栀子茵陈汤治疗急性胆囊炎

急性胆囊炎是临床上常见病。其发病与胆囊管梗阻，胆囊局部缺血，胆汁淤积，细菌感染，代谢障碍，神经因素等有关。中医学认为与肝胆疏泄不畅，湿热蕴结有关。在此期如治疗不善则易转化成慢性。自1995年6月至2004年5月，笔者用自拟的栀子茵陈汤治疗急性胆囊炎38例，收到了满意的疗效，现报告如下。     

马应龙麝香痔疮膏治疗糜烂型间擦疹35例

间擦疹是一种发生在皮肤皱襞部位的急性炎症性疾患，多由于皮肤皱襞处出汗潮湿，角质层被浸软加上局部皮肤随躯体活动不断摩擦导致充血糜烂而发生本病，而且常继发细菌和念珠菌感染，本病好发于婴幼儿和肥胖病人，多见于颈部、腋窝，腹股沟、臀沟和妇女乳房下，马应龙麝香痔疮膏对皮肤黏膜具有很好的消炎、镇痛、修复组织的作用，临床用其治疗间擦疹取得良好效果，现报告如下。     

翼状胬肉旋转撕脱联合自体角膜缘干细胞移植的临床研究

目的为减少胬肉术后复发，使手术更简便安全而寻找一种理想手术方式。方法对70例（77眼）原发性翼状胬肉患者施行改良的旋转撕脱法胬肉切除联合自体角膜缘干细胞移植术治疗。结果术后随访6～12个月，70例移植片全部存活，仅1例复发（1．3％），无其他并发症。结论运用改良的旋转撕脱法胬肉切除联合自体角膜缘干细胞移植术治疗翼状胬肉，使手术操作更简便安全易行，胬肉切除更干净彻底，角膜损伤小，上皮愈合时间短，取材方便，无排斥反应，术后胬肉复发率低。     

Influence of moderate hypothermia on cerebral oxygenation in pigs with intracranial hypertension

BACKGROUND: Moderate hypothermia is one of the effective therapeutic methods for head injury in recent years, there are many mechanisms of moderate hypothermia for brain protection, and its influence on cerebral oxygenation is also one of them. OBJECTIVE: To observe the influence of moderate hypothermia on cerebral oxygenation of animals with acute intracranial hypertension, and further investigate the protective mechanism of moderate hypothermia. DESIGN: A randomized controlled trial. SETTING: Department of Neurosurgery, Renji Hospital affiliated to the Medical College of Shanghai Jiao Tong University. MATERIALS: Twenty healthy little pigs, either male or female, weighing 4.5–5.5 kg, were used. Neurotrend-typed multiparameter monitoring system (Diametrics Company, British); CMA/100 micro-injection pump (Carnegie Company, Sweden). METHODS: The experiment was conducted in the Changzheng Hospital affiliated to the Second Military Medical University of Chinese PLA in November, 2001. The pigs were randomized into two groups: the normothermia group (control group, n =10) and moderate hypothermia group (n =10). ① Bilateral femoral arteries were separated, one was connected to pressometer for monitoring mean arterial pressure (MEP), and the other for analysis of blood gases [including peripheral blood pH value, arterial partial pressure of carbon dioxide (PaCO2), arterial partial pressure of carbon dioxide (PaCO2), HCO3–]. ② Rectal temperature was monitored with mercurial thermometer. ③ Intracranial pressure was monitored using Camino optic ICP probe placed in the subdural space. ④ Neurotrend multiparameter monitoring sensor was inserted into the white matter for about 4 cm to determine cerebral perfusion pressure (CPP, CPP=MAP(ICP), brain tissue partial oxygen pressure (PO2), partial pressure of carbon dioxide (PCO2), HCO3– and brain temperature. The rectal temperature of animals in the moderate hypothermia group was lowered to 34 ℃ using ice bags, and the body temperature was maintained at 33–35 ℃ for 2 hours. The changes of the parameters were observed continuously, and the pigs in the normothermia group were not treated with cooling. MAIN OUTCOME MEASURES: ① MAP, ICP, rectal temperature, CCP; Indexes of cerebral oxygenation detected with Neurotrend-typed multiparameter monitoring system; ② Results of blood gases analysis in the moderate hypothermia group. RESULTS: All the 20 pigs were involved in the analysis of results. ① MAP, ICP, rectal temperature, CCP and indexes of cerebral oxygenation: In the moderate hypothermia group, the ICP after cooling was obviously lower than that before cooling [(3.31±1.19), (5.33±0.95) kPa, P < 0.05], CCP was higher, brain tissue PCO2 [(12.03±1.73), (10.59±2.01) kPa, P < 0.05], and brain tissue pH value was higher [(7.03±1.63), (9.40±1.30) kPa, P < 0.05], whereas the brain temperature was decreased as compared with that before cooling [(34.9±0.3), (37.2±0.2) ℃, P < 0.05]. ② Results of blood gases analysis in the moderate hypothermia group: There were no significant differences in the parameters of peripheral arterial blood gases analysis before and after cooling in the moderate hypothermia group (P > 0.05) CONCLUSION: Moderate hypothermia will not impair the cerebral oxygenation, and it can reduce brain tissue CO2 and decrease brain tissue acidosis.     

