急性出血坏死性胰腺炎手术治疗的临床观察

总结了经手术证实为急性出血坏死性胰腺炎的５３例患者的手术疗效。发现该病应早期手术。若发病４天后手术，体温在３８℃以上、脉搏超过１２０次／分、收缩压在１２ｋＰａ（１ｋＰａ＝７．５ｍｍＨｇ）以下、有弥漫性腹膜炎、白细胞高于１６×１０９／Ｌ和术后有重要器官功能衰竭者，术后病死率明显增高。手术方法以胰腺坏死组织清除加三造瘘、腹腔三套管持续冲洗为优。抑制胰腺分泌的药物主要选用５氟脲嘧啶。引起胰腺感染的常见病原菌依次是大肠杆菌、肺炎克雷白杆菌、肠球菌、金黄色葡萄球菌、绿脓杆菌、奇异假单胞菌、链球菌、产气肠杆菌和脆弱类杆菌９种细菌。选用抗生素应遵守３个原则：①抗生素必须能通过血胰屏障。②能在胰腺组织中形成有效的治疗浓度。③能有效地抑制引起胰腺感染的病原菌。这样，才能取得良好的治疗效果。     

Small-dose oral iron absorption test in anaemic and non-anaemic elderly hospitalized patients

Abstract: The small-dose (20 mg) oral iron absorption test (OIAT) was performed in 76 hospitalized elderly patients and 30 healthy adults. Of the elderly patients, 34 were considered as iron deficient (serum ferritin level <20 μg/L) of whom 23 were anaemic and 11 not anaemic, 21 had the anaemia of chronic disorders (ACD) and another 21 were non-anaemic patients with a normal serum ferritin level. There was a significant inverse correlation between the serum ferritin level as a measure of iron store and the maximum increase in serum iron during a 3-h test (C_max), in the elderly as well as in the healthy adult group. A decision limit of 80 μg/dL for C_max is a good discriminant between absent (serum ferritin <20 μg/L) and adequate body iron stores. Sixty-eight per cent of the patients with a serum ferritin level <20 μg/L but virtually none of the ACD patients, non-anaemic elderly inpatients with normal serum ferritin levels and healthy adults had a C_max level >80 μg/L. Although further investigation is needed before the OIAT can be recommended as a valuable test for evaluating iron absorption, predicting mild iron deficiency and differentiating between different categories of anaemia, it seems worthwile that more effort should be done to validate this simple and safe test.     

战士体内VitB_1、VitB_2储备水平检测

选择南方热区某特种部队战士５２人，分两组分别口服５ｍｇＶｉｔＢ１和ＶｉｔＢ２，收集４ｈ尿液，用荧光法进行负荷试验。结果：ＶｉｔＢ１组，所测２９人中，１５人缺乏，９人不足，２人正常，３人充裕；ＶｉｔＢ２组，所测２３人中，１１人缺乏，１２人不足，反映该部队全年约５％的发病是由于ＶｉｔＢ１、ＶｉｔＢ２缺乏不足所致。其原因为膳食摄入不够     

Active behaviors in the rat forced swimming test differentially produced by serotonergic and noradrenergic antidepressants

This study demonstrated that distinct patterns of active behaviors are produced by antidepressants that selectively inhibit norepinephrine (NE) or serotonin (5-HT) uptake in the rat forced swimming test (FST). A behavior sampling technique was developed to score the active behaviors swimming, climbing and diving, as well as immobility. The rat's behavior was recorded at the end of each 5-s period during the test session. The sampling technique was both reliable, as demonstrated by test-retest reliability and inter-rater reliability, and valid, as shown by comparison to the timing of behavior durations. Five different antidepressant drugs which block monoamine uptake and two 5-HT_1A receptor agonists were shown to decrease immobility in the FST; however, they produced distinct patterns of active behaviors. The selective NE uptake inhibitors desipramine and maprotiline selectively increased climbing, whereas the selective serotonin reuptake inhibitors (SSRIs) fluoxetine, sertraline and paroxetine selectively increased swimming. The 5-HT_1A receptor agonists 8-OH-DPAT and gepirone also selectively increased swimming. These results show that:1) SSRIs are not false negatives in the FST; 2) at least two behaviorally distinct processes occur in the FST; and 3) enhancement of NE neurotransmission may mediate climbing in the FST, whereas enhancement of 5-HT neurotransmission may mediate swimming.     

