低能耗喷雾干燥塔用于氨苄青霉素钠生产

我厂采用15升/时低能耗无菌喷雾干燥机组将氨苄青霉素钠盐水溶液喷雾干燥成干粉,1983年正式投入生产。该机组的无菌热空气系统是采用鼓风机送风——高效空气过滤器的流程代替了压缩机供气——棉花活性炭过滤的流程,其动力消耗大大降低,仅为后者的1/4～1/8.66(风量以 1200米~3/时计)。该机组与本厂所使用的LGJ型医用冷     

重组减毒沙门菌粘膜免疫的研究进展

文章介绍以减毒沙门菌为载体进行粘膜免疫的机制 ,讨论沙门菌的不同减毒类型 ,所用的启动子 ,可呈递的抗原 ,免疫的途径以及免疫效果的检测和存在的问题     

Massive lipoma of the scrotum

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译者评论:过犹不及

丹麦医生调查了 2 2 84例 40～ 6 0岁妇女的下尿路症状 (ＬＵＴＳ) ,随访 1年。患病率 2 8.5 % ,发病率 10 % ,缓解率 2 8%。说明中年妇女有下尿路症状者很常见 ,有的症状时轻时重 ,相当数量可自行缓解。提出了目前存在过度治疗的问题。在泌尿外科、内科、妇科都可遇到因下尿路症状就医的病人。下尿路症状含义很广 ,有尿频、尿急、尿痛的膀胱刺激症状 ,也可有排尿不畅、尿后滴沥、排尿踌躇等 ,有的存在尿失禁。近年 ,在泌尿外科把良性前列腺增生的病状也归入下尿路症状。在临床上 ,经常可以见到两种类型的下尿路症状病人。一种是确实存在器…     

头颈癌研究现状与展望

１临床病理学特征［１，２］最近对美国国家癌症数据库（ＮＣＤＢ）中头颈癌资料进行的分析，显示了近１０年来美国头颈癌的构成情况、临床病理特征、治疗及结局。这些资料对于进一步研究头颈癌的病因、发病、诊断和治疗，具有重要的参考价值。１９８５～１９９５年，登记的头颈癌病例共２９５０２２例，在ＮＣＤＢ病例中占６．６％。为了进行比较，分为早期（１９８５～１９８９）和近期（１９９０～１９９４）两个时段。早期病例１１８２９２例，近期病例１７６７３０例。年龄、性别分布基本稳定，高发年龄为６０～６９岁（２７％），男女…     

CT和鼻咽纤维镜对正常发音者腭咽闭合功能检测的比较

目的　比较 CT和鼻咽纤维镜两种方法对正常发音者腭咽闭合功能的检测。方法　应用 CT和鼻咽纤维镜分别对 10例正常发音者的腭咽闭合类型和腭咽闭合不全比率进行检测并比较。结果　用这两种方法检测所观察到的腭咽闭合类型分布完全一致 ;对用这两种方法分别测得的腭咽闭合不全比率进行配对比较 t检验 ,结果 P>0 .0 5。结论　说明应用 CT和鼻咽纤维镜这两种方法对腭咽闭合功能检测的结果是一致的     

秋季谨防干燥综合症

秋天由于特殊的气候环境,人们会出现鼻燥、唇干、咽痛等秋燥的症状。如果总是眼干难受、口干发燥,则要当心干燥综合症,这是一种常见的自身免疫性疾病,必须由医生确诊后予以治疗。     

