替考拉宁治疗胰十二指肠切除术后革兰阳性球菌肺部感染的疗效观察

目的观察替考拉宁对行胰十二指肠切除术患者术后出现革兰阳性球菌肺部感染的疗效以及安全性。方法对31例肺部革兰阳性球菌[耐甲氧西林金黄色葡萄球菌(MRSA)、耐甲氧西林表皮葡萄球菌(MRSE)、粪肠球菌/溶血性葡萄球菌]感染的胰十二指肠切除术后患者给予替考拉宁治疗,观察药敏结果、疗程及预后。结果31例肺部革兰阳性球菌对替考拉宁全部敏感;替考拉宁总痰菌清除率较高(90.32%),痰菌清除时间较短(13.2±4.0)d;替考拉宁未调整剂量,未发现明显肝肾功能损害及其他严重并发症。结论对于胰十二指肠切除术后革兰阳性球菌肺部感染,替考拉宁敏感率较高,总体疗效好,安全性较好,敏感菌清除时间较短,控制胰十二指肠切除术后革兰阳性球菌肺部感染效果明显。     

膀胱内大量积血的处理(附35例报告)

目的：探讨膀胱内大量积血的处理方法。方法：对2000年3月～2005年12月处理的35例膀胱大量积血病例进行回顾性分析。结果：对35例膀胱内大量积血的患者,通过选择不同方式（膀胱冲洗、膀胱镜下手术、开放手术等）成功清除了膀胱内积血。结论：根据患者的具体情况,合理选择处理方法可以及时、安全地处理多种痛因引发的膀胱内大量积血情况。     

The clinical relevance of ultra-widefield angiography findings in patients with central retinal vein occlusion and macular oedema receiving anti-VEGF therapy

AimsTo report, using ultra-widefield angiography (UWFA) the area, distribution, and change in retinal capillary nonperfusion (RCNP) at baseline and 100 weeks in eyes with central retinal vein occlusion (CRVO) receiving anti-VEGF for macula oedema.MethodsProspective longitudinal multi-centre cohort study. Adults with CRVO treated with anti-VEGF therapy for macular oedema underwent UWFA at baseline and week-100. The area, distribution, and change in total, peripheral and posterior pole RCNP were determined.ResultsOf 153 eyes at baseline, mean area of RCNP was 34.3DA and 12 (7.8%) had ≥75DA RCNP. More than 10DA RCNP was present in the temporal periphery in 75.8% of eyes vs. 10.5% in the nasal periphery. At week-100, mean RCNP was 42.1DA with a median change from baseline of 3.3DA 95% CI [0.4, 7.3]; p < 0.01. Of 146 eyes with ≤10DA of posterior pole RCNP at baseline, 16/146 (11.0%) progressed to >10DA at week-100. These eyes had a median increase in total RCNP of 69.7DA [95% CI 27.2–85.4] vs 0DA [0.0–1.4]; p < 0.001 for those who did not, and two developed neovascular glaucoma. Larger baseline area of RCNP and history of glaucoma were risk factors for posterior pole RCNP developing.ConclusionsWith UWFA, significant baseline RCNP was identified in the majority of CRVO patients, notably in the temporal periphery, but large increases over 100 weeks were uncommon. Development of >10DA posterior pole RCNP is a marker for widespread RCNP and in such cases the risk of anterior segment neovascularisation is not abolished by concomitant anti-VEGF therapy.Subject terms: Retinal diseases, Vision disorders     

Comparison of glomerular filtration rate measurements with the two plasma sample and single plasma sample, gamma camera Gates, creatinine clearance, and prediction equation methods in potential kidney donors with normal renal function

OBJECTIVE: To compare measured glomerular filtration rate (GFR) by single plasma sample methods (SPSMs), gamma camera Gates, 24-h endogenous creatinine clearance, and prediction equations (Cockcroft-Gault and modification of renal disease (MDRD)) with the two plasma sample method (TPSM) considered as the reference in potential kidney donors with normal renal function. METHODS: One hundred and fifteen subjects (50 male, 65 female; mean age 41.9+/-12.2 years) with normal renal function were prospectively included in this study. GFR was calculated by TPSM (120-min and 240-min samples) and SPSM (180-min sample). RESULTS: While there was strong statistically significant correlation between the TPSM and all SPSMs, low correlation was found in Gates, creatinine clearance, Cockcroft-Gault and MDRD. In all SPSMs, 95% limits of agreements were consistent with each other and within clinically acceptable limits. The lowest bias, median absolute difference, mean percentage error, and the best precision were found for Christensen and Groth's method as modified by Watson (CGmW). CONCLUSIONS: Among the SPSMs, CGmW can reflect GFR more accurately than the other methods. Neither the gamma camera Gates method nor the creatinine clearance method nor the prediction equations (Cockcroft-Gault and MDRD) could calculate GFR accurately. All these techniques could result in mistakes in the management of potential kidney donors.     

