肠套叠患儿行腹腔镜下空气灌肠整复术的护理

对13例难复性肠套叠患儿行腹腔镜下空气灌肠整复术.结果11例整复成功,2例改行肠切除吻合术.提出术前做好准备及心理护理;术后做好体位护理及病情观察,加强饮食、皮肤、引流管等护理和康复指导是手术成功的重要保证.     

Anatomic and spiral computed tomographic study of the genial tubercles for genioglossus advancement.

OBJECTIVE: To measure and compare Chinese mandibular genial tubercles measured anatomically and with computed tomography (CT). STUDY DESIGN AND SETTING: Spiral CT scans were taken of 40 adult human skulls; the superior genial spines were measured using anatomic and CT methods. RESULTS: The height and width of the superior genial spines, mandible thickness, and distance from the menton to the inferior and superior margins of the superior genial spines were 5.82 +/- 0.71, 6.98 +/- 1.35, 11.95 +/- 1.59, 11.08 +/- 2.05, and 16.91 +/- 2.30 mm from anatomic measurements and 6.17 +/- 0.71, 7.01 +/- 1.13, 12.19 +/- 1.64, 10.41 +/- 1.55, and 15.73 +/- 2.12 mm using spiral CT, respectively. The anatomic and CT measurements were correlated. CONCLUSION: Spiral CT of the genial tubercles can help locate the osteotomy in genioglossus advancement. SIGNIFICANCE: This study acquired reference data on Chinese genial tubercles demonstrating that CT measurements of the genial tubercles reflect their anatomy, which should allow accurately locate the osteotomy.     

Pregnancy: Oral misoprostol versus placebo for cervical dilatation before vacuum aspiration in first trimester pregnancy

Intravaginal misoprostol has been shown to be effective forcervical priming before a surgically induced abortion. The objectivewas to investigate the effectiveness of oral misoprostol incervical dilatation prior to vacuum aspiration between the 6thand 12th weeks of pregnancy. The results showed that in nulliparouspatients, the median cervical dilatation in the treatment group(7.8 mm) was significantly greater than that in the placebogroup (3.7 mm). In multiparous patients, the difference wasalso statistically significant (9.8 versus 6.0 mm). The easeof dilatation, assessed subjectively by the operating surgeons,was significantly improved in the treatment group. There wasalso a significant reduction in the duration of the operationand in the mean blood loss in the treatment group. The side-effectsencountered in the treatment group were mild and well acceptedby the women. Oral misoprostol is an effective and safe methodfor cervical dilatation prior to vacuum aspiration in firsttrimester pregnancy.     

千捶膏配合生肌玉红膏治疗感染性伤面的临床观察

我院多年来应用千捶膏和生肌玉红膏治疗感染性伤面。千捶膏用于去腐,生肌玉红膏用于生新。据我们观察二药有较强的抗感染作用,尤其有抗绿脓感染作用。应用千捶膏可以较快地达到脱腐作用,应用生肌玉红膏可以促进肉芽增生,达到伤面早期愈合,值得推广。     

上腹部不对称联体双胎一例

患儿男,4 d.因联体畸形于2008年3月17日入院.体检:体重共3 kg.正常侧婴儿无明显外部畸形,其胸骨柄的下方剑突部至脐的上方有一畸形体与之相连(图1).畸形体(寄生体)仅有四肢、腹部、臀部、男性外生殖器,有尿从阴茎自主排出.寄生体与正常侧婴儿相连接处,长12.0 cm,宽5.5 cm,周长30.0 cm,连接处两腹腔相通.寄生体四肢无自主运动,对刺激无反应,能做被动关节运动.     