右美托咪定联合乌司他丁对大鼠呼吸机相关性肺损伤的保护作用及机制

目的探讨右美托咪定联合乌司他丁对大鼠呼吸机相关性肺损伤的保护作用及机制。方法将40只SD大鼠随机分为生理盐水组、乌司他丁组、右美托咪定组、右美托咪定+乌司他丁组。每组大鼠在大潮气量机械通气开始即刻给予相应干预,通气240min后对各组大鼠进行血气分析[检测p(O_2)、p(CO_2)、实际HCO_3~-、血乳酸及p H值],检测血清和肺泡灌洗液中白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、超氧化物歧化酶(SOD)及磷酸化的核转录因子-κB(p-NF-κB)水平,取肺组织计算肺组织湿干比,HE染色观察肺组织病理学变化并评分,蛋白免疫印迹法检测肺组织中SOD及NF-κB表达情况。结果右美托咪定+乌司他丁组肺组织湿干比、病理评分、p(CO_2)、血乳酸水平和血清及支气管肺泡灌洗液(BALF)中IL-1β、TNF-α、p-NF-κB水平均明显低于其他组(P均0.05),p(O_2)、实际HCO_3~-、p H值和血清及BALF中SOD水平均明显高于其他组(P均0.05),4组间肺组织湿干比比较差异均有统计学意义(P均0.05);乌司他丁组和右美托咪定组病理评分、p(CO_2)、血乳酸水平和血清及BALF中IL-1β、TNF-α、p-NF-κB水平均明显低于生理盐水组(P均0.05),p(O_2)、实际HCO_3~-、p H值和血清及BALF中SOD水平均明显高于生理盐水组(P均0.05),但2组间各指标比较差异均无统计学意义(P均0.05)。右美托咪定+乌司他丁组SOD蛋白表达灰度值最高,其次为乌司他丁组、右美托咪定组及生理盐水组,而右美托咪定+乌司他丁组NF-κB蛋白表达灰度值最低,其次为右美托咪定组、乌司他丁组及生理盐水组。结论右美托咪定联合乌司他丁能增强机体抗氧化及抑制炎症反应的能力,对大鼠VILI起到较好的保护作用。     

盆底重建术后早期低频电刺激预防尿潴留的效果分析

目的探讨盆底重建术后早期低频电刺激对术后尿潴留的疗效和安全性。方法采用单中心前瞻随机对照研究方法,自2018年8月至2019年1月在北京大学人民医院妇科病房因盆腔器官脱垂接受盆底重建手术的患者,按照入排标准纳入病例,将患者随机分为干预组(36例)和对照组(28例)。干预组术后第1～5天给予膀胱区及骶3区的低频电刺激治疗,一日2次,共10次,对照组仅做常规护理,所有患者均在术后第3天拔除尿管,比较两组患者术后第3天、第7天尿潴留、残余尿量及尿流率情况。结果干预组术后第3天的最大尿流率大于对照组[16.00 ml/s(12.00～21.00 ml/s)vs 12.00 ml/s(7.00～19.00 ml/s)],术后第7天最大尿流率(ml/s)大于对照组[17.00 ml/s(11.35～25.82 ml/s)vs 13.40 ml/s(8.50～19.00 ml/s)],两组比较,差异均有统计学意义(P 0.05)。两组患者术后第3天、第7天的平均尿流率比较,差异有统计学意义(P 0.05),但两组排尿时间及达峰时间比较,差异均无统计学意义(P 0.05)。干预组术后第7天尿潴留率(2.78%,1/36)明显低于对照组(28.57%,8/28)两组均无并发症发生。结论低频电刺激能够提高盆底重建术后患者的尿流率,降低尿潴留的发生率。     

