幽门螺杆菌感染与冠心病发病的关系

目的　探讨幽门螺杆菌(Hp)感染是否为增加冠心病发病率的危险因素。方法　采用病例对照研究,从健康体检者中随机挑选127名作为正常对照组。根据病史、心电图、冠脉造影等确诊为冠心病的111例患者作为冠心病组,以血清抗HpIgG抗体阳性为感染标志,并测定血浆纤维蛋白原及脂质过氧化物浓度。结果　冠心病组Hp感染率(61%)高于正常对照组(39%)(P＜0.001);Hp感染是独立于其它冠心病易患因素的危险因素(比值比2.785,x2=14.82,P＜0.001);冠心病组CagA阳性感染率(98.5%)高于正常对照组(67.4%)(P＜0.05);冠心病组Hp阳性者的血浆纤维蛋白原及LPO浓度高于Hp阴性者(P＜0.05)。结论　Hp感染可能是发生冠心病的危险因素。慢性炎症引起脂质过氧化物、血浆纤维蛋白原增高,促进血栓形成可能是Hp感染诱发冠心病的机制之一。     

Percutaneous balloon angioplasty of coarctation of the aorta in children: 12 -year follow-up results

Objective To evaluate the efficiency of percutaneous balloon angioplasty of coarctation o f the aorta in children and discuss its risk factors that can lead to poor long -term results.Methods From September 1987 to August 1999, 24 patients underwent 27 balloon angioplasty procedures for native or recurrent coarctation of the aorta at our institution . There were 19 patients with discrete (membranous) coarctation, 4 patients wit h long-segment and aortic arch hypoplasia, and 1 patient with postoperative recu rr ence. The balloon diameter was chosen not to exceed the diameter of the aorta p roximal to the stenotic site (11.06±2.80 mm vs 11.78±3.18 mm), with th e chosen diameter two to four times that of the stenotic segment (2.57±0.68 t imes). The patients have been followed up for half to twelve years (mean 6.2 ±2.8 years). Satisfactory result was defined as a reduction in the pressure g radient across the site of coarctation to ≤20 mm Hg. Results The systolic pressure gradient across the coarctation site decreased from 48. 17±14.68 mm Hg to 14.96±13.12 mm Hg (P<0.01) and the diameter of the coarctation site increased from 4.66±2.43 mm to 8.80±3.32 mm (P<0. 01). Immediate satisfactory results were obtained in 19 patients (79%). Of the 5 patients with unsatisfactory results, 4 had aortic arch hypoplasia and 1 had membranous coarctation. Of the 19 patients with satisfactory results, 18 patie nts had membranous coarctation and 1 patient had recurrent postoperative coarcta tion. No aneurysm and other complications had occurred in any patients at the follow-ups. Conclusion Percutaneous balloon angioplasty is an effective treatment alternative to surger y in most patients with recurrent postoperative or native membranous coarctation of the aorta. It should not be recommended for the coarctation of aortic arch hypoplasia.     

147例辐照血临床疗效观察

目的：观察输注γ射线辐照血预防输血相关移植物抗宿主病（TA-GVHD）。方法：观察干细胞移植术后、恶性血液病化疗抑制期,肾移植术后患者输注经γ射线辐照的红细胞悬液、浓缩血小板共147例,比较输血前后的血红蛋白（Hb),红细胞计数（RBC）和血小板计数（PLT）,观察输注后1个月有无皮肤、骨髓,肝肠等系统器官受损表现,结果：辐照血液成分输注后,Hb、RBC、PLT均明显升高,有显著性差异。所有患者无1例出现与输血相关的脏器受损表现。结论：γ射线辐照血可以有效预防TA-GVHD,可以达到与输注未经辐照的等量血液成分同样的疗效。     

基层医院如何开展临床药学工作

临床药学是现代药学的重要组成部分,临床药学工作在各级医院开展极不平衡,特别是基层医院开展较差。本文论述了在基层医院应从人才的选择入手开展临床药学工作。     

直序商陆炮制品毒性成分测定

目的：探讨炮制对直序商陆毒性成分的影响。方法：采用薄层扫描法测定直序商陆不同炮制饮片中商陆毒素的含量。结果：清蒸品、醋煮品及醋品中商陆毒素的含量仅分别为原药材的１６．;７３％、２１．８８％及４５．８５％。结论：清蒸法和醋煮法为直序商陆炮制的最佳工艺。     

CT配套自动洗片机故障的应急检修

近几年,ＣＴ配套已经向“扫描检查、激光照像、自动洗片”一条龙发展,许多医院取消暗室,采用明室装片,实现了照像洗片一体化。由于ＣＴ病人量大、综合效益高,ＣＴ停机一天,都会给医院带来可观的损失。据统计因为自动洗片机、激光相机等外围设备故障影响ＣＴ正常工作的情况占总故障的１５％。我们多年来对ＣＴ配套的自动洗片机快查快修,应急处理,取得良好效果。一、洗片机显影液不加温１．故障现象：ＣＴ片整体显影不足,测量显影液温度接近水温。２．故障分析及应急处理自动洗片机显影液的加热装置,设在显影槽液体循环管前端,并和…