应用中草药环轮宁于小儿麻醉期间降压

中国科学院上海药物研究所自防己科植物地不容(Stephania epigeae Lu)中提取得到生物碱环轮藤宁(Cycleanine),经季铵化,成为二甲基溴化盐,称环轮宁,有明显降压作用(1),上海第二医学院附属新华医院麻醉科自1977年11月起应用环轮宁于小儿全麻期间控制性降压,效果满意,至1980年6月底已应用64例,报导如下

硅橡胶薄膜在小儿外科的应用

医学领域内使用的合成高聚物,称为医用高聚物.目前,合成高分子材料用于机体内公认的必需具备的条件有:(1)在化学方面呈惰性,不因机体组织及组织液的影响而变性;(2)在机体内不发生炎症和异物反应,不引起过敏反应;(3)长期放置机体内不丧失强度、弹性和机械度,无膨胀性;(4)与血液接触时不形成血栓;(5)无致癌性;(6)可以耐受常用的消毒方式如煮沸、高压消毒、药液浸泡等方法灭菌;(7)易加工和造型.除此之外,根据使用于不同的器官和部位,还要考虑一些特殊的条件.

大量环已亚硝脲与自身骨髓移植治疗小儿脑部恶性肿瘤

本文报道应用大剂量环已亚硝脲(CCNU)辅以自身骨髓移植治疗小儿脑肿瘤22例.分三组采用不同方案治疗,均能渡过药物所致骨髓抑制期,可以延长小儿脑部恶性肿瘤手术后的生存期,并有可能获得痊愈.

B超监视下水压和水气压灌肠治疗小儿急性肠套迭110例

国内外普遍采用X光监视下空气或钡灌肠复位治疗小儿肠套迭,但X线对患儿有一定影响,特别是对反复发病和复位时间较长的患儿接受X线的剂量更多些.本院1986年1～6月在B超监视下水压或水气压灌肠治疗小儿肠套迭110例,不仅避免了X线的照射,而且复位中影像清晰,复位标准明确,复位效果满意.

胎儿新生儿股骨近端血运分布的研究

股骨近端的血运供应对髋关节的发育及某些疾病的发生十分重要,Trueta(1)Ogden(2)Chung(3)等曾报道生长时期殷骨近端的血运分布,但对不同时期的胎儿和新生儿血运变化的特点至今尚未见劲.本文通过灌注造影,切片观察探讨了胎儿新生儿股骨近端血运变化的特点,为研究一些髋关节疾病的病理提供了解剖学基础,也是探讨胎儿发育的重要资料.

带蒂臀大肌瓣皮下括约肌成形术治疗小儿闭肛术后肛门失禁

本文报告用带蒂臀大肌瓣括约肌成形术治疗小儿闭肛术后肛门完全失禁6例.年龄5～11岁.5例术后随诊2个月～5年,失禁均已治愈;另1例术后一周明显好转,正在训练括约功能.6例术后均作了肛直肠测压对照检查,都恢复括约肌收缩反射和松弛反射,肛直肠压力差比术前升高1～4倍,高压区长度增加50%至3倍,患儿自主收缩臀大肌时,肛管括约部产生相当高的收缩压,达115～212mmH_2O,而手术前则为"零".作者认为手术年龄以5岁以上为合适,双侧带蒂臀大肌瓣左右交义成形肛门括约肌效果快而确实.保证肌瓣血循环和防止感染是手术成败的关键.

临床常用疼痛程度评估方法的评价

英国人能表达Hamlet的思想和Lear的悲剧,却无法形容颤抖和头痛……一个中学女孩陷入爱河时,有莎士比亚和Keats为其诉说;但若一个病人向医生描述他的头痛,立刻就显得词藻枯竭.

