改良超滤对婴幼儿心脏手术输血的影响

目的　观察改良超滤技术在婴幼儿体外循环心血管手术中对输血及术后出血的影响。方法　 6 0例接受体外循环下心血管手术的先天性心脏病患儿 ,均分为对照组 (不接受任何超滤 )、常规超滤组 (CUF组 )和改良超滤组 (MUF组 )。观察术中库血用量、血浆用量、血球压积的变化及术后2 4h出血量 ,并用SSPS/PC进行统计学处理。结果　MUF组库血用量、血浆用量、术后 2 4h出血量显著低于对照组和CUF组 (P <0 0 1) ,且滤出水量明显多于CUF组 (P <0 0 1)。结论　在婴幼儿心血管手术中 ,改良超滤可有效排出体内水分 ,提高血球压积 ,明显减少输血及术后出血 ,是节约用血的重要手段之一。     

Treatment of hepatitis B and C after liver transplantation. Part 2, hepatitis C

Abstract End-stage liver disease caused by the hepatitis C virus is a major indication for liver transplantation. However, recurrence of hepatitis in the graft is a major issue. HCV re-infection after transplantation is almost constant, and recent data confirm that it significantly impairs patient and graft survival. Factors that may influence disease severity and consequent progression of HCV graft injury remain unclear. Chronic HCV infection develops in 60%–80% of patients, and 6%–28% ultimately progress to cirrhosis within 5 years. Pre-transplantation antiviral treatment is not easily related to poor tolerance. Attempts to administer prophylactic post-transplantation antiviral treatment are under evaluation but are limited by antiviral drug side effects. Treatment of established graft lesions with interferon or ribavirin as single agents has been disappointing. Combination therapy gave promising results, with sustained virological response in 25% of patients, but indications, modality and duration of treatment should be assessed.     

Postnatal formation of the blood-testis barrier in the rat with special reference to the initiation of meiosis

Summary Postnatal formation of the Blood-Testis Barrier (BTB) in the rat was studied by either fixation in hypertonic fixative or employing lanthanum tracer. After 15 days of age, meiosis has reached different stages of spermatogenesis in differnt zones of the seminiferous cords. Only in those parts where germ cells are in the pachytene stage of meiosis do Sertoli cells form an effective barrier or tight compartment. Between 16 and 19 days of age, final formation of the BTB, which is to be found in the adult rat testis, occurs by zygotene and then leptotene stages successively entering the tight compartment. Thus, formation of a BTB by Sertoli cells does not occur synchronously along the length of the seminiferous cord but in accordance with the stage of meiosis of the associated germ cells.     

EDTA Registry centre survey, 1986. Report from the European Dialysis and Transplant Association Registry

This paper summarises the information given on the 1986 EDTA Registry centre questionnaire which was returned by 82% of the 2,065 known dialysis and transplant centres in 33 European countries. Information is given on the number of patients alive on haemodialysis according to the type of dialysis facilities available where the patient was receiving dialysis and the number of patients receiving special types of dialysis. The centre questionnaire also included questions on testing for HIV infection, serological evidence or symptoms of AIDS and the diagnosis of hepatitis B in patients and staff. The data given in response to these questions are presented together with data on the involvement of dietitians and social workers in the treatment of patients with end stage renal failure. Finally, information on transplant activity in Europe and the treatment policies of transplanting centres is provided.     

去除白细胞输血的临床意义

目的:评估去除白细胞输血的临床应用价值。方法:251例患者接受了去除白细胞红细胞悬液761U,(每人1￣8U不等),对其中200U红细胞悬液滤除白细胞前、后分别进行白细胞计数和血红蛋白测定,并对其输血反应进行了观察。结果:发现应用白细胞滤器后,其白细胞数比过滤前显著减低,过滤前、后白细胞数分别为(6.16±1.44)×109/L与(0.12±0.10)×109/L(P<0.01),血红蛋白过滤前、后无显著性差异,分别为:(161.58±23.31)g/L与(157.84±22.35)g/L,P>0.05。251例接受去白细胞受血者均未出现输血反应。结论:白细胞滤器能有效去除白细胞,去除白细胞能减少非溶血性输血反应。     

