Influence of botulinum toxin site of injections on healing rate in patients with chronic anal fissure

BACKGROUND: Botulinum toxin induces healing in patients with idiopathic anal fissure. METHODS: Fifty patients affected by posterior anal fissure were treated with 20 units of botulinum toxin, injection in the internal anal sphincter on each side of the posterior midline (group I) or on each side of the anterior midline (group II). RESULTS: At 2 months evaluation, a healing scar was observed in 15 patients of group I and in 22 patients of group II(P = 0.025). Resting anal pressure was significantly different from the baseline values at 1-month as well as at 2-month check-ups in both groups, but the values were significantly lower in patients of group II. CONCLUSIONS: The intersite comparison revealed that anterior injection of the internal anal sphincter resulted in improved lowering of resting anal pressure and produced an earlier healing scar.     

贯穿以人为本管理思想 建设新时期医院文化

医院文化建设是医院管理的重要组成部分 ,是精神文明建设的主要内容 ,也是医院可持续发展的关键要素。贯穿以人为本的管理思想 ,把医院文化建设作为重点 ,与医院发展同步进行 ,与精神文明建设紧密结合 ,打造医院品牌 ,树立医院形象 ,提高综合效率。     

香烟烟雾溶液作用下大鼠淋巴细胞的氧化应激反应

目的　以细胞内活性氧自由基 (ROS)水平、DNA损伤、脂质过氧化物 (LPO)水平以及超氧化物歧化酶 (SOD)活力为指标 ,研究细胞在香烟烟雾溶液作用下产生的氧化应激反应。方法　以PBS作吸收液 ,用大包氏管收集香烟主流烟雾 ,将香烟烟雾溶液 (CSS)分别以 0、1× 10 - 3、2× 10 - 3、4× 10 - 3、8× 10 - 3、12× 10 - 3、16× 10 - 3支 ml的浓度作用于大鼠淋巴细胞。用 2′ ,7′ 二乙酰二氯荧光素 (DCFH DA)测定细胞内ROS水平 ,用彗星试验检测细胞DNA损伤 ,同时检测细胞内SOD活力和LPO水平。结果　 2× 10 - 3支 ml以上剂量组二氯荧光素 (DCF)荧光强度、彗星尾长以及LPO水平均显著高于对照组 ,且随剂量增加而增加。 16× 10 - 3支 ml组SOD活力显著低于对照组。与对照组相比 ,1× 10 - 3支 ml组LPO水平显著降低、SOD活力则显著增高。结论　CSS达到一定剂量时使细胞内ROS水平增高 ,引起细胞DNA损伤和脂质过氧化 ,高剂量时SOD活力降低 ,而低剂量时能够诱导SOD活力     

HCV准种复杂性与干扰素疗效关系的初步探讨

目的　探讨丙型肝炎病毒 (HCV) 1b型患者HVR1 ,NS5A区准种复杂性与干扰素疗效的关系。方法　应用单链构象多态性聚合酶链反应 (SSCP)法检测慢性丙型肝炎患者干扰素治疗前后HCV准种的动态变化。结果　治疗前HCVHVR1准种的SSCP条带数 (复杂性 )≤ 3者在经干扰素治疗后HCVRNA阴转率为 71 .4 3% ,>3者HCVRNA阴转率为 1 5 .38% ,两者相比 ,差异有显著性 (P <0 .0 5 ) ;治疗有效组SSCP条带数为 2 .4 3± 0 .98( x±s) ,无效组为 4 .4 6± 0 .88,两者相比 ,差异亦具显著性 (P <0 .0 1 )。而NS5A区SSCP条带数则无差异。结论　HCV1b型慢性丙型肝炎患者HVR1区准种的复杂性与干扰素疗效有关 ;而NS5A区准种的复杂性与干扰素疗效无关。     

我院医院感染现患率调查分析

目的了解某院医院感染现患率,发现医院感染管理中存在的问题和医院感染发生的特点,以改进预防控制措施.方法统一培训调查人员,床旁询问病史、体格检查与在架病历调查相结合,填写统一的个案调查表.对调查日处于医院感染状态的病例进行统计分析.结果应查病例512人,实查495人,实查率96.68%.发生医院感染40例,41例次,医院感染现患率为8.08%、例次现患率为8.28%,高于日常连续性调查结果.医院感染部位以下呼吸道居首位.结论医院感染现患率调查有利于发现医院感染管理工作中存在的问题,为制定医院感染监控措施提供可靠依据.     

