Perioperative respiratory events in smokers and nonsmokers undergoing general anaesthesia

Background: The prevalence of respiratory diseases in smokers and nonsmokers and the incidence of perioperative respiratory events (PREs) were investigated for patients undergoing general anaesthesia. The aim was to quantify well-known problems and to identify possible new associations between smoking and PREs.
Methods: From July 1992 to December 1994, risk factors, demographic data, and PREs were documented by an automatically readable anaesthetic record (ARAR). PREs were used as defined by the German Society of Anaesthesiology and Intensive Care.
Results: Of 26 961 subsequent anaesthesias in adults, 7122 (26.4%) were performed in smokers with a prevalence of chronic bronchitis of 23.3% (4.8% in nonsmokers). 1573 PREs occurred in 1397 (5.2%) of all anaesthetics. 459 events concerned intubation problems and problems in technical airway management. 1114 specific respiratory events (SPREs) like re-intubation, laryngospasm, bronchospasm, aspiration, hy-poventilation/hypoxaemia and others had a total incidence of 5.5% in smokers and 3.1% in nonsmokers. The relative risk (RR) of SPREs was 1.8 in all smokers, 2.3 in young (16–39 years) smokers, and 6.3 in obese young smokers. The RR of perioperative bronchospasm was 25.7 in young smokers with chronic bronchitis.
Conclusion: The impact of smoking on perioperative respiratory problems should make anaesthetists take this widespread preoperative condition seriously, particularly in young adults. The presented method of incident reporting (based on a national classification) could contribute to future research in anaesthetic epidemiology.     

各种肝病的肝纤维化标志改变的探讨

目的 :探讨各种肝病患者血清肝纤维化标志的改变 ,甘草酸二胺注射液对肝脏炎症、纤维化指标的作用。方法 :用放免法检测透明质酸 (HA)、层粘蛋白 (LN)、Ⅲ型前胶原多肽 (PCⅢ )。结果 :急性肝炎的三种肝纤指标均升高 (P <0 0 5 )。急黄肝高于急无黄肝 (P <0 0 5 )。慢性肝炎 1 1 2例 ,三项肝纤指标显著高于正常对照 (P <0 0 5 )。慢肝重度显著高于慢肝轻度 (P<0 0 0 1 )。肝硬化的三项肝纤指标又显著高于慢肝 (P <0 0 0 1 ) ,其它肝病的肝纤指标也升高。 2 5例慢肝用甘草酸二胺注射液治疗 2月 ,ALT、AST、GGT显著降低 (P <0 0 1 )。三项肝纤指标中HA降低较显著 (P =0 0 5 ) ,LN和PCⅢ虽有降低 ,但差异不明显 (P =0 4 5 9,P =0 1 92 )。结论 :各种肝病的三项肝纤维化指标均升高 ,以慢肝重度 ,肝硬化升高明显。甘草酸二胺注射液治疗有抗炎及改善肝纤维化的作用     

Large striatocapsular infarcts: Clinical features and risk factors

We defined large striatocapsular infarcts as subcortical softenings of more than 20 mm in diameter involving the territories of the lateral and medial groups of lenticulostriate arteries. The aim of this study of 56 patients was to compare the clinical features and risk factors of these infarcts with those of cortical and lacunar infarcts. On the whole, our data suggest that both the clinical features and risk factors of large striatocapsular infarcts are similar to those of cortical infarcts, but significantly different from those of lacunar infarcts. The clinical manifestations of large striatocapsular infarcts with a maximum diameter of less than 50 mm may sometimes resemble those of lacunar infarcts because neuropsychological disorders are less frequent; however, our study indicates that, even in these cases, cardioembolic sources and artery-to-arteiy embolism are significantly more frequent in large striatocapsular than in lacunar infarcts, thus suggesting a different pathogenesis.     

