巩膜隧道小切口白内障摘除76例疗效观察

目的:探讨基层医院开展白内障摘除人工晶体植入术简便易行的术式。方法:比较76例巩膜隧道6 mm小切口与对照组12 mm大切口术后视力、角膜散光等。结果:由于6 mm巩膜隧道小切口下前房保持好,空间大,易操作,故术后视力≥0.5者占59.2%以上,角膜散光手术前后变化仅为0.08 DS。结论:基层医院在有限条件下开展白内障摘除人工晶体植入术,采取巩膜隧道内小切口术式值得一试。     

脑动脉瘤破裂伴发急性硬膜下血肿的诊治

目的 探讨脑动脉瘤(AN)破裂所致的急性硬膜下血肿(ASDH)的临床、影像学特点和诊治方案。方法 回顾288例破裂AN，发现10例伴有ASDH。Huni Hess分级，Ⅱ级3人，Ⅲ级1人，Ⅳ级3人，Ⅴ级3人，均经CTA诊断为AN破裂，除2例外均被脑血管造影或手术所证实。保守治疗2例，血肿清除加AN夹闭术4例，电解脱弹簧圈(GDC)栓塞后加血肿清除2例，栓塞加脑室外引流1例，单纯栓塞l例。结果 疗效优者2例，中残者l例，7例死亡。结论 AN性ASDH的预后极差，同术前分级相关；CTA检查后立即行血肿清除加动脉瘤夹闭有助于提高预后，合适患者可联合栓塞和血肿清除术。     

Antimicrobial susceptibility of respiratory Haemophilus influenzae strains isolated from pediatric respiratory tract infections

BACKGROUND: Haemophilus influenzae (H. influenzae) is the most frequent bacterial pathogen of respiratory tract infections in children. Detection of antimicrobial susceptibility of H. influenzae is necessary for institution of appropriate antibiotic treatments. METHODS: A total of 281 strains of H. influenzae isolated from sputum samples of 281 pediatric patients with respiratory tract infections were recruited for study. Antibiotic susceptibility was determined by assessing minimum inhibitory concentrations (MIC) of antimicrobial agents. MIC were measured by utility of Agar dilution susceptibility test. RESULTS: Of the total, 38 (13.5%) strains produced beta-lactamase (BLP), 56 (19.9%) strains were beta-lactamase non-producing, ampicillin resistant (BLNAR). The overall resistant proportion to ampicillin was 33.4%. The data indicated that sulbactam/ampicillin, cefotaxime, ceftriaxone and cefditoren are effective against BLP strains. In addition, a high prevalence of BLNAR H. influenzae strains was identified, with an overall isolation rate of 19.9%. Those strains mainly demonstrated intermediate level to ampicillin (ampicillin-MIC 相似文献   

A preliminary study of the relationship between antibiotic administration and changes in bacteriological profile of wound infection in a burn unit

Objective:To investigate the relationship between antibiotic administration and the changes in bacteriological profile in a burn unit. Methods: The data of consumption of different kinds of antibiotics, including total antibiotic consumption [expressed as the number of defined daily doses (DDD)] as well as pathogen identification, were collected in a 8-year period. The constituent ratios of different kinds of antibiotics in total antibiotic consumption to isolation rates of various species of bacteria were calculated, and their correlation was analyzed. Results: Within this period, it was found that the aminoglycosides and first generation cephalosporins were used less frequently, while the polypeptides, carbopenem and macrolides were used proportionally more. At the same time, the isolation rates of Staphylococcus aureus, Acinetobacter sp, Enterobacter cloacae, Klebsiella pneumoniae and methicillin-resistant Staphylococcus aureus were gradually increased. The constituent ratios of predominant pathogens were correlated to the different kinds of antibiotics consumption in the burn unit. Conclusion: The results suggested that the consumption of different antibiotics was closely related to the trends of emergence of bacterial isolates from infected burn wounds. The result might imply that to regulate the administration of certain antibiotics might help decrease the emergence of certain pathogenic bacteria in burn infections.     

