小儿急性脊髓炎临床分析

目的探讨小儿急性脊髓炎的临床特点，诊断，治疗及院内感染。方法回顾我院儿科1998-2007年收治12例小儿急性脊髓炎的病因、临床表现、实验室检查结果、治疗及院内感染进行分析。结果12例患儿的主要临床表现有：运动功能障碍100％，90．2％为首发症状，感觉功能障碍占41．7％，括约肌功能障碍占83．3％，18．2％脑脊液异常，64％脊髓MRI异常，16．7％合并院内呼吸道感染，50％治愈，41．7％好转，8．3％无效。结论小儿急性脊髓炎临床表现较不典型，脑脊液、MRI检查是诊断的关键，治疗上以糖皮质激素为主的综合疗法，治疗效果好，但呼吸道院内感染率较高。     

心电图诊断左房增大价值的探讨

对窦性心律109例、持续性房颤313例的各种心脏疾病患者参照UCG检查,探讨ECG诊断左房增大的价值及左房增大与房颤的关系.P波诊断左房增大的3项指标(P波时间>110ms、P波切迹双峰间距≥40ms、PTFv_1<一30mm·ms)的敏感性较低(58%-71%),但特异性高(83%—94%),其中PTFv_1的诊断价值最大.ECG对诊断左房增大仍不失为有用方法.左房增大程度与并发房颤的比例在风心病有密切关系,但在非风心病则否.     

驻西南某部战士心理健康调查

目的了解驻西南某部战士近期心理卫生状况。方法(1)对驻西南某部战士进行症状自评量表(SCL-90)测试,将结果与中国18~29岁常模和军男组常模进行比较;(2)将战士按军龄分为5组,比较各组战士间心理健康状况:(3)将新兵组和陆军新兵常模,一级士官组和军男组常模比较。结果(1)战士除躯体化外,其余所有因子均低于军男组常模(P<0.01);与全国18~29岁常模比较,躯体化、焦虑、精神病性3项因子偏高(P<0.05),人际关系敏感、抑郁、恐怖、偏执4项因子偏低(P<0.05)。(2)各组战士间心理健康存在差别,其中新兵健康水平最高,一级士官最低。(3)新兵组躯体化、强迫症状、敌对和恐怖因子与陆军新兵常模无明显差异,余因子均显著低于陆军新兵常模组(P<0.05)。(4)与军男组常模比较,一级士官组躯体化偏高(P<0:01),人际关系敏感、抑郁和偏执偏低(P<0.01)。结论驻西南某部战士心理健康状况较好,但一级士官心理健康状况仍不理想,需引起部队心理卫生工作者的重视。     

再次准分子激光原位角膜磨镶术后屈光回退的多因素分析

目的探讨准分子激光原位角膜磨镶术(LASIK)术后屈光回退导致再次手术的的原因。方法对2002年3月至2003年1月所做的LASIK全部病例中于2004年2月前再次手术的21例(41只眼)(回退组),测量并统计分析其术前屈光度(等效球镜)、角膜曲率、手术前后超声波和角膜地形图测的角膜厚度、术中角膜瓣厚、角膜切削深度、所留角膜基质床厚度、角膜切削有效光区直径。随机选同期手术随访3月以上、术后裸眼视力1.0以上的受术者21例(41只眼)做对照比较。并就上述因素及年龄是否引起屈光回退做Lojistic回归分析。结果再次手术者占其首次手术同期全部受术者的1.6％。回退组与对照组的年龄、性别、术前屈光度数、角膜曲率、角膜厚度、术中角膜瓣厚、角膜切削深度、所留角膜基质床厚度、角膜切削有效光区直径的均数没有统计学差异。回退组预期术后角膜厚度(术前角膜厚度减去手术切削厚度)(468.1μm±24.5)较一次术后实际角膜厚度(496.8μm±25.7),有统计学差异(t=5.600,P=0.008);如果将一次预期角膜厚度与二次预期角膜厚度(术后角膜厚度减去二次手术切削厚度)(467.5±29.0)相比较,则没有统计学差异(t=1.093,P=0.299);而对照组的预期角膜厚度(463.2μm±34.8)与术后实际角膜厚度(481.1μm±34.4359)没有统计学差异(t=3.584,P=0.062)。Logistic回归分析9个因素中只有3个因素有统计学意义。为0.9324+0.1100年龄-5.3427切削光区+0.1432瓣厚。结论 LASIK术后回退需再次手术者第一次术后角膜厚度未能达到术后预期角膜厚度,似应考虑因为术后角膜再增生而增厚所致。术后屈光是否出现回退与年龄呈正相关,年龄越大越易回退;与有效切削光区呈负相关,光区越小越易回退;与术中所作角膜瓣厚度成正相关,角膜瓣越厚越易回退。     

