膀胱癌术后膀胱灌注患者的心理状况调查及护理干预

目的掌握膀胱癌术后膀胱灌注患者的心理动态,及时给予护理干预,提高患者的生活质量。方法填写《癌症患者心理反应状况量表》进行心理测试,评估患者的心理状况,进行护理干预,干预前后进行心理状况比较。结果干预前后患者的心理状况有明显差别(P<0.01)。结论及时给予有效的护理干预,能改善患者的不良心理,增强战胜疾病的信心,提高患者的遵医行为,按时定期灌注,降低复发率,提高患者的生活质量。     

吡柔比星预防浅表性膀胱癌术后复发的效果观察

目的探讨吡柔比星预防浅表性膀胱癌术后复发效果厦其副作用。方法55例浅表性膀胱癌患者经尿道电切术后随机分为观察组29例和对照组26例，观察组；吡柔比星30mg＋蒸馏水30ml；对照组：塞替哌60mg＋蒸馏水30ml，术后立即膀胱灌注1次,保留30min。术后1周继续灌注．每周1次。共8次，之后每月1次。比较二组术后复发及不髓反应情况。结果观察组4例复发（13．8％）；对照组7例复发（26．9%）。复发后肿瘤临床分期；观察组4例均为T1前期；对照组7例分别为Ta期3例、T1期1例、T2期3例。复发肿瘤病理分级：观察组G1级3例、G2级1例；对照组G1级3例、G2级1例、G3级3例。二组复发及不良反应情况比较差异有统计学意义,P〈0．001。结论浅表性膀胱癌术后THP膀胱灌注能有效抑制肿瘤复发，提高患者生存率。     

应用镍钛根扩仪和根管超声仪治疗弯曲根管的临床观察

目的：观察联合应用镍钛根扩仪和根管超声仪在治疗后磨牙弯曲根管的临床效果。方法：联合使用镍钛根扩仪及超声根管仪对后磨牙弯曲根管进行根充治疗，并与传统根扩方法进行疗效比较。结果：镍钛根扩仪和根管超声仪联合应用比较传统根扩方法术后反应少，治疗时间短，预后及转归良好。结论：提倡联合使用镍钛根扩仪和根管超声仪治疗根管弯曲的后磨牙。     

The effect of intraoperative colonic lavage withN G -nitro-l-arginine methyl ester (l-NAME) on anastomotic healing in the presence of left-sided colonic obstruction in the rat

-arginine methyl ester (L-NAME) on the healing of colonic anastomosis in the presence of a left-sided obstruction in the rat was investigated. Left-sided colonic obstruction was created in 144 Wistar rats. The obstruction site was excised 24 h later and anastomosis was performed after either no irrigation or colonic lavage with either saline, povidone iodine (PI), short-chain fatty acids (SCFA), L-NAME, or glutamine, in 24 animals each. Animals were killed on days 3 and 6, and a 4-cm colonic segment with the anastomosis at the center was excised. Bursting pressure (BP) and hydroxyproline (HP) content were measured. In the saline, PI, and SCFA groups, BP was higher (P < 0.05, P < 0.05, and P < 0.001, respectively) and HP concentration was similar compared with controls. Both the BP and HP concentrations were higher in the glutamine group compared with controls (P < 0.001). BP was lower (P < 0.05) and HP concentration was similar in the L-NAME group compared with the control group. Colonocyte nutrition and tissue perfusion are the mainstays of anastomotic healing. Intraoperative colonic lavage with L-NAME suppresses colonic anastomotic healing in the presence of a left-sided obstruction. (Received for publication on Mar. 29, 1999; accepted on Nov. 11, 1999)     

关节冲洗配合透明质酸钠联合阻滞疗法治疗膝骨关节炎疗效观察

目的探讨关节冲洗配合透明质酸钠联合阻滞疗法治疗膝骨关节炎的疗效。方法1998至2006年，对420名膝骨关节炎患者的500个膝关节行关节冲洗，配合透明质酸钠关节内注射，并联合阻滞疗法进行治疗，每周1次，连续5周1疗程，每6个月重复1疗程（透明质酸钠＋阻滞疗法）。头半年每月随访1次，以后每半年随访1次。参照Lequesne评估法制定观察表，分析比较治疗前、后效果。结果本组420名患者，有完整记录者360名（400个膝关节），平均治疗3．5个疗程，随访时间3个月～8年。400个膝关节经治疗后，显效64个（16．00％），有效100个（25．00％），好转155个（38．75％），无效81个（20．25％），总有效率79．75％。结论关节冲洗配合透明质酸钠联合阻滞疗法，治疗膝骨关节炎远期效果良好，适合基层医院开展。     

