注射后臀肌挛缩症的分型及手术治疗

目的 探讨注射后臀肌挛缩症的分型、分型与病变的关系和手术范围。方法 根据臀肌挛缩症特有的临床表现.分为轻型、中型、重型：根据分型术中分别显露髂胫束、臀大肌、臀中肌、臀小肌至髋关节囊后方。结果 153例均手术治疗，随访141例、随访时间1～10年，平均6．8年，优良率96．5％。结论 将臀肌挛缩症进行分型？更有利于准确的区别病情轻重程度，选择相应的手术范围和评估预后。     

鞘内注射吗啡对切口疼痛大鼠脊髓背角蛋白激酶Cγ免疫反应的影响

目的 研究鞘内注射吗啡对切口疼痛大鼠脊髓背角蛋白激酶Cγ(PKCγ)免疫反应的影响。方法 SD雄性大鼠24只,随机分为4组(每组6只):假手术组(Ⅰ组)、对照组(Ⅱ组)术前30 min鞘内注射人工脑脊液20μl,术后吗啡治疗组(Ⅲ组)、术前吗啡治疗组(Ⅳ组)分别于术后和术前30min鞘内注射吗啡5μg(10 μl)。所有大鼠均按Brennan法制成切口疼痛模型,用免疫组织化学方法观察脊髓背角PKCγ的表达。结果 Ⅱ组术侧脊髓背角PKCγ-IR表达高于非术侧及Ⅰ组(P<0.01)。与Ⅱ组比较,Ⅲ组、Ⅳ组脊髓背角PKCγ-IR表达降低(P<0.05或0.01),而Ⅲ组、Ⅳ组比较差异无显著性。结论 在大鼠切口疼痛模型中,鞘内注射吗啡的镇痛作用可能与抑制脊髓背角的PKCγ-IR免疫反应有关。     

超声引导下注射皮质类固醇治疗狭窄性腱鞘炎

目的 探讨超声引导下注射皮质类固醇治疗狭窄性腱鞘炎的方法及效果。方法 38例狭窄性腱鞘炎患者,按药物注射方法的不同随机分成2组。治疗组(21例)在10-MHz超声引导下向腱鞘内腱周间隙内穿刺注射醋酸强的松龙0.6 ml,对照组(17例)采用闭合穿刺法注射等量药物。注射前及随访时(注射后3周)测定疼痛强度视觉类比评分(Visual analogue score,VAS)。结果 随访时疼痛消失率治疗组为81％、对照组为53％,VAS下降值治疗组为[(6.8±1.9)x±s,下同]对照组为(5.1±3.0)。结论超声引导下将针尖穿刺于腱鞘内腱周间隙的操作简单、准确并可实时观察药物的分布,是治疗狭窄性腱鞘炎的较好方法。     

同息通C2横突注射配合好及施外用治疗颈源性头痛

颈源性头痛（cervicogenic headache，CEH）特征是单侧后头痛伴上颈部疼痛、颈部压痛、僵硬或活动时上颈部疼痛、活动受限。女性多见，发病年龄为20-60岁。过去常被诊断为神经性或神经血管性头痛、枕大神经痛等，使用小针刀、针灸、牵引、按摩等“圳方法往往不能有效控制头痛。本研究在明确诊断的同时，采用不同的治疗措施，比较不同治疗方法之间的疗效。     

硬膜外腔注射生理盐水对剖宫产术患者腰麻效果的影响

目的探讨硬膜外腔注射生理盐水对剖宫产术患者腰麻效果的影响。方法择期行子宫下段剖宫产术患者60例,年龄24～30岁,体重59～73 kg,随机分为2组,每组30例,A组蛛网膜下腔注射规定剂量的0.75%布比卡因后硬膜外腔注射生理盐水5 ml;B组蛛网膜下腔注射0.75%布比卡因。按序贯法进行试验,设定布比卡因的起始剂量为9 mg,剂量梯度为1.5 mg,若上一例有效,则下一例递减一个剂量梯度,若无效则下一例递增一个剂量梯度,蛛网膜下腔阻滞有效的标准为注射布比卡因后20 min内阻滞上平面达T5。采用概率单位法计算ED50。结果A组布比卡因的ED50（5.8 mg）低于B组（8.1 mg）,两组比值为0.72,95%置信区间为0.27～0.98,区间范围不包括1,差异有统计学意义（P〈0.05）。结论硬膜外腔注射生理盐水可增强剖宫产术患者腰麻的效果。     