门静脉、肠系膜上静脉的解剖与临床应用的初步研究

目的 为提高肝门胆管癌和壶腹周围癌的手术切除率,使该区域受肿瘤浸润的血管能同时切除,血管直接重建提供解剖学依据.方法 在实施肝门胆管癌切除术及胰十二指肠切除术中,对病人的肝蒂内门静脉干、胰腺钩突内的肠系膜上静脉干进行解剖学定位并分段测量长度及可以纵向折叠的长度,以此估计可切除的静脉长度及重新再建血管的长度.结果 测量肝蒂内门静脉干104例,男性(5.8±1.99)cm,女性(5.5±O.81)cm,优势长度大于4.5cm者,男性56例占76.7%,女性25例占80.6%.胰腺钩突内段肠系膜上静脉干测量54例,男性(3.7±0.77)cm,女性(3.5±0.64)cm,优势长度大于3.0cm者,男性28例占77.6%,女性14例占77.8%.门静脉纵向折叠移动的范围在1.8～4.2cm,平均折叠2.2(1.8～2.4)cm者占66.3%,平均折叠2.8(2.5～4.2)cm者占33.7%.切除胰十二指肠后胰腺钩突内肠系膜上静脉段纵向折叠范围平均4.0cm,最长达5.2cm.结论 肝门胆管癌和壶腹周围癌切除术合并受浸血管切除在一定范围是可行的.     

中心静脉压监测在胃肠道手术后患者补液治疗中的应用

目的：探讨监测中心静脉压的液体治疗对胃肠道术后患者的液体平衡水平、电解质水平、血流动力学的影响。方法将130例胃肠道手术后患者随机分为对照组65例(应用监测中心静脉压的液体治疗),观察组65例(普通液体治疗)检测两组患者治疗期间(术后、1、3、5 d)尿比重、钾、钠、心率、平均动脉压水平变化及呼吸、循环及其他不良事件发生率。结果两组患者治疗期间(术后、1、3、5 d)尿比重、钾、钠、心率、平均动脉压水平比较(t =5.22、5.54、5.75、6.26、5.91, P<0.05,具有显著性差异)。两组患者治疗期间呼吸、循环及其他不良事件发生率(χ2=4.23、4.56、4.65, P<0.05,具有显著性差异)。结论监测中心静脉压的液体治疗对胃肠道术后患者液体、电解质平衡及血流动力学稳定有重大意义。     

Aggregate Geometrical Features and Their Influence on the Surface Properties of Asphalt Pavement

Aggregate geometrical features directly affect asphalt pavement surface properties, which further affect the resistance to skidding of a road surface. In order to establish a relationship between the aggregate geometrical features and pavement surface properties, this paper employs an aggregate geometric characteristic evaluation system (AGCES) to describe the form property, angularity, and surface texture of aggregate particles. The geometrical feature parameters of 15 different aggregates were examined by AGCES and the corresponding surface properties of asphalt pavement prepared from the mentioned aggregates were evaluated by sand patch method, 2-Dimension Image-based Texture Analysis Method (2D-ITAM) and Walking Friction Tester (WFT), respectively. The relationships between the pavement surface property parameters and the aggregate geometric characteristic parameters studied were developed by the Levenberg-Marquarat and universal global optimization (LM-UGO). The results show that the calculated geometric characteristic parameters are in agreement with traditional manual measurement results. The pavement surface properties are significantly influenced by aggregate angularity and aggregate surface texture. Regression relationships were established to predict pavement surface properties from the aggregate geometrical features.     

Role of sodium in hypertensive cardiac hypertrophy

Cardiac hypertrophy in systemic hypertension may not result simply from increased afterload. Previous studies indicate that factors other than blood pressure may influence cardiac hypertrophy. We evaluated the effects of dietary sodium restriction in two-kidney one-clip renal hypertensive rats. After the renal artery had been clipped, the rats received a normal diet until hypertension was established; thereafter, a sodium-deficient diet was instituted in one group. Clipped rats on a regular diet had significantly higher systolic blood pressures than sham-operated controls (205 +/- 9 vs. 129 +/- 1 mm Hg, respectively). Sodium restriction did not reverse hypertension (190 +/- 8 mm Hg), but led to a significant reduction of relative heart weight compared to rats on the normal diet (2.94 +/- 0.24 vs. 3.86 +/- 0.23 mg/g, respectively; P less than 0.01). The hypertrophied hearts of animals on the regular diet showed depressed tissue catecholamines (significant only for norepinephrine); sodium restriction resulted in a restoration to normal levels. Thus, we demonstrated a dissociation of blood pressure and cardiac hypertrophy in the two-kidney one-clip model, similar to previous findings in other models. Our results support the concept that factors other than blood pressure contribute to cardiac hypertrophy. Dietary sodium intake appears to be one such factor. In addition, a possible role of the sympathetic nervous system is suggested.