Application of siphon principle to fluid drainage in transurethral surgery

Transurethral resection is usually performed using an all-in-one drape with a fluid collection pouch, drainage port and hose. Gravity drainage of irrigation fluid through the hose is often hampered, resulting in fluid retention in the pouch. We applied a siphon principle to facilitate fluid drainage by making a U-shaped bend near the distal end of the hose, using an adhesive tape, and hooking the distal end of inverted U shape on the edge of bucket placed on the floor. When the hose is filled with irrigation fluid up to the crest of the siphon, fluid flow driven by atmospheric pressure continues until the pouch is evacuated. Repriming and restarting occur automatically throughout the operation. This simple device has virtually eliminated fluid retention in the pouch and proved to be especially useful in transurethral prostatectomy, which requires a large amount of irrigation fluid.     

Effect of hyperthermic vesical irrigation with bleomycin on the ultrastructure of the well-differentiated tumour and non-tumorous mucosa of the human urinary bladder

Summary Bladder tumours and non-tumorous bladder mucosa were studied by scanning and transmission electron microscopy in seven patients who had undergone hyperthermic vesical irrigation with bleomycin. The treatment induced sloughing of the outermost tumour cells, an increase of blebs and a decrease of cytoplasmic processes of the deeply located tumour cells as well as cellular degeneration. Although less severe, non-tumorous mucosa showed similar changes. Microvilli also appeared on the superficial cells of non-tumorous mucosa after the treatment. This treatment is effective by inducing cell degeneration and desquamation but not selective to the bladder tumour.     

High risk of hookworm infection among wastewater farmers in Pakistan

The health risks of wastewater use in agriculture were investigated in the city of Faisalabad, Pakistan, by means of a cross-sectional study. The study showed an increased risk of intestinal nematode infection and hookworm infection, in particular, in wastewater farmers (OR = 31.4, 95% CI 4.1-243) and their children (OR = 5.7, 95% CI 2.1-16) when compared with farming households using regular (non-wastewater) irrigation water. Textile labourers living in the same village as the wastewater farmers showed a lower risk of hookworm infection than wastewater farmers but an increased risk compared with farming households using regular irrigation water. Many urban and peri-urban farmers make a living by using untreated wastewater in the production of fresh produce for the urban market. Banning the use of untreated wastewater would deprive these farmers of their livelihood and affect food supply for the urban population. If treatment of wastewater is not a feasible option, the promotion of footwear and improved hygiene, the construction of toilets, in combination with regular anthelminthic treatment, would be suitable alternatives to safeguard the health of wastewater farmers and their children.     

Effect of endodontic irrigation on bonding of resin cement to radicular dentin

The influence of endodontic irrigation on shear bond strengths of resin cement to radicular dentin was investigated. Human radicular dentin blocks were divided into four groups and subjected to one of four endodontic irrigations: ethylenediaminetetraacetic acid (EDTA) group, 17% EDTA for 60 s; EDTA/sodium hypochlorite (NaOCl) group, 17% EDTA for 60 s followed by 10 ml of 5% NaOCl for 15 s; NaOCl group, 10 ml of 5% NaOCl for 15 s; and control group, no treatment. Morphological changes of dentin surface after endodontic irrigation were observed by scanning electron microscopy (SEM). A resin block was bonded to the radicular dentin after irrigation using resin cement with either wet-bonding (Uni-Etch/One-Step; Bisco) or self-etching (Tyrian SPE/One-Step Plus; Bisco) adhesives. Shear bond strengths were measured and the penetration of resin tags into dentinal tubules at resin-dentin interface was observed by SEM. With the wet-bonding system, the shear bond strengths for the EDTA/NaOCl group, in which dentinal tubules openings and uniform resin tag penetration into dentinal tubules were observed, were significantly higher than the EDTA and control groups. With the self-etching system, the shear bond strengths were significantly lower in the EDTA group compared with the NaOCl and control groups. The effects of endodontic irrigation on the bonding of resin cement to radicular dentin depended on the dentin bonding system used.