火针刺血疗法的临床应用心得

目的:探讨火针刺血疗法在临床的应用价值。方法:对实践经验和临床资料进行分析。结果:火针刺血疗法疗效快无不良反应。结论:火针刺血疗法对寒凝血瘀证疗效较好。     

溴环己胺醇预先给药对大鼠盐酸吸入性肺损伤的作用

目的 观察溴环己胺醇预先给药对大鼠盐酸吸入性肺损伤是否具有保护作用，并探讨其可能机制。方法30只健康 SD 大鼠，随机分成3组，A 组：生理盐水吸入组；B组：稀盐酸吸入组；C组：稀盐酸吸入 溴环己胺醇处理组，每组10只。C 组腹腔注射溴环己胺醇，1次/d，连续3d，A、B 组以等体积生理盐水代替。第3天注药后30min，B、C 组气管注入pH 值为1.25的稀盐酸1.2ml/kg，制成盐酸吸入性肺损伤模型，A 组气管注入生理盐水1.2ml/kg。观察注药后5h 动脉血气、氧合指数(PaO_2/FiO_2)、肺湿/干重比(W/D)、肺组织及血清中肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)水平。结果 与 A 组比较，B、C 组 PaO_2、PaO_2/FiO_2降低(P<0.01)，B、C 组W/D、B 组肺组织 TNF-α、IL-8含量、血清 IL-8浓度升高(P<0.01)。与 B 组比较，C 组 PaO_2、PaO_2/FiO_2升高(P<0.01)，C 组W/D、肺组织TNF-α、IL-8含量及血清 IL-8浓度降低(P<0.01)。结论 溴环己胺醇可能通过抑制 TNF-α、IL-8炎症因子的产生和释放机制对盐酸吸入性损伤肺产生保护作用。     

简易定向锥颅脑内血肿碎吸术治疗高血压脑出血——介绍一种简易脑内血肿碎吸器的研制及临床应用

本文介绍一种高血压脑出血外科治疗的新方法,即简易定向锥颅脑内血肿碎吸术。截至1988年10月临床应用19例,年龄41～79岁,出血量平均为48.1ml,一次吸除量为总量的79％(38ml),术后立即清醒者8/19例,偏瘫好转者4/19例,死亡4例。实践证明本法简单,安全有效,病人负担轻。     

Effect of surfactant lavage in a rabbit model of meconium aspiration syndrome

Meconium aspiration syndrome (MAS) is a frequent cause of respiratory distress in neonates. Recent reports have suggested that surfactant dysfunction contributes to the pathophysiology of MAS and surfactant therapy improves oxygenation of infants with MAS. We evaluated the effect of bronchial lavage with surfactant solution in a rabbit model of meconium aspiration. All animals were given 5 mL/kg of a 20% slurry of human meconium into the endotracheal tube and mechanically ventilated. The animals were then divided into saline lavage (n = 5) or surfactant lavage (n = 5). Lavage was performed an hour after meconium instillation. After the lavage the total amount of meconium recovered was measured. Blood gas was monitored during the experiment. The amount of meconium recovered by saline lavage was 14%, and by surfactant lavage was 57%. The surfactant group had a significant improvement in gas exchange, whereas the saline group had no improvement. It was concluded that the lavage with surfactant solution effectively washed out meconium and improved gas exchange in rabbit model of MAS.     

Cytology of transitional-cell carcinoma of the urinary bladder: diagnostic yield and histologic basis.

The diagnostic yield of cytology in histologically proven transitional-cell carcinoma (TCC) of the urinary bladder has been studied in 100 cases. Cytohistologic correlation rates were 20 percent, 61.7 percent, and 92.8 percent, respectively, for grade 1, 2, and 3 tumors. When further evaluated, G2 cases were segregated into 2 subcategories, G2a and G2b, based on histologic preservation of nuclear polarity, pleomorphism, and other cellular irregularities. Correlation rates were rather low for G2a cases (6/18, 33%) and high for G2b cases, (23/29; 79%). The prevalence of atypical cells was 2 (11.1%) cases in G2a and 16 (55.2%) cases in G2b. The results of this study confirm that cytology has an extremely varying diagnostic yield in urinary bladder TCC. Greater cell exfoliation, increased atypia, and a tendency to infiltration of G2b and G3 cases probably account for the higher diagnostic yield detected in these groups.     

