标准通道和微通道经皮肾镜取石术对血生化指标的影响

目的 探讨标准通道和微通道经皮肾镜术对血生化指标的影响.方法 选择肾结石患者59例,其中标准通道29例,微通道30例.术中监测灌注前、灌注后30 min、60 min、90 min、120 min及术后4h和12h的血电解质、酸碱度(pH)、碱剩余(BE)、血肌酐(Scr)、胱抑素C(Cys C)、肾小球率过滤估算值(eGFR).结果 两组间灌注时间、灌注液用量、灌注液出入差具有显著性差异(P＜0.05);标准通道组术前、中、后各项指标差异均无统计学意义(P＞0.05);微通道组灌注90 min时,Cys C显著升高,差异具有显著性(P＜0.05).灌注120 min时,pH、BE、Scr及eGFR的变化具有显著性(P＜0.05),但术后4h恢复到正常范围.两组间比较,灌注120 min时,pH、BE、Scr及eGFR各项指标均具有显著性差异(P＜0.05).结论 标准通道经皮肾镜取石术对肾结石患者血生化无明显负面影响,而长时间微通道经皮肾镜术可引起血生化明显的变化;建立通道过程中的扩张远低于灌注压对肾功能造成的损害;Cys C是监测肾小球滤过率更敏感的指标,但术后短期内都可恢复到正常范围;对复杂性巨大肾结石采用较大通道为更合理的选择.     

腹腔冲洗对根治性全胃切除术后胰瘘转归的影响

目的：探讨预防性放置腹腔冲洗管治疗胃癌D2根治性全胃切除术后胰瘘的有效性和必要性。 方法：将2012年3月—2013年9月间收治的196例胃癌D2根治性全胃切除术患者随机均分为对照组和观察组,对照组患者术毕常规放置腹腔引流管,观察组患者除常规放置腹腔引流管外,于胰腺腹侧上缘放置1根冲洗管,对发生胰瘘患者缓慢滴注生理盐水冲洗胰腺区域。比较两组胰瘘发生率,以及两组胰瘘患者术后腹腔引流液淀粉酶浓度、肠功能恢复时间及住院费用。 结果：两组的胰瘘发生率差异无统计学意义（P>0.05）,但观察组B+C级胰瘘发生率较对照组明显降低（P<0.05）;两组术后胰瘘患者比较,观察组第3天淀粉酶浓度较明显下降,肠功能恢复时间缩短,住院费用明显减少（均P<0.05）,但其他并发症发生率两组间差异无统计学意义（P>0.05）。 结论：放置腹腔冲洗管对胃癌术后胰瘘具有较好的治疗效果,对于术中疑有胰腺损伤的患者建议预防性放置腹腔冲洗管。     

Various irrigation fluids affect postoperative brain edema and cellular damage during experimental neurosurgery in rats

BACKGROUND: This study was conducted to investigate how various irrigation fluids used during neurosurgical procedures affect the degree of postoperative brain edema and cellular damage during experimental neurosurgery in rats. METHODS: The cerebral cortex was exposed and incised crosswise with a surgical knife under irrigation with an artificial CSF, lactated Ringer's solution, or normal saline. Four hours after injury, irrigation was stopped and brain tissue samples were obtained from injured and uninjured sites. Specific gravity, cerebrovascular permeability, and TTC staining of the samples were evaluated. Incision and irrigation of the brain were not performed on the control group. RESULTS: At the injured site, specific gravities of the samples in the normal saline group and the lactated Ringer's solution group were significantly lower than the specific gravity in the artificial CSF group. The EB concentration was significantly higher in the lactated Ringer's solution group and relatively high in the normal saline group as compared with the artificial CSF group. TTC staining did not differ significantly between the artificial CSF group and the control group. It was significantly lower in the lactated Ringer's solution group and the normal saline group than in the control group and the artificial CSF group. CONCLUSIONS: As compared with normal saline and lactated Ringer's solution, artificial CSF reduced postoperative brain edema, cerebrovascular permeability, and cellular damage in sites injured by experimental neurosurgery in rats.     

Technique et indications de l'irrigation continue d'antibiotiques dans les infections ostéo-articulaires

Résumé L'irrigation continue d'antibiotiques garde sa place dans le traitement des infections ostéo-articulaires. Ses indications sont limitées, mais précises. Sa réalisation et sa surveillance doivent être particulièrement attentives. Mais il est certain qu'il ne s'agit que d'un traitement complémentaire qui ne saurait dispenser d'un nettoyage chirurgical préalable, réalisé avec la plus grande minutie. Dans ces conditions l'irrigation continue d'antibiotiques contribue efficacement à la guérison d'infections ostéo-articulaires graves et tout particulièrement des complications septiques de la chirurgie de la hanche.Travail du Service du Pr. Postel, Hôpital Cochin, Paris     

关节镜下清理加镜下置管灌洗术治疗化脓性膝关节炎

目的：探讨关节镜术和置管灌洗术在诊治化脓性膝关节炎中的应用。方法；2001年6－12月用关节镜下清理术治疗化脓性膝关节炎5例，其中对3例急性化脓性膝关节炎术后置2管持续冲洗5－10天，平均7天。结果：随访1－6月，5例（5膝）手术效果好，无术后并发症，术后肿胀、疼痛均明显缓解，膝关节功能可；综合评定，3例优，1例良，1例中。结论：关节镜下清理加镜下置管灌洗术治疗化脓性膝关节炎的方法，可以完成切开手术同样的效果。且损伤小、恢复快、临床效果好，值得推广。     

