44例老年重症哮喘的院前急救体会

目的探讨老年重症哮喘急性发作的院前急救措施。方法在常规平喘治疗基础上,治疗组用甲基泼尼松龙80mg加入5%葡萄糖溶液(0.9%氯化钠溶液)40ml中静脉注射,对照组用地塞米松10mg加入5%葡萄糖溶液(0.9%氯化钠溶液)20ml中静脉注射,观察治疗前、后两组患者临床疗效评分变化。结果治疗组比对照组起效快,疗效好,两组疗效间差异有显著性意义(P<0.01)。结论甲基泼尼松龙是老年重症哮喘院前急救的首选方法,尽早使用,有利于提高抢救成功率。     

便携式负压吸引装置的设计及材料学特点

对负压吸引装置便携方式的研究一直是急救医学追求的目标之一，因为它能够极大地促进急救成功率。文章基于这种需要，研制了一套便携式负压吸引装置，并根据实际应用效果，选择优化的制造材料。研制的便携式负压吸引装置主要由特殊设计的储液罐及罐盖、负压产生装置、过渡接头等部分组成，关键部件采用特殊材料制作，体积小，质量轻，操作简单，易于携带，完全能满足临床抢救及治疗的需要。作为一种急救中必不可少的器械，便携式负压吸引装置在急救伤病员运输、转运，家庭急救，及无动力源环境等情况下，对于抢救患者及提高救治效果，具有极大的竞争优势和应用前景。     

足底深支或(和)第一跖背动脉逆行足背岛状皮瓣的临床应用

目的探索足部远端软组织缺损修复的较佳方法。方法采用足底深支或(和)第1跖背动脉逆行足背岛状皮瓣对6例足部远端软组织缺损创面进行修复。结果6例患者均一次性修复,软组织缺损最大面积8cm×6cm,术后随访1~4年,足部功能与外观均较满意。结论足底深支或(和)第1跖背动脉逆行足背岛状皮瓣血管解剖比较恒定,操作简单,是修复足远端软组织缺损的较好方法。     

整合出版资源 迎接国际性竞争

笔者指出需从整合出版权资源、整合出版人才资源、整合作者资源、整合读者资源、整合版权资源、整合发行资源6个方面来加强我国出版业在整体上的实力，来迎接即将到来的国际性竞争。     

Combined evaluation of first pass radionuclide angiography and equilibrium radionuclide ventriculography in the diagnosis of coronary artery disease

Results of 203 patients who underwent first pass radionuclide angiography (FP) and quantitative equilibrium radionuclide ventriculography (qERNV) were stored in a data base system and evaluated statistically. Eighty eight of these patients also underwent exercise equilibrium radionuclide ventriculography (E-qERNV). In patients with coronary artery disease (CAD) without previous myocardial infarction (MI), evaluation of global and regional ejection fraction (gEF, rEF) at rest revealed a poor sensitivity of 64%, the specificity was about 71% (qERNV). FP at rest revealed similar values of sensitivity (69%) and specificity (83%). Additional assessment of stress induced changes of gEF, significantly (P<0.05) improved sensitivity of qERNV in CAD patients without a history of previous MI to 84% (specificity 86%). In patients with one previous MI, however, similar values of sensitivity were found (RFP: 87%, R-qERNV: 84%, E-qERNV: 93%). In patients with several MI's, sensitivity was above 90% at rest and during exercise (R-FP: 96%, R-qERNV: 93%, E-qERNV: 100%).     

第一掌背动脉双叶皮瓣在手外科中的应用

我们设计主要以第1掌背动脉为蒂的手背双叶皮瓣,同时修复两个部位的手部皮肤缺损和拇指再造,共10例均获成功。皮瓣面积最小10cm×3cm,最大13cm×5cm,蒂宽1.5cm×2.5cm。皮瓣每叶面积最小为3.5cm×2cm,最大6cm×3cm。文中介绍了本皮瓣的解剖学基础,并对其手术适应证和优缺点进行了讨论。     

Plasma concentrations and bioavailability of propranolol by oral, rectal, and intravenous administration in man

Eight normal male volunteers received 80 mg doses of propranolol by the oral and rectal routes and 2.2 mg by intravenous administration in a crossover fashion. Plasma concentrations of propranolol were measured by a gas chromatographic method using an electron capture detector. Individual subject concentration-time data were analysed and results indicated that the data fit a two compartment model with first order absorption. An approximately two-fold higher plasma propranolol concentration was observed after rectal administration as compared with oral dosing. Statistical analysis of the difference in the total AUCs indicates a significantly higher bioavailability of propranolol administered by the rectal route. The reduced bioavailability after oral administration indicates a substantial first pass effect but that it is possible to bypass the liver, at least partially, by giving the drug rectally to man.