喉头喷雾器污染状况调查与5种消毒方法消毒效果的比较

目的调查喉头喷雾器使用前后的污染状况,探讨理想的消毒方法以降低医院感染发生率.方法分别用酒精、酒精灯烧烤、氧化电位水、碘伏和碘酒+酒精5种消毒方法对喉头喷雾器消毒,操作方法按"消毒技术规范"规定方法进行,并比较5种方法的消毒效果.结果使用前的喷雾器有细菌存在;使用后的喷雾器存在严重的污染,有大量的细菌,除了有口咽部和鼻腔分布的正常菌群外,还有较多的致病菌;5种方法消毒效果均较明显,酒精灯烧烤法与碘酒+酒精法优于氧化电位水冲洗、碘伏和酒精擦拭3种消毒方法.结论要重视喉头喷雾器污染状况,并选用合适方法进行严格消毒,防止侵 入性操作引起医源性医院感染的发生.酒精灯烧烤法与碘酒+酒精擦拭法是较理想的消毒方法.     

Morphometric analysis of particulate debris extracted by four different embolic protection devices from coronary arteries, aortocoronary saphenous vein conduits, and carotid arteries

Different embolic protection devices have been introduced for endovascular interventions: filters or balloon occlusion and aspiration systems. Despite widening use in a variety of vascular beds and clinical syndromes, little is known about the particulate burden liberated from different vascular beds and caught by different protection devices. We performed histologic and morphometric analyses of particulate debris captured during stenting of degenerated saphenous vein bypass grafts and native coronary arteries during acute myocardial infarction or during elective intervention and carotid arteries to assess the relative performance of different protection devices. We analyzed 232 interventions (90 saphenous vein bypass grafts, 77 native coronary arteries, and 65 carotid arteries) with 4 different devices (65 FilterWires, 99 Interceptors, 41 GuardWires, and 27 Proxis catheters) using the RapidVue particle analyzer. No difference in embolic volume retrieved was demonstrated between devices in saphenous vein bypass grafts and carotid interventions. A smaller volume of particulate debris was retrieved by the GuardWire compared with the FilterWire and the Proxis catheter in native coronary artery interventions. The Interceptor and the GuardWire captured more smaller particles than did the FilterWire or Proxis catheter. During saphenous vein bypass graft or carotid intervention, different embolic protection strategies were performed similarly. In native coronary artery stenting, however, proximal embolic protection retrieved larger amounts of debris than did distal filters or occlusion devices. These data may allow greater tailoring of embolic protection device development and application in specific anatomic locales.     

解毒通络方对脑缺血损伤大鼠海马与皮质神经递质变化的影响

目的:观察解毒通络方对脑缺血大鼠恢复期海马与皮质中单胺类递质和乙酰胆碱含量的影响。方法:实验于2005-05/2006-02在北京中医药大学病理实验室与中国中医科学院西苑中医院药理实验室完成。选择健康SD大鼠150只,采用双侧颈总动脉夹闭结合低血压状态制作脑缺血模型,将造模成功的150只大鼠随机数字表法分为5组,正常组、模型组及解毒通络方低剂量组、中剂量组、高剂量组,各30只。每组又分为造模后4,8周2个时相点,每个时相点15只。各剂量治疗组每天按不同剂量灌服解毒通络口服液(由栀子、丹参、黄芪、天麻等组成),低、中、高剂量分别相当于生药1.85,3.7,7.4g/kg,配置成给药体积为5mL/kg的溶液;模型组、正常组同时灌胃相应体积的洁净水。以改进的柱前、柱后双酶柱结合高效液相电化学方法检测大鼠海马与皮质的乙酰胆碱含量;以高效液相电化学方法检测大鼠海马与皮质的单胺类神经递质及其代谢产物的含量。结果:纳入动物150只,均进入结果分析。①脑缺血后4周模型组大鼠海马去甲肾上腺素水平与正常组比较显著升高[分别为(797.29±60.04),(528.90±149.13)μg/L,P<0.01]、乙酰胆碱水平显著降低[分别为(19.72±10.09),(39.73±22.31)μg/L,P<0.01],皮质去甲肾上腺素、高香草酸水平与正常组比较显著降低[分别为(52.81±21.71),(258.65±125.82)μg/L,P<0.01;(5.22±3.19),(9.02±2.27)μg/L,P<0.05],海马与皮质多巴胺、5-羟色胺及其他代谢物及皮质乙酰胆碱水平均无明显变化。②脑缺血后8周模型组大鼠海马去甲肾上腺素、多巴胺水平与正常组比较显著升高[分别为(346.88±125.98),(110.76±18.56)μg/L,P<0.05;(7.16±3.52),(3.78±0.44)μg/L,P<0.01],5-羟色胺、乙酰胆碱水平显著降低[分别为(79.38±26.47),(127.64±23.03)μg/L,P<0.01;(14.75±5.21),(22.59±6.58)μg/L,P<0.05],皮质去甲肾上腺素水平也显著降低[分别为(57.67±18.30),(133.43±39.15)μg/L,P<0.01],皮质单胺类递质代谢产物及乙酰胆碱水平则无明显变化。解毒通络方可使上述各项指标的绝大部分恢复到接近正常大鼠水平。结论:解毒通络方能够有效促进脑缺血大鼠海马与皮质中单胺类递质和乙酰胆碱代谢紊乱状态的恢复。     

