南山区与某社区常住人口6年恶性肿瘤发病调查

目的：了解某社区常住人口恶性肿瘤平均年发病率是否高于周边人群，重点是白血病平均年发病率。方法：采用回顾性调查法及个案调查表收集该社区1998年6月～2004年9月常住人口中的确诊恶性肿瘤病人22例，将该社区恶性肿瘤平均年发病率与南山区在该时段恶性肿瘤平均的发病率进行比较。结果：1998年6月～2004年9月南山区常住人口恶性肿瘤平均年发病66．1／10万，某社区常住人口恶性肿瘤平均年发病率29．9／10万，两地差异有统计学意义（F=0．0001，P〈0．05）；南山区常住人口白血病平均年发病率2．79／10万，某社区常住人口白血病平均年发病率4．07／10万，两者无统计学意义差异（F=0．467，P〉0．05）。结论：该社区常住人口恶性肿瘤及白血病平均年发病水平低于南山区全区水平。     

不同免疫剂治疗扩张型心肌病患儿心功能和临床预后评价

目的观察比较泼尼松联用硫唑嘌呤和大剂量静脉用免疫球蛋白(IVIG)对扩张型心肌病(DCM)患儿心功能及预后的影响。方法将DCM患儿20例分为治疗Ⅰ和Ⅱ组,分别在传统抗心衰治疗基础上加泼尼松联用硫唑嘌呤和大剂量IVIG,治疗1个疗程后评价心功能,检测治疗前后左房横径(LA)、左室舒张期内径(LV)、左室射血分数(LVEF)、心脏指数(CI),并计算其治疗前后变化。所有病例随访1年,计算1年存活率。结果治疗Ⅱ组心功能明显优于治疗Ⅰ组(P均<0.05);两组LA、LV、LVEF和CI治疗后较治疗前均有明显改善(P均<0.05);治疗Ⅰ组各参数变化明显低于治疗Ⅱ组(P均<0.05),其1年存活率明显低于治疗组Ⅱ(P<0.05)。结论泼尼松联用硫唑嘌呤和大剂量IVIG均能改善DCM患儿心功能,但IVIG疗效优于泼尼松联用硫唑嘌呤。     

BIOCHEMICAL CORRECTION IN THE SYNDROME OF HYPERTENSION AND HYPERKALAEMIA BY SEVERE DIETARY SALT RESTRICTION SUGGESTS RENIN-ALDOSTERONE SUPPRESSION CRITICAL IN PATHOPHYSIOLOGY

1. Plasma potassium and chloride concentrations were raised and plasma renin activity, aldosterone, bicarbonate and arterial pH were reduced in two brothers with the syndrome of hypertension and hyperkalaemia with normal glomerular filtration rate (Gordon's syndrome), on unrestricted or moderately restricted sodium diets. 2. These abnormalities were corrected in both patients within 10 days of severe sodium restriction. 3. Pressor sensitivity to cold and angiotensin II decreased on low sodium diet, associated with a fall in blood pressure. 4. Increasing distal tubular sodium delivery by infusion of normal saline increased fractional excretion of potassium when aldosterone had been stimulated by severely restricted sodium diet, but not when aldosterone levels were low on unrestricted sodium diet. 5. These findings are consistent with excessive sodium reabsorption as the primary renal lesion in Gordon's syndrome, leading to volume expansion and suppression of renin and aldosterone. Severe dietary sodium restriction leading to volume contraction, by stimulating renin and aldosterone and promoting kaliuresis, corrects the abnormalities.     

Peak Endocardial Acceleration-Based Clinical Testing of the "BEST" DDDR Pacemaker

The peak endocardial acceleration (PEA, unit g) shows a near correlation with myocardial contractility during the isometric systolic contraction of the heart (dP/dtmax), with sympathetic activity and, thus, with physiological heart rate modulation. The (Biomechanical Endocardial Sorin Transducer (BEST) sensor is incorporated in the tip of a pacing lead and measures PEA directly near the myocardium. In an international study, the lead was implanted with the dual chamber pacemaker Living-1 (Sorin) in 105 patients. The behavior of the PEA signal was tested under conditions of physical and mental stress and during daily life activities by 24-hour recordings of PEA (PEA Holter) at 1 to 2 months and approximately 1 year after implantation. Implantation of the BEST lead was performed without complications in all patients. The sensor functioned properly in the short- and long-term in 98% of patients. Although PEA values differed from patient to patient, the values closely reflected the variations in sympathetic activity due to physical and mental stress in each patient. During exercise and during daily life activities a close correlation between PEA and heart rate was observed among patients with normal sinus rhythm. Peak endocardial acceleration allows a nearly physiological control of the pacing rate.     

