脊柱侧凸翻修手术

目的探讨脊柱侧凸手术失败原因及翻修手术的处理方法。方法回顾性分析我院自1997年以来收治的脊柱侧凸矫形术后需要进行翻修手术患者33例。男10例，女23例。翻修时距初次手术时间平均为13．4个月(0．5．66个月)。33例患者共行43次翻修手术，其中29例进行1次翻修手术，2例进行3次翻修手术，2例进行4次翻修手术。另有4例患者增加脊柱矫形和融合，同时行脊柱前路松解、支撑植骨手术。结果翻修手术时间平均3．9h(1．5—7．3h)，手术中平均出血601ml(50—2000ml)，平均输血量643．3mk(0-2000ml)。术后随访平均27个月(3—67个月)，未出现畸形加重、内固定失败等并发症。结论脊柱侧凸翻修手术是脊柱畸形矫形术后的一种补救手术。术前完善的手术策略和良好的手术技术是翻修手术的关键。     

236例无痛人工流产术的疗效观察

目的:探讨异丙酚和芬太尼混合液静脉麻醉、笑气吸入麻醉及2%利多卡因宫颈局部浸润麻醉三种镇痛方法在人工流产手术中的疗效比较。方法:自2003年8月至2004年1月对236例妇科门诊早孕要求终止妊娠的妇女实施无痛人工流产术。随机分成3组。A组:异丙酚+芬太尼静脉麻醉(85例);B组:N2O(笑气)吸入麻醉(88例);C组:2%利多卡因宫颈局部浸润麻醉(63例),观察人流术中其镇痛效果并对疼痛进行分级。结果:A组85例100%可达到完全不痛(疼痛分级为0级);B组65.90%可达到完全不痛,Ⅰ级23.86%,Ⅱ级9.09%,Ⅲ级1.15%;C组0例可达到完全不痛,Ⅰ级63.49%,Ⅱ级30.16%,Ⅲ级6.35%。结论:受术者如无心肺疾患及人流禁忌证,无痛人工流产术应选择异丙酚+芬太尼静脉麻醉可达到完全无痛,痛苦最小。     

晕可消胶囊治疗椎—基底动脉缺血性眩晕疗效观察及其对红细胞膜流动性的影响

目的:较大样本观察晕可消胶囊治疗椎-基底动脉缺血性眩晕疗效及其对红细胞膜流动性的影响。方法:符合入选标准的门诊病例203例随机分为观察组(晕可消组)102例,对照组(维脑路通组)101例,治疗10d后行疗效评定并以荧光偏振法检测红细胞膜流动性的变化。结果:观察组疗效优于对照组,并显著改善了红细胞膜的流动性。结论:晕可消胶囊具有改善红细胞膜流动性作用,用于治疗椎-基底动脉缺血性眩晕疗效肯定,值得推广。     

云克治疗类风湿关节炎临床疗效观察

目的:观察云克 (99Tc- MDP)治疗类风湿关节炎 (RA)的疗效。 方法:对 80例类风湿关节炎 (RA)患者应用云克进行静脉治疗 2 1d,并对治疗前后的相关指标进行对照分析。结果 :治疗前与治疗后相比 ,患者晨僵持续时间、握力、ESR、CRP、RF有统计学意义 (P <0 .0 5 ) ,患者关节压痛数及关节肿胀数差异无统计学意义 (P >0 .0 5 )。 结论:云克治疗类风湿关节炎能改善临床症状及实验室指标 ,远期疗效好 ,而且毒副作用小。     

132例男性不育患者遗传学病因分析

目的：对男性不育患者进行遗传学病因分析，并探讨其遗传效应。方法：采取132例男性不育患者外周血进行染色体核型分析。结果：132例男性不育患者中，染色体异常24例，染色体变异22例。其中大Y20例，47，XXY18例，45．XY，t(13；14)3例，小Y和46，XY，inv(9)各2例，46，XY，t(9；22)1例。结论：染色体异常是男性不育的重要原因，并建议男性不育患者进行基因诊断，以便确诊是否属于遗传病，为生育提供指导，避免盲目治疗。     

射频消融治疗肝肿瘤315例报告

目的总结1999年6月至2003年8月用射频消融（radiofrequency ablation，RFA）治疗315例肝肿瘤病人的病例资料，探索RFA治疗肝肿瘤近远期疗效。方法采用了一次定位、多点穿刺，RFA联合肝动脉栓塞（TAE）、选择性门静脉栓塞（SPVE）治疗直径5～13cm的大肝癌，及经皮经肺经膈肌RFA治疗膈顶部肝癌。结果总并发症发生率为5．1％，无一例住院期间死亡。AFP阳性的169例肝癌病人中，RFA后有124例（73．6％）明显降低，其中有95例（56．2％）转阴。半年生存率为89．5％，1年生存率为80．1％，18个月生存率为61．4％，24个月生存率为48．3％，〉36个月生存率为35．6％。结论采用TAE、SPVE及RFA一次定位多点穿刺法治疗无手术切除指征的中晚期（含大肝癌）的病人，疗效明显，总并发症发生率低。     

