Treatment of resistant distal intestinal obstruction syndrome with a modified antegrade continence enema procedure

We report a case of a patient with CF who had a long history of recurrent distal intestinal obstruction syndrome. She had been treated with conventional treatment including gastrografin, n-acetyl cysteine, Klean prep and Picolax. She underwent a modified antegrade continence enema procedure. She currently irrigates her conduit every 2-3 days. She has had no further symptoms of distal intestinal obstruction syndrome.     

Modified Damus–Kaye–Stansel procedure using aortic flap technique for systemic ventricular outflow tract obstruction in functionally univentricular heart

Damus–Kaye–Stansel procedure is a useful method to relieve the systemic ventricular outflow tract obstruction in functionally univentricular heart. Regurgitation of pulmonary valve and recurrence of systemic ventricular outflow obstruction are the major concerns at the late phase of this procedure. Modification of original Damus–Kaye–Stansel procedure that can prevent the use of prosthetic materials is evaluated. The modified Damus–Kaye–Stansel procedure using aortic flap technique was performed in eight patients with functionally univentricular heart. Patients’ ages ranged from 3 to 28 months (mean 14 months). Follow-up period was 37 months as a mean (9–71 months), and the follow-up was complete. There was no operative mortality and no late death. In addition, there was no recurrence of systemic ventricular outflow tract obstruction throughout the follow-up period. Regurgitation of the pulmonary valve estimated by echocardiography at the latest follow-up was none to trivial in seven patients and mild in one. The modified Damus–Kaye–Stansel procedure using aortic flap technique is a safe, useful and reproducible technique to solve systemic ventricular outflow tract obstruction in functionally univentricular heart, and it can be an alternative for original technique or the so-called double-barrel modification.     

Nucleic acid spot hybridization with nonradioactive labeled probes in screening for human papillomavirus DNA sequences

We examined 161 human tissue samples using the spot hybridization technique with nonradioactive labeled DNA probes of human papillomavirus (HPV). Whole cells were spotted on nitrocellulose filters; DNA of the cells was denatured and fixed to the filter. Then the DNA spots were hybridized to nonradioactive labeled DNA and monitored by a sandwich immunoenzymatic reaction. This technique is simple, sensitive, specific, requires no special equipment, and can be used in clinical settings. HPV DNA was found in 92% of samples in which, on the basis of histologic and colposcopic criteria, its presence was suspected, as well as in 31 samples where it was not suspected.     

Development of computer-assisted simulation procedure to analyze receptor modulatory processes

Summary Experimentally induced changes in neurotransmitter receptors have been analyzed by means of a computer assisted simulation procedure over a wide range of free ligand concentrations. This approach allows to evaluate, for a given range of ligand concentrations, the relative influence of simultaneous variations in binding parameters (i.e. dissociation constant or K_d and in maximal number of binding sites or B_m) and to predict the net and final effect of the experimental condition on the receptor-mediated transmission line. The function representing the changes in bound values versus the respective free ligand concentrations, has been studied analytically on the basis of all the possible values that the percent changes in both K_d and B_m parameters induced by a given experimental condition can assume. A well characterized change in the pattern of bound radioligand could in this way be defined. This approach, developed to show in an immediate and clear way treatment-induce changes in receptor populations or to fit directly rough experimental data expressed as differences in bound values versus free ligand concentrations, seems to be an useful complement to the widely used saturation analysis of binding data.     

63例CT导引下经皮肺穿刺活检术的围手术期护理

目的：探讨CT导引下经皮肺穿刺活检术围手术期的护理程序及注意事项。方法：对我院2007年11月至2009年7月63例行CT导引下经皮肺穿刺活检术的患者实施术前、术中、术后护理及健康指导等围手术期护理程序。结果：实施围手术期护理程序后,患者焦虑程度明显减轻,并发症明显减少,术后恢复良好,患者均安全度过围手术期。结论：认真落实护理程序各阶段的护理措施,是减少CT导引下经皮肺穿刺活检术围手术期意外和各种护理并发症的关键。应用围手术期护理程序可提高手术的护理质量,减少术后并发症,为患者迅速康复奠定良好的基础。     

