弹力绷带与医用棉两种衬垫在电动气压止血带中的应用比较

目的通过比较医用棉纸与弹力绷带作为电动气压止血带衬垫的方法,观察不同衬垫材料在电动气压止血带中的应用效果。方法将2018年1月至12月镇江市中西医结合医院骨科收治的100例患者采用随机数字表分为弹力绷带组(50例)和棉纸组(50例),分别采用弹力绷带和医用棉纸作为电动气压止血带衬垫材料,观察比较两组的止血效果、皮肤损伤发生率以及对电动气压止血带袖带的保护情况。结果弹力绷带组患者的皮肤压痕、瘀斑、水泡等皮肤损伤发生率低于棉纸组,差异有统计学意义(P<0.05);两组止血效果比较差异无统计学意义;弹力绷带组的袖带污染发生率(4%)明显少于棉纸组(16%),差异有统计学意义(P<0.05)。结论弹力绷带作为止血带衬垫材料止血效果明显,而且能有效降低患者受压处皮肤的损伤率,同时减少了止血带袖带的污染,有利于袖带的清洁消毒。     

3L透明膜作为中药脐疗贴膜的效果观察

目的：观察医用3L透明膜作为中药脐疗贴膜的应用效果。方法将160例需要进行中药脐疗的患者随机分为对照组和观察组各80例,对照组采用常规一次性医用胶带固定药饼,观察组选用3L透明膜作为贴敷材料,12 h后对2组的贴敷效果进行观察比较。结果观察组所使用的3L透明膜粘贴牢固,药饼无脱落;局部皮肤完好,无过敏反应,且贴敷部位皮肤视野清晰,有利于观察脐部皮肤情况。结论医用3L透明膜作为中药脐疗贴膜的应用效果优于普通医用胶带,值得临床推广应用。     

Inhibitory effect of calcitonin on growth hormone and insulin secretion in man

The effect of calcitonin administration on basal and arginine-stimulated growth hormone and insulin plasma levels was investigated. The intramuscular injection of synthetic salmon calcitonin (100 U MRC) in five normal subjects produced a significant decrease (p less than 0.05) in insulin concentration. The same amount of calcitonin given 15 min before an arginine infusion test in seven normal subjects significantly reduced the response of growth hormone (p less than 0.025) and insulin (p less than 0.005) to the stimulus.     

Relationship between expression of Pad1 homologue and multidrug resistance of idiopathic nephrotic syndrome

Background:  Multidrug resistance is an occasionally seen phenomenon in children with idiopathic nephrotic syndrome (INS), but the mechanism of multidrug resistance is not clear as yet. The purpose of the present study was to investigated whether expression of Pad1 homologue ( POH1 ) plays a role in the onset of multidrug resistance of INS.
Methods:  Comparison was done of the mRNA level of POH1 on real-time quantitative polymerase chain reaction in peripheral blood mononuclear cells among children with multidrug-resistant INS, children with steroid-sensitive INS and healthy controls.
Results:  The POH1 mRNA level of the onset INS group (5852.3 ± 2676.4 copies/µg) was significantly lower than that of the control group (10 877.1 ± 2386.6 copies/µg; P < 0.05). The POH1 mRNA level of the onset INS group with multidrug resistance was not significantly higher than that of the onset INS group without multidrug-resistance before treatment (6977.1 ± 6312.3 copies/µg vs 5281.3 ± 1926.7 copies/µg; P > 0.05), but significantly higher than that of the onset INS group without multidrug resistance after treatment (436 579.6 ± 99 727.4 copies/µg vs 38 438.2 ± 16 772.5 copies/µg; P < 0.001). The POH1 mRNA level of non-onset multidrug-resistant INS group (337 446.4 ± 107 423.5 copies/µg) after treatment was not significantly higher than that of the onset INS group with multidrug resistance after treatment (436 579.6 ± 99 727.4 copies/µg; P > 0.05), but was significantly higher than that of the onset INS group without multidrug resistance after treatment (38 438.2 ± 16 772.5 copies/µg; P < 0.001).
Conclusions:  Disorder of POH1 expression is involved in the onset of INS, and confers multidrug resistance in children with INS.     

Sequential assessment of urodynamic findings before and after transobturator tape procedure for female urodynamic stress incontinence

The objective of this study was to sequentially compare the urodynamic findings of patients with urodynamic stress incontinence before and after transobturator tape procedure. Between May 2004 and December 2005, 26 of 34 consecutive patients with urodynamic stress incontinence who underwent transobturator tape procedure were enrolled. The sequential urodynamic findings of each case were compared and analyzed. Based on pad test, the cure and improvement rates were 69.2 and 30.8%, respectively. A significant increase in pressure transmission ratio at maximal urethral pressure at 1 year postoperatively (p = 0.005) was observed after surgery. The improvement group (n = 8) had significantly lower preoperative maximal urethral closure pressure (45.4 vs 68.2 mmHg, p = 0.036) than did the cure group (n = 18). The postoperatively increased pressure transmission ratio at maximal urethral pressure appears to contribute to its cure for urodynamic stress incontinence.     

