耳廓复合组织瓣连续法修复鼻翼缺损

目的观察耳廓复合游离组织瓣连续法修复鼻翼缺损的疗效，以探讨鼻翼缺损的有效修复手段。方法耳廓复合游离组织瓣2次连续法修复鼻翼缺损7例，移植物面积0．5cm×0．7cm～0．8cm×1．2cm。结果7例耳廓复合游离组织瓣移植后全部成活。术后随访6～18个月，移植物无明显回缩，鼻外形满意。结论耳廓复合游离组织瓣连续移植修复鼻翼缺损，适合较严重鼻翼缺损，手术成功率高，术后鼻外形满意，双侧分次取材，耳廓外形双侧对称无畸形。     

脾动脉栓塞治疗外伤性脾破裂28例临床疗效观察

目的：探讨脾动脉栓塞术对外伤性脾破裂的疗效及并发症的处理。方法：采用Seldinger法行脾动脉栓塞术治疗外伤性脾破裂28例。结果：所有患者出血立即停止，其中4例行2次栓塞。28例均有脾区疼痛，22例发热。脾动脉栓塞5天后血小板、白细胞上升近1倍，7天后恢复至正常范围。28例随访6－36月，查免疫球蛋白、CT等结果满意，未有再出血及发生暴发性感染。结论：脾动脉栓塞不但有良好的止血作用，而且能保留脾脏的免疫功能，可在非手术治疗失败时选用，是外伤性脾破裂的一种有效治疗方法。     

Does Follow-up of Osteoporotic Women Treated with Antiresorptive Therapies Improve Effectiveness?

The use of biochemical markers of bone turnover has been advocated to improve follow-up of women receiving antiresorptive therapies for osteoporosis, but this strategy is not yet supported by trials showing it improves effectiveness of treatments. To explore the potential value of markers of bone turnover to monitor antiresorptive treatments of osteoporosis, we conducted a decision analysis using a decision tree and Markov modeling. We have compared two strategies: treatment of a woman without specific monitoring; and treatment of this woman with measurement of a serum marker of bone resorption after 3 months of treatment, with change of treatment if response to treatment assessed by this marker was not satisfactory. The base case is the treatment of a 60-year-old osteoporotic woman with a total hip T-score of −3, using a second generation bisphosphonate during 5 years. We found that follow-up produced slightly greater quality adjusted life years (QALYs) than no follow-up (8.1560 vs 8.1532, i.e. a one day difference). In a two-way sensitivity analysis, the follow-up option produced higher QALYs so long as adherence rate with follow-up was equal or superior to the proportion of women who adhered without follow-up. For example, if the proportion of women adherent to treatment was increased from 50% to 60% by follow-up, then the expected value of the follow-up branch was increased from 8.1560 QALYs to 8.1800 QALYs (i.e. a difference of 9 days). In addition, the higher the non-response rate, the greater the benefit from monitoring with a biochemical marker. In conclusion, our decision analysis model suggests that follow-up of osteoporotic women treated with a second generation bisphosphonate during a 5-year period using an early measurement of a serum marker of bone resorption may increase effectiveness of the treatment on quality of life, but the effect is very small. So, the use of follow-up measures of bone turnover may be based on patient and physician preferences. Received: 6 July 2001 / Accepted: 1 April 2002     

高效液相法测定金樱子中三萜酸类成分的含量

定量测定不同产地金樱子中2α,3α,19α,23-四羟基乌苏-12-烯-28-羧酸的含量.采用高效液相法,色谱柱:Kromasil-C18(4.6 mm×250 mm,5 μm)柱,大连依利特公司;检测波长203 nm,柱温:35 ℃;流动相:乙腈-水(35:65),流速1 mL/min.结果表示所测成分与其他组分具有良好的分离度,线性范围为0.4～10 μg, 加样回收率为102.5%,RSD=2.66%.说明不同产地的三萜类有机酸的含量差别很大.本方法操作简单,结果准确,可用于含2α,3α,19α,23-四羟基乌苏-12-烯-28-羧酸的药物的含量测定.     

