新鲜羊膜移植联合自体血清治疗严重眼化学烧伤的临床观察

目的:观察新鲜羊膜移植联合自体血清治疗严重眼化学伤的临床疗效.方法:将病例按照治疗方法不同随机分为新鲜羊膜移植术联合自体血清的治疗组和单独应用新鲜羊膜治疗组及单独应用自体血清组,观察疗效及治疗时间.结果:新鲜羊膜移植联合自体血清的治疗组治疗严重眼化学烧伤治愈率高,组间差异有统计学意义(P＜0.05);在治疗时间上,组间亦有统计学差异(P＜0.05).结论:新鲜羊膜移植术联合自体血清治疗眼化学烧伤有较好的疗效.     

鲜薄荷外用治疗小儿红痱疗效观察

痱（miliaria）亦称为粟粒疹,是由于高温闷热环境中出汗过多不易蒸发致使汗腺导管口堵塞,汗液储藏后汗管破裂而引起汗液外溢渗入周围组织的浅表性炎症反应。包括四种类型：白痱或晶形粟粒疹（miliaria crystallina）,红痱或红色粟粒疹（miliaria rubia）,脓痱或脓胞性粟粒疹（miliaria pustulosa）和深痱或深部粟粒疹（miliaria profunda）[1]。     

熟地黄含药血清对成骨细胞及分泌胰岛样生长因子1的影响

目的：探讨熟地黄含药血清对新生SD大鼠成骨细胞（ OB）增殖及胰岛样生长因子1（ IGF-1）分泌的影响。方法：采用1日龄SD大鼠分离培养OB;熟地黄水煎剂分高、中、低3个剂量组对SD大鼠灌胃,生理盐水作为对照组,8 d后取大鼠血清加入培养,每组分别培养24、48、72 h,用MTT法、pNPP法分别检测熟地黄含药血清对OB增殖及ALP活性的影响,用ELISA法测定培养上清中IGF-1的含量。结果：与对照组比较,在24、48、72 h时间点熟地黄含药血清高、中、低剂量组OB增殖程度显著升高,且高剂量组促进增殖效果较好（ P〈0.05）;与对照组比较,熟地黄含药血清高、中、低剂量组ALP 活性显著增强,且高剂量组较高（ P〈0.05）;在48 h时间点熟地黄含药血清高、中、低浓度组IGF-1分泌量升高,且高剂量组分泌量较高（ P〈0.05）。结论：熟地黄含药血清能够促进成骨细胞的增殖与分化,同时促进成骨细胞分泌IGF-1的作用。     

Non‐contrast enhanced MR angiography: Established techniques

Until recently, time‐of‐flight (TOF) and phase contrast (PC) were the only non‐contrast MR angiography (NC‐MRA) techniques practically used in clinical. In the decade, NC‐MRA have been gained a revival of an interest among the MR researchers and scientists, in part because of safety concerns related to the possible link between gadolinium‐based contrast agents and nephrogenic systemic fibrosis (NSF). This article introduces other established NC‐MRA techniques, such as ECG‐gated partial Fourier fast spin echo (FSE) and balanced steady‐state free precession (bSSFP), both with and without arterial spin labeling. Then, the article focuses on two main applications: peripheral run‐off and renal MRA. Recently, both applications have achieved remarkable advancements and have become a viable clinical option as an alternative to contrast‐enhanced (CE)‐MRA. In addition, developments on the horizon including whole body MRA applications and further advancement at 3 Tesla are discussed. J. Magn. Reson. Imaging 2012 © 2011 Wiley Periodicals, Inc.     

Influence of the respiratory flow pattern on rebreathing in Mapleson A and D circuits

In a lung model the rebreathing effects of different respiratory flow patterns (RFP) were studied in the coaxial Mapleson A (Lack) and D (Bain, Coax-II) systems during spontaneous breathing. In the Mapleson A system RFP was not found to have any impact. In the D systems FACO2 was higher with an RFP typical of halothane-anaesthetized patients than with an RFP with an exponentially decreasing expiratory flow and an end-expiratory flow pause (FTEP). The difference in FACO2 was 26% with a VF corresponding to 100 ml X min-1 X kg-1 body weight. The RFP in a non-anaesthetized volunteer was intermediate between these two patterns. Rebreathing decreased in the D systems with prolongation of FTEP and when a decelerating expiratory flow was used.     

