An epidemiological study of methicillin-resistant Staphylococcus aureus (MRSA) isolated from medical staff, inpatients, and hospital environment in one ward at our hospital.

Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most important causative microorganisms for nosocomial infections. Recently, the incidence of isolation of MRSA has been increasing every year in Japan and is, notably, much more frequently found in inpatients than in outpatients. Therefore, we have done epidemiological studies of MRSA isolated from medical staff, inpatients, and the hospital environment in one ward of our hospital. Thereafter, we examined the antibiotic susceptibility (ABPC, DMPPC, CET, CMZ, IPM, GM, MINO, OFLX, EM, CLDM, VCM), phage typing, and coagulase typing of these MRSA. MRSA were isolated more frequently from anterior nares of inpatients than from doctors and nurses. MRSA were isolated more frequently from the environment near carriers of MRSA. Coagulase type II and phage type N.T. (not typable) were the dominant types of MRSA in our hospital (69% and 61%). MRSA strains were resistant to most antibiotics with a few exceptions (VCM, IPM, CMZ, CET). The high isolation frequency of MRSA in our hospital seems to suggest that inpatients who are carrying MRSA spread MRSA throughout the hospital environment and that the anterior nares of inpatients are the major MRSA harbor.     

医院内下呼吸道革兰阴性杆菌感染59例临床分析

目的：探讨医院内下呼吸道革兰阴性杆菌感染的病原菌谱、药物敏感性及主要危险因素。方法：回顾性分析我院1998年1月～2001年12月医院内获得性下呼吸道感染，所取痰标本行细菌学培养，阳性菌以K—B纸片法行药物敏感性测定。结果：共获73株革兰阴性杆菌，其中，铜绿假单胞菌(28．77％)，克雷伯杆菌(26．03％)，大肠埃希菌(23．28％)等，共同构成我院医院内下呼吸道感染的主要致病菌。基础疾病以气管插管或气管切开机械通气、昏迷、患有慢性阻塞性肺疾病、使用广谱抗生素以及高龄患者是造成医院内感染的主要危险因素。第三代头孢菌素、氟喹诺酮类和氨基甙类抗生素为治疗革兰阴性杆菌的有效抗生素。结论：抵抗力低下、不合理应用抗生素及基础疾病严重是造成医院内下呼吸道感染的主要危险因素。下呼吸道感染以革兰阴性杆菌感染为主。出现多重耐药菌，应根据药敏选择抗生素，必要时联合用药。     

A new nematode, <Emphasis Type="Italic">Pongobius hugoti</Emphasis> gen. et sp. n. from the orangutan <Emphasis Type="Italic">Pongo abelii</Emphasis> (Primates: Hominidae)

Summary Light and scanning electron microscopical examination and molecular analysis of pinworm samples collected from the Sumatran orangutan (Pongo abelii) from Sumatra (Indonesia) revealed the presence of a new taxon, Pongobius hugoti gen. et sp. n. (Oxyuridae: Enterobiinae). The monotypic genus Pongobius is characterised by the presence of a triangular mouth, three rounded teeth and three chisel-like inner teeth in the buccal cavity, an oesophagus with a long pharyngeal part, corpus posteriorly slightly enlarged and continuing as a pyriform bulb, isthmus absent. These features differentiate P. hugoti from all members of the subfamily Enterobiinae. The male has a long caudal appendix (> 50% of total tail length). Molecular analysis of the new taxon is presented for more precise identification.     

跷式骨科牵引架的研制和应用

目的 研制一种一架通用的骨科牵引架。方法 在我们发明的跷式下肢骨折牵引架的基础上，结合人体各部位牵引治疗的不同需要，对各构件进行多用途改造设计并新增构件，使其在需要时能重新组成各种类型的牵引架，材料选用金属。结果 经6次样机实验与修改，研制出可应用于全身各部位牵引的跷式骨科牵引架，结构包括可拆卸和重组的主件(主架，副架，基架)和辅件(L形架、功能扩张板、稳定杆)以及各种连接件等。经102例的住院、门诊和家庭患者的应用，重组功能和疗效均达到了要求，效果满意。结论 一台(架)具备全部骨科牵引架功能的装置(跷式骨科牵引架)的设计和制造是能实现的，并能获得良好的应用效果。     

Pharmacological modulation of endogenous dopamine and DOPAC outflow from nucleus accumbens