鞘内注射吗啡对大鼠中脑导水管周围灰质、海马和脊髓μ阿片受体mRNA表达的影响

目的研究鞘内注射吗啡对大鼠中脑导水管周围灰质（PAG）、海马和脊髓μ阿片受体（MOR）mRNA表达的影响,探讨大鼠鞘内注射吗啡免疫功能抑制的机制。方法清洁级成年雄性SD大鼠,鞘内置管成功的16只大鼠随机分为2组（n=8）：生理盐水组（NS组）和吗啡组（M组）。M组鞘内持续输注吗啡10μg/h 7 d（生理盐水稀释）,NS组给予等体积的生理盐水。输注7 d后断头处死大鼠,取出大鼠PAG、海马和脊髓标本,采用巢式RT-PCR测定MOR mRNA的表达。结果与NS组比较,M组PAG和海马MOR mRNA表达下调（P〈0.05或0.01）,脊髓MOR mRNA表达无统计学意义（P〉0.05）。结论大鼠PAG和海马MOR表达下调可能是鞘内注射吗啡导致免疫功能抑制的机制之一。     

Unnecessary injections given to children under five years

Adults accompanying 64 children attending a hospital out-patient clinic were questioned about treatment and injections given for illnesses in the previous month. Half the children had received injections, almost all given by private doctors: we consider most of these injections to have been unnecessary. Three girls were paralysed by aggravation poliomyelitis after unnecessary injections. Adults approved of injections although they did not know what was injected.     

Additive Antinociception between Intrathecal Sildenafil and Morphine in the Rat Formalin Test

The possible characteristics of spinal interaction between sildenafil (phosphodiesterase 5 inhibitor) and morphine on formalin-induced nociception in rats was examined. Then the role of the opioid receptor in the effect of sildenafil was further investigated. Catheters were inserted into the intrathecal space of male Sprague-Dawley rats. For induction of pain, 50 µL of 5% formalin solution was applied to the hind-paw. Isobolographic analysis was used for the evaluation of drug interaction between sildenafil and morphine. Furthermore, naloxone was intrathecally given to verify the involvement of the opioid receptor in the antinociception of sildenafil. Both sildenafil and morphine produced an antinociceptive effect during phase 1 and phase 2 in the formalin test. The isobolographic analysis revealed an additive interaction after intrathecal delivery of the sildenafil-morphine mixture in both phases. Intrathecal naloxone reversed the antinociception of sildenafil in both phases. These results suggest that sildenafil, morphine, and the mixture of the two drugs are effective against acute pain and facilitated pain state at the spinal level. Thus, the spinal combination of sildenafil with morphine may be useful in the management of the same state. Furthermore, the opioid receptor is contributable to the antinocieptive mechanism of sildenafil at the spinal level.     

超早期脑室穿刺引流术治疗重型脑室出血

目的 探讨重型脑室出血的治疗方法。方法 11例重型脑室出血患者，原发性脑室系统出血7例，继发性脑室系统出血4例，脑实质损伤轻微。在超早期行脑室穿刺引流加脑室内注射尿激酶溶栓治疗。结果 经治疗后11例患者预后良好8例，中残1例，死亡2例，无植物生存状态，并发脑积水3例，行脑室腹腔分流术后好转。结论 在超早期行脑室穿刺引流加脑室内注射尿激酶溶栓可以解除或缓解四脑室血肿对脑干的压迫作用，降低四脑室内压力，提高治疗效果。     

72例中药注射剂的不良反应分析

目的:对中药注射剂引发的药品不良反应进行分析.方法:从我院临床报告的163例药品不良反应病例的引发药物、严重程度、损伤类型、主要表现、发生时间进行分析.结果:163例不良反应报告中由中药注射剂引发的72例,占全部报告的44.17%,严重程度4例,涉及5个器官/系统、12个品种药物.结论:对中药注射剂引发的不良反应引起高度重视.