川芎嗪对预防犬急性脊髓损伤神经保护作用的实验研究

目的研究川芎嗪对犬急性脊髓损伤模型的神经保护作用。方法Allen’s法打击犬胸13节段脊髓制成急性脊髓损伤模型，所有动物均行介入下选择性动脉插管至伤椎水平肋下动脉，留置导管作为局部给药途径。实验动物随机分为正常对照组、脊髓损伤组、川芎嗪治疗组。术后采用胥少汀脊髓功能评分标准对脊髓神经功能进行评分、MRI检查、血清和脑脊液中髓鞘碱性蛋白(MBP)和S-100B蛋白的测定来衡量脊髓损伤程度和药物治疗效果。结果川芎嗪治疗组在各时间点的神经功能评分高于脊髓损伤组并且在1W有统计学意义。核磁共振检查发现川芎嗪治疗组的相对信号值低于脊髓损伤组，在72h、1W有统计学意义。川芎嗪治疗组血清和脑脊液中MBP低于脊髓损伤组，并且MBP在72h时差异有显著性。结论川芎嗪对于急性脊髓损伤具有神经保护作用。     

睫状体缝合复位术的临床观察及护理

目的:探讨适合睫状体缝合复位术病人的护理方法。方法:对34例(34只眼)因外伤致睫状体分离和脱离导致低眼压,随后行睫状体缝合复位术的病人进行观察和护理。结果:32只眼术后1周至6个月眼压恢复正常,其中5只眼术后2～5个月内分别进行第二次手术或氩离子激光光凝而痊愈。视力改善者21例,无变化者13例。结论:睫状体缝合复位术是治疗外伤性睫状体分离和脱离的有效方法。术前行超声生物显微镜(UBM)检查、术后密切观察眼压变化并给予正确处理、做好心理护理和出院指导是确保手术成功的重要措施。     

胃癌高系家族成员胃蛋白酶原C基因多态性及其诊断意义的探讨

采用限制性酶切片段长度多态性分析法，检测在胃癌高发区庄河检出的１９例胃癌高系家族成员胃蛋白酶原Ｃ基因多态性，发现三种常见片段及一种稀有片段。对其中４例携带稀有片段的受检者进行了胃镜追踪观察，２．５年后发现１例早期胃癌。本文对此作了初步探讨。     

Evaluation of hypothesis testing for comparing two populations using NONMEM analysis

In a simulation study of inference on population pharmacokinetic parameters, two methods of performing tests of hypotheses comparing two populations using NONMEM were evaluated. These two methods are the test based upon 95% confidence intervals and the likelihood ratio test. Data were simulated according to a monoexponential model and, in that context, power curves for each test were generated for (i)the ratio of mean clearance and (ii)the ratio of the population standard deviations of clearance. To generate the power curves, a range of these parameters was employed; other pharmacokinetic parameters were selected to reflect the variability typically present in a Phase II clinical trial. For tests comparing the means, the confidence interval tests had approximately the same power as the likelihood ratio tests and were consistently more faithful to the nominal level of significance. For comparison of the standard deviations, and when the volume of information available was relatively small, however, the likelihood ratio test was more able to detect differences between the two groups. These results were then compared to results on parameter estimation in order to gain insight into the question of power. As an example, the nonnormality of estimates of the ratio of standard deviations plays an important role in explaining the low power for the confidence interval tests. We conclude that, except for the situation of modeling standard deviations with only sparse information, NONMEM produces tests of significance that are effective at detecting clinically significant differences between two populations.Partial support from the Upjohn Company, NIH-BRSG SO RR 07066, and the Burroughs Wellcome Foundation.     

交链孢酚单甲醚在大鼠小鼠体内的分布

对食管癌高发区粮食中分离的互隔交链孢霉的毒素交链孢酚单甲醚(AME)在大鼠、小鼠体内的分布进行研究。给动物腹腔内注射氚标记的交链孢酚单甲醚(~3H-AME),然后在不同时间测各脏器的放射性。结果表明:在所测9个脏器中,2h肝脏含量最高,食管下段在大小鼠分别居第四和第三。但大小鼠分别在72、24h则以食管下段最高,说明AME及其代谢物在此清除较慢,即对其有较高的亲和力。     

缺血－再灌注兔心肌肌浆网自由基的测定

应用电子自旋共振波谱仪（ＥＳＲ）直接检测了缺血－再灌注兔心肌肌浆网自由基的变化，以探讨肌质网系统与氧自由基的关系。实验中将２０只兔随机分为再灌注对照组、超氧化物歧化酶（ＳＯＤ）组、ＡＴＰ－氯化镁组和人参皂甙Ｒｅ组。实验结果，ｇ值２．００４６处为半醌自由基波谱，其相对浓度各组依次为７８．９４±２．１２６，１４．４６±２．８６，２０．６５±７．６５，１４．６６±３．６７（ｘ±ＳＤ），对照组与用药组均有显著性差异（Ｐ＜０．０５），表明缺血－再灌注兔心肌肌浆网产生大量的自由基，用ＥＳＲ可以直接检测到半醌自由基，外源性高能磷酸盐制剂ＡＴＰ－氯化镁及人参皂甙Ｒｅ与超氧化物歧化酶一样，发挥清除兔心肌肌浆网自由基的作用。