生长抑素治疗食管静脉曲张破裂出血30例疗效分析

目的：观察生长抑素治疗食管静脉曲张破裂出血的疗效。方法：治疗组30例用生长抑素静滴维持，对照组30例用垂体后叶素及硝酸甘油静滴维持。结果：治疗组48h内止血27例，止血率为90％，对照组48h止血16例，止血率为53．3％。两组相比止血率有非常显著性差异（P＜0．01）。结论：生长抑素治疗食管静脉曲张破裂出血，具有止血速度快，止血率高及无明显副作用等优点，疗效优于垂体后叶素。     

Inhibition of hemorrhagic and edematogenic activities of snake venoms by a broad-spectrum protease inhibitor, murinoglobulin; the effect on venoms from five different genera in Viperidae family.

In order to obtain basic data on the effect of broad-spectrum protease inhibitor against local symptoms of Viperidae snake envenomation, inhibitory capacity of rat murinoglobulin on local hemorrhagic and edematogenic activities of venoms from Crotalus atrox, Bothrops jararaca, Lachesis muta muta, Trimeresurus flavoviridis and Echis carinatus sochureki were examined. Murinoglobulin, pre-incubated with the crude venoms at 37 degrees C for 15 min, inhibited hemorrhagic activity of all five venoms to various extents. The activity of C. atrox was almost completely inhibited at the murinoglobulin/venom ratio (w/w) of 20. The activity of B. jararaca, Lachesis muta muta and T. flavoviridis venoms was considerably inhibited at the ratio of 20 (77.2, 80.0 and 86.2% inhibition, respectively), however some of the activity still remained even at the ratio of 40 (84.2, 79.8 and 86.2% inhibition, respectively). Among the five venoms, E. c. sochureki venom is quite resistant to murinoglobulin treatment and statistically significant inhibition was only found at the ratio of 40 (64.1% inhibition). Fibrinolytic and gelatinase activities were more susceptible to murinoglobulin inhibition. The treatment at the ratios of 10 and 20 almost completely inhibited respectively the fibrinolytic and the gelatinase activities of all the venoms. Murinoglobulin treatment also significantly inhibited the edematogenic activity of L. muta muta, T. flavoviridis and Echis carinatus sochureki. The treatment of murinoglobulin at the ratio of 40 considerably suppressed the swelling up to 60 min after subcutaneous injection of L. muta muta and E. c. sochureki venoms, and up to 30 min after T. flavoviridis venom injection. Murinoglobulin is a potent inhibitor against local effects of multiple snake venoms in Viperidae family.     

Hemorrhagic activity of Bothrops venoms determined by two different methods and relationship with proteolytic activity on gelatin and lethality

The changes in hemorrhagic activity, proteolytic activity on gelatin and the lethal potency of four Bothrops venoms treated at different pH values or with EDTA were studied. Venoms from B. alternatus, B. jararaca, B. moojeni and B. neuwiedii of Argentina were preincubated at pH 5.8, 5.1 or 3.8 or with EDTA and the hemorrhagic activity expressed as size of the hemorrhagic lesion or as the amount of hemoglobin extracted, the proteolytic activity on gelatin and the lethal potency were determined. Although the MHDs recorded in rats were 19–56 fold higher than those recorded in mice, the A₅₅₀ extracted per gram of hemorrhagic haloes was very similar in rats or mice independent of the venom dose. Inhibition of proteolytic activity after preincubation at pH 5.1 or 3.8, agrees with the decreased amount of hemoglobin extracted from the hemorrhagic haloes, and with the increase in mean survival time after the i.p. injection to mice. Preincubation with EDTA resulted in 80% inhibition of hemorrhagic activity of B. jararaca venom and complete inhibition with the other Bothrops venoms tested. Measurement of the amount of hemoglobin extracted gives significant information in comparative studies, not available by measurement of the size of hemorrhagic haloes.     

辨证治疗中风病248例临床分析

本文通过对２４８例中风病临床分型分析，以气虚血瘀证最多，占３８．３１％，其次为阴虚风动证，肝阳暴亢，风火上扰证。本组病人不论是出血性中风，还是缺血性中风，均采用中药辨证治疗基础上，口服中成药及静脉滴注活血化瘀针剂以加强活血化瘀、涤痰通络这一治疗法则，总有效率为８４．２７％，其中出血性中风和缺血性中风的总有效率分别为８６．９５％和８３．２４％，对血液流变学、脑出血患者治疗前后脑ＣＴ对照观察，认为 一     

BREUS' MOLE: DNA SHOWS MASSIVE SUBCHORIONIC HEMATOMA IS MATERNAL IN ORIGIN

Breus' mole, a massive subchorionic placental hematoma, is associated with intrauterine growth retardation and second trimester stillbirth. It is relatively rare and, hence, is poorly understood. Initially, Breus' mole was thought to be a consequence of fetal demise, but subsequent observations in placentas of live - born infants as well as identification in prenatal ultrasounds prior to fetal demise discredited this tenet. A number of theories have been proposed to explain the etiology of Breus' mole; some suggest that it is a fetal hemorrhage, others claim a maternal thombosis. However, these theories are based entirely on speculation, and it is unclear from the literature whether the source of the hematoma is maternal or fetal. A macerated female fetus was delivered of a 31 - year - old G1 P0 woman at 24 weeks' gestation; the autopsy showed only marked intrauterine growth retardation while placental examination showed a massive subchorionic hematoma. DNAs extracted from portions of the fresh hematoma, placental villi (i.e., fetal tissue), and maternal blood were compared using molecular analyses. Polymerase chain reaction using primers that identify highly polymorphic loci distinguished fetal from maternal DNAs. This is the first case of Breus' mole analyzed using molecular methods; the source in this case is definitively maternal, suggesting the etiology is maternal thrombosis.     

