兔坐骨神经挤压伤的MRI与SEP对比研究

目的:探讨磁共振成像和体感诱发电位以及两者结合在坐骨神经急性挤压伤中的诊断价值。方法:24只兔按钳夹力的不同随机分为A、B两组,左后肢为损伤侧,右后肢为对照侧,建立坐骨神经急性挤压伤模型,于伤后1、2、4、8周行MR扫描,同时行双侧体感诱发电位检查。结果:损伤侧24条神经,有23条MR显示异常,诊断正确率95.8%,假阴性率4.17%(1/24);24条损伤侧坐骨神经,有22条SEP显示异常,诊断正确率91.6%,假阴性率8.3%(2/24)。MRI与SEP对神经损伤的正确诊断率无统计学差异(P>0.05)。MRI与SEP结合起来,24条损伤神经均显示异常,诊断正确率100%。结论:MR与SEP检查可无创、准确地判断神经损伤,两者结合可明显提高神经损伤的正确诊断率,重复性好,可作为神经损伤的较好诊断手段。     

肾功能损伤分级系统在成人心脏术后的应用

Objective The aim of this study was to evaluate of adilty of two acute renal failure-specific scoring systenms (the classification by Bellome et al and the AKIN criteria) for predicting hospital mortality after cardiac surgery in adult patients. Methods Between October 1 st 2006 to Decemjber 31 st 2006, 509 adult patients who ungerwent coronary artery bypass grafting (CABG) and/ or valve operation were enrolled in this study. The medical data collection included gender, age, types of operation, perioperative he- modynamic parameters, urine output, biochemical parameters and outcome. Renal function was assessed daily according to the classi- ficatinn by Bellomo and the AKIN criteria, respectively. As references, Acure Physiology and Chronic Health Evaluation(APACHE) Ⅱ and Sepsis-related Organ Failure Assessment (SOFA) score were also calculated. Resuits Three hundred and forty-one patients were male (67.0%), and 168 were female (33.0%), mean age was (56.2±12.0) years old. Tnree hundred and nine patieats un- derwent CABG, 182 underwent valve operation and 18 underwent CABG plus valve operation, Mean duration of ventilation support was (20.4±17.7) houra, and the ICU stay was (1.4±1.0) days. Postoperative hospital stay was (13.8±9.1) days. According to the classification by Bellomo., the highest in-hospital mortality was 52.9% in ARFS group. Mahiplicatinn of in-hospital morality rate was abserved (X2 for trend, P<0.01) in 0.4% (non-ARF), 1.2% (stage 1), 12.0% (stal～ 2) and 32.4% (stage 3) of pa- tients based on the AKIN criteria. By applying the area under the receiver operating characteristic ourve, the classification by Bellomo and the AKIN criteria had good discriminative power. Furthering, multivariate logistic regression analysis verified that the Odds Ratio of the AKIN criteria was 5.478 (P =0.028, 95% Confidence Interval 1.027- 24.856), after adjusting for gender and age. Con- clusion Analytical data confinned good discriminative power of both the AKIN criteria and the classification by Bellomo for predicting hospital mortality of adult postoperative patient with ARF.     

硝基甲烷对作业工人肝影响的初步探讨

硝基甲烷属硝烷类化合物,文献报告部分硝烷类化合物有肝毒作用。为了探明硝基甲烷是否对人的肝脏有一定的影响,我们对从事硝基甲烷生产的作业工人进行了调查。对象和方法一、调查对象,观察组系从事硝基甲烷生产的90名工人,其中男80人,女10人;年龄19～50岁,平均32.4岁;作业工龄1～10年,平均5.1年。对照组45人,其中男36人,女9人;年龄18～50岁,平均34.2     

局限期肺小细胞未分化癌的非手术综合治疗79例分析

本文总结了中国医学科学院肿瘤医院放射治疗科及内科组成的肺小细胞未分化癌综合治疗组1984年1月1日至1984年12月31日收治的局限期肺小细胞未分化癌82例的结果。其中3例未能完成诱导化疗,故可以分析总结的为79例。其中病理证实的为46例(58.2％),细胞学证实的为33例(41.8％)。     