抑郁患者血清皮质醇与血压在应激前后的变化

目的研究抑郁患者血清皮质醇浓度、血压在应激前后的变化以及它们之间的关系。方法分别在安静状态、心理应激状态和心理应激后 (恢复状态 )测量抑郁组和对照组的血清皮质醇浓度、血压 ,比较两组上述指标的差异 ,以及心理应激前后的变化。心理应激以规定时间内的计算试验模拟 ,血清皮质醇以酶联免疫试验检测 ,血压为常规检测。结果 1.皮质醇 :抑郁组在安静状态、应激状态、恢复状态的皮质醇浓度显著高于对照组 (P <0 .0 5 ) ,抑郁组应激前后皮质醇浓度的波动显著小于对照组 (P <0 .0 5 )。2 .收缩压 :安静状态和恢复状态时抑郁组的收缩压显著高于对照组 (P <0 .0 5 ) ,应激状态时两组无统计学差异 ;应激前后收缩压的波动两组无统计学差异。 3 .舒张压 :抑郁组在安静状态时舒张压显著高于对照组(P <0 .0 5 ) ,在应激状态和恢复状态时两组无统计学差异 ;应激前后舒张压的波动两组无统计学差异。结论抑郁患者存在基础血压升高 ,此现象可能与抑郁患者血清皮质醇浓度升高有关。     

Treatment of hepatitis B and C after liver transplantation. Part 1, hepatitis B

Abstract The outcome of OLT for HBV-related liver disease is dependent on the prevention of allograft re-infection. Over the past decade, major advances have been made in the management of HBV transplant candidates. The advent of long-term hepatitis B immune globulin (HBIG) administration as a prophylaxis against HBV recurrence, and the introduction of new antiviral agents against HBV infection, such as lamivudine (LAM), were a major breakthrough in the management of these patients. Results of OLT for HBV infection are similar to those achieved with other indications. Pre-OLT antiviral treatment such as LAM can suppress HBV replication before OLT and thus decrease the risk of re-infection of the graft. Combination prophylaxis with LAM and HBIG after transplantation highly effectively reduces the rate of HBV re-infection, even in HBV replicative cirrhotic, patients. The optimal HBIG protocol in the LAM era is yet to be defined: dosing of HBIG, routes of administration, and possibility of stopping HBIG. Several antiviral drugs have been developed for the management of HBV infection on the graft, so outcome is currently good.     

小包装全氟丙烷气体动力学实验研究

为检验塑料小包装全氟丙烷气体（C3F8）在不同包装和储存方法时浓度变化，将装有5～7mlC3F8的聚氯乙烯小袋，根据不同储藏温度和外包装方法随机分成四组：（1）22℃聚乙烯外包装，（2）36℃聚乙烯外包装，（3）22℃铝箔真空外包装，（4）-29℃聚乙烯外包装；每一组C3F8小袋气体存放一定时间后，应用气相色谱分析方法进行浓度测量。结果：第3组C3F8浓度最高和稳定，第2组浓度随放置时间降低最明显，第4组是临床应用气体的储藏和包装方法，其30天样本浓度和第3组相等，但放置一年时浓度降低。结果显示：塑料小包装C3F8予以铝箔真空外包装是一种可行的方法，利于C3F8运输和普及；聚乙烯外包装的C3F8，应放在-29℃保存，时间不超过一年。     

The epidemiology and surveillance of blood lead in Taiwan (R.O.C.): A report on the PRESS-BLL project

 To monitor the lead hazards in industries and to investigate the prevalence of elevated blood lead levels (BLLs) in lead-exposed workers, a lead surveillance system (PRESS-BLLs) has been established and operated in Taiwan, Republic of China, since July 1993. A cohort of lead-exposed workers who received a periodic annual health examination at 55 accredited hospital laboratories was constructed. A total of 9807 separate BLL measurements were reported to the system in 1994. The mean BLL was 15.8 μg/dl in male workers and 11.6 μg/dl in female workers. The mean BLL of lead-exposed workers was significantly (P<0.05, z-test) higher than that of the general Taiwanese population (8.6 μg/dl for males and 6.7 μg/dl for females). In addition, the BLLs of 983 (10.0%) workers exceeded the regulatory action level (40 μg/dl for males; 30 μg/dl for females). The workplaces and homes of 57% of the workers with elevated BLLs were thoroughly investigated to determine the sources of lead contamination. These actions identified the causes of elevated BLLs and set up strategies to reduce workers’ lead exposure. The establishment of this occupational lead surveillance system represents a method for monitoring of lead hazards from occupational and environmental settings to prevent lead poisoning. The information acquired from the system can help in the setting up of a priority of prevention and the development of control measures. It is also useful for further monitoring of changes in the BLLs of the lead-exposed-worker cohort. The Health Department of Taiwan can use this information to evaluate the effectiveness of current industrial hygiene practice. Subjects with elevated BLLs have been medically treated and placed on long-term follow-up for sequelae. Received: 2 September 1996/Accepted: 29 November 1996