Rebreathing and ventilatory response to different fresh gas flows in the Bain and Lack systems. A clinical study

Thirty-four adults were studied during halothane anaesthesia with spontaneous breathing, while undergoing orthopaedic surgery. They were randomly divided into two groups according to whether the Bain (n = 18) or the Lack (n = 16) system was used. Respiratory flows were recorded and arterial blood gases drawn at different fresh gas flows (VF). The values obtained were compared with those recorded under non-rebreathing conditions (NRC). In the Bain system the proportion of rebreathers was 0.22, 0.25, 0.55 and 0.83 when the VF was 175, 150, 125 and 100 ml X min-1 X kg-1 body weight (b.w.), respectively. In the Lack system these proportions were 0.43, 0.55 and 0.92 at VF of 85, 70 and 55 ml X min-1 kg-1 b.w., respectively. The ventilatory response to rebreathing was an increase in minute ventilation (VE), keeping the partial pressure of arterial carbon dioxide (PACO2) almost unaltered. In the Bain system the VE X kg-1 X b.w. thus increased by 18% and 38% at VF of 125 and 100 ml X min-1 X kg-1 b.w., respectively, when compared to NRC (P less than 0.05). The corresponding increases in the Lack system were 15% and 37% at VF of 70 and 55 ml X min-1 X kg-1 b.w., respectively (P less than 0.01). In the Lack group also the PACO2 increased by 6% when a VF of 55 ml X min-1 X kg-1 b.w. was used compared to the value obtained under NRC (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)     

Transfusion-related acute lung injury (TRALI) after fresh frozen plasma in a patient with coagulopathy

Background: Transfusion-related acute lung injury (TRALI) is due to specific antigen-antibody reaction involving the donor's leucocyte or granulocyte antibodies towards the recipient's antigens. Aggregation in small pulmonary vessels occurs, leading to derangement of permeability.
Case history: TRALI after transfusion of four units of fresh frozen plasma (FFP) for factor V deficiency prior to elective cholecystectomy is presented. Within a few minutes after the third unit of FFP a florid pulmonary oedema developed. Hypotension and hypoxia with SpO₂ 83–87% at FiO₂ 1.0 followed. Prompt monitoring of central haemodynamics revealed a normal cardiac index without pulmonary hypertension. The operation was then conducted as planned. The bilateral pulmonary oedema resolved after 72 hours with ventilatory support. The patient recovered without complications. When tested postoperatively, the second unit of FFP contained granulocyte antibodies and the third unit contained HLA antibodies. The crossmatch of the patient's granulocytes and lymphocytes towards the two donors of the two units of FFP was positive.
Conclusion: When TRALI is suspected the donor blood has to be tested against the recipient. Ventilatory support of the patient is continued until adequate oxygenation is reached.     

用血清标本结果均值控制临床化学检测系统探讨

目的探讨用“正常人”血清标本结果均值控制临床化学检测系统的可行性。方法用待控制检测系统对“正常人”某项目进行测定,统计测定结果加权均值并与全国临床检验操作规程中该项目相同方法测定正常参考范围中间值比较。结果误差≤1/2TE a适用,否则,需要调整仪器参数,更换试剂或更换标准品。结论应用“正常人”血清标本结果控制检测系统经济实用。     

小剂量环孢素A及熟地多糖口服液联合康力龙治疗再生障碍性贫血36例临床观察

目的探索用小剂量环孢素A及熟地多糖口服液联合康力龙治疗成人再生障碍性贫血.方法用联合康力龙治疗再障36例,疗程3个月,同时和18例单用康力龙的病例作对比.结果联合治疗组总有效率为88.9%,对照组为61.1%,两组比较有显著性差异.联合治疗组症状改善明显较对照组快.联合治疗组治疗3个月后外周血细胞明显升高,和治疗前比较有显著性差异,治疗中未发现熟地多糖有任何毒副作用.结论康力龙联合环孢素A及热地多糖口服液治疗再障,具有方法简便、安全经济的特点.能加速症状的改善,提高疗效,不增加副作用.