上腹器官簇移植术实验中血流动力学及血生化的变化

目的:观察上腹器官簇移植术实验中血流动力学及血生化变化。方法:杂种猪32只。随机分为供体组和受体组,无肝期行体外静脉转流。测定术中的血流动力学和血生化指标。结果:(1)术中血流动力学在无肝期初期及开放后早期时间内有明显的波动,心输出量、血压、肺动脉压和肺毛细血管楔压下降,心率加快;(2)转流在一定程度上稳定血流动力学;(3)生化变化:开放前行肝冲洗的8例,血钾仅轻度升高;未作冲洗的6例,则血钾明显升高;(4)开放后均有不同程度的代谢性酸中毒。结论:上腹器官簇移植术,机体血流动力学及血生化均有改变,特别是在肝移植阶段明显。其它器官移植期处理也应考虑肝移植后续作用的影响。     

Expression and kinetic characteristics of muscle type acetylcholine receptors in Xenopus oocytes

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Impaired cellular host defence in peritoneal dialysis by two granulocyte inhibitory proteins

Bacterial and fungal peritonitis is associated with a high riskof morbidity and mortality in patients undergoing continuousambulatory peritoneal dialysis (CAPD). Impaired cellular hostdefence in the peritoneal cavity underlies this risk. Two granulocyteinhibitory proteins with a molecular weight of 28000 dalton(GIP I) and about 9500 dalton (GIP II) with homology to light-chainproteins and beta respectively, were isolated from peritonealdialysis effluents. In vitro, both granulocyte inhibitory proteinsinhibit PMNL glucose uptake, phagocytosis and intracellularkilling of bacteria. The IC₅₀ of GIP I or GIP II required forinhibition of half-maximal FMLP-induced or PMA-stimulated PMNLfunction was found to be in the nanomolar range, suggestingvery specific inhibition. These data may explain, at least inpart, defective local cellular host defence in CAPD patients.     

化工废水中N-亚硝基二正丙胺的吹扫捕集-GC-MS测定法

目的建立简单快速提取并测定N-亚硝基二正丙胺(NDPA)的方法。方法采用Trap3捕集管,利用标准吹扫捕集程序(吹扫气体流速40ml/min,吹扫时间11min,解吸温度225℃,解吸时间4min,烘烤温度230℃,烘烤时间10min),有效富集了化工废水中μg/L级的NDPA,建立了吹扫捕集(P&T)气相色谱质谱联用(GC-MS)化学源(CI)选择离子模式(uSIS)快速、准确分析废水中NDPA的分析方法。结果方法的相对标准偏差为7.5%;废水的加标回收率在62.60%～96.31%;在5～30μg/L范围内线性良好,线性回归系数为0.978;方法的最低检出限为3μg/L。结论采用P&T-GC-MS/CI/uSIS法可用于化工废水中半挥发性有机物NDPA的测定。     

益气养阴清热法合化疗治疗急性髓细胞白血病

目的 :探讨益气养阴清热法为基本治法配合化疗治疗急性髓细胞白血病的临床疗效。方法 :用黄芪、太子参、白术、生地、黄精、天门冬、麦门冬、白花蛇舌草、半枝莲、小蓟、蒲公英、甘草组方。配合 DA、HA、IA等联合化疗方案。部分 M3 患者应用维甲酸、亚砷酸治疗。部分患者静脉滴注榄香稀乳、参脉、丹参等辅助治疗。结果 :1 5 6例完全缓解 1 1 3例 ,完全缓解率 72 .4% ;部分缓解 2 0例 ,部分缓解率 1 2 .8% ;总缓解率 85 .3% ;3年生存率 37.2 % ,5年生存率 2 2 .1 %。 32例老年患者完全缓解率 43.8% ,明显低于其他年龄段 ( P<0 .0 1 )。应用维甲酸治疗的 1 8例 M3 完全缓解 1 5例 ,完全缓解率 83.3%。亚砷酸治疗 3例完全缓解 2例。结论 :益气养阴清热法作为中医的基本治法治疗急性髓细胞白血病符合临床实际。中西医结合治疗急性髓细胞白血病缓解率高 ,患者易于接受 ,有比较高的实用价值。其中提示老年患者治疗比较困难。     

