Principles for managing penetrating craniocerebral injuries caused by firearm missiles

Penetrating craniocerebral firearm injuries remain one of the most lethal causes of all trauma and are common both in war or peace time. Data were reviewed for 4140 severely head-injured patients (Glasgow Coma Scale (GCS) scores 3-8) treated at Xi-Jing Hospital between 1973 and 1993; 51 of these patients had acute penetrating craniocerebral injuries caused by firearm missiles. These patients consisted of 46 males (90.2%) and 5 females (9.8%) ranging in age from 3 months to 48 years (median 22.4 years). The lesion types included 2 tangential wounds, 37 tubular wounds and 12 through-and-through wounds. All cases were urgent with the patients in severe and unstable states. After emergency treatment and operation, 5 cases died (9.8%). Follow up studies at three months showed that 23 cases (45.1%) had made a good recovery. Moderate disability, severe disability and vegetative states in this series were 29.4%, 13.7% and 2.0% respectively. Long term follow up studies indicated that 32 were able to resume their occupation. The principles for managing penetrating craniocerebral firearm injuries and suggestions for operation are discussed.     

Ligase chain reaction for diagnosis of familial hypertrophic cardiomyopathy

ＬｉｇａｓｅｃｈａｉｎｒｅａｃｔｉｏｎｆｏｒｄｉａｇｎｏｓｉｓｏｆｆａｍｉｌｉａｌｈｙｐｅｒｔｒｏｐｈｉｃｃａｒｄｉｏｍｙｏｐａｔｈｙＳｕｎＷｅｉｄｏｎｇ孙维东，ＨａｎｓｅｌＳｔｅｄｍａｎ，ＣｈｅｎＸｉａｏｌｉ，ＷｅｉＹｕ，ＬｉｕＭｅｉｚｈｅｎ，Ｘｕ...     

Dose-Response Characteristics of Spinal Bupivacaine in Volunteers: Clinical Implications for Ambulatory Anesthesia

Background: Small doses of bupivacaine may be a reasonable choice for spinal anesthesia for patients having ambulatory surgery. However, few dose-response data are available to guide the selection of reasonable doses of bupivacaine for different ambulatory procedures.

Methods: Eight volunteers per group were randomized to receive 3.75, 7.5, or 11.25 mg of 0.75% bupivacaine with 8.25% dextrose in a double-blind manner. Sensory block was assessed with pinprick, transcutaneous electrical stimulation equivalent to surgical incision at the ankle, knee, pubis, and umbilicus, and with duration of tolerance to pneumatic thigh tourniquet. Motor block at the quadriceps and gastrocnemius muscles was assessed with isometric force dynamometry. Times until recovery from spinal anesthesia were recorded. Dose-response relationships were determined by linear regressions. Mean (95% confidence intervals) for durations of sensory and motor block per milligram of bupivacaine administered were calculated from linear regressions.

Results: Significant dose-response relationships (P < 0.006) were determined for sensory block, motor block, and time until recovery (R from 0.6 to 0.9). Within the range of doses studied, each additional milligram of bupivacaine was associated with an increase in duration of tolerance to transcutaneous electrical stimulation of 10 (7 to 13) min, an increase in tolerance to tourniquet of 7 (2 to 11) min, an increase in duration of motor block of 8 (5 to 12) min, and an increase in time until recovery of 21 (17 to 25) min.     

西宁地区幼儿园儿童的膳食调查报告

本文对西宁地区幼儿园儿童进行了膳食调查。了解该人群的营养素摄入情况以及热能、蛋白质、脂肪来源分布和三大营养素供热比。同时提出所存在问题。     

高原地区人胎儿脊柱的生长发育

本文用X线摄片的方法,对西宁地区胎龄为17—36周的60例胎儿脊柱的骨化及生长动态进行了研究。结果:1、提供了高原地区人胎儿脊柱长轴生长发育的资料。脊柱各段以胸段为最长,其次为腰、颈、骶段。2、计算出胎龄与脊柱各段长度间的回归方程,据此可以胎龄推算脊柱的长度,反之亦可以脊柱的长度估计胎龄。3、报道了颈、骶、尾段亿发骨化点出现顺序的规律。     

大鼠下丘脑弓状核的形态计量研究

为了探讨急性癫痫弓状核形态改变与可复性，我们采用光、电镜技术和形态计量方法对下丘脑弓状核进行了形态定量研究。结果显示：弓状核切面面积为317500±6460um2，神经元胞体和胞核的等效直径分别为12.94±0.34um和8.54±0.43um，暗细胞内线粒体、粗面内质网、高尔基复合体、溶酶体、游离核相体和分泌颗粒的面积分数分别是5.87±1.98％、3.53±0.25％、0.81±0.49％、2.13±0.42％、10.53±0.46％和0.86±0.35％，其面数密度（单位面积为30um2）分别为15.68±1.14um-2、21.29±3.52um-2、10.20±0.42um-2、5.62±067um-2、101.35±7.55um-2和5.22±0.77um-2.本文还对弓状核的形态结构、神经元类型及其功能进行了讨论。     

广西5个县（市）级医院腹泻病门诊病人的调查分析

为了解医院腹泻病门诊病人分布、诊断和治疗情况，对广西５个腹泻病控制规划县（市）级医院１９９５年６月１日￣１５日腹泻病门诊登记的资料进行分析。５个医院腹泻病人共１０５１人，其中男性占５２．０％，女性占４７．９％；以肠炎最高占７９．７％，其次痢疾占２０．２％；轻度脱水病人占４６．７％，无脱水病人占３７．９％；以〈５岁儿童发病数最高，占２８．８％，静脉输液使用率为１８．８５％，口服补液盐（ＯＲＳ）使用率     

应把防治医患纠纷作为临床医德教育的重要内容

不断强化医务人员的服务意识是消除医患纠纷的首要条件,认真培养敬业精神是避免医患纠纷的根本途径;提高道德境界是避免医患纠纷的决定因素.     

微小病变型肾病综合征患者IL－2的检测及其意义

３２例微小病变型肾病综合征（ＭＣＮＳ）患者，采用￣３Ｈ－ＴｄＲ掺入法测定其外周血Ｔ淋巴细胞产生白介素２（ＩＬ＿２）的浓度，结果显示本病患者Ｔ细胞产生ＩＬ＿２的能力显著降低，与对照组相比差异非常显著（Ｐ＜０．０１），故认为ＭＣＮＳ的发生与Ｔ细胞功能异常有关。