早期鼻饲生大黄粉防治重型颅脑损伤后上消化道出血的临床研究

目的研究重型颅脑损伤后早期鼻饲生大黄粉对防治上消化道出血的作用.方法选择GCS3～8分重型颅脑损伤患者90例,随机选45例(实验组)伤后早期(24～48h)鼻饲生大黄粉,另45例(对照组)未予生大黄粉治疗.所有患者其他治疗措施均基本相同.结果39例患者出现上消化道出血.其中实验组14例,有13例上消化道出血治愈,治愈时间(7.6±2.5)d;对照组25例,有16例上消化道出血治愈,治愈时间(13.4±3.3)d.实验组上消化道出血率和上消化道出血治愈平均时间均显著低于对照组(P＜0.05),而上消化道出血治愈率显著高于对照组(P＜0.05).结论早期鼻饲生大黄粉能有效防治重型颅脑损伤后并发上消化道出血,值得临床推广应用.     

ENDOSCOPIC ULTRASOUND GUIDED TRUCUT BIOPSY

Endoscopic ultrasound (EUS) is sensitive for staging gastrointestinal malignancies and pancreatic lesions. EUS‐fine‐needle aspiration (EUS‐FNA) offers a diagnostic accuracy of about 60–90% for pancreatic tumors and > 90% for lymph nodes. There are several limitations of EUS‐FNA including the need for on‐site cytopathology review. In addition, accuracy of cytologic review is hampered by the presence of blood, benign epithelial cells, desmoplasia, and well‐differentiated tumors. Furthermore, the small biopsy sample and destruction of tissue architecture limits the diagnostic sensitivity for GISTs and lymphomas. Many of these problems can be overcome with use of EUS trucut biopsy (TCB) needles. These large caliber, cutting needles acquire larger tissue samples allowing preservation of tissue architecture and histologic examination. Our recently described experience with EUS‐TCB initially in swine and later humans demonstrated the safety for acquiring histologic tissue representative of the target organs sampled enabling accurate diagnosis. These studies suggested greater diagnostic accuracy of EUS‐TCB for submucosal mass lesions and lymphoma and potentially the need for fewer needle passes for solid pancreatic neoplasms. In this paper we will review the current TCB literature, device design and technique, help troubleshoot potential problems, and offer opinion as to the utility and role of this new device.     

超微粉体技术对穿心莲药材中穿心莲内酯及脱水穿心莲内酯溶出率的影响

目的:探讨超微粉碎对穿心莲药材中有效成分溶出率的影响.方法:用高效液相色谱法(high performance liquid chromatography,HPLC)测定穿心莲超微粉与药材120目细粉中穿心莲内酯及脱水穿心莲内酯的溶出率.结果:超微粉药材中穿心莲内酯及脱水穿心莲内酯的溶出率明显增加.结论:超微粉碎可显著提高穿心莲药材中有效成分的溶出率.     

愈银汤3号在治疗银屑病的临床应用

愈银汤3号存临床银屑病的治疗中作用确定，银屑病在临床中可分为寻常型、脓疱型、关节病型、红皮病型银屑病，其发病原因有很大的不同．在治疗中应辩证治疗。     

大鼠直肠壁内淋巴管的微细分布和形态特征

目的观察大鼠直肠壁内淋巴管的分布和形态、结构特点，为探讨直肠癌淋巴道转移的机制，提供形态学依据。方法用半薄、超薄切片、光镜和电镜下观察大鼠淋巴管的微细分布。结果大鼠直肠壁的黏膜固有层深部可见毛细淋巴管，黏膜下层、肌层和浆膜层均有毛细淋巴管和淋巴管。结论直肠壁各层内均有毛细淋巴管，除黏膜层外，还存有淋巴管。     

