全喉切除术后发音重建56例分析

目的：总结喉癌全喉切除术后Ⅰ期安放发音管发音重建的临床经验。方法：分析自1998年9月至2002年5月全喉切除术后Ⅰ期Blom-Singer发音重建56例的发音情况。结果：Ⅰ期安放发音管发音重建成功率92．9％，发音流利、响亮、清晰。结论：全喉切除术后Ⅰ期安放发音管发音重建成功率高。     

肝脏外科患者术后输注脂肪乳剂对蛋白质代谢的影响

将32例肝脏外科疾病患者随机分为Ⅰ组（单能源TPN组10例）；Ⅱ组（双能源TPN组11例，其中脂肪乳剂用量为1g·kg－1·d－1）；Ⅲ组（双能，TPN组11例，其中脂肪乳剂用量为2g·kg－1·d－1）。术后按组别给予TPN支持共6天，术前1天、术后第1和第6天测定肝功，糖代谢及蛋白质合成代谢指标。结果：①Ⅱ、Ⅲ组术后第6天肝脏酶学指标明显下降（P＜0．05），而Ⅰ组仍高于术前水平（P＜O．05）；②Ⅱ、Ⅲ组术后糖代谢基本恢复正常，而Ⅰ组出现高血糖症及高胰岛素血症（P＜0．05）；③Ⅱ组肝脏蛋白质合成水平恢复术前水平或略有提高（P＜0．05），而Ⅰ和Ⅲ组术后蛋白质合成功能仍低（P＜0．05）。结果提示：含脂肪乳剂的TPN支持对肝脏外科患者术后的肝功恢复有益，能促进蛋白质合成及肝细胞再生，并且在进行TPN支持时按1g·kg－1·d－1给予脂肪乳剂较为安全合理。     

三七中人参三醇甙对大鼠离体心脏缺血再灌注损伤及心律失常的保护作用

三七中人参三醇甙(PTS)5,50μg·ml~(-1)灌流对离体大鼠Langendorff心脏缺血再灌注所致心律失常具有明显的保护作用,可降低室颤发生率,并可保护心肌组织中超氧化物歧化酶的降低,PTS 50μg·ml~(-1)还可抑制心肌丙二醛的产生,对缺血再灌注所致心肌乳酸脱氩酶和磷酸肌酸激酶的漏出亦有明显的抑制作用。     

Metastatic thyroid carcinoma presenting as an expansile intraluminal esophageal mass

We report a patient with metastatic thyroid carcinoma invading the esophagus in whom barium and MR examinations revealed an expansile intraluminal mass indistinguishable from that of a primary esophageal malignancy. Metastatic thyroid carcinoma should therefore be included in the differential diagnosis of an expansile esophageal mass. As in our patient, MR imaging may be useful for showing that the mass originates in the thyroid gland.     

The cold pressor test: Vascular and myocardial response patterns and their stability

The purposes of the present study were to compare the cardiovascular response patterns evoked by three versions of the cold pressor test (either forehead stimulation or hand or foot immersion) and to determine the reproducibility of the responses over a 2-week interval. Blood pressure, heart rate, stroke volume, cardiac output, total peripheral resistance, and systolic time intervals were obtained during rest and during the cold pressor test in 42 young men. Across conditions, the pressor response was supported by peripheral resistance increases with concomitant stroke volume decreases. Although the response panerns were generally similar across sites, exceptions were apparent for heart rate. Forehead stimulation was characterized by no significant change in heart rate, whereas limb (hand or foot) immersion was associated with significant heart rate acceleration. The responses elicited by the three cold pressor test conditions were reliable and showed little evidence of attenuation over the test-retest interval.     

Linkage guide for rotational alignment during total knee arthroplasty

A linkage guide was devised for use in conjunction with knee arthroplasty instruments to achieve proper component rotation. The femoral component was rotationally aligned to the surgical epicondylar axis using one guide. The other guides were used after all bone surfaces were cut and soft tissue balancing was completed. A Kirschner wire was guided into the proximal tibial aspect parallel to the sagittal plane of the femoral component with the patella in its normal position and the knee in full extension. The wire was used as a reference to determine tibial component rotation. The relative rotational alignment of 21 knees in 19 patients who had undergone cruciate-retaining total knee arthroplasty utilizing this guide was assessed using the modified Eckhoff method. The results of radiographic analysis were compared with those in a control group of 25 knees where the guide was not employed. The external rotation of the femoral component relative to the tibial component was 1.3° ± 2.0° (mean ± SD) in the guided group and 1.1° ± 4.4° in the control group. The relative rotational angle was significantly more consistent using the guide. Implant malrotation can be reduced using our technique.     

红景天胶囊治疗中医虚证100例临床报告

采用随机双盲对照法观察了红景天胶囊与绞股蓝胶囊治疗中医虚证１６０例的临床疗效，结果表明：红景天胶囊治疗明显效率为５４％，总有效率为８７％，与绞股蓝胶囊对照组比较，其疗效有高度统计学意义。红景天胶囊有确切的升高血红蛋白，高密度脂蛋白，超氧化物歧化酶及皮质醇的作用，同时能过氧化脂质，表明该药物具有益气生血，保护细胞免疫损伤，延缓和防止细胞衰老和作用．     

直肠癌全直肠系膜切除术后直肠阴道瘘原因与防治

本文通过分析近5年来我院18例女性直肠癌全直肠系膜切除术后直肠阴道痿的临床资料。发现直肠阴道痿多发生于中低位直肠癌行全直肠系膜切除保肛手术的患者。痿的发生与肿瘤的位置、肿瘤的分期、肿瘤距肛门口的距离．以及手术技巧、手术难度、引流方法有关。而与是否进行预防性造口，以及是否采用腹腔镜手术无关。预防上强调应重视术中直肠前壁的锐性分离、结肠直肠吻合以及术后盆腔的负压引流。治疗上应首先进行保守治疗，即肠内营养，阴道冲洗。早期配合肠外营养、及全身或局部抗炎治疗，大部分直肠阴道痿通过保守治疗可以治愈。保守治疗无效时考虑结肠或回肠末端造口。若长期不愈应考虑吻合口肿瘤复发的可能。     

冲击式二级采样对呼吸粉尘与总粉尘浓度比值的影响

为了验证冲击式二级粉尘采样对呼吸性粉尘与总粉尘浓度比值的影响，作者采用瞬时定点采样方法测定作业场所空气中呼吸性粉尘浓度与总粉尘浓度。结果表明，在采样体积相同的条件下，呼吸性粉尘的比值与总粉尘浓度间具有较好的从属共变关系（ｒ＞０．８），呼吸性粉尘的比值随着总粉尘浓度的升高而相应增大