重庆市肺结核可疑症状者就诊延迟及其影响因素研究

目的了解重庆市肺结核可疑症状者就诊延迟程度,探索影响就诊延迟的主要因素,以及流动人口和常住人口间影响因素的差异。方法在重庆市流动人口较多的两个区中,对在随机抽取的20所医疗机构就诊,年龄在15岁以上的肺结核可疑症状者进行问卷调查。结果590份有效问卷中,就诊延迟中位时间为19 d;其中常住人口15 d,流动人口为22．5 d。影响就诊延迟的主要因素有:出现症状后是否愿意就诊、职业、文化程度、结核病史、恩格尔系数、就诊点远近、有无医疗保障、婚姻状况和性别。结论肺结核可疑症状者就诊延迟较为严重;影响其就诊延迟的主要因素有出现症状后是否愿意就诊等。采取综合性干预措施,有助于减少肺结核可疑症状者就诊延迟,提高结核病发现率。     

指背血管蒂逆行岛状皮瓣的临床应用

目的：探讨一种新的方法修复手指部皮肤软组织缺损。方法：以手指背血管为蒂，于近节指背、指蹊及掌背远端区域设计逆行岛状皮瓣转移至手指皮肤软组织缺损处，皮瓣及蒂部包涵指背动脉及指背浅静脉，皮瓣供区可直接拉拢缝合或皮片移植修复。结果：1999年10月～2002年8月，临床应用12例13个皮瓣，11个皮瓣完全成活，2个皮瓣发生表皮层坏死，经换药后自愈。结论：指背血管蒂逆行岛状皮瓣邻近手指皮肤软组织缺损区，血运可靠，可以安全、简便地修复手指创面。     

经喉内镜手术治疗喉部疾病的并发症分析

目的：分析经喉内镜手术后并发症的发生原冈及其防治措施。方法：使用从德国STORZ公司引进的国内首套喉内镜手术系统，治疗包括声带小结、声带息肉、喉乳头状瘤、声带囊肿、会厌囊肿、喉部炎性假瘤、喉部血管瘤等58例患者，并随访2～36个月，观察主要并发症并作相应处理。结果：58例患者中发音正常者54例，发音功能明显好转者4例。主要并发症有：牙齿松动2例，牙齿脱落1例，声带粘连1例，舌体麻木1例，舌运动障碍1例，术后拔管时喉痉挛1例。结论：经喉内镜手术可住微创的前提下彻底清除病灶，并最大限度地保留发音功能，只要术前严格掌握适应证，术中精细操作，其并发症是可以避免的。     

Azoospermia in two brothers with Kartagener syndrome:a family history and diagnosis

0This article describes 2 infertile brothers of asoospermia equally associated with co-existing sinusitis,bronchiectasis,and situs inversus and their family history.These two cases were diagnosed as Kartagener syndrome(KS).The patients were not offspring of kin marriages but their family members with scattered bronchi-pulmouary infections were discovered.No one manifests azoospermia,dextrocardia or situs inversus in the paternal family ex-cept two cases reported.No abnormalities were found in their mother-side family.KS should be differentiated from Young's syndrome,cystic fibrosis(CF),and other diseases such as Kallmann's syndrome in male infertility clinic.     

外伤性脾切除术后中医证候及免疫功能的研究

目的:研究外伤性脾切除术后中医辨证与免疫功能变化的关系.方法:选择15例脾切除和15例非脾切除患者作为观察对象,以其症状、舌苔、脉象及免疫功能的测定作为观察指标,观察其中医辨证与免疫功能变化.结果:脾切除组在术后早期可出现脾胃虚弱的证候群,同时免疫功能测定补体C3、免疫球蛋白IgG、免疫球蛋白IgM的水平明显降低,与非脾切除组有显著性差异.结论:脾切除容易造成患者术后出现的脾胃虚弱症候群,并降低患者的免疫功能.     

