中西医结合治疗复发性口腔溃疡48例临床分析

复发性口腔溃疡是长期反复发作的疑难之症。可单发或多发于口腔粘膜的任何部分 ,有剧烈自发性灼痛 ,致使患者饮食及睡眠困难 ,严重危害健康。其发病一般以青壮年为多 ,男性少于女性 ,约为 1∶ 2 4,目前尚无特效疗法。本文通过对 48例复发性口腔溃疡中西医结合治疗的临床观察 ,认为疗效显著 ,无副作用 ,患者易接受 ,有效率达到 86% ,可用于临床 ,值得推广。     

ICU 医院感染细菌学特点及相关因素分析

①目的观察 ICU 患者医院感染细菌特点及其相关影响因素。②方法回顾性分析 ICU 病房2372例住院患者的资料。③结果2372例患者共发生感染114例,医院感染发生率为4．81％。感染部位分布以呼吸道感染最多,占39．47％,其次为泌尿道和血液,分别占19．30％和14．04％。114例患者中共分离出130株病原菌,其中分离出单一病原菌98例,占85．96％;分离出2种病原菌10例,占8．77％;分离出3种病原菌6例,占5．26％。130株病原菌中革兰阴性菌89株,占68．46％;革兰阳性菌29株,占22．31％;真菌12株,占9．23％;分布前3位的致病菌为铜绿假单胞菌、金黄色葡萄球菌和肺炎克雷伯菌,分别占29．23％、18．46％和16．15％。单因素χ2检验分析,医院感染发生的高危因素为高龄、侵袭性操作、较长时间入住 ICU 和使用激素（ P ＜0．05）。④结论ICU 医院感染发生率高,并且感染情况复杂,应加强 ICU 医院感染的监测工作,降低医院感染的发生率。     

Antimicrobial Peptides Derived from Fusion Peptides of Influenza A Viruses,a Promising Approach to Designing Potent Antimicrobial Agents

The emergence and dissemination of antibiotic‐resistant bacterial pathogens have spurred the urgent need to develop novel antimicrobial agents with different mode of action. In this respect, we turned several fusogenic peptides (FPs) derived from the hemagglutinin glycoproteins (HAs) of IAV into potent antibacterials by replacing the negatively or neutrally charged residues of FPs with positively charged lysines. Their antibacterial activities were evaluated by testing the MICs against a panel of bacterial strains including S. aureus, S. mutans, P. aeruginosa, and E. coli. The results showed that peptides HA‐FP‐1, HA‐FP‐2‐1, and HA‐FP‐3‐1 were effective against both Gram‐positive and Gram‐negative bacteria with MICs ranging from 1.9 to 16.0 μm , while the toxicities toward mammalian cells were low. In addition, the mode of action and the secondary structure of these peptides were also discussed. These data not only provide several potent peptides displaying promising potential in development as broad antimicrobial agents, but also present a useful strategy in designing new antimicrobial agents.     

高龄初产妇合并重度子痫前期对妊娠结局的影响

目的探讨高龄初产妇并发重度子痫前期对妊娠结局的影响。方法对高龄（≥35岁）和正常年龄（〈35岁）两组重度子痫前期单胎妊娠初产妇患者的临床资料进行回顾性分析,比较两组孕妇及围生儿的最终结局。结果观察组内科合并症发生率较对照组高,差异具有统计学意义（P〈0.05）,产后出血、胎盘早剥发生率两组比较无统计学差异（P〉0.05）。观察组低体质量儿出生率、新生儿窒息和围产儿死亡率较对照组高,差异有显著性（P〈0.05）,胎儿窘迫、新生儿畸形发生率组间比较无显著性差异（P〉0.05）。结论高龄初产妇并发重度子痫前期对对妊娠结局有着不利的影响,有必要进行有效的预防保健和临床处理。     

自体微粒皮与异体皮混合移植治疗特重度烧伤

目的探讨运用自体微粒皮移植与异体皮混合移植在特重度度烧伤创面治疗效果。方法对我科与2002年1月～2006年12月应用自体微粒皮与异体皮混合移植治疗特重度烧伤19例的临床资料进行回顾性分析。结果18例特重度烧伤患者存活,自体微粒皮生长良好,创面覆盖率达到95％以上。所以患者接受随访5～12个月,供、受皮区未见明显瘢痕或仅有轻度瘢痕,愈合后皮肤外观、弹性及功能恢复较好。结论早期自体微粒皮与异体皮混合移植治疗特重度烧伤效果良好,患者存活率高。     

PBL与导师制教学对本科护生科研能力的培养

目的 探讨"以问题为中心"(PBL)的教学模式与导师制教学相结合对本科护生科研实践能力培养的效果.方法 将117名临床实习本科护生随机分为对照组(60人)和实验组(57人).对照组采用PBL教学,实验组在PBL教学的同时实施导师制模式教学.结果 实验组毕业论文评分、实习期间论文写作与发表情况、参与导师科研课题率显著高于对照组(P<0.05,P<0.01).结论 PBL教学模式与导师制相结合有助于调动本科护生的创新积极性,提高其科研实践能力.     

