烧伤病人血气变化

报导了50例烧伤病人的血气分析。男43例;女7例。年龄15—60岁。烧伤面积6～93％。按面积分成三组:第一组烧伤面积小于30％;第二组30—50％;第三组大于50％。检查期限在伤后1—15天,3天送检一次。结果表明:（1） 烧伤面积小于30％者血气无明显变化,大于30％者血气有改变,并随烧     

外用碘伏治疗烧伤创面的疗效观察

Effectsofexternaliodopherforburns碘伏是一种以表面活性剂作为助溶剂和载体的不定型结合物。由于碘伏中的碘在表面活性中缓慢释放出,保持了碘的广谱杀菌性质,作用持久,刺激性小,黄染消失决［1］。我科1995年1月～1996年12月,应用碘伏—PON—1治疗烧伤创面40例,取得较好疗效。1资料与方法1．1一般资料本组患者40例,男25例,女15例;年龄最大56岁,最小2岁;烧伤面积大于50％者5例,30％～50％者15例,小于30％者20例;Ⅲ度烧伤＞5％面积者5例;一次用药最大面积为60％者3例,其中20％Ⅲ度伤1例;用药面积小于50％者37例;其中5例…     

严重烧伤63例的临床观察

我院自1958年9月起至1963年6月的4年9个月中,共收治烧伤病员216名;其中严重烧伤63例,占烧伤总病例的29.1%。63例中小儿占40例,成人占23例。小儿中烧伤面积在10—19%者23例,20—29%者13例,30%以上者4例(一例50%以上),成人中烧伤面积在30—49者17例,50—69%者3例,70%以上者2例,另1例烧伤面积25%,Ⅲ度面积占15%,而且是特殊部位的     

急性脑血管病的血气改变(附98例病例分析)

本文报告66例急性脑血管病98例次的血气检查结果。急性脑血管病首次血气检查出现低PaCO_2者36例(54.5％)、低PaO_2者37例(56％)、碱血症20例(30.3％)。脑出血组低PaO_2发生率明显高于脑梗塞组(P<0.05)。轻度低PaO_2最常见(27/37)。     

三医大烧伤营养公式临床疗效的观察

32例烧伤面积>50％TBSA的成年病员分为营养组和对照组,前者按三医大烧伤营养公式“千焦耳(kJ)/d=4184(1000cal)×体表面积(m~2)+105(25cal)×烧伤面积(％),糖:脂肪:蛋白质=50～60:20～30:15～20,千焦耳:氮(g)=628～711(150～170cal):1”实施营养计划,后者为住院常规饮食,观察28d,结果显示营养组病员的营养状况明显优于对照组。     

烧伤患者血清前白蛋白的检测及其意义（附58例报告）

目的探索烧伤患者血清前白蛋白(PA)的变化规律及其临床意义。方法烧伤病人58例,其中烧伤总面积小于15%组38例,面积大于50%组20例,正常健康人30例为对照组,伤后1、7 d及14 d采取静脉血标本。应用透射比浊法测定血清PA的浓度。结果大面积烧伤组的PA水平在检测的不同时期明显低于小面积烧伤组,每组在不同时间检测的PA水平差异有统计学意义(P<0.01)。结论PA水平随着烧伤面积的增加而降低,PA作为烧伤后的炎症程度的动态变化指标,具有重要的临床意义。     

严重烧伤肾损害的实验研究

严重烧伤并发急性肾功衰(AFR)采用传统实验方法不能早期发现。作者通过测定部分钠排泄(FeNA),α—糖戒酶,亮氨酸氨基钛酶(ZAP)和血,尿中的β2—微球蛋白对20例严重烧伤病人进行了研究。 20个病人分成式组。第一组15人,烧伤面积大于35％35—95％>1既往无肾脏病史。其     

成批儿童烧伤的抢救处理

目的总结成批儿童烧伤救治的经验。方法对两批共31例儿童严重烧伤进行回顾性分析。结果 平均烧伤面积(60±28)％;平均Ⅲ度烧伤面积(42±13)％。其中烧伤总面积>90％者7例;Ⅲ度烧伤面积50％以上者7例,合并吸入性损伤8例,除1例总面积84％合并严重吸入性损伤,行气管切开的患儿于伤后15 d意外死于呼吸道大出血窒息外,余30例全部治愈。结论成批儿童烧伤的抢救应迅速成立抢救小组;采取同类伤情同步治疗;适当放宽气管切开指征以及休克期大面积切、削痂植皮。     

烧伤后难治创面相关因素分析及治疗策略

本组共88例，男62例，女26例，年龄15岁以下5例，15～40岁54例，40岁以上29例，均于烧伤1个月后到我队住院治疗。其中烧伤面积小于1％的有15例，1％～5％的有25例，5％～10％的有30例，大于10％的有18例。浅Ⅱ°度烧伤3例，深Ⅱ°度烧伤35例，     

烧伤患者血清前自蛋白的检测及其意义(附58例报告)

目的 探索烧伤患者血清前白蛋白(PA)的变化规律及其临床意义.方法 烧伤病人58例,其中烧伤总面积小于15%组38例,面积大于50%组20例,正常健康人30例为对照组,伤后1、7 d及14 d采取静脉血标本.应用透射比浊法测定血清PA的浓度.结果 大面积烧伤组的PA水平在检测的不同时期明显低于小面积烧伤组,每组在不同时间检测的PA水平差异有统计学意义(P<0.01).结论 PA水平随着烧伤面积的增加而降低,PA作为烧伤后的炎症程度的动态变化指标,具有重要的临床意义.     

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.     

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.     

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.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.