青春期人类免疫缺陷病毒患者窗口期经输血传播给两例受血者

美国在对献血者进行病毒核酸检测（NAT）前，估计重复献血者通过输血传播艾滋病毒（HIV）的几率为1／4．5万～1／6．6万。采用NAT后，风险估计为1／213．5万；初次献血者传播HIV的风险为1／120万到1／180万。从1999年3月起，献血者除按标准检测HIV-1／2EIA和P24抗原外，还做NAT检查。NAT进一步缩短了HIV感染后的窗口期。虽然在献血人群中的HIV检测已经有了很大的进步，输血传播HIV的危险已经很小了，但风险终究不是零。对于HIV的传播，公共卫生机构必须进行有效和系统性调查以确定预防失误和紧急的流行趋势，并立即干预。本文报道2例经输血感染HIV，     

局灶性脑皮质发育不良致难治性癫痫病理分型和手术疗效分析

目的 探讨难治性癫痫术后局灶性脑皮质发育不良(FCD)不同病理分型与术后疗效的相巨关系.方法 回顾性分析54例经手术治疗后,病理证实为FCD的药物难治性癫痫患者的临床资料,分析病理分型与手术预后的关系.结果 轻型组(FCD Ⅰ A)24例,重型组(FCD Ⅰ B+ⅡA+ⅡB)30例.术后有效率:轻型组96%,重型组70%,总有效率82%.结论 随着FCD病理改变程度的逐渐加重,手术后疗效越来越差,FCD可能是影响药物难治性癫痫术后疗效的一个重要因素.     

神经生长因子基因转染联合强化铁营养防治豚鼠爆震性聋的实验研究

Objective To study the protective effects of adenovirus-mediated human beta-nerve growth factor gene (hNGFβ) transfer combined with iron fortified nutrition on blast hearing damage in guinea pigs. Methods Deafness was induced by blast (172dB SPL) in 35 healthy guinea pigs. Seven days after noise exposure, 10 guinea pigs were inoculated with adenovirus-mediated hNGFβ (Ad-hNGFβ) into the perilymphatic space (the gene group), another 10 guinea pigs were given hNGFβ combined with iron fortified nutritional diet (the combination group), still another 10 guinea pigs were inoculated with artificial perilymphatic fluid (APF), and 5 guinea pigs served as control, given neither medicine nor noise exposure. Auditory brainstem response (ABR) threshold shifts were monitored in the guinea pigs before blast exposure and after gene transfer. Changes in cochlear morphology were examined with immunohistochemical and HE staining. Results One week after successful inoculation of hNGFβ, it was noted that Ad-hNGFβ protein was expressed in each turn of the cochlea, and its intensity was almost equal. After gene transfer in the combination group and the gene group, ABR threshold shifts at week 1 and 4 were significantly smaller than those of the APF group. HE staining showed that the number of the spiral ganglion cells in the combination group and the Ad-hNGFβ group was significantly higher than that of the control group after 4 weeks (P<0.01). Conclusions Ad-hNGFβ combined with iron fortified nutritional diet was effective in the prevention and treatment of blast hearing damage of cochlear hair cells.     

复发脑胶质瘤的诊断与治疗进展

复发脑胶质瘤,是指原发性脑胶质瘤术后以及其他治疗后再次复发,既可单发,也可多发.复发脑胶质瘤的部位大多较局限,约80％左右的复发病灶在其原发灶周围2 cm处[1].脑胶质瘤的复发与手术切除程度、肿瘤的病理分级、术后放化疗等因素有关.脑胶质瘤术后复发率可达50％以上,复发后的胶质瘤恶性程度增加,侵袭力更强[2],其组织学分化的恶性特征也更加明显[3],成为加速患者死亡的主要危险因素[4].随着影像学诊断技术的提高,显微技术、神经导航等神经外科技术的普及,间质内放化疗等新技术、新疗法手段的应用,使复发脑胶质瘤的诊断与治疗取得显著进步.关键词：脑肿瘤;外科手术;放射疗法分类号：R739.41 文献标识码：A文章编号：1002-3429（2013）11-0096-04     