移植前低钾右旋糖苷液二次灌洗减轻供肺再灌注损伤

目的观察移植前低钾右旋糖苷液(LPD)二次灌洗对供肺再灌注损伤的保护作用。方法24只大鼠随机分为对照组(n=12)和实验组(n=12),对照组供肺经LPD液灌洗后于4℃保存18 h,取右肺组织测丙二醛(MDA)、髓过氧化物酶(MPO)、白细胞介素-8(IL-8),建立离体肺再灌注模型,左肺灌注30 m in;实验组供肺灌注前用LPD液再灌洗一次,余同对照组。灌注期间每隔10m in测定供肺静脉流出血氧分压(PaO2)、供肺平均肺动脉压(PaP)、气道峰压(PawP),灌注结束后测肺组织丙二醛(MDA)、髓过氧化物酶(MPO)、白细胞介素-8(IL-8)的含量。结果实验组供肺右肺组织MDA、MPO、IL-8含量明显低于对照组,差异有统计学意义(P<0.01);再灌注30m in后实验组供肺PO2明显高于对照组,PaP、PawP明显低于对照组,差异有统计学意义(P<0.01);灌注后供肺组织MDA、MPO、IL-8含量,实验组明显低于对照组,差异有统计学意义(P<0.01)。结论移植前LPD液二次灌洗可以减少供肺组织内MDA、MPO、IL-8含量,减轻供肺的再灌注损伤,改善供肺的功能。     

长江中游湖区防止灌溉系统钉螺扩散新技术研究

目的　探索防止涵闸引水灌溉扩散钉螺新技术。方法　运用流体力学、生物学进行跨学科研究和应用及实验室和现场相结合的方法 ,形成钉螺水力学及新的方法学特色的技术路线。在取得表达钉螺水力生物力学特征及其运动规律、物理参数、实用公式、沉降、起动流速值域的基础上 ,进而运用于现场涵闸防止钉螺扩散工程的设计、兴建及效果考核。结果　经过 5年多的努力 ,确定了测定钉螺、螺卵重率的方法并测得钉螺的平均重率 (1.80± 0 .0 1) g/cm3 ,螺卵的平均重率 (2 .2 9±0 .0 1) g/cm3 ;确立了钉螺壳形几何特征的分级法及分级标准 ,即按钉螺的螺体小、中、大进行了Ⅰ、Ⅱ、Ⅲ级分级 ;获得了表达钉螺静、动水沉速及起动流速的 6个特征值 ;建立了钉螺水体沉降、起动 5类实用公式 ;观察和测定了水体钉螺的水力运动特征及值域 ;阐明了水体钉螺扩散运动机理 ;并根据基础研究的结果 ,研制了“沉螺池”和“中层取水”防止钉螺扩散设施 ,经考核该工程设施沉、阻螺率达10 0 %。结论　本研究可为大江大河防止钉螺扩散及对涵闸的改建提供理论依据和实用、有效的防螺工程模式     

The potential of reuterin derived from Indonesian strain of Lactobacillus reuteri against endodontic pathogen biofilms in vitro and ex vivo

ObjectivesDespite the use of common irrigating solution with antimicrobial properties, failed root canal treatment remains a significant problem in endodontics. In the present study, we examined the efficacy of reuterin derived from probiotic bacteria, Lactobacillus reuteri on the biofilms of major endodontic pathogens using ex vivo model of root canal infections.MethodsBiofilms of major endodontic pathogens namely Enteoroccus faecalis, Fusobacterim nucleatum, Porphyromonas gingivalis, and Candida albicans were formed on root canals of 60 human premolar tooth samples accordingly a standard protocol. Thereafter, teeth were treated with either 2.5 % NaOCl (positive control), various concentrations of reuterin (test-group) or sterilized-distilled water (negative control) in a time-dependent assay. The efficacy of irrigation was evaluated by a time-dependent assay at 5 min and 30 min after irrigation by colony-forming units assay. The findings were further confirmed by species-specific real-time PCR. Data were statistically analysed using one way ANOVA with a significance level of P < 0.05.ResultsReuterin isolated from L. reuteri was effective against E. faecalis, C. albicans, F. nucleatum, and P. gingivalis biofilms, with a concentration of 100 µg/mL being the most effective compared to the negative control (P < 0.05) and also showed similar efficacy when compared with NaOCl.ConclusionReuterin isolated from L. reuteri has ability to inhibit in vitro and ex-vivo biofilms of endodontic pathogens, namely E. faecalis, F. nucleatum, P. gingivalis, and C. albicans. Reuterin has potential as a root canal irrigating solution due to its antibiofilm activity. Further research is warranted to determine the potential of probiotic bacteriotherapy in root canal systems.     

Ti鱼腐败气体中毒病人的护理抢救与预防研究

目的：降低Ｔｉ鱼腐败气体中毒病人的致残率,提高护理抢救成功率,促进病人及早康复。方法：采用２％～４％的碳酸氢钠溶液清洗皮肤。结果：碳酸氢钠溶液能够和Ｔｉ鱼中的有害气体硫化氢和二氧化硫,减轻神经系统、呼吸系统的中毒症状。结论：该方法效果确切,简便易引,对病人无不良刺激。