A district urinary catheter policy. Why have one?

A catheter audit was performed at the Central Manchester Trust, which found that there was excessive ordering, inappropriate catheter selection by size, materials, balloon size and poor guidelines on catheter storage. From these findings and from the available literature, we have proposed guidelines on catheter selection with the aim of offering the best patient care and to provide cost efficiency which may be of benefit to other hospitals.     

Laparoscopic nephrectomy in a porcine model.

Laparoscopic nephrectomy was performed in 15 male pigs, the procedure was successful in 14. Extraction of the intact kidney through a 5-cm lower abdomen incision was done in 7 animals; complete destruction and evacuation of the kidney was accomplished by a round-knife suction device through a 1-cm port in another 7 pigs. Grossly, the specimen consisted of sausage-like tubular renal tissue and a small amount of tissue debris. Pathology revealed that the glomerular and tubular structures were well preserved, no interstitial hematoma could be found. Four ports were usually used, one 1-cm umbilical camera port, one 0.5-cm port for ureter traction, and two 1-cm working ports along the midclavicular line. All the pigs recovered uneventfully. The average operation time was 3 h 20 min. The application of endo-GIA (United States Surgical Corporation) for renal hilum reduced the operative time to 2 h 20 min. Complications included renal vein tear during endoclip application and cutting in the first case, mild subcutaneous emphysema in 2 cases. This first pig received exploratory laparotomy for the repair and ligation of the renal vein. No more major complications occurred with increasing experience. From this porcine experiment, we conclude that the combination of laparoscopy, a tissue destroyer and an endobag for the entrapment of kidney seem to be a promising technique for clinical nephrectomy.     

地高辛素标记的DNA探针快速鉴定产不耐热肠毒素大肠杆菌的研究

用地高辛素标记的６７０ｂＰ－ＬＴ－ＤＮＡ片段作为探针，用菌落原位杂交法对９株标准参考株进行检测，结果全部相符。对７０株从临床分离的菌株也进行菌落原位杂交．并与３２－Ｐ标记的探针进行比较．结果地高辛素探针的特异性为９７．７％，敏感性为１００％，符合率为９８．６％。从含正常肠道菌的粪便中可以直接检出ＬＴ－ＥＴＥＣ而无须经纯培养。定量试验表明本法最低检出量为６ＣｆｕＬＴ－ＥＴＥＣ／斑点。整个检测过程短．仅须２４～３０ｈ。探针的稳定性好，有效期可长达１年。     

Three years' experience with levonorgestrel-releasing intrauterine device and Norplant-2 implants: a randomized comparative study

A randomized comparative study of levonorgestrel-releasing intrauterine device (LNG-IUD) and Norplant^R-2 implants was carried out in 200 women for 36 months. Three thousand one hundred woman-months of use were observed with each device. Only one pregnancy occurred in users of LNG-IUD at the 12th month of use. The change in bleeding pattern was the most frequent reason for discontinuation. The discontinuation rate for irregular bleeding with Norplant-2 was 17.3 and 26.8 at 24 and 36 months, respectively, as compared to 3.3 with LNG-IUD at both 24 and 36 months. The differences were statistically significant. Removal for amenorrhea and pain only occurred in acceptors of LNG-IUD. About 20–40% of women using Norplant-2 had prolonged bleeding through 36 months. The percentage of amenorrhea in LNG-IUD was the highest (29.3%) at the end of two years of use. More than 97% of subjects reported satisfaction with the methods used by themselves.

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Resumen Un estudio aleatorizado en el que se comparan los dispositivos intrauterinos que descargan levonorgestrel (LNG-IUD) con los implantes Norplant-2 se realizó en 200 mujeres durante 36 meses. Se observó un período de utilización correspondiente a tres mil cien meses-mujer con cada uno de los dispositivos. Hubo un solo embarazo, en el decimosegundo mes, entre las usuarias de LNG-IUD. La alteración del flujo menstrual fue la razón invocada con mayor frecuencia para el abandono del método. Los porcentajes de abandono por la irregularidad de la menstruación en el caso de los Norplant-2 fue de 17,3 y 26,8 a los 24 y 36 meses, respectivamente, en comparación con 3,3 con los LNG-IUD a los 24 y 36 meses. Estas diferencias son estadísticamente significativas. El retiro por amenorrea y dolores sólo ocurrió entre las mujeres que tenían los LNG-IUD. Los Norplant-2 ocasionaron sangrado prolongado durante los 36 meses estudiados en alrededor del 20 al 40% de las mujeres. El porcentaje de amenorrea con los LNG-IUD llegó al nivel máximo (29,3%) al cabo de dos años de uso. Más del 97% de las mujeres se mostraron satisfechas con los métodos que utilizaban.