白松片对慢性应激抑郁模型大鼠行为学及血浆CORT、ACTH的影响

目的：观察白松片对慢性应激抑郁大鼠模型行为学和血浆CORT、ACTH含量的影响。方法：SD雄性大鼠28只随机分为空白对照组、模型对照组、氟西汀对照组及白松片试验组，选用慢性轻度不可预见性应激加孤养造模，观察各组大鼠敞箱实验和液体消耗等行为学指标变化，采用放射免疫方法检测大鼠血浆皮质醇(CORT)和促肾上腺皮质激素(ACTH)含量。结果：慢性应激抑郁大鼠体重增加缓慢，敞箱实验中的水平运动、垂直运动得分、清洁动作次数显著减少，中央格停留时间显著延长；糖水消耗明显下降，纯水消耗显著增多，而且其血浆皮质醇和促肾上腺皮质激素含量增加。氟西汀和白松片均显著改善慢性应激抑郁大鼠模型的行为学和神经内分泌变化。结论：慢性轻度不可预见性应激可使大鼠行为及神经内分泌发生异常改变，引起抑郁状态，白松片对此具有一定拮抗作用。     

寰枕关节完全骨化2例伴先天脊柱裂1例

笔者在整理100余套散骨标本时,发现有两例寰枕关节完全骨化、愈合,其中1例伴有先天性脊柱裂,此类标本实属罕见,现将观察和测量结果报告如下:     

掌指关节的三维解剖及形态分析

目的：观测掌指关节关节面的几何形态,为人工关节的设计和应用提供解剖学依据。方法：10只成人手标本,解剖掌指关节,测量侧副韧带起点距掌骨头关节面的直线距离,三维数据检测仪获得关节面三维坐标数据,应用SPSS软件进行统计分析和成像。结果：掌骨头有双髁结构,桡侧髁略大,第1掌骨头形态特殊;各掌骨头高度的比较无显著差异;其掌侧关节面大于背侧,第2、3掌骨头关节面面积明显较大。近节指骨底在形态、高度和面积方面各序列相似;各序列侧副韧带起点桡侧较尺侧距离掌骨头关节面远。结论：手指人工关节的设计应符合解剖形态,并根据各序列形态的差异进行个体化设计,尤其拇指更应区别对待;手指人工关节的设计和应用中应注意软组织保护,关节的切除范围应注意保留侧副韧带的起止点。     

Preparation of Aminated Macroporous Polyvinyl Alcohol Resins and Evaluation for Bilirubin Adsorption

In the present study we prepared macroporous polyvinyl alcohol beads. A series of bilirubin adsorbents were generated by immobilization of eight amine agents to the beads as ligands. The adsorption of bilirubin was evaluated by in vitro static and dynamic adsorption tests. The results show that these adsorbents have excellent adsorption efficiency and capacity. Among the eight ligands, trimethylamine (TMA), triethylamine (TEA) and 1,6- hexanediamine(HDA) showed the highest adsorption capacity. The adsorption equilibrium can be achieved in half an hour, and the adsorption percentage of bilirubin was up to 80%. Static electricity and hydrophobic interaction played the main role in bilirubin adsorption, and the adsorption was found to match the monolayer model. The excellent adsorption of these adsorbents indicates their potential in clinical treatment.     

Partial characterization of a non-proteinaceous, low molecular weight antigen of Eimeria tenella

A low molecular weight (LMW) antigen of Eimeria tenella, initially identified using a murine monoclonal antibody (mAb C₃4F₁) raised against E. tenella sporozoites, was partially characterized using enzymatic degradation, solvent extraction, and immunization into various inbred lines of mice. The LMW antigen could be isolated using Folch extraction (methanol/chloroform/water) and the epitope recognized by mAb C₃4F₁ was resistant to degradation by α-amylase, pronase, and proteinase K, but was sensitive to sodium m-periodate treatment or digestion using mixed glycosidases (from Turbo cornutus). These observations suggest that the antigenic epitope recognized by mAb C₃4F₁ is carbohydrate-dependent and, based on our ability to isolate the LMW antigen by Folch extraction, the epitope probably resides on a polar glycolipid. The inability of sporozoite-immunized nude mice to elicit a serum antibody response to this molecule indicates that it acts as a T-dependent antigen. Furthermore, sporozoite-immunized male CBA/N mice (with an X-linked immunodeficiency) also failed to elicit a serum antibody response to this molecule, which is consistent with a carbohydrate antigenic epitope. We propose that this antigenic molecule be designated ET-GL1 to reflect its origin and probable structure (E. tenella glycolipid 1). Received: 30 June 1999 / Accepted: 2 December 1999