Insights into antiradical mechanism and pro-oxidant enzyme inhibitor activity of walterolactone A/B 6-O-gallate-β-d-pyranoglucoside originating from Euonymus laxiflorus Champ. using in silico study

The ability of a new compound, Wal, (walterolactone A/B 6-O-gallate-β-d-pyranoglucoside) originating from Euonymus laxiflorus Champ. as a hydroperoxyl radical scavenger and pro-oxidant enzyme inhibitor was studied in silico. Different mechanisms, reaction locations, and chemical species of Wal in aqueous solution were taken into consideration. Formal hydrogen transfer from the OH group has been discovered as the chemical process that contributes most to the antioxidant properties of Wal in nonpolar and aqueous solutions. The overall rate coefficients for polar and non-polar environments are expected to have values of 7.85 × 10⁶ M⁻¹ s⁻¹ and 4.84 × 10⁵ M⁻¹ s⁻¹, respectively. According to the results of the investigation, Wal has greater scavenging activity against the HOO˙ radical than the reference antioxidant Trolox at physiological pH (7.4). In addition, docking results indicate that Wal''s antioxidant properties involve the inhibition of the activity of enzyme families (CP450, MP, NO, and XO) that are responsible for ROS production.

In silico evaluation of a novel compound isolated from Euonymus laxiflorus Champ. for its ability as a hydroperoxyl radical scavenger and pro-oxidant enzyme inhibitor.     

加味桂枝加葛根汤治疗神经根型颈椎病80例疗效观察

目的观察加味桂枝加葛根汤治疗神经根型颈椎病（CervicalSpondylosisadiculopathy）的疗效。方法选择神经根型椎病风寒湿型病例80例,服用加味桂枝加葛根汤,7天为1个疗程,两个疗程后评价疗效。结果治疗两个疗程后,临床控制50例（65．0％）,显效20例（25．0％）,有效7例（8．75％）,无效3例（3．75％）,总有效率96．25％。结论加味桂枝加葛根汤治疗神经根型颈椎病具有显著疗效,值得临床推广。     

急性梗阻性大肠癌的外科治疗

由于大肠的解剖及生理特点，一旦发生大肠癌致急性梗阻，急诊手术时处理比较困难。对该病的处理应注意，①抗菌药物在急性梗阻性大肠癌中的应用；②梗阻上段肠内容物的清除；③结肠—期切除或扩大的右半结肠切除术；④分期手术；⑤腹壁结肠造口方法的改进。     

Preservation versus Non-preservation of the Duodenal Passage Following Total Gastrectomy: A Systematic Review

Background

Various reconstruction procedures have been proposed for restoring the alimentary tract continuity after total gastrectomy. However, so far there is no consensus on the ideal post-gastrectomy reconstruction procedure. The necessity of preserving the duodenal passage is one of the major focuses of the debate concerning gastrointestinal reconstruction and is the objective of this study.

Methods

A systematic literature search of PubMed, EMBASE, the Cochrane Library, SCI, and Chinese Biomedical Literature Database (CBM) was carried out before March 2012 to obtain studies of randomized controlled trials (RCT). Analysis was performed using RevMan 5.0 software.

Results

Nine RCTs involving 642 participants met the selection criteria. The results of the meta-analyses showed that operative mortality and morbidity were not significantly different between the two procedures (preservation vs. non-preservation of duodenum). However, operative time was considerably prolonged by preserving the duodenal passage. Patients in the preservation group had an improved nutritional parameters (body weight, levels of serum iron and hemoglobin) in the short term (<6 months) after surgery. Beneficial effect on preventing postgastrectomy symptom (heartburn, dumping syndrome) was not found by maintaining the duodenal passage throughout a 2-year follow-up. Moreover, a qualitative measurement showed that no significant quality of life improvement for patients with a preserved duodenal passage.

Conclusion

This systematic review failed to demonstrate obvious advantage in preserving duodenal passage after total gastrectomy.