青少年拔牙矫治期间对颅面部硬组织结构影响的研究

目的 研究青少年拔牙矫治时颅面部硬组织的影响。方法 选择50例为青少年恒牙He，安氏Ⅰ类患者，25例需拔除四个第一双尖牙治疗，25例无需拔牙治疗，用标准方丝弓技术矫治，共收集到完整病例43例，拔牙20例，非拔牙23例，利用X线头影测量技术，比较拔牙与非拔牙组治疗前后的变化。结果 拔牙矫治与非拔牙矫治组都存在一定的颅面部骨骼的生长，但两者矫治前后改变无明显差别。拔牙矫治明显改变了前牙位置。结论 青少年拔牙矫治期间对颅面部骨骼的改变无影响。     

护理人员的职业损伤因素及健康维护

作者指出临床一线的护理人员是发生职业损伤的高危群体。产生职业损伤的危险因素包括基础教育和继续教育缺乏职业损伤及其防范知识；影响护理人员身体健康的诸因素，如化疗专用的溶药设备、洁净操作台或相对密闭的溶药环境不健全；乙型肝炎等医院内易感性等疾病增加，被血液、体液等污染的医疗锐器刺伤是护理人员职业感染的主要途径；护理人员工作职业特点对健康不利的影响，护理人员心理压力大。为维护护理人员身心健康，应加入医院感染、职业损伤和健康维护的在校理论教育内容，加强护理人员职业安全教育，采取防范职业损伤的措施，如化疗药物中心配药、使用一次性手套等措施。     

发热门诊的感染控制

笔者介绍了我院发热门诊的特点以及特殊规定，为加强控制感染，我院要求对发热门诊人员进行培训、体检，实行军地患者分开诊治，重视消毒隔离工作，发热门诊人员集中居住，无关人员禁入发热门诊，制订了严格的规章制度及就诊流程图。经过严格的控制，我院发热门诊运转正常，发热门诊无交叉感染出现。     

美宝湿润烧伤膏在治疗慢性泪囊炎的应用

目的：观察美宝湿润烧伤膏(MEBO)在治疗慢性泪囊炎的应用价值。方法：对87例102只慢性泪囊炎采用泪道探通手术与MEBO置留治疗。常规泪点表面麻醉，扩张泪点，用生理盐水或氯霉素眼水冲洗鼻泪管、泪囊、泪小管，再用无菌注射器装入5ml MEBO，用5号自制泪道冲洗针沿泪道方向插入，直达泪囊推药，使鼻泪管、泪囊、泪小管内充满MEBO，一周后继续上述方法治疗，一般连续治疗2—5次。结果：治疗总有效率为100％，随访6个月，无一例复发。结论：在泪道探通手术后随即留置MEBO治疗慢性泪囊炎，临床效果良好，操作简单方便，经济有效，值得临床推广应用。     

哈乐在良性前列腺增生伴急性尿潴留中的应用

目的 :探讨α1A肾上腺素能受体阻滞剂哈乐 (tamsulosin)对良性前列腺增生 (BPH)伴急性尿潴留病人的治疗作用。方法 :对 72例BPH伴急性尿潴留病人采用随机、对照研究 ,分为治疗组和对照组。病人均行保留导尿 ,口服抗生素治疗。治疗组加用哈乐 0 .4mg ,1次 /d ,连续服用 3次。 72h后拔除导尿管。　结果 :拔除导尿管后 4 4 % (32 / 72 )的病人能自行排尿。有效率治疗组为 6 1% (2 2 / 36 ) ,对照组为 2 8% (10 / 36 ) ,两组比较差异有显著性 (P <0 .0 1)。　结论 :对BPH伴急性尿潴留应用哈乐治疗 ,可提高早期拔除导尿管后病人自行排尿的成功率 ,且疗效与前列腺体积大小无关。     

静注加肌注曲马多防治硬膜外麻醉期间寒战反应的研究

目的　观察曲马多防治硬膜外麻醉期间寒战反应时两种用药方法的临床效果。　方法硬膜外麻醉手术期间发生寒战的 6 0例成年患者 ,当出现寒战分级达 2～ 3级时 ,用室温下盐酸曲马多 1mg kg加氟哌啶 2 .5mg缓慢静脉推注 ,随机分成二组 :研究组 (R组 )与对照组 (C组 ) ,每组各 30例 ;R组在 5min内用上述同样药物和剂量予以肌内注射 ,C组以生理盐水 2ml肌内注射。观察寒战的治疗效果及 6h内寒战复发率。　结果　两组均于静注曲马多后 3min内起效 ,所有病人寒战反应均得到缓解 ,6h内R组均无寒战反应复发 ,C组有 5例再次出现寒战达 2级以上 ,给予追加首次量的 1 2后缓解 ,两组间差异有显著性 (P <0 .0 5 )。　结论　静注加肌注曲马多和氟哌啶可更有效地防治硬膜外麻醉期间的寒战反应。     

