食管癌与贲门癌术后胃排空障碍15例临床分析

目的：探讨食管癌、贲门癌术后胃排空障碍的病因、诊断及防治。方法：回顾性分析15例食管癌、贲门癌术后胃排空障碍的病因，区分功能性及机械性胃排空障碍的诊断，提出防治措施。结果：15例患者中11例功能性胃排空障碍，经保守治疗治愈。4例机械性胃排空障碍经手术治愈。常规行幽门成形术者，无胃排空障碍发生。结论：食管癌、贲门癌术后胃排空障碍的发生与手术方式、术中操作及迷走神经干的切断等因素有关。应规范手术操作，常规行幽门成形术及辅以胃肠动力药物等进行治疗。     

夜间护理纠纷的常见原因及防范对策

针对夜间护理特殊性，分析导致护理纠纷的常见原因，包括抢救不到位，患不能理解夜间护士的护理行为．服务态度问题等。提出护士应增加法制观念，加强体质锻炼，强化服务意识，严格执行诊疗护理规范、常规，落实各项规章制度，以减少护患纠纷。     

The role of insurance data in setting priorities for netball injury prevention strategies

The aim of this study was to investigate insurance records for a one-year period to determine the injury frequencies and costs associated with different age groups in netball. The insurance records for all netball claims made during 1999 in Victoria were obtained from the insurer and entered into a database. The overall injury rate was 9.49 injuries per 1000 players, with 829 claims for injuries filed with the insurance company. Of all injuries claimed for, 85.3% were to the lower limb, 8.7% to the upper limb, 3.1% to the spine/torso and 2.9% to the head and face. Lower limb injuries accounted for 85.4% of costs, upper limb injuries 10.7% and head/neck/torso injuries 3.9% of total injury costs. Knee injuries accounted for 56.9% of total costs, with ankle and calf/Achilles injuries costing 12.7 and 11.8% of total costs, respectively. Injury prevention strategies should therefore be directed to three main injuries taking into account costs and incidence. These injuries were: ankle sprains, knee ligament sprains and Achilles tendon strains. Specifically, the prevention program for Achilles injuries should be directed to the >25 years age groups.     

Musculoskeletal Ultrasound in Pediatric Trauma

Abstract Background and Purpose: The radiologic evaluation of musculoskeletal injuries in young children is difficult due to the absent ossification of several secondary ossification centers, which therefore cannot be seen directly on plain radiographs. When relying on conventional radiographs, even severe cartilaginous or soft tissue injuries cannot be visualized, as there is no possibility to differentiate them from bruises or sprains. It is the aim of this review to present clinically relevant applications of ultrasound imaging in pediatric musculoskeletal trauma. Methods: Currently used ultrasound techniques for evaluation of typical pediatric fractures or joint dislocations, techniques for differentiation between stable and unstable intraarticular fractures, the use of sonography for monitoring reduced bone length in long bones after fracture, sonographic guidelines for evaluation of tendon injuries or lesions, and sonographic imaging techniques in arthritis and osteomyelitis are described. Conclusion: Musculoskeletal sonography—despite its inability to view through intact cortical bone and its accuracy being dependent on skill and experience of the investigator—provides important information about soft tissue, bony or cartilaginous injuries in children.     

1.318 μm近红外激光对皮肤损伤效应的研究

目的 研究1．318μm近红外激光对皮肤的损伤效应，确定损伤阈值并观察损伤修复情况。方法 以普通白色仔猪为实验动物，以输出波长1．318μm的Nd：YAG激光照射猪躯干两侧皮肤。损伤阈值实验时以肉眼可见红斑反应为判定标准，于照后即刻观察皮肤红斑发生率，采用加权概率单位法计算红斑发生率为50％时所对应的激光剂量，即损伤阈值ED50。损伤修复观察实验所用激光剂量均高于损伤阈值，于照后即刻至49d观察皮肤损伤修复情况。结果 1．318μm激光致仔猪皮肤损伤的阈值剂量为9．2J／cm^2。随着激光剂量的提高，皮肤损伤反应依次表现为暂时性红斑反应、持续性红斑反应、白色凝固斑、淡褐色（炭化）凝固斑。损伤修复所需的时间依次为数分钟、数天、十余天、数十天。结论 1．318μm激光可致仔猪皮肤损伤的阈值剂量ED50为9．2J／cm^2。激光剂量越高，皮肤损伤越重，修复所需时间越长。     

去除外膜的外周神经移植对大鼠脊髓损伤的影响

目的检测大鼠脊髓损伤经显微外科技术处理的自体外周神经移植后神经纤维的再通及后肢功能恢复情况。方法利用改良Allen撞击方法建立脊髓打击损伤模型，12周后，将大鼠分为2组，实验组切取后肢腓肠神经，利用显微外科技术去除神经外膜，将其修剪成小段，游离移植于脊髓损伤处，对照组仅显露脊髓损伤段，不作神经移植。分三个时相点（1、2、3个月）进行辣根过氧化物酶（HRP）逆行示踪，并观察损伤移植处的形态学变化及大鼠后肢运动功能恢复情况。结果损伤移植处脊髓的形态学明显好转；损伤移植处上段脊髓中，移植1个月组有HRP阳性标记物，以后逐渐增多；移植组大鼠后肢运动功能明显恢复。结论经显微外科技术预处理外周神经组织移植后可促进大鼠脊髓结构和功能的恢复。     

益肝灵保护大鼠肾缺血再灌注损伤的实验研究

目的探讨益肝灵对肾缺血再灌注损伤的保护作用。方法建立肾缺血再灌注模型，大鼠右肾切除，左侧肾蒂夹闭45min后再灌60min。用益肝灵预防性治疗，检测并比较肾组织及血清中MDA及SOD的活性变化。结果益肝灵能明显押制缺血再灌所致的血及肾组织中MDA的升高和SOD的活性降低。结论益肝灵对肾缺血再灌注损伤具有保护作用。     

甲状腺手术中避免喉返神经损伤的实用解剖研究

对２０例单发良性甲状腺瘤手术进行了动态解剖学观察，主要针对侧叶切除术中喉返神经的有关解剖学关系进行测量分析，对术中处理甲状腺下动脉的方法提出与传统观念不同的意见认为术中游离并托起患侧叶，紧贴腺体切断甲状腺下动脉各分支，保留甲状腺下动脉主干的方式是避免喉返神经损伤的有益方式     

天麻素对缺血再灌注神经细胞膜的保护作用

用新生Wistar大鼠大脑皮层进行神经细胞培养 ,将培养 8d的神经细胞置于模拟“缺血”状态下 ,5h后神经细胞发生肿胀 ,胞内乳酸脱氢酶 (LDH)漏出增加 ,膜流动性下降、脂质过氧化(LPO)含量增加 ;将经过“缺血”损伤神经细胞置 1 8h模拟“再灌注” ,“再灌注”后细胞数目明显减少 ,LDH的漏出、膜流动性下降和LPO增加继续加重 ,说明细胞损伤进一步加重。经过天麻素孵育后的神经细胞“缺血”或“再灌注”后LDH的漏出及LPO含量明显低于损伤组 ,而膜流动性则明显高于损伤组。表明 :天麻素对体外培养神经细胞的缺血再灌注损伤有保护作用     

消化内镜病毒污染的现状及对策

从乙型肝炎病毒、丙型肝炎病毒和人类免疫缺陷病毒污染情况综述了消化内镜病毒污染的现状，分析了污染的原因以及消化内镜消毒现状。