Impact of yeast-bacteria coinfection on the detection of Candida sp. in an automated blood culture system

Invasive candidiasis remains a major cause of morbidity and mortality. It is now well known that an early diagnosis contributes to the patients' outcome. Blood cultures, which are the first-line test in case of bloodstream infection suspicion, can be carried out using fungus-selective medium (containing antibiotics) or standard microorganism medium allowing both bacterial and fungal growth. Some patients can suffer from polymicrobial sepsis involving bacteria and yeasts, so we decided to investigate in blood cultures the influence of the presence of bacteria on fungal development. Simulated blood cultures were performed using Candida albicans or C. glabrata coincubated with Escherichia coli or Staphylococcus aureus at different concentrations. The results showed that, in a standard microorganism medium, bacterial growth could hide the fungal development. Thus, in patients at risk of invasive candidiasis, the use of a specific fungal medium could improve the diagnosis and allow an earlier efficient antifungal treatment.     

超声造影和增强CT诊断肾盂癌的比较研究

目的 对比分析超声造影和增强CT显示肾盂癌血流灌注特点的异同点,探讨超声造影的临床应用价值.方法 对40例行超声造影和增强CT检查并经手术病理证实的肾盂癌病例进行回顾性分析,观察肿块的增强时相和增强方式,包括肿块的增强、消退时间和灌注表现.结果 超声造影显示皮质期40个肿块全部增强;同步增强14个,缓慢增强26个;达峰值呈低回声31个,高回声4个,等回声5个;实质期快速消退35个,同步消退2个,缓慢消退3个;显示最小病灶为1.5 cm.增强CT显示38个肿块增强,多呈轻、中度均匀强化,增强程度低于周围肾实质.超声造影诊断准确率为77.5％(31/40),增强CT诊断准确率为82.5％(33/40),两者比较差异无统计学意义(P＞0.05).结论 超声造影和增强CT对肾盂癌均有较高的诊断准确率,联合检测可提高早期诊断的检出率.     

杜仲甙治疗被动吸烟导致的骨质疏松的实验研究

目的通过实验研究探讨杜仲甙治疗被动吸烟导致的骨质疏松的效果。方法本研究构建被动吸烟引起的骨质疏松模型,同时通过杜仲甙灌胃治疗的方法观察对被动吸烟引起的骨质疏松的疗效。30只SD大鼠分为对照组、被动吸烟组、杜仲甙治疗组,每组10只,处理后分别观察大鼠的体质量、骨密度、血清钙、碱性磷酸酶、酸性磷酸酶、骨形态学等指标,分析杜仲甙对骨质疏松的治疗情况。结果杜仲甙治疗组大鼠体质量较被动吸烟组大鼠体质量高16%;杜仲甙治疗组大鼠的骨密度值（0.209±0.029）g.cm-2明显较被动吸烟组骨密度值（0.171±0.0...     

