心脏介入治疗院内感染的调查分析

目的：对我科心脏介入治疗后的院内感染发生率及易感因素进行回顾性调查分析,并探讨其防治措施。　方法： 我科自１９７３～１９９９年６ 月共收治行心脏介入治疗患者１ １００ 例,按照年龄、性别、手术种类、院内感染发生率及感染部位等资料进行比较分析。　结果：１ １００ 例患者中,术后感染２７例,感染率为２．４５％ 。包括经皮二尖瓣球囊成形术（ＰＢＭＶ）３８０ 例,感染２１ 例,感染率为５．５３％ ;永久性心脏起搏器安置术５２０ 例,感染６ 例,感染率为１．１５％ ;射频消融术２００ 例,无感染发生。最常见的感染为血管相关性感染和切口感染。感染发生与性别无显著相关性。　结论： 心脏介入治疗后院内感染发生率较低,通过严格的无菌操作和抗生素的合理应用,可防止院内感染的发生。     

乳腺癌组织中第Ⅷ因子相关抗原和组织蛋白酶D与癌转移及预后的关系

目的探讨乳腺癌组织中第Ⅷ因子相关抗原和组织蛋白酶Ｄ在其转移、预后中的关系。方法采用免疫组化ＳＰ法对３３例乳腺癌进行第Ⅷ因子相关抗原（Ｆ８）和组织蛋白酶Ｄ（Ｃａｔｈ－Ｄ）染色。结果３３例乳腺癌微血管Ｆ８染色均阳性（１００％）。癌组织内染色阳性在７０％以上者７例（２１．２１％）,癌周组织阳性在７０％以上者２５例（７１．６７％）,两者有明显差异（Ｐ＜０．０１）。Ｆ８表达与腋窝淋巴结转移有相关性（Ｐ＜０．０１）。３３例乳腺癌Ｃａｔｈ－Ｄ阳性者３０例,占９０．０９％。结论Ｆ８、Ｃａｔｈ－Ｄ免疫组化染色对判断乳腺癌转移、预后有着重要意义。两项同时检测可起互补作用。     

性罪错妇女的性伴关系属性与HIV危险行为发生频率相关性的研究

为探讨性伴关系属性与ＨＩＶ 有关危险行为发生频率的相关性,对深圳收容教育所收容的８１３ 名性罪错妇女进行调查。对其中性伴结构相同、性伴关系多重的两组人群进行单向有序变量的Ｌｏｇｉｓｔｉｃ 回归分析,并将结果以数学模型形式表达出来。分析结果显示,性罪错妇女的性伴关系属性与ＨＩＶ危险行为的发生频率密切相关。提示：加强性伴关系干预将可能提高目前在ＨＩＶ 重点人群中开展的以健康宣传、健康教育为主的干预措施效果     

OCT imaging of choroidal neovascularisation and its role in the determination of patients'' eligibility for surgery

AIM: To evaluate the optical coherence tomographic characteristics of choroidal neovascularisation (CNV) in age related macular degeneration (AMD) and in idiopathic and inflammatory CNV. The use of this technique in the selection of patients for surgery is discussed. METHODS: Ocular coherence tomography (OCT), fluorescein, and indocyanine green angiography were performed in 23 patients affected by AMD complicated by well defined CNV and in 10 patients affected by inflammatory or idiopathic CNV. The neovascular membrane was surgically removed in five age related CNVs, two inflammatory choroidopathies, and two idiopathic CNVs. RESULTS: In inflammatory and idiopathic CNV, the OCT displayed a neovascularisation on the retinal pigment epithelium (RPE). In three cases the CNV was excised with an improvement of visual acuity equal to or greater than two Snellen lines; in a fourth case, the visual acuity after surgery was unchanged. In the cases of AMD the OCT fell into three different patterns: (A) CNV above the RPE (five cases); (B) focal, irregular thickening of the retinal pigment epithelial band (12 cases); (C) CNV above and below the RPE (six cases). The five pattern A CNV patients underwent the surgical excision of the neovascularisation. In four cases the visual acuity improved by two or more Snellen lines; in the fifth case the visual acuity remained unchanged. CONCLUSIONS: The authors suggest that the surgical removal of early age related CNV could be performed in those cases where the OCT shows a neovascular membrane on the RPE, as in idiopathic and inflammatory CNVs.     

