输卵管镜临床应用进展

输卵管镜是用于检查输卵管腔的显微内窥镜,其经过宫腔镜、腹腔镜、生育镜的引导,或单独进入输卵管内,可检查输卵管管腔是否通畅,有无狭窄、粘连、梗阻、充血、积液、息肉、憩室、子宫内膜异位病灶等,评价输卵管的功能,能纠正传统输卵管通畅性检查的假阳性和假阴性结果,还可以对病变进行活检,并同时疏通输卵管,能够兼顾诊断与治疗。输卵管镜检查可以明确输卵管性不孕的原因,病变严重时需及时选择体外受精-胚胎移植(in vitro fertilization and embryo transfer,IVF-ET),而病变较轻时保守性手术治疗可以显著提高不孕症患者的自然受孕率。随着生殖医学技术的发展和对输卵管研究的不断深入,输卵管镜显示出明显的优势,在输卵管疾病诊治方面发挥不可替代的作用。对近年国内外有关输卵管镜诊治的进展进行综述,总结输卵管镜诊治的临床应用价值。     

A longitudinal evaluation of hearing and ventilation tube insertion in patients with primary ciliary dyskinesia

IntroductionPrimary ciliary dyskinesia (PCD) is an autosomal recessive genetic disease, which primarily manifests with oto-sino-pulmonary symptoms. Otitis media with effusion (OME) is common from early childhood. The existing literature on OME management in PCD is conflicting.The goals of the present study were firstly to evaluate the long-term hearing in PCD patients and secondly to determine the influence of ventilation tube (VT) insertion on hearing and postoperative otorrhoea.MethodsA longitudinal retrospective study extracting the hearing level (pure tone average (0.5, 1, 2, 4 kHz, PTA)) and tympanometry from the medical records. Furthermore, the patient files were reviewed for VT insertion and postoperative otorrhoea. Postoperative otorrhoea was defined prolonged when it lasted for four weeks or longer.ResultsFifty-seven patients were identified in a 30-year period, age 2–72 years, and 278 audiometries were evaluated. The median number of audiometries per patient was 3 (range 1–29) and the median follow-up was 60 months (range 0–351 months). The mean PTA was 34 dB HL in patients below six years of age and improved significantly (p < 0.0001) with age. VT insertion improved hearing; however, 48% of patients with VT insertion experienced prolonged otorrhoea.ConclusionIn this study of PCD patients the hearing improved as a function of age as well as following VT insertion. However, VT insertion was also associated with prolonged otorrhoea.     

Non-invasive endotracheal delivery of paclitaxel-loaded alginate microparticles

Aerosolized chemotherapeutics leads to higher, localized and continuous concentrations of active agents in lung tissue with lower side effects for other organs. The present study was performed on jugular vein cannulated rats which endothracheally received 4 mg/kg of free paclitaxel powder (Free-PTX), paclitaxel-loaded alginate microparticles (PTX-ALG-MPs) and i.v. paclitaxel (Anzatax^®). Pharmacokinetic parameters for Free-PTX and PTX-ALG-MPs contain higher AUC, mean residence time (MRT),half-life and bioavailability, with lower elimination constant (k_e). Statistical analysis showed that the amount of paclitaxel per gram of lung tissue after 0.5, 6 and 24 h after administration of Free-PTX was lower than PTX-ALG-MPs. Lung tissue AUC for Free-PTX was lower than PTX-ALG-MPs. According to the obvious advantages obtained, such as dose lowering and increasing paclitaxel residence time and half-life. It should be noted that cell cytotoxicity test on normal airway cell lines was not examined in this study but due to previous reports on safety of inhaled paclitaxel, it can be suggested that pulmonary delivery of paclitaxel can be a useful non-invasive route of administration compared with i.v administration.     

Non-Electric Aids to Hearing: A Short History

The historical development of non-electric aids to hearing is traced and a classification of the different types presented. Comparative measures of their different acoustical characteristics will be shown, indicating their relative value in various types of hearing losses. Attitudes towards such devices and principles involved in their selection in the 19th Century are discussed.     

Inclined position is associated with improved first pass success and laryngoscopic view in prehospital endotracheal intubations

Purpose

In hospital-based studies, patients intubated by physicians while in an inclined position compared to supine position had a higher rate of first pass success and lower rate of peri-intubation complications. We evaluated the impact of patient positioning on prehospital endotracheal intubation in an EMS system with rapid sequence induction capability. We hypothesized that patients in the inclined position would have a higher first-pass success rate.

院前急救使用气管插管和球囊面罩的效果对比

目的探究在院前心脏停搏患者应用气管插管和球囊辅助呼吸进行急救的效果。方法选自本院2010年²012年进行院前急救的心脏停搏患者共50例,以随机的方式分为对照组与观察组,每组各有患者25例。对照组患者接受气管插管辅助呼吸,观察组患者接受球囊人工通气治疗。对比2组患者的各项临床指标。结果相对于对照组患者,观察组患者在建立通气时间方面有显著优越性,二者对比具有统计学意义(P<0.05);其余各项临床指标对比无统计学意义(P>0.05)。结论对心脏停搏患者进行院前急救的时候,应用球囊或者气管插管的急救方法,在临床效果对比方面相似,但是球囊辅助呼吸建立通气的时间要比气管插管短很多。     

护理干预对行输卵管结扎妇女术后心理问题的作用

目的 探讨护理干预对输卵管结扎术后心理问题的作用.方法 将1 020例行输卵管结扎术的妇女随机分为干预组和对照组,每组510例.干预组根据不同的心理问题进行护理干预,对照组不进行干预.结果 干预组合作型比例明显高于对照组(P＜0.01),在紧张、恐惧和焦虑等方面明显低于对照组(P＜0.01)；干预组的疼痛程度低于对照组(P＜0.01).结论 护理干预对输卵管结扎术后心理问题有积极作用.