Closed suction drainage after orthopaedic surgery: evidence versus practice

Abstract Closed suction drainage systems are commonly used in orthopaedic surgery, particularly in joint arthroplasty. The rationale for the use of drains is a theoretical reduction of wound haematomas and infection. However the benefit of using drains after total hip or knee arthroplasty is controversial. Several reports have shown that the use of drains does not reduce infection and morbidity and is an unnecessary and potentially dangerous practice. In fact most studies highlighted that at best their use appears to make no difference to important clinical outcomes. Recently a metaanalysis raised the question about the usefulness of closed suction drainage again, concluding that it has no major benefits. The purpose of this study was to review the evidences available concerning the utility of closed suction drainage outlining that this practice is not supported by clinical evidence.     

Evaluation ofin vitro drug screening leads using experimental models of human ovarian cancer

Summary Five compounds which were identified as potential new anticancer drugs inin vitro screening with the human tumor colony forming assay were selected for further evaluation usingin vitro andin vivo models of human ovarian cancer. Three of five compounds were found to inhibitin vitro colony formation of ovarian cancer cell lines derived from both untreated and combination chemotherapy refractory patients. One compound was also found to prolong survival in a human ovarian carcinoma xenograft model system. This compound, chloroquinoxaline sulfonamide, was selected for development and has shown preliminary indication of activity in phase I clinical testing.     

胆汁4种初级结合型胆汁酸的多因素判别对胆汁成石性的判断价值

本文运用二值回归判别法探讨了胆汁中4种初级结合型胆汁酸含量变化对胆汁成石性的判断价值。根据52例测试数据得出4因素二类判别函数:Y=0.0395X_1-0.0386X_2 0.0185X_3 O.0586X_4-1.0513。87例自、回代结果表明,该判别函数在判断符合率、错误率、假阳性率、假阴性率等诸方面均较使用1种初级结合型胆汁酸作为判别指标优越。     

轻、中度精神发育迟滞儿童的中药和行为干预综合治疗探讨

采用中药与行为干预综合治疗的方法对１４０名轻、中度精神发育迟滞的儿童进行分组康复观察。结果发现中药加行为干预组治疗后智力商数（ＩＱ）及能力的变化最大，明显优于单用中药组和单纯行为干预组（Ｐ＜０．０１）；与对照组相比有非常显著的差异（Ｐ＜０．００１）。从而为精神发育迟滞儿童的康复治疗提供了新的途径。     

再生医学技术在烧伤传统治疗无效病人中的应用(附38例报告)

目的：总结重度烧伤传统疗法无效改为再生医学(MEBT/MEB0)技术治疗变化规律和临床验．方法：将我科l995年5月至2002年5月收治的院外采用传统疗法无效改用MEBT/MEBO技术治疗的38例重度烧伤病人临床资料进行回顾性总结，病人一旦入院创面均改用MEBT/MEBO治疗，初始予以彻底清创，规范用药、规范操作，规范认识；全身实行系统综合治疗措施．以临床观察和病人感觉评价治疗效果。结果：本组38例全部治愈，末植皮自行愈合者21例．占55.26％．深Ⅲ度创面自愿要求植皮者17例，占44.74％。经随访多数无增生性瘢痕，部分愈后有局限性瘢癌，质软无残废。结论：重度烧伤经传统疗法久治不愈或疗效欠佳病人．病情复杂，并发症较多治疗难度也较大，再生医学可有效改善以上缺陷和病症．是重度烧伤病人传统治疗无效时的理想疗法。     

Stochastic models for geriatric in-patient behaviour

Departments of geriatric medicine engage in two distinct formsof clinical activity: acute/rehabilitative and long-stay care.These are organizationally distinct and have very differentresource needs. Current hospital planning models, however, assumethat patients all move through the system at the same rate,thereby ignoring this effect of inherent heterogeneity in patientbehaviour. The present paper describes the movement of patientsthrough geriatric hospitals by a two-stage continuous-time Markovmodel, where the stages represent acute/rehabilitative and long-staypatients respectively. Patients are initially admitted to thefirst stage, from which they may depart from the system, bydeath or discharge, or move into the second stage, from whichthey eventually depart by death or discharge (unlikely). Admissionsare modelled in two ways: either as replacements for departuresor as a Poisson stream. Expressions for the distribution andmovement of numbers of patients are derived and evaluated fordata from a number of hospitals. Such an approach has the advantage,over previous crude models, of taking into account differenttypes of patients and introducing variability, thus making itpossible to extract variances as well as means of numbers ofgeriatric patients requiring hospital care.     

