喉癌术后迟发性感染32例报告

目的：探讨喉癌患者术后出现迟发性感染的原因和治疗方法。方法：患者均为男性，平均58岁；声门上区21例(T1N0M0 5例、T1N1M0 6例、T1N2M0 4例、T2N0M0 2例、T2N0M0 3例、T3N2M0 1例)，声门区10例(T2N0M0 3例、T3N0M04例、T3N1M0 3例)，外院全喉切除术后1例(TNM分期不详)；喉重建术31例，术后18例(56．25％)患者接受放疗。迟发性感染发生在术后1～10个月，平均术后5．6个月；1～3个月13例，4～6个月16例，7～10个月3例，合并颌下隙感染2例。静脉应用广谱抗生素同时切开排脓或行局部扩大清创术，32例中23例(72．5％)切口内发现缝合丝线头。结果：10例10d左右完全愈合，22例愈合时间为15d～0，5年，平均2个月。随访2月～8年，失访5例，20例患者存活，9例患者拔管保留喉功能，死亡7例。结论：迟发性感染的主要原因是颈部切口留有缝线、细菌感染、手术局部血运差、放射治疗等。     

SPM5软件分析癫痫患者脑PET图像的应用研究

Objective To investigate the value of statistical parametric mapping 5 (SPM5) and its parameter settings in analysis of PET imaging for epilepsy patients. Methods Seventeen epilepsy patients and seventeen controls were scanned with PET. The datns were analyzed using PET and SPM5 with qualitative and semiquantitative analysis, statistical analysis of the percentage (numbers of agent distribution decreasing in focus to brain) for different parameters combinations, which were value adjustment to contral-p and voxels-k. Results There was decreasing of agent distribution at temporal lobe in epilepsy patients detecting with PET; the T/NT of focus to cerebellum was 1.07±0.24, the T/NT of normal tissue in opposite side to cerebellum was 1.27±0.18, there was a significant difference (t=1.87, P<0.05). Dealing with SPM5, there was more significant decreasing of agent in regions 19, 21, 39 of temporal lobe, regions 7, 19, 31, 40, 47 of parietal lobe and occipital lobe in epilepsy patients. With different value of k, the percentage was (27±22)%, (29±24)%, (32±23)%, (35±27)%, (39±31)%respectively, there was not significant difference (F=0.59, P>0.05) ; for different value of p, the percentage was (42±30) %, (29±25) %, (26±21) % respectively, with a significant difference (F=3.60, P<0.05); there was linear regression in value adjustment to contral-p and the percentage(b=-18.24, t=2.57, P<0.05). Conclusions Semiquantitative analysis by SPM5, the setting of value adjustment to contral-p would affect the results, the smaller of value adjustment to contral-p, the better of the result. SPM5 would be more objective and accurate to locate the focuses.     

颈椎脱位的闭合复位

1985年5月～1996年3月,我们经治34例单纯颈椎脱位患者,30例行Crutchfield颅骨牵引闭合复位,20例成功,占66.6％。在成功组中,牵引重量最大为18kg,无一例出现神经损害加重。不全瘫均有不同程度恢复。尸体头颅标本测定,Crutchfield颅骨牵引承受的最大抗拨出力为60.3kg,在治疗颈椎脱位时,颅骨牵引是安全有效的闭合复位方法。     

Fluid shear induced endothelial cell detachment from glass - influence of adhesion time and shear stress

In this study, human umbilical vein and human saphenous vein endothelial cells were seeded on glass and exposed to fluid shear in a parallel-plate flow chamber. Cell retention, morphology and migration were studied as a function of shear stress and of adhesion time prior to exposure to shear. Three-hour and 24-h adhesion times gave rise to comparable cell retention values after 2 h of flow for both cell types. Cell retention decreased from 85 to 20% as shear stress increased from 88 to 264 dynes cm⁻² (8.8 to 26 Pa). Mean spreading areas decreased after the onset of flow, but subsequently stabilized to plateau values, which were smaller at higher shear stresses. Shape factors increased faster to higher values as cells were exposed to higher shear stresses, without any obvious preference in orientation of the cells with respect to the direction of flow. Migration was unidirectional with flow and linear with time. Migration was faster for cells which had adhered for 24 h than for cells which had adhered for 3 h and was accompanied by the presence of fibrillar structures left behind on the surface upstream of migrating cells. It is concluded that after 3 h adhesion to glass, cells have adhered with an adhesion strength that does not substantially increase during the next 21 h. However, during this time changes in cell-substratum interactions seem to occur judging by the differences in, e.g., migration rates.     

