检测眼顺序对瑞典交互式阈值运算标准24-2程序检测自动视野的影响

目的:使用瑞典交互式阈值运算(SITA)标准24-2程序检测自动视野时,评价检测眼顺序不同是否影响平均偏差(M D)或视野检查的可靠性。方法:证实或怀疑青光眼的连续性患者,先前进行过2次SITA标准24-2程序检查自动视野,右眼首先检查的患者纳入本研究。随后对左眼进行1次首先检查。对每眼的M D和检测可靠性指数(≥20%)在3次连续的检测试验中进行比较。结果:47例(29例女性和18例男性,平均年龄70.6±11.9岁)患者右眼M D为-5.83±5.43dB,左眼为-5.46±4.86dB。每眼3次试验结果的M D和检查可靠性无明显统计学差异。几乎每例患者的固视丢失都会…     

不同的通气方式对大鼠肺和肺内毒素受体CD14表达的影响

目的观察不同的通气方式对大鼠肺及对内毒素受体CD14的影响。方法将成年雄性SD大鼠随机分为4组(每组12只):自主呼吸组(R组),不给予机械通气;机械通气组(M组),潮气量(Vt)=12ml/kg,呼气末正压(PEEP)=8mmHg;保护性机械通气组(P组),Vt=6ml/kg,PEEP=0mmHg;大潮气量机械通气组(N组),Vt=40ml/kg,PEEP=0mmHg。每组中6只大鼠实验开始2h后注射50mg/kg伊万斯蓝(EB)。分别于机械通气前(基础值)及机械通气1、2、3h行动脉血气分析,实验3h结束,放血处死大鼠。测定大鼠肺病理形态学积分、肺组织湿/干重比(W/D)、支气管灌洗液(BALF)炎性细胞数、血管壁通透性。酶联免疫分析法(ELISA)测血浆肿瘤坏死因子α(TNF-α)及巨噬细胞炎性蛋白2(MIP-2)浓度。RT-PCR测肺组织内毒素受体CD14的表达,免疫组化法测BALF单核细胞的CD14表达。结果肺病理形态学积分:R组和P组无变化,M组有轻度升高,N组明显高于M组(分别为6·0±1·6、0·7±0·8,t=8,P=0·000)。肺W/D:与R组比较,P组和M组差异无统计学意义;N组高于R组(分别为5·73±0·39、4·91±0·24,t=4·38,P=0·000)。EB:与R组比较,P组和M组差异无统计学意义;N组明显高于R组(分别为84·50±3·01、32·33±1·75,t=36·63,P=0·000)。BALF中WBC:与R组比较,P组无显著变化;M组高于R组(分别为0·83±0·12、0·59±0·62,t=4·272,P=0·02),N组明显高于R组(分别为5·68±0·45、0·59±0·62,t=26·68,P=0·000)。TNF-α在4组都没有测到。MIP-2:P组(35·4±5·3)与R组(31·5±2·4)比较,差异无统计学意义,M组(44·7±6·9)升高(t=4·382,P=0·04),N组(167·7±11·8)明显升高(t=27·779,P=0·000)。BALF中单核细胞的CD14蛋白表达和肺组织CD14基因表达:R组和P组二者表达基本一致,M组蛋白表达与R组差异无统计学意义,但基因表达升高;N组二者表达都显著升高(P=0·000)。结论常规机械通气导致大鼠肺部发生轻度损伤,并可使肺部CD14基因表达上调,但是肺部CD14蛋白表达无改变;大潮气量机械通气导致大鼠的肺部损伤,使肺部CD14表达明显上调。保护性机械通气可使大鼠肺部避免上述改变的发生。     

降低门诊晚期心力衰竭患者达到移植术或死亡等综合终点事件预测时间的用途

在一项对142例晚期心力衰竭门诊患者平均随访3年的前瞻性队列研究中,29%基线诊断标准低的受试者更有可能经历死亡或移植术等综合终点事件(H R2.54,95%CI1.16～5.55)。经社会人口统计范围及临床特征校正后,诊断标准低的患者更可能到达综合终点(H R2.41,95%CI1.24～4.68)。第1年的随访中,此类患者心力衰竭相关的住院率(1.5±1.8vs0.6±1.4,P=0.04)以及临床就诊率(2.4±1.7vs1.7±1.8,P=0.04)也较高。降低门诊晚期心力衰竭患者达到移植术或死亡等综合终点事件预测时间的用途@Sullivan M.D.$Dr. Psychiatry and Behavioral Sciences, Un…     

湛江地区人群血糖水平的调查分析

目的探讨湛江地区人群血糖平均水平及随龄递增上升的幅度。方法采用美国钡克迈全自动生化分析CX7仪氧化酶终点法对8467例健康体检人群进行空腹血糖检测。结果空腹血糖男、女均值分别为(5·33±0·91)mmol/L和(5·22±0·82)mmol/L,空腹血糖随年龄递增逐渐上升,50~69岁年龄组血糖均值最高,年龄增加10岁血糖上升0·21mmol/L。结论空腹血糖均值随年龄递增呈上升趋势。     

医学科技论文中有效数字的确定

有效数字是在测量中所能得到的有实际意义的数字。一个有效数字构成的数值,只有末位数字是估计数字,其他均为准确数字。有效数字与测量仪器的灵敏度有关,如天平的敏感度为0·1mg,那么称重结果12·34mg中,12·3mg为准确数字,0·04mg为估计数字,2项合在一起组成有效数字。平均值±标准差(x±s)的位数,一般按标准差的1/3来确定,如:(3·61±0·42)kg,标准差的1/3为0·14,标准差波动在百克位,即小数点后第1位上,故应取到小数点后第1位,即3·6±0·4,过多的位数并无意义。但是在一系列数值并列时,小数点后的位数应一致。例如在3·61±0·42、5·86…     

