蛇毒治疗不能解释肺动脉高压的研究

本通过对不能解释的肺动脉高压患，进行右心导管测定肺动脉平均压（ＰＡＭＰ）作为主要对照指标，观察蛇毒制品（精制溶栓酶）的急性药物试验和近期药物试验。发现该药物在近期有理想的降低ＰＡＭＰ作用，症状及胸片、超声心动图异常也明显取得改善，提示其可能为治疗该病的理想药物。     

Catheter embolization of pulmonary arteriovenous fistulas in an infant

Summary An infant with pulmonary arteriovenous fistulas is described. Surgical ligation of the fistulas and limited resection of paraenchyma from the right lung was followed at 11 months of age, by successful steel coil embolization of residual fistulas.     

肺性脑病与多器官功能障碍临床分析

目的：分析43例肺性脑病与多器官功能障碍的关系，以便早期采取预见性防治措施。方法：把43例肺性脑病时伴发的功能障碍器官个数与死亡率的关系及酸碱、电解质测定进行统计列表分析，结果：肺性脑病100％并发器官功能障碍，最常受损器官：肺、心、脑、肝或肾，受损器官数目越多，病情越严重，肺性脑病时，呼酸代酸，低钠，低氯血症明显增多。结论：肺性脑病100％伴发多器官功能障碍，随功能障碍器官数目的增加，死亡率亦增加，酸碱失衡及电解质紊乱与多器官功能障碍有关。     

Histometric analysis of the distal pancreas in pancreatic head cancer

To clarify the histological status of the pancreas tail after pancreatoduodenectomy (PD), fibrosis, islets of Langerhans, and A, B, and D cells were examined histometrically in surgical cases of pancreatic cancer. The same investigations were also performed during an autopsy examination of the pancreas tail of survivors of surgery who had received either PD or total pancreatectomy with segmental autotransplantation (SAT). In the surgical cases, fibrosis and the islet percentage compared with nonpancreatic cancer cases were significantly higher while the B cell ratio was significantly lower. In addition, in pancreatic cancer patients, the fibrosis and islet ratio in the group with a blocked pancreatic duct were higher while the B cell ratio was lower than in the group with an open pancreatic duct. A direct relationship between the islet ratio and the degree of fibrosis, and an inverse relationship between the B cell ratio and the degree of fibrosis, were thus found. From the autopsy cases, the fibrosis progressed and the islet ratio increased following PD, but after SAT only the islet ratio increased compared to the time of surgery. The progression of fibrosis after PD thus suggests the presence of some problems in both the surgical method and postoperative management.     

A nocturnal nasogastric feeding programme in cystic fibrosis adults

Fourteen adult patients (mean age 22.5 years, range 18–35) with cystic fibrosis undertook nocturnal nasogastric feeding for a mean period of 14.7 (range 6–18) months consuming an average of 1042 ml of a high energy feed on five nights of each week. Following this protocol all patients gained weight (mean weight gain 5.4 kg, range 2–17). For the group as a whole, lung function remained stable during the period of feeding; however a significant correlation between improvement in lung function and weight gain was demonstrated. Hyperglycaemia during feeding in this adult population was common (9/14, 64%) but was easily controlled with insulin therapy.     

心导纳微分环,肺导纳微分环最大向量正常值及其临床意义

本文报道３－５０岁２１４例心导纳微分环（ＣＡＤＬ）和肺导纳微分环（ＰＡＤＬ）最大向量振幅及方位正常值，结果随增龄变化振幅递减，方位递增，多数男＞女，部分组间有差异。４８例左向右分流先心病环体最大向量与肺动脉压之间呈平行关系，并探讨其临床意义。     

棉尘对工人肺功能的影响

目的　评价棉尘对工人肺功能的影响。方法　对 14 6名接棉尘工人和 12 5名对照工人的肺活量(FVC)和第 1秒时间肺活量 (FEV1 0 )进行了检查。结果　前纺、后纺和细纱作业场所空气中的棉尘浓度几何均值分别为 (7 1± 8 7) ,(2 5± 1 7) ,(2 2± 2 4 )mg/m3 ,样品超标率 16 8%。接触组前纺、后纺工人的急性肺功能改变 (APFC)和前纺工人的慢性肺功能改变 (CPFC)检出率较对照组明显增高 (P <0 0 5 ) ,OR及 95 %CI分别为 4 7(1 4～ 16 3) ,4 5 (1 3～ 15 6 ) ,5 6 (1 1～ 2 9 8) ;4 0～岁年龄段接棉尘工人APFC检出率高于对照工人 (P <0 0 5 ) ,OR及 95 %CI为 9 0 (1 1～ 73 8) ;接棉尘女工APFC检出率也比对照女工高 (P <0 0 1)。结论　棉尘有损害肺通气功能的作用 ,以急性改变更为明显     

各种肝病的肝纤维化标志改变的探讨

目的 :探讨各种肝病患者血清肝纤维化标志的改变 ,甘草酸二胺注射液对肝脏炎症、纤维化指标的作用。方法 :用放免法检测透明质酸 (HA)、层粘蛋白 (LN)、Ⅲ型前胶原多肽 (PCⅢ )。结果 :急性肝炎的三种肝纤指标均升高 (P <0 0 5 )。急黄肝高于急无黄肝 (P <0 0 5 )。慢性肝炎 1 1 2例 ,三项肝纤指标显著高于正常对照 (P <0 0 5 )。慢肝重度显著高于慢肝轻度 (P<0 0 0 1 )。肝硬化的三项肝纤指标又显著高于慢肝 (P <0 0 0 1 ) ,其它肝病的肝纤指标也升高。 2 5例慢肝用甘草酸二胺注射液治疗 2月 ,ALT、AST、GGT显著降低 (P <0 0 1 )。三项肝纤指标中HA降低较显著 (P =0 0 5 ) ,LN和PCⅢ虽有降低 ,但差异不明显 (P =0 4 5 9,P =0 1 92 )。结论 :各种肝病的三项肝纤维化指标均升高 ,以慢肝重度 ,肝硬化升高明显。甘草酸二胺注射液治疗有抗炎及改善肝纤维化的作用     

地塞米松对冷藏离体肺表面活性物质和顺应性的影响

目的:观察地塞米松对冷藏离体肺表面活性物质和顺应性的影响.方法:32只家兔肺随机均分为对照组、地塞米松冷藏(4℃)保存24h、72h、120h3个组.对照组:测定室温条件下的肺表面活性物质及顺应性.冷藏组:肺离体后立即置于含有地塞米松台式液中冷藏,在相应时间取出肺,室温条件下复温后,置入生理盐水中,测定肺表面活性物质,并测定注气(生理盐水)和抽气(生理盐水)过程中,肺容积在10ml、20ml、30ml时的肺顺应性.结果:冷藏24h组注水、抽水;72h组肺容积在10ml、20ml抽气、冷藏120h组在肺容积为10ml、20ml抽气的肺顺应性同对照组比较,差异无显著性(P>0.05).其余各组、项与对照组比较差异具有显著性(P<0.05),伴有表面活性物质的减少.结论:地塞米松冷藏离体肺顺应性增大,其影响程度随冷藏时间的延长而增加,同时伴有肺表面活性物质的减少.