面部烧伤病人感染危险因素的分析及护理

面部是人体的暴露部位,在烧伤病中占有较大比例。烧伤后很容易引起组织毁损及吸入性损伤,反复感染影响创面愈合,伤愈后常留有色素沉着、瘢痕增生、睑外翻、唇外翻等后遗症,影响面部美观及五官功能,给病人带来长期精神痛苦。我院1998年—2001年面部烧伤病人感染率为6.09%。因此,2002年—2005年,我科护理人员加强面部烧伤感染的防护措施,使其感染率下降到2.49%。正确的护理干预可以有效预防病人感染,减轻各种并发症的发生。现对面部烧伤病人的护理干预报告如下。1临床资料我科2002年—2005年共收治烧伤病人558例,其中面部烧伤281例,男195例,女…     

Characterization of bortezomib-adapted I-45 mesothelioma cells

Background  

Bortezomib, a proteasome-specific inhibitor, has emerged as a promising cancer therapeutic agent. However, development of resistance to bortezomib may pose a challenge to effective anticancer therapy. Therefore, characterization of cellular mechanisms involved in bortezomib resistance and development of effective strategies to overcome this resistance represent important steps in the advancement of bortezomib-mediated cancer therapy.     

36例胰腺浆液性囊腺瘤的临床分析

目的：探讨胰腺浆液性囊腺瘤的诊断和治疗。方法：对1998年6月至2006年9月瑞金医院收治的36例病理诊断为胰腺浆液性囊腺瘤的临床资料进行回顾性分析。结果：胰腺浆液性囊腺瘤好发于中老年女性,多见于胰腺头颈部,无特征性临床表现。B超和CT诊断囊性肿瘤的正确率分别为69%（25/36）和94%（34/36）。CT对于囊腺瘤的诊断正确率为80%（29/36）,对浆液性囊腺瘤的诊断正确率为61%（22/36）。在不能排除或考虑实性假乳头状瘤的病人中MRI对于囊腺瘤的诊断正确率80%（4/5）。本组35例行手术治疗,其中7例行胰十二指肠切除;11例行胰腺节段切除;12例行胰体尾切除;5例行局部切除,1例行剖腹探查活组织检查。10例术后出现并发症,包括胰瘘、内出血、幽门梗阻、胰腺假性囊肿合并肠瘘病人及不同程度的胸腔积液。1例因内出血死亡。本组3例失访,32例获随访,除2例因其它疾病死亡,其余均健在,术后无复发。结论：CT和MRI,结合肿瘤学指标和临床病理特征可大大提高浆液性囊腺瘤的术前诊断率。浆液性囊腺瘤是一种良性的肿瘤,但手术治疗并发症较多。大多数浆液性囊腺瘤可考虑随访;有症状的胰腺浆液性囊腺瘤,或与黏液性囊性肿瘤不能鉴别者,应手术治疗。     

同种异体骨支撑架微创治疗股骨头坏死的临床研究

目的应用改良髓芯减压术结合同种异体骨支撑架加自体骨和脱钙骨基质（decalcified bone matrix，DBM）治疗早期股骨头坏死，探索早期股骨头坏死的微创治疗方法。方法2004年1月～2005年4月，23例24个髋关节采用经大转子下通过股骨颈钻隧道至股骨头骨坏死区，将装有自体松质骨和DBM的同种异体骨支撑架经隧道拧入骨坏死区直至软骨下骨约5mm处，隧道远端用自体髂骨填塞。观察手术前后Harris评分变化、x线影像学表现及是否需进一步治疗。结果本组所有患者均获得随访，平均随访19（12—27）个月，以最后一次随访资料作为最终评价依据。Harris评分，术前优良率为43．5％（10／23）。术后优良率为91．3％（21／23）。22侧髋关节影像学表现保持稳定，无明显并发症发生。结论同种异体骨支撑架植入结合自体松质骨和DBM治疗成人股骨头坏死，增加了股骨头负重区软骨下骨的机械支撑，成骨作用强，有利于股骨头坏死的修复与重建，同时，不破坏患者股骨头本身的血液供应，创伤小，操作简单，值得临床推广使用。     

Isoflurane Preconditioning Improves Long-term Neurologic Outcome after Hypoxic-Ischemic Brain Injury in Neonatal Rats

Background: Preconditioning the brain with relatively safe drugs seems to be a viable option to reduce ischemic brain injury. The authors and others have shown that the volatile anesthetic isoflurane can precondition the brain against ischemia. Here, the authors determine whether isoflurane preconditioning improves long-term neurologic outcome after brain ischemia.

