Colorectal neoplasms: accuracy of US in demonstrating the depth of invasion

Six normal and 16 neoplastic colorectal specimens were examined with 8.5-MHz ultrasound (US). An articulated system facilitated precise spatial correlation between US and histologic sections. Images were blindly interpreted and then compared with histologic results. All six normal specimen showed five distinct echo layers and were distinguished from neoplastic specimens by all the observers. The central echogenic layer, corresponding to the submucosa, is useful in determining the depth of origin of a neoplasm and the presence of submucosal invasion. US had an accuracy of 92.5% in demonstrating invasion of the submucosa and 77% for invasion of the muscularis externa. For mucosal neoplasms with invasion through the muscularis externa and extension into the subserosal tissues, nearly 90% of US interpretations were correct. High-frequency US may be useful in determining the depth of invasion of mucosal tumors with respect to the submucosa and in differentiating mucosal from extramural masses.     

造血干细胞移植研究进展

造血干细胞移植(hematopoietic stem cell transplantation,HSCT)是通过化学药物及放射治疗清除患者的骨髓,再将健康供者的造血干细胞植入患者体内,建立新的造血系统及免疫系统,从而达到治愈血液系统恶性肿瘤及骨髓衰竭的目的.自从1981年我国开始第一例异基因造血干细胞移植(allo-HSCT)以来,经过20余年的努力,HSCT技术已取得很大进步,根据北京市道培医院移植中心统计结果,白血病标危组同胞人类组织相容性抗原(HLA)配型相合组5年生存率为80%,HLA半相合(单倍体)及非血缘造血干细胞移植组5年生存率为70%-75%,白血病高危组长期生存率为35%-40%.     

住院患者对护理职业的认知调查

目的 了解住院患者对护理职业的认知状况,增强护士职业自豪感.方法 自行设计住院患者对护理职业认知调查问卷,对197例住院患者进行调查.结果 认为护理工作包括发药打针、健康指导和心理护理的患者占49.24%;认为护士在治疗康复中所起的作用重要和非常重要者占85.28%、一般和不重要占14.72%;认为护士学历应为大专及以上学历的患者占87.82%,中专占12.18%;认为医生和护士是平等关系的患者占76.65%、从属关系占18.78%;认为护理职业发展前途好和很好的患者占79.19%.不好和很差占5.58%.不同性别、年龄、文化程度住院患者对护理职业的评价比较,差异无统计学意义(均P>0.05);有选择护理职业意愿者56.85%.不愿意选择43.15%;112例住院患者愿意选择护理职业的主要原因是受人尊敬(66.96%)和工作稳定(29.46%).结论 住院患者正在逐步正视护理职业.护理工作者应提高职业自豪感,热爱护理工作,全心全意为人类的健康服务,为护理事业的发展做出贡献,以赢得应有的社会地位.     

复方甘草酸苷注射液联合钙剂及维生素C治疗慢性荨麻疹45例疗效观察

目的评价复方甘草酸苷注射液(美能)治疗慢性荨麻疹的疗效和安全性。方法对照组40例,5%葡萄糖注射液(或生理盐水)150ml加入10%葡萄糖酸钙注射液10ml及维生素C注射液2.0g静滴;治疗组45例,在对照组基础上加用复方甘草酸苷注射液20~60ml静滴,两组均1次/d,疗程6周。结果复方甘草酸苷治疗组有效率88.89%,平均起效时间2.1周,明显优于对照组60.00%和4.2周,两组有效率相比差异有显著性(P<0.05)。结论复方甘草酸苷注射液治疗慢性荨麻疹起效时间短,疗效较好。     

数字化手术室的开发和建设

数字化手术室属于信息技术与医学技术的交叉点。从目前的应用环境来看。将实时数据监测与查询和远程医学影像技术相结合，应用到手术室环境中，具有重要意义。数字化手术室的开发和建设，是利用先进的远程会议技术和图像处理技术，集成了HIS和PACS信息，提高了医院临床教学水平，同时提高了医生手术效率和安全性。     

Bradyarrhythmias and Laparoscopy: A Prospective Study of Heart Rate Changes with Laparoscopy

Cardiac arrhythmias are a common complication of laparoscopy. Brady-arrhythmias (including asystole) may be life-threatening. The recent introduction of new shorter-acting muscle relaxants (atracurium and vecuronium), with their lack of vagolytic activity, may exacerbate this situation. At the Royal Women's Hospital there have been several episodes of severe bradyarrhythmias and/or asystole associated with these relaxants. This study evaluated heart rate changes in 49 women during laparoscopy: 47% of patients had arrhythmias, 30% of these being bradyarrhythmias. Nearly all the episodes occurred during carbon dioxide insufflation or with traction on pelvic structures. The life-threatening nature of this phenomenon should be understood by all anaesthetists and gynaecologists engaged in laparoscopic procedures.