输卵管妊娠患者解脲支原体检测

目的：探讨生殖道解脲支原体（ＵＵ）感染与输卵管妊娠的关系。方法：采用聚合酶链反应（ＰＣＲ）方法，检测３０例输卵管妊娠患者的宫颈分泌物、输卵管组织中ＵＵＤＮＡ。结果：输卵管妊娠患者的宫颈分泌物、输卵管组织中ＵＵＤＮＡ阳性检出率分别为４６．７％和１０．０％，盆腔宫组和无粘连组宫颈分泌物，输卵管组织ＵＵＤＮＡ阳性检出率比较，差异无显著性，结论：输卵管妊娠与生殖道ＵＵ感染有关，生死道与盆腔粘连形成与否无明     

呼吸生理学参数对于呼吸机撤离预测的研究新进展

目前，机械通气已成为危重病治疗的必要手段，而及时撤机可以避免因机械通气过久所造成的并发症和对呼吸机的依赖。长期以来延迟撤机和过早撤机现象均相当普遍。单点、瞬时呼吸生理学的相关参数层出不穷，但是准确性均较差，不能准确的指导撤机。复合参数研究，提供了相对准确的预计能力，但是特异性相对不足；而且测量复杂，不值得进一步推广。自动管道补偿是新近发展的预测撤机技术，初步研究表明：在ATC辅助下的自主呼吸试验具有较准确的撤机预测和拔管预测率，受试者工作特征（ROC）曲线下面积显著升高。但是研究例数较少，ATC下的变量数量研究较少，无相关趋势研究。呼吸生理学参数的趋势研究显示趋势研究对撤机、拔管预测的成功率较以前研究显著增加，ROC曲线下面积可达0．94。因此，较大规模的、相对无创的呼吸生理学参数的趋势研究势在必行。     

Comparison of the Pharmacokinetics of an Ondansetron Solution (8 mg) When Administered Intravenously,Orally, to the Colon,and to the Rectum

Ondansetron, an antagonist of the serotonin type 3 (5-HT₃) receptor, is indicated for the treatment of chemotherapy-induced emesis. This study compares the pharmacokinetics, especially the bioavailability, of an Ondansetron 8-mg solution when administered intravenously, orally, to the colon via nasogastric intubation, and to the rectum using a retention enema. Six healthy, male volunteers received ondansetron infused into the colon during the first treatment period. These subjects then received the remaining three treatments in random order, with a minimum 1-week washout period between treatments. Serial plasma samples were obtained for up to 24 hr after dosing in each treatment period. Absolute bioavailability after the oral dosing, colonic infusion, and rectal administration averaged 71 ± 14, 74 ± 26, and 58 ± 18%, respectively. These values were not significantly different (P > 0.05). Values of T _max and C _max were also not significantly different among the nonparenteral routes. Mean absorption half-lives were 0.66, 1.1, and 0.75 hr after the oral, colonic, and rectal administrations, respectively. These results indicate that ondansetron is well absorbed in the intestinal segments studied including the upper small intestine, the colon, and the rectum and that sustained-release and suppository formulations of ondansetron are feasible.     

导管扩张术和活血祛瘀中药治疗输卵管阻塞的临床研究

５０例输卵管阻塞患者首先行输卵管导管扩张术，然后用痛经宝与复方当归液分组治疗，并与西药对比。结果：导管扩张术有效率为９４％；矫正妊娠率：中药组为１００％，西药组为５０％；血液流变学改善，中药组与西药组治疗后比较有显著差异（Ｐ〈０．０１），中药组治疗前后自身比较亦有显著差异（Ｐ〈０．０１）。提示：中药有降低血液粘稠度，防止输卵管再粘连等作用。导管扩张术与中药配合治疗输卵管阻塞是一种新的有效治疗方法。     

口含液体置胃管法用于中毒洗胃的研究

目的　探讨对各种口服药物中毒且清醒合作的患者采用口含液体插胃管法的可行性。方法　将 88例患者随机分为口含液体组和对照组各 4 4例。对照组采用传统插胃管法 ,口含液体组在插胃管时口含温开水 ,随吞咽动作将胃管插入。结果　口含液体组一次插管成功率95 .4 % ,对照组 6 5 .9% (P <0 .0 1)。结论　对各种口服药物中毒且清醒合作的患者 ,宜采用口含液体置胃管法 ,不仅能提高一次插管成功率 ,而且能减少胃肠道刺激症的发生 ,增加患者的舒适感。     