伽玛刀治疗后的肿瘤内出血

目的：探讨颅内肿瘤患者伽玛刀治疗后肿瘤内出血的原因。方法：在伽玛刀治疗的３４５例颅内肿瘤病变患者中，发现３例有肿瘤内出血，分析了他们的临床特点及ＣＴ，ＭＲＩ表现，结果：２例经保守治疗基本痊愈，１例恶化。结论：对于那些曾有过肿瘤卒中史、高血压病史或肿瘤血运丰富的病人行伽玛刀治疗后应警惕发生肿瘤内出血的危险     

平肝熄风汤对脑出血大鼠海马细胞色素C氧化酶活性和细胞凋亡影响同步研究

目的 从神经元线粒体能量代谢和细胞凋亡的角度探讨中药复方的平肝熄风汤对脑出血神经元损伤的保护作用机制。方法 采用Ⅶ型胶原酶诱导大鼠脑出血模型，以组织化学方法结合灰度值半定量测定细胞色素C氧化酶(cytochromc c oxidase，CCO)活性，采用Tunel法检测细胞凋亡结果造模12h，脑出血大鼠海马CA1区CCO活性较假手术组明显降低(P＜0.01)，凋亡细胞较假手术组明显增多(P＜0．01)随后均呈进行性加重。用平肝熄风汤治疗后町维持其CCO活性，减少细胞凋亡。结论 脑出血神经元损伤与神经元CCO活性降低及细胞凋亡有关平肝熄风汤能维持线粒体关键酶CCO活性，改善细胞有氧代谢，减少细胞凋亡，此可能为本方对脑出血继发性神经元损伤保护机制之一。     

内毒素对新生大鼠肺组织金属基质蛋白酶2及其抑制因子2表达影响的研究

目的　探讨金属基质蛋白酶 2 (MMP 2 )和金属基质蛋白酶抑制因子 2 (TIMP 2 )蛋白及mRNA在内毒素 (LPS)致新生大鼠肺损伤中的作用。　方法　将新生 7日龄大鼠 88只随机分为八组 ,即生理盐水对照组 (对照组 ) ,LPS注射后 30min组 ,1h ,2h ,4h ,8h组 (每组 8只 ) ,16h组 (16只 ) ,2 4h组 (2 4只 ) ,其中 16h组死亡 8只 ,2 4h组死亡 17只。观察不同时间点存活大鼠肺组织大体、光镜和电镜下的病理改变 ,应用免疫组化和RT PCR方法分别检测肺组织MMP 2和TIMP 2蛋白及mRNA的表达改变。　结果　病理改变证实了新生大鼠肺出血的发生 ,对照组MMP 2mRNA和蛋白的表达相对值分别为 (0 .5 2 3± 0 .0 30 )和 (12 6 .2 0± 17.98) ;注射LPS后 4h和 8hMMP 2mR NA(0 .82 6± 0 .5 6 7)和MMP 2蛋白 (15 0 .77± 9.80 )表达达高峰 ,差异有显著性 (P <0 .0 1)。TIMP 2蛋白及mRNA的表达无明显改变。　结论　用LPS制备了新生大鼠肺出血的动物模型 ,肺组织MMP 2的降解作用明显增加 ,可能导致肺出血的发生。     

米索前列醇防治高危产后出血临床研究

目的 :观察口服米索前列醇用于预防高危产后出血的效果。方法 :将足月妊娠分娩有发生产后出血高危因素的产妇 98例随机分为 :①实验组 :5 0例 ,在胎儿娩出后立即口服米索前列醇 4 0 0 μg ,②对照组 :4 8例 ,在胎儿娩出后立即宫体内注射催产素 2 0U。产后 2 4h内平均出血量 ,试验组 (390± 6 2 .9)mL ,对照组 (435± 6 9.3)mL ,两组比较 ,P <0 .0 5。用药前后血压变化差异无显著意义。结论 :米索前列醇具有比催产素更强的子宫收缩作用 ,能很好地预防高危因素的产后出血 ,且用药方便、安全。     

盆腔动脉化疗栓塞术治疗子宫颈癌合并大出血

目的:探讨髂内动脉化疗灌注术同时超选择性栓塞肿瘤供血动脉及出血动脉,治疗子宫颈癌合并大出血的临床价值。方法:对15例子宫颈癌合并大出血的患者进行选择性髂内动脉灌注化疗,同时超选择性栓塞肿瘤供血动脉及出血动脉。区域联合灌注化疗同时超选择肿瘤供血动脉给予化疗药-碘油乳化剂栓塞,供血动脉主干明胶海绵颗粒栓塞。结果:5例1~3月内再次出血并给予了二次栓塞治疗,10例确切止血未见复发。抗肿瘤疗效观察,完全缓解8例、部分缓解4例,总有效率80%。结论:对于子宫颈癌合并大出血患者,在选择性髂内动脉灌注化疗术同时选择性、超选择性栓塞肿瘤供血动脉及出血动脉,是一种安全有效地止血治疗措施,同时也是宫颈癌抗肿瘤治疗的一种有效方法。