Congenital Heart Disease in Adolescents With Gluteal Muscle Contracture

Gluteal muscle contracture (GMC), presented with hip abduction and external rotation when crouching, is common in several ethnicities, particularly in Chinese. It remains unclear that the reasons why these children are weak and have no choice to accept repeated intramuscular injection. Here, we found some unique cases which may be useful to explain this question.We describe a series of special GMC patients, who are accompanied with congenital heart disease (CHD). These cases were first observed in preoperative examinations of a patient with atrial septal defect (ASD), which was proved by chest X-ray and cardiac ultrasound. From then on, we gradually identified additional 3 GMC patients with CHD. The original patient with ASD was sent to cardiosurgery department to repair atrial septal first and received arthroscopic surgery later. While the other 3 were cured postoperative of ventricular septal defect (VSD), tetralogy of fallot (TOF), patent ductus arteriosus (PDA), respectively, and had surgery directly.The study gives us 3 proposals: (1) as to CHD children, it is essential to decrease the use of intramuscular injection, (2) paying more attention to cardiac examination especially cardiac ultrasound in perioperative period, and (3) taking 3D-CT to reconstruct gluteal muscles for observing contracture bands clearly in preoperation. However, more larger series of patients are called for to confirm these findings.     

逍遥散治疗经前期综合征69例

逍遥散出自《太平惠民和剂局方》，由当归、白芍药、柴胡、茯苓、白术、炙甘草、薄荷、煨姜组成。经前期综合征为临床常见的妇科病症，笔者近年来采用逍遥散加减治疗经前期综合征69例，疗效满意，现报道如下。     

Update on the management of neuromuscular block: focus on sugammadex

Steroidal neuromuscular blocking agents (NMBAs), such as rocuronium, are widely used in clinical anesthesia and emergency medicine to facilitate endotracheal intubation and artificial ventilation and to allow surgical access to body cavities. Reversal of neuromuscular blockade is important for the acceleration of patient recovery and prevention of postoperative residual neuromuscular blockade and reduces the incidence of severe morbidity and mortality associated with anesthesia management. Sugammadex is the first selective relaxant binding agent (SRBA) and has been designed to reverse the steroidal neuromuscular blocking drug rocuronium. Encapsulation of the rocuronium molecule by sugammadex results in a rapid decrease in free rocuronium in the plasma and subsequently at the nicotinic receptor at the motor endplate. After encapsulation, rocuronium is not available to bind to the nicotinic receptor in the neuromuscular junction. This promotes the liberation of acetylcholine receptors, and muscle activity reappears. This new concept of reversal of neuromuscular block induced by rocuronium (or vecuronium) led to impressive results in animal and phase 1 and 2 studies. Sugammadex is currently in phase 3 clinical studies and may be commercially available by 2008.     

股骨假体周骨折治疗方法的探讨

目的 探讨股骨假体周骨折不同处理方法的临床应用价值。方法 对16例股骨假体周骨折分别采用钢丝、钢板螺钉、环抱器固定和更换长柄假体植入方法处理．总结分析其相关临床资料。结果 16例病人术后随访4～14个月．平均6个月，全部病例骨折愈合，功能恢复良好。髋关节功能评定：90分以上3例、80～89分9例、70-79分3例、63分1例，优良率达75％。结论 股骨假体周骨折类型不同，处理方法应不同：股骨颈端到小粗隆下缘的劈裂骨折，采用钢丝捆扎；全劈裂骨折移位明显，更换较小型号的假体，再用钢丝捆扎固定并植骨；小粗隆下缘到股骨干髓腔狭窄段的上缘骨折，选用长柄假体植入再用钢丝捆扎，假体远端加锁固定或选用环抱器固定；股骨干髓腔狭窄段以下的骨折，采用钢板固定或环抱器固定并植骨。     

大白鼠皮肤Ⅱ度、Ⅲ度碱烧伤模型复制

目的 根据大白鼠皮肤碱烧伤创面早期病理组织学观察复制Ⅱ、Ⅲ度碱烧伤模型,研究碱烧伤的临床治疗.方法 Wistar纯种健康大白鼠20只,以不同浓度2mol/l、2.5mol/l、5mol/lNaOH,作用时间分别为30秒、45秒、60秒、75秒,涂抹于脱毛后的表皮.结果 2mol/L(60s)、2.5mol/L(45s),5mol/L(30s)即可直接造成Ⅱ度～深Ⅱ度烧伤;2mol/L(75s)、2.5mol/L(60s)、5 mol/L(45s)即可造成Ⅲ度烧伤,其烧伤深度与NaOH溶液浓度和作用时间呈正比.结论 Ⅱ度、Ⅲ度碱烧伤均为渐进性烧伤,与文献中介绍的潜拙样损伤似乎不同.另外,不同浓度NaOH溶液在相同时间对皮肤组织的损伤及同一浓度NaOH溶液在不同时间对大白鼠皮肤的损伤病理学变化均有差异.     

Incompatibility of contrast agents with intravascular medications. Work in progress

In vitro and in vivo precipitation of iodinated contrast agents when ioxaglate and papaverine are given together has been reported. To verify these reports and to investigate other medications not previously tested, the authors analyzed mixtures of contrast agents and medications in vitro with a light spectrophotometer and observed them for visible precipitates for up to 120 minutes. Previously reported incompatibilities between ionic or low-osmolality contrast media and medications were verified, and several new incompatibilities were discovered. No incompatibilities were found when the drugs tested were mixed with the new nonionic contrast media.     

南京口岸1987—1993年艾滋病监测报告

本文报道了南京卫生检疫局1987～1993连续7年对南京口岸重点人群进行艾滋病监测的情况．7年来南京局共监测各类标本43085份，在外籍留学生中检出HIV感染者2例，另外还检出4份进口人血丙种球旦白HIV抗体阳性．该局对检出的2侧HIV感染者及4份阳性进口人血丙种球旦白进行了游行病学调查和处理．并对艾滋病监测管理的有关问题进行了探讨．