无创脑水肿动态监测在自发性脑出血患者中的应用

目的:观察甘露醇和开塞露塞肛联合治疗自发性脑出血(SICH)脑水肿的动态演变.方法:选58例自发性脑出血患者随机分为实验组29例和对照组29例,前者采用甘露醇和开塞露塞肛联合治疗,后者仅采用甘露醇治疗,余一般常规治疗处理均相同.采用BORN-BE脑水肿无创动态监护仪在发病后第1、3、5、7天分别测定2组患者患侧大脑半球的综合扰动系数,并进行对比、分析.与对照组患侧比较,实验组患侧综合扰动系数在发病第1天略高,但在第3、5、7天明显降低(P<0.05).结果:甘露醇和开塞露塞肛联合治疗明显优于单纯甘露醇治疗,可显著减轻脑出血后脑水肿形成.     

利妥昔单抗联合氟达拉滨、环磷酰胺治疗慢性淋巴细胞白血病17例

目的 评价利妥昔单抗联合氟达拉滨、环磷酰胺（FCR方案）治疗慢性淋巴细胞白血病(CLL)患者的疗效和安全性。方法选取年龄＜70岁且CD20阳性的初治或既往仅用苯丁酸氮芥治疗的CLL患者,应用FCR方案治疗,利妥昔单抗375 mg/m2,第1天,静脉滴注;氟达拉滨25 mg/m2,第2天至第4天,静脉滴注;环磷酰胺250 mg/m2,第2天至第4天,静脉滴注。28d为1个疗程,治疗4～6个疗程,治疗结束后评价疗效。结果共入组17例患者,总有效率为94.12％(16/17),完全缓解率为35.29％(6/17)。Ⅲ-Ⅳ级不良反应主要为中性粒细胞减少,白细胞减少。结论FCR方案治疗CLL疗效确切,患者耐受良好,可以作为初治患者的一线治疗方案。     

强脉冲光联合药物治疗面部皮炎的临床疗效评价

目的:探讨强脉冲光联合药物治疗面部皮炎的效果,阐明强脉冲光联合药物治疗面部皮炎的可行性及安全性.方法:将门诊确诊的90例面部皮炎患者随机分为脉冲光联合药物组和单纯药物组,每组45例.脉冲光联合药物组采用强脉冲光联合雷公藤多甙和羟氯喹治疗,单纯药物组采用雷公藤多甙和羟氯喹治疗;6个月后随访,以面部潮红范围、丘疹数目、干燥脱屑改变情况及患者刺痒、刺痛、灼热等自觉症状改善情况作为临床观察指标判定疗效.结果:脉冲光联合药物组和单纯药物组有效率分别为93.3%和77.8%,接受治疗的患者自我评价的满意度分别为91.1%和75.6%,2组患者均未见不良反应发生,脉冲光联合药物组患者有效率及患者自我评价的满意度高于单纯药物组(P<0.05).脉冲光联合药物组随访31例,复发2例,复发率为4.5%(2/31); 单纯药物组随访29例,复发7例,复发率24.1%(7/29),脉冲光联合药物组患者复发率明显低于单纯药物组(P<0.05).结论:强脉冲光联合雷公藤多甙和羟氯喹治疗面部皮炎安全有效且复发率较低.     

负压吸引治疗急性根尖周炎的临床疗效分析

目的:观察急性根尖周炎常规开髓引流后进行负压引流以减轻临床症状的疗效.方法:将本院收治的急性根尖周炎的患者142例,随机分为实验组(72颗患牙,负压吸引引流)和对照组(70颗患牙,常规开髓引流).比较两组患者临床症状的缓解情况以及根管内白细胞介素1β(IL-1β)、前列腺素E2(PGE2)及C反应蛋白(CRP)水平的变化.结果:两组数字化疼痛评判法(VAS)差值比较差异具有统计学意义(P<0.05).实验组IL-1β、PGE2和CRP变化的差值大于对照组(P<0.05),实验组的治疗有效率高于对照组(P<0.05).结论:应用负压引流等一系列处置能有效缓解急性根尖周炎的症状,愈后良好.     

