优良资源植物——三颗针的质量考查研究之二

对四种同季不同产地采集的“三颗针”不同部位的四种生物碱进行了含量测定和分析,为该类药材的质量研究、生药采收、药厂选投料及开发应用等提供了科学依据。同时对该类资源的可持续利用也具有积极意义。     

Ambulatory laparoscopic fundoplication

Background: Increasingly larger series of laparoscopic fundoplications (LF) are being reported. A well-documented advantage of the laparoscopic approach is shortened hospital stay. Most centers report typical lengths of stay (LOS) for LF of 2–3 days. Our success with LF with a LOS of 1 day led to an attempt at performing LF on an ambulatory basis. Methods: Sixty-one consecutive patients with appropriate criteria for LF underwent surgery at our institution. Patients were counseled by the authors as to the usual postop course and progression of diet. All patients received preemptive analgesia (PEA) consisting of perioperative ketorolac and preincisional local infiltration with bupivicaine. Anesthetic management included induction with propofol, high-dose inhalational anesthetics, minimizing administration of parenteral narcotics, and avoidance of reversal of neuromuscular blockade. Immediate postop pain management included parenteral ketorolac and oral hydro- or oxycodone. All patients were given oral fluids and soft solids after transfer from the recovery room to the postoperative observation unit. Two patients were excluded from ambulatory consideration due to excessive driving distance from our hospital. Another two were hospitalized for observation after experiencing intraoperative technical problems. Results: Of 57 patients in whom same-day discharge was attempted, there were three failures requiring overnight hospitalization: All were due to pain and nausea; one patient also suffered transient urinary retention. There were no adverse outcomes related to early discharge, and there were no readmissions. One patient returned to the emergency room after delayed development of urinary retention. Median time from conclusion of operation to discharge was less than 5 h. No patients expressed dissatisfaction with early discharge on follow-up interview. Conclusions: LF can be safely performed as an ambulatory procedure. Analgesic and anesthetic management should be tailored to minimize nausea and provide adequate pain control. Received: 1 April 1996/Accepted: 29 May 1997     

江门市乡镇集中式供水卫生现状分析

为加强乡镇集中式供水卫生管理，进一步普及与提高农村的改水工作，我们按统一的调查方案，于１９９４￣１９９５年在全国范围内开展乡镇自来水厂调查登记和水质监测工作。据统计全市建成投产乡镇水厂６８座，普及率７７．３％，受益人口１４９．０９万，占农村总人口６２．５％，调查结果显示，水源总污染率为８．８２％，在监测项目中主查细菌学指标合格率不高，丰、枯水期水源水平均合格率分别为４０．０％和８８．９％，而出厂水     

压缩回复式椎管扩大成形术治疗胸腰椎骨折并脊髓损伤

目的介绍压缩回复式椎管扩大成形加内固定术在胸腰椎骨折并脊髓损伤中的应用。方法对58例胸腰椎骨折合并脊髓损伤患者，采用自制组合式嵌打整复器对突入椎管的碎骨块，嵌击复位压缩成形，从而扩大椎管容积，同时重建病椎棘上棘间韧带，并行内固定，恢复脊柱后部结构的稳定性。结果50例获得随访，平均2年6个月，30例已恢复轻工作，9例可扶拐下地活动。结论压缩回复式椎管扩大成形术是治疗胸腰椎骨折合并脊髓损伤的新术式，值得在基层医院推广。     

不同性别长爪沙鼠血液生理生化值的比较

目的:测定长爪沙鼠的血液生理生化正常值,并对两性的正常值进行比较。方法:采血后,用Coulter ACT血球计数仪检测血液生理指标,用日立7170全自动生化分析仪测定血清生化指标,用Beckman CX3生化仪测定血清电解质。结果:血液生理指标中RBC、HCT、HGB、MCH和WBC性别差异有显著性(P<0.05),而MCV、MCHC、RDW、PLT、MPV、PCT和PDW等性别差异无显著性(P>0.05);血清生化指标中ALT和UA性别差异有显著性(P<0.05),而TPROT、GLB、A/G、BUN、CREAT、CHOL、TRIG、ALT和血清电解质(Na+、K+、Cl-、总Ca2+)等均性别差异无显著性(P>0.05)。结论:长爪沙鼠血液的生理生化值受多种因素影响,部分指标两性间测定值有差异,但多数指标差异不显著。     

医疗器械不良事件监测-现状与展望

介绍医疗器械不良事件的基本概念,论述美国、欧盟、日本和有关国际组织关于医疗器械不良事件监测的管理规定,并回顾和展望我国在该领域的相关工作.     