龙血竭散在肛瘘术后的临床应用

目的：探讨龙血竭散在肛瘘术后促进创面愈合的疗效和机理。方法：选用50例肛瘘手术病人，分为治疗组（用龙血竭散）和对照组（用雷夫奴尔纱条）各25例，分别观察术后创面换药疼痛和愈合时间。结果：治疗组在减轻创面疼痛，促进肉芽组织生长，加速创面愈合等方面明显优于对照组（P〈0．01）。结论：龙血竭散可明显缩短创面愈合时间，且无瘢痕过度生长，具有临床应用价值。     

STANDARD IMAGING TECHNIQUES OF ENDOSCOPIC ULTRASOUND‐GUIDED FINE‐NEEDLE ASPIRATION USING A CURVED LINEAR ARRAY ECHOENDOSCOPE

Standard imaging techniques using a curved linear array echoendocope are summarized to facilitate the attainment of expertise in endoscopic ultrasonography and endoscopic ultrasound‐guided fine needle aspiration, and to promote the widespread use of this diagnostic and therapeutic tool. Typical images of the mediastinal organs, the bilio‐pancreatic systems and neighboring organs by scanning from the esophagus, stomach, duodenal bulb, and descending portion of the duodenum, are shown in a sequential manner. The basic techniques of endoscopic ultrasound‐guided fine needle aspiration are also presented.     

豆番粉与玉米粉对人体血糖胰岛素胰升血糖素的影响

目的探讨豆番粉和玉米粉对人体餐后血糖、胰岛素、胰升血糖素的影响。方法选择Ⅱ型糖尿病人、肥胖人、健康人，ｄ１均进食面粉，ｄ２随机进食豆番粉或玉米粉，测量２ｄ的空腹血糖及餐后３０、６０、１２０、１８０ｍｉｎ各５个时点的血糖、胰岛素、胰升血糖素值。结果糖尿病人进食豆番粉后６０、１２０、１８０ｍｉｎ的血糖值低于进食面粉，Ｐ分别＜０．０１、０．０１、０．０５；进食玉米粉后１２０、１８０ｍｉｎ血糖值低于面粉，Ｐ＜０．０５。２种实验食物的血糖增值面积均低于面粉，Ｐ＜０．０５；进食豆番粉后各时点胰岛素值、胰升血糖素值明显低于进食面粉，Ｐ＜０．０５或＜０．０１；进食玉米粉后同时点胰岛素值与面粉相比无显著性差异，胰升糖素值３０、１２０ｍｉｎ有显著性差异。肥胖人进食豆番粉后血糖值与面粉相比无显著性差异，但胰岛素值、胰升血糖素值有明显下降，各时点值Ｐ均＜０．０５。结论①豆番粉血糖指数低，可控制餐后高血糖状态，不增加胰岛素、胰升血糖素分泌，可减轻胰岛素抵抗。②玉米粉血糖曲线增值面积、低于面粉，可作为糖尿病人选择的食品，对改善胰岛素抵抗也有较好的作用。     

显微定量法测定中成药中猪牙皂的含量

目的 :制定猪牙皂在脐风散与惊风散中的显微定量标准。方法 :用显微定量法 ,以猪牙皂特有的石细胞为显微特征物 ,对脐风散与惊风散中的猪牙皂进行测定。结果 :猪牙皂含量与每毫克特征数呈显著的线性正相关 ,回归方程为 y =61 .42 x -1 .1 0× 1 0 - 3(γ=1 .0 0 ,α=0 .0 5 )。结论 :显微定量法测定脐风散与惊风散中猪牙皂的含量是可行的 ,结果可靠     

疔毒丸对小鼠巨噬细胞活性抑制作用的观察

观察了疗毒丸对小鼠腹腔巨噬细胞吞噬功能的影响。结果表明,疔毒丸及其主要成分巴豆霜对小鼠腹腔巨噬细胞的吞噬活性有明显的抑制作用。从而提示临床上使用疔毒丸时,不可忽视它可能抑制免疫功能的副作用。