Changes in total sodium intake do not lead to proportionate changes in total sodium removal in CAPD patients.

BACKGROUND: Dietary salt and fluid restriction is important in controlling fluid balance in patients on continuous ambulatory peritoneal dialysis (CAPD). However, it is often difficult to monitor patients' dietary total sodium intake (TSI). Usually, total sodium removal (TSR), the sum of urinary sodium removal (USR) and dialysate sodium removal (DSR), is suggested to represent TSI. In the present study, we investigated the reliability of using TSR as a surrogate to TSI in CAPD patients. METHODS: 40 clinically stable CAPD patients were closely followed for 3 months. Their TSI, USR, DSR, and fluid status were measured twice: at baseline and at the end of this study respectively. Fluid status was evaluated by bioimpedance analysis. Patients with increased sodium intake (group ISI) or decreased sodium intake (group DSI) (both >0.5 g/day or >21.74 mmol/day elemental sodium) were included in this study. RESULTS: There were 15 patients in group ISI and 9 patients in group DSI. During the follow-up, although TSI increased in group ISI and decreased in group DSI (p < 0.05), there were no significant changes in USR, DSR, or TSR in either group. No relationship was found between TSI and TSR. Changes in weight, blood pressure, urine volume, ultra-filtration, and small solute removal (Kt/V and creatinine clearance) were not statistically significant between the two groups. Fluid status deteriorated in group ISI and improved in group DSI (p < 0.05). CONCLUSIONS: Our study suggests that changes in total sodium intake do not lead to proportionate changes in total sodium removal in CAPD patients. Therefore, TSR (the sum of USR and DSR) should be used cautiously to monitor TSI in this patient population.     

Phase II study of high-dose ifosfamide in hepatocellular carcinoma

Summary A phase II study of high-dose ifosfamide in hepatocellular carcinoma was conducted among 17 Chinese patients. The dose of ifosfamide used was 2.5 g/m² daily given as a continuous infusion for 5 days. In all, 15 patients were evaluable for tumour response. There was no complete or partial responder. The treatment was well tolerated. The most frequent toxicity was alopecia, which occurred in 11 patients, and 5 patients developed mild haematological toxicity. There was no evidence of liver or bladder toxicity. Overall, 14 patients were evaluable for survival. The median survival was 92 days (range, 30–568 days). We conclude that high-dose ifosfamide is well tolerated but ineffective in hepatocellular carcinoma in Chinese patients.     

Membrane lipids of B16 melanoma cells and heat-resistant variants

Membrane lipid composition and fluidity of a series of B16 melanoma cell variants with increased resistance to heat were analysed for changes within the lipid component that may contribute to the acquisition of heat resistance. Within one series of heat-resistant lines the cholesterol content of the cells decreased as their heat resistance increased. The most heat-resistant line, WH75, had 40 per cent less cholesterol than the parent line. No change in the composition of phospholipid fatty acids was found. An increased level of membrane fluidity in WH75 was demonstrated by electron paramagnetic resonance using 5- or 12-doxyl stearic acid. When challenged by heat the increase in membrane fluidity was similar for WH75 and for the parent line. Thus the increased heat resistance of the variants is probably not due to their ability to adapt to heat challenge by increasing membrane thermostability. The inverse relationship between heat resistance and cholesterol content was not demonstrated in two other series of heat-resistant variants. The cholesterol decrease, therefore, is not a universal response of cells as they acquire heat resistance.     

截瘫患者医院感染的监测及预防措施

目的了解截瘫患者医院感染的病原菌对药物敏感情况. 方法回顾分析我院自1996年9月～2003年11月,316例截瘫患者的有关临床资料. 结果 98例患者发生医院感染,医院感染率为31.01%,感染部位主要以呼吸道、皮肤软组织、手术切口、泌尿道感染为多;医院感染的病原菌主要是条件致病菌,以G-菌为主.结论医护人员必须严格无菌操作,根据细菌药敏结果合理选用抗菌药物,加强营养,提高患者机体抵抗力.     

准分子激光原位角膜磨镶术患者主客观因素与疗效的相关性分析

目的：通过对准分子激光原位角膜磨镶术(LASIK)患者主客观因素与疗效的相关性分析，了解临床影响术后视力的主观、客观因素。方法：对2002年间在我院行ASIK的164例患者325只眼(其中3例为单眼)进行连续性临床观察研究，分别进行术前、术后问卷式主客观因素调查，并对患者手术疗效进行相关性统计学分析。结果：患者术前对手术效果的期望值、手术中疼痛程度与手术后视力有显著相关性。结论：解除患者术前忧虑及避免术中疼痛对提高术后疗效有重要意义。     

10%水合氯醛在小儿MR扫描应用中的护理体会

<正>磁共振已成为一种安全、可靠、无创伤、无X线福射,适用于小儿的影像学检查方法。但此项检查时间长、噪声大,且需患儿在整个扫描过程中都要保持安静,稍有躁动便会引起伪影,影响图像成像质量。为此,我院自2000年6月至2006年12月对6岁以下不合作的儿童给予10%水合氯醛口服或灌肠后行MR扫描,均取得了满意效果。现将用10%水合氯醛在小儿MR检查扫描应用中的护理体会总结如下。     

种植牙手术的导向模板定向法临床研究

本文介绍了用于人工牙根种植手术的一种导向模板定向法。该导向模板由圆柱形金属定向杆、导向钛管、负压成型的塑料牙列套及自凝塑料增强基托组成。临床应用35例.效果满意。     

医械时代

曾几何时,一个小药箱,一个听诊器,就是一个医生的全部家当。但今天这也许意味着医疗事故官司和失去患者信任度的双重危险。在科学日益昌明的现在,医者和患者都越来越仰仗更昂贵、更先进的仪器,而在这现象之后,是各种医疗仪器设备的迅速普及,是诊疗过程的快速、高效和缜密,是更多科技新发明对人体的近距离关照,当然随之衍生出来的,还有过度医疗服务的不当取利,和种种难见阳光的幕后交易。     

经尿道等离子双极汽化电切(TUPKVP)治疗前列腺增生症580例

目的:探讨经尿道等离子前列腺双极汽化电切术(TUPKVP)治疗前列腺增生的效果。方法:回顾性分析580例良性前列腺增生(BPH)患者行TUPKVP的临床资料。结果:中转开放手术2例,切除前列腺组织10~80 g,平均32.5 g。手术时间25~150 min,平均60 min,术中输血10例,无电切综合征(TURS)发生。术后随访2~36个月,患者最大尿流率升高,IPSS症状评分值降低,排尿通畅,疗效好,并发症少。结论:TUPKVP出血少,手术安全,疗效确切,是治疗前列腺增生的有效方法。