Joint capsule matrix turnover in a rabbit model of chronic joint contractures: Correlation with human contractures.

To evaluate changes in matrix molecules of the joint capsule, the right knees of 24 skeletally mature female NZW rabbits were immobilized while the contralateral limb served as an unoperated control. The immobilization was discontinued at 8 weeks and the rabbits were divided among four groups (n = 6) based on the number of weeks the right knees were remobilized: 0, 8, 16, or 32. Three rabbits (six knees) that did not have operations provided normal control joint capsules. The mRNA levels for collagen types I, II, and III, and MMP-1 and -13 were significantly increased in the joint capsules of the contracture knees in all groups when compared to normal and contralateral limb joint capsules. In contrast, the mRNA levels for TIMP-1, -2, and -3 were decreased in the joint capsules of the contracture knees in all groups when compared to normal and contralateral limb joint capsules. The mRNA levels for lumican and decorin were increased in the joint capsules of the contracture knees in all groups when compared to normal capsules. Many of the changes observed in this animal model are similar to those observed in human joint capsules from posttraumatic elbow contractures, supporting the value of this rabbit model.     

小鼠原位脂肪肝移植模型的建立

目的　建立了ob/ob小鼠脂肪肝移植模型 ,探讨保证建模成功的关键因素。方法　采用小鼠非动脉化肝移植技术 ,5～ 7周肥胖小鼠为供体 ,正常小鼠为受体 ,双袖套法行原位肝移植。受体肝组织行HE染色和油红O染色 ,血清ALT、AST水平检测采用常规生化分析法。结果非脂肪肝移植组 (lean to lean)受体长期存活率 (n =10 )为 70 % ,脂肪肝移植组 (ob/obtoagematchedlean)受体存活率为 0 (n =10 ) ,差异有显著性 (P <0 .0 5 )。脂肪肝移植给体积相当的正常小鼠 ,其短期存活率为 3 0 % (n =10 ) ,所有小鼠术后存活并苏醒 ,但均未超过 2 4h。脂肪肝移植受体ALT水平为 (62 85± 2 93 7)U /L ,AST为 (5 812± 2 942 )U /L ;而正常小鼠移植组ALT与AST水平分别为 (5 96± 114 )U /L ,(1796± 870 )U/L ,差异有显著性 (P <0 .0 5 ) ,组织学检测显示大量胆管中央凝固性坏死伴出血。结论　该模型的成功建立为我们提供了一种新的肝原发性肝无功能移植模型 ,为脂肪肝移植后脂肪肝细胞受损的机制研究奠定了基础。     

耒阳市1093例不同年龄人群缺锌状况的调查分析

[目的]探讨人体内锌缺乏与年龄是否相关。[方法]采集头发用强酸消化后，利用北京振教科贸有限公司产WL-3微量元素分析仪进行检测。[结果]我们发现儿童的缺锌率高于青少年和成人人群，具有显著的统计学意义（P〈0．05），其中3～5岁时的儿童的缺锌率达到了79．1％。而青少年与成人之间的缺锌率并无差异（P〉0．05），分别为20．5％和18．4％。[结论]因膳食结构不当引起锌缺乏在儿童中常见，由此我们应当根据不同年龄阶段特点进行不同的补锌措施。     

从脾胃论秋冬养阴——凌耀星教授的膏方经验一隅

冬令膏方是依据“秋冬养阴”为原则的养生和疾病防治方法。凌耀星教授在膏方辨证施治的过程中,尤重脾胃,从《内经》理论出发证实了“脾胃”在“秋冬养阴”中占有主导地位。