妊娠期血小板减少程度对母儿结局的影响

目的 比较妊娠期不同程度血小板减少对母儿结局的影响.方法 回顾性分析2000年1月1日至2010年1月31日本院收治的妊娠期血小板减少病例305例,病因学诊断分别为妊娠期血小板减少症、特发性血小板减少性紫癜及部分病因不明者.根据孕期最低血小板计数分成4组:I组:(50～100) ×109/L;Ⅱ组:(30～50)×109/L;Ⅳ组:(10～30)×109/L;Ⅳ组:＜10×109/L.Ⅰ～Ⅳ组病例数依次为101、85、87和32例.比较各组患者孕期并发症、治疗、新生儿结局和随访情况.应用SPSS 17.0统计软件进行数据处理,采用方差分析、Spearman等级相关分析、卡方检验、趋势卡方分析.结果 305例孕妇并发贫血68例(22.30%),早产40例(13.11%),产后出血60例(19.67%),患病率均随血小板减少程度加重而升高(P均＜0.05),产后24 h内出血量随血小板减少程度加重而增多.孕期并发妊娠期高血压疾病35例(11.48%),糖代谢异常23例(7.54%),各组患病率差异均无统计学意义.产褥感染2例(0.66%),无孕产妇死亡.305例产妇随访血小板恢复者共211例(69.18%),产后半年内母体血小板恢复正常率Ⅰ～Ⅳ组依次为90.59%(77/85)、82.36%(42/51)、46.16%(24/52)和39.13%(9/23),随孕期血小板减少程度加重而恢复率下降(x2趋势=42.616,P趋势=0.000).活产儿301例,胎死宫内5例,早期新生儿死亡4例,新生儿血小板减少18例(5.98%),颅内出血1例.随母体血小板减少程度加重,新生儿血小板减少患病率增高(x2趋势=17.806,P趋势=0.000);16例新生儿血小板减少在出生后3～8周恢复正常,2例随访3年未恢复.结论 随着血小板减少程度加重,母体贫血、早产、产后出血及新生儿血小板减少的患病风险均有增加.严密的围产期保健可改善不同程度血小板减少患者的母儿结局.

Abstract：

Objective To investigate the perinatal outcomes of pregnancies complicated with varying degrees of thrombocytopenia.Methods Clinical data of 305 pregnant women with thrombocytopenia,who admitted to Peking University People's Hospital from January 1,2000 to January 31,2010 were retrospectively analyzed.The etiological diagnosis of them were gestational thrombocytopenia (GT),idiopathic thrombocytopenic purpura (ITP) or undetermined.The patients were divided into 4 groups according to the minimal level of platelets in pregnancy ( platelets count was lower than 100 ×109/L at least twice) : groupⅠ,(50-100) ×109/L (n=101) ; group Ⅱ,(30-50) × 109/L (n = 85); group Ⅲ,(10-30) × 109/L (n = 87); group Ⅳ,< 10 × 109/L (n = 32).Demographic data such as pregnancy complications,treatment,neonates and follow-up results of the patients in each group were compared with ANOVA,Spearman rank correlation analysis,Chirsquare test and Chi-square trend test in SPSS 17.0.Results Medical complications in pregnancy of these patients included hypertensive disorder complicating (n = 35,11.48%) and abnormal glucose metabolism (n=23,7.54%),no difference was found in the incidence of these diseases among the four groups.There were 68 patients complicated with anemia (22.30%),40 preterm delivery (13.11%),60 postpartum hemorrhage (19.67%); there were significant differences in the incidence among the four groups (P＜0.05),the incidence increased with the aggravation of thrombocytopenia (P＜0.05).There were 2 cases of puerperal infection (0.66%),no maternal deaths.Fifty-one patients (16.72%) accepted treatment of corticosteroids or Gamma globulin during pregnancy.There were 116 cases (38.03%) of vaginal delivery and 189 cases (61.97%) of cesarean section.The postpartum bleeding amount within 24 hours increased with the aggravation of thrombocytopenia.Two hundred and eleven (69.18%) patients were followed up and platelet count regained normal,among which 152 cases recovered within six months after delivery.The recovery rates were 90.59% (77/85),82.36% (42/51),46.16% (24/52) and 39.13% (9/23) from group Ⅰ to group Ⅳ,as declined with the aggravation of thrombocytopenia in pregnancy ( x2trend = 42.616,Ptrend =0.000).Among the 306 perinatal fetuses,neonatal outcomes included 301 live births,5 fetal deaths,4 early neonatal deaths,4 low birth-weight infants after term birth,1 intracranial hemorrhage and 18 (5.98%) neonatal thrombocytopenia cases.Incidence of neonatal thrombocytopenia increased with the aggravation of maternal thrombocytopenia.Sixteen cases of neonatal thrombocytopenia recovered at 3-8 weeks after birth,but two cases did not recover within three years during followed up.Conclusions The perinatal outcomes are different in pregnancies complicated with varying degrees of thrombocytopenia.As thrombocytopenia in pregnancy become worse,the risk of anemia,premature delivery,postpartum hemorrhage and neonatal thrombocytopenia increases.While,perinatal outcomes may be better under close perinatal care.