Methods: Six-day-old rats were exposed to 1.5% isoflurane for 30 min at 24 h before the brain hypoxia-ischemia that was induced by left common carotid arterial ligation and then exposure to 8% oxygen for 2 h. The neuropathology, motor coordination, and learning and memory functions were assayed 1 month after the brain ischemia. Western analysis was performed to quantify the expression of the heat shock protein 70, Bcl-2, and survivin 24 h after isoflurane exposure.

Results: The mortality was 45% after brain hypoxia-ischemia. Isoflurane preconditioning did not affect this mortality. However, isoflurane preconditioning attenuated ischemia-induced loss of neurons and brain tissues, such as cerebral cortex and hippocampus in the survivors. Isoflurane also improved the motor coordination of rats at 1 month after ischemia. The learning and memory functions as measured by performance of Y-maze and social recognition tasks in the survivors were not affected by the brain hypoxia-ischemia or isoflurane preconditioning. The expression of Bcl-2, a well-known antiapoptotic protein, in the hippocampus is increased after isoflurane exposure. This increase was reduced by the inhibitors of inducible nitric oxide synthase. Inducible nitric oxide synthase inhibition also abolished isoflurane preconditioning-induced neuroprotection.     

灵芝菌合剂中灵芝多糖含量的测定

目的：探讨灵芝菌合剂中灵芝多糖含量的检测方法。方法：采用分光光度法，以无水葡萄糖为对照品，检测波长为490nm。结果：此方法在0～120μg范围内线性关系良好，灵芝多糖的平均回收率为99．09%。RSB为1．14％。结论：本法简便快捷，准确度高，重现性好，可作为本制剂的质控方法。     

高血压病患者动态脉压与左心室肥厚的关系

OBJECTIVE: To evaluate the relationship between the left ventricular hypertrophy (LVH) and the ambulatory pulse pressure and aortic root dimension (AOD) in essential hypertensive patients. METHODS: We monitored the 24-hour ambulatory blood pressure and applied echocardiography in 107 essential hypertensive patients. Using the left ventricular mass index (LVMI) as an index in evaluating LVH, the patients were divided into 2 groups: 29 cases in the LVH group and 78 in the non-LVH group. RESULTS: The average levels of 24-hour pulse pressure, daytime pulse pressure, nighttime pulse pressure and AOD were significantly different between patients with LVH and without LVH (P < 0.05). Multiple stepwise regression analysis showed that the changes in nighttime pulse pressure and AOD were closely related to LVMI (P < 0.001). CONCLUSION: The pulse pressure and AOD are important factors leading to LVH in patients with essential hypertension.     

支气管动脉栓塞术治疗咯血的疗效分析

目的 评价支气管动脉栓塞术治疗咯血的临床疗效.方法 对45例咯血患者用明胶海绵颗粒、聚乙烯醇(PVA)微球栓塞剂行支气管动脉栓塞术.结果 45例患者均成功行支气管动脉栓塞术,41例咯血完全控制,4例复发,复发率8.9%,5例患者术后出现胸痛和低热不适,无需特别处理,可自行缓解,未出现穿刺部位血肿和截瘫等并发症.结论 支气管动脉栓塞术是治疗咯血的一种快速、安全、有效的方法.     

利福昔明对比环丙沙星治疗急性肠炎临床研究

目的　研究利福昔明对比环丙沙星治疗急性肠炎的有效性和安全性。　方法　采用随机对照方法 ,共治疗 5 1例急性肠炎。利福昔明治疗 2 5例 ,环丙沙星 2 6例 ,用药时间方法相同。观察治疗前后临床症状、大便性状、大便次数、便常规、血常规、尿常规及肝肾功能 ,以了解其疗效及不良反应情况。　结果　利福昔明组 (治疗组 )与环丙沙星组 (对照组 )相比 ,显效率分别为 92 .0 %和 80 .8% ,总有效率分别为 92 .0 %和 96 .2 % ,止泻时间治疗组 2 8.6 7± 15 .92h ,对照组 36 .12± 2 0 .70h ,均未见明显毒副作用。以上各项指标及两组在治疗过程中大便次数变化、大便常规复常率经统计学处理均无显著性差异 (P >0 0 5 )。　结论　利福昔明可用于治疗急性肠炎 ,与环丙沙星比较 ,疗效相仿 ,但耐受性好 ,口服不吸收 ,故值得推广