应用龈色树脂修复前牙颈部缺损的临床评价

目的:评价采用龈色树脂修复前牙颈部缺损的临床效果.方法:选择北京大学口腔医院第一门诊部 2007年6月至2008年10月前牙唇侧颈部缺损患者80例,先单纯使用牙色树脂模拟充填,然后用龈色树脂配合牙色树脂按照前牙美学标准模拟充填.采用视觉模拟评分法,由患者从整体印象、龈位置和牙齿轮廓3个方面对两种充填方法的美学效果满意度分别进行评价.用龈色树脂配合牙色树脂充填缺损,在术后1周、6个月、1年、2年,根据改良的美国公共卫生署标准对充填体进行纵向临床评价.结果:(1)患者对两种充填方法的美学效果满意度评价结果:配合使用牙龈色树脂修复法和单纯牙色树脂修复法的患者满意度在整体印象、龈位置和牙齿轮廓方面的差异均有统计学意义(P<0.1),配合使用龈色树脂充填法可获得更理想的美学效果.(2)纵向临床评价结果:术后1周、6个月、1年、2年,龈色树脂充填体在色彩匹配性、修复体表面形态、边缘密合性、边缘着色、继发龋及术后敏感性等方面差异均无统计学意义(P>0.1).结论:龈色树脂用于前牙颈部缺损的美学修复不但能满足牙体缺损的治疗要求,还能达到良好的美学效果,该技术值得临床推广.     

不同类型桩核修复牙体重度缺损的回顾与进展

桩核是用于根管治疗后修复牙齿残冠、残根的常见修复体,桩是粘固在患牙根管内用于获得桩核固位的部分,核是连接固定于桩之上,与牙冠剩余的牙体硬组织一起形成全冠预备体的部分.桩核可以分体或一体制作,用以初步重建缺损牙齿的临床冠外形,增加牙齿抗力,创造条件以利于进一步制作最终恢复牙齿功能、形态、颜色的外部全冠.多年以来,桩核的应用材料与制作加工技术不断改进,对牙齿残冠、残根的修复有很好的效果.     

沙利度胺联合MP方案治疗多发性骨髓瘤的疗效评价

目的 比较沙利度胺联合美法仑+泼尼松方案(MPT)与美法仑+泼尼松方案(MP)治疗多发性骨髓瘤(MM)的疗效与患者不良反应.方法 采用回顾性分析,MPT组26例,美法仑每天9 mg/m2口服,第1天至第4天,泼尼松60 mg/m2,第1天至第4天,或者美法仑每天4 mg/m2口服,第1天至第7天;泼尼松每天40 mg/m2口服,第1天至第7天,28 d为1个疗程,沙利度胺白化疗开始持续给药,100～200 mg/d,每4周为1个疗程,MP组21例,美法仑及泼尼松用法用量同MPT组,6个疗程后评价总疗效结果 MPT组的总有效率(ORR)为65.4%,明显高于MP组的42.9%(P＞0.05);MPT组中位反应时间为2个月,MP组为3个月;MPT组患者治疗后血红蛋白及清货白升高明显高于MP组(P＜0.05);MPT组不良反应的发生率高于MP组(P＜0.05),但两组3度以上的不良反应差异无统计学意义;MPT组中位无进展生存时间(PFS)为11个月,2年PFS为66.18%.结论 与MP方案相比,MPT方案可以提高MM患者的有效率,改善生活质量,延长生存时间,耐受性良好.     

无创通气联合支气管肺泡灌洗对COPD合并肺部感染和Ⅱ型呼吸衰竭患者的疗效

目的:探讨无创通气联合支气管肺泡灌洗对COPD合并肺部感染和Ⅱ型呼吸衰竭患者的疗效.方法:50例不需立即有创机械通气治疗的COPD合并肺部感染和Ⅱ型呼吸衰竭患者,随机分为对照组26例和灌洗组24例.对照组行常规治疗及无创正压通气(NIPPV);灌洗组在对照组治疗基础上行支气管肺泡灌洗(BAL).观察两组在治疗前后各项指标变化及疗效.结果:血气分析同组内治疗前后比较差异有统计学意义(P<0.01),两组间比较差异有显著性(P<0.01);第4天灌洗组WBC、中性粒细胞率、CRP水平较对照组明显降低(P<0.01);灌洗组细菌培养阳性率及观察第7天X线示胸片炎性病变吸收率均明显高于对照组(P<0.01);灌洗组有创通气上机率、住院时间明显低于对照组(P<0.05),治愈率明显高于对照组(P<0.05),两组病死率差异无统计学意义(P＞0.05),两组均无严重并发症.结论:对不需立即行持续有创通气治疗的COPD合并肺部感染和Ⅱ型呼吸衰竭患者,无创通气联合BAL治疗较安全,临床疗效确切,值得临床推广应用.     

