器官移植患者随访中的问题与解决方案

目的对当前器官移植患者随访专业人员设置的问题并探讨相应的解决方案。方法结合当前国内移植中心对移植患者随访工作开展的现状及某院开展随访工作的经验,对当前的随访工作中存在的问题提出解决方案。结果构建完善专业岗位人员以保障患者健康为核心、复查为手段的随访方式是可行的途径。结论实施完善的随访手段有望改善当前移植患者随访工作的现状。     

Venous drainage in retrograde island flap: An experimental study using fluorescence tracing technique

The pathway of venous drainage in retrograde island flaps was investigated by fluorescence tracing technique using the saphenous fasciocutaneous flap in New Zealand White rabbits. Forty animals were allocated into four groups according to the different times at 30 minutes (I), 24 hours (II), 72 hours (III), and 7 days (IV) after the operation. According to the different routes to give tracer, each group was further allocated into two subgroups of the artery injection and vein injection. For each animal, one hindlimb was assigned as the experimental side, the contralateral side as control without giving tracer. The erythrocytes were separated, labeled with fluorescein isothiocyanate (FITC), detected, and injected into the artery or vein. Subsequently, the flaps were harvested 5 seconds after injection and immediately frozen, sectioned, and observed under microscope. In group I and II, the fluorescence was observed mainly around the vessel adventitia of the vein and artery and tunica intima of the artery. In group III, there was weak fluorescence observed in the lumen of vein. In group IV, fluorescence was distributed principally in the lumen of the vein. In addition, fluorescence was not observed in the saphenous nerve in group I and there was mild fluorescence in the saphenous nerve in groups II, III, and IV. These findings suggest that the venous return is through “bypass route” in earlier period. In later period, the venous retrograde return is through “bypass route” and “incompetent valves route;” however, “incompetent valves route” becomes the main route. © 2009 Wiley‐Liss, Inc. Microsurgery 2010.     

脑肿瘤患者生活质量评价一致性分析

目的 研究脑肿瘤患者本人和其代理人对患者生活质量评价的一致性.方法 对在天津环湖医院住院的原发性脑肿瘤患者和与其密切相关的代理人,分别采用EORTC QLQ-C30中文版对患者的生活质量进行评价,并分析他们之间的一致性.结果 在2008至2009年间有25对患者和其代理人入选.绝大多数入选的生活质量项目在患者和代理人之间表现出很好的一致性(0.53).特别是在躯体功能,食欲减退,腹泻,便秘,恶心呕吐等方面表现突出.在社交活动,感情情感,意识状态,疲劳,疼痛等方面一致性较差.结论 当患者不能提供自身信息时,可以通过对同脑肿瘤患者有密切关系代理人的评价,来获取生活质量相关的某些信息,为临床工作提供可靠信息.     

Effect of urinary tract infection on the risk of prosthetic joint infection: A systematic review and meta-analysis

PurposeUrinary tract infection (UTI) are very common in the general population, however it is unclear whether UTI is a risk factor of prosthetic joint infection (PJI). Our purposes were: (1) To determine whether UTI is a risk factor of PJI after joint replacement, and (2) to determine whether the microorganisms causing PJI and UTI are the same.MethodsPubMed, Web of Science, the Cochrane Library, and EMBASE were searched systematically for studies. The effect sizes of RR were calculated for included studies that reported raw counts with 95% CIs. The aim 1 of the study is a meta-analysis; the aim 2 is a systematic review.ResultsThe aim 1 indicated that the risk of PJI was significantly higher in the UTI group than in the control group (RR = 3.17; 95% CI, 2.19–4.59). The aim 2 indicated that the microorganisms of UTI and PJI were the same in the same patient, and these included Enterococcus faecalis, and Pseudomonas, which supports the theory of PJI occurring via the haematogenous route from the genitourinary tract that harbours bacteria in UTI.ConclusionThis study identified UTI as being significantly associated with PJI after joint arthroplasty and PJI occurring via the haematogenous route from the genitourinary tract harbouring bacteria in UTI. Therefore, postponing surgery and even treating patients with known UTI preoperatively are recommended.     

乳汁中药物浓度测定的研究进展

母乳喂养对婴儿来说是一种非常健康及有营养的获取能量的方式，对母亲和婴儿都有益处。患有某些疾病的哺乳母亲在进行药物治疗时，需要考虑药物是否会进入乳汁而对婴儿产生一些不良反应或对母亲产生影响。由于许多药物的哺乳期用药安全性并不十分明确，因此在临床治疗中不推荐哺乳期妇女使用。测定乳汁中的药物浓度可以明确合理的给药时间和给药剂量，提高用药安全性，对临床用药具有非常重要的意义。但乳汁成分复杂，含有大量脂质和蛋白质等干扰物质，使乳药浓度测定有一定困难。本文综述了国内外乳药浓度测定方法，以期为哺乳期合理用药提供参考。     

Streptococcus pneumoniae serotype 1 causing invasive disease among children in Barcelona over a 20-year period (1989–2008)

Fifty-six isolates of serotype 1 were identified during a 20-year prospective study (1989–2008), including all children with culture-proven invasive pneumococcal disease (IPD) admitted to a children's hospital in Barcelona. Forty-eight of them (85.7%) were in children aged >2 years. Complicated pneumonia (n = 28) and non-complicated pneumonia (n = 20) were the main clinical presentations. The frequency of serotype 1 IPD increased from 1999–2003 to 2004–2008: 1.2 to 4.4 episodes/100 000 children (p <0.001). The ST306 clone were identified in 70.4% of isolates. As IPD caused by serotype 1 is mainly detected in older children, a vaccination programme for children >2 years should be considered.     

Trophozoites of <Emphasis Type="Italic">Entamoeba histolytica</Emphasis> express a CD59-like molecule in human colon

In vitro studies have proved the presence of epitopes of CD59 in the surface of trophozoites of Entamoeba histolytica (E. histolytica). However, it has not been proved if CD59 molecules are expressed in the surface during the trophozoites’ tissue invasion. The aim of the present study was to determine whether the complement-regulatory protein CD59 is present on trophozoites of E. histolytica in human colon. Eleven specimens of amoebic colitis were studied by immunohistochemistry and electron microscopy techniques with a monoclonal antibody against human CD59 molecule. Our results show that a CD59-like molecule is expressed in trophozoites of E. histolytica found in colonic amebic lesions. Also, a CD59-like molecule was detected by western blot analysis in whole lysate of E. histolytica as well as on the plasma membrane by immunocytochemistry. These results suggest that E. histolytica can use CD59-like protein against the lytic action of membrane attack complex.