The effects of phorbol esters with different biological activities on protein kinase C

The sapintoxins are a series of naturally occurring fluorescent phorbol esters with a range of selective biological activities (e.g. pro-inflammatory but non-tumour promoting). Their ability to activate protein kinase C (PKC) in vitro has been studied. Both tumour promoting and non-promoting phorbol derivatives activate the enzyme in vitro at low concentrations. 12-deoxyphorbol-13-phenylacetate-20 acetate (DOPPA) acts as a partial agonist in the activation of protein kinase C. Structurally distinct phorbol esters may therefore preferentially activate different forms of protein kinase C. α-sapinine, a biologically inactive compound, binds to protein kinase C without stimulating the enzyme and prevents subsequent activation by phorbol esters such as 12-O-tetradecanoyl phorbol-13-acetate (TPA).     

肿瘤患者医院感染的分析与预防措施

目的了解肿瘤科医院感染特点,为临床减少肿瘤患者感染提供参考信息。方法以主动监测与系统回顾相结合的方法,对2005年全年入住肿瘤科2 679例患者的临床资料进行统计、分析、评定。结果2 679例肿瘤患者发生医院感染120例次,医院例次感染率为4.47%,其中感染1次者179例、2次者31例、≥3次者10例;以呼吸道感染占首位,其中上呼吸道38例、下呼吸道36例,其次为消化道10例、血液9例、手术切口感染8例、泌尿道6例和其他部位感染13例。结论提高机体免疫力、控制内源性感染,是预防与控制肿瘤患者感染的主要措施。     

利培酮对氯氮平血浓度影响的研究

目的　了解利培酮对氯氮平血浓度的影响及二药合用的疗效与不良反应。方法　对 5 0例原服用氯氮平治疗的难治性精神分裂症患者合并利培酮治疗 ,分别于合并治疗前及后 1月、2月、3月测定氯氮平血浓度 ,同时评定PANSS ,TESS量表。结果　合用利培酮后 ,氯氮平血浓度无明显升高 ,PANSS评分明显降低(P <0 .0 1) ,TESS评分有所增加。结论　利培酮对氯氮平血浓度无明显影响 ,二药合用能增加疗效 ,不良反应有所增加。     

浅议高中生物教师“三种意识”的确立

在建设学习型社会和新课改的新形势下,高中生物教师应确立三种意识:"学习意识、信息意识、科研意识",不断提高自身素质,使自己成为一名学者型、研究型的现代生物教师.     

胆囊鳞癌6例报告

目的：探讨胆囊鳞癌的发病情况、特点、诊断、治疗、预后及预防。方法：结合有关文献复习分析6例胆囊鳞癌的病例。结果：5例行手术治疗，术后两月内死亡3例，另两例至今存活，分别为术后8个月，3个月。1例行B超引导穿刺活检，入院后两周死亡。结论：胆囊鳞癌早期无特异症状，诊断时多已属晚期，手术效果较差。早期诊断、根治性手术有助于胆囊鳞癌的预后。     

脑静脉血栓病人的死亡因素分析(附5例分析)

目的分析脑静脉血栓(CVT)病人的死亡原因。方法回顾分析136例CVT病人中5例死亡病例的病因、临床表现、影像学资料、治疗经过及死亡原因。结果病死率为3.7%。2例在急性期死亡,3例在慢性期死亡。直接死亡因素均为脑疝;间接死亡因素为颅内多发性出血和多个部位的脑静脉血栓形成,死亡组(3.20±0.84)支静脉受累,存活组(2.09±1.00)支静脉受累(P=0.016)。而性别、年龄、确诊时间、癫疒间发作、病灶部位及治疗前颅内压等没有显著增加死亡的危险性。某些临床表现,如失语、运动障碍、精神症状及意识障碍与死亡有关,但其系多发性颅内出血及多个部位脑静脉血栓所致。结论CVT病人的直接死亡原因为脑疝,间接原因为多发性脑静脉血栓和颅内多发性出血。死亡不仅可以发生在急性期,也可以出现在慢性期。