五倍子液联合金因肽治疗放射性口腔炎的疗效观察

目的 探讨五倍子液联合金因肽治疗头颈部肿瘤患者放射性口腔炎的效果.方法 随机将90例头颈部放射治疗的肿瘤患者分为2组,各45例.观察组使用五倍子液于3餐饭前30min、3餐饭后和睡前7个时间点口腔含漱,然后将金因肽喷在口腔黏膜处;对照组采用生理盐水混合剂于3餐饭前30min、3餐饭后、睡前7个时间点交替含漱.2组患者治疗过程中不采用其他药物性漱口液,坚持使用漱口液至放疗结束.2组疼痛严重患者均予静脉补充能量、抗炎治疗.观察比较2组患者放疗第3周末、第7周末口腔黏膜炎损伤及疼痛程度.结果 2组放疗后第3周末、第7周末,2组口腔黏膜炎损伤及疼痛程度比较,差异均有统计学意义(P＜0.01),观察组口腔黏膜炎损伤及疼痛程度明显轻于对照组.结论 使用五倍子液联合金因肽治疗可以减轻放射性口腔黏膜炎的损伤及疼痛程度.     

臭氧联合镇痛液治疗膝关节滑膜炎疗效观察

目的 观察臭氧联合镇痛液关节腔内注射治疗膝关节滑膜炎临床疗效.方法 选取360例膝关节滑膜炎患者,随机分为治疗组和对照组,180例/组.治疗组给予臭氧联合镇痛液关节腔注射治疗;对照组仅给予关节腔内注射镇痛液.对比观察两组患者治疗后的效果.结果 治疗组优130例,良45例、差5例,对照组优90例,良60例,差30例,治疗组优良率(97.2%)显著高于对照组(83.3%),差异具有统计学意义(P<0.05).结论 臭氧联合镇痛液关节腔内注射治疗膝关节临床疗效优于单纯镇痛液关节腔内注射.     

Regional differences in suicide in Hungary in the light of registered cases of depression

Author made a revision on the theory published by Rihmer and alii in the year 1989. According to this theory the marked regional differences of suicide in Hungary are caused by the different discovery of the "endogen depression" (rate of diagnosed depression). So the lower is the diagnosis of depression the higher is the suicide rate in a given territory. They have seen a negative correlation between the number of working physicians and the suicide rates. Author made a reexamination on a correct database between 1985-1994. He has also made a study using the DSM-III-R diagnostic criteria in four counties of Hungary. His results deny the theory above mentioned. The rank-correlation of the number of GP and the suicide rates in Hungary in years 1985-1994 did not show correlation. So the underdiagnosis of the depressive disorders and the different number of GP are not the cause of the regional differences of suicide in Hungary.     

Role of clozapine in the occurrence of chromosomal abnormalities in human bone-marrow cells in vivo and in cultured lymphocytes in vitro

Bone-marrow chromosomes were examined from 38 mentally and physically retarded and two psychiatric patients who were being treated with a variety of neuropharmacologic drugs. Twenty of these patients used clozapine (Leponex). The clastogenic effects of clozapine in vitro were studied in the lymphocyte cultures of three patients--one free of hematologic disease and two who 6 months earlier had had agranulocytosis attributed to the use of clozapine. The mean frequency of cytogenetic abnormalities in the bone-marrow cells of patients who used clozapine was significantly increased (P less than 0.05). The two patients who had had agranulocytosis had a greater frequency of cytogenetic abnormalities in their cultured lymphocytes in vivo and in vitro than the patient free of hematologic disease. A clone with a 13/14 chromosome translocation was detected in one of the patients. As all patients received a number of drugs during the in vivo and in vitro studies no definite conclusions could be drawn regarding the role played by clozapine in the occurrence of chromosomal abnormalities.     

Efficacy of lomefloxacin in treatment of nonspecific inflammatory diseases and in prophylaxis of postoperative complications in urology

Clinical and bacteriological efficacies of lomefloxacin and ofloxacin were comparatively estimated in the treatment of 104 urologic patients with nonspecific inflammatory diseases and in 36 urologic patients for prophylaxis of inflammatory complications after surgical interventions. The majority of the urinary tract pathogens i.e. Enterobacteriaceae spp. and gramnegative nonfermenting bacteria were highly susceptible to both the fluoroquinolones. The clinical and bacteriological efficacies of lomefloxacin amounted to 94.4 and 80.7 per cent and those of ofloxacin to 92 and 79.2 per cent respectively. The prophylactic use of lomefloxacin and ofloxacin was efficient in 94.7 and 94.1 per cent of the cases respectively. The antibacterial prophylaxis in urologic patients should be applied not only at the period of surgical interventions but also during the early postoperative period.     

