Changes in bladder function following a surgical alteration in outflow resistance

The changes in bladder function occurring after a surgical alteration in bladder outflow resistance were studied in 20 males undergoing transurethral prostatectomy (TURP) and in 20 females undergoing an endoscopic bladder neck suspension (EBNS). Serial cystometrograms (CMG) were performed before operation, and on alternate days after spontaneous micturition was re-established, for 5 days in the males and for 21 days in the females. CMGs were repeated at 3 months and 1 year after operation. After TURP voiding pressures (P_det) fell rapidly from a mean of 118 cm H₂O before operation to 57 cm H₂O at 5 days, with an increase in flow rate during this time from 10.5 ml/s to 24 ml/s. Detrusor instability that had been present in 14 patients resolved within 2 days in 12. There was no further significant urodynamic change over the 1-year study period. After EBNS, there was an early rise in voiding pressure (P_det rose from 26 cm H₂O before operation to 42 cm H₂O at 3 days). This continued to increase up to 21 days particularly in those patients with initial large residuals. Three patients developed detrusor instability. Flow rates were greatly reduced at first (27 ml/s before operation and 13 ml/s at 3 days), and gradually increased in line with voiding pressures, yet were still diminished 1 year after operation. The urodynamic changes following a reduction in bladder outflow resistance by TURP are immediate and sustained and unlikely to be the result of structural changes within the bladder wall. EBNS produces an increase in outflow resistance and it can be several weeks before balanced voiding is achieved, with significantly increased detrusor pressures needed to achieve complete bladder emptying at a reduced flow rate.     

Methicillin-resistant Staphylococcus aureus: investigation of a hospital outbreak using a case-control study

A retrospective case-control study of 50 MRSA-positive patients was carried out during an outbreak of methicillin-resistant Staphylococcus aureus (MRSA) at an acute general hospital in London. Controls were randomly selected from MRSA-negative patients admitted during the outbreak period. Risk factors investigated included length of admission prior to screening, number of ward changes, main diagnosis, extent of staff contact, pressure sores, surgical and other invasive procedures and antibiotic treatment. Outcome variables examined were rates of infection (versus colonization) with MRSA and mortality. Patients with MRSA were in hospital longer before microbiological specimens were taken and moved wards more often than controls. In a logistic regression analysis, length of stay in hospital, pressure sores, physiotherapy and surgical procedures were associated with a significantly increased risk of acquiring MRSA. Odds ratios (and 95% confidence intervals) for having acquired MRSA were: 8·3 (1·02−71·43) if a patient had pressure sores; 3·7 (1·10−12·5) if they received physiotherapy; and 3·2 (1·82−10·0) if they underwent surgical procedures. The rate of clinical infection amongst patients with this strain of MRSA was 26% and included life-threatening infections such as septicaemia, underlining the potential virulence of MRSA. Surgery and physiotherapy may have been markers of debility. Physiotherapy was probably a marker of increased rates of contact with all hospital staff, and high standards of hand hygiene should be promoted amongst all staff as the most important factor in controlling an outbreak of MRSA. Good bed management is essential for hospital infection control.     

Hereditary Hypertriglyceridemic Rat: A New Animal Model of Metabolic Alterations in Hypertension

Hereditary hypertriglyceridemic rats (hHTg) were developed as a new genetic model for the study of relationships between blood pressure (BP) and metabolic abnormalities. This strain has been produced by selective inbreeding from Wistar rats according to the rise of plasma triglycerides induced by a high-sucrose diet. Though hHTg rats display hypertriglyceridemia, impaired glucose tolerrance, hyperinsulinemia, insulin resistance and increased BP even without nutritional stimuli, high sucrose feeding further aggravates these symptoms. High plasma triglycerides levels in hHTg rats seem to be a consequence of their hyperproduction. Impaired insulin action is responsible for the defective glucoregulation in this strain. The loss of insulin responsiveness might be due to a reduction in the number of glucose transporters. Highly significant relationships among plasma triglycerides, ouabain-resistant Na⁺ transport and BP were demonstrated in the hHTg rats. Segregating populations (F2 hybrids) should be used for genetic analysis of the primary role of lipid and/or ion transport abnormalities in the pathogenesis of this form of genetic hypertension.     

