腔镜法卵巢良性肿瘤剥除术电凝法重建卵巢

0引言腹腔镜手术是妇产科良性肿瘤首选方式[1],随着内套圈、打结缝合技术、电外科技术和超声刀应用,腹腔镜手术已成为卵巢良性肿物的适应症,现将我院近年来卵巢良性肿物剥除术后,电凝法保留卵巢的体会介绍如下.     

腹式横切口鞘内全子宫切除术与传统术式比较

1　材料和方法1. 1　材料　我院 2003 02 /2004 12对子宫肌瘤、子宫腺肌症,采用腹式横切口鞘内全子宫切除术 26例.同时随机选择 22例常规全子宫切除术宫颈楔形切除术作为对照组,两组年龄分别为 43±4(38~52)岁, 41±6(38 ~53)岁,患者年龄,手术适应证及子宫大小两组间无显著性差异,具有可比性.1. 2　方法　①连续硬膜外麻醉,取膀胱截石位,采用耻 2~3横形切 10~12cm,仅切开皮肤,撕开脂肪及筋膜,钝性加锐性分离肌肉与筋膜粘着处,钝性分离腹直肌,腹膜剪一小横口,切开腹膜.用腹纱牵开肠宫,大块纱布排垫肠管,大弯钳钳夹子宫两角尽量钳拉子宫至腹腔…     

用气囊充气模拟结肠镜引起大鼠胃运动的变化

1 对象和方法成年雄性SD大鼠84只,清洁级,体质量(200±20) g. 置于安静、温暖(20℃)、避强光的环境中饲养. 随机均分成2组,每组42只; 再随机均分成7个亚组用于直肠顺应性检测,制定压力曲线.     

中西医结合治疗男性免疫性不育症1806例

0 引言近年来的免疫学研究发现,不明原因的不育患者体内存在着抗精子抗体(Anti-sperm antibody, ASAb)并对不育产生影响[1,2]. 我院近年来对抗体阳性者进行了中西医结合治疗,有效消除了抗体,取得了较好的临床效果,现报道如下.     

肝移植术后严重精神神经并发症2例分析

1临床资料 1997-06／2004—10共连续施行肝移植52例,发生神经精神并发症12例,其中严重2例,均为男性,年龄为56岁和38岁,原发病均为乙型肝硬化,均经背驮式肝移植．术前6h服用3mgFKS06,术后拔管后给予FK506口服,0．07mg／kg,同时常规应用强的松及骁悉口服,应用ELISA法动态监测患者全血FK506浓度,使其保持在10～12μg／L．分别在术后2d和4d出现神经精神并发症,并逐渐加重,开始以谵妄样精神障碍为主要症状,发展为癫痫发作和深昏迷,随时间的延长,出现排痰不畅、高热、大量胸水等症状．     

Kundenverständnis in der Gesetzlichen Krankenversicherung

Background

Empirical and scientific studies prove the causality between a company’s sustainable value creation and its focus on the respective target customer. The most success is granted to those companies that establish a robust relationship with their customers on a broad analytical basis.

Results

This study aimed to establish a multidimensional, customer-related value management system that allows segmentation of the customer base of a compulsory health insurance fund according to strategic and action-oriented parameters. For the first time, a customized system was developed specifically for this branch.

Conclusions

Customer understanding is the basis for the development of strategic initiatives for communication, customer retention, and sales; for product portfolio management; and for risk management systems in the sense of broad, value-based management of medical care.     

Chemokines and pain

Chemokines are chemotactic mediators controlling cell trafficking under physiological and pathological conditions. Recently, it has been discovered that chemokines are not only important in various inflammatory conditions, but that they also play a role in pain and analgesia. Chemokine function in the periphery has been evaluated under non-inflammatory, inflammatory and neuropathic conditions. While many studies have examined the hyperalgesic action of chemokines, increasing evidence points to the antinociceptive properties of chemokines. This review focuses on the role of chemokines in the peripheral tissue.     

Critical reevaluation of cyclooxygenase two inhibitors in perioperative pain therapy

A significant increase in thromboembolic events (i.e. myocardial infarction and stroke) was demonstrated in multicenter studies after several months of treatment with cyclooxygenase 2 (cox-2) inhibitors. In February 2005, the European medical agencies (EMEA) substantially increased the number of contraindications for all cox-2 inhibitors. They are now contraindicated for patients with coronary artery disease. Furthermore, 2 out of 6 cox-2 inhibitors have been withdrawn from the market. In this review, the current state of knowledge on the use of cox-2 inhibitors in perioperative pain therapy is summarized: i) they are equally as potent as other non-opioid analgesics, ii) they decrease opioid consumption, iii) a reduction in postoperative nausea and vomiting (PONV) has not been adequately demonstrated. Regarding side-effects, it can be concluded that i) the incidence of thromboembolic events is increased in patients undergoing coronary artery bypass surgery, ii) perioperative blood loss is not affected, iii) ulcer formation is not promoted, iv) the risk for acute renal failure is probably increased to the same extent as for NSAIDs and v) severe bronchospasm can be triggered in patients with asthma and chronic obstructive pulmonary disease (COPD).