Belt device for simplified CT-guided puncture and biopsy: A technical note

A new radiolucent device for increased accuracy of CT-guided fine-needle punctures permits precise determination of the optimum angle, depth, and position of the fine needle, which can be preset from the data supplied on the CT monitor. Puncture and repeat scans for controlling the tip of the needle can be performed with the patient in a stationary position. The device is designed as a belt that holds a needle holder sheath and a goniometric scale, both of which can be moved to varying positions around the patient.     

ENDOSCOPIC ULTRASOUND GUIDED TRUCUT BIOPSY

Endoscopic ultrasound (EUS) is sensitive for staging gastrointestinal malignancies and pancreatic lesions. EUS‐fine‐needle aspiration (EUS‐FNA) offers a diagnostic accuracy of about 60–90% for pancreatic tumors and > 90% for lymph nodes. There are several limitations of EUS‐FNA including the need for on‐site cytopathology review. In addition, accuracy of cytologic review is hampered by the presence of blood, benign epithelial cells, desmoplasia, and well‐differentiated tumors. Furthermore, the small biopsy sample and destruction of tissue architecture limits the diagnostic sensitivity for GISTs and lymphomas. Many of these problems can be overcome with use of EUS trucut biopsy (TCB) needles. These large caliber, cutting needles acquire larger tissue samples allowing preservation of tissue architecture and histologic examination. Our recently described experience with EUS‐TCB initially in swine and later humans demonstrated the safety for acquiring histologic tissue representative of the target organs sampled enabling accurate diagnosis. These studies suggested greater diagnostic accuracy of EUS‐TCB for submucosal mass lesions and lymphoma and potentially the need for fewer needle passes for solid pancreatic neoplasms. In this paper we will review the current TCB literature, device design and technique, help troubleshoot potential problems, and offer opinion as to the utility and role of this new device.     

Axonal swellings in human intramuscular nerves.

The presence, morphology, distribution, and abundance of axonal swellings in intramuscular nerves were evaluated. Axonal swellings were present in intramuscular nerves in 42% of 127 muscle biopsies from patients with a variety of conditions. The incidence was highest in muscle from patients with peripheral neuropathy, but swellings were present in muscle from patients with motor neuron disease, primary muscle diseases, and some individuals without clinical or histological evidence of neuromuscular disease. The greatest number of swellings in intramuscular nerves was in muscle from patients with chronic inflammatory demyelinating neuropathy. Swellings were spherical or elliptical, 4-20 microns in diameter, 5-30 microns in length, and composed of neurofilaments. Swellings were present only in myelinated axons of intramuscular nerves, proximal to nodes of Ranvier or in internodal regions. Swellings were not associated with axonal degeneration. They were probably not transported. The formation or accumulation of swellings may reflect altered axonal dynamics common to a number of disease processes.     

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目的 探讨辅助检查在诊断亚急性甲状腺炎中的作用。方法 回顾分析372例亚急性甲状腺炎病人所做的各项辅助检查结果。结果 血沉，B超，彩色多普勒，甲状腺核素扫描，甲状腺吸^131I率测定，细针穿刺细胞学，TMA，TGA等项检查诊断本病的阳性率分别为93.75%,81.63%,95.62%,89.66%,69.70%,89.41%,13.46%和9.62%。T3，T4，TSH检查结果随着病程的进展变化较大。结论 血沉检查对诊断本病缺乏特异性；彩色多普勒，细针穿刺细胞学检查诊断率高，特异性强，是首选的检查手段；甲状腺核素扫描可以准确地反映甲状腺功能状态；检测血清中T3，T4，TSH水平可以协助诊断本病，判断疾病所处时期。     

钻颅碎吸治疗急性期高血压性脑出血疗效观察

目的总结钻颅碎吸治疗高血压性脑出血的疗效。方法利用配对方法与保守治疗病人进行对比。碎吸组反复穿刺血肿,调整血压。对照组采取降颅压,营养脑细胞等内科治疗。结果碎吸组病死率15.6%,对照组病死率27%,两组相比P<0.05,CT观察发现,碎吸治疗可加速血肿的吸收。半年后随访结果表明,碎吸治疗可降低致残率。结论钻颅碎吸术可作为治疗部分高血压性脑出血病人的理想选择。