An audit of pain and vomiting in paediatric day case surgery

Three hundred and thirteen paediatric day case patients were prospectively audited to assess postoperative pain, nausea and vomiting using data sheets completed by nursing staff, anaesthetists and parents. The incidence of nausea and vomiting was 7.3% and was commoner in older children and those who had received opioids. Forty per cent of patients had some degree of postoperative pain; 17% of these patients were scored as having severe pain. Of children who had pain on returning home (31.4%), 85% of these required paracetamol. Fifteen per cent of children had a disturbed night due to pain and/or vomiting after their operation and 28.5% of children had pain on the following day. Boys undergoing circumcision were responsible for a disproportionately high percentage of the severe pain scores. Audit has helped to highlight deficiencies in the service provided and has led staff to try and improve their methods of analgesia.     

食管癌术后乳糜胸：（附9例报告）

本文报告我院从1954年12月～1988年12月切除食管癌733例,发生乳糜胸9例(中段食管癌8例,下段食管癌1例,均侵犯食管左后壁),发生率1,2％,死亡3例。乳糜胸发生的中位年龄63岁。男8例,女1例。9例均行闭式引流。5例保守病例中2例死亡,4例2次手术病例中,死亡1例。乳糜胸的发生在术后2～8天,乳糜引流量为3500～8680ml。保守1例中,使用四环素加50％葡萄糖胸内注入,治愈。     

不同海拔高度健康藏汉族青年脉象图研究

本文通过对不同海拔高度藏汉族健康青青年的４００幅脉图分析后认为，健康藏汉族青年的脉象以滑、平、弦、缓为多。结古和西宁的藏汉族青年脉力图的主要生理参数中不同海拔高度上有一定差异，表现为结古青年弦脉较多，而西宁教地区滑脉较多，究其形成原因，主要与高海拔缺氧、寒冷环境有密切关系；在民族间也存在一定差异，表现为汉族弦脉多，藏族滑脉多，它们的形成与移居高原后心血管的反庆和代偿机制有关，在性别间有明星的差异。     

Expression of tyrosine hydroxylase and neuropeptide tyrosine in mouse sympathetic airway-specific neurons under normal situation and allergic airway inflammation

BACKGROUND: The traditional neurotransmitter catecholamine and the neuropeptide tyrosine in sympathetic airway nerves have been proposed to be involved in the pathogenesis of airway diseases. OBJECTIVE: The aim of the present study was to investigate the effect of allergic airway inflammation on the expression of catecholamine enzyme tyrosine hydroxylase (TH), neuropeptide tyrosine (NPY) and tachykinins in mouse sympathetic airway ganglia. METHODS: Using neuronal tracing in combination with immunohistochemistry, the present study was designed to characterize TH, NPY and tachykinin profiles of superior cervical (SCG) and stellate ganglia after allergen challenge. RESULTS: The vast majority of fast blue-labelled SCG neurons (allergen: 97.5+/-1.22% (mean+/-SEM) vs. controls: 94.5+/-1.48%, P=0.18) and stellate neurons (allergen: 95.3+/-1.01% vs. controls: 93.6+/-1.33%, P=0.34) were immunoreactive for TH. Of the TH immunoreactive and fast blue-labelled SCG neurons, 52.0+/-1.01% allergen vs. 51.2+/-3.58% controls (P=0.83) and stellate neurons, 57.3%+/-0.97 allergen vs. 56.4+/-1.65% controls (P=0.64) were positive for TH only but not NPY, whereas 45.3+/-1.05% allergen vs. 43.3+/-1.18% controls (P=0.47) of fast blue-labelled SCG neurons and 37.9+/-0.86% allergen vs. 37.1+/-1.24% controls (P=0.62) of fast blue-labelled stellate neurons were immunoreactive for both TH and NPY immunoreactivities. There was a trend of an increase, but not significant one, in the percentage of TH-/NPY-immunoreactive and fast blue-labelled neurons in allergen-treated animals in comparison with the controls. Tachykinins, however, were not expressed by sympathetic neurons and were also not induced in sympathetic neurons after allergen challenge. CONCLUSION: The present study indicates that allergic airway inflammation does not alter the expression of noradrenalin and NPY in sympathetic ganglia and also shows that sympathetic neurons do not respond to allergic airway inflammation with tachykinins induction. However, a participation of catecholamine and NPY in the pathogenesis of allergic airway inflammation cannot be excluded in the present study as a higher neurotransmitter output per neuron following allergen challenge could be possible.     