记忆-遗忘规律应用于护士手估气囊测压训练的效果

目的应用艾宾浩斯记忆-遗忘规律对老年病房护士进行气管导管气囊手估测压培训，提高估测法测压的准确率，摸索一种科学的估测法测压培训方法。方法90名各级职称护士手估测压训练，用气囊测压仪进行结果比对，随机测量各压力水平，对培训前后做统计学分析。结果各级职称护士培训后测压准确率提高显著，其中高压水平手估准确率明显高于常压和低压水平，各级职称护士间无显著差异。结论护士经培训后手估气囊测压的准确率较高，此培训方法可靠，值得在临床推广应用。     

A new sterilization technique with balloon-tube thoracostomy for thoracic empyema

Objective: Failure or prolongation of treatment for refractory thoracic empyema by the current chesttube drainage technique is often due to sterilization difficulties. Insufficient sterilization prolongs hospitalization, and is often associated with life-threatening complications and/or additional invasive surgical procedures. A new chest-tube sterilization technique aimed at making it less invasive and shortening the therapy is proposed.Methods: Following pretreatment for complications including loculation, bronchopleural fistula, or corticated lung, a double-lumen trocar catheter was introduced at the bottom of the empyemic cavity through the lateral chest wall. Then, a Foley balloon urethra-catheter was inserted and attached just inside the anterior chest wall at the top of the cavity for the evacuation of intrathoracic air. After irrigation of the cavity with distilled water once or twice, the cavity was completely filled with a bactericidal solution which was left in place for 30–60 minutes, followed by an antibiotic solution for more than 20 hours.Results: Among the five treated post-lobectomy or pneumonectomy cases, sterilization was obtained after only one treatment in four cases and after two courses in the other. Catheterization duration from the initial treatment was 2–13 days. Neither recurrence nor treatment-related major complications were observed.Conclusions: This balloon-tube thoracostomy technique is simple, minimally invasive and cost-effective, due to shortening of the treatment time with minimal manpower and equipment requirements. It is thus a promising therapeutic approach to thoracic empyema and has the potential for application to other intrathoracic disorders.     

经蝶入路垂体腺瘤切除手术的麻醉

我院1990年3月至2002年12月经蝶路治疗垂体腺瘤患者493例,术前应用地塞米松10～20 mg,以咪达唑仑0.1 mg/kg、芬太尼2μg/kg、丙泊酚2 mg/kg、琥珀胆碱2 mg/kg或罗库溴铵0.6 mg/kg快速诱导全麻,术中以异氟烷、丙泊酚静吸复合麻醉维持,术后在丙泊酚镇静下拔管.术中2例出现困难气管插管,4例发生严重高血压,均成功处理,其余麻醉顺利.这提示,因垂体腺瘤患者常并发各种内分泌异常,其麻醉处理有一定特殊性,困难气管插管、术中高血压等处理是关键.     

The effect of tonsillectomy on eustachian tube function

A two-part study was designed to investigate the effect of tonsillectomy on eustachian tube function and to identify if any change is related to postoperative pain. Middle ear pressure was measured by tympanometry and results were classified as type A (+50 daPa to ?99 daPa), type B (flat) or type C (?100 daPa to ?350 daPa). Thirty-one patients with type A tympanograms, undergoing tonsillectomy enrolled in study A. Patients had tympanometry the next day and filled in a questionnaire incorporating visual analogue pain scores. In study B, 30 patients underwent a similar protocol and were followed up at 1 week with tympanometry and a questionnaire. A control group of 26 patients undergoing appendicectomy was recruited. Follow-up was available on 23 patients from study B. Combining A and B, on the first postoperative day 39% of patients developed type C tympanograms. No member of the control group developed any change in middle ear pressure. There was no significant relationship between pain scores for throat pain or otalgia and the development of negative middle ear pressure. By day 7 all patients had type A tympanograms. Otalgia was a delayed symptom significantly associated with increased throat pain. Transient negative middle ear pressure commonly occurs following tonsillectomy.