湘西自治州1995～2002年男性劳教人员法定性病监测报告

目的 了解湘西自治州重点人群性病患消长趋势，为性病防治工作提供科学依据。方法 从1995年起，采用统一的表格，每年对湘西州劳教所新入教人员进行一次法定性病监测。结果 三种法定性病平均患病率为14．64％(4．96～26．7％)，以1995年最低，1997年最高，8年未发现HIV／AIDS，患病率以20～39岁的性跃期人群为最高，汉族患病率高于其它民族；化程度越高，患病率越低。结论 男性劳教人员作为性病患病的高危人群，是哨点监测理想的目标人群。     

特殊型前列腺增生症的诊治

收治特殊型前列腺增生症１１０例，分别伴有逼尿肌无力、不稳定性膀胱、前列腺结石、膀胱结石、前列腺炎或糖尿病。认为：治疗前认真检查发现特殊前列腺增生症，是提高治愈率、减少并发症的关键步骤之一。     

Is there an association between periodontal condition and HIV infection?

Abstract Individuals in Tanzania who have limited access to medical and dental treatment provide an opportunity to study the natural association between periodontal condition and HIV infection and the stage of infection. 119 HIV infected adult individuals and 73 individuals with AIDS from the AIDS Clinical Trial Clinic at Muhimbili Medical Centre (MMC) in DaresSalaam participated as cases. Mean age was 35.3 and 35.1 years, respectively. 156 individuals with a mean age of 28.3 years, confirmed as HIV seronegative, served as controls. There were no significant differences in bleeding on probing, pocket formation or attachment loss among the HIV seronegative individuals. HIV seropositive and AIDS patients. We applied multiple logistic regression to calculate odds ratios for presence of periodontal conditions adjusting for age, gender and DMFT. Our odds ratios did not reveal any significant associations between bleeding on probing, pocket formation or attachment loss with regard to lymphocyte and CD4+ T cell counts among the HIV infected individuals and AIDS patients. When associations were investigated with regard to HIV serostatus (HIV seronegative. HIV seropositive or AIDS), our adjusted odds ratios were insignificant, too. In fact, most odds ratios were close to 1. Thus, our study supports recent views that the presence, extent and severity of periodontal disease among HIV infected individuals, may be less that hitherto thought.     

胸腺瘤与重症肌无力的外科处理

10例胸腺瘤中3例合并重症肌无力症,经手术治疗配合抗胆碱酯酶药物治疗,9例治愈。     

脐带夹对防止脐部感染和出血的临床与实验研究

目的应用国产脐带夹用于农村山区破伤风高发区，并经离体试验验证其可靠性。方法经湖南、江西、广西等省基层接生员临床应用、并与当地同期或前一年未用夹者进行对照；同时经离体脐带用脐带夹、气门芯或纱线结扎阻断血管后进行金黄色葡萄球菌和破伤风毒素通透试验以及测试承受气压程度试验。结果1年临床使用2296例中，无1例发生破伤风和败血症。可靠性试验结果证明，粗纱线结扎最差，气门芯虽优于前者，但不如脐带夹。结论该脐带夹由于夹持力持久有力，细菌、毒素难以通过、安全可靠，因此能降低新生儿“病从脐入”的发病率和死亡率，有利干优生优育的贯彻．这是一项花费少、收效大的简而易行的适宜技术，值得推广。     

The Clinical Effects of Alantoin Powder for Gargleon Periodontal Diseases and Aphthous Ulcer

ＴｈｅＣｌｉｎｉｃａｌＥｆｅｃｔｓｏｆＡｌａｎｔｏｉｎＰｏｗｄｅｒｆｏｒＧａｒｇｌｅｏｎＰｅｒｉｏｄｏｎｔａｌＤｉｓｅａｓｅｓａｎｄＡｐｈｔｈｏｕｓＵｌｃｅｒＹｕＷｅｉｙｉ（俞未一）ＳｕｎＷｅｉｂｉｎ（孙卫斌）ＤｅｐａｒｔｍｅｎｔｏｆＳｔｏｍａｔｏｌ...