输卵管积水处理方式对体外受精-胚胎移植临床结局的影响

目的探讨输卵管积水的不同腹腔镜手术处理方式对体外受精-胚胎移植(IVF-ET)临床结局的影响。方法回顾性分析2006年1月至2007年7月因输卵管因素在本中心行常规IVF-ET治疗的294例不育患者的资料,按IVF-ET前腹腔镜下输卵管积水处理方式分组:A组:双侧输卵管近端结扎术28例;B组:双侧输卵管造口术42例;C组:双侧输卵管切除术64例;D组:输卵管阻塞不伴积水80例;E组:单或双侧输卵管积水80例。比较5组患者在IVF-ET周期中卵巢对超排卵的反应性及临床结局的影响。结果C组的窦卵泡数少于B组,发育的卵泡数及获卵数少于其他4组,均有显著性差异(P<0.05);与其他4组相比,C组使用促性腺激素(Gn)的支数最多,但无显著性差异(P>0.05);E组的胚胎植入率为15.9%,临床妊娠率为27.5%,为各组间最低,其中胚胎植入率与A、C和D组比较有显著性差异,临床妊娠率与A和D组比较有显著性差异(P<0.05);各组流产率E组最高(22.7%),其次为B组(14.4%),E与C组(4%)比较有显著性差异(P<0.05);异位妊娠率E组最高,其次为B组,但各组间无显著性差异(P>0.05)。结论输卵管积水对IVF-ET结局有负面影响,对输卵管积水进行适当预处理有助于改善其临床结局。输卵管近端结扎术不降低卵巢反应性,异位妊娠率及流产率低,是IVF-ET前输卵管积水预处理较理想手术方式。     

血清铁和铁蛋白与肝病患者肝纤维化指标的关系

OBJECTIVE: To study the relationship of serum iron and ferritin with the indicators for hepatic fibrosis and hepatic iron overload. METHODS: Liver tissue specimens were obtained from 41 patients with benign (16) or malignant (25) liver diseases by 1 second liver biopsy, and routine microscopic examination was performed after haematoxylin-eosin (HE) and Perl's Prussian staining. Atomic absorption spectrum, radioimmunoassay and enzyme-linked immunosorbent assay were respectively employed to examine the serum levels of iron, ferritin, hyaluronic acid, laminin, human procollagen type , and collagen type . RESULTS: Between patients with benign and malignant liver diseases, significant differences were found in the serum ferritin levels (P < 0.05), but not in serum iron levels (P > 0.05). It was also noted that the levels of the indicators for hepatic fibrosis in patients with benign and early-stage malignant diseases varied significantly from the levels in normal subjects, but these differences were not observed between normal subjects and patients with end-stage hepatic malignancies. Serum iron and ferritin were found to be associated with serum laminin levels (serum iron: r=0.439, P=0.031; serum ferritin: r=0.476, P=0.016), and no iron granules detected in the tissue specimens of hepatocellular carcinoma. CONCLUSIONS: Most of the patients with hepatocellular carcinoma have elevated serum ferritin levels. The serum levels of iron and ferritin are statistically correlated with serum laminin level. Obvious reduction of iron content is typical of hepatic malignant tissues in comparison with the benign tissues, and the reduction in the levels of the indicators for hepatic fibrosis might involve the inhibition of collagen synthesis in the tumor tissues from patients with end-stage hepatocellular carcinoma. Most of the cases of alcoholic fatty liver are complicated by liver iron overload, often marked by serum iron and ferritin levels.     

A new Le Fort I internal distraction device in the treatment of severe maxillary hypoplasia.

PURPOSE: The purpose of this pilot study was to test a new Le Fort I internal distraction device. PATIENTS AND METHODS: A new internal Le Fort I distraction device designed by 1 of the authors was used in 3 patients with cleft lip and palate and severe maxillary hypoplasia who needed maxillary advancements in excess of 12 mm. Presurgical planning used CASSOS (SoftEnable Technology, Ltd, Hong Kong SAR, China) prediction tracing software and a stereolithographic model to calculate the distraction vector. The distractors were pre-bent and installed on the stereolithographic model and activated to advance the maxilla. Surgery was performed in a conventional manner, and distraction was started after a 7-day latency phase at the rate of 1 mm/day and continued until the presurgical plan was achieved. The distractor was removed after a 3-month consolidation phase. Cephalometric radiographs were taken at the completion of each phase. RESULTS: This new Le Fort I internal distraction device successfully distracted the maxillae as planned in all 3 patients. At the end of the distraction phase, the maxillary advancement was measured at 15.8 mm, 15.8 mm, and 13.5 mm, respectively. In each patient, a clockwise rotation of the maxilla was observed with a tendency to a posterior open bite. Postoperative radiographs also showed that the actual distraction vectors differed from the planned vectors. After the consolidation phase, radiographs showed a relapse of 2.6 mm, 0 mm, and 5.0 mm, respectively. There was no further relapse on 3-month follow-up radiographs. Each case showed radiographic evidence of excellent new bone formation at the osteotomy sites. CONCLUSION: The new Le Fort I internal distraction device produced the necessary advancement in all 3 patients. The study also showed that the actual distraction vector differed from the planned vector. This discrepancy was caused by a clockwise rotation of the maxilla during the distraction. Finally, the study showed a variable relapse rate not previously reported in maxillary distraction.     