Indocyanine green guided laser photocoagulation in patients with occult choroidal neovascularisation

AIMS: To determine whether indocyanine green (ICG) guided laser photocoagulation of occult choroidal neovascularisations (OCNV) is beneficial for patients with occult choroidal neovascularisation secondary to age related macular degeneration (AMD). METHODS: A prospective pilot study was performed in 21 eyes with OCNV secondary to AMD that could be identified extrafoveolarly or juxtafoveolarly in an early ICG angiographic study. Laser photocoagulation was applied to the neovascular membrane identified in the early ICG angiographic study. RESULTS: Visual acuity ranged from 20/400 to 20/20 (logMAR 0.54 (SD 0.29) before and hand movements and 20/30 (logMAR 0.81 (0.69)) at the last follow up after laser photocoagulation. During the follow up (30 (13) months) vision improved in four eyes (two lines), in seven eyes the initial visual acuity could be stabilised (two lines), in five eyes vision dropped moderately (three to five lines), and in five eyes vision decreased severely (six or more lines). Recurrences (seven patients) or persistent CNV (six patients) was observed in 13 patients. CONCLUSION: This preliminary study of ICG guided laser photocoagulation of occult extrafoveal and juxtafoveal choroidal neovascularisations suggests that this technique may improve the visual prognosis of these patients. Further prospective controlled studies are necessary to confirm these data.     

Pharmacokinetic profile of Mitoguazone (MGBG) in patients with AIDS related non-Hodgkin's lymphoma

Summary Mitoguazone is a unique chemotherapeutic agent whose activity is believed to result primarily from the competitive inhibition of S-adenosyl-methionine decarboxylase leading to a disruption in polyamine biosynthesis. Initial clinical trials demonstrated that the dose-limiting toxicities (mucositis and myelosuppression) of Mitoguazone were both dose and schedule dependent. Early pharmacokinetic studies of Mitoguazone in man revealed a prolonged half-life. Concurrent with a recent Phase II trial of Mitoguazone in patients with AIDS related non-Hodgkin's lymphoma, the single dose pharmacokinetics of Mitoguazone were characterized. Twelve patients received 600 mg/m² of intravenous Mitoguazone over 30 minutes on an intermittent every 2 week schedule. Blood, urine, cerebrospinal fluid (CSF), pleural fluid and tissue samples were collected and analyzed by HPLC. Mitoguazone was cleared from the plasma triexponentially with a harmonic mean terminal half-life of 175 hours and a mean residence time of 192 hours. Peak plasma levels occurred immediately post-infusion, ranged from 6.47 to 42.8 g/ml, and remained (for an extended period) well above the reported concentration for inhibition of polyamine biosynthesis. Plasma clearance averaged 4.73 l/hr/m² with a relatively large apparent volume of distribution at steady-state of 1012 l/m² indicating tissue sequestration. Renal excretion of unchanged Mitoguazone accounted for an average of 15.8% of the dose within 48 to 72 hours post-administration. Detectable levels of drug were present in random voided samples eight days post-dose. Mitoguazone levels in CSF ranged from 22 to 186 ng/ml post-dose with CSF/plasma ratios ranging from 0.6% to 7%. The pleural fluid/plasma ratio was approximately 1. Tissue levels of Mitoguazone were highest in the liver followed by lymph node, spleen and the brain.     

薄层色谱法测定地红霉素中的有关物质

目的采用薄层色谱法检查地红霉素中的有关物质。方法地红霉素供试品经无水甲醇溶解后 ,以正己烷 二氯甲烷 甲醇 浓氨水 (2∶3∶0 .8∶0 .0 6)为展开剂 ,在硅胶GF2 5 4薄层板上展开 ,以硫酸显色后观察。结果确立供试品有关物质限度。结论此法简便、灵敏、准确 ,可作为地红霉素有关物质的快速测定     

用HPLC法测定马来酸依那普利片的含量和有关物质

目的:采用改进的HPLC法测定马来酸依那普利片中马来酸依那普利和有关物质的含量。方法:采用HypersilBDS C8色谱柱(250 mm×4.0 mm,5μm ID);0.001 mol/L磷酸二氢铵溶液(用磷酸调节pH值至2.0)-甲醇(60:40);检测波长215 nm。结果:马来酸依那普利在0.1～0.3 mg/ml范围内线性关系良好(r=0.999 9);方法的平均回收率为99.8％。依那普利与有关物质之间分离良好。结论:本法有较高的回收率、精密度和重现性。     

儿科重症监护病房中影响机械通气成功的相关因素

目的 探讨儿科重症监护病房(PICU)中影响机械通气成功的相关因素。方法 将lll例行机械通气的危重病儿分成治疗成功组与失败组，对其相关因素进行回顾性分析。结果两组患儿在上机前危重病例评分、是否伴有心跳呼吸骤停和(或)休克及并发多系统器官功能衰竭(MODS)等方面差异有权显著意义(P＜0．001)；超过48h的机械通气患儿是否继发呼吸机相关肺炎(VAP)亦有显著意义(P＜0.05)。结论 PICU中影响机械通气成功率的因素主要是原发病的性质及严重程度，并与MODS与VAP有密切关系。