Influence of Preparation Factors on the Sustained Release of Nifedipine from Eudragit RL/RS Microspheres

用乳剂—溶剂挥发法制备硝苯地平的丙烯酸树脂缓释微球。微球中药物的释放速度随丙烯酸树脂ＥｕｄｒａｇｉｔＲＬ／ＲＳ比率的增加以及制备时搅拌速率的增加而增大，随内相聚合物浓度的增加及微球粒径的增加而减小，释药５０％所需时间与微球粒径呈良好线性。微球的释药速率也随药物含量的增加（从４．２％到１６．７％）而增大，并快于药物结晶的溶解速率，但药物含量达２６．６％时，微球释药速率明显下降并低于药物结晶的溶解速率。用差热分析和Ｘ射线衍射分析证明，药物含量为４．２，９．４和１６．７％的微球中药物完全是以非晶态分散的，而含药２６．６％的微球中有药物结晶存在。不同微球释药低于７０％时，释放方式均符合Ｈｉｇｕｃｈｉ时间平方根方程。     

1870株致病菌感染概况及敏感性情况

目的了解临床标本中主要致病菌分布及敏感性分析，指导抗生素的选择及合理治疗方法对我院1994～1996年临床分离的1870株细菌的分布及敏感性、耐药性进行分析，1996年与1994年的结果进行比较，并将1995年的结果与北京地区5家教学医院同年的结果进行比较。结果分离菌株主要分布于呼吸道、消化道、泌尿道、血液及骨髓。G＋菌占10.5％，G-菌占89.5％，占明显优势。沙门氏菌对头孢唑啉和哌拉西林的耐药性明显降低（P＜0.01），大肠埃希氏菌对氨苄西林和氟嗪酸的耐药性明显增高（P＜0.01），其余菌株无明显差异。抗生素敏感性覆盖率最高的是复达欣，其次为丁胺卡那，最低者氨苄西林。大肠埃希氏菌、假单胞菌对哌拉西林的耐药率，克雷伯杆菌属对西力欣的耐药率，肠肝菌属对哌拉西林的耐药率均高于北京地区。结论本组资料显示不断监测和分析菌丛的变化及对不同抗生素耐药性出现的频率和耐药谱至关重要。     

老年男性心肌缺血患者心率变异分析（附67例报告）

采用正常搏动ＲＲ间期的标准差（ＳＤ）及心率变异指数（ＨＲＶ ｉｎｄｅｘ）作为指标，分析６７例老年男性心肌缺血患者的心率变异，并与正常老年男性组及正常青壮年男性组进行了对比，发现前组的ＲＲ间期ＳＤ、ＨＲＶｉｎｄｅｘ均明显低于后两组，其结果有显著性差异（Ｐ均〈０．０１）。提示心肌缺血可破坏交感与迷走神经的均衡性，造成心率变异降低。     

胎儿声振动刺激反应的研究

目的：了解不同孕龄胎儿对声振动刺激的反应。方法：对４３５例次正常中、晚期妊娠妇女进行声振胎心试验（ＶＡＳ－Ｔ）、声振胎动试验（ＳＰＦＭ），并对声振动刺激前、后胎心率变化规律进行前瞻性研究。结果：（１）从２４周开始，胎儿对声振刺激有反应，但大部分未能达到ＶＡＳ－Ｔ诊断标准，而胎动反应良好。（２）妊娠２８周开始，声振刺激后，９０％以上的胎儿出现显著的胎动、胎心率加速反应，足月胎儿反应率在９８％以上。（３）ＳＰＦＭ阳性率的显著提高早于ＶＡＳ－Ｔ。提示：２８周后胎儿神经系统发育已趋完善。胎儿运动神经的发育成熟早于植物神经。