尺神经腕背支营养血管逆行皮瓣的临床应用

目的探讨应用尺神经腕背支营养血管逆行皮瓣修复小指皮肤缺损的临床效果及手术操作要点。方法以尺神经腕背支营养血管远端为蒂,选择小指尺侧分支为皮瓣轴心血管,将皮瓣向小指远端转移,修复小指掌背侧皮肤缺损8例。结果8例全部成活,其中1例因创面止血不彻底,皮瓣受压导致远端部分坏死,经换药后痊愈。结论尺神经腕背支走向较恒定,本组未发现变异。沿皮神经干有纵行的皮神经旁血管网及皮神经干内血管网,此皮瓣血供可靠的,皮瓣切取容易,对供区影响小,是修复小指皮肤缺损的理想方法。     

直肠癌根治会阴部造口术后二期股薄肌移植肛门成形

目的　回顾性总结32例直肠癌根治会阴部造口术后二期股薄肌移植肛门成形术的治疗效果。方法　采用Williams 5级评分法对重建前后肛门功能进行评价。结果　二期股薄肌移植肛门成形术前,32例患者肛门功能均在4级以上[4级28.4%(9/32),5级71.6%(23/32)],二期股薄肌移植肛门成形术后肛门功能明显好转。结论　二期股薄肌移植肛门成形术是直肠癌根治会阴部造口术后有效的肛门重建手段。     

腹腔镜胆囊切除术严重并发症10例分析

目的对腹腔镜胆囊切除术发生严重并发症的常见原因进行分析. 方法回顾分析986例腹腔镜胆囊切除术中出现的10例严重并发症的诊治经过. 结果因钛夹松脱致胆漏2例,膈下脓肿1例,胆总管损伤3例,胆总管残余结石2例,十二指肠损伤1例,气腹针穿刺致空肠穿孔1例.经治疗未出现严重后果. 结论导致腹腔镜胆囊切除并发症的原因为局部粘连、炎性水肿严重,脐孔周围严重的腹腔粘连,胆囊解剖的变异,术者经验欠丰富、操作欠熟练.     

Exogenous advanced glycosylation end products induce diabetes-like vascular dysfunction in normal rats: a factor in diabetic retinopathy

BACKGROUND. Diabetic retinopathy has been shown to be directly associated with the degree and duration of hyperglycemia, and advanced glycosylation end products (AGEs) have been implicated in this pathological process. The purpose of the experiments reported here was to study the effect of AGE deposition on retinal vascular damage which leads to diabetic retinopathy. METHODS. Intravenous injection of exogenous AGEs was used to treat wild-type non-diabetic Sprague-Dawley rats. One of the two retinal slides from each animal was treated using immunohistochemical staining to label retinal vascular AGE deposition, the other H&E staining for counting of capillary pericytes. The results were compared with the findings in untreated wild-type and diabetic controls and in rats treated with unmodified rat serum albumin (RSA). RESULTS. After 2 weeks of continuous treatment, AGEs were identified in the retinal vascular tissue of the AGE-RSA-injected group. The average number of retinal capillary pericytes per 10x100 microscope power field was 4.313+/-0.34 (mean +/- SD) in the AGE-RSA-injected group, compared with 5.798+/-0.481 in the control group ( P<0.01). CONCLUSION. These experiments demonstrate that AGEs, independent of other metabolic factors, can induce vascular change resembling that of diabetic retinopathy.     

郑健教授治疗小儿哮喘经验

郑健教授对小儿哮喘病的治疗有较深造诣，分别从急性期主要治则治法、缓解期主要治则治法、佐治法、预防发作4个方面介绍了郑健教授治疗小儿哮喘的经验。     

湿热环境下密闭性功能敷料护理伤口对β—内啡肽的影响

OBJECTIVE: To study the changes of plasma beta-endorphin (beta-EP) in pigs with traumatic injury after occlusive wound dressing supplemented with antiphlogistic and analgesic agents in hot and humid environments (HHE). METHODS: Traumatic models were established in 10 pigs, 5 of which received antiphlogistic- and analgesic-supplemented occlusive dressings of the wounds (experiment group, EG), while the rest pigs were assigned to control group (CG) to receive routine wound management. The pigs in both groups were then exposed to artificial HHE and at different time points during the exposure, the plasma beta-EP level, respiratory frequency and heart rates were measured respectively. RESULTS: The plasma beta-EP concentration of EG was significantly lower than that of CG (P <0.01) after the injury, but in both groups, the levels before the injury were similar to those measured at hour 8 during HHE exposure and at hour 24 following the injury. The variation range of the respiratory frequency and heart rates during HHE exposure were significantly smaller in EG than CG (P <0.01). CONCLUSION: This supplemented occlusive wound dressing can help restrain the peak of plasma beta-EP level and the variation range of respiratory frequency and heart rates of pigs exposed to HHE.     

经尿道前列腺电汽化切除加雄激素阻断治疗晚期前列腺癌

目的探讨经尿道前列腺电汽化切除加雄激素阻断治疗晚期前列腺癌的临床疗效。方法对31例前列腺癌晚期(D)患者采用经尿道前列腺电汽化切除及睾丸切除术,术后3~5d口服氟他胺做全雄激素阻断以及氟他胺加达菲林的药物去势治疗。结果随访3~42个月,生存者29例,2例患者生存超过5年,20例超过1年。其中7例骨转移病灶减少,6例骨痛患者治疗后疼痛消失。前列腺特异性抗原(PSA)从术前的75.37μg/L降至1.34μg/L(术后1个月),3个月后降为0.27μg/L。B超、胸片、骨扫描未见新的转移灶。结论经尿道前列腺癌电汽化切除加全雄激素阻断治疗晚期前列腺癌具有较好的临床疗效。     

以专业建设为契机在教学评估中推进学校的建设与发展

自贡卫生学校位于有“盐都、龙乡、灯城”美誉的四川省自贡市。学校创建于1918年，前身系加拿大基督教会创办的仁济义济高级护士职业学校，“大仁求学、大医济人”的校训有其深远的历史渊源。2005年被教育部批准为国家级重点卫生职业学校。护理专业被批准为省级重点专业。学校现有120多个班级，     

黄芪对ESWL致兔肾损伤后缺氧诱导因子-1α表达的影响

目的探讨缺氧诱导因子-1α（HIF-1α）在ESWL致肾脏损伤中的作用及黄芪是否通过调节HIF-1α的表达而发挥对肾脏的保护作用。方法45只家兔随机分为对照组、ESWL损伤组和黄芪治疗组,每组15只,除对照组外,所有动物接受ESWL处理（18kV,1 500次）。黄芪治疗组家兔于冲击前3d至后2d,每天注射黄芪注射液2.0g/kg。2周后处死家兔,取肾脏HE染色观察肾组织形态学改变,免疫组织化学染色观察HIF-1α在肾脏中的表达。结果ESWL处理后肾小管上皮细胞肿胀、脱落,小管内可见大量管型,肾间质大量炎细胞浸润;黄芪治疗组以上病变显著减轻。ESWL损伤组HIF-1α显著表达于肾小管上皮细胞及间质,黄芪能够明显抑制HIF-1α的表达。结论HIF-1α参与了ESWL对肾脏的损伤,黄芪可能通过抑制HIF-1α的表达发挥对肾脏的保护作用。     

Data Bank and Consulting System for Medical Management of Patiens with Acute Radiation Sickness

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