组织黏合剂闭合血管影响因素的血液流变学研究

目的通过血液流变学研究组织黏合剂N-丁基-2-氰丙烯酸盐在模拟血管中的实际行为，分析影响其闭合血管的主要因素，找到发挥作用的最佳条件。方法利用聚四氟乙烯管建立血流模拟装置，分别研究血管直径、血流速度以及组织黏合剂配比浓度这三个因素对组织黏合剂闭合血管的影响。结果组织黏合剂与碘油1：1配比混合物1．0ml快速注射至聚四氟乙烯管内可以完全阻塞血流速度15cm／s、直径0．4cm的以及血流速度10cm／s且直径0．6cm的血流。当管腔直径增加至0．8cm或血流速度加快为20cm／s时，血流只是部分闭塞。改变组织黏合剂与碘油配比为0．5：0．8以及0．5：1．0，则注射后聚合体断裂成碎片状。结论实验验证了随着血管直径增大、血流速度加快及配比浓度降低，组织黏合剂闭合血管的效应下降，以供临床定量参考。     

肩肱皮瓣修复颈部瘢痕挛缩畸形疗效分析

目的:探讨颈部瘢痕挛缩畸形的有效外科治疗手段。方法:采用瘢痕广泛松解、双侧或单侧肩肱皮瓣转移,同时用全厚皮片移植修复供瓣区创面。结果:本组21例中,17例手术一次性完成,4例分两次完成。不但改善了患者的上肢功能,还可进一步改善患者颈部的活动度。结论:瘢痕广泛松解、双侧或单侧肩肱皮瓣转移,同时用全厚皮片移植修复供瓣区创面是颈部瘢痕挛缩畸形的有效外科治疗手段。     

冰蜜生肌膏对兔成纤维细胞增殖影响的实验研究

目的:观察冰蜜生肌膏促进体外培养兔成纤维细胞增殖的影响。方法:采用消化分离法进行兔成纤维细胞的原代培养,通过形态学和免疫组织化学的方法鉴定成纤维细胞。第3代纯化的成纤维细胞分为5组,空白对照组每孔加入等量的PBS,实验组每孔分别加入125、62·5、31·25、15·625mg/ml的冰蜜生肌膏提取液进行培养,培养24、48、72h后分别行MTT法检测每孔的光吸收值(OD值)。结果:冰蜜生肌膏提取液加入到成纤维细胞中培养24、48、72h后,经MTT法检测,不同浓度(浓度分别为125、62·5、31·25、15·625mg/ml)冰蜜生肌膏与对照组OD值比较差异有显著性统计学意义(P<0·05)。结论:15·625mg/ml浓度冰蜜生肌膏对成纤维细胞的生长有明显促进作用(P<0·05),药物浓度在15·625~62·5mg/ml时其作用随药物浓度升高而增加,并在浓度为62·5mg/ml时达到最大效应值(P<0·01),当药物浓度大于62·5mg/ml时则作用趋向于饱和,提示一定浓度范围内的冰蜜生肌膏药液能明显增加成纤维细胞数量,且促进作用和浓度呈显著依赖性。     

正常人颈段脊柱结构内CGRP和SP阳性神经纤维的分布

目的 为深入探讨颈肩痛的发病机理。方法 用免疫组织化学方法观察人颈段脊柱结构内CGRP和SP阳性神经末梢存在的情况。结果 人颈段脊柱结构的纤维层内均有CGRP和SP免疫反应阳性神经末梢存在，多数神经末梢独立行走，呈树枝状或念珠状，少量神经末梢交织网状。结论 CGRP和SP可能参与了人颈段脊柱结构的伤害性感觉信息的传递。当人颈段脊柱结构的神经末梢受刺激时，可能引起CGRP和SP的释放和传递，这可能是引起原发性颈肩痛的原因之一。     

茶叶多糖的研究进展

茶叶多糖是一种复合杂多糖，具有许多生物活性。作者系统地介绍了茶叶多糖的提取、分离、纯化、纯度鉴定及相对分子质量测定的方法，以及其含量和组成、理化性质、化学结构及空间构象、生物活性等方面的研究进展，并对上述方法及研究进展进行了分析和评述。     

Adaptive group sequential design for phase II clinical trials: A Bayesian decision theoretic approach

Bayesian decision theoretic approaches (BDTAs) have been widely studied in the literature as tools for designing and conducting phase II clinical trials. However, full Bayesian approaches that consider multiple endpoints are lacking. Since the monitoring of toxicity is a major goal of phase II trials, we propose an adaptive group sequential design using a BDTA, which characterizes efficacy and toxicity as correlated bivariate binary endpoints. We allow trade‐off between the two endpoints. Interim evaluations are conducted group sequentially, but the number of interim looks and the size of each group are chosen adaptively based on current observations. We utilize a loss function consisting of two components: the loss associated with accruing, treating, and monitoring patients, and the loss associated with making incorrect decisions. The performance of our Bayesian modeling, and the operating characteristics of decision rules under a wide range of loss function parameters are evaluated using seven scenarios in a simulation study. Our method is illustrated in the context of a single‐arm phase II trial of bevacizumab, gemcitabine, and oxaliplatin in patients with metastatic pancreatic adenocarcinoma. Copyright © 2009 John Wiley & Sons, Ltd.