The release of endogenous DA and DOPAC from nucleus accumbens slices were studied measuring net outflow of DA and DOPAC in the superfusate of static chambers, to analyze the correlation between DA and DOPAC outflows and identify which DA stores may serve as possible sources for DOPAC formation. Under resting conditions, or following stimulation with low (< 15 mM) KCl concentration, DOPAC outflow was greater than DA. When DA release was stimulated by higher (> 25 mM) KCl concentrations, DA outflow increased, proportionally more than DOPAC. In the virtual absence of Ca²⁺ in the Krebs solution DA outflow, induced by 25 mM KCl, was reduced to about 10%, while DOPAC outflow was only reduced to 45%. When the synthesis of DA was inhibited with -MPT, DA and DOPAC outflow were unchanged during the first stimulation period. During a second stimulation period, however, their outflow were significantly reduced. Nomifensine, a DA uptake inhibitor, increased the basal DA outflow by about 100%, but only blocked DOPAC basal outflow by about 25%. The 25 mM KCl stimulated DA outflow was not affected by Nomifensine, while the stimulated DOPAC outflow was reduced by about 50%. These results demonstrate that there is a weak correlation between the outflows of DA and DOPAC, suggesting a complex relationship between the mobilization of the different DA pools and DOPAC outflow. The formation of DOPAC from some of these pools, appear to be dependent on the stimulation levels and on the pharmacological manipulation of the tissue.     

Candidaemia: a 10-year study in an Indian teaching hospital

Retrospective evaluation of candidaemia patients was performed in an Indian teaching hospital over a 10-year period. The incidence of patients with candidaemia increased eleven-fold in the second half of the study period (55 patients) compared with the first half (5 patients). Haematological malignancies (11 patients), neonatal septicaemia (9), cardiac abnormalities and cardiac surgery (9) were the commonest underlying diseases in these patients. Candida albicans (50%), C. guilliermondii (17%), C. tropicalis (15%) and C. parapsilosis (8%) were the most common fungal pathogens isolated from blood culture. Therapy with two or more antibiotics (92%), corticosteroid administration (25%), intravascular catheter use for over 24 h (78%) and neutropenia (48%) were the accountable predisposing factors. Prolonged hospitalization (mean average 22.2 days as compared with 11.2 days in other patients) was an added risk factor in these patients.     

丹参抗大鼠乙酸性十二指肠溃疡作用机制的探讨

目的　探讨丹参抗大鼠乙酸性十二指肠溃疡的作用及机制。方法　按Okabe方法复制大鼠乙酸十二指肠溃疡模型 ,按传统方法测定溃疡指数、溃疡抑制率 ;用放射免疫法测定十二指肠溃疡部位的前列腺环素 (PGI2 )含量。结果　丹参组的溃疡指数显著低于对照组 (P <0 .0 1) ,其溃疡抑制率高于对照组 ,PGI2 的含量亦显著高于对照组 (P <0 .0 1)。结论　丹参具有抗大鼠十二指肠溃疡的作用 ,其机制可能是丹参提高了十二指肠粘膜的防御能力     

医院感染及漏报率统计分析

目的　了解我院医院感染发生及漏报率。方法　将我院 2 0 0 3年 1～ 12月出院的所有病例进行回顾性调查。结果　医院感染率 7.3 2 %、漏报率 14 .93 %,均符合国家卫生部要求。结论　做好医院感染监测工作 ,严格执行各项工作制度 ,掌握医院感染与手术并发症的鉴别诊断 ,提高医院感染诊断的准确率     

直肠癌全直肠系膜切除术后直肠阴道瘘原因与防治

本文通过分析近5年来我院18例女性直肠癌全直肠系膜切除术后直肠阴道痿的临床资料。发现直肠阴道痿多发生于中低位直肠癌行全直肠系膜切除保肛手术的患者。痿的发生与肿瘤的位置、肿瘤的分期、肿瘤距肛门口的距离．以及手术技巧、手术难度、引流方法有关。而与是否进行预防性造口，以及是否采用腹腔镜手术无关。预防上强调应重视术中直肠前壁的锐性分离、结肠直肠吻合以及术后盆腔的负压引流。治疗上应首先进行保守治疗，即肠内营养，阴道冲洗。早期配合肠外营养、及全身或局部抗炎治疗，大部分直肠阴道痿通过保守治疗可以治愈。保守治疗无效时考虑结肠或回肠末端造口。若长期不愈应考虑吻合口肿瘤复发的可能。     

Metabolic and hormonal blood flow modeling in patients with coronary heart disease: In vitro and clinical study

The blood flow pattern investigations are of great importance in coronary blood flow destabilization pathogenesis understanding, and consequently in acute coronary event (ACE) risk stratification in patients with coronary heart disease. The aim of the study was to research the principal hormonal and metabolic blood flow regulative aspects and its structure in patients with ischemic heart disease and the contribution to cumulative ACE risk.A total of 182 patients with stable angina pectoris were included in the prospective study (2000–2006). Complex clinical examination, biochemical tests and blood tests were performed. Whole-blood (WB) viscosity, erythrocyte aggregation and deformation ability, WB suspension stability, and initial erythrocytes disaggregation parameter were studied. Dynamic characteristics of blood flow were obtained in the experiment.Received results allow marking the principle components of blood flow pattern with proven high prognostic value of ACE in patients with ischemic heart disease. ACE risk stratification program was developed.