骨科外固定架相关感染的危险因素及预防

目的分析骨科外固定架相关感染的危险因素,提出预防性管理措施。方法对2005年5月-2007年5月收治的固定架固定各种疾病542例患者进行了回顾性调查分析,密切观察是否有感染出现并对伤口分泌物进行细菌培养。结果542例外固定架固定患者中,总感染率为2.77%,其中肢体延长患者发生伤口感染6例,感染率为8.82%;骨不连和骨缺损患者固定后发生感染3例（5.36%）;普通骨折外固定后感染发生率最低,为0.39%。结论外固定架的穿针位置是最常见的感染部位,而耐药性细菌是产生术后感染的最常见菌群,因此增加外固定架的稳定性、加强手术室感染管理,术后伤口充分引流、抗菌药物合理使用等,是预防骨科外固定架相关感染最有效的管理措施。     

TACE联合应用内皮抑素对兔VX2肝癌VEGF表达的影响

目的研究兔VX2肝癌经导管肝动脉栓塞化疗术（TACE）联合应用内皮抑素（ES）后残瘤组织血管内皮生长因子（VEGF）的表达情况及意义。方法建立兔肝移植瘤模型，随机分为对照组（NS，n=10），TACE组（Lipidol＋ADM，n=10）和抗血管生成组（Lipidol＋ADM＋ES，n=10），TACE术后1周取出病理标本，利用免疫组织化学染色和半定量RT-PCR的方法，分别从蛋白和分子水平对残瘤组织VEGF的表达进行检测。结果VEGF蛋白的平均光密度值：对照组为0．130±0．038，TACE组为0．200±0．049，抗血管生成组为0．120±0．047，TACE组与对照组和抗血管生成组之间比较均具有明显差异性（P〈0．01）；VEGF165 mRNA的相对吸光度值：对照组为0．850±0．056，TACE组为1．100±0．087，抗血管生成组为0．720±0．065，TACE组表达水平最高，与其余两组比较差异非常明显（P〈0．01）。结论TACE联合应用内皮抑素治疗与单纯化疗栓塞相比可以明显降低肿瘤VEGF的表达，联合治疗可能影响肝癌的复发和转移。     

深低温体外循环温度管理

目的探讨深低温体外循环(Extracorporeal c ircu lation,ECC)温度管理策略。方法选取15例夹层动脉瘤患者在深低温停循环下行主动脉弓部手术,ECC复温过程中采用平衡变温方法进行温度管理,用pH稳态管理酸碱平衡,合理应用药物。结果动脉血气指标PaCO2及pH值等维持在正常范围内,全组无神经系统等重要脏器并发症,无术后明显体温降低。结论深低温下采用pH稳态血气管理、平衡复温、合理应用药物等综合措施,能取得满意的临床效果。     

构建以读者为中心的高校图书馆文化

阐述了图书馆文化的内涵和构建以读者为中心的图书馆文化的意义,提出了构建以读者为中心的图书馆文化的途径和方法。     

Efficacy and safety of acarbose in the treatment of elderly patients with postprandial hypotension

Background Postprandial hypotension （PPH） occurs frequently in elderly people and may lead to syncope, falls, dizziness, weakness, angina pectoris, and stroke. Some studies suggest that the magnitude of the postprandial fall in blood pressure （BP） is influenced by the rate at which glucose enters the small intestine. We hypothesized that acarbose （α-glucosidase inhibitor）, a hypoglycemic agent that decreases the rate of glucose absorption in the small intestine, would attenuate PPH in the elderly, and would be safe in the treatment.
Methods Forty-three elderly in-patients with PPH were recruited. All of them were in relatively stable conditions. They had semi-liquid standard meals without and with acarbose for the two following days： screening day and intervention day. Blood pressure and heart rate （HR） were recorded at baseline and every 15 minutes for 120 minutes using a non-invasive ambulatory blood pressure monitoring system during the study, and ejection fraction （EF） and fractional shortening （FS） were measured by two dimensional echocardiography.
Results Compared with the screening day, the falls in systolic, diastolic and mean arterial blood pressure （SBP, DBP, MAP） （all P 〈0.05） were significantly attenuated after taking acarbose during breakfast, so were MAP （P 〈0.05） during lunch, DBP （P 〈0.05） and MAP （P 〈0.05） during supper. The change of HR was not statistically significant after taking acarbose in three meals. EF and FS were positively correlated with the relief rate. The effective power was 63%, and the incidence of adverse drug reaction （ADR） was 9%.
Conclusion Acarbose is effective and safe in the treatment of elderly patients with PPH.     

