985份病案质量检查分析

根据浙江省病历管理质控中心出台的住院病案质量检查评分表,对我院2003年4至12月九个月期间的住院病案随机抽检985份,探讨我院病历书写质量的现状、存在的问题,以及进一步提高病历质量的对策.     

冠状动脉内支架置入术并发症的观察及护理

目的 探讨冠状动脉内支架置入术并发症的观察及护理.方法 回顾分析338例行冠状动脉内支架置入术患者的临床资料.结果 术中发生室颤5例,均经电复律后窦性心律恢复.术后共发生并发症27例,其中亚急性支架内血栓形成1例,心包填塞1例,拔管时发生血管迷走神经反射12例,穿刺部位出血5例,皮下血肿7例,假性动脉瘤3例.结论 严密的观察和护理干预可有效减少冠脉内支架置入术并发症的发生.     

跳水运动员颈椎损伤的生物力学研究

作者通过在新鲜成人颈椎标本上做了椎体静力性负荷和动力性负荷实验,表明颈椎在后伸位应力为前屈位的50%,最大应力位于颈椎4-6,是跳水运动员头颈部入水时引起颈椎致伤的生物力学因素。     

洁净手术部病理标本的管理

医疗标本是指用来化验或研究的血液、痰液,组织切片等[1]。我院于2006年1月正式启用洁净手术部。洁净手术部管理的目标是杜绝事故,减少差错,确保病人手术安全,其中病理标本的管理是最重要的项目之一。根据洁净手术部严格分区管理的特色,对日常工作中的病理标本管理在控制污染,严禁标本混淆、丢失、及时送检4个方面进行严格规范,取得了满意的效果。现介绍如下。1存在的问题1.1容易扩散污染手术结束后,手术医生穿着带有血渍的手术衣、手套到标本室填写病理检查单,接取保存液,再返回手术间处理手术后事宜,容易造成污染和血液传染性疾病的发生。…     

冷敷在重睑成形术中的应用效果观察

重睑成形术是眼睑美容手术之一。随着人民生活水平的提高,要求美容的人也越来越多[1]。由于该手术大部分需要切开剥离,去除眼轮匝肌或去脂去皮,容易引起皮下组织水肿、淤血,影响恢复和术后效果。2005年11月—2006年11月,笔者对124例重睑受术者进行术中冰生理盐水冷敷,在减轻水肿、淤血程度、缩短恢复期方面疗效显著。现报道如下。1资料与方法1.1临床资料本组共124例,其中女118例,男6例,年龄20岁～58岁。将受术者按手术时间先后顺序随机分为实验组和对照组各62例。1.2方法两组均使用电凝止血,5-0丝线缝合后用无菌纱布包扎伤口,口服5d抗生素。…     

Serum levels of specific glucuronidated androgen metabolites predict BMD and prostate volume in elderly men.

Androgens are important regulators of bone and prostate health in elderly men. The role of serum levels of glucuronidated androgen metabolites as predictors of BMD and prostate volume in men is unclear. We show that specific glucuronidated androgen metabolites predict BMD and prostate volume in elderly men. INTRODUCTION: Androgens are important regulators of bone and prostate health in elderly men. Local synthesis and degradation of androgens are likely to be important parameters of biological action of androgens in androgen-responsive tissues. The aim of this study was to determine the role of serum levels of glucuronidated androgen metabolites as predictors of BMD and prostate volume in elderly men. MATERIALS AND METHODS: A subsample of the population-based Swedish part of the MrOS study (n = 631, average age = 75.9 years) was investigated. Bone parameters were measured using DXA. Serum levels of total testosterone (T) and dihydrotestosterone (DHT) were measured by gas chromatography/mass spectroscopy (GC-MS); androstane-3alpha,17beta-diol-3glucuronide (3G) and androstane-3alpha,17beta-diol-17glucuronide (17G) were measured by liquid chromatography/mass spectroscopy. Prostate volume (n = 159) was measured by transrectal ultrasound. RESULTS: The general pattern is that two of the glucuronidated androgen metabolites, namely 17G and 3G, are stronger positive predictors of BMD than the bioactive androgens (T and DHT). In addition, 17G is a clear positive predictor of prostate volume, explaining 4.5% of the variance in prostate volume, whereas the bioactive androgens do not display any association with prostate volume. CONCLUSIONS: Serum levels of specific glucuronidated androgen metabolites predict BMD and prostate volume in elderly men. Future studies should determine if the glucuronidated androgen metabolites also reflect other biological correlates of androgenic activity, including prostate cancer, and if low levels might be a marker of general androgen deficiency in men.     

