白术茯苓汤及其配伍对脾虚大鼠胃肠激素的影响

目的：探讨益气健脾方剂治疗脾虚证的配伍规律。方法：采用苦寒泻下法复制大鼠脾虚模型，运用放射免疫分析法（RIA）检测白术茯苓汤及其与补气药。行气药及除湿药的不同配伍对脾虚大鼠胃泌素（GAS）、胃动素（MTL）及血管活性肠肽（VIP）的含量影响。结果：与正常对照组比较，脾虚模型大鼠GAS、MTL降低（P＜0．01），VIP升高（P＜0．01）；与自然恢复组比较，各治疗组以上部分或全部指标均有不同程度的改善，其中，以综合配伍组改善作用最优。结论：白术茯苓汤的脾虚大鼠胃肠激素的紊乱的某些指标，有一定的改善作用，综合配合组以上指标的改善，优于白术茯苓汤组及其余各配伍组，说明中医关于复方配伍的理论与实践，有其科学价值。     

七种常见舌苔的细胞化学计量诊断研究

以１１７例常见舌苔上皮细胞内ＬＤＨ、ＭＤＨ、Ｇ－６－ＰＤＨ、ＡＣＰ、ＡＮＡＥ、－ＳＨ、ＲＮＡ七种生物大分子物质的定量检测为基础，运用多元逐步回归方法建立正常薄白、虚寒薄白及白厚、薄黄、黄厚、花剥、光剥种舌苔的计量诊断模型，经临床回代检验，其敏感性、特异性、准确度、可用度分别为９３．２％、８１．４％、８７．２％和７５．７％。     

高能聚焦超声刀联合氟脲嘧啶、四氢叶酸治疗晚期胰腺癌临床疗效观察

目的探讨高能聚焦超声刀加氟脲嘧啶、四氢叶酸治疗晚期胰腺癌临床疗效及毒副作用。方法30例经病理学或细胞学确诊的晚期胰腺癌病人先用高能聚焦超声刀(HIFU)治疗，再予氟脲嘧啶、四氢叶酸联合化疗。氟脲嘧啶500mg／m^2加入5％GNS500ml静滴持续6小时以每天1次连用5天，CF(四氢叶酸)100mg／m^2加入生理盐水250ml静滴每天1次连用5天，28天为1周期，至少治疗2个周期。结果CR1例；PR9例；MR9例；NC5例；PD6例。总有效率63％。毒副作用主要消化道反应，其他副作用轻微。结论应用HIFU局部治疗胰腺癌同时合用四氢叶酸加氟脲嘧啶全身化疗近期疗效提高明显，止痛明显达75％，副反应小，值得应用。     

Osteoporosis and Back Pain among the Elderly

Questionnaire responses from 120 men and 337 women over the age of 50 years were studied to determine the prevalence of back pain among the elderly. In order to gain a rough indication of the back pain among elderly women which might be due to osteoporosis, the prevalence was compared in the two sexes. The prevalence of back pain without radiation to the legs and concomitant morbidity was found to be similar among men and women up to the 70–79-year age-group. After this age the prevalence was higher in women. Those with exceptional loss of body height or kyphosis had a high prevalence of back pain, while those who had sustained previous hip or radius fractures did not. There was increasing prevalence of back pain among women with increasing number of previous fractures. The study gives little indication of serious morbidity of osteoporosis in the form of back pain before very old age.     

桡骨与尺骨的测量及回归分析

本文测量了桡骨与尺骨各100例,其中桡骨15项指标,尺骨14项指标。并用IBM·PC—XT计算机DBASEⅢ数据库管理系统进行了统计分析以及用桡、尺骨最大长分别与桡、尺骨其它各项指标间进行直线相关分析,建立了25个回归方程。     

Inter- and intraobserver variability in the histopathological diagnosis of medullary carcinoma of the breast,and its prognostic implications

Summary One hundred thirty-one breast carcinomas with medullary features, registered in the Danish Breast Cancer Cooperative Group from 1977–1982, have been histopathologically reviewed by two senior pathologists and classified as typical medullary carcinoma (TMC), atypical medullary carcinoma (AMC), and non-medullary carcinoma (NMC). Diagnostic criteria were based on those put forward by Ridolfiet al. and Fisheret al. The procedure was repeated with an interval of about one year by both pathologists. The diagnostic interobserver agreement was 72% with a Kappa of 0.55. The intraobserver agreement was 77% and 63% with Kappa values of 0.64 and 0.44, respectively. To see whether the observed inter- and intraobserver variability had any prognostic implications, diagnostic subgroups for both pathologists were analyzed with Kaplan Meier plots for recurrence-free survival (RFS) and with log rank tests. In the first evaluation pathologist 1 segregated a group of TMC with a significantly better RFS than for the NMC group, and pathologist 2 segregated a group of TMC with a corresponding strong trend. These findings could not, however, be reproduced in the second evaluation. The study indicates that the criteria of TMC and AMC as proposed by Ridolfiet al. need to be sharpened and simplified in order to reduce inter-and intraobserver variability. Larger studies with a control group of infiltrating ductal carcinomas are mandatory to elucidate the clinical importance of the diagnoses of Typical and Atypical Medullary Carcinoma of the breast.     

应用国产球囊导管经皮球囊二尖瓣成形术12例报告

本文报告经皮球囊二尖瓣成形术治疗二尖瓣狭窄12例。10例术前平均左房压为18mmHg～40mmHg(26.7±7.15mmHg),术后即刻为4mmHg～18mmHg(10.6±3.86mmHg)P<0.01。跨瓣压差术前10mmHg～40mmHg(19.6±9.05mmHg),术后为0～5mmHg(2.65±2.21mmHg)P<0.01。1例失败,1例术后发生二尖瓣关闭不全急性左心衰竭死亡。     

红细胞同工酶ADA－EAP一AK_1同步电泳分型方法的建立

综合、改良了分别分型的方法，建立了红细胞同工酶ＡＤＡ一ＥＡＰ一ＡＫ１同步电泳分型方法，为ＡＤＡ，ＥＡＰ和ＡＫ１３种红细胞同工酶在法医学鉴定中更广泛的应用，提供了一种可靠、经济、实用的方法。     

延髓—脊髓P物质能神经元下行通路参与毒扁豆碱的中枢升压反应

大鼠延髓腹侧面头端应用毒扁豆碱引起血压升高和心率加快,伴有延髓腹侧面头端胆碱酯酶活性降低和脊髓蛛网膜下腔灌流液中P物质样免疫反应活性升高。在延髓腹侧面头端应用阿托品或脊髓蛛网膜下腔注射P物质拮抗剂D-脯~2,D-苯丙~7,D-色~9-P物质均可阻断毒扁豆碱的心血管效应。脊髓蛛网膜下腔注射P物质抗血清或辣椒素均可减弱毒扁豆碱的升压反应。实验结果提示,毒扁豆碱作用于延髓腹侧面头端的M受体,兴奋了延髓-脊髓P物质能神经元下行通路,使之释放P物质,引起交感肾上腺髓质系统兴奋,从而使血压升高和心率加快。