氨苯砜综合征诊治探讨——附6例报告

目的：探讨氨苯砜综合征的诊治要点：方法：对6例氨苯砜综合征患者的临床资料进行回顾性分析。结果和结论：6例氨苯砜综合征患者均为中青年，从服药到出现症状的时间较长，为9～55日.6例患者均以高热起病，起病急骤、凶险，病初均有麻疹紫癜样皮疹，皮疹多形，严重者出现尼氏征阳性或阴性的大疱和（或）全身性红皮病样皮疹；均有浅表淋巴结肿大；多数患者有血液系统损害；并均有肝损害：确诊后及时停氨苯砜，给予足量肾上腺皮质激素和（或）大剂量免疫球蛋白静脉注射，以及支持对症处理，住院12～80（中位数53）日，4例痊愈，1例病情得到控制，另1例因治疗第2日自动出院放弃治疗，死于肝功能衰竭？提示氨苯砜综合征需要及时、正确处理，否则预后不良.     

肝移植术后胆道并发症的介入治疗

目的 探讨原位肝移植术后胆道并发症的介入治疗疗效。方法 回顾性分析我院2002年6月至2005年9月诊治的173例原位肝移植患者的临床资料。结果 术后出现胆道并发症14例（8．1％），其中胆管狭窄6例．胆管狭窄合并胆漏1例，胆泥淤积或结石3例，肝断面胆漏2例（劈离式肝移植患者），T管拔除后胆漏1例，Oddi括约肌功能失常1例。除1例胆道狭窄再次行肝移植，因发生严重感染导致肝功能衰竭死亡外．其余患者经介入治疗均获得满意的效果。结论 介入治疗是诊断和治疗肝移植术后胆道并发症的首选方法。     

岗位业绩导向的医院薪酬设计

基于现代管理理论和医院的实际情况，设计了一种以岗位和业绩为导向的医院薪酬制度。该设计的主要特点是：①薪酬结构以岗位工资和绩效工资为主体，同时兼顾稳定和逐步过渡原则，原档案工资的固定部分(约占档案工资的60％)保留。②岗位工资采用全院统一的等级薪酬结构，等级的评定基于全院统一的指标体系和权重，岗位工资每年随绩效考核结果在工资带宽中升降；③绩效工资与岗位等级和绩效考核紧密挂钩，考核的依据是全院统一模式的岗位绩效合同；④整个薪酬设计建立在岗位调查、岗位评价和岗位说明书等的科学规范的工作基础之上。     

岛状皮瓣静脉淤血再通后对大鼠全身情况的影响

目的：探讨岛状皮瓣静脉淤血再通后对全身多脏器的影响。方法：按静脉淤血时间的不同将大鼠分为4组。观察耳部微循环的改变，测量术后肿瘤坏死因子α(TNFα），白细胞介素10（IL－10）的动态变化，观察心，肺，肝，肾，小肠及耳部血管等组织结构及中性粒细胞浸润数目。结果：皮瓣原位缝合组及静脉淤血2h组，耳部微循环、TNFα、IL-10浓度基本保持不变，各脏器结构改变较轻，中性粒细胞浸润数目少。静脉淤血6、10h组，微循环，肺，小肠，血管则有明显组织学改变，大量中性粒细胞浸润其中，但心，肝，肾组织学改变较轻。TNFα浓度再灌注1h达到高峰，其后逐渐下降，IL－10浓度3h达到最低，然后逐渐上升。结论：皮瓣静脉淤血再通后可造成肺、小肠及血管器官损伤，静脉淤血时间越长，再通后则损伤程度越重。全身微循环的改变，中性粒细胞在肺、小肠中的浸润，与血管内皮细胞的粘附及细胞因子TNFα与IL－10的浓度失衡是重要的操作原因。     

The effects of literacy and education on the quantitative and qualitative aspects of semantic verbal fluency.

