彩色多普勒超声血流图在心脏手术中的应用(附19例病例分析)

在心脏手术中应用多普勒彩色超声心动仪直接探测和观察19例患者,其中风湿性心瓣膜病11例、先天性心脏病7例、左心房粘液瘤1例。风心病及左房粘液瘤患者手术前、中检查的结果基本一致;先心病术前诊断符合率为84.2％(5/7),术中诊断符合率为100％。本文对检查结果作了分析讨论,并提出符合我国情况的有关检查设想。     

长沙地区孕妇CMV感染状况及其临床追踪观察

研究了７７例长沙地区孕、产妇的宫颈排毒（ＣＭＶ）情况及母、婴的免疫状态，并对宫颈排毒及ＣＭＶ一ＩｇＭ阳性的母亲所生小孩进行临床追踪。结果显示：孕妇宫颈排毒率为４．５％，抗ＣＭＶ－ＩｇＧ和抗ＣＭＶ－ＩｇＭ阳性率分别为７７％和１３％，５９例脐血ＣＭＶ－ＩｇＭ阴性。宫颈排毒的３例其抗体检测抗ＣＭＶ－ＩｇＧ均阳性，抗ＣＭＶ－ＩｇＭ仅一例阳性。作者认为，对妊娠期活动性ＣＭＶ感染的诊断，仅检测抗ＣＭＶ－ＩｇＧ和抗ＣＭＶ－ＩｇＭ抗体滴度仍不足，尚须结合病毒分离和其它检测手段。     

弥漫性轴索损伤病人的护理

弥漫性轴索损伤（diffuse axonal injury，DAI）是以胼胝体、脑十等中线部位局灶性病变及脑白质广泛性轴索损伤为主，以原发昏迷时间长而又缺乏神经定位体征为其临床特征的一组原发性弥散性脑损伤。在重型颅脑损伤中占20％，病死率高达42％～62％。最常见于车祸颅脑损伤病人，也可见于高处坠落伤者。病人多合并其他部位损伤，特点为伤情重、变化快、并发症和休克发生率高，且病死率高。护理时矛盾多，易顾此失彼，影响临床治疗效果。为更好地总结对该类损伤病人的救治，     

A preliminary study of the relationship between antibiotic administration and changes in bacteriological profile of wound infection in a burn unit

Objective:To investigate the relationship between antibiotic administration and the changes in bacteriological profile in a burn unit. Methods: The data of consumption of different kinds of antibiotics, including total antibiotic consumption [expressed as the number of defined daily doses (DDD)] as well as pathogen identification, were collected in a 8-year period. The constituent ratios of different kinds of antibiotics in total antibiotic consumption to isolation rates of various species of bacteria were calculated, and their correlation was analyzed. Results: Within this period, it was found that the aminoglycosides and first generation cephalosporins were used less frequently, while the polypeptides, carbopenem and macrolides were used proportionally more. At the same time, the isolation rates of Staphylococcus aureus, Acinetobacter sp, Enterobacter cloacae, Klebsiella pneumoniae and methicillin-resistant Staphylococcus aureus were gradually increased. The constituent ratios of predominant pathogens were correlated to the different kinds of antibiotics consumption in the burn unit. Conclusion: The results suggested that the consumption of different antibiotics was closely related to the trends of emergence of bacterial isolates from infected burn wounds. The result might imply that to regulate the administration of certain antibiotics might help decrease the emergence of certain pathogenic bacteria in burn infections.     

