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111.
用化学发光法检测粒细胞吞噬功能具有灵敏、准确、快速等优点。用我校同位素实验室LS3801型液体闪烁分析仪,全部使用国产试剂,建立了分离的中性粒细胞化学发光测定法,并对影响因素作了初步观察和探讨。实验表明,此法既可用于中性粒细胞吞噬杀菌功能机理研究,亦可用于临床监测。对糖尿病人粒细胞功能化学发光测定结果,显示了此法应用的潜力。 相似文献
112.
The results of external beam radiotherapy for clinically localized adenocarcinorna of the prostate in 448 patients treated in the period 1980–90 were reviewed. The average follow up was 4.9 years. The patients were aged 44–87 years (median 69 years) and all had histopathological evidence of adenocarcinoma by needle biopsy or transurethral resection of prostate. The histopathological grading was: 127 G1; 154 G2; 127 G3; 12 G4; 28 Gx. Clinical staging according to TNM (American Urological Association) was: 29 T0 (A2); 4 T1 (B1); 173 T2 (B2); 176 T3 (C1); 63 T4 (C2); 3 Tx. Routine surgical pelvic lymph node staging was not performed but patients had radiological (computerized tomography scan or lymphogram) nodal staging: 350 N0; 22 N1; 12 N2; 64 Nx. High energy linear accelerator external beam radiotherapy was given by multiple fields to total doses of 50–70 Gy (median 60 Gy). The majority of patients (307, 69%) was treated by a uniform policy under the care of one radiation oncologist (HM). The rates of local and distant failure at 5 years were 10% (s.e. = 2%) and 42% (s.e. = 3%), respectively. The late complication rate at 5 years was 25% (s.e. = 2%), comprising mild 16%, moderate 7% and severe 1.3%. The 5 year overall survival rate was 64% (s.e. = 2%) and the cancer-specific survival rate was 74% (s.e. = 3%). Both histological grade and clinical stage were strongly predictive of overall survival and distant failure. Only histological grade was predictive of local failure. Treatment with external beam radiotherapy for this common cancer resulted in survival and disease control rates that compare favourably with other published radiotherapy series and has been accompanied by acceptably low morbidity. 相似文献
113.
Serge Evrard Yves Bécouarn René Brunet Marianne Fonck Caroline Larrue Simone Mathoulin-Pélissier 《Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie》2007,392(1):41-44
BACKGROUND AND AIMS: The aim of this work was to test the feasibility of using a bipolar low thermal acting system inducing collagenic sealing but not protein coagulation to secure hepatic parenchyma cutting. MATERIALS AND METHODS: Thirty consecutive hepatectomies were carried out using kellyclasy plus ligatures and clips (controls), while the following 50 hepatectomies used kellyclasy plus bipolar vessels sealer (BVS). Blood loss, duration of hepatic pedicle clamping, length of hospital stay, and complications were recorded. RESULTS: There was no statistically significant difference in blood loss and duration of clamping between controls and BVS. Specific complications (9/21 in the control group vs 1/49 for the BVS group, p<0.00045) and length of hospital stay (14 days in the control group vs 11 days in the BVS group, p<0.014) were statistically lower in BVS group than in the controls, mainly due to prevention of bile duct leakages. CONCLUSIONS: Our data suggest that BVS may be particularly efficient to achieve bilistasis leading to the highest level of safety in performing hepatectomies. Further studies are now needed to confirm its superiority on the classical biliary ducts occlusion techniques. 相似文献
114.