腮腺外面神经颊支的应用解剖研究

目的:观测面神经颊支出腮腺后的各级分支,为相关外科手术提供解剖学依据。方法:10例(20侧)防腐人头标本,描述面神经颊支出腮腺后的走行、定位及层次。结果:面神经颊支出腮腺后分为2～4支,均走行在SMAS筋膜下;颊Ⅰ、颊Ⅱ恒定出现,其一级分支距腮腺导管分别为(1.1±0.5)cm及(0.5±0.3)cm,且分别向前走行(1.3±0.9)cm及(1.8±0.5)cm后发出二级分支。结论:面神经颊支较为恒定,在面瘫治疗中健侧面神经颊支的二级分支可以作为受体神经,可不损伤面神经颊支主干。面神经颊支的分布及走行也可指导除皱术、扩张器植入、瘢痕切除等手术的剥离范围,不致产生并发症。     

重度烧伤患者休克期血浆B型钠尿肽含量变化及意义

Objective To study the plasma content of B-type natriuretic peptide (BNP) in patients with severe burn during shock stage and probe its clinical significance. Methods Forty-two patients aged 18-60 years, with total burn surface area ≥30%TBSA or full-thickness burn area ≥10% TBSA, hospital-ized within 4 hours after burn, were divided into A group (with total burn surface area 30% -50% TBSA or full-thickness burn area 10% -20% TBSA, n = 21 ), and B group (with total burn surface area 50% TB-SA or full-thickness burn area > 20% TBSA, n = 21 ). Twenty patients admitted during the same time for plastic surgery were enrolled as control group. The plasma levels of BNP, creatine kinase (CK), CK-MB, troponin I (Tnl) of all patients were determined on admission. The levels of BNP, Tnl and fluid resuscita-tion volume were examined at 8, 16, 24, 48 post burn hour (PBH) in A and B groups. Analysis of correla-tion between BNP and fluid resuscitation volume was performed. Results On admission: BNP level in A group (68±19 ng/L) and B group (99±38 ng/L) , respectively, was increased as compared with that in control group (17±7 ng/L, P <0.01 ). Tnl level in A group (2.13±0.67 μg/L) and B group (2.98± 0.58μg/L), respectively, was increased as compared with that in control group (0.12 ± 0.03 μg/L, P < 0.01). There was no obvious difference in CK, CK-MB levels among A, B, and control groups ( P > 0.05). BNP levels in A, B groups continuously rose during 8 - 48 PBH, and they were positively correlated with fluid resuscitation volume. TnI level peaked at 24 PBH, and decreased at 48 PBH. Conclusions The plasma level of BNP is sensitive to reflect changes in myocardial ischemia and hypoxia as a rise in level of TnI in shock stage of severe burn, and it was positively correlated with fluid resuscitation volume. BNP can be used to guide fluid resuscitation during shock stage.     

Loss of cables, a novel gene on chromosome 18q, in ovarian cancer.

Cables, a cyclin-dependent kinase (cdk) interacting protein, has recently been identified and mapped to human chromosome 18q11. Cables appears to be primarily involved in cell cycle regulation and cell proliferation. Overexpression of Cables in Hela and other cell lines inhibits cell proliferation and tumor formation. We hypothesize that loss of Cables expression is associated with ovarian cancer. To test our hypothesis, we examined Cables expression in the four most common subtypes of ovarian carcinomas: serous, endometrioid, mucinous, and clear cell. In addition, mucinous and serous borderline tumors were also included. Loss of Cables expression was observed at high frequency in ovarian serous (11 of 14 cases, 79%) and endometrioid (5 of 10 cases, 50%) carcinomas. In contrast, strong Cables staining was detected in all clear cell carcinomas (10 cases) and mucinous tumors (5 carcinomas and 5 borderline tumors). The majority of serous borderline tumors (11 of 14 cases, 79%) showed positive Cables staining, with the rest showing focal loss of Cables expression. Furthermore, RT-PCR revealed the lack of Cables mRNA in a human ovarian cancer xenograft. No correlation was noted between loss of Cables and histologic grade, tumor stage, and survival. In conclusion, our results indicate that loss of Cables is common in ovarian serous and endometrioid carcinomas and imply that Cables may be involved in the pathogenesis of these two types of ovarian carcinomas.     

Chronic Kidney Isograft and Allograft Rejection

In this study antigen-independent factor in the pathogenesis of chronic rejection of organ transplants was examined.Kidney isografts and allografts were transplanted orthotopically into bilaterally nephroectomized rat recipients and studied functionaaly,morphologically and immunohistologically,at serial intervals up to 52 weeks after transplantation.Allograft recipients developed progressive proteinuria after 12 weeks,with gradual renal failure ultimately leading to death.At the same time,morphological changes,including progressive arteriosclerosis and glomerulosclerosis ,tubular atrophy and interstitial fibrosis,developed.Immunohistologically,macrophages infiltrated glomeruli during this period and cytokines became unregulated.Our results showed that antigen-independent functional and morphological changes occurred in long-tern kidney isografts and mimicked those appearing much earlier in allografts that reject chronically.Initial injury and extent of functioning renal mass is suggested to be important factor for such late changes.