^125I放射微粒微创植入治疗前列腺癌

目的观察^125I放射微粒植入对前列腺癌的治疗效果。方法对26例临床确诊为前列腺癌患者经皮穿刺在癌组织植入^125I放射微粒，每例平均36粒，术后复查肛诊、B超、影像学及血生化指标。结果患者植入治疗经过顺利，2例少量出血，留置导尿后愈合，3个月后经肛诊、直肠B超示结节缩小，前列腺特异性抗原（PSA）降低，多普勒超声显示结节内动脉收缩期最大血流速度（VS）、阻力指数（RI）及动脉搏动指数（PI）均明显下降。结论^125I放射微粒植入对前列腺癌的治疗安全性好、效果可靠。     

MILITANCY TRAUMA : MAXILLOFACIAL INJURY,ANAESTHESIA AND CRITICAL CARE

Eighty four out of 2151 militancy trauma patients sustained severe maxillofacial injury from Jan 1990 to March 1993. The resuscitation, stabilisation and intensive care of these patients was based on management priorities of primary resuscitation, care of airway, management of haemodynamics, oxygenation and monitoring. Anaesthesia was administered in a situation when the airway was likely to be compromised and the patients were critically sick. Initial ventilation and oxygenation was the most difficult and could be achieved with satisfactory seal around the face mask by applying water-soaked guaze pieces around the mouth and nose to “fill-in” the defects. Tracheal intubation could be accomplished with intravenous sedation by an experienced anaesthesiologist. Dental occlusion and wiring necessiated the placement of nasotracheal tube for 48-72 hours after surgery.KEY WORDS: Trauma, Maxillofacial injury, Trauma anesthesia, Anaesthesia and critical care     

显微镜辅助下颈前路椎间盘切除植骨融合术治疗多节段脊髓型颈椎病

目的探讨显微镜辅助下颈前路椎间盘切除植骨融合术(anterior cervical discectomy with fusion,ACDF)治疗多节段脊髓型颈椎病的疗效。方法回顾性分析2011年1月~2012年8月本院行颈前路手术治疗的60例脊髓型颈椎病患者的临床资料,根据手术方式分为常规ACDF组(A组,30例)和显微镜辅助ACDF组(B组,30例)。比较2组的手术时间、术中出血量、住院天数及并发症,以日本骨科学会(Japanese Orthopaedic Association,JOA)评分(17分法)及其改善率评价术后神经功能改善情况。结果 A组手术时间为(132.5±8.9)min,B组为(137.0±9.1)min,差异无统计学意义(P0.05)。A组术中出血量为(113.6±8.0)m L,B组为(93.7±5.3)m L,差异有统计学意义(P0.01)。A组住院(7.37±1.73)d,B组(6.63±1.13)d,差异无统计学意义(P0.05)。A组术前JOA评分为6.60±1.21,术后12个月为13.83±0.91,改善率为(69.72±7.66)%;B组术前JOA评分为6.87±1.46,术后12个月为14.23±1.17,改善率为(72.51±11.26)%。A组和B组改善率差异有统计学意义(P0.05)。结论显微镜辅助ACDF和常规ACDF是治疗多节段脊髓型颈椎病有效的方法,但显微镜辅助ACDF可减少术中出血量,是治疗多节段脊髓型颈椎病优先选择的手术方案。     

Two types of NP-NP associations in influenza virus-infected cells

Two types of NP-NP associations are shown to form in the influenza virus-infected cells. Early NP synthesis gives rise to NP associations stabilized by relatively weak bonds. These structures are designed as NP multimers. The high protease- and heat-sensitivities allow NP-multimers to be regarded as incompletely folded proteins. Post-translationally, NP-multimers transform to compact NP associations (NP oligomers) that are relatively highly heat-and protease-resistant. The NP-multimers untransformed to the folded compact NP-oligomers accumulate in the cells and partially degraded. Whether both types of NP-NP associations may be of significance is under discussion.     

新生儿呼吸机相关性肺炎的病原分析及护理

目的通过对呼吸机相关性肺炎的病原及药敏分析,从护理角度探讨预防措施,以降低呼吸机相关性肺炎发生率。方法对40例NICU呼吸机相关性肺炎进行回顾性分析。采取一次性吸痰液收集器从气管插管至患者气道最远端采集痰液进行细菌培养及药敏分析。结果G-菌55株(88.71%),G+球菌5株(8.06%),真菌2株(3.23%)。其中醋酸不动杆菌21株,铜绿假单胞菌15株,大肠埃希氏菌11株,肺炎克雷伯氏菌5株,阴沟杆菌2株,嗜麦芽假单胞菌1株,耐甲氧西林金葡菌5株,白色念珠菌2株,革兰氏阴性杆菌是呼吸机相关性肺炎的主要致病菌,其耐药率高,对β-内酰胺类抗生素不敏感,对亚胺培南、环丙沙星较敏感。结论呼吸机相关性肺炎危险因素甚多,发病机制复杂,提高预防意识,采取综合防治措施,是控制呼吸机相关性肺炎的最佳策略。