子宫内膜体外构建及其应用研究进展

体外构建子宫内膜是利用组织工程学原理,在体外构建结构、形态与功能上与体内子宫内膜相似的三维模拟体。种子细胞分离培养、生物支架材料的合理选择及体外构建方法的优化是体外构建子宫内膜的重要因素。构建的子宫内膜在病理研究、三维培养体系、胚胎发育学及移植等方面具有重要的研究意义。只有更进一步模拟自然子宫的结构,优化构建技术路线和培养条件,才可以再造出真正意义上的组织工程化子宫。     

医源性桡神经损伤46例分析

目的阐述医源性桡神经损伤的伤因、治疗和预防措施。方法分析1991年～2003年间收治的46例医源性桡神经损伤的病例。结果伤因分为上肢手术误伤，肱骨干和桡骨上端闭合性骨折复位手法不当，头静脉穿刺致桡神经浅支损伤。本组21例保守治疗，22例手术治疗，3例行肌腱转位功能重建。结论手术误伤是医源性桡神经损伤的首要原因；临床医生丰富的解剖知识和细致、轻柔的操作是预防医源性桡神经损伤的关键。     

Incidence and Management of Chyle Leaks Following Pancreatic Resection: A High Volume Single-Center Institutional Experience

Background   No data on incidence, management, or natural history of chyle leaks following pancreatic resection have been published. We sought to identify possible risk factors associated with chyle leaks following pancreatic resection, as well as determine the natural history of this rare complication. Methods   Between 1993 and 2008, 3,532 patients underwent pancreatic resection at a single institution. Data on demographics, operative details, primary tumor status, and chyle leak were collected. To identify risk factors associated with chyle leak, a matched 3:1 paired analysis was performed. Results   Of 3,532 patients undergoing pancreatic resection, 47 (1.3%) developed a chyle leak (n = 34, contained chyle leak versus n = 13, diffuse chylous ascites). Chyle leak was identified at median 5 days following surgery. Median drain triglyceride levels were 592 ng/dl. After matching on tumor size, disease etiology, and resection type, the number of lymph nodes harvested and history of concomitant vascular resection predicted higher risk of chyle leak (both P < 0.05). Total parenteral nutrition (TPN) was required in more patients with chylous ascites (92.3%) than those with chyle leaks (44.1%) (P = 0.003). The median time to resolution was shorter for contained chyle leaks (13 days) versus chylous ascites (36 days) (P < 0.001). Patients with chylous ascites tended to have shorter overall survival (3-year, 18.8%) versus patients with no chyle leak (3-year, 46.9%) (P = 0.12). In contrast, patients with a contained chyle leak had a similar survival as patients with no chyle leak (3-year, 53.4% versus 46.9%, respectively) (P = 0.32). Conclusion   Chyle leak was a rare (1.3%) complication following pancreatic resection that was associated with number of lymph nodes harvested and concomitant vascular resection. In general, chyle leaks were successfully managed with TPN with no adverse impact on outcome. Patients with chylous ascites, however, had a more protracted clinical course and tended to have a worse long-term survival. Presented at the Society for Surgery of the Alimentary Tract, 49th Annual Meeting, San Diego, CA, May 18th, 2008 Support: Dr. Pawlik is supported by Grant Number 1KL2RR025006-01 from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research. The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official view of NCRR or NIH.     

外生殖器部位非性传播性皮肤疾病的诊断

我国由于人口流动性高,加之无任何保护措施的性行为不断增加的趋势,性传播性疾患的发病快速增长。然而,同时也要认识到在外生殖器部位的非性传播性皮肤疾病,根据病因,分为23类,约200种皮肤病,为避免不必要的医疗纠纷,必须关注外生殖器部位非性传播性皮肤疾病的鉴别诊断。     

图片学习测验在识别老年人轻微认知功能损害中的作用

目的　分析图片学习测验在识别老年人轻微认知功能损害 (MCI)中的作用。方法　选择符合MCI诊断标准的老年人 4 8例与正常对照组 5 6名完成图片学习测验、简易智能状态检查、听觉词语学习测验及多种非记忆测验。结果　图片学习测验的 3个记忆指标 (图片短时记忆、延迟记忆和学习记忆 )在MCI与正常对照组之间有非常显著的差异。已经给出这三个图片记忆指标区分MCI与正常老年人的划界分、敏感性和特异性。结论　图片记忆操作简便、信度和效度好 ,可以作为临床医师筛选MCI的有效工具     

地震伤患者医院感染目标性监测

对某院收治的50名地震伤员进行医院感染目标性监测，有效地预防与控制医院感染的发生。通过分类安置伤员，专人目标监测，严格执行消毒隔离制度及手卫生、标准预防措施等，将医院感染发生率降至最低：仅1例重症挤压伤者发生医院感染，医院感染率为2．00％。     

2001年与2004年抗菌药物应用情况比较

目的　了解抗菌药物应用的基本情况。方法　将 2 0 0 1年 3月 14 3 0例住院患者病历与 2 0 0 4年 3月的 2 0 66例住院患者病历进行回顾性调查和对比分析。结果　 2 0 0 1年的 14 3 0例中有 948(66 3 % )例 ,和 2 0 0 4年的 2 0 66例有 10 60例 (5 1.3 % ) ,应用了抗菌药物。结论　定期检查考评 ,严格掌握用药指征 ,是加强抗菌药物应用管理的关键。