金纳米链与人喉癌Hep-2细胞共培养自由进出细胞的形式

背景：金纳米颗粒对肿瘤细胞具有杀伤效应。目的：观察金纳米链对人喉癌Hep-2细胞增殖的影响。方法：首先运用葡萄糖体系合成法制备金纳米链溶胶,然后MTT法检测不同终浓度（10%,25%,50%,75%,95%）金纳米链溶胶对人喉癌Hep-2细胞增殖的影响,并通过电镜观察金纳米链进出Hep-2细胞的过程。结果与结论：金纳米链在75%和95%高浓度时对Hep-2细胞增殖有一定的抑制,但并没有随着浓度的增加而加重,均属于一级范围,表明金纳米链对人喉癌Hep-2细胞无毒性。金纳米链在与Hep-2细胞共培养8h后即能以胞吞的方式进入细胞,48h后大部分出胞,能够自由进出细胞。     

老年人血浆D-二聚体增高相关因素研究

目的从凝血系统、纤溶系统及血管内皮系统的角度,分析影响老年人D-二聚体增高的相关因素。方法研究对象为2011年3～11月海军总医院体检或门诊就诊老年人群。符合标准的有132例老年人,年龄60～91岁,男:女=68:64。根据D-二聚体检测结果(D-二聚体参考区间0～232ng/mL)将研究对象分为增高组和正常组。记录临床资料及病史;检测凝血系统、纤溶系统及血管内皮因子等相关指标。统计学分析:两组计量资料采用t检验和非参数检验,计数资料采用χ2检验;偏相关分析变量间关系。结果增高组与正常组比较年龄、纤维蛋白原、血管性血友病因子抗原和血栓调节蛋白水平增高,差异均有统计学意义(P值分别为0.000、0.001、0.000和0.008),增高级珠以上指标均高于正常组。固定变量年龄,DD水平的对数值与血管性血友病因子抗原、血栓调节蛋白和纤维蛋白原水平的偏相关系数分别为0.450(P=0.001)、0.301(P=0.025)和0.187(P=0.034),相关关系显著,且密切程度递减,即DD水平的对数值与反映血管内皮受损的指标(血管性血友病因子抗原和血栓调节蛋白)的密切程度强于DD水平的对数值与反映凝血的指标(纤维蛋白原)。结论老年人D-二聚体水平随年龄增高而升高可能与血管内皮受损有关。     

组织多普勒超声测定正常人心肌作功指数

目的应用组织多普勒成像(TDI)评价正常人左心室Tei指数。方法对50例正常人分别行超声心动图检查,脉冲血流多普勒方法测算传统Tei值(conventionalTeiindex,c-Tei,);TDI条件下,分别显示二尖瓣环后间隔位点和左室侧壁位点(心尖四腔观)、左室前壁位点和下壁位点(心尖二腔观)、前间隔位点和左室后壁位点(心尖左室长轴观),分别测算各位点的Tei值,取6个位点测值的均值作为左心室整体Tei指标(tissueDopplerTeiindex,t-Tei)测值。结果正常人的左心室整体t-Tei测值为(0.41±0.07),各年龄组间Tei指数测值无明显差别(P>0.05)。不同室壁间心肌的Tei指数测值无差别(P>0.05)。将正常人t-Tei测值与c-Tei值(0.44±0.08)进行比较,无统计学差异(P>0.05)。结论TDISK准确测定正常人心脏整体Tei指数及心肌各节段Tei指数,为评价Tei指数提供了一种新的检测手段。     

Tumor thrombus types influence the prognosis of hepatocellular carcinoma with the tumor thrombi in the portal vein

BACKGROUND/AIMS: To evaluate the benefits of the tumor thrombus types system on determining treatments and prognosis of hepatocellular carcinoma patients (HCC) with tumor thrombi in the portal vein. METHODOLOGY: According to anatomic features of the portal vein in the liver and tumor thrombus of HCC developing modes, a uniform tumor thrombus types system (types I-IV) was first recommended. 84 HCC patients with portal vein tumor thrombi, which from January 2000 to January 2003 in the Eastern Hepatobiliary Surgery Hospital, were divided into I-IV groups according to types I-IV of the tumor thrombus system. The median survival periods and effectiveness of surgical resection or non-resection for I-IV groups were retrospectively observed. RESULTS: The median survival periods for patients of group I (n=17), II (n=26), III (n=35) and group IV (n=6) were 10.1, 7.2, 5.7 and 3.0 months, respectively (p = 0.0001). From tumor thrombus type I to type III, the patients received surgical resection were better than that of non-resection (P = 0.0006). Among the patients receiving resection treatment, resection of tumor thrombus type I had the best effects, while for patients with tumor thrombus type IV, the results were not good. In case of non-resection treatments, the survival periods of patients with tumor thrombi type I, II and III were similar, which supposed that TACE may be of little effects on tumor thrombi. CONCLUSIONS: Types of tumor thrombus system suggested may be helpful to determine the treatments and prognosis of HCC patients with tumor thrombi in the portal vein.