AIM:To examine and compare the effects of several ARBs that are widely used in clinics , on the ACE-Ang II-AT1 receptor and the ACE2-Ang(1-7)-Mas axis during the development of cardiac remodeling after pressure overload .METHODS: All of the mice used in the study underwent transverse aortic constriction (TAC) or sham operation for 2 or 4 weeks.A solution of either ARBs or sa-line was administered through a stomach tube 3 days before the operation .Meanwhile , to eliminate the influence of Ang II , a recombi-nant adenovirus expressing small interfering RNAs targeting angiotensinogen ( Ad-ATG siRNA) was injected via the tail vein .The sur-gery was then performed and the drug was administered as mentioned above .Cardiac function and remodeling were evaluated by echo-cardiography , hemodynamic measurements and cardiac histology .Western blotting was used to determine the protein expression levels . Meanwhile , we performed similar experiments using ARBs with or without ATG siRNA in cardiomyocytes induced by mechanical stretch.RESULTS:Although all of the six ARBs , none of which repressed the elevation of left ventricular pressure after TAC , attenu-ated the development of cardiac hypertrophy and heart failure in the wild-type mice, the degree of attenuation by Olmesartan , Candesar-tan and Losartan tended to be larger than that of the other three drugs tested .Additionally , the degree of downregulation of the ACE-Ang II-AT1 axis and upregulation of the ACE2-Ang(1-7)-Mas axis was higher in response to Olmesartan, Candesartan and Losartan administration in vivo and in vitro.Additionally, Olmesartan had a larger influence when administered long term .However, the expres-sion of ACE was not influenced by the administration of ARBs in vivo and in vitro.Moreover, in angiotensinogen-knockdown mice, TAC-induced cardiac hypertrophy and heart failure were inhibited by Olmesartan , Candesartan and Losartan but not by Telmisartan , Valsartan and Irbesartan administration .Furthermore , only Olmesartan and Candesartan could downregulate the ACE-Ang II-AT1 axis and upregulate the ACE2-Ang(1-7)-Mas axis in vitro.CONCLUSION: Olmesartan, Candesartan and Losartan could effectively in-hibit pressure overload-induced cardiac remodeling even when with knockdown of Ang II , possibly through upregulation of the expres-sion of the ACE2-Ang(1-7)-Mas axis and downregulation of the expression of the ACE-Ang II-AT1 axis.In contrast, Telmisartan, Valsartan and Irbesartan only played a role in the presence of Ang II , and Losartan had no effect in the presence of Ang II in vitro.

急性原发性闭角型青光眼

Acute primary closed angle glaucoma is fast becoming one of the most important causes of blindness in the 21 st Century. World bhnding statistics show that there are 60 million people suffering from glaucoma. Of these,approximately 6 million are blind and 1.5 million (25%) are due to acute closed angle glaucoma. With the aging population, the number of patients blind from glaucoma will continue to increase.Attacks from acute primary closed angle glaucoma can lead to irreversible blindness to the affected eye.Blindness can be effectively prevented in acute primary closed angle glaucoma because the severity of symptoms will draw the attention of the patient who will then seek for medical care. Therefore, it is essential to educate the public,doctors and healthcare workers about the danger and symptoms of acute glaucoma. With early diagnosis and treatment to the affected eye and laser iridotomy to the fellow eye-bilateral blindness from acute glaucoma can be prevented.This paper highlights important clinical advances in the management of acute primary closed angle glaucoma and also poses several questions for discussion.(1) What evidence is there to suggest that bilateral blindness from acute primary closed angle glaucom is preventable?(2) In what way is Ultrasonic Biomicroscopy (UBM) useful in clinical research in glaucoma?(3) Will UBM be important in clinical diagnosis in primary closed angle glaucoma?(4) What is the scientific basis of treatment in acute primary closed angle glaucoma?(5) What are the essential procedures to preserve vision in chronic primary closed angle glaucoma?(6) What are the reasons for blindness after laser iridotomy?(7) What is the mechanism of laser iridoplasty?(8) What are the reasons why laser iridoplasty should be combined with laser iridotomy?(9) Why there is an intraocular pressure increase in 50% of eyes within 3 months after laser iridoplasty?(10) Can UBM explain the changes in the angle after lens removal in primary closed angle glaucoma?(11) Are there reasons why trabeculectomy is infrequently used in acute glaucoma, yet it is an important procedure in chronic primary closed angle glaucoma?(12) The scientific reasons why laser iridotomy is essential in the fellow eye.

Progress on renal sympathetic nerve ablation for refractory hypertension

Hypertension is a chronic cardiovascular disease worldwide.Its association with major adverse cardiac and cerebral events and favorable effects of antihypertensive therapy are ndisputed.It has been estimated that the total number of patients are more than one billion people［1］.In recent years, the drug reatment of hypertension has made great progress, especially for a large number of long-acting antihypertensive drugs and the application of the new compound preparation so that the control rate of hypertension significantly increased.However, hypertensive patients received diuretics, including more than three high-dose antihypertensive drug treatment, but has not yet reached the target blood pressure, clinically known as refractory hypertension (treatment resistant hypertension) about the total number of patients with 20% to 30% ［2］, and such patients have a higher incidence of adverse cardiovascular events［3］.efractory hypertension is not only caused by many reasons, but also illustrates the limitations of the medication.Therefore, people began to say, non-drug treatment of hypertension.Most recently, attention has been redirected to the sympathetic nervous system in the pathogenesis of hypertension.In addition, interruption of the renal sympathetic nervous system in humans with resistant hypertension has been studied with promising results.In 2009, Monash University, Australia Krum professor′s first report of renal sympathetic nerve ablation(Renal sympathetic denervation) was used in the treatment of resistant hypertension, creating a non-drug treatment of essential hypertension in new ways.In this review, a brief introduction mentioned the research progress of this new technology.