Urological emergency in neonates with congenital hydronephrosis

OBJECTIVE: It is well described that unilateral pelviureteric junction obstruction (PUJO) is a benign condition, because the dilatation resolves spontaneously and the function does not decrease in most of the kidneys. However, there is exceptional PUJO that requires emergent treatment in neonatal periods. The aim of this article is to report the urological emergency and management in neonates with PUJO. MATERIALS AND METHODS: Nine children (seven boys and two girls) with PUJO who underwent neonatal emergent treatment during the last 13 years were reviewed. Renal function was evaluated according to decay curve of serum creatinine (SCr) levels corresponding to gestational age (GA) at delivery. Physical examination, ultrasonographic monitoring, and chest and abdominal plain radiographs were repeated in each neonate. RESULTS: Eight patients were detected prenatally. In five patients, multicystic dysplastic kidney (MCDK) was demonstrated on the contralateral side. Three patients underwent percutaneous puncture of fetal hydronephrosis. Decrease of amniotic fluid was evident in three fetuses. Indications for emergent treatment included mass effect from hydronephrosis in three patients, renal dysfunction in five, and severe urinary tract infection in one. During neonatal periods, a percutaneous nephrostomy tube was placed in seven, and open nephrostomy in one with anorectal malformation. Repeated punctures of the dilated renal pelvis were done in one patient. Renal function after pyeloplasty was stable in eight patients, while it was moderately decreased in one who was associated with oligohydramnios in utero. CONCLUSION: Indications for emergent treatment in neonates with PUJO included mass effect from giant hydronephrosis, renal dysfunction and severe urinary tract infection. At birth, respiratory and circulatory conditions must first be stabilized. In neonates with hydronephrosis of the solitary kidney or severe bilateral PUJO, serial SCr should be monitored to evaluate renal function. Decrease of amniotic fluid suggested renal functional compromise that would not recover after urological management.     

Visual fixation offsets affect both the initiation and the kinematic features of saccades

It is well known that the removal of a fixation point prior to the presentation of a peripheral target dramatically reduces saccadic reaction time (SRT). This effect has become known as the “gap effect”. The present study examined several detailed kinematic variables to determine whether the removal of the fixation point also affects the manner in which saccades are produced. The findings indicate that saccades that were initiated after the removal of the fixation point had higher average velocities and reached greater peak velocities, accelerations, and decelerations than did saccades produced in the presence of the fixation point. The results suggest that the removal of the fixation point may affect the force-time curves of saccades in addition to affecting the time needed to initiate the saccades. Received: 21 February 1997 / Accepted: 24 July 1997     

Chronic opioid treatment of neuroblastoma X dorsal root ganglion neuron hybrid F11 cells results in elevated GM1 ganglioside and cyclic adenosine monophosphate levels and onset of naloxone-evoked decreases in membrane K+ currents

Prolongation of the action potential duration of dorsal root ganglion (DRG) neurons by low (nM) concentrations of opioids occurs through activation of excitatory opioid receptors that are positively coupled via G_s regulatory protein to adenylate cyclase. Previous results suggested GM1 ganglioside to have an essential role in regulating this excitatory response, but not the inhibitory (APD-shortening) response to higher (μM) opioid concentrations. Furthermore, it was proposed that synthesis of GM1 is upregulated by prolonged activation of excitatory opioid receptor functions. To explore this possibility we have utilized cultures of hybrid F11 cells to carry out closely correlated electrophysiological and biochemical analyses of the effects of chronic opioid treatment on a homogeneous population of clonal cells which express many functions characteristic of DRG neurons. We show that chronic opioid exposure of F11 cells does, in fact, result in elevated levels of GM1 as well as cyclic adenosine monophosphate (AMP), concomitant with the onset of opioid excitatory supersensitivity as manifested by naloxone-evoked decreases in voltage-dependent membrane K⁺ currents. Such elevation of GM1 would be expected to enhance the efficacy of excitatory opioid receptor activation of the G_s/adenylate cyclase/cyclic AMP system, thereby providing a positive feedback mechanism that may account for the remarkable supersensitivity of chronic opioid-treated neurons to the excitatory effects of opioid agonists as well as antagonists. These in vitro findings may provide novel insights into the mechanisms underlying naloxone-precipitated withdrawal syndromes and opioid-induced hyperalgesia after chronic opiatf addiction in vivo. © 1995 Wiley-Liss, Inc.     

安吉复口服液的耐缺氧,耐低温和抗疲劳作用

采用缺氧、寒冷和负重游泳等方法,观察了安吉复口服液(0.025、0.1和0.4mg·kg~(-1),ig,qd×14d)对小鼠的耐缺氧、耐低温及抗疲劳作用.结果表明,安吉复口服液0.1、0.4mg·kg~(-1)可延长KCN中毒小鼠的存活时间及延长小鼠在寒冷环境中存活时间,而0.4mg·kg~(-1)可延长常压缺氧条件下小鼠存活时间及延长小鼠负重游泳时间.