载银磷酸锆纱布对烧伤创面常见细菌作用的实验研究

目的 了解载银磷酸锆纱布对烧伤大鼠创面感染常见细菌的抗菌效力。方法制作Wistar大鼠烫伤(以下称烧伤)感染模型，采用试管双倍稀释法测定载银磷酸锆及磺胺嘧啶银的最低抑菌浓度(MIC)及最低杀菌浓度(MBC)。观察大鼠创面用磺胺嘧啶银纱布、普通尢菌纱布、载银磷酸锆纱布(小水洗及水洗20次)后痂下组织的细菌计数和对创面愈合的作用。结果载银磷酸锆对金黄色葡萄球菌、铜绿假单胞菌、大肠竹菌的MIC各为8、8、16mg／L，MBC各为16、8、32mg／L，为磺胺嘧啶银的2～8倍?大鼠创面用未水洗的载银磷酸锆纱布覆盖后，痂下细菌计数比用磺胺嘧啶银纱布低91％，比普通无菌纱布低99％未水洗的载银磷酸锆纱布对创面愈合的作用明显优于其他两种纱布，且其痂下组织细菌计数与水洗20次的效银磷酸锆纱布比较，差异无显著性意义(P＞0．05)。结论载银磷酸锆埘烧伤创面感染常见细菌有较强的抑制和杀灭作用，其敷料可作为治疗措施中新的选择。     

中枢神经系统白血病血清神经元特异性烯醇酶测定的临床意义

目的 探讨血清神经元特异性烯醇酶与中枢神经系统白血病之间的关系。方法 对确诊的30例急性白血病患者及匹配的正常人的血清神经元特异性烯醇酶进行测定。结果 中枢神经系统白血病组血清神经元特异性烯醇酶含量21．92 7．5μg/L均明显高于白血病组、对照组，差异有显著性。结论 血清神经元特异性烯醇酶可作为反映中枢神经系统白血病病情的生化指标。     

肌腱结嵌压固定法重建前交叉韧带生物力学实验研究

目的探讨绳肌腱结嵌压固定法重建前交叉韧带(ACL)影响初始固定效果的相关因素及对策。方法采用猪膝关节模拟重建ACL不同术式,即绳肌腱结股骨隧道嵌压固定和胫骨端肌腱编织缝合骨桥打结固定法,与骨-髌腱-骨两端界面螺钉固定法,比较其生物力学初始固定最大拔出载荷、抗拉刚度和位移等生物力学指标。结果最大抗拉载荷肌腱结组与正常ACL组接近,无显著性差异;肌腱结组大于骨-髌腱-骨界面螺钉固定组。抗拉载荷在100N和400N时的位移两组无显著性差异。胫骨端肌腱编织缝合骨桥上打结固定组最大抗拉载荷大于BPTB界面螺钉固定组和肌腱编织缝合后界面螺钉固定组。抗拉刚度正常ACL组>骨-髌腱-骨组>绳肌腱结组。最大位移正常ACL<髌腱骨组<肌腱结组。结论绳肌腱结嵌压固定法抗拉强度和刚度完全可以满足重建后ACL的生理需求;术中克服位移因素,是有效防止ACL重建术后松弛的关键。     

医院感染流行病学监测分析

介绍了我院１９９３年７月１日～１９９３年１２月２０日出院的１０３１例病人医院感染病率的监测分析，半年中感染率为８．４％，妇产科疗区发病率高于外科疗区，感染部位以泌尿道、下呼吸道、手术伤口为最多，侵袭性操作及易感因素引起的感染在感染病例中分别占４０．２％和５９．８％。     

Pancreas divisum with early pancreatic cancer--presenting as chronic obstructive pancreatitis.

A 61-year-old man experienced four bouts of pancreatitis in 1 year. Detailed history taking and a series of examinations, including sonography, computed tomography scan, and endoscopic retrograde cholangiopancreatography (ERCP), revealed pancreas divisum on the first admission. He was treated conservatively. However, repeated ERCP on the fourth admission, 1 year later, showed a small filling defect in the tail of the pancreatic duct. A distal pancreatectomy was carried out. Pathological studies revealed a small papillary adenocarcinoma (1.5 x 1.0 x 0.5 cm) confined to the pancreatic duct grossly with minimal parenchymal invasion microscopically. He has been free from cancer and pancreatitis for 13 months since the operation.     

