Infection control and anesthesia: Lessons learned from the Toronto SARS outbreak

PURPOSE: To describe the outbreak of severe acute respiratory syndrome (SARS) in Toronto, its impact on anesthesia practice and the infection control guidelines adopted to manage patients in the operating room (OR) and to provide emergency intubation outside the OR. Clinical features: The SARS outbreak in Toronto was the result of a single index patient. The causative virus, SARS-CoV, is moderately contagious, and is spread by droplets and contact. The virus gains access to host through the mucosa of the respiratory tract and the eyes. It can affect both healthy and compromised patients. The use of several precautionary measures such as goggles, gloves, gowns and facemasks and the application of various infection control strategies designed to minimize the spread of the virus are discussed. CONCLUSION: In containing the spread of SARS, vigilance and strict infection control are important. This results in the rediscovery of standards of infection control measures in daily anesthesia practice.     

医学美学与美容医学的整体学科研究

回顾医学美学与美容医学形成独立的学科系统的十多年来的发展历程，认为这个新兴学科在“整体学科”方面还存在一些学术问题有待人们进一步探讨。并认为，所谓“整体学科研究”是遵循该学科发展的内在规律所进行的各项研究的总和，是该学科发展的灵魂。学者们的任务在于：通过“整体学科研究”寻求其学科内在规律，经一代代同道有志者坚持不懈的努力，达到学科完善的目的。     

体外培养新生大鼠心房壁中的CGRP-IR和NPY-IR神经细胞

对体外培养新生SD大鼠心房壁的神经细胞，按SternbergerPAP法进行了降钙素基因相关肽（CGRP）和神经肽Y（NPY）免疫细胞化学研究。结果显示：CGRP-IR阳性细胞数量较少，实验的5份标本只有2份见到阳性细胞，而NPY-IR阳性细胞在所有实验标本中均可见到。本研究在培养条件下证实心内神经节中有CGRP-IR阳性细胞存在，支持心脏有器官内感觉神经细胞的设想。同时对心内神经细胞的化学性质进行了讨论。     

颅内室管膜下瘤2例报告

目前，室管膜下瘤的组织学起源仍不明确。但很可能来源于室管膜下层的胶质细胞。此类肿瘤呈膨胀性生长．是生长缓慢、非侵袭性的一种低级别胶质瘤，有症状者非常少见．至今国内外文献报道的有症状病例仅百余例。本文报道了我科收治的2例颅内室管膜下瘤患者的临床特点、影像学特点、和手术治疗效果。     

Whole CanA Gene Amplification of Helicobacter pylori and Its Fingerprinting by Restriction Fragment Length Polymorphism

To set up a method of amplification for the whole CagA gene of Helicobacter pylori and its fingerprinting by restriction fragment length polymorphism(RFLP),nested PCR was employed in combination with TD-PCR to amplify the gene and EcoRI and Hind Ⅲ were used to generate the RFLP fingerprinting.Target DNA fragments from 13 of 20 samples were successfully amplified and the relevant RFLP fingerprintings were obtained.It is concluded that the method can be used to amplify the whole CagA gene and CagA gene has apparent diversity of RFLP profile.     

Regional anaesthesia in ambulatory surgery

Regional anaesthesia provides many advantages and can be practised safely in ambulatory surgery. It provides better postoperative pain control, avoids many complications associated with general anaesthesia and shortens recovery time. However, extra time required, associated complications and acceptance of patients are the factors of concern in practising regional anaesthesia in an ambulatory setting. This review will discuss various regional anaesthesia techniques suitable for outpatients.     

骨骼肌钝挫伤后愈合质量的肌电评价

目的 :观察大鼠骨骼肌钝挫伤后 ,不同干预方法对骨骼肌修复过程中肌电信号的影响 ,研究肌电图在骨骼肌损伤愈合过程中的评价作用。方法 :10 8只雄性SD大鼠 ,利用自制的重物坠落打击装置造成右侧腓肠肌钝挫伤。随机分成 3组 ,即胰岛素样生长因子 - 1(IGF - 1)组、中药组和自然愈合组 ,分别于损伤局部注射IGF - 1、黄芪丹参注射液、不作处理。于伤后第 2、5、7、10、14、2 1、2 8、35、5 6天观察并比较双侧腓肠肌的肌电图变化 ,记录纤颤电位和正尖波等自发活动 ,分析复合肌肉动作电位 (CMAP)并测量其潜伏期和波幅 ,观察伤后CMAP的变化。结果 :(1)各组大鼠均于伤后第 2～ 5天出现纤颤电位和正尖波 ,约至第 7～ 10天达到高峰 ,然后逐渐减少。以IGF - 1组最早消失 ,中药组次之。 (2 )各组大鼠的伤侧肌电图CMAP中的潜伏期逐渐缩短 ,波幅逐渐增高。以IGF - 1组最快 ,中药组次之 ,自然愈合组最慢。 (3)伤后第 8周 ,IGF - 1组和中药组大鼠损伤侧CMAP波幅接近正常 ,自然愈合组则显著低于其它两组。结论 :(1)肌电图检测证实 ,IGF - 1和黄芪丹参注射液均具有促进骨骼肌损伤愈合的作用 ,但以IGF - 1的作用更明显。 (2 )损伤肌肉局部肌电信号的变化 ,可以用来评价损伤骨骼肌的修复进程和愈合质量     

头臂干型大动脉炎围手术期麻醉管理

目的 探讨头臂干型大动脉炎手术的麻醉管理.方法 回顾分析11例头臂干型大动脉炎手术的临床资料.结果 麻醉平稳,围手术期血液动力学稳定.术后2例死于多脏器衰竭.结论 围手术麻醉处理的关键是维持血液动力学平稳,保证脑供血,注意脑保护.