交锁髓内钉治疗股骨骨折骨不连19例

1999年12月-2004年3月，我院应用交锁髓内钉治疗股骨骨不连19例，现报告如下。     

球形牙洁治模型在牙周前期实习中的应用

本文旨在比较在牙周前期实习中应用球形牙模型结合离体牙模型进行洁治练习与单纯离体牙模型洁治练习的教学效果.将三届共130名口腔医学专业四年级本科学生随机分成两组,一组在牙周前期实习中采用球形牙模型结合离体牙模型洁治练习,另一组单纯采用传统的离体牙模型洁治练习.由一名对分组情况不知情的牙周病学教授从两组中随机选择各20名学生进行洁治考核,由带教教师考核其余学生.结果显示应用球形牙模型结合离体牙模型进行洁治练习的实验组学生的成绩显著高于单纯采用离体模型进行洁治练习的对照组学生.研究证明,在牙周前期实习中应用球形牙模型进行模拟洁治练习,对学生掌握龈上洁治术有良好的辅助作用.     

内外固定治疗肱骨干骨折临床探索

目的探讨有限内固定结合外固定支架治疗肱骨干多段骨折的临床疗效。方法采用有限内固定结合外固定支架治疗肱骨干多段骨折24例。结果本组经6～14个月,平均12个月的随访,骨折全部达骨性愈合,肩肘关节功能恢复良好。结论采用有限内固定结合外固定架治疗肱骨干多段骨折,能获得较好疗效。     

提高毛发移植的覆盖率

目的探讨显微外科技术自体毛发移植的特点和方法,提高毛发移植成活的覆盖率。方法在较低温度(20°C)环境下,采用边切边缝方法取耳后或枕后毛发,在显微镜下分离成保留周围少量脂肪组织的毛囊族或单株,按需要移植部位不同进行不同的毛囊族或单株并套插的显微外科技术移植共31例。结果31例移植毛发后随访21例,随访时间6~38个月,移植后的毛发能基本覆盖无毛发区的皮肤和瘢痕,移植覆盖率较原来的移植方法提高33%,且外形自然,效果稳定。结论显微外科技术自体毛囊族状(微株小株)或单株移植,具有操作快、损伤小、低温保湿等特点,能较好地保留毛囊周围少量脂肪,在孔与孔的皮肤间隙内再用毛发移植针植入单株毛坯的“套插”移植,更有助于增加毛发覆盖率。     

肾功能损伤分级系统在成人心脏术后的应用

Objective The aim of this study was to evaluate of adilty of two acute renal failure-specific scoring systenms (the classification by Bellome et al and the AKIN criteria) for predicting hospital mortality after cardiac surgery in adult patients. Methods Between October 1 st 2006 to Decemjber 31 st 2006, 509 adult patients who ungerwent coronary artery bypass grafting (CABG) and/ or valve operation were enrolled in this study. The medical data collection included gender, age, types of operation, perioperative he- modynamic parameters, urine output, biochemical parameters and outcome. Renal function was assessed daily according to the classi- ficatinn by Bellomo and the AKIN criteria, respectively. As references, Acure Physiology and Chronic Health Evaluation(APACHE) Ⅱ and Sepsis-related Organ Failure Assessment (SOFA) score were also calculated. Resuits Three hundred and forty-one patients were male (67.0%), and 168 were female (33.0%), mean age was (56.2±12.0) years old. Tnree hundred and nine patieats un- derwent CABG, 182 underwent valve operation and 18 underwent CABG plus valve operation, Mean duration of ventilation support was (20.4±17.7) houra, and the ICU stay was (1.4±1.0) days. Postoperative hospital stay was (13.8±9.1) days. According to the classification by Bellomo., the highest in-hospital mortality was 52.9% in ARFS group. Mahiplicatinn of in-hospital morality rate was abserved (X2 for trend, P<0.01) in 0.4% (non-ARF), 1.2% (stage 1), 12.0% (stal～ 2) and 32.4% (stage 3) of pa- tients based on the AKIN criteria. By applying the area under the receiver operating characteristic ourve, the classification by Bellomo and the AKIN criteria had good discriminative power. Furthering, multivariate logistic regression analysis verified that the Odds Ratio of the AKIN criteria was 5.478 (P =0.028, 95% Confidence Interval 1.027- 24.856), after adjusting for gender and age. Con- clusion Analytical data confinned good discriminative power of both the AKIN criteria and the classification by Bellomo for predicting hospital mortality of adult postoperative patient with ARF.