短程大剂量激素治疗急性喉炎75例临床分析

急性喉炎是耳鼻咽喉科、儿科常见急症，由于小儿有特殊的解剖结构，发病急骤，病情进展快，如处理不，预后凶险。治疗以抗炎抗病毒、激素为主，若上述治疗不能缓解，急需气管插管或气管切开。作者总结近两年收住我院两科急性喉炎病例75例，分析报告如下。     

肱骨大结节粉碎性移位骨折手术治疗——一种新型双排缝合线锚定器固定技术及其远期效果

对于移位的肱骨大结节骨折,复位后常规的固定方法包括螺钉、钢丝及缝合等,但这些固定方法往往并不适用于粉碎性骨折,亦未见相关文献报道。该研究的目的是评估一种新型双排缝合线锚定器内固定治疗移位的肱骨大结节粉碎性骨折的长期效果。2000年至2005年间,共21例单纯移位的肱骨大结节粉碎性骨折,在切开复位内固定治疗中采用双排缝合线锚定器固定（近侧锚定 器修复大结节与肱骨头的解剖关系，远侧锚定器固定大结节骨片）。21例中骨折原因为直接暴力17例，间接暴力4例；男10例，     

大咯血的急诊外科治疗

目的　总结 4 4a急诊手术治疗大咯血经验。方法　回顾性研究 195 8～ 2 0 0 1年在本院急诊手术的 89例大咯血患者 ,收集临床表现、诊断方法、原发病因、治疗和结果等相关资料。结果　 85 4 %病例的X线表现与出血部位一致 ,其它诊断方法 (支气管镜、CT、血管造影术等 )作为重要补充。由于 1982年后的早期外科干预 ,术前咯血总量、咯血平均量和低血压、休克发生比例较前明显减少 ,术后并发症从 1982年前的 2 2 2 %降至 17 1% ,围手术期死亡率从 9 3%降至 0。急诊全肺切除术并发症 ( 2 3 3% )高于肺叶切除术 ( 15 2 % )。在过去 4 4a肺结核一直是大咯血的主要原发病因。结论　符合新的外科治疗标准的患者应及早手术 ;选择切除范围要保守 ,首选叶切     

胸大肌肌皮瓣脂肪液化的相关危险因素探讨

目的探讨胸大肌肌皮瓣术后发生脂肪液化的相关危险因素。方法对1998年5月至2005年12月采用胸大肌肌皮瓣修复口腔癌术后组织缺损的82例中10例术后发生不同程度脂肪液化的病例,进行Logistic回归分析。结果Logistic单因素回归分析结果表明：肥胖、电刀切开皮下组织、皮岛设计低于第7肋、吸烟等因素与胸大肌肌皮瓣术后发生脂肪液化有关;Logistic多因素回归分析结果表明：胸大肌肌皮瓣术后发生脂肪液化与肥胖、电刀切开皮下组织、皮岛设计低于第7肋等因素有关,而与吸烟无关。结论肥胖、电刀切开皮下组织、皮岛设计低于第7肋等因素是胸大肌肌皮瓣术后发生脂肪液化的危险因素。     

腔内激光治疗大隐静脉曲张192例报告

目的 探讨腔内激光治疗大隐静脉曲张的疗效。方法 2004年7月～2006年3月我院对192例238条肢体大隐静脉曲张行高位结扎、激光烧灼静脉主干和小腿曲张静脉。小腿局部严重曲张的静脉团,另做切口做局部切除或点状抽拨。结果 本组一次治愈率96.2%（229/238）。9例9条肢体术后因仍有少量曲张静脉存在,局麻下行切除或再次激光治愈。114例大隐静脉主干及小腿局部条索状硬结、疼痛;9例皮肤灼伤。术后住院时间4～8 d,平均5.6 d。158例随访1～18个月,平均11.6月,未见复发。结论 腔内激光治疗大隐静脉曲张效果确切,创伤小。     

^1H-magnetic resonance spectroscopy screening for animals with acute cerebral infraction suitable forthrombolytic therapy

