An Evaluation of the Residual Activity of Antiseptic Handrub Lotions: An ‘In Use’ Setting Study

An evaluation of the residual activity of quick-drying agents (alcoholic solutions) used for hygienic hand disinfection is described. We looked for residual efficacy following hand disinfection with soap and water alone or followed by one of two alcoholic handrub lotions supplied from an automatic hand washing machine. The bacterial counts on the hands obtained before and within 2 successive hours after disinfection showed that alcoholic chlorhexidine was the most effective for 10 minutes after contamination of the hands. WELPAS® (alcoholic chlorbenzarconium) followed this in its immediate effect and was better than soap and water alone. There were no significant differences after 30‘ or 120‘ between the three disinfecting methods.     

内镜治疗老年总胆管结石30例体会

目的：探讨内窥镜治疗老年总胆管结石的安全性和有效性。方法：对我院普外科收治的30例70岁以上的老年总胆管结石患者进行回顾性分析，所有患者均经B超或螺旋CT明确诊断并接受内镜治疗，治疗方法包括逆行胰胆管造影（endoscopic retrograde cholangiopancreatography,ERCP)，鼻胆管引流（endoscopic nasobiliary drainage,ENBD)，乳头括肌切开（endoscopic shincterotomy,est)和取石术，碎石术，测定患者内镜治疗前后的生化指标变化。结果：30例老年总胆管结石患者行ERCP检查，成功率100％，28例行EST，总胆管结石直径＜1.0cm者成功率100％，结石直径1.0-1.5cm者成功率86％，结石直径≥1.5cm者需进行机械碎石取石，成功率75％；另有2例患者植入塑料支架作长期引流。1例患者发生与内镜有关的并发症，死亡例，30例患者治疗后各项生化指标较治疗前均有明显改善（P＜0．001）。结论：内镜治疗老年总胆管结石成功率增高，避免了手术创新，安全性好，缩短住院时间，是当前治疗老年总胆管结石的首选方法。     

Clinico-pathological aspects of a residual natal tooth: a case report

A Japanese girl was referred to Osaka University Dental Hospital for examination of a tooth-like structure that had erupted following spontaneous exfoliation of a natal tooth in the lower left primary central incisor region. The structure had erupted at 6 months of age, and radiographic and clinical examination showed composition of pulp and dentin, but no enamel. On histological examination, the majority of the dentin area had a tubular dentin-like appearance, while the outer area of the root appeared to be composed of an osteodentin-like substance. Most of the dentin was covered by cementum. These findings suggest that the structure had originated from a developing remnant of the extracted natal tooth, which must have remained in the gingival tissues. We termed this calcified structure a residual natal tooth.     

纤维胆道镜370例取石体会

目的 进一步提高纤维胆道镜结石取净率，从而提高胆道结石治愈率。方法 总结10年370例纤维胆道镜取石体会，归纳出“网、拉、冲、扩、咬、推”六种操作技巧。结果 对370例胆道结石术后残留结石病人共取石537例次，完全取净率达89．5％，基本取净率8．4％，取石失败2．1％。结论 纤维胆道镜正确灵活的操作方法可避免取石过程中不必要的损伤，缩短操作时间，避免遗漏结石并能取出困难部位的结石。     

B超在药物流产不全中的诊断价值

目的 :探讨B超在药物流产不全中的诊断价值及宫内残留胚胎物的超声图像特征。方法 :采用ALOKASSD5 0 0型超声诊断仪 ,对 94例米非司酮药流后阴道不规则出血的患者进行超声检查。结果 :胚胎残留物超声图像特征明显 ,阳性率为 77 66% ,与病理检查的符合率为 95 74%。结论 :B超检查能迅速、准确地诊断药流后宫内胚胎组织残留 ,为临床治疗提供可靠的依据。     

Symptoms, diagnosis and endoscopic management of common bile duct stones

Symptomatic BDS commonly cause significant morbidity and attempt at stone removal should be attempted if possible. Complications of CBDS include biliary colic, jaundice, cholangitis and pancreatitis. Investigations aimed to predict the presence of stones within the bile duct include serum bilirubin, AST, ALP, common bile duct diameter and age as independent predictors of choledocholithiasis. TUS is a sensitive test in detecting bile duct dilatation but the sensitivity is reduced in its ability to detect choledocholithiasis. A NIH consensus statement found that ERC, MRC and EUS were comparable in their sensitivities, specificities and accuracy rates for detection of choledocholithiasis. ERC and stone removal using a balloon or basket is often performed following EST. EBD may be performed if patients have uncorrected coagulopathies but the risk of pancreatitis is higher than for EST (although the risk of bleeding complications is lower for EBD). ML is often required in difficult to remove CBDS and using this device, CBDS can be removed in 90–95% of cases. Other forms of lithotripsy including laser lithotripsy and EHL are confined to specialised centres and the evidence for their use is based on small studies. ESWL may clear stones from the bile duct in up to 93% of patients but frequently ERC and stone fragment removal is required post ESWL. The role of medical therapy in difficult to remove CBDS (or in CBDS in patients with severe co-morbid illness preventing ERC + stone removal) is still currently uncertain due to a lack of large randomised control trials.     

肝胆管结石术后疗效观察

按本文提出的病型分类方法对121例肝胆管结石进行术后随访,结果表明:肝内、上部、下部胆管狭窄型及胆管无狭窄型分别以肝叶切除、肝门部狭窄胆管切除或整形胆肠吻合、胆总管空肠吻合或Oddi括约肌成形、胆总管切开取石术为基本术式,术后疗效较好。多数病例术后残余结石长期存在,肝功能恢复与残余结石有直接关系。     

纤维胆道镜在治疗胆道术后残余结石的应用

目的总结纤维胆道镜在治疗胆道术后残余结石的应用经验。方法回顾性分析2005年1月至2006年1月我们对60例肝内外胆管残余结石应用纤维胆道镜治疗术后胆道残余结石的疗效。结果60例患者一次取石成功51例(85.0%),二次取石成功9例(15.0%),击碎最大结石为3.5cm×2.5cm×2.0cm,无胆道穿孔等严重并发症发生。结论应用纤维胆道镜治疗术后胆道残余结石能提高结石的清除率,有较高的安全性,值得推广应用。     

CLINICAL SIGNIFICANCE OF THE DETECTION OF MINIMAL RESIDUAL DISEASE IN CHILDHOOD B-ALL BY FLOW CYTOMETRY

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