Epicardial radiofrequency ablation for chronic atrial fibrillation undergoing simultaneous on-pump beating coronary artery bypass grafting

Off-pump coronary artery bypass grafting has become an attractive surgical alternative for myocar-dial revascularization because of the advantage of myocardial protection and other benefits of patients. However, it is still regarded as a controversial treatment for the coronary artery disease accompanied by atrial fibrillation (AF). A significant number of patients in need of coronary revascularization have chronic AF. Although the Cox-Maze III procedure is the gold standard for the surgical treatment of AF, few of these patients undergo AF operations at the time of their coronary bypass grafting. We report herein a case of the pulmonary vein isolation to eliminate the AF by means of epicardial radiofrequency ablation combined with 2 vessels coronary artery bypass grafting on the beating heart with the aid of cardiopulmonary bypass.     

利用外国政府贷款医疗项目操作程序及需要注意的问题

综合了申请利用外国政府贷款医疗项目所涉及的部门、政策规定、申请程序、工作要求等,并按照实际工作中的大体操作顺序作了较为具体的介绍。     

A Test to Detect Chest Tube Kinking

Objectives: To determine whether the Mac‐technique test can detect kinking of the chest tube upon thoracostomy tube placement. Methods: This was a prospective observational study that was conducted October 2000 through October 2001 in an urban Level 1 trauma center. There were 103 consecutive nonrandomized adult trauma patients who required immediate tube thoracostomy during their initial resuscitation who were entered into the study. The Mac‐technique test was performed during standard tube thoracostomy insertion to the appropriate depth. The test involved grasping the external portion of the thoracostomy tube, turning it clockwise 180°, and then releasing the tube. If the tube spontaneously spun back to its original position, the test was considered positive, and the tube was considered kinked. If the tube did not spontaneously spin back and stayed in position upon release, the test was considered negative. Regardless of the results of this test, the tube was secured, and a postprocedure chest radiograph was obtained. The criterion standard for determining a kinked chest tube was its appearance on this chest radiograph. Results: A total of 103 chest tubes were placed by using the Mac‐technique test. The test was positive in eight placements; four tubes were kinked on chest radiograph. The Mac‐technique test was negative in 95 placements; four tubes were kinked on chest radiograph. The Mac technique had a sensitivity of 50% (95% confidence interval [CI] = 15.7% to 84.3%), a specificity of 95.8% (95% CI = 89.6% to 98.8%), a positive likelihood ratio of 11.9, a negative likelihood ratio of 0.52, and an odds ratio using Yates correction of 20.3 (95% CI = 4.1 to 102.1). Conclusions: On the basis of this study, a positive Mac‐technique test is useful to detect chest tubes that are likely to be kinked after insertion and before securing.     

国产重组人脑钠素与硝普钠用于心脏手术围术期处理的对比研究

目的 对重组人脑钠素（rhBNP）用于心脏手术围术期处理的可行性、安全性和有效性进行初步观察，并与硝普钠的作用进行比较。方法 选择择期心脏手术病人22例，随机分为rhBNP组（B组）和硝普钠（SNP）组（s组），每组11例。比较rhBNP与SNP对病人血流动力学和肝肾功能的影响。结果 与给药前和S组比较，B组用药后15、30、60、120和180min各点心输出量增加显著（P〈0．05，P〈0．01）；B组与给药前比较，给药后即刻、15、30和60min时点外周血管阻力下降显著（P〈0．05）；给药后即刻、15和30点与S组比较，下降显著（P〈0．05）。B组肺毛细血管楔压（PCWP）与用药前比较，用药后即刻、15、30、60、120和180min下降显著（P〈0．05，P〈0．01）；与S组比较，给药后30、60、120和180min差异有统计学意义（P〈0．05，P〈0．01）。S组PCWP与用药前比较，用药后60min、120min和180min下降显著（P〈0．05）。B组与输注rhBNP前以及S组比较，平均动脉压、心率和中心静脉压差异均无统计学意义。输注rhBNP后病人24h尿量明显增加。用药过程中以及30d后进行电话随访，未见药物不良反应。结论 rhBNP用于心脏手术围术期处理是可行的，具有改善心功能和稳定循环的作用。