Dissociation,unfolding and inactivation of creatine kinase in urea solutions

It was previously reported that, during unfolding of creatine kinase in guanidinium chloride or urea solutions, inactivation occured before noticeable conformational change could be detected, suggesting that the conformation at the active site is more easily perturbed and, hence, more flexible than the molecule as a whole [Tsou (1986) Trends Biochem. Sci. 11 , 417–429]. In the present paper, the urea-gradient electrophoresis and the isoenzyme hybrid of creatine kinase has been studied. The results show that at low urea concentrations, creatine kinase is still in the dimeric state or only slightly dissociated. The dissociation and inactivation of creatine kinase during denaturation by urea are also compared. It was found that the enzyme was nearly inactivated in low urea concentrations before noticeable dissociation was detected. It therefore appears that in low urea concentrations, inactivation of creatine kinase is not due to the dissociation of the active dimer. The present result supports the hypothesis of the conformational flexibility of the active site in this enzyme. © Munksgaard 1996.     

高温高湿环境颅脑火器伤脑组织病理变化研究

目的研究高温高湿环境颅脑火器伤后脑组织病理学的改变,方法选用杂种狗6只,在高温高湿环境下采用国产54式军用手枪,7.62mm手枪弹,枪口距动物30 cm远,于狗额部冠状方向致狗脑火器伤。伤后脑组织大体病理及切片进行光、电镜下形态学变化观察。结果脑组织挫伤出血,神经毯疏松,神经胶质细胞肿胀,白质内大量轴索损伤;脑血管周围间隙明显增宽和脑内血管痉挛表现;皮层下细胞存在液化坏死,皮层细胞空泡变性及坏死;外伤性蛛网膜下腔出血。结论高温高湿环境颅脑火器伤白质内轴突损伤严重,除原发伤道区、挫伤区和震荡区外,枪伤可引起皮层神经细胞的反弹性损害和皮层下组织细胞的挤压性破坏。     

高温高湿环境下颅脑火器伤血液流变学变化研究

目的研究高温高湿环境下颅脑火器伤伤前和伤后2 h血液流变学变化。方法选用杂种狗6只,采取高温高湿环境下手枪弹致颅脑火器伤模型。伤前和伤后2 h抽血进行血液流变学检测及相关血气分析。结果高温高湿环境下颅脑火器伤后血液流变学高切、中切、低切和血浆粘度无明显改变,血液PO2值和PaCO2值下降。结论高温高湿环境下颅脑火器伤后早期血液流变学变化不明显。     

高温高湿颅脑火器伤血气分析和电解质变化

目的研究高温高湿环境下颅脑火器伤血气分析和电解质变化。方法选用杂种狗6只,采取高温高湿环境下手枪弹致颅脑火器伤模型。检测伤前与伤后2 h血气分析和电解质改变。结果伤后血液PO2、BE、HCO3-、PaCO2、TCO2下降,血钠、钙离子浓度无明显变化,血钾离子浓度降低。结论高温高湿环境下颅脑火器伤中可引起低氧、呼吸性碱中毒和低钾血症。     

隐孢子虫免疫学检测方法研究进展

隐孢子虫病是一种重要的人兽共患机会性致病原虫病,可通过食源和水源等途径传播,主要引起免疫抑制人群和易感动物腹泻,有重要的公共卫牛意义.免疫学检测方法有特异性强、灵敏度高等特点,应用广泛.该文主要介绍了免疫荧光榆测、酶免疫分析法、免疫层析法、酶联免疫电转印法、免疫磁珠分离法、流式细胞仪技术等几种常用的隐孢子虫免疫学检测方法,并初步分析了各种方法的优、缺点.