Semantic verbal fluency tasks are commonly used in neuropsychological assessment. Investigations of the influence of level of literacy have not yielded consistent results in the literature. This prompted us to investigate the ecological relevance of task specifics, in particular, the choice of semantic criteria used. Two groups of literate and illiterate subjects were compared on two verbal fluency tasks using different semantic criteria. The performance on a food criterion (supermarket fluency task), considered more ecologically relevant for the two literacy groups, and an animal criterion (animal fluency task) were compared. The data were analysed using both quantitative and qualitative measures. The quantitative analysis indicated that the two literacy groups performed equally well on the supermarket fluency task. In contrast, results differed significantly during the animal fluency task. The qualitative analyses indicated differences between groups related to the strategies used, especially with respect to the animal fluency task. The overall results suggest that there is not a substantial difference between literate and illiterate subjects related to the fundamental workings of semantic memory. However, there is indication that the content of semantic memory reflects differences in shared cultural background--in other words, formal education--, as indicated by the significant interaction between level of literacy and semantic criterion.     

低张结肠水灌肠CT检查诊断结肠癌的价值

目的 :探讨低张结肠水灌肠CT检查对结肠癌的CT表现及诊断价值。材料和方法 :肌注 65 4 2 2 0mg后 ,结肠灌注微温生理盐水进行CT扫描。分析经手术病理证实的 3 8例结肠癌资料。结果 :CT显示肿瘤部位准确率为 10 0 % ,CT分期与手术分期符合率为 92 % ,低张结肠水灌肠CT可见病变肠壁增厚、突出腔内的肿块、肠腔狭窄及其浆膜面毛糙 ;可见结肠癌侵犯邻近器官、淋巴结肿大及远处转移。结论 :低张结肠水灌肠CT检查对结肠癌的术前诊断有很大的价值。     

内镜治疗甲状腺功能亢进7例报告

目的总结内镜治疗甲状腺功能亢进（甲亢）的经验。方法7例原发性或继发性甲亢，内镜经胸人路行甲状腺全切或次全切除术。结果7例手术均成功，无中转开放手术。手术时间130～260min，平均168min；术中出血量10～200ml，平均70ml。无喉返、喉上神经损伤，无术后出血等并发症。术后恢复良好，近期随访美容效果满意。随访1～12个月，平均5．1月，无复发，2例出现甲状腺功能低下，1例在术后2个月时恢复。结论内镜治疗甲亢技术安全、可行。除常规手术前甲亢准备外，必须行CT检查确认腺体大小，确定残留腺体的大小和位置。     

无皂乳液聚合法合成均一性聚苯乙烯微球

研究了聚苯乙烯微球的合成过程中，离子强度、聚合时间对粒径的影响及其稳定性，实验结果表明：适当改变离子强度、聚合时间可以得到不同粒径的聚苯乙烯微球，且粒子稳定性较好。     

甲醛固定源同种异体骨移植材料的体外实验研究

OBJECTIVE: To conduct an in vitro study to assess the preliminary possibility of using formalin-fixed, instead of fresh, human bone tissues for allografting. METHODS: Fresh cadaveric bone tissues were fixed by formalin for more than 6 months and dissected into 5 mmx5 mmx5 mm pieces and 5 mmx5 mmx40 mm sticks, followed by chemical treatments to prepare the allograft bone materials. When alls treatments were completed, the bone grafts were centrifuged and their properties and cellular compatibility assessed in comparison with the currently used bone grafts clinically. RESULTS: The residual formaldehyde of the fixed allograft bone material was much below the controlled level and no significant differences were noted between the bone graft materials tested in regard to the chemical and mechanical properties and biocompatibility. CONCLUSION: This material we have prepared may meet the clinical demands for bone grafting, with good biocompatibility and less chance for infection by pathological agents.     

截骨矫形"∩"形钉内固定治疗关节畸形55例

目的探讨肘、膝、踝关节内外翻畸形的治疗方式。方法对55例8～16岁的关节内、外翻畸形患儿(肘关节30例，膝15例，踝10例)，采用肘外侧切口，踝、膝内外侧切口，截骨矫形，1枚或2枚“∩”形钉内崮定治疗，术后石膏托外固定4周，结果随访50例，随访时间3～24个月，截骨均达到骨性愈合，无一例发生感染，内固定松动临床疗效优48例(96％)，良2例(4％)。结论用“∩”形钉作为截骨矫形内固定材料．具有操作简单、损伤小、效果好的优点。