力学在食管胃腔内弹力环扎吻合术的应用

本文探讨食管胃腔内弹力环扎吻合术的力学机理。这是一种不用任何缝合材料或吻合器进行胃食管吻合的新技术,我们已成功应用于临床。取临床所用的乳胶管按该材料多向异性特征、实验条件以及弹力环数目分为8组,每组3个样品进行各种体外力学试验。通过应力—应变(拉力—伸长)关系曲线和定伸长松驰试验确定它的力学特性是一种粘弹性材料。根据实验所得的应力换算为弹力环对食管和胃组织所施加的最佳压力(压强)是4.23±0.23Kg/cm~2,这样才能保证这一种新颖的吻合术可达到简便、安全、可靠的目的。     

Additive effects of earthworm extract with HpD-laser on the enhancement of reactive oxygen production and the inhibition of[~3H]—thymidine.uptake in mouse ascitic tumor cells

The effects of combined use of earthworm extract(912)and HpD-laser on the produc-tion of reactive oxygen and the biosynthesis of DNA in S_(180) tumor cells were studied throughchemiluminescence measurement and[~3H]-TdR incorporation assay.The results showed that as com-pared with the control,the intensity of chemiluminescence emitted by tumor cells treatedsimultaneously with 912 and HpD-laser was enhanced more than ten-folds,while that treated with912 or HpD-laser alone was increased only 2～4 folds.The[~3H]-TdR incorporation into tumorcells of the former group was inhibited upto 74.1%,and that of the latter groups decreased onlyby 42.2% and 40.0%,respectively.In accordance with these biochemical changes,the ultrastructuraldamage of tumor cells of the former,combinedly treated group appeared to be the most serious.This suggests an additive effect of 912 with HpD-laser on tumor cells.In addition,if free radicalscavengers,such as catalase and superoxide dismutase,were added to the reaction systembefore chemiluminescence assay,the luminescent enhancement effect mentioned above was dramaticallyalleviated,implying the presence of O_2~ and H_2O_2 in the system.Therefore,as to the toxic effecton tumor cells,912 and HpD-laser are not only additive in efficiency,but also similar in theunderlying mechanism of action.     

Epilepsy in Ancient India

The ancient Indian medical system, Ayurveda, meaning science of life, is the oldest system of medicine in the world. Epilepsy is defined as Apasmara: apa, meaning negation or loss of; smara, meaning recollection or consciousness. Aura was recognized and was called Apasmara Poorva Roopa. A large number of symptoms indicative of aura were listed. Worthy of mention are subjective sensation of sounds, sensation of darkness, feeling of delusion, and dream-like state. An actual attack of Apasmara includes falling down; shaking of the hands, legs, and body; rolling up of the eyes; grinding of the teeth; and foaming at the mouth. Four major types of epilepsy based on the disturbance of doshas (humors) that govern the physiological and physiochemical activities of the body are mentioned. Apasmara is considered a dangerous disease that is chronic and difficult to treat. Several causes are mentioned. Treatment included correcting the etiological factors and dietary regimen and avoiding dangerous places that may result in injuries.     

Polymorphisms in manganese superoxide dismutase and catalase genes: functional study in Hong Kong Chinese asthma patients

BACKGROUND: Reactive oxygen species may contribute to the pathogenesis of asthma. Functional genetic polymorphisms of antioxidant enzymes, superoxide dismutase (SOD) and catalase are good candidates for asthma susceptibility. OBJECTIVE: To investigate the association of the manganese-containing form of SOD (MnSOD) gene at amino acid position 16 (Val16Ala) and catalase gene in the promoter at A-21T and C-262T polymorphisms and asthma in a Hong Kong Chinese population. METHODS: The association study was conducted in a case-control design in asthma patients (n=251) and healthy controls (n=316) by genotyping. The functional significance was assessed by determining erythrocyte SOD and catalase activity. RESULTS: The Val allele of MnSOD at Val16Ala and the A allele of catalase gene at A-21T were not different between patients and controls, while the C allele of catalase gene at C-262T was found to be significantly different between patients and controls (P=0.033). The less frequent variant of catalase gene (-262T) was found to be protective from the development of asthma in a Hong Kong Chinese non-smoking population (adjusted odds ratio=0.35, 0.15-0.85; P=0.017). Asthma patients had elevated erythrocyte SOD and catalase activities in comparison with healthy controls (P<0.01). However, their activities were not associated with different genotypes within healthy controls or asthma patients. CONCLUSION: This is the first report showing that SOD and catalase functional activities are not associated with their respective genetic polymorphisms but related to the presence of asthma in a Hong Kong Chinese population.