荧光分光光度法测定饮用水中挥发酚类的研究

〔目的〕分析 4-氨基安替比林氯仿萃取分光光度法、直接荧光分光光度法、正丁醇萃取荧光分光光度法三种方法测定水中挥发酚的优缺点及适用范围 ,旨在找出一个更好的检测方法测定饮用水中挥发酚。〔方法〕使用此三种方法分别测定样品及标准中的挥发酚的含量 ,比较其相关系数、线性范围、灵敏度、回收率与检出限。〔结果〕以上三种方法的相关系数分别为 0 .9988、0 .9998、0 .9994,线性范围分别为 0 -0 .0 40mg L、0 -0 .0 40mg L、0 -0 .0 2 0mg L ,平均回收率分别为 95 .9%、10 0 .2 %、96.9% ,检出限分别为 0 .0 0 2mg L、0 .0 0 10 7mg L、0 .0 0 0 3 3mg L ,灵敏度分别为 11.177、3 2 61.9、3 745 6。〔结论〕正丁醇萃取荧光分光光度法有很好的灵敏度、回收率、检出限和相关系数 ,方法较简单且试剂毒性小 ,适合饮用水中挥发酚测定的国家标准要求 ,可以取代 4-氨基安替比林氯仿萃取分光光度法成为国家标准方法。     

关于血液透析机维护和管理中需要注重的问题

随着医疗卫生事业的飞速发展，大量高科技电子设备不断涌现，是技术密集．知识密集、资金密集的产品，而血液透析机无论是国产还是进口的设备，（进口占比侧大），均属高科技机电一体化医电产品，并且采用微机技术．自检报警功能多，操作相对复杂，而不同产地（不同型号其操作方法和日常维护方法也不同着重阐述了透析机供电和透析掖的配制和血液透析机的维护与保养和维修。     

4799例妇女病普查结果分析

目的:掌握和了解十堰市妇女常见病、多发病患病率,制定干预措施。方法:于2004年1~12月对十堰市4 799名妇女进行了妇科病、乳腺病普查。结果:4 799人中患各种妇科病1 885人,患病率为39.28%。妇科疾病前3位是阴道炎、宫颈糜烂、附件炎或附件包块,4 799例中患乳腺疾病者570人,患病率为11.88%,乳腺疾病以乳腺增生为主,其次是纤维瘤。结论:应广泛宣传妇女常见病、多发病的防治知识及乳腺自检方法,以降低生殖道感染发生率。     

肺动脉栓塞多排螺旋CTA血管成像

目的探讨肺动脉栓塞多排螺旋CTA血管成像扫描延迟时间的最佳值，最佳肺动脉血管成像。方法收集了45例肺动脉栓塞多排螺旋CTA血管成像，造影剂用量按1．5ml／kg，注射速率3ml／sec。扫描延迟时间用Bolus Tracking第一组20例；test Bolus为二组15例；常规计算时间为一组10例。准直器宽度2．5mm，层厚3mm。数据重建用最大密度投影（MIP）和容积显示（VR3D）等常规方法。一、二、三组图像分别由两位高年资医师阅片。结果第一组20例中19例和第二组15例图像肺动脉均清晰显示。第三组10例中4例图像模糊，第三组与第一、二组图像质量有显著差异。结论肺动脉栓塞CTA血管造影中扫描延迟时间用Test Bolus和Bolus Tracking较优，常规计算时间延迟图像质量较差。     

Continued axillary sampling is unnecessary and provides no further information to sentinel node biopsy in staging breast cancer.

INTRODUCTION: Sentinel lymph node biopsy (SLNB) has become increasingly accepted as a diagnostic method to stage the axilla in breast cancer, selecting women with a positive sentinel node for completion axillary clearance. As SLNB became established, many surgeons supplemented SLNB to sample a minimum of four lymph nodes, on the assumption that the four-node technique is supported by randomised trial data. We hypothesised that the practice of undirected sampling to supplement SLNB adds little information to the status of the residual axilla. METHODS: One hundred and sixty-five patients with early breast cancer were studied. Following successful identification of the sentinel node, 84 women had completion axillary dissection and 81 women had an axillary sample with at least four nodes available for pathological assessment. RESULTS: Following successful identification of the sentinel node in 165 patients, the false negative rate (FNR) was 2/44=4.5% (95% CI 0.6-15.5), sensitivity 42/44=95.5% (84.5-99.4) and negative predictive value (NPV) 121/123=98.4% (94.2-99.8). In the axillary dissection cohort, the FNR was 2/26=7.7% (0.9-25.1), sensitivity 24/26=92.3% (74.9-99.1) and NPV 58/60=96.7% (88.5-100). In the axillary sample group, the FNR was 0/18=0% (0-18.5), sensitivity 18/18=100% (81.5-100) and NPV 63/63=100% (94.3-100). The SLNB was the only positive node in 12/26 (46.2%) in the axillary dissection group and 10/18 (55.6%) in the axillary sampling group. There was no patient in the axillary sampling group where the sample node was positive and the sentinel node negative. CONCLUSION: Once SLNB is validated within the multidisciplinary unit, undirected sampling of the axilla following identification of the sentinel node(s) is unnecessary. The additional sampling of non-sentinel nodes has no role to play either in the assessment of a potential false negative SLNB nor as predictive information on the status of the residual axillary nodes.