Prognostic factors for surgical resection in patients with multidrug-resistant tuberculosis.

Although surgical lung resection could improve prognosis in some patients with multidrug-resistant tuberculosis (MDR-TB), there are no reports on the optimal candidates for this surgery. The aim of the present study was to elucidate the prognostic factors for surgery in patients with MDR-TB. Patients who underwent lung resection for the treatment of MDR-TB between March 1993 and December 2004 were included in the present study. Treatment failure was defined as greater than or equal to two of the five cultures recorded in the final 12 months of treatment being positive, any one of the final three cultures being positive, or the patient having died during treatment. The variables that affected treatment outcomes were identified through univariate and multivariate logistic regression analysis. In total, 79 patients with MDR-TB were included in the present study. The treatment outcomes of 22 (27.8%) patients were classified as failure. A body mass index <18.5 kg x m(-2), primary resistance, resistance to ofloxacin and the presence of a cavitary lesion beyond the range of the surgical resection were associated with treatment failure. Low body mass index, primary resistance, resistance to ofloxacin and cavitary lesions beyond the range of resection are possible poor prognostic factors for surgical lung resection in multidrug-resistant tuberculosis patients.     

Pulmonary Lophomonas blattarum infection in patients with kidney allograft transplantation

The aim of the study was to analyse the clinical manifestation and management of pulmonary Lophomonas blattarum infection in four allograft transplantation recipients retrospectively. Four patients with pulmonary L. blattarum infection were diagnosed by using Fiberoptic bronchoscopy (FOB) and bronchoalveolar lavage (BAL) examination. Their clinical manifestation and management are summarized. Four cases of pulmonary L. blattarum were found during the period from the second month to the third month after transplantation. Concurring infection by other pathogens was found in three of them. Common initial symptoms included fever (>38 degrees C) without cough and breathlessness. Lower lobe shadowing could be found on chest X-ray. Body temperature decreased to the normal range in three patients and to 37.5 degrees C in the other one, after intravenous injection of metronidazole and tapering immunosuppressant. Radiological examination confirmed improved health condition of the patients afterwards. Two patients received repeated FOB and only dead L. blattarum was found. Pulmonary L. blattarum infection in allograft transplant recipients carry relatively obscure initial symptoms. Possible L. blattarum infection needs to be screened in post-transplantation pulmonary infection patients with similar symptoms, especially in those who respond poorly to anti-infection treatment. Microscopic examination of BAL fluid can help to identify pulmonary L. blattarum infection and metronidazole is an ideal treatment choice.     

Lugol液染色对食管早期癌和癌前病变的诊断价值

目的 探讨Lugol液染色对食管早期癌和癌前病变的诊断价值。方法 对45例食管黏膜可疑病变经内镜以2％Lugol液喷洒染色，观察黏膜染色情况，并取活检送病理组织学检查。结果 45例食管病变染色后，39例呈浅染色或不染色，其中食管癌8例（食管早期癌5例，进展期癌3例），Barrett食管5例，轻至中度不典型增生1l例。本组Lugol液染色对食管早期癌和癌前病变的检出率达46．7％。结论 内镜下应用Lugol液染色结合活检有助于食管早期癌和癌前病变的诊断，且操作简便，具有重要的临床价值。     

颈椎前路手术内置物并发症的分析

在颈椎前路减压、植骨、带锁钢板内固定技术日渐成熟的今天,越来越多的医院开展了该项手术。自1998年2月-2005年8月应用该方法治疗颈椎病215例,发生与内置物钢板及钛网相关的并发症14例,为此积累了一定的经验,现总结如下。1临床资料本组215例,男126例,女89例;年龄42～82岁,平均     

循证护理在临床实习教学中的尝试

循证护理（evidence based nursing，EBN），直译为“以证据为基础的护理”，指护理人员在护理实践中将科研结论与病人需求相结合，考虑当时护理环境，结合个人经验，最终做出护理决策，其核心内容是运用现有最好的科学证据为服务对象提供服务。循证护理是20世纪90年代随着循证医学的发展而发展起来的，是一种新概念，新观点，新思维。经调整发现我市实习护生对循证护理了解甚少。     

3种霍乱弧菌检测方法在外环境标本中的应用研究

目的：通过改进霍乱弧菌检测的技术手段，提高外环境标本中霍乱弧菌的检出率。方法：将常规分离鉴定法、PCR检测法和胶体金免疫层析试验法同时用于检测霍乱流行期间的外环境标本，并对其现场应用结果进行比较分析。结果：3种方法检测80份外环境标本霍乱弧菌的结果显示：它们均未出现假阳性，3种方法各有优势，且结果相互符合性好，但也存在各自弱点。结论：只用单一种方法来检测外环境标本霍乱弧菌存在明显不足。建议在外环境霍乱监测中选用胶体金法进行初筛，再用常规法和PCR法检测。最大限度减少漏检的可能性。     

顺铂聚乳酸微球的药物释放特性及肝动脉栓塞研究

对顺铂聚乳酸微球进行了体外药物释放和家犬肝动脉栓塞研究。该微球粒径范围为50～200μm,平均粒径为115.76±35.94μm,顺铂含量为37.16%(W/W);体外药物释放机制符合Higuchi方程;肝动脉栓塞后8h,肝组织顺铂浓度高达21.55±12.18μg/g,明显高于肝动脉灌注顺铂组:3.16±0.09μg/g(P<0.05);肝动脉栓塞组的顺铂血浓峰值、各取血点浓度及曲线下面积AUC皆低于肝动脉灌注顺铂组。可望达到提高栓塞部位的药物疗效,降低全身毒副反应的作用。     

Clinical Study on Long-Term Treatment of Ankylosing Spondylitis with Integrative Medicine

Ａｎｋｙｌｏｓｉｎｇｓｐｏｎｄｙｌｉｔｉｓ（ＡＳ）ｉｓａｒｈｅｕｍａｔｉｃｄｉｓｅａｓｅｗｉｔｈｈｉｇｈｉｎｃｉｄｅｎｃｅ，ｉｎｄｕｃ ｉｎｇｄｉｓａｂｉｌｉｔｙａｎｄｉｎｖａｄｉｎｇｔｈｅｓｐｉｎａｌａｘｉａｌｊｏｉｎｔａｓｉｔｓｃｈｉｅｆｃｈａｒａｃｔ     

铁路系统医院136篇口腔修复、正畸学论文的统计分析

通过对铁路系统医院１３６篇口腔修复、正畸学论文的统计分析，来评价医院口腔修复、正畸的科研水平，同时也揭示了科研工作中存在的问题。指出只有加强科研协作、扩大学术交流、增加科研投入，提高科研水平，使科研成果更趋完善。