四联疗法治疗腰椎间盘突出症120例体会

腰椎间盘突出症是临床常见病、多发病，约占本科门诊腰腿痛患者的25％左右。笔者自1996年以来，将经本人接诊资料较完整的120例门诊患者分为两组，分别采用四联疗法进行了治疗观察，现报告如下：     

结直肠癌组织二氢嘧啶脱氢酶的表达及意义

[目的]探讨二氢嘧啶脱氢酶(DPD)在结直肠癌组织中的表达及其同临床病理特征和预后的关系。[方法]用免疫组化SP法检测72例结直肠癌组织中DPD的表达,分析DPD表达与临床分期、病理特征、预后的相关性。用Kaplan-Meier法分析生存情况。用多因素Cox模型分析影响患者预后的相关因素。[结果]在72例结直肠癌组织中DPD表达从10%～85%不等,平均28.73%±23.57%。DPD的表达随Dukes’分期的增加而降低,差异具有显著性(P=0.007)。早期(Dukes’A～Dukes’B期)结直肠癌的预后明显优于晚期结直肠癌(Dukes’C～Dukes’D期,P<0.0001)。结直肠癌组织DPD高表达者预后稍优于低表达者,但无统计学差异(P=0.1419)。[结论]结直肠癌治疗前Dukes’分期是影响预后的主要因素。DPD的表达状况和预后无明显相关性。     

脑肿瘤

颅咽管肿瘤的手术入路选择及显微手术治疗；经眶上匙孔入路切除鞍结节脑膜瘤；经蝶窦入路显微切除垂体腺瘤；第四脑室肿瘤的诊断和显微外科治疗；大型嗅沟脑膜瘤的显微外科治疗[编者按]     

“四畔”理论源流述要

所谓“四畔”，是中医学对痈疽疮疡四周的描述。探究大量中医外科文献，四畔疗法是通过病灶四畔的特征，来辨识不同证候、不同疾病及其善恶顺逆的诊断方法，即着眼于纠正“四畔”的病理变化进行治疗和施药、施术于“四畔”的外治法。例如“箍围药”、“贴焙药”、“围针”治法等。这些有关“四畔”的辨证和治疗经验形成了独具特色的中医“四畔”理论。     

黄连解毒汤对MPTP帕金森小鼠的防治作用

目的观察黄连解毒汤(HJD)对1-甲基-4-苯基-1,2,3,6-四氢吡啶(MPTP)所致帕金森病(PD)小鼠的防治作用。方法将45只C57BL小鼠随机分为3组:正常组、模型组和HJD组。模型组小鼠每天腹腔注射MPTP 30 mg/kg,连续5 d,制备PD模型;HJD组小鼠每天灌胃HJD 17.55 g/kg(生药量),连续15 d。应用爬杆、悬挂和游泳实验检测小鼠肢体运动功能;高效液相色谱-电化学法(HPLC-ECD)法检测小鼠脑纹状体多巴胺(DA)及其代谢产物二羟苯乙酸(DOPAC)和高香草酸(HVA)含量;分光光度法测定小鼠脑组织超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)活性及丙二醛(MDA)含量。结果 HJD对小鼠肢体运动功能的减退和脑神经组织的代谢异常有不同程度的调节和改善作用。结论 HJD对MPTP所致帕金森小鼠有一定的防治作用。     

四维全科医生智能全息辅助系统

“四维全科医生智能全息辅助系统”是北京中医药大学多位专家在几十年临床经验的基础上，结合生物全息理论与计算机信息处理技术，研制出的一套中西医结合，集辅助医生诊断、全面提供治疗建议方案和各种保健方案于一体，“医、教、研”功能予一身的全科医生智能辅助系统。     

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.     

针刺四关穴治疗产后尿潴留51例

产后尿潴留是产后常见继发病症之一,笔者运用针刺四关穴治疗本病51例,现报道如下。1临床资料 51例患者均为我院产科住院部患者,其中自然分娩28例,剖宫产23例;初产43例,经产8例;年龄最小21岁，最大37岁；病程最短0．5d，最长5d。     

仙人掌粉对糖尿病大鼠血糖的影响

目的　研究仙人掌对糖尿病血糖的影响。方法　采用四氧嘧啶造成大鼠实验性糖尿病模型 ,然后将高、中、低 3种剂量的仙人掌粉加入到基础饲料中进行实验观察。结果　仙人掌粉高 (10g kg·d)、中 (5 .0g kg·d)剂量组均可显著降低糖尿病大鼠空腹血糖 ,并且高剂量组具有显著改善糖尿病大鼠尿量增加的作用。各剂量组对正常大鼠血糖无明显影响。结论　仙人掌粉能有效降低四氧嘧啶所导致的糖尿病大鼠的血糖、尿量