中医药对外教育新模式的构建及探索

教育全球化进程的加速,给中医对外教育的发展带来机遇和挑战,构建和探索中医对外教育新模式势在必行,以进一步拓展中医药对外教育和推进中医药走向世界。     

Thrombotic occlusion of the common carotid artery (CCA) in acute ischemic stroke treated with intravenous tissue plasminogen activator (TPA)

Although common carotid artery (CCA) occlusions are rare, acute clinical presentations vary from mild to devastating strokes primarily due to tandem occlusions in the intracranial arteries. Three patients with acute CCA occlusions were treated with systemic tissue plasminogen activator (TPA). Blood pressures were kept at the upper limits allowed with TPA therapy with fluid balance and the 'head-down' position. Recanalization occurred in intracranial vessels only. Marked early neurological improvement occurred in two of three patients. CCA occlusions should not be considered contra-indication to systemic thrombolysis.     

一次手术法对自制两段式种植体种植效果的实验研究

本实验用自制纯钛两段式种植体,以一次手术法植入到狗的下颌前磨牙区,观察5个月,结果表明,观察期间内牙龈无炎症,种植体稳固,X线片显示种植体周围无透射区,镜下可见种植体表面与牙龈之间形成上皮附着样结构,与骨组织之间大多呈骨性愈合。提示了两段式种植体有两种设计和手术方式可供选择。骨内部分在开放的环境中也可达到骨性愈合。     

医疗收费应参照"众均收入"标准制定

医疗费用过高的客观存在,对于大多数患者来说是绝对肯定的事实,对于少部分患者来说只是相对肯定的, 而对于医院来说又是绝对否定的。一个客观存在的事实,在事物的不同方面,看法和观点或截然不同,或存在程度上的差异,这是医疗费用在当今表现出的一个特征,这种现象则是“患者有怨言,医院有苦衷”。那么,怎样才能让患者和医院都较为满意呢?     

健侧颈7移位治疗臂丛神经根性撕脱伤最佳时间选择的实验研究

健侧颈７移位治疗臂丛神经根性撕脱伤手术分第一阶段（健侧颈７移位到移植神经），第二阶段（移植神经另一端移植修复患侧神经），二次手术间隔多少时间才能获得最好的神经再生？选用ＳＤ大鼠及健侧颈７移位的实验模型，按二次手术间隔时间的不同（０、１、２、３、４、８、１６周）分成７组，在第二次术后１２周，进行电生理测定肌张力恢复率及组织切片的形态学观察，结果证实二次手术最佳间隔时间为４～８周．此结果可提供临床参考．     

帕金森氏病和肌营养不良症（Erb型）中线粒体DNA的部分缺失

用ＰＣＲ技术对１２例神经肌肉性疾病患者的１６个标本进行了线粒体ＤＮＡ缺失情况的研究。发现２例帕金森氏病患者的肌肉组织以及其中１例的外周血和另１例肌营养不良（Ｅｒｂ型）患者的肌肉组织中线粒体ＤＮＡ至少有５２６ｂｐ的缺失。还对线粒体ＤＮＡ的部分缺失与疾病发生的关系进行了讨论。     

20例胃平滑肌肿瘤的病理-X线分析

为了提高对胃平滑肌肿瘤的认识,作者回顾性分析了20例经手术、病理证实的胃平滑肌肿瘤的钡餐造影所见。结果表明,胃底与胃体上部是胃平滑肌肿瘤的病变高发区。本病具有典型胃粘膜下肿瘤的X线特征,腔内型者可见胃内边缘光滑的充盈缺损或软组织肿块,粘膜展平或推移;腔外型者可见突出胃外肿块或/和胃与邻近脏器受压;腔内外型者具有上述双重特征,肿瘤较大者多有溃疡形成,甚至囊变,根据肿瘤的大小、形态、生长类型及溃疡表现可作良恶性鉴别。本病的术前诊断主要依靠X线钡餐检查,但无胃肠压迫的腔外型肿瘤,钡餐则难以发现,CT或选择性血管造影可助诊断。     

Therapeutic limitations of argon laser trabeculoplasty.

Sixty-one patients (82 eyes) were studied after argon laser trabeculoplasty (ALT) to determine the lasting efficacy of such treatment. This investigation, now in its fourth year, was prospective, and the information derived was analysed with the aid of a computer. Success was defined as intraocular pressure (IOP) below baseline (22 mmHg). The mean follow-up time was 24.5 months, when the success rate was 74% compared with 75% at three months. Success declined to 45% at 42 months. No significant difference was noted when (a) first lasered eyes of all patients and those fellow eyes treated were analysed separately, (b) when right and left eyes were analysed separately, nor (c) when patients were divided into two treatment groups, (I) 100 burns at 1 W, and (II) 65 burns at 850 mW. Eight of 11 eyes showed progressive postlaser field loss despite below-baseline intraocular pressures. ALT is an alternative to carbonic anhydrase inhibitor therapy, with a success rate of 66.7% at two years. However, repeat ALT was successful in only 25% of patients seven months after treatment.     

Rupture of the gravid uterus

Seventeen cases of uterine rupture in late pregnancy managed over an eight-year period in one hospital in Hong Kong were analysed. Labour was associated with rupture in 16 cases, including ten with one or more previous caesarean section scars. Rupture occurring in an unscarred uterus was associated with high fetal losses and all required hysterectomy. All of these patients had at least one previous vaginal delivery, in contrast to the patients with a scarred uterus. Labour should be closely monitored in multiparous patients with or without a uterine scar, and oxytocics should be used carefully. Patients with previous sections who are scheduled for repeat elective sections should be delivered before 39 weeks.     

醋酸棉酚对大鼠肾皮质形态结构的影响

醋酸棉酚每天30mg/kg(6次/周)给药6～8周后,大鼠肾曲小管线粒体肿胀,嵴模糊,伴有早期溶酶体增多、增大,形态多样,其后转而减少、变小。肾近曲小管微绒毛水肿,部分肾曲小管基底膜水肿。未见肾小球毛细血管内皮细胞、基膜和足细胞的超微结构明显变化。