Per‐oral transgastric abdominal surgery

Laparoscopic surgery has several advantages over traditional surgery because it has been shown to be less invasive. The next logical step in the evolution of minimally invasive surgery may be to eliminate all abdominal incisions. The natural orifices provide a port of entry via the gastrointestinal tract to the peritoneal cavity. This approach would require the creation of a perforation, which is considered to be a major complication of endoscopy with significant morbidity and mortality. However, there are several recent studies that have described the technical feasibility and safety of a per‐oral transgastric approach to the peritoneal cavity using conventional endoscopes. Theoretically, this approach could reduce postoperative abdominal wall pain, wound infection, hernia formation, and adhesions. This article aims to summarize the current status of transgastric surgery, currently referred to as natural orifice transluminal endoscopic surgery (NOTES), and to address some of its future challenges.     

Auriculo-ventricular block and distal myopathy with rimmed vacuoles and desmin storage.

A young patient had an auriculo-ventricular block and a distal myopathy with muscle biopsy findings suggestive of inclusion body myositis. What was most unusual was the presence of numerous sarcoplasmic bodies identified as desmin by electron microscopy and immunocytochemistry. The nosological situation of this condition is discussed.     

运用人力资源管理策略 改革病房护理管理

从发展成功管理的共同文化,创建优质服务病房;建立有效的护理人力资源管理支持系统,创建适合于专业护理的工作环境,确保护理质量;以病人为中心,以病人满意度作为衡量护理工作优劣的标准三个方面介绍了乐山市人民医院运用护理人力资源管理策略,改革病房护理管理,创建优质服务病房的实践经验及其效果。     

影响去离子水质量的主要因素及排除方法

利用电渗析和离子交换柱除去原水中的各种杂质可得到去离子水．而去离子水的质量直接决定了医用注射液的质量。通过近二年的实际操作．列出了与去离子质量有关的主要因素，并提出一些相应见解。     

Tumor cell surface-associated binding site for the M(r) 72,000 type IV collagenase.

We have studied the capacity of two human breast adenocarcinoma cells, MDA-MB231 and MCF-7, to bind exogenous M(r) 72,000 type IV collagenase by both morphological and radioreceptor binding assays. By indirect immunofluorescence, staining with a specific anti-M(r) 72,000 type IV collagenase antibody was strongly induced when cells were preincubated with the purified enzyme. Scatchard plot analysis indicated the existence of a binding site for the M(r) 72,000 type IV collagenase with high affinity for both cell lines (Kd = 2 x 10(-9) M). These results are the first demonstration of the existence of a tumor cell membrane-associated putative receptor for a member of the matrix metalloproteinase family, as previously evidenced for the urokinase-type plasminogen activator.     

医院后勤服务社会化实践中的几点思考

就医院后勤服务社会化的实际操作中的几个问题进行了论述,指出实行后勤社会化服务,必须有相应的外部环境;后勤部门实行企业化管理,必须有相配套的政策作保障;实施商品化服务,必须有对等的经济意识;加大后勤服务化的力度,必须有果敢超前的决策意识。     

溶栓及经皮冠脉腔内成形术治疗急性心肌梗死的疗效分析

目的　对比直接冠状动脉腔内成形术 (PTCA)及静脉尿激酶 (UK)溶栓对急性心肌梗死 (AMI)治疗的临床疗效。方法　采用观察性队列研究的方法 ,对 97例AMI患者采用UK溶栓 ,60例AMI患者采用直接PTCA治疗 ,比较两组住院期及随访期的超声心动图 (UCG)和临床结果。结果　住院期间UCG检查室壁运动正常者在PTCA组为 (4 6.0 0 % ) ,高于UK组 (2 4.73 % ) (p =0 .0 2 1) ,矛盾运动发生率PTCA组为 0 ,而UK组为 11.83 %。LVEF在PTCA组为 5 6.88± 10 .47,高于UK组 (5 1.5 8± 10 .97) (p =0 .0 41)。住院期心衰发生率UK组为 3 2 .5 9% ,高于PTCA组 (18.3 3 % ) (p =0 .0 2 9)。随访 13 .3 2± 6.86个月累计心衰发生率UK组为 16.2 8% ,也高于PTCA组 (5 .19% ) (p =0 .0 0 1)。住院期间的病死率UK组为 10 .3 1% ,PTCA组为 5 .0 0 % (p =0 .10 0 )。累计病死率UK组为 15 .5 6% ,明显高于PTCA组 (5 .0 0 % ) (p =0 .0 2 1)。 60岁以上年龄组累计的病死率仍然是UK组 (2 8.99% )高于PTCA组 (10 .3 4% ) (p =0 .0 49)。在随访 3、6、12及 2 4个月时PTCA组的生活质量计分各自为 :5 9.90± 14 .67、74.40± 12 .86、73 .86± 9.70、82 .47± 10 .47均高于同时期UK组的计分 (分别是 5 2 .0 8± 14 .49、65 .0 0± 14 .72、67.0 2     

驼背二种截骨术远期效果对比

作者对６３２例强直性脊柱炎并驼背畸形施行二种脊柱截骨矫治术，对其中１３５例病人进行了６～１０年观察，结果表明：７１例椎弓椎体联合截骨效果较好，驼背复发平均３．２°。而６４例椎板截骨效果略差，驼背平均复发１３．５°。经统计学处理，两者对比有显著的统计学意义（ｐ＜０．０１）。作者认为病变未完全静止，截骨术式的选择，术中身体重心前移未彻底纠正，以及外固定时间过短等是影响远期效果的因素。