ICR 小白鼠脏器中铜,锌锰含量

对40只正常成年远交系 ICR 小白鼠的主要脏器,用 WFX—Ⅱ型双光束原子吸收分光光度计测定了各脏器中铜、锌、锰含量.结果表明,主要脏器中铜、锌、锰含量大小顺序不一,铜含量最多的脏器是心,锌、锰含量最多的脏器是肝,在雌雄之间均无显著性差异.     

急性苯中毒对小鼠末梢血象和骨髓细胞构成的影响

取３２只２～３个月的ＢＡＬＢ／Ｃ小白鼠，随机分为４组，每组８只，第１组为对照组，其余３个组为实验组，实验组小白鼠左腿皮下注射苯０．３ｍｌ（１５ｍｌ／ｋｇ体重）．注射后分别于２４ｈ，４８ｈ，７２ｈ脱颈处死。观察中毒前、后末梢血象、骨髓细胞、骨髓细胞构成的变化。结果表明，苯中毒时骨髓变化先于末梢血象的变化，骨髓的病变为造血细胞变性、坏死，大量毛细血管扩张、充血，骨髓细胞构成降低，而且骨髓细胞构成中细胞成分降低早于外周血粒细胞减少。     

Thrombopoietin in postoperative thrombocytopenia following living donor hepatectomy.

Thrombocytopenia is a frequent finding following living donor hepatectomy. It appears more pronounced in right graft donors than in left graft donors. This study analyzed postoperative thrombocytopenia in 20 living liver donors and examined the change of endogenous thrombopoietin (TPO) in its recovery. Platelet count, TPO level, fibrinogen degradation product (FDP), and D-Dimer were measured before surgery and on postoperative days (PODs) 1, 2, 3, 5, 7, and 14. Concurrently, liver and spleen volumes were calculated by computed tomography. Platelet count on POD 3 was significantly lower in right graft donors than in left graft donors (13.0 +/- 3.7 x 10(4)/microL vs. 16.8 +/- 4.0 x 10(4)/microL, P = 0.039) but recovered by POD 7 in all donors. Postoperative elevations of FDP and D-Dimer were significantly higher in right graft donors than in left graft donors. TPO level rose immediately after surgery, peaked on POD 5 in left graft donors and on POD 7 in right graft donors, and fell nearly to preoperative levels by POD 14. Postoperative TPO level per liver volume was significantly higher in right graft donors than in left graft donors. In conclusion, thrombocytopenia following living donor hepatectomy resolved within the first week regardless of graft type and was mainly associated with increasing consumption of circulating platelets, possibly due to intrahepatic and splenic congestion. With a reduced number of circulating platelets, TPO level rapidly increases. Also, with reduced consumption of platelets related to recovery from surgery, thrombocytopenia should resolve. As a consequence, TPO level would be expected to fall.     

关于老年人植入心脏起搏器术后疗养康复的体会

目的避免或减少老年人植入心脏起搏器术后疗养康复过程中起搏器故障和相关疾病的发生。积极治疗基础疾病,改变其不良症状,并通过心理治疗改善不良心理情绪,使其增强自信,提高生活质量。方法入院后,详细了解安置起搏器的时间、类型及工作情况,全面掌握其身体状况和心理特点,为其制定合理的疗养计划。结果疗养期结束后,疗养员无一例出现起搏器故障和发生相关疾病;基础疾病及不良症状得到进一步控制,心理不良情绪得到进一步控制,基本达到了疗养的目的。结论疗养院医务人员应全面了解起搏器的类型及特性;掌握安置起搏器的适应症和容易出现的病症;掌握此类疗养员的身体情况和心理特点,制定合理的疗养计划并按计划认真予以实施,是保证老年人植入心脏起搏器疗养员能够顺利完成疗养生活的有效措施。