佛山市城区室内装修污染特征初探

目的 为了解佛山市室内装修空气污染状况，通过对佛山市室内装修污染物进行调查，掌握室内装修污染的一些基本特征并提出控制措施。方法 根据卫生部《室内空气质量卫生规范》以及《室内空气污染物的检验方法》方案，调查采用了问卷调查和现场检测的方法。结果 佛山市室内装修空气污染物主要为甲醛，苯，总挥发性有机物(TVOC)，超标率分别为86％，36％，23％。结论 目前佛山市城区室内装修污染物的特征为：有机污染较无机污染严重，室内甲醛污染严重，苯次之而氢污染相对较轻，室内空气苯污染车辆、居室高于办公室，甲醛污染居室，办公室高于车辆。     

Textual study on traditional Chinese drugs caodoukou and baidoukou]

Through a critical study of herbalogy, it is concluded that the mature seeds of Alpinia zermubet were used as caodoukou in ancient times. The original plant of Yutao recorded in Zhiwu Mingshi Tukao may be the species of Alpinia katsumadai. Baidukou used in ancient times may be the seeds of Alpinia katsumadai found in the south of China, or Amomum compactum and Am. kravanh imported from foreign countries.     

控制性降压在临床麻醉中的应用进展

控制性低血压是指在某些手术麻醉期间，用药物等方法降低血压，以达到减少手术野出血，便于手术操作的一种方法，通常采用血管扩张剂，钙通道阻断剂及麻醉来控制血压，现就这一领域的研究进展作一综述。     

关于Reed－Frost模型的研究和改进

笔者提出了对Ｒｅｅｄ－Ｆｒｏｓｔ模型的学术评论，并新建了一种Ｒｅｅｄ－Ｆｒｏｓｔ模型的改进模型。该改进模型全面考虑了隐性感染者的产生、传染作用及向免疫者的转化。应用这个模型，模拟了ＮｅｗＥｎｇｌａｎｄ的麻疹流行和中国上海市某保育院的水痘流行，结果颇为理想。该模型包括了基本的流行要因，故能用以解释流行过程，并可帮助流行病学工作者理解隐性感染在传染病流行过程中的作用。     

26例前置胎盘分娩方式临床分析

[目的 ]探讨前置胎盘分娩方式的选择及分娩过程中减少出血的方法。 [方法 ]对 2 6例前置胎盘病例的发病率、诊断方法、胎盘分型、分娩方式、出血情况及剖宫产术子宫切口方式与出血的关系几个方面进行回顾性分析。[结果 ]2 6例中手术率为 96 .1 5 % ,阴道分娩率为 3.85 % ,1例阴道分娩出血量为 6 0 0mL ,剖宫产术平均出血量为 6 74 .5 5mL ;剖宫产术中切口方式选择推开胎盘与避开胎盘出血量比较 ,差异无显著性 (P >0 .0 5 ) ,切开胎盘与推开胎盘出血量比较及切开胎盘与避开胎盘的出血量比较 ,差异均有显著性 (P均 <0 .0 1 )。[结论 ]剖宫产术可成为前置胎盘终止妊娠的主要方法 ,同时原则上应避开胎盘选择切口     

肝硬化病人施行胆道手术35例分析

本文对我院近10年来收治的肝硬化病人施行胆道手术35例进行分析，术前漏诊肝硬化12例，占3O％以上，死亡5例，有3例死于胆囊床大出血与术前漏诊有关。作者就术前漏诊原因、术前准备和手术处理体会进行讨论。