单用体外震波碎石治疗尿路结石的体会

本文报道1988年6月～11月,单独应用上海交通大学电力工程系研制的JT—ESWL—Ⅱ型体外震波碎石机,治疗尿路结石506例,其中肾结石304例(双侧12例)输尿管结石199例(双侧5例),膀胱结石3例。冲击能量15～40焦耳,每次治疗冲击波次数为400～2800次。本组无开放手术、无肾脏丧失、无死亡。效果满意者96.44％。其并发症主要有血尿、结石串。作者认为单用ESWL治疗小于3Cm的尿路结石安全可靠、无严重并发症。文中对单用体外震波碎石(ESWL)治疗尿路结石病例选择,如何减少并发症,提高治疗效果进行了讨论。     

Obstructive and restrictive ventilatory impairment in polyvinylchloride fabrication workers

Responses to a standardized respiratory symptom questionnaire, spirometry, and cross-shift decreases in lung function between 70 current employees of a polyvinylchloride (PVC) fabrication plant and a control group consisting of 48 men employed in a vegetable packing plant were compared. FEV1/FVC was significantly lower in the PVC workers. Cross-shift drops in Vmax75 of 15% or more were also more prevalent in the exposed group (p = .01). When examining the association between months of work within the exposed workforce and spirometric indices of airway obstruction, no relationship could be demonstrated. However, an inverse dose-response relationship was seen between level of FVC and duration of employment, suggesting a restrictive impairment. While the specific exposures have not been identified, it appears that employment in PVC fabrication may be associated with both obstructive and restrictive ventilatory effects.     

尿路复合性恶性肿瘤（附21例报告）

报告２１例尿路复合性恶性肿瘤，位于肾盂２例，膀胱１９例。主要临床表现为血尿，绝大多数病人伴有尿路刺激症状。低分化的移行细胞癌（ＴＣＣ）与继发性复合肿瘤有密切关系。２１例中１例为ＴＣＣ复合肉瘤，１１例为ＴＣＣ复合鳞癌，７例为ＴＣＣ复合腺癌，２例为腺癌复合鳞癌。本组２例肾盂肿瘤分别行肾输尿管全长加膀胱袖口状切除术和肾部分切除术，术后存活６个月和１年；膀胱肿瘤１４例行膀胱部分切除术，已生存３年４例，１年２例，未满１年２例，３例１～２年内死亡，失访３例；２例根治性膀胱全切术已生存５年和３年以上；３例行ＴＵＲＢｔ，已生存３年１例，１５年１例，未满１年１例。对尿路复合性恶性肿瘤的组织学、临床和病理特征进行了讨论。     

家兔呼吸道内分泌细胞的形态学研究

研究新生仔兔和成兔呼吸道内分泌细胞的形态结构及分布，结果显示在呼吸道有单个物成群的内分泌细胞，单个的内分泌细胞从喉直至肺内导气部粘膜上皮内均可观察到，细胞形态多样，细胞胞质充满大量银染黑色颗粒；成群的内分泌细胞，仅分布于肺的支气管树粘膜上皮内，由几个或几十内分泌细胞组成圆形或卵圆形的小体，细胞胞南内也有大一银染黑色颗粒。     

Articulation of Asthma and Its Care Among Low-Income Emergency Care Recipients

Low-income minority patients from East St. Louis, Illinois, a depressed midwestern urban city, who had visited acute care settings with asthma symptoms, participated in a focus group. Questions were constructed around the Health Belief Model to characterize participants' experiences in receiving asthma care, their confidence in long-term asthma self-management, barriers they perceived to managing their asthma, and recommendations they would make for improving asthma care in their community. Analysis of comments suggests an appreciable understanding of asthma triggers, limited coping behaviors for asthma symptoms, very limited practice of active asthma management, perception of the health care system as frequently insensitive to their needs or their knowledge of their own care, exchange of well-articulated information regarding how to deal with the system, and an apparent lack of awareness of any potential contribution of patient education or support system.     

呼吸道感染与气象因素的关系

呼吸道感染是呼吸系统常见病、多发病。利用杭州地区1990年1月～1992年12月气象资料作了统计分析，并对同期来海军杭州疗养院门诊就诊的呼吸道感染病人进行了调查。结果为1～3、11、12月发病率高，与5～9月相比有非常显著差异（P＜0．001），呼吸道感染与气温低，湿度高，温差大，天气骤变等气象因素密切相关。潮冷天气（气温在10℃以下），频繁降温（每月3次以上），大幅度降温（4℃以上）三种气象因素共同存在情况下可导致呼吸道感染性疾病的高发。同时从气象学角度提出了预防该病的一些措施。     

Respiratory health status in swine producers using respiratory protective devices