应用BOLD进行核磁脑功能成像的误区：神经元活动时脑血氧变化的多样性

Functional MRI (fMRI) is recognized as a well-established non-invasive diagnostic method to image activating cortical areas. Currently, the blood oxygenation level dependent (BOLD) contrast method is widely used in fMRI. BOLD-fMRI images activating are as by detecting a reduced concentration of deoxyhemoglobin during neuronal activity, which is caused by a larger increase in O2 delivery compared with O2 consumption in normal adults. In the present study, near infrared spectroscopy, which is an optical method to evaluate cerebral blood oxygenation changes, has demonstrated an increase of deoxyhcmoglobin associated with increases of oxyhemoglobin and total hemoglobin at activation areas of stroke patients, whereas BOLD-fMRI failed to image the activation areas. The present findings have serious implications for the appiication of BOLD-fMRI to the patients with brain disorders because BOLD-fMRI may overlook neuronal activities in these patients unless both increases and decreases of signals are considered.

地学层析技术在工程中的应用

自1985年以来,地学层析技术在中国被广泛地应用于工程探测中,并取得了大量的成果.地学层析技术目前主要包含着地震层析、电磁波层析和电阻率层析成像这三个技术途经.中国工程技术人员在观测仪器和数据处理的软件方面均做出了许多贡献和发展.在工业生产和深部探测方面,地震层析无疑是重要的-种手段.把速度图像和Q值图像结合起来可以很好的推断矿产、石油、资源以及地质构造.本文给出了我国在地震测深、矿产勘探和井间地震等方面成功应用的实例,并进行了分析讨论.

In recent years the pedicle screw system has been widely used in treating thoracolumbar vertebral fractures. The effect to recover the injured vertebrae height, the spinal physiological curve and to decompress vertebral canal has been confirmed. But the problems of internal fixation bending, loosening and breaking, which result in the loss of the vertebral height and spinal angulation deformity, are quite common and cause a lot of difficulties for surgeons. To solve these problems and decrease the sequelae from treating thoracolumbar vertebrae fractures with vertebral pedicle screw system, we have tried using vertebral pedicle screw system plus ACPC perfusion to treat 18patients with thoracolumbar vertebral fractures.Satisfactory results have been obtained.

In the management of traumatic skull defect, the classical treatment has usually been adopted, i.e.,primary debridement and secondary repair of bone defect, especially in cases of open lacerated skull fracture. 1 In general, the use of prosthetic material in repair is often not so satisfactory either in China or abroad. Decalcificated human dentin matrix (DHDM)has been used in autogenous repair of traumatic skull defect in primary operation and a good curative effect has been gained since the time from September 1996 to March 1998. Clinical results and CT scanning observation are reported in the following.

99mTc-Methylene diphosphonate (99mTc-MDP) is widely used in clinical settings to detect bone abnormalities. However, the mechanism of 99mTc-MDP uptake in bone is not well elucidated. In this study, we utilized a mouse tibia injury model, single-photon emission computed tomography (gamma scintigraphy or SPECT), ex vivo micro-computed tomography, and histology to monitor 99mTc-MDP uptake in injury sites during skeletal healing. In an ex vivo culture system, calvarial cells were differentiated into osteoblasts with osteogenic medium, pulsed with 99mTc-MDP at different time points, and quantitated for 99mTc-MDP uptake with a gamma counter. We demonstrated that 99mTc-MDP uptake in the injury sites corresponded to osteoblast generation in those sites throughout the healing process. The 99mTc-MDP uptake within the injury sites peaked on day 7 post-injury, while the injury sites were occupied by mature osteoblasts also starting from day 7. 99mTc-MDP uptake started to decrease 14 days post-surgery, when we observed the highest level of bony tissue in the injury sites. We also found that 99mTc-MDP uptake was associated with osteoblast maturation and mineralization in vitro. This study provides direct and biological evidence for 99mTc-MDP uptake in osteoblasts during bone healing in vivo and in vitro.