扩张程度和皮肤血运关系的实验研究

目的研究扩张皮肤血运和扩张程度的关系。方法以扩张容量和扩张皮肤面积作为扩张程度的指标，观察猪皮肤在不同程度超量扩张下的皮肤激光多普勒血流值（LDF）和血管造影。结果超量扩张下LDF呈下降的趋势，而血管密度却是增加的，主要以小静脉和微小静脉的增生扩张为主。结论超量扩张下虽然皮肤血管密度增加，但皮肤血运却逐渐下降。本文浅略解释了这一特殊现象的机制。     

手部关节损伤的治疗

目的 通过对手部关节损伤治疗方法的对比和随访观察，总结出各种方法的优缺点，并指出相对较好的治疗方法。方法 1980～2002年对手部关节损伤进行各种手术治疗，通过观察病人术后关节的活动度、肿胀、疼痛、畸形及捏力的改善等项目，评价哪种方法相对更好。结果 通过对各种数据的测量比较，特别是关节活动度的改善情况，认为人工关节置换是所有治疗方法中相对最好的。结论 尽管人工关节置换也有不少缺点，但随着新材料的不断应用和设计的不断改进，其治疗效果将越来越好。     

Degradation of Paclitaxel and Related Compounds in Aqueous Solutions III: Degradation Under Acidic pH Conditions and Overall Kinetics

Paclitaxel and related taxanes are complex molecules with numerous hydrolysable ester groups, possible epimerization at the 7‐position, and possessing a strained oxetane ring, a possible site for acid‐catalyzed cleavage. Presented here is the stability of paclitaxel, 10‐deacetylbaccatin III, baccatin III, and N‐benzoyl‐3‐phenylisoserine ethyl ester in aqueous solution over a pH range of 1–5 at various temperatures. Analysis of various samples was by HPLC–UV and LC–MS. Baccatin III, 10‐deacetylbaccatin III, and N‐benzoyl‐3‐phenylisoserine ethyl ester were found to undergo acid catalysis since pH‐rate profiles all followed a first‐order dependency in hydrogen ion concentration. No evidence of any epimerization was noted at acidic pH values. Baccatin III and 10‐deacetylbaccatin III showed similar degradation rates with possible products being possible dehydration around the 13‐hydroxy group and cleavage of the oxetane ring. Cleavage of the 10‐acetyl group of baccatin III was a minor initial pathway. N‐Benzoyl‐3‐phenylisoserine ethyl ester degraded significantly slower than both 10‐deacetylbaccatin III and baccatin III. At pH 2, paclitaxel degraded at a rate between that of N‐benzoyl‐3‐phenylisoserine ethyl ester and 10‐deacetylbaccatin III. The pH of maximum stability for all compounds appeared to be around pH 4. © 2009 Wiley‐Liss, Inc. and the American Pharmacists Association J Pharm Sci 99: 1288–1298, 2010     

新生儿脐炎85例脐部分泌物细菌学分析

目的：了解新生儿脐部感染细菌学状况，为临床提供预防及治疗参考。方法：调查我院1997年1月－2002年6月收治的有完善细菌学资料的新生儿脐炎85例，对所获得的98例致病菌的种类及药敏状况进行分析。结果：社会获得性感染主要致病菌为G^ 球菌（70．5％），金黄色葡萄球菌占比例较高。医院感染主要致病菌为C^-杆菌（51．4％），以大肠埃希菌占比例较高。两类感染所分离的细菌均具有多重耐药性，但对氨基糖苷类及喹诺酮类耐药率较低，其次是第三代头孢菌素类抗生素。结论：临床对新生儿脐部感染，特别是有严重感染中毒症状时，应首先考虑使用第三代头孢菌素类抗生素。     

Ischemia and reperfusion reduce the endogenous basic fibroblast growth factor in rat skeletal muscles: an immunohistochemical study.

Polyclonal antibodies directed against human recombinant basic fibroblast growth factor were used in immunohistochemical studies to localize this growth factor in normal and wounded rat skeletal muscles. According to the intensity of the stain, three main classes of fibers could be identified: the strongly, moderately, and weakly stained fibers. Basic fibroblast growth factor immunoreactivity was found mainly in the extracellular matrix, primarily in the endomysium, which includes the heparin-containing basal lamina, and also in the capillary basal membrane of both normal and wounded muscles; however, the signal intensity was much stronger in normal muscles. The distribution of basic fibroblast growth factor in wounded muscles became markedly heterogeneous and sparse. After 4 hours of ischemia, about 40% of skeletal muscle fibers lost their basic fibroblast growth factor immuno-reactivity. Muscles which underwent 4 hours of ischemia and 24 hours of reperfusion had only a diminished basic fibroblast growth factor immunoreactivity. The pathologic results supported the concept of destroyed cell connection and fiber necrosis in ischemic and reperfused muscles. Potential mechanisms involved in this reduced concentration of basic fibroblast growth factor in wounded muscles may include oxygen free radical activation, a generalized effect of the inflammatory response, and reduced secretion of endogenous basic fibroblast growth factor. These results are only partially compatible with the established mitogenic role of this growth factor and suggest that a reduction of endogenous fibroblast growth factor may partly contribute to a delay in wound healing.