A cross-sectional survey on respiratory health in swine producers showed that 30% of 301 examined men usually used a dust mask when working inside a barn. They did not differ significantly from dust mask nonusers in respect to respiratory symptoms and lung function. This analysis was undertaken to determine whether the respiratory health of dust mask users was associated with reasons why they had started individual respiratory protection. The subjects were recontacted in order to identify those who started using a mask to deliberately prevent symptoms (42 men) and those who started protection because of pre-existing respiratory symptoms (44 men). Not unexpectedly, betweengroup comparisons of respiratory symptoms and lung function suggest that swine producers who wear dust masks for preventive purposes have better respiratory health than those who wear dust masks because of symptoms or those who do not use individual respiratory protection. The individual reasons for starting dust mask usage should be examined among potential determinants of the outcomes of prospective studies which can then provide more valid assessment of the effect of individual respiratory protection. © 1993 Wiley-Liss, Inc.     

Safety pharmacology of the respiratory system: Techniques and study design

The known effects of drugs from a variety of pharmacologic/therapeutic classes on the respiratory system and worldwide regulatory requirements support the need for conducting respiratory evaluations in safety pharmacology. The objective of these studies is to evaluate the potential for drugs to cause secondary pharmacologic or toxicologic effects that influence respiratory function. Changes in respiratory function can result either from alterations in the pumping apparatus that controls the pattern of pulmonary ventilation or from changes in the mechanical properties of the lung that determine the transpulmonary pressures (work) required for lung inflation and deflation. Defects in the pumping apparatus are classified as hypo- or hyperventilation syndromes and are evaluated by examining ventilatory parameters in a conscious animal model. The ventilatory parameters include respiratory rate, tidal volume, minute volume, peak (or mean) inspiratory flow, peak (or mean) expiratory flow, and fractional inspiratory time. Defects in mechanical properties of the lung are classified as obstructive or restrictive disorders and can be evaluated in animal models by performing flow-volume and pressure-volume maneuvers, respectively. The parameters used to detect airway obstruction include peak expiratory flow, forced expiratory flow at 25 and 75% of forced vital capacity, and a timed forced expiratory volume, while the parameters used to detect lung restriction include total lung capacity, inspiratory capacity, functional residual capacity, and compliance. Measurement of dynamic lung resistance and compliance, obtained continuously during tidal breathing, is an alternative method for evaluating obstructive and restrictive disorders, respectively, and is used when the response to drug treatment is expected to be immediate (within minutes post-dose). The species used in the safety pharmacology studies conducted in our laboratory are the same as those used in toxicology studies since pharmacokinetic and toxicologic/pathologic data are available in these species. These data can be used to help select test measurement intervals and doses and to aid in the interpretation of functional change. The techniques and procedures for measuring respiratory function parameters are well established in guinea pigs, rats, and dogs.     

共同管综合征———胆、胰管异常汇合

对我院14年来2322例直接胆管造影所发现的27例AJPBD进行研究，27例中胆总管囊肿8例，胆石症9例，慢性胰腺炎4例，胆管炎3例，胆囊癌2例，胰体癌1例。临床表现为上腹痛（92．6％），黄疸（70．4％），发热（48．1％）或Charcot三联症（44.4％）。发病年龄3～60岁（36．9士17．8）。共同管长15～44mm（20.2士5．9）。据胆、胰管汇合形式作者将AJPBD分为三型。值得注意的是本组3例复杂型患病年龄均＜15岁。本组以胆、肠内引流手术效果满意。AJPBD与胆、胰疾病发生、发展密切相关，作者建议用“共同管综合征”来表述这一复杂病理现象。     

Single-dose oral omeprazole for reduction of gastric residual acidity in adults for outpatient surgery

Omeprazole is a substituted benzimidazole that causes dose-dependent intracellular inhibition of gastric acid secretion in humans. This double-blind study examined the effect of omeprazole in decreasing gastric acidity and gastric residual volume in outpatient adults. Unpremedicated outpatients, ASA I-III, 18 years or older (n = 17), were randomly assigned to receive omeprazole 80 mg, or placebo by mouth the night before scheduled elective outpatient surgery. The patients were fasted for 8 h prior to surgery. After the patient was anesthetized, an orogastric tube was inserted with proper placement verified by auscultation for gastric sounds. Gastric residual contents were withdrawn into a Luken's trap, and pH was then determined and gastric volume indexed to weight (ml.kg-1). Data were analyzed by a t-test, with P less than 0.05 considered statistically significant. Patient characteristics of both groups were similar. There was a statistically significant difference between the two groups for pH (P = 0.02), but not between the two groups for gastric volume indexed to weight (P = 0.07).