Expression of CD68 CD45RO CD20 and proliferating cell nuclear antigen in nasal polyps]

OBJECTIVE: To study the cellular expression of CD45RO, CD20, CD68 and proliferating cell nuclear antigen (PCNA) in nasal polyps. METHODS: Nasal polyp tissues from 50 patients were evaluated for cellular expression of CD45RO, CD20, CD68 and PCNA using immunohistochemistry SP by counting the average number in 5 chosen high-power fields, Histopathological observations were combined with HE. Analyses were performed on SPSS10.0. RESULTS: CD68+ cells were expressed more in nasal polyps dominated by eosinophils than by neutrophils(P < 0.05). There was no difference between CD45RO and CD20, but both of them had negative correlation(P = 0.05). Significant correlation was found between CD68+ cells and eosinophils or PCNA positive cells on epithelium. PCNA positive cells on epithelium had significant correlation on fibroblast (P < 0.05). CONCLUSION: Inflammatory cell infiltration (eosinophilia CD45RO, CD20, CD68) and cell proliferating in epithelium cells, glandular cell and fibroblast are strongly correlated with formation of nasal polyps. The nasal polyps are not only characteristic of eosinophilia but also by lymphocytes dominated by CD45RO and CD68 positive cells. CD68 may be stem cell of nasal polyp.     

Expression of Eph receptor tyrosine kinases and their ligands in human Granulosa lutein cells and human umbilical vein endothelial cells.

Corpus luteum development is regulated by gonadotropins and accompanied by extremely rapid vascularization of the avascular granulosa cell compartiment by endothelial cells (EC). The proliferation of Granulosa cells (GC) and EC is a complex interplay and takes place in a spatially and temporarily coordinated manner. The erythropoietin-producing hepatoma amplified sequence (Eph) receptors and their ligands-the ephrins- are a recently detected family of membrane located protein tyrosine kinases which play a crucial role in the growth and development of nerve and blood vessel network. We report about the mRNA expression pattern of Ephs and their ligands in human GC, in human EC, and in carcinoma cell lines OvCar-3 and Hela. The mRNA of EphA4, EphA7, ephrinA4, ephrinB1 and ephrinB2 was detected in GC and EC, while EphA2 was expressed only in GC. The expression of various Ephs and ephrins did not change in GC after stimulation with human chorion gonadotropin. Our study analyzes for the first time the expression of the complete human Eph/ephriny-system in GC and in EC. The remarkable similarity between these two cell types supports the theory of a functional relationship of EC and GC. In addition, it was shown that hCG is not a major determinant of Eph/ephrin regulation in GC.     

急性胆囊炎腹腔镜手术时机探讨及操作技巧

目的 探讨急性胆囊炎行腹腔镜胆囊切除术的手术时机，并总结操作技巧。方法 回顾性分析2000年6月～2005年6月265例腹腔镜胆囊切除术治疗急性胆囊炎的临床资料。结果 265例中手术成功244例，成功率92．1％。中转开腹21例，其中小于72小时（Ⅰ组），超过72小时（Ⅱ组）的中转率分别为3．1％（4／129），12．5％（17／136）。Ⅰ组与Ⅱ组比较成功率无明显差别（P〉0．05）。全组无死亡病例，也无严重并发症发生。结论 急性胆囊炎行腹腔镜胆囊切除术安全可行，只要无内科禁忌证，应积极开展腹腔镜手术。     

肱骨干骨折--髓内钉与钢板固定的比较

总体而言，这些报道提示：采用髓内钉治疗肱骨干骨折较采用钢板带来更多的并发症，尤其是采用顺行人路。同时，这些报道没有提供确切的证据证明何种方法在骨折愈合、减少感染或上肢总体功能上优于另一种。