BACKGROUND: As a non-invasive technique which can provide comprehensive biological information, 1H-magnetic resonance spectroscopy (1H-MRS) may provide valuable reference data for irreversible recovery or reversible changes in ischemic tissue after stroke. OBJECTIVE: To monitor and evaluate the effect of the urokinase thrombolytic therapy after experimental acute cerebral ischemia by 1H-MRS technology and investigate its adaptability. DESIGN: Randomly controlled animal study. SETTINGS: Shenzhen Hospital of Peking University and National Key Laboratory of Pattern and Atom & Molecular Physics, Wuhan Physics and Mathematics Institute, Chinese Academy of Science. MATERIALS: Eleven healthy adult Sprague-Dawley (SD) rats, weighing 260–300 g and of both genders, were supplied by Experimental Animal Center of Tongji Medical Collage, Huazhong University of Science and Technology [SCXK (e) 2004-007]. 4.7T superconducting nuclear magnetic resonance meter was provided by Brucker Company. METHODS: The experiment was carried out in Shenzhen Hospital of Peking University and National Key Laboratory of Pattern and Atom & Molecular Physics, Wuhan Physics and Mathematics Institute, Chinese Academy of Science from August 2003 to December 2005. ① The rats were randomly divided into 30-minute self-thrombo-embolism group (n =6) and 60-minute self-thrombo-embolism group (n =5). Six rats in 30-minute self-thrombo-embolism group were occluded with clot embolus for 30 minutes and 5 rats in 60-minute self-thrombo-embolism group were occluded for 60 minutes. 10 000 U/kg urokinase was dissolved in 2 mL saline and the operation lasted for 5 minutes. ② 1H-MRS was performed before thrombolysis and at 3 hours and 24 hours after successful embolization. The metabolic changes of N-acetyl-L-aspartic acid (NAA)/phosphocreatine (PCr) + creatine (Cr), choline phosphate (Cho)/PCr+Cr and lactic acid (Lac)/PCr+Cr in the region of interests were analyzed. ③ The T2W image was conducted 24 hours after the thrombolytic therapy with TR=500 ms and TE=25 ms. ④ The subjects were sacrificed immediately after 1H-MRS and the brain tissues were cut into pieces and stained with HE method; in addition, pathological changes were observed under optic microscope. MAIN OUTCOME MEASURES: ① Metabolic changes of NAA/PCr+Cr, Cho/PCr+Cr and Lac/PCr+Cr in the region of interests; ② T2W image at 24 hours after the thrombolysis; ③ pathological observation of brain tissue. RESULTS: Eleven rats were all involved in the final analysis. ① Metabolic changes in the region of interests : In 30-minute self-thrombo-embolism group, the Lac peak emerged immediately after the embolism, but the ischemic zone decreased 3 hours after the thrombolytic therapy (0.252±0.01, 0.603±0.01, P < 0.01). Lac/(PCr+Cr) ratio was 0.290±0.01 at 24 hours after thrombolysis, which was higher than that at 3 hours after thrombolysis (P < 0.01). The NAA/ (PCr+Cr) ratio decreased significantly at 3 hours after the thrombolysis as compared with that before thrombolysis (0.922±0.16, 1.196±0.01, P < 0.05). In 60-minute self-thrombo-embolism group, the Lac/(PCr+Cr) ratio was higher at 3 hours after thrombolysis than that before thrombolysis (0.846±0.12, 0.601±0.11, P < 0.05) and the NAA/(PCr+Cr) decreased at 3 hours after the embolism. Fluctuation of NAA/ (PCr+Cr) ranged from 0.68 to 0.75 before thrombolysis and from 0.71 to 0.75 at 3 hours after thrombolysis. ② T2W image: T2W image showed that 2 subjects in 30-minute self-thrombo-embolism group whose Lac/NAA was higher than 0.7 suffered from intracranial hemorrhage. This meant that the subjects with Lac/NAA > 0.7 were more likely to suffer from intracranial hemorrhage. ③ Histological and morphological examinations: Optic microscope demonstrated that interspace surrounding nerve cells was widened at ischemic center; neurons were swelling; nucleus was stained lightly; pyknosis and mesenchymal edema were mainly observed in lateral cortex of brow and vertex and in lateral part of corpus striatum. CONCLUSION: ①Compound parameters in ischemic area before thrombolysis should be regarded as an important predicting marker for thrombolytic therapy, effect evaluation and termination. ② 1H-MRS combining with other imaging technique is a detecting way for screening cases who are suitable for thrombolytic therapy.     

外伤性急性弥漫性脑肿胀46例临床治疗

外伤性急性弥漫性脑肿胀（posttraumatic acute diffuse brain swelling,PADBS）是指外伤后数小时（一般4～14 h）脑组织广泛肿大或膨胀.临床处理棘手,预后不良,日益受到人们重视.为探讨其预后影响因素,我们对2001年1月至2004年12月收治的46例做了回顾性分析,报告如下.     

大颗粒小泡非突触部位的胞吐——论神经肽释放的另一种形式

本文在以前的工作基础上,进一步用电镜及免疫细胞化学方法,研究了大颗粒小泡非突触部位胞吐作用。实验结果表明,切除大鼠刚髭部皮肤1—24小时之后,术侧延髓后角浅层大颗粒小泡胞吐比对照侧明显增多(P<0.01),术后3—9天复又下降(近似对照动物),术后14—15天又急剧上升(P<0.01)。这些胞吐大部分出现于延髓后角浅层四种轴突终末的非突触部位,少最也发生于树突及轴突中。从术后第6天开始,术侧P物质明显减弱,而甲硫-脑腓肽略有增强。研究结果提示;1)后角浅层胞吐增多,P物质下降及脑腓肽增高,反映了中枢内不同神经元对去传入神经的功能调整作用;2)大颗粒小泡在非突触部位释放神经肽,弥散地作用于远距离的受体,可能起着神经调制物的作用。     

04124 大日本和住友协作销售和研发

大日本和住友制药公司都高度重视计划于2005年10月合并后的协作利益，尤其是关于加强联合研发实力方面。两家合作伙伴预期到中期这些因素会有助于扭转两家公司最近销售额下降的局面。     

标准外伤大骨瓣开颅减压术治疗重型颅脑损伤30例的临床分析

严重颅脑外伤是各种意外事故的主要死因,具有病情凶险、治疗效果差、死亡率高及致残率高的特点。为了提高治疗效果,降低死亡率及致残率,我科于2002年1月至2005年1月期间,对收治的重型颅脑损伤且需行去骨瓣减压术的60例病人,进行了标准外伤大骨瓣开颅减压术治疗与常规骨瓣减压术