Evaluation of prosthetic mesh closure in semiopen-abdomen patients

Abstract Background. To avoid the adverse consequences of abdominal compartment syndrome and to reduce the high mortality the celiotomy wound in patients with abdominal sepsis was closed without tension using prosthetic mesh. This produces a semiopen situation that permits staged reinterventions together with the functional reconstitution of the continuity of the abdominal wall. Material and Methods. Twenty-five patients with intra-abdominal sepsis of various causes were evaluated retrospectively to assess the results of semiopen management of the septic abdomen and reoperations on demand in severe peritonitis. All of the patients were in a state of neglected peritonitis, and had at least one failing organ system. The Mannheim Peritonitis Index (MPI) scoring system was used for stratification of abdominal sepsis. Results. The mean MPI score of 25 patients was 24, ranging 10 to 33. Eight (32%) patients were reexplored (MPI=21). There were overall 9 (36%) complications in patients with mean MPI score of 23. Six (24%) mesh-related complications (infection and enterocutaneous fistulas) developed (MPI=19). The mean MPI score of patients without complications was 24. Four (16%) patients died with index MPI score of 26 due to fulminant hepatitis, myocardial infarction, and multiple organ failure. The admission period averaged 63 days. Conclusions. In 25 critically ill patients with abdominal sepsis the mortality was lower than expected, relative to heterogeneous data from the literature; also, major complications occurred less frequently although the mean MPI score was high. The authors conclude that this approach is a reliable contribution to the complex treatment of these patients. Electronic Publication     

Differential sensitivity of mouse oocytes to colchicine-induced aneuploidy

Unpublished results from our laboratory showed that colchicine increased the incidence of hyperploid mouse metaphase II (MII) oocytes when injected at the same time as human chorionic gonadotrophin (HCG). The objective of the present study was to determine whether the time of administering colchicine influenced the incidence of aneuploidy in MII oocytes. CD-1 mice were given pregnant mare's serum (PMS) and 48 hr later, HCG. An intraperitoneal injection of 0.2 mg/kg colchicine was given at +4, +2, 0, -2, or -4 hr relative to HCG. Oocytes were collected 17 hr post-HCG and processed, and chromosomes were subsequently C-banded. The percentage of hyperploid oocytes was 0.77, 2.56, 5.71, 7.79, 3.54, and 2.70 for control, +4, +2, 0, -2, or -4 hr pre/post-HCG, respectively. Chi-square analyses of these data demonstrated that colchicine significantly increases the proportion of aneuploid oocytes, and that the relative sensitivity of colchicine-induced aneuploidy depends upon the time that this drug is administered relative to HCG.     

Semiconductor manufacturing: an introduction to processes and hazards

Recent studies suggest that semiconductor workers have an increased incidence of work-related illness. Semiconductor manufacturing is a chemically intensive industry involving many potentially hazardous operations. As this industry moves into new geographic areas, health care professionals will be asked to evaluate medical or workplace conditions associated with unfamiliar and complex production processes. This paper provides an overview of semiconductor manufacturing processes for these health practitioners. Each step of device fabrication is detailed with its attendant chemical and physical hazards. Broader concepts of industrial control technology, clean room ventilation, and ergonomics are explained. The hazards are tabulated to allow rapid assessment of the risks inherent to each processing step. References have been chosen to guide the reader to more indepth information.     

Management of bacterial peritonitis and exit‐site infections in continuous ambulatory peritoneal dialysis*

SUMMARY: Peritonitis and exit‐site infections remain the most important limitations to the delivery of continuous ambulatory peritoneal dialysis (CAPD). Contamination of the peritoneum, from endogenous or exogenous sources, is responsible for most peritonitis episodes. Patients usually present with a cloudy bag, although other causes should be distinguished. Clinical suspicion of peritonitis should be followed rapidly by microbiological examination and empirical treatment. Microbiological confirmation allows for subsequent treatment based on sensitivities. Other interventions such as catheter removal may be appropriate in some patients. Exit‐site infections should also be identified and treated early. Peritonitis may be further prevented by adequate exit‐site care, hygienic methods, and techniques to minimise early contamination of the exit site. Mupirocin may also have a role in preventing infections caused by Staphylococcus aureus.