骨外科手术切口医院感染相关因素分析

目的对骨外科手术切口医院感染的相关因素进行分析。方法选取2002年10月-2011年10月在该院治疗的骨折患者1316例,对这1316例骨折患者的临床资料进行回顾性分析。结果选取的1316例骨折患者中,有25例发生了手术切口医院感染,切口医院感染率为1.90%;25例发生了手术切口感染患者的送检本中,共分离出了27株病原菌,结果2例为双重感染,革兰阴性菌20株,占74.07%,革兰阳性菌7株,占25.93%。手术切口感染与患者年龄、手术持续时间有直接关系。结论对骨外科手术切口医院感染的监控力度一定要继续加强,并且采取相关应对措施,积极对骨外科手术切口医院感染进行预防、控制。     

223株酵母样真菌的鉴定及药敏分析

我院检验科细菌室自 1 998年 1月至 2 0 0 0年 2月间从临床标本中分离到酵母样真菌 2 2 3株 ,用念珠菌鉴定试条 ID32 C进行鉴定 ,并用 ATB FUN-GUS药敏试条对 6种抗真菌药物进行药敏试验 ,结果报告如下。1　材料和方法1 .1　材料1 .1 .1　菌株来源 :临床送检培养标本 ,2 2 3株酵母样菌中来自痰标本 1 86株 (包括咽拭子 7株 ) ,尿标本 1 8株 ,粪便标本 8株 ,血标本 4株 ,其他标本 7株。1 .1 .2　 ID32 C念珠菌鉴定试条 ,ATB FUNGUS药敏试条 ,ATB expression全自动药敏分析仪均为法国生物—梅里埃公司产品。1 .2　方法 :标本接种于…     

185株真菌鉴定及药敏结果分析

近年随着临床大量抗生素及免疫抑制剂的使用 ,深部真菌感染日益增多 ,从多种临床标本 (包括血、尿、痰、分泌物等 )中均可获得真菌检出 ,真菌的医院感染日益受到重视。本文对我院细菌室 2 0 0 1年 1月到 2 0 0 2年 4月从临床标本中分离到的真菌 185株进行分析。1　材料与方法1.1　标本来源 :185株阳性标本均来自我院住院及门诊患者送检的各类标本 ,包括痰、尿液、血液、粪便、各种分泌物、引流物、咽拭子等。1.2　试验试剂及仪器 :ID32 C念珠菌鉴定试条 ,ATB Ex-pression全自动细菌鉴定 +药敏分析仪及其配套设备均为法国生物 -梅里埃公司…     

骨外科手术切口医院感染相关因素分析

目的:为了探讨骨外科手术切口医院感染的相关因素,从而进行有针对性的预防。方法:对1 240例骨折住院患者的临床资料进行分析。结果:1 240例患者共有38例发生手术切口感染,感染率为3.71%。38例患者送检标示中共分离出25株病原菌,有3例双重感染;革兰阴性菌18株,占72%,革兰阳性菌7株,占28%,以金黄色葡萄球菌和铜绿假单胞菌为主。分析证明手术切口感染与切口类型、手术时机、骨折类型、围手术期抗菌药物使用以及是否有糖尿病有明显关系(P<0.05)。结论:应加强骨外科手术切口医院感染的监测工作,并进行有针对性的预防措施,减少手术切口感染的发生。     

外科手术切口感染调查分析

外科手术部位感染是常见的医院感染，可分为切口和器官／无菌体腔感染，前者包括皮肤及皮下组织的浅表切口感染和筋膜肌肉层的深部切口感染，感染发生的时间一般在手术后30天内，有异物植入的手术，感染可发生在术后1年内。笔者对我院145例手术感染病例统计其病原菌种类及构成比，分析其相关不利因素以达到预防和减少手术切口感染的发生。     

外科手术切口感染的危险因素分析及护理对策

目的探讨外科手术切口感染的危险因素分析及护理对策。方法选择2010年1月-2014年1月在我院住院普外科住院治疗的病例120例,入选病例均有完整的临床资料,对切口感染的发生率采用χ^2检验进行单因素分析,同时采用非条件Logistic回归分析进行多因素分析,并针对相关因素采取对应的护理对策。结果入选的120例病例中发生切口医院感染共11例,感染发生率9.17%。年龄、基础疾病、手术时间、切口类型、住院时间、切口长度、切口引流与外科手术切口感染密切相关（P〈0.05）。年龄〉60岁（OR=6.384）、有基础疾病（OR=5.237）、手术时间≥3 h（OR=4.726）、切口类型Ⅲ类（OR=7.153）是外科手术切口感染发生的危险因素。结论年龄、基础疾病、手术时间、切口类型、住院时间、切口长度、切口引流与外科手术切口感染密切相关,其中年龄〉60岁、有基础疾病、手术时间≥3 h、切口类型Ⅲ类是外科手术切口感染发生的危险因素。外科手术切口感染直接影响到手术的质量和患者的生活水平,护理人员应明确引起切口感染的危险因素,同时针对引起外科手术切口感染的危险因素采取有效的护理干预对策,从而有利于降低手术切口感染发生率,促进疾病早日康复。     

普外科手术切口感染相关因素调查与预防对策

目的:分析普外科手术切口感染的相关因素,提出有效的预防对策。方法:选取2014年1月~2016年12月在我院普外科就诊的531例手术患者为研究对象,研究普外科切口感染发病率及病原菌。结果:发生切口感染的有32例,感染率高达6.03%,占我院外科手术切口感染的78.8%。结论:通过在术前术中术后采取控制手术室感染、加强相关人员的管理工作、合理使用抗菌药物等预防对策,降低普外科手术切口感染的发生率。     

腹部外科手术切口感染的危险因素及对策

目的:重点研究和探讨腹部外科手术切口感染相关危险因素调查与对策。方法:利用回顾性分析的方法对随机选取我院于2009年1月1日-2012年12月31日收治的800例腹部外科手术患者中出现术后切口感染的患者共64例患者的临床资料进行回顾性对照分析。结果:我院收治的800例患者中有32例出现切口感染的情况,感染率为4.00%,同时通过调查发现造成患者出现术后切口感染的危险性因素有患者的住院治疗时间、年龄、手术类型等,患者年龄越大,手术时间越长发生手术切口感染的几率越大,在急诊和夏季手术的腹部外科患者出现手术切口感染的几率比较大。结论:针对可能造成患者出现术后切口感染的危险性因素,在腹部外科围手术期间采取相应对策进行预防,可以有效降低手术切口感染率,提高患者术后生活质量。     

普外科手术切口感染分析

目的 探讨普外科手术患者术后切口感染的危险因素及预防措施.方法 对1264例普外科手术患者进行回顾性分析.结果 1264例外科手术患者有7例发生切口感染,感染率为0.554%.结论 外科手术患者易发生切口感染,针对各种相关因素采取相应预防措施可减少切口感染.     

普外科手术切口感染危险因素及预防

目的:探讨普外科手术导致切口感染的相关危险因素及预防措施。方法:选取2010年6月至2013年6月收治我院普外科行外科手术的542例病例资料,回顾性分析患者手术切口感染的情况及相关危险因素。结果:542例患者发生手术切口感染42例,感染发生率为7.75%,感染的主要危险因素有患者年龄、肥胖、糖尿病、切口类型及手术时间等。结论:切口感染在普外科手术并发症中较为常见,多种相关的危险因素与感染的发生具有密切关系,针对危险因素进行积极的预防,降低手术切口感染的发生率。     

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.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

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.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.