Posture-induced nasal obstruction in patients with allergic rhinitis

Nasal resistance is affected by posture. In this study, the effects of supine and lateral recumbent positions were investigated in eight normal subjects and 31 patients with allergic rhinitis. Of the 31 patients with allergic rhinitis, five showed unilateral complete nasal obstruction and one patient showed bilateral complete obstruction during the change of posture. Total nasal resistance had a tendency to increase with repeating the change of posture (a paired t-test, P < 0.05). The supine and lateral recumbent positions did not induce variable changes in total nasal resistance in normal subjects. Posture induces complete nasal obstruction in the supine or lateral recumbent positions in some patients with allergic rhinitis.     

HIV/AIDS合并深部真菌感染的调查与耐药研究

目的：了解艾滋病病毒／艾滋病(HIV／AIDS)合并深部真菌感染的临床状况、病原菌分类及耐药现状。方法：总结近年来收治的131例HIV/AIDS患者的临床资料，分析深部真菌感染的发生情况及药敏试验结果。结果：HIV／AIDS患者合并深部真菌感染48例，感染率为36．6％，其中以念珠菌为主，占61％，感染部位以消化道为主，占62．7％。随着CD4^ T淋巴细胞的减少，合并深部真菌感染的感染率逐渐增加。念珠菌对益康唑(ECO)、酮康唑(KET)、咪康唑(MIC)、制霉菌素(NYS)、氟康唑(FLU)、伊曲康唑(ITR)、5-氟胞嘧啶(5-FC)、两性霉素B(AMB)耐药率分别为69．4％、66．7％、58．3％、44．4％、43．8％、36．4％、14．3％、13．9％。结论：HIV／AIDS患者合并深部真菌感染率高，且多有药耐药性，特别是对咪唑类抗真菌药物已呈明显耐药，应引起临床医生的高度警惕。     

创收工资—医院按劳分配的探索

遵循“各尽所能，按劳分配”的社会主义分配原则，我院对职工分配进行了积极的探索。从８０年代初起，在院内实行定量、定质的超额劳务提成。但随着医院改革不断深化，医院总收入增加，院内、外独立核算，限期还本息项目增多，原超额劳务提成办法不能适应医院发展。因此，在原有基本工资、奖励工资基础上，增设了创收工资，医院对创收工资从质量、数量、文明建设、医德医风建设等方面进行宏观调控。创收工资使科主任责、权、利落到实     

血清保存方法对促甲状腺激素结果的影响观察

目的 :观察血清保存方法对促甲状腺激素 (TSH)结果的影响。方法 :将甲状腺功能正常、异常患者共 10份血清 ,采用不同血清量、不同条件分组保存后测定 TSH。结果 :保存方法对 TSH结果有一定的影响。结论 :用于 TSH血清的保存量要多、要密封管口、低温保存。     

应用羧化胶乳凝集试验诊断人、畜布鲁氏菌病的研究

应用以化学交联法制备的布鲁氏菌１６Ｍ抗原－羧化胶乳制剂的羧化胶乳凝集试验（ＬＡＴ）、试管凝集试验（ＳＡＴ）、虎红平板凝集试验（ＲＢＰＴ）以及酶联免疫吸附试验（ＥＬＩＳＡ）、半胱氨酸凝集试验（ＣＹＴ），对在四省布鲁氏菌病疫区收集的部分人、畜血清中布氏菌抗体进行对比检测。结果表明，ＬＡＴ较之ＲＢＰＴ具有更高的特异性；与ＳＡＴ相比，无论阳性或阴性符合率均较一致。另外，ＬＡＴ可检测血清中ＩｇＧ、ＩｇＭ两类布氏菌特异性抗体。因而本试验对人、畜布病的诊断具有特异、敏感和简便的优点，更宜在基层推广应用。     

Correlation between Cyclin A Gene Expression in Adult Patients with Acute Leukemia and Drug Resistance

Adultacuteleukemia (AL)isoneofthemostcommonmalignanttumorsofhematology .Withtherecentprogressinchemotherapyandsupportivether apy ,theremissionandsurvivalrateinALhavebeenmarkedlyimproved .However ,drugresistanceandrelapsearestillimportantfactorsaffectinglongsur vivalofthese patients .Theabnormalregulationofcellcycleisanotherfactorthatcannotbeignoredex ceptformultipledrugresistance (MDR) .WedetectcyclinA ,multidrugresistantgene (mdrl) ,topoiso meraseⅡα(TopⅡα)andbcl 2inadultpatientswithA…