57例糖尿病并肺结核病并存支气管内膜结核分析

糖尿病合并肺结核病患者气道防御机制常减退,加上糖尿结核患者体内结核菌数量大,痰菌阳性率高,多数糖尿病人血糖控制不佳,常常同时并存支气管结核,纤支镜能有效提高检出率。     

内镜辅助肋骨-软骨移植重建髁突与同期正颌手术的临床研究

目的 探讨内镜辅助肋骨-软骨移植重建髁突与同期正颌手术治疗严重颞下颌关节病变及牙颌面畸形的效果. 方法 于术前对患者进行临床检查和治疗设计,术中行Le Fort Ⅰ型截骨术、下颌支矢状骨劈开术、髁突等关节区病变的处理、内镜辅助下肋骨-软骨移植和颏成形术,术后进行随访. 结果 2003年9月至2005年12月,于临床应用15例,所有患者同期手术均顺利完成.术中、术后均无严重出血、神经损伤、受区感染等严重并发症发生.术后随访29～52个月,平均31.8个月,所有患者面容均显著改善,关节功能良好,且无关节区疼痛等主观症状,患者对手术疗效满意.术后张口度平均为33.6 mm,侧向运动度为0～6 mm. 结论 选择合适的适应证、设计合理的手术方案,内镜辅助髁突重建同期正颌手术效果较好.     

感觉神经系统-肺神经内分泌细胞与支气管哮喘的关系

支气管哮喘（哮喘）是一种严重危害人们生命健康的常见病，不断上升的哮喘患病率和病死率促使我们对其发病机制和治疗进行深入研究。多种因素共同参与的气道慢性炎症被认为是哮喘的本质，其机制复杂，迄今尚不十分清楚。目前神经肽介导的神经源性炎症与哮喘关系受到高度重视。     

同种异体骨髓移植治疗严重系统性硬化症

临床前研究显示同种异体造血细胞移植可以有效地诱导并维持自身免疫性疾病的缓解。系统性硬化症是一种多系统的免疫性疾病。为了评价经过骨髓抑制调理后，应用同种异体骨髓移植治疗严重系统性硬化症的安全性和有效性，美国Fred Hutchinson癌症研究中心的Nash教授对HCT治疗2例系统性硬化症患者的疗效进行观察。方法：选择预后较差的系统性硬化症患者，给予骨髓抑制调理剂-白消安（稳定浓度700ng／mL），环磷酰胺（120mg／kg），抗胸腺球蛋白（90mg／kg），     

前臂掌侧静脉移植在旋转撕脱性拇指离断再植术中的应用

自Pho[1](1979年)、程国良等[2]报道以血管、神经、肌腱一期转位再植成功后,拇指旋转撕脱性离断伤由再植的禁忌证转为相对适应证。我们采用前臂掌侧静脉倒植桥接拇指主要动脉解决旋转撕脱性拇指离断再植中动脉修复问题25例,现报告如下。1资料与方法     

神经干细胞移植与脊髓损伤修复

众所周知，脊髓损伤(spinal cord injury，SCI)是临床治疗的世界性难题。以往，许多学者曾尝试周围神经移植、胚胎脊髓移植、雪旺细胞移植、大网膜移植及应用神经营养因子治疗脊髓损伤。这些研究虽有很大进展，但都未达到目的。近年，国内外把研究焦点集中到了具有自我复制能力和多向分化潜能的神经干细胞(neural stem cells，NSCs)上，已取得了一些突破。笔者就脊髓损伤修复和NSCs移植及应用前景作一简介。