Inhibitory effect of suramin in rat models of angiogenesis in vitro and in vivo

The aim of the present study was to test the ability of the chemotherapeutic agent suramin to inhibit angiogenesis in experimental models in vitro and in vivo. In the culture of rat aortic rings on fibronectin, suramin dose-dependently inhibited vascular cell growth, achieving the maximal effect (mean - 88% versus controls, P < 0.05) at 400 microg/ml. Image analysis showed that suramin could inhibit microvessel sprouting in fibrin from rat aortic rings as evaluated by the ratio between the cellular area and the mean gray value of the sample (sprouting index); suramin at 50 microg/ml significantly reduced the sprouting index from the control value of 0.35+/-0.04 to 0.14+/-0.02 mm2/gray level (P < 0.05). Likewise, the area occupied by cells was 19.2+/-1.8 mm2 as compared with 41.8+/-4.2 mm2 in controls (P < 0.05). In the rat model of neovascularization induced in the cornea by chemical injury, suramin at 1.6 mg/eye per day reduced the length of blood vessels (0.7+/-0.1 mm as compared with 1.5+/-0.1 mm in controls, P < 0.05). In the same model the ratio between the area of blood vessels and the total area of the cornea (area fraction score) was decreased by suramin from 0.19+/-0.02 in controls to 0.03+/-0.003 (P < 0.05). Suramin given i.p. at 30 mg/ kg per day markedly inhibited the neovascularization induced in the rat mesentery by compound 48/80 or conditioned medium from cells secreting the angiogenic protein fibroblast growth factor-3 (FGF-3). The area fraction score in control rats treated with compound 48/80 was 0.31+/-0.03, and this was reduced to 0.07+/-0.01 by suramin (P < 0.05). After i.p. administration of FGF-3 the area fraction score was reduced by suramin from 0.29+/-0.03 to 0.05+/-0.01 (P < 0.05). These results provide evidence that suramin exerts inhibitory effects on angiogenesis in both in vitro and in vivo models.     

Difference in changes of plasma volume in two types of Goldblatt hypertension in rabbits

High plasma renin concentration (PRC) and hematocrit (Ht) were observed in hypertensive rabbits with one renal artery clipped and an intact opposite kidney (Group A), while rather low PRC and Ht in hypertensive ones with one renal artery clipped and the opposite kidney removed (Group B). Plasma volume (PV), blood volume (BV), and packed cell volume (PCV) were estimated in these two types of hypertensive rabbits, and also in sham-operated rabbits (Group C). In Group A, 4 weeks after clipping of a renal artery, PV was decreased and significant inverse correlations were observed between PV and the elevation of blood pressure and between PV and PRC. A significant correlation between PRC and the elevation of blood pressure was also found 4 and 12 weeks after the clipping. PCV was increased until 12 weeks after clipping. In Group B, PV was increased 1 and 4 weeks after clipping, then returned to the initial level. Ht was decreased 1 and 12 weeks, and PCV was decreased 12 weeks after clipping. These results would indicate that a high Ht seen in Group A was partly due to the decreased PV and partly due to the increased PCV, while, in Group B, a low Ht in early stage might be mainly due to the increased PV, but in the late stage, a decreased PCV appeared to play a role to lower Ht. PRC seems to be affected differently by PV in these two types of hypertension.     

PLC在高炉汽动式鼓风机监控系统的应用

鞍钢高炉15号鼓风机是VASi-9018型轴流式汽轮压缩机，通过技术改造，采用先进的电子控制技术，建成了全新的具有现代化水平的汽轮压缩机控制系统。     

Role of signal peptides in targeting of proteins in cyanobacteria

Proteins of cyanobacteria may be transported across one of two membrane systems: the typical eubacterial cell envelope (consisting of an inner membrane, periplasmic space, and an outer membrane) and the photosynthetic thylakoids. To investigate the role of signal peptides in targeting in cyanobacteria, Synechococcus sp. strain PCC 7942 was transformed with vectors carrying the chloramphenicol acetyltransferase reporter gene fused to coding sequences for one of four different signal peptides. These included signal peptides of two proteins of periplasmic space origin (one from Escherichia coli and the other from Synechococcus sp. strain PCC 7942) and two other signal peptides of proteins located in the thylakoid lumen (one from a cyanobacterium and the other from a higher plant). The location of the gene fusion products expressed in Synechococcus sp. strain PCC 7942 was determined by a chloramphenicol acetyltransferase enzyme-linked immunosorbent assay of subcellular fractions. The distribution pattern for gene fusions with periplasmic signal peptides was different from that of gene fusions with thylakoid lumen signal peptides. Primary sequence analysis revealed conserved features in the thylakoid lumen signal peptides that were absent from the periplasmic signal peptides. These results suggest the importance of the signal peptide in protein targeting in cyanobacteria and point to the presence of signal peptide features conserved between chloroplasts and cyanobacteria for targeting of proteins to the thylakoid lumen.