经胸门奇静脉断流术的外科解剖学基础(附52例临床疗效分析报告)

观测了１００例成年尸体胃底、贲门及食管区静脉。结果显示：胃左、右静脉的出现率是９６％和９２％，胃小弯侧的静脉分布可归纳为５型：胃左静脉型、胃右静脉型、胃左静脉优势型、胃右静脉优势型和胃左右静脉均衡型。胃后静脉出现率为７３．６％，胃左静脉与左膈下静脉间有相对恒定的吻合，此种情况占４８％。在此基础上作者于１９７６年３月至１９９２年３月对５２例因门脉高压症大出血患者行经胸门奇静脉断流术，急症手术死亡率为４．９％，急症手术止血率为９２．６％，远期再出血率为１１．４％。作者认为彻底断流的关键是识别胃小弯侧静脉分型、胃左静脉汇入部位及属支变化；胃后静脉及门腔吻合。阐述了经胸门奇静脉断流的优越性。     

血管缺损断指的回植

某些断指的伤情复杂，常合并血管缺损，回植难度大。我们在微血管移植动物实验和尸体手指显微解剖的基础上，据情分别采用了１２种方法，修复断指中血管缺损共２０７例（２６１指），成活２４０指，成活率９２％。我们认为精湛的显微外科技术和正确选择处理方法，是手术成功的关键。     

交链孢酚单甲醚在大鼠小鼠体内的分布

对食管癌高发区粮食中分离的互隔交链孢霉的毒素交链孢酚单甲醚(AME)在大鼠、小鼠体内的分布进行研究。给动物腹腔内注射氚标记的交链孢酚单甲醚(~3H-AME),然后在不同时间测各脏器的放射性。结果表明:在所测9个脏器中,2h肝脏含量最高,食管下段在大小鼠分别居第四和第三。但大小鼠分别在72、24h则以食管下段最高,说明AME及其代谢物在此清除较慢,即对其有较高的亲和力。     

黄疸出血群赖型017株钩端螺旋体外膜单克隆抗体免疫...

BALB/c mice were immunized intraperitoneally with outer envelopes of serogroup icterohaemorrhagiae lai serovar strain 017 leptospires. Monoclonal antibodies against outer envelopes (IgG, agglutinating titre 1:25,600) were produced by hybridoma technique. The monoclonal antibodies ascites (diluted 1:100) 1 ml administered intraperitoneally 1 hour before the intraperitoneal injection of 2 x 10(8) leptospires of strain 017 and the subsequent daily administration of McAb in similar doses for five days protected 80% of guinea pigs. Survival rates of three control groups which received physiological saline, ascites of BALB/c mouse myeloma cell lines SP2/0, and monoclonal antibodies against Pseudomonas aeruginosa in place of monoclonal antibodies against outer envelopes of strain 017 leptospires were 10%, 20% and 10% respectively. When killed 20 days after challenge, guinea pigs of experiment group were normal at autopsy. Old pulmonary haemorrhage were present in the animals of three control groups. Passive immunoprotection experiments have demonstrated immunoprotection of monoclonal antibodies against outer envelopes of strain 017 leptospires. It will be valuable for separating protective antigen fraction of outer envelopes and studying new vaccine of leptospira.     

棉尘及吸烟对肺功能影响的观察

对８３名接触棉尘的健康者作肺功能测定，并与３９名不接触棉尘的健康者对照。其中男性均为吸烟者；女性均为不吸烟者。结果表明，ＭＭＥＦ、ＰＥＦＲ、Ｖ２５％～７５％均明显低于对照组（分别为Ｐ＜０．０１和Ｐ＜０．０５）．在男性吸烟组，ＶＣ，ＭＢＣ，ＦＥＶ１％也有明显下降（Ｐ＜０．０１），作者认为棉尘对人体的危害主要部位在小气道，吸烟者因损害严重可累及大气道。以往对棉尘反应的肺功能评估仅以ＦＥＶ１％为指标，不能反映早期的变化，有必要进一步完善。     

杂多阴离子对SiO_2细胞毒性的拮抗作用

本文采用离体细胞培养法,以细胞存活率、乳酸脱氢酶活性和酸性磷酸酶活性为指标,研究了几种α-Keggin结构的杂多阴离子对石英粉尘细胞毒性的影响。结果表明,与对照组比较,所用杂多阴离子无细胞毒性(P>0.05),石英尘经杂多阴离子作用后,细胞毒性显著降低,与石英尘组比较,上述三项指标差异均有显著意义(P<0.01),由此表明杂多阴离子对石英的细胞毒性有明显的拮抗作用。