CT结肠成像对炎症性肠病的诊断价值

目的:探讨CT结肠成像(CTC)在炎症性肠病(IBD)诊断中的价值。方法:回顾性分析我院经结肠镜活检病理证实的7例IBD的CTC资料并文献复习。结果:7例IBD中克罗恩病(CD)4例、溃疡性结肠炎(UC)3例。4例CD的CTC主要表现为病变呈多节段性,病变段肠壁明显增厚、强化,病变段管腔狭窄,导航下病变段肠壁黏膜面凹凸不平呈鹅卵石状,肛周及回盲部周围脓肿并瘘道形成。3例UC的CTC导航下见整个直结肠黏膜面弥漫分布多个浅表溃疡灶,溃疡部位黏膜面毛糙、肠壁轻度不规则增厚、肠壁轻到中等度强化。结论:CTC可多方位、多角度观察肠壁、肠腔或肠外病变,形成整体的二维、三维结肠影像,为临床提供比结肠镜更丰富的信息,对IBD的诊断有其独特的优越性。     

脑磁图描记联合术中唤醒用于显微镜下切除功能区胚胎发育不良性神经上皮瘤

目的总结脑磁图(magnetoencephalography,MEG)描记与术中唤醒联合应用切除功能区胚胎发育不良性神经上皮瘤(dysembroplastic neuroepithelial tumor,DNT)的经验。方法根据MEG结果大体确定功能区范围,在唤醒麻醉下应用术中皮质电刺激刺激相应区域皮质,明确功能区和DNT边界。在显微镜下切除DNT 4例,观察治疗效果。结果 4例患者手术效果良好,无功能区损害。长期随访未出现癫发作及DNT复发。结论联合应用MEG与术中唤醒技术显微镜下切除肿瘤是治疗功能区DNT安全、有效的方法。     

一种转运床多功能雨篷的设计和应用

探讨转运床多功能雨篷的适用性。自行设计制作转运床多功能雨篷,由雨篷主体、主支撑杆、底座、左右端拉链门、前后端拉链门、仪器外罩、子母扣组成,具有为患者挡雨遮阳,便于观察患者病情等作用。经重症科、急诊科医护人员临床应用,获得肯定。此转运床多功能雨篷设计创新合理,能为转运患者挡雨遮阳,减少转运风险,节约人力且便于病情观察,使重病患者转运变得高效安全。     

神经生长因子基因转染联合强化铁营养防治豚鼠爆震性聋的实验研究

Objective To study the protective effects of adenovirus-mediated human beta-nerve growth factor gene (hNGFβ) transfer combined with iron fortified nutrition on blast hearing damage in guinea pigs. Methods Deafness was induced by blast (172dB SPL) in 35 healthy guinea pigs. Seven days after noise exposure, 10 guinea pigs were inoculated with adenovirus-mediated hNGFβ (Ad-hNGFβ) into the perilymphatic space (the gene group), another 10 guinea pigs were given hNGFβ combined with iron fortified nutritional diet (the combination group), still another 10 guinea pigs were inoculated with artificial perilymphatic fluid (APF), and 5 guinea pigs served as control, given neither medicine nor noise exposure. Auditory brainstem response (ABR) threshold shifts were monitored in the guinea pigs before blast exposure and after gene transfer. Changes in cochlear morphology were examined with immunohistochemical and HE staining. Results One week after successful inoculation of hNGFβ, it was noted that Ad-hNGFβ protein was expressed in each turn of the cochlea, and its intensity was almost equal. After gene transfer in the combination group and the gene group, ABR threshold shifts at week 1 and 4 were significantly smaller than those of the APF group. HE staining showed that the number of the spiral ganglion cells in the combination group and the Ad-hNGFβ group was significantly higher than that of the control group after 4 weeks (P<0.01). Conclusions Ad-hNGFβ combined with iron fortified nutritional diet was effective in the prevention and treatment of blast hearing damage of cochlear hair cells.     

我院加强医疗质量与安全管理的做法

本文从狠抓标准化建设、健全组织机构、注重环境监管、加强岗位培训、狠抓制度落实、深化管理创新、强化管理职能、强化责任意识和增强防范意识等方面,总结了加强医疗质量与安全管理的做法。