白细胞介素11联合粒细胞集落刺激因子对小鼠异基因骨髓移植后移植物抗宿主病影响的研究

目的探讨重组白细胞介素11(rhIL-11)联合重组粒细胞集落刺激因子(rhG-CSF)用于供者对小鼠异基因骨髓移植后移植物抗宿主病(GVHD)的作用及其机制。方法建立同种异基因骨髓移植急性GVHD模型,以C57BL/6H-2b为供鼠,rhIL-11、rhG-CSF或二者联合应用作为动员剂,BALB/CH-2d受鼠经致死剂量(8·0Gy)照射后随机分为5组,A组为单纯照射组(10只),B组为GVHD对照组(18只),C组为G-CSF移植组(18只),D组为IL-11移植组(18只),E组为联合移植组(18只),在照射后4h移植供鼠骨髓细胞和脾细胞。观察移植后小鼠的生存期和病死率,应用流式细胞仪测定嵌合体形成情况,用四甲基偶氮唑盐(MTT)法检测混合淋巴细胞反应,酶联免疫吸附实验(ELISA)检测白细胞介素4(IL-4)、γ干扰素(IFN-γ)等细胞因子的分泌情况,并进行组间比较。结果E组小鼠生存时间明显长于其他各组(B、C、D),差异有统计学意义(P<0·01),30d存活率B、C、D、E组分别是:0、27·3%(3/11)、36·4%(4/11)、63·6%(7/11)。B组小鼠均出现GVHD病理改变,其程度与发生GVHD的时间密切相关,GVHD发生越早,病理改变越重;E组有3只小鼠在移植后20d内发生GVHD,病理程度改变较其他各组轻。与B、C、D组相比,E组移植后14d脾细胞培养上清中IFN-γ水平较低(92pg/ml±14pg/mlvs172pg/ml±31pg/ml、132pg/ml±23pg/ml、117pg/ml±28pg/ml,均P<0·01),IL-4的水平较高(36pg/ml±7pg/mlvs16pg/ml±4pg/ml、26pg/ml±4pg/ml、24pg/ml±4pg/ml,均P<0·05),D、E组肿瘤坏死因子α(TNF-α)水平相近,但明显低于B、C组(均P<0·01),并且E组对宿主抗原的淋巴细胞增殖均低于B、C、D组(0·22±0·08vs0·87±0·14、0·54±0·21、0·49±0·18,均P<0·01)。结论rhIL-11联合rhG-CSF用于供者能产生协同作用,减轻GVHD,其机制可能与受者体内T细胞向Th2细胞因子极化、炎症介质如TNF-α降低有关。     

Realtime-PCR动态检测巨细胞病毒在肾移植术后的临床应用

目的探讨巨细胞病毒(C M V)D N A检测在肾移植术后C M V病预防中的作用。方法采用R ealtim e-PC R定量检测肾移植受者外周血白细胞中C M V-D N A,术后4月内每周1次。结果95例患者中有55例检出C M V-D N A阳性(57.9%),初次检出C M V-D N A的平均时间为(25.6±16.3)d,C M V-D N A的平均拷贝数为(1396.4±445.2)/105白细胞。在随访过程中,18例患者的C M V-D N A水平超过警戒线—800copy/105白细胞,经调整免疫抑制剂后,均降至警戒线以下,所需平均时间为(16.3±8.5)d。所有患者均未出现C M V病。结论C M V-D V A检测可用于预防肾移植术后C M V病的发生。     

上海医科大学学报 1995年 第22卷 目次

Rg 人胚视网膜细胞培养研究………………………………,……………………………··周国民等(丑) 用Bayey定理多指标筛查Wi1Son、病家系、……………··t…………………………··张咸宁等(5) 脐血抗HPOA-2和丁0k3标记的0D39阳性细胞的流式细胞仪比较分析………蓝丰硕等(9) 大鼠丘脑柬旁核的传人纤维联系………………………………………………………赵晓蓉等(14)/ 大 鼠中央灰质》OO蛋白与甲啡肽的共存…·,—……。…………………·,…·,,……··黄晓平等(19> 5-羟色胺M受体和胆碱能受体阻断剂在红霉素所致小肠动力紊乱和呕吐 中的…     

《中原医刊》1990年总目录

·论著·维生素K,肌注治疗小儿毛细支气管炎200例 ..............................·..……魏中银(1)利福平、异烟阱、链霉素联用治序初治肺 结核1的例临床分析·······一李玉忠等(2),o例男性精神分裂症M、M、P,I分析 ”..........................·.··.……李茜(礴)态性心肌梗寒患者的心理才浅汽及护理 .,..........................·……罗宝珠等(5)尿管内固定的应用及护理···……郭家宝等(6)自拟份能氏扮治疗拼低148例···……刘勤英等(7)清热解毒活血化寮法在治疗再生障碍性贫 血中的应用··············…     

瘢痕疙瘩的临床和流行病学特征

目的了解中国人瘢痕疙瘩患者的临床和流行病学的特点。方法采用SPSS13·0软件对550例瘢痕疙瘩先证者流行病学分析并用Falconer法计算遗传度。结果发病年龄(22·61±12·34)岁,男女之间差异无显著性。有家系患者比无家系患者病情更重且此种差异有显著性(χ2=8·430,P<0·05)。有家系患者中58·20%为多发患者,而无家系患者中该比例为47·40%,两者差异有显著性(χ2=5·167,P<0·05)。患者一、二和三级亲属的遗传度分别是71·55%、40·51%和17·14%,加权平均遗传度为58·89%。结论年轻人好发且无性别差异,遗传因素可能在发病中起重要作用。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.