目的 观察玻璃体视网膜手术后早期睫状体脱离的发生率及其自然病程,并分析其与手术后早期低眼压的关系。方法 利用超声生物显微镜检查(UBM)连续观察行玻璃体视网膜手术治疗的患者46例46只眼。按玻璃体视网膜手术后不同填充内容分组:气体填充组11例11只眼,硅油填充组8例8只眼,平衡盐溶液(BSS)填充组27例27只眼。按手术后眼压分组:眼压<10 mm Hg(1 mm Hg=0.133 kPa)组25例25只眼,≥10 mm Hg组21例21只眼。玻璃体视网膜手术后第3天行UBM确定有无睫状体脱离,手术后每天用非接触眼压计监测眼压,有睫状体脱离者每隔7 d复查1次,直至睫状体脱离复位,所有患者均随访观察14~35 d。结果 手术后睫状体脱离20例,占本组患者的43.5%。无睫状体脱离者26例,占本组患者的56.5%。玻璃体视网膜手术后气体填充组睫状体脱离发生率 27.3%,硅油填充组25.0%,而BSS填充组为55.6%。睫状体脱离者手术后平均眼压(6.47±4.49) mm Hg (1 mm Hg=0.133 kPa),无睫状体脱离者平均眼压(15.61±7.72) mm Hg,两者差异有统计学意义(t=8.031,P<0.001)。手术后眼压<10 mm Hg组患者睫状体脱离发生率为68.0%,眼压≥10 mm Hg组患者睫状体脱离发生率为14.3%,两组差异有统计学意义(χ2=15.60, P<0.001)。玻璃体视网膜手术后早期睫状体脱离患者除1例因低眼压引起视盘水肿而需行气体填充外,其余患者均在手术后30 d内自行复位。结论 手术后早期睫状体脱离是玻璃体视网膜手术的常见并发症。玻璃体视网膜手术后行BSS填充患者手术后睫状体脱离的发生率高。绝大多数患者睫状体脱离能够在玻璃体视网膜手术后30 d内自行复位。 相似文献
115.
F. Mattner D. Sohr A. Heim P. Gastmeier H. Vennema M. Koopmans 《Clinical microbiology and infection》2006,12(1):69-74
Norovirus infections have been described as self-limiting diseases of short duration. An investigation of a norovirus outbreak in a university hospital provided evidence for severe clinical features in patients with several underlying diseases. Clinical outcomes of norovirus infection were defined. Risk-factor analysis targeting underlying diseases and medication was performed using multivariate analyses. In five outbreak wards, 84 patients and 60 nurses were infected (an overall attack rate of 32% in patients, and 76% in nurses). The causative agent was the new variant Grimsby virus. Severe clinical features, including acute renal failure, arrhythmia and signs of acute graft organ rejection in renal transplant patients, were observed in seven (8.3%) patients. In multivariate analyses, cardiovascular disease (OR 17.1, 95% CI 2.17-403) and renal transplant (OR 13.0, 95% CI 1.63-281) were risk-factors for a potassium decrease of >20%. Age >65 years (OR 11.6, 95% CI 1.89-224) was a risk-factor for diarrhoea lasting >2 days. Immunosuppression (OR 5.7, 95% CI 1.78-20.1) was a risk-factor for a creatinine increase of >10%. Norovirus infections in patients with underlying conditions such as cardiovascular disease, renal transplant and immunosuppressive therapy may lead to severe consequences typified by decreased potassium levels, increased levels of C-reactive protein and creatine phosphokinase. In the elderly, norovirus infection may lead to an increased duration of diarrhoea. Therefore patients at risk should be hospitalised early and monitored frequently. Strict preventional measures should be implemented as early as possible to minimise the risk of nosocomial outbreaks. 相似文献
116.
S. Giridharan B. Vakkalanka M. S. Anwar J. I. Geh J. Glaholm M. Churn† F. Adab‡ R. Grieve§ C. McConkey¶ A. Hartley 《Colorectal disease》2005,7(1):43-46
BACKGROUND: The addition of short course pre-operative radiotherapy to total mesorectal excision reduces local recurrence in resectable adenocarcinoma of the rectum. In a previous retrospective study potential factors associated with early complications following this combination were identified. The aim of this study was to examine these relationships in a prospective multicentre audit. METHODS: One hundred and seven patients who received short course pre-operative radiotherapy in four cancer centres between 1 October 2001 and 30 September 2002 were included. Data including patient age, radiotherapy field length, overall treatment time, operation type, surgical outcomes and complications occurring within 3 months of the 1st day of radiotherapy were collected. These were compared and combined with the previously studied cohort of 176 patients treated at one centre between 1st January 1998 and 31st December 1999. RESULTS: In the prospective cohort only patient age (P=0.001) was significantly associated with acute complications. However, both the overall treatment time (median 9.0 vs 11.0 days P <0.0001) and field length (median 16.6 vs 17.0 cm P=0.03) were significantly shorter in this cohort when compared to the previous retrospective study. In patients from both studies (n=283), increasing age (P=0.002) and field length (independent of operation type) (P=0.02) were independently associated with an increased risk of acute complications. CONCLUSIONS: This study suggests that meticulous selection of patients for short course pre-operative radiotherapy and smaller planning target volumes may be associated with a lower risk of acute complications. The use of MRI scanning to stage pelvic disease may reduce the number of patients with R1 resections receiving short course pre-operative radiotherapy. 相似文献
117.