The optimal hepatocyte density for a hollow-fiber bioartificial liver

A bioartificial liver (BAL) based on viable porcine hepatocytes can serve as a bridge to liver transplantation in patients with acute liver failure (ALF). To support liver functions, an adequate mass of hepatocytes is needed, which depends upon the cell density in the BAL device. This study evaluated the optimal density of hepatocytes within BAL devices that were constructed by perfusing porcine hepatocyte suspensions mixed with cytodex-3 into polysulfon hollow-fibers. The BAL devices were prepared with 6 different cell densities. The mass of hepatocytes in each device was evaluated for (a) cell viability, (b) ability to degrade diazepam, (c) ability to synthesize urea, (d) incorporation of [3H]-leucine into protein, (e) glucose-6-phosphatase activity, (f) total RNA content, and (g) p53 gene expression. Hepatocyte viability was about 90% in each device. With increasing hepatocyte density, the diazepam concentration in the medium decreased from 9.26 +/- 0.96 mg/L at 1 x 10(5) cells/ml to a minimum of 5.25 +/- 1.02 mg/L at 5 x 10(6) cells/ml and thereafter remained at low levels. Urea production and [3H]-leucine incorporation into protein increased progressively until the cell density reached 5 x 10(6)/ml and thereafter remained at high levels. Glucose-6-phosphatase activity and total RNA content stayed at high levels until the cell density reached 5 x 10(6)/ml and then progressively decreased. p53 gene expression differed from the other parameters, since it increased only when the cell density reached 5 x 10(7)/ml. In conclusion, the density of 5 x 10(6) cells/ml is a critical inflection point for most of the functional parameters, although p53 gene expression is not elevated at this cell density. These findings suggest that 5 x 10(6) cells/ml is the optimal hepatocyte density in the hollow-fiber BAL device.     

吸烟致气道炎症反应临床诊断方法的研究

【目的】寻找临床上简便易行、可靠的早期诊断吸烟致气道炎症的方法。【方法】检测了５１例健康吸烟者支气管肺泡灌洗液（ＢＡＬＦ），并以ＢＡＬＦ中细胞计数绝对值将炎症程度分为Ⅰ，Ⅱ，Ⅲ度；同时进行乙酰甲胆碱（Ｍｃｈ）支气管激发试验与２４ｈ最大呼气流量（ＰＥＦ）测定。【结果】①５１例检测对象ＢＡＬＦ细胞计数绝对值为（２．３～４７．２）×１０８／Ｌ，其炎症分度为Ⅰ度１６例，Ⅱ度２２例，Ⅲ度１３例。②Ｍｃｈ支气管激发试验阳性率６４．７％（Ⅰ度５０％，Ⅱ度６８．２％，Ⅲ度７６．９％）。③２４ｈ－ＰＥＦ变异值异常率６２．７％（Ⅰ度３７．５％，Ⅱ度７２．７％，Ⅲ度７６．７％），以上结果与ＢＡＬＦ炎症程度的相关性较好。【结论】本文方法可较好地反映吸烟致气道炎症的严重程度，Ｍｃｈ支气管激发试验与ＰＥＦ测定可作为吸烟气道炎症早期诊断的无创性指标之一。     

Thoracic myelopathy caused by ossification of ligamentum flavum of which fluorosis as an etiology factor

Purpose  

To evaluate the clinical feature, operative method and prognosis of thoracic ossification of ligamentum flavum caused by skeletal fluorosis.     

高血压脑出血术后早期康复疗效的对比研究

目的探讨早期康复治疗对高血压脑出血手术患者术后功能恢复的影响。方法将68例高血压脑出血术后、GCS〉8分的患者随机分为早期康复组和对照组,每组34例,除进行常规的药物治疗外,早期康复组在术后24-72h病情稳定的情况下开始早期康复程序,对照组仅进行未经指导的自我锻炼。两组患者手术后康复治疗前、治疗后1个月和2个月均由同一医师进行运动功能评定（Fugl-Mey-er评定法,FM积分）和日常生活活动能力（ADL）评定（FIM评定法）。结果两组患者手术后1个月和2个月FM、FIM评分均明显升高。数据经统计学分析处理,结果显示手术后康复治疗前两组的FM、FIM评分无统计学意义（P〉0.05）,手术治疗后1个月、2个月两组的FM、FIM评分差异有统计学意义（P=0.000,0.000,0.001,0.000）（见表1）。结论早期规范的康复治疗可以提高高血压脑出血术后患者的日常生活能力和肢体运动功能。