FE复合酶防治烧伤后期肉芽创面感染的临床观察

目的观察FE复合酶控制烧伤后期肉芽创面常见耐药菌感染的作用。方法选取笔者单位烧伤患者30例,随机分为治疗组15例,将FE复合酶50 ml溶于等渗盐水0-150 ml中,使其终浓度为1-3 U/ml,用无菌纱布浸湿该液后湿敷创面,1-2次/d;对照组15例,用庆大霉素+ 等渗盐水纱布湿敷创面,1-2次/d。于用药前及用药后1-5 d取创面分泌物作细菌培养,检测两组患者创面的细菌种类及所用药物对创面细菌的敏感率;观察两组患者创面愈合时间及植皮术后3、5、 8、10、12 d的创面愈合率。结果两组患者创面细菌以铜绿假单胞菌、大肠杆菌、阴沟肠杆菌、甲氧西林耐药金黄色葡萄球菌(MRSA)为主。治疗组对MRSA、表皮葡萄球菌、腐生葡萄球菌、铜绿假单胞菌、大肠杆菌、阴沟肠杆菌的敏感率分别为93．8％、100．0％、100．0％、100．0％、100．O％、95．0％,高于对照组的17．6％、31．3％、28．6％、44．0％、33．3％、28.0％(P<0．01)。治疗组植皮术后创面愈合时间为(10．6±1．5)d,明显短于对照组[(15．3±1．7)d,P<0．01]。治疗组患者植皮术后各时相点创面愈合率均明显高于对照组(P<0．01),植皮术后10 d治疗组创面愈合率为(85．4±2．4)％,与对照组(51．3±1．5)％比较,差异有统计学意义(P<0．01)。结论 FE复合酶可以有效控制创面感染,提高烧伤后期感染创面植皮成功率。     

Performance characteristics and image fidelity of gray-scale monitors.

Gray-scale monitors are an essential element of electronic radiology, and their ability to provide images that are perceived to be identical to those available on conventional or laser-printed film is crucial to success of electronic radiology. Image fidelity is measured in physical characteristics (luminance, dynamic range, distortion, resolution, and noise) and with psychophysical techniques, including receiver operator characteristics analysis with clinical images and testing with contrast-detail patterns to determine threshold contrast. Currently, laser-printed images facilitate greater information transfer than does a gray-scale monitor because of their higher absolute luminance (500 ft-L vs 60 ft-L), greater perceived dynamic range, and better spatial resolution. In the near future, the developments of gray-scale monitors with 150-200 ft-L luminance, a display standard based on just noticeable differences, and algorithms to improve similarities between gray-scale display images and laser-printed images will help increase the acceptability of monitors as a means to make primary diagnoses.     

医院双语标识使用之我见

在现代化医院面临国内国际竞争时，医院双语服务摆到了医院管理者的议事日程上来。医院双语服务，特别是医院外语（英语）标识应采用国际化、标准化外语（英语）。医院使用双语标识时应注意几个问题：     

Polymorphism p53 codon-72 and invasive cervical cancer: a meta-analysis.

OBJECTIVES: Although some studies have reported that the arginine isoform on codon 72 of p53 increases the susceptibility to invasive cervical cancer, such data remain controversial. The objective of this study was to quantitatively summarize the evidence for such a relationship. METHODS: Our data sources consisted of a MEDLINE search of the literature published before December 2002, bibliography review, and expert consultation. Thirty-seven studies met the inclusion criteria. Information on sample size, study design, Hardy-Weinberg equilibrium, and method of genotype determination was abstracted by two reviewers using a standardized protocol. The overall odds ratio (OR) of the p53 gene on invasive cervical cancer was estimated using the Mantel-Haenzel method. RESULTS: The overall OR (95% confidence interval) for cervical cancer among those with the homozygous mutant (Arg/Arg) was 1.2 (1.1-1.3, P=0.001) compared with those with the heterozygous mutant (Arg/Pro). By a cellular type of cervical cancer, the overall OR among those with Arg/Arg was statistically significant in adenocarcinomas (1.7, 1.1-2.6, P=0.024), but not in squamous cell carcinomas (1.1, 0.9-1.2, P=0.960), compared with Pro/Pro. Compared with Arg/Pro, the OR among those with Arg/Arg was statistically significant in HPV types 16 (1,5, 1.2-2.0, P=0.002). CONCLUSIONS: Overall, the p53 gene was associated with increased risk for invasive cervical cancer. However, the risk varied by country, cellular, and HPV type.     