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Resumé Une étude randomisée comparant les dispositifs intra-utûrins libérant du lévonorgestrel (LNG-IUD) aux implants Norplant-2 a été effectuée sur 200 femmes pendant 36 mois. On a ainsi observé une période d'utilisation correspondant à trois mille cent mois/femme avec chacun des dispositifs. Une seule grossesse s'est produite, au douzième mois, parmi les utilisatrices de LNG-IUD. L'altération du flux menstruel a été la raison le plus souvent invoquée pour l'abandon de la méthode. Les pourcentages d'abandon du fait de l'irrégularité de la menstruation dans le cas des implants se sont élevés à 17,3 et 26,8 après respectivement 24 et 36 mois, alors qu'ils n'atteignaient que 3,3 pour les LNG-IUD, tant à 24 qu'à 36 mois. Ces différences sont statistiquement significatives. Le retrait à la suite d'aménorrhée et de douleurs n'a été constaté que chez des femmes portant les LNG-IUD. Le Norplant-2 a occasionné des saignements prolongés pendant les 36 mois étudiés chez environ 20 à 40% des femmes. Dans le cas des LNG-IUD, le taux d'aménorrhée était le plus élevé (29,3%) au terme de deux années d'utilisation. Plus de 97% des patientes se sont dites satisfaites de la méthode qu'elles appliquaient.

     

辽宁产东亚钳蝎毒镇痛作用与脑内中枢关系的研究

应用立体定位、核团内注射与电解损毁核团技术及微电极细胞外记录方法，以猫丘脑后核内脏大神经诱发单位放电为内脏痛指标，观察向尾状核、中脑导水管周围灰质及杏仁内侧核内注入东亚钳蝎毒及在电解损毁３个核团前后ＰＯ内脏大神经诱发单位放电的变化。在损毁诸核之前刺激内脏大神经引起单位诱发放电，损毁诸核之后诱发放电减弱或消失，这与辽宁产东亚钳蝎毒注入诸核团中的作用相一致。表明蝎毒的作用部位与上述核团有关，更进一步证明蝎毒作用部位     

癌旁组织CD44vmRNA的表达对原发性肝癌术后复发的影响

研究原发性肝癌癌旁组织ＣＤ４４ｖｍＲＮＡ表达的意义。应用ＲＴ－ＰＣＲ检测原发性肝癌癌旁组织ＣＤ４４ｖｍＲＮＡ的表达并结合术后近２年的随访结果进行综合分析。癌旁组织ＣＤ４４ｖｍＲＮＡ表达高于癌组织者的肿瘤包膜缺如、门静脉癌栓和瘤周卫星结节等与转移相 关的病理指标高于癌旁组织ＣＤ４４ｖｍＲＮＡ表达低于癌组织的病例，前者复发率亦高于后者。结论：癌旁组织ＣＤ４４ｖｍＲＮＡ的表达肝癌侵袭潜能以及预测其复发等     

Magnetic resonance imaging and single-photon emission computed tomography changes in hypoglycemia-induced chorea.

We present two case studies, one of generalized chorea and one of hemichorea, both after severe hypoglycemia episodes. Both cases showed hyperperfusion in their SPECT scans. The MRI and SPECT findings serve as clues regarding the role of basal ganglion dysfunction associated with chorea.     

广东汉族人群HLA-Cw多态性及单体型分析

目的检测广东汉族人群HLA．Cw及HLA-A、B、DRB1基因频率，分析该人群HLA-Cw等位基因多态性及其单体型特点。方法骨髓移植供者185例，抗凝血提取DNA，半量全自动PCR-RSSO分型检测HLA-A、B、Cw、DRB1基因型。结果在分辨水平检出Cw等位基因11个，其中分布频率较高的依次为：Cw*03(0．2580)、Cw*07(0．1887)、Cw*01(0．1732)、Cw*08(0．1070)。统计分析呈现显著连锁不平衡的HLA-Cw．A单体型7个，HLA-Cw-B单体型20个，HLA—Cw．DRB1单体型10个。结论广东汉族群体HLA-Cw基因具有较为丰富的多态性，其与HLA-A、B、DRB1间连锁不平衡单体型具有地区性遗传特征。