手术治疗。结果 术中见45例硬膜外脂肪完全消失，43例髓核未见溶解，2例髓核溶解呈糊状但未被吸收，21例伴有侧隐窝狭窄，15例突出物与神经根粘连，20例黄韧带增厚，2例椎管骨性狭窄，14例突出物钙化。结论 腰椎间盘突出症病变间隙合并有侧隐窝狭窄、神经根粘连、椎管狭窄、突出物钙化等，不是溶核治疗的适应证。