小耳畸形残耳软骨的生物化学研究

目的　探讨正常耳软骨与先天性小耳畸形的残耳软骨生化成分的异同 ,进而推论小耳畸形的病因。方法　选取年龄在 10岁左右 ,Tanzer分类ⅡA型的 7例先天性小耳畸形患者的残耳软骨 (A组 )。同时取 7名同龄尸体的正常耳廓耳甲部分的软骨 (B组 )。各取 7份标本做生化检查 ,测定胶原、糖胺多糖 (glycoaminoglycan ,GAG)含量 ;硫酸软骨素 (chondroitinsulfate,Chs)、硫酸角质素 (keratansulfate ,KS)和透明质酸 (hyaluronan ,HA)各占GAG的百分含量。结果　A组与B组之间胶原含量差异无显著性意义 ;GAG含量差异有显著性意义A组 (49.0 0± 2 5 .6 0 ) μg/mg比B组 (2 8.2 5± 4 .80 ) μg/mg多。在GAG中的组成部分中 ,A组HA(38.96± 4 .97) %、Chs(2 9.0 2± 4 .12 ) %、KS(32 .16± 7.4l) %与B组HA(32 .94± 3.2 4 ) %、Chs(33.10± 2 .6 1) %、KS(33.96± 1.6 6 ) %之间HA和Chs含量差异有显著性意义 ,而KS含量差异无显著性意义。结论　残耳软骨与正常耳软骨中胶原含量无差异 ,但含GAG前者比后者多。在GAG中的各成分的百分含量中 ,残耳软骨含HA较高 ,Chs较低 ,KS与正常耳软骨无差异。     

Simple measurement of spinal cord evoked potential: a valuable data source in the rat spinal cord injury model.

Measurement of spinal cord evoked potentials (SCEPs) is proposed as a means of predicting locomotion outcome in the rat spinal cord injury (SCI) model. Using 55 rats, three reproducible peak waves (waves I, II and III) were observed during stimulation at the C7 level with recording at the L1 epidural space. Hemisection at the T13 level showed three wave loss patterns: wave III loss only, loss of both wave II and III, and loss of all three waves. Defining an ideal SCI model as establishment of stable monoparesis or paraparesis, all animals in the wave II-III loss group showed favorable results. Histological data and electrophysiological properties allowed reasonable assumptions of wave origin: wave I from extrapyramidal tracts, wave II from the ventral corticospinal tract, and wave III from the dorsal corticospinal tract. Complete destruction of pyramidal tracts in both dorsal and ventral fibers was essential for long-term impairment of locomotion.     

Anterior lumbar instrumentation improves correction of severe lumbar Lenke C curves in double major idiopathic scoliosis

Fifteen skeletally immature patients with double major adolescent idiopathic scoliosis with large lumbar curves and notable L4 and L5 coronal plane obliquity were retrospectively studied. Seven patients who underwent anterior release and fusion of the lumbar curve with segmental anterior instrumentation and subsequent posterior instrumentation ending at L3 were compared with eight patients treated with anterior release and fusion without anterior instrumentation followed by posterior instrumentation to L3 or L4. At 4.5 years follow-up (range 2.5-7 years), curve correction, coronal balance and fusion rate were not statistically different between the two groups; however, the group with anterior instrumentation had improved coronal plane, near normalangulation in the distal unfused segment compared with the group without anterior instrumentation. In cases involving severe lumbar curvatures in the context of double major scoliosis, when as a first stage anterior release is chosen, the addition of instrumentation appears to restore normal coronal alignment of the distal unfused lumbar segment, and may in certain cases save a level compared with traditional fusions to L4.     

纤维连接蛋白与动脉粥样硬化的关系

炎症机制在动脉粥样硬化斑块的发生、发展中扮演了重要角色。近年来,不断有研究证实前炎性因子纤维连接蛋白(fibronectin,Fn)密切参与了此过程,并与急性冠状动脉综合征的发生有着极强的关联性。本文就Fn与急性冠状动脉综合征的关系及其应用前景进行综述。     

输精管结扎对家兔心功能及心肌NE含量的影响

本实验用日本大耳白兔复制输精管结扎的长期动物模型，分为结扎２５月组（ＶＧ２５），同龄假手术２５月组（ＳＯＧ２５）；结扎６月组（ＶＧ６），同龄假手术６月组（ＳＯＧ６）。记录各组家兔心功能，检测心肌及血清ＮＥ含量，称取心重（ＷＨ）。结果表明，左心室收缩期末压（ＬＶＳＰ），ＶＧ略高于ＳＯＧ；左心室舒张末压（ＬＶＥＤＰ），Ｖ６２５显著的低于ＳＯＧ２５Ｐ＜０．０５），ＶＧ６与５ＯＧ６比较虽无显著差异，也呈低值；±ｄｐ／ｄｔｍａｘ，ＶＧ均明显高于ＳＯＧ（Ｐ＜０．０１）。相关检验表明，＋ｄｐ／ｄｔｍａｘ与血清及心肌ＮＥ含量无相关性；心重与＋ｄｐ／ｄｔｍａｘ呈明显正相关，Ｐ＜０．０５；在２５月组，ＬＶＳＰ与＋ｄｐ／ｄｔｍａｘ呈正相关，Ｐ＜０．０５。提示输精管结扎可提高心肌收缩功能。