浅谈高校校园危机管理

高等院校校园危机频繁发生，危机管理已成为校园稳定和发展的重要内容。校园危机管理包括校园危机预防和校园危机处理。而危机管理重在预防，强化危机意识是危机预防的立足点和出发点。危机处理是危机管理的关键环节，即危机出现时运用有效的危机佘关手段正确处理危机，消除影响。     

575名新疆汉族青年学生手长、掌长与身高的关系

目的：研究新疆汉族青年手长、掌长与身高的关系，为人类学、法医学提供参考，同时为中国人体质调查积累资料。方法：应用Ｈｒｄｌｉｃａｓ标准和我国普遍采用的方法测量了５７５名（男２７０名，女３０５名）１８～２４岁汉族青年学生的手长、掌长和身高，并将原始数据进行医学统计学处理。结果：按年龄组和性别组计算出各组手长、掌长和身高的均值，身高与手长、掌长的比值。并提出由手长、掌长推算身高的简单公式（身高＝手长×比值，身高＝掌长×比值）和回归方程（身高＝回归系数×手长＋截距，身高＝回归系数×掌长＋截距）。结论：手长、掌长和身高各组性差有显著性（Ｐ＜０．０１）；由手长、掌长推算身高的简单公式和回归方程成立（Ｐ＜０．０５）。     

尿中糖胺多糖总量的测定方法

本文采用原子吸收的方法测定样品中糖胺多糖的含量。此法的灵敏度为0.102μg/ml,样品中铜检出值的变异系数为9％,平均回收率为103％,因此认为本方法的灵敏度、精密度和准确度都较高。此外,样品中存在的铜和葡萄糖对本实验均无干扰作用。     

卡马西平片体外溶出度与体内吸收相关性

目的：考察卡马西平（ＣＢＺ）片溶出度与体内吸收的相关性。方法：应用ＺＲＳ－４溶出度仪测定卡马西平片的溶出度。４名男性健康志愿性ｐｏ单剂量２００ｍｇＣＢＺ用ＴＤｘ分析仪测定血药浓度，并按照Ｗａｇｎｅｒ－Ｎｅｌｓｏｎ公式计算药物吸收分数。结果：体外溶出度与体内药物吸收分数的相关系数ｒ＝０．９２６１，体外溶出度与体内药物吸收分数的相关系数ｒ＝０．９９７７。结论：ＣＢＺ片体外溶出度与体内吸收有较好的相关性     

手部烧伤后重度虎口挛缩虎口重建术

自１９８９年２月～１９９５年３月，对２３例手部烧伤后重度虎口挛缩行瘢痕切除及虎口开大后，选用带旋髂浅血管蒂的腹股沟皮瓣移植重建虎口，术后均取得了满意效果。虎口挛缩的程度为０°～２５°。虎口开大后达８０°～９０°。虎口区瘢痕切除后皮肤缺损最小８ｃｍ×５ｃｍ，最大１２ｃｍ×６ｃｍ，平均１０ｃｍ×５ｃｍ。皮瓣切取面积最小１４ｃｍ×７ｃｍ，最大１８ｃｍ×８ｃｍ，平均１６ｃｍ×７ｃｍ。术后皮瓣断蒂时间为２～３周，２３例皮瓣均完全成活。对重度虎口挛缩应用带旋髂浅血管蒂的腹股沟皮瓣移植重建虎口是一种简单易行、成功率高的方法。因其具有供区部位隐蔽，皮肤质量好，不损伤肢体重要血管及可早期断蒂等优点，极易被患者接受。     

复方环丙氟哌酸鼻腔膜的研制及临床疗效观察

本文以明胶海绵为衬底,用环丙氟哌酸和氢化考的松、云南白药酊、达克罗宁制备的鼻腔消炎止血药膜,制备简便,质量稳定。临床观察结果证明,具有给药方便、疗效高、疗程短、药物作用持久,无毒副作用等优点。     

重庆地区近五年小儿菌痢菌群变化及耐药状况

我院近五年收治小儿菌痢２０３１例，培养分离出痢杆菌９８５珠，其中福氏９０４株，占９１．７８％，全部为福氏２ａ型，宋内氏８１株，占８．２２％。常见抗菌药物如氨苄青霉素、氯霉素、痢特灵的耐药性均达９５％以上，庆大霉素、吡哌酸、氟哌酸、丁胺卡那霉素、卡那霉素的耐药性逐年升高；头孢噻肟、环丙沙星耐药率也迅速增加。目前重庆地区治疗小儿菌痢宜推荐先锋霉累Ｖ、环丙沙星、头孢噻肟、卡那霉素，待有药敏试验结果后结合临床效果进行调整。