1例切口全层哆裂合并肠造口皮肤黏膜分离患儿的护理

总结1例切口全层哆裂合并重度肠造口皮肤黏膜分离营养不良脑瘫患儿的护理经验。护理要点包括：积极抗感染;切口、造口及造口周围皮肤管理,运用湿性愈合理念,科学裁剪、粘贴造口袋,及时清除伤口及造口渗液和粪水,促进创面及周围皮肤愈合;实施个性化营养方案,积极预防压力性损伤发生。经过62 d的治疗及精心护理,患儿创面恢复,效果满意。     

Consistency of normalized cerebral blood volume values in glioblastoma using different leakage correction algorithms on dynamic susceptibility contrast magnetic resonance imaging data without and with preload

Background and purpose

Several leakage correction algorithms for dynamic susceptibility contrast (DSC) magnetic resonance imaging (MRI)-based cerebral blood volume (CBV) measurement have been proposed, and combination with a preload of contrast agent is generally recommended. A single bolus application scheme would largely simplify and facilitate standardized clinical applications, while reducing contrast agent (CA) dose. The aim of this study was, therefore, to investigate whether appropriate leakage correction redundantizes prebolus application by comparing normalized DSC-based CBV (nCBV) measures of two consecutive CA boli.

医用电气设备漏电流的产生原因

本文对医用电气设备漏电的产生原因提出理论依据,并进行具体分析。     

护理干预对预防神经内科留置导尿患者漏尿的效果评价

目的 探讨护理干预对防治神经内科留置导尿患者漏尿的效果.方法 将神经内科留置导尿患者76例随机分为观察组和对照组各38例.对照组给予常规护理,观察组在此基础上给予系统护理干预.比较2组留置尿管期间漏尿的发生率及2组患者对护理服务的满意度.结果 对照组导尿管留置期间漏尿的发生率为21.1％,显著高于观察组的2.6％.观察组患者对护理满意度评分为(4.66±0.62)分,显著高于对照组的(3.26±0.42)分.结论 护理干预能有效减少神经内科留置导尿患者漏尿的发生,提高满意度评价,值得临床推广应用.     

Evaluation of three instrumentation techniques at the precision of apical stop and apical sealing of obturation

Objective

The aim of this study was to investigate the ability of two NiTi rotary apical preparation techniques used with an electronic apex locator-integrated endodontic motor and a manual technique to create an apical stop at a predetermined level (0.5 mm short of the apical foramen) in teeth with disrupted apical constriction, and to evaluate microleakage following obturation in such prepared teeth.

Material and Methods:

85 intact human mandibular permanent incisors with single root canal were accessed and the apical constriction was disrupted using a #25 K-file. The teeth were embedded in alginate and instrumented to #40 using rotary Lightspeed or S-Apex techniques or stainless-steel K-files. Distance between the apical foramen and the created apical stop was measured to an accuracy of 0.01 mm. In another set of instrumented teeth, root canals were obturated using gutta-percha and sealer, and leakage was tested at 1 week and 3 months using a fluid filtration device.

Results

All techniques performed slightly short of the predetermined level. Closest preparation to the predetermined level was with the manual technique and the farthest was with S-Apex. A significant difference was found between the performances of these two techniques (p<0.05). Lightspeed ranked in between. Leakage was similar for all techniques at either period. However, all groups leaked significantly more at 3 months compared to 1 week (p<0.05).

Conclusions

Despite statistically significant differences found among the techniques, deviations from the predetermined level were small and clinically acceptable for all techniques. Leakage following obturation was comparable in all groups.     

航空橡胶密封制品泄漏因素及预防措施

本文通过对密封制品基本要求的介绍,从介质、压力、温度、速度、粗糙度以及安装要求六个方面,说明了影响航空橡胶密封制品泄漏的主要因素及预防措施。     

鼻饲管在治疗食道,贲门癌术后吻合口瘘中的应用

本文报告了食道，贲门癌术后吻合口瘘通过鼻饲管实施十二指肠及空肠内营养支持治疗的方法。将导丝引志的远端带金属头的硅胶管在Ｘ线电视监视下经鼻腔，食道送入到吻合口以下的十二指肠或空肠内，建立鼻饲管营养通道，提供足量的营养成分，以满足机体生理及促进组织修复的需要。     

壳聚糖体外抗幽门螺杆菌机制研究

目的 探讨壳聚糖抗幽门螺杆菌(Hp)的作用机制。方法 将Hp与壳聚糖溶液作用24和48h后，取上清液测天冬氨酸转氨酶(AsT)活性和葡萄糖含量．并在透射和扫描电镜下观察Hp的细菌形态和超微结构变化。结果Hp与壳聚糖溶液作用后上清液巾渗漏的AST活性和葡萄糖含量显著高于对照组(P＜0．01或P＜0．05)；透射电镜见Hp肜态多样，以球形体为主，并可见V形、U形和不规则形；Hp胞壁变薄不完整，有的菌体细胞壁部分或全部脱落消失．细菌轮廓模糊，结构不清，且发生不同程度的凹陷变形，甚至穿孔和破碎；胞质内容物稀疏，空隙明显扩大；细菌内部结构消失或分布异常，胞质不均匀或密度下降，出现高电子密度颗粒。扫描电镜见Hp形态多样，以球形体为主．并可见U形和不规则形；细菌表面广泛改变，粘附有可折射物质，外观呈毛刺状。结论 壳聚糖可能通过破坏Hp外膜的结构、功能和通透性，使细菌内容物渗出，细菌破裂；且从破损的细胞外膜进入Hp菌内．与胞质作用，扰乱其代谢这两种机制发挥抗Hp作用。     

Radiological evaluation of colorectal anastomoses

BACKGROUND AND AIMS: The purpose of this study was to determine the accuracy, interobserver variability, timing and discordance with relaparotomy of postoperative radiological examination of colorectal anastomoses. PATIENT/METHODS: From 2000 to 2005, 429 patients underwent an ileocolonic, colo-colonic, or colorectal anastomosis. Radiological examination of the anastomosis was not performed routinely, but only when there were clinically signs of leakage. Radiological imaging was reviewed by an independent radiologist and medical records were retrospectively analyzed. Clinical anastomotic leakage was the standard of reference and defined as leakage confirmed during relaparotomy, drainage of pus per anum or as an anastomotic defect identified at digital examination. RESULTS: Radiological evaluation of the anastomosis was performed in 91 patients (21%): CT in 27 patients, contrast radiography in 40, and both imaging modalities in 24 patients. The interobserver variability of CT and contrast radiography was 10% and 14%, respectively. The sensitivity and negative predictive value of imaging of the anastomosis was 65% and 73%, respectively. Anastomotic leakage was found in 11 of 21 patients (52%) who underwent relaparotomy despite negative imaging. Three of 36 patients (8%) with a diagnosis of anastomotic leakage based on radiological examination had an intact anastomosis at relaparotomy. CONCLUSION: Radiological imaging of the anastomosis after colorectal surgery should be restrictively applied and interpreted with caution because of the high false-negative rate and the substantial interobserver variability.