喉大部切除联合双蒂肌皮瓣声门整复术的疗效

目的 探讨喉癌手术的疗效,提高喉癌病人的生存质量。方法 ５３例男性声门型鳞状细胞癌采用垂直前侧位喉大部切除颈前皮瓣和肌筋膜双蒂整复术。术后辅以放疗。结果 ５３例病人术后吞咽及发音功能基本恢复,拔管率９２．５％,３年生存率为８２．５％,５年生存率为７６．８％。结论 对一侧声带癌向前至声带前联合并累及对侧声带前１／３的病人,采用垂直前侧位喉大部切除颈前皮瓣和肌筋膜双蒂整复是一种有效的术式,在切除肿瘤的     

Underreporting of percutaneous exposure accidents in a teaching hospital in Spain

The study's objectives were to determine the frequency of biological-risk accidents involving percutaneous exposure and to identify factors associated with underreporting. Two hundred fifty healthcare professionals from inpatient services at high risk for exposure at the Puerta del Mar University Hospital of Cádiz, Spain, participated in the study. A questionnaire was used to measure personal and work variables, the number of accidents suffered and reported in the last year, and the circumstances motivating the reporting or nonreporting. Two hundred thirty-two persons (92.8%) completed the questionnaire. The accident rate was 12 per 100,000 hours worked. Physicians were the most frequent accident victims (rate 22/100,000 hours). The general surgery and emergency services had higher rates than other services (rates 19.82 and 14.17, respectively). Sixty-six percent of the accidents were not reported to the register. The main predictors of the underreporting were length of professional service greater than 19 years, working in the surgery service, and the perception that the accidents did not involve health risk. The true accident rate was higher than that reflected in the Accident Register. Underreporting was high. The main variables associated with underreporting were length of professional service, work area or department, and perception of risk from the accident.     

单纯性肥胖儿血清Leptin浓度测定及意义

目的了解单纯性肥胖儿童和青少年血清Leptin（LEP）浓度,其与体重指数（BMI）、血脂间的关系。方法用放免法检测30例肥胖儿童和30例健康儿童的血清LEP,并对其与BMI、血脂水平作相关分析。结果肥胖组与健康组比较血清LEP、BMI均显著增高（P＜0.01）,血脂六项指标中有三项（TG、apo-A、apo-B）肥胖组高于对照组（P＜0.01）肥胖组血清LEP浓度与BMI间相关性具显著意义（P＜0.05）,与血脂间（TG、apo-A）也呈现高度显著性相关（P＜0.005,P＜0.05）。＃哈肥胖儿童和青少年的血清LEP浓度增高,与BMI、与血脂部分指标间的正相关,表明脂肪组织分泌LEP与肥胖程度相关,血清LEP可能在血脂代谢活动中起作用。     

刺五加化学药理研究的新进展

近年来从刺五加的根、叶中又分离出数种新皂苷,并对刺五加抗肿瘤、抗疲劳、抗衰老及对心血管、免疫功能方面的药理研究又有新的进展。     

中药2号方抗肝纤维化的形态学和血清学实验研究

用猪血清腹腔注射法复制大鼠免疫性肝纤维化模型,用以清热利湿、补气健脾、养血活血为主要治法的中药２号方进行预防和治疗,用光镜观察肝脏ＨＥ、Ｍａｌｏｒｙ染色的变化,用电镜观察肝脏超微结构的变化,并检测了血清生物化学的变化。结果证明中药２号方有明显的改善肝功能和抗肝纤维化的作用     

Neutropenia with fever

CAUSAL GERMS: Over the last 10 years, hemotology units have seen many changes in the epidemiological pattern of infections in neutropenic patients, with a growing number of infections caused by Gram-positive germs. The number of septicemias due to multiresistant Gram-negative germs (Pseudomonas aeruginosa, Strenotrophomonas maltophilia) has however remained high. IMPACT OF THERAPEUTIC REGIMENS: Improved prognosis in neutropenic patients depends for a large part on careful management of septic episodes. As the risk of septicemia is strongly correlated with the degree of efficacy of antibiotic regimens, susceptibility data must always be examined when developing antibiotic protocols in units caring for neutropenic patients.     

Influence of surgery on renal amyloidosis

It is well known that renal amyloidosis (RA) leads to ESRD in a few years. This evolution may be accelerated by several factors such as steroids, renal vein thrombosis, infections or surgery. We report 22 patients (14M,8F) mean age = 41.6 years (13-72) with RA in whom surgery revealed or aggravated renal disease. The group I includes 15 patients with no previous history of renal disease and who developed oedema few days after surgery with acute renal failure in 5 of them. Proteinuria was present in all the cases with a nephrotic syndrome in 10. Percutaneous kidney biopsy (KB) showed renal amyloidosis in all patients (AA+ = 8 cases, AA- = 3 cases). Only 9 patients were followed-up (mean period = 40 months): 2 patients are stationary; 1 is on complete remission 2 are on HD and 4 died. The group II includes 7 patients with a previous history of nephropathy (Histologically proven amyloidosis: 3 CRF = 1, Oedema: 3). All these patients developed oedema few days after surgery with acute RF in 4 patients. KB performed in all of them showed RA (AA+ = 33, AA- = 1). 6 patients were followed up for a mean period of 11 months: 5 died, 1 patient is on HD. The influence of surgery on renal amyloidosis is often unforeseeable. It may have no effect on renal disease, but very often it reveals RA and sometimes dramatically aggravates the course of the disease with occurrence of irreversible CRF. The pathogenic role of surgery on RA is discussed.