Variability of the Schirmer tear test values in a normal Arab population

Background: As in many parts of the world, the Schirmer tear test is the main test used by optometrists in Saudi Arabia for assessing adequacy of tear production. Variability of the test has been reported in different ethnic groups but not in Arabs. This paper looks at the mean and repeatability of the values obtained by the Schirmer test in a normal Arab population Method: The test was performed on the right eyes of 23 young adult Saudi male subjects at five visits over two weeks. Result: Results showed that for each subject the test values were not repeatable, varying widely over the period of evaluation. The mean value was estimated at 10.6 mm and the 95 per cent confidence limits were 7.9 and 13.3 mm. It was also established that the greater the amount of tears, the greater the variability. Conclusion: This study supports the claim that the Schirmer test is not repeatable and hence is unreliable. Therefore, caution should be exercised in employing it for clinical diagnosis. (Clin Exp Optom 1995; 78: 5: 190–193)     

高海拔（2261m）急性习服期大鼠脑内β—EP含量的实验研究（之三）

选用标化成年雄性Wistar大鼠、以放射免疫测定法（RIA），研究了大鼠由平原引入高海拔环境后，在24小时急性司服期，垂体及各脑区内β－内啡肪样免疫活性物质（β－EPLI）的含量变化。结果表明，大鼠引入高海拔环境后脑内β－EP含量发生明显的动态变化。高海拔实验组与平原对照组相比，垂体内β－EP含量降低非常显著（P＜0．01）。纹状体、下丘脑、丘脑、桥延、海马、皮层内β－EP含量增加非常显著（P＜0．01）。中脑内β－EP含量虽然也增加，统计学处理无显著性意义（P＞0．05）。据此推测：大鼠急进高海拔低氧环境后垂体β－EP的分泌与释放受到影响。提示，脑内β－EP参与低氧的应激反应过程，可能作为神经递质和调质，通过神经──内分泌环路在应激反应中起介导作用，β－EP可能为中枢神经系统内调节应激反应的主要应激激素之一。     

正常人口腔粘膜不同部位表面感觉的测试

目的 建立正常人口腔粘膜不同部位表面感觉的正常参考值，并测试各年龄组感觉值是否存在差异。方法 利用动静两点辨别觉试验，测试90例健康人口腔粘膜不同部位的表面感觉。结果 舌尖感觉功能最好，其次为舌背、舌腹、颊粘膜、口底和硬腭。健康人的口腔粘膜不同部位的表面感觉随着年龄增长有显著性变化。结论 口腔粘膜不同部位感觉辨别力存在差异，健康人口底、舌腹、舌背、颊和硬腭粘膜感觉功能有增龄性变化。     

益母草防治初发期急性肾小管坏死的实验研究

ＳＤ成年雄性大鼠，禁止１６小时，肌注甘油引起急性肾小管坏死（ＡＴＮ），于其初发期给予不同药液，观察到益母草组３、２４及４８小时Ｂｃｒ升高值，２４及４８小时ＢＵＮ升高值均明显低于自来水组和单纯禁水组，而与校正对照异搏停组近似，肾组织损伤程度亦明显减轻。结果表明，益母草对初发期急性肾小管坏死（ＩＡＴＮ）有一定的防治作用。     

The influence of anaesthetic techniques and type of delivery on peripartum serum interleukin-6 concentrations

Background: Interleukin-6 is a pleiotropic cytokine with a wide range of physiological activities. It plays an important role in the immuno-neuro-humoral axis during stress and surgery.
Methods: Serum interleukin-6 in parturients was measured on hospital admission, immediately after birth and 12 and 24 hours later. All parturients had uncomplicated pregnancies, and delivered vaginally without (n=31) or with (n=20) epidural analgesia, or underwent Caesarean section under epidural (n=20) or general (n=10) anaesthesia.
Results: Serum interleukin-6 assayed immediately following Caesarean section was low, but peaked 12 hours later, irrespective of the anaesthetic technique or other foetomaternal characteristics. Patients who delivered vaginally showed the highest interleukin-6 levels immediately after delivery. These were positively correlated with serum interleukin-6 on admission and duration of labour. Serum interleukin-6 was significantly higher in parturients who had epidural analgesia, and was significantly lower in those receiving intravaginal prostaglandins compared to those without prostaglandins.
Conclusion: The interleukin-6 response after Caesarean section can be explained by a generalized acute phase response to surgery, with no anaesthetic, maternal or neonatal interference. The rapid increase in peripartum serum interleukin-6 levels after vaginal delivery reflects, in part, cervical ripening or labour, their physiological triggers and psychological or physical stress. Regional anaesthesia, duration of labour and exogenous prostaglandin administration can modulate the peripartum interleukin-6 response and subsequently the physiological effects of this cytokine.