垫棉压迫法在肛肠疾病的应用

垫棉压迫法属于中医外科的特色疗法,适用于溃疡脓出不畅有袋脓现象、疮孔窦道形成脓水不易排尽及溃疡脓腐已尽,新肉已生,而皮肤与肌肉一时不能粘合的患者。近年来运用垫棉压迫法治疗体表窦瘘类疾病、乳房部疾病的报道较多,但在肛肠疾病中应用的报道甚少。文章就垫棉压迫法治疗复杂性肛周脓肿、复杂性肛瘘、肛周藏毛窦、肛周坏死性筋膜炎等肛肠疾病的临证经验和操作要点进行整理,为临床医师治疗这类疾病提供具有中医外科特色的治疗方法,从而进一步提高疗效。     

一种新型一体化甲状腺手术体位垫在术中的应用探讨

目的 探究一种新型一体化甲状腺手术体位垫在甲状腺手术中的应用效果。方法 选取2019年7月至2020年4月我院154例甲状腺手术患者,按患者入院顺序分为两组,每组均为77例,对照组采用传统凝胶肩垫、凝胶头圈和辅助软垫实施体位摆放。观察组采用新型一体化甲状腺体位垫实施体位摆放。对比两种体位垫摆放时间、手术野暴露程度及甲状腺体位综合征的发生率。结果 观察组在体位摆放时间(5.25±1.15)、手术野暴露程度上(94.33±4.17)和甲状腺体位综合征发生率均优于对照组,差异具有统计学意义(P<0.05)。结论 新型一体化甲状腺手术体位垫显著缩短了体位摆放的时间,同时更好的暴露手术野,减轻了患者术后甲状腺体位综合征的发生率,具有临床使用价值。     

Perineal Pad Test in Evaluating Outcome of Treatments for Female Incontinence: A Systematic Review

Our objective was to systematically review clinical studies of incontinence treatments for women that used pad tests to assess outcome, to determine how closely the ICS guidelines had been followed. Our review (Medline 1988–2000, plus referenced studies) identified 75 relevant papers, carrying out pad tests in clinics (n= 53) or patients’ homes (n= 28). Clinic pad tests lasted between 60 seconds and 2 hours, with inconsistent starting bladder volumes, activities carried out, other test details and presentation of results. Home pad tests lasted between 1.5 and 48 hours: the conduct and reporting of these tests were also variable. Only 25 studies used pad tests that were apparently consistent with ICS guidelines. Pad tests are important in identifying urine loss in clinical evaluations; however, we found wide variations in their conduct and reporting. We recommend that the ICS should review the guidelines, and that further research should develop clinically valid pad tests. Authors and journal editors should ensure that pad test details are fully reported.     

单一电铃电路条件性行为疗法在建立儿童自主排尿反射中的作用研究

本工作在于探讨单一电铃电路条件性训练在建立儿童自主排尿反射中的治疗作用。采用新型研制的电铃电路床单，将电铃声刺激与膀胱充盈刺激有效的吻合起来，夜间训练遗尿患儿清醒后自主排尿。对年龄５～１０岁，经多项检查诊断确定为功能性遗尿的患儿（男１８名，女４名）２２人施行条件性行为训练方法。临睡的铺平电铃电路床单、患儿遗尿初期浸湿床单，引起铃响（患儿不惊醒时由母亲唤醒），患儿起床自主排尿。采用阳性强化法对患儿自主排尿进行巩固，给予原发以及继发性奖赏。结果：单一电铃电路条件性训练平均１２个有效治疗日后，９４．９７％（１８／１９）患儿遗尿症状消失，其中效果最佳者仅用了３个有效治疗日，最后长的达３０个有效治疗日，２人因故中断治疗，１人治疗无效。可见，单一行为方法是一条治疗儿童功能性遗尿的有效措施。     

Plasma ACTH-response to the corticotropin releasing factor in patients with Cushing's disease. Comparison with the lysine-vasopressin test

In three female patients with Cushing's disease, 100 micrograms of synthetic ovine corticotropin releasing factor (CRF) were administered before surgery and 1 week after transsphenoidal microadenomectomy. In these patients a test with lysine-vasopressin (LVP), 10 U intramuscularly, was also performed before and after pituitary surgery. Before surgery, both stimuli induced a clear increase in plasma ACTH and cortisol in all patients; the response of ACTH to CRF was of greater magnitude. Postoperatively, the responses were virtually absent in two patients, but were still present in the third one in whom the removal of adenoma had been partially unsuccessful. The CRF test was also performed in a female patient with Cushing's syndrome due to adrenal adenoma; in this patient no responses of plasma ACTH and cortisol to CRF were recorded. This paper demonstrates that pituitary microadenomas causing Cushing's disease may retain the ability to respond to CRF; this stimulus may be useful in the differential diagnosis between ACTH-dependent and independent Cushing's syndrome; the lack of response after microadenomectomy indicates successful removal of the tumor. CRF is more potent than LVP in releasing ACTH at the doses employed.