糖尿病大鼠骨折后骨形态发生蛋白-2、胰岛素样生长因子-1的变化 总被引:2,自引:1,他引:1
目的 观察糖尿病大鼠骨折后骨形态发生蛋白-2(BMP-2)、胰岛素样生长因子-1(IGF-1)的变化,探讨糖尿病对骨折愈合的影响.方法 70只大鼠随机分为对照组和糖尿病组,均造成左侧胫骨骨折.定期摄X线片,取骨痂HE染色,免疫组化检测骨痂BMP-2、IGF-1,ELISA法检测血清BMP-2、IGF-1.结果 2周BMP-2灰度值:实验组为149±8,对照组为107±7(P<0.01);2周IGF-1灰度值:实验组为137±9,对照组为103±8(P<0.01).2周血清BMP-2含量:实验组为(3.45±0.12) ng/ml,对照组为(5.60±0.11) ng/ml(P<0.01);2周IGF-1含量:实验组为(5.89±0.12) ng/ml,对照组为(8.36±0.11) ng/ml(P<0.01).结论 糖尿病大鼠骨折后血清及骨痂中BMP-2、IGF-1减少是导致糖尿病大鼠骨折愈合差的原因之一;BMP-2与IGF-1可能存在相互作用. 相似文献
118.
Frank Makowiec Stefan Post Hans-Detlev Saeger Norbert Senninger Heinz Becker Michael Betzler Heinz J. Buhr Ulrich T. Hopt German Advanced Surgical Treatment Study Group 《Journal of gastrointestinal surgery》2005,9(8):1080-1087
Despite decreasing mortality rates, morbidity is still high after pancreatic head resection. Comparative data in the United
States and Europe show a relationship between hospital volume and mortality. Treatment strategies vary frequently, partially
because of the lack of evidence-based data. We performed a multi-institutional analysis in Germany evaluating current numbers,
indications, techniques, and complication rates of pancreatic head resection. Questionnaires were completed by seven high-volume
surgical departments regarding quantitative and qualitative aspects of pancreatic head resections in the period from 1999
to 2004 (five prospective and two retrospective institutional databases). A total of 1454 pancreatic head resections (944
for malignancy) were reported. Mean annual hospital volume ranged from 14 to 52 (10 to 43 in malignancy). Mortality was between
1.1% and 4.8%, morbidity was between 24% and 46%, and pancreatic leakage was between 9% and 20%. In malignant disease, all
centers perform standard lymphadenectomy and regard arterial infiltration as a contraindication for resection. However, the
rate of portal vein resection varied from 0% to 28%. No consensus is seen on the type of surgery for malignancy and chronic
pancreatitis. After resection for pancreatic cancer less than one fourth of the patients receive adjuvant therapy. The results
of our analysis in Germany confirm that pancreatic head resection can be performed with low mortality in specialized units.
Variations in indications, operative technique, and perioperative care may demonstrate the lack of evidence-based data and/or
personal and institutional experience. The low number of patients receiving adjuvant therapy after resection of pancreatic
cancer suggests that more efforts must be made to establish novel adjuvant therapies under randomized study conditions.
Presented at the Forty-Sixth Annual Meeting of The Society for Surgery of the Alimentary Tract, Chicago, Illinois, May 14–18,
2005 (oral presentation). 相似文献
119.
高龄骨折患者术后并发症的观察与护理 总被引:1,自引:0,他引:1
自2004年1月至2005年12月,对31例70岁以上的骨折患者施行了手术,通过精心治疗与护理,有效地预防了并发症的发生。现将观察与护理体会报告如下。1临床资料本组31例,其中男19例,女12例;年龄70~95岁,平均78岁。股骨颈骨折11例,股骨粗隆间骨折20例。行全髋关节置换6例,人工股骨头置换10例,动力髋15例,伤后3~18 d手术。手术入路采用髋外侧或后外侧入路,术后常规应用抗生素7~10 d,均不应用止血类药物。2术后并发症的观察与护理2·1切口感染术后1~3 d可有暂时性体温升高,如不超过38·5℃,可嘱其多饮水,无须特殊处理;如持续低热,要及时查明原因,对症… 相似文献
120.