使用便携式微量输液泵持续输注氟尿嘧啶的临床观察及护理

目的：探讨使用便携式微量输液泵在肿瘤化疗中持续输注氟尿嘧啶的应用效果。方法：选取我科2006年3月-2008年7月96例癌症化疗病人按入院先后顺序分为对照组和实验组,每组48例。对照组采用传统的化疗方式,采用浅静脉留置针直接从外周静脉输注氟尿嘧啶（5-Fu）连续5天,每天维持6-8小时。实验组采用浅静脉留置针连接便携式微量输液泵持续泵入氟尿嘧啶（5-Fu）120h～135h,两组均以21天为1个周期,观察两组病人化疗毒副反应发生情况。结果：实验组化疗毒副反应发生率明显低于对照组,平均住院时间明显缩短,两组比较差异有统计学意义（P〈0.01）。结论：使用便携式微量输液泵持续泵入氟尿嘧啶能减轻病人的毒副反应,缩短住院时间,提高肿瘤病人生活质量,有效减轻护士的工作负担。     

腹腔镜胆囊切除术后钛夹在腹腔内异位的观察

目的　观察腹腔镜胆囊切除术 (LaparoscopicCholecystectomy ,L .C)后钛夹在腹腔内异位。方法　前瞻性对2 0 0 2年 1～ 5月间 6 0例L .C病人进行追踪观察临床表现 ,采用B超、腹部X线检查等方法 ,观察钛夹位置的变化与肝外胆管的关系。结果　 6 0例L .C后病人中 5例钛夹发生位置改变。结论　①钛夹在体内 ,对胆道无压迫、无胆漏 ;②观察钛夹异位 ,以采用B超为最简单、经济的方法。     

雾化吸入二性霉素B治疗肺部霉菌感染的临床观察

采用雾化吸入二性霉素Ｂ治疗肿瘤合并肺部霉菌感染１６例，与静脉滴注二性霉素Ｂ相比较，有显著性差异（Ｐ＜０．０５），且毒副作用小，患者易于接受。     

Two selective 5-HT1A receptor antagonists, WAY-100 635 and NDL-249, stimulate locomotion in rats acclimatised to their environment and alter their behaviour: a behavioural analysis

The aim was to study firstly, the motor effects of a new 5-HT_1A antagonist, NDL-249 [(R)-3-(N-cyclopentyl-N-propylamino)-8-fluoro-3,4-dihydro-2H-1-benzopyran-5-carboxamide hydrochloride] and of the reference 5-HT_1A antagonist WAY-100 635 [N-(2-(1-(4-(2-methoxyphenyl)piperazinyl))ethyl)-N-(2-pyridinyl) cyclohexanecarboxamide trihydrochloride], in comparison to the 5-HT_1A agonist (±)-8-OH-DPAT [(8-hydroxy-2-(di-N-propylamino) tetralin, hereafter 8-OH-DPAT], in rats acclimatised to the automated activity cages; secondly, to study whether the behavioural effects of NDL-249 and 8-OH-DPAT are sensitive to the 5-HT depleting effects of p-chlorophenylalanine (PCPA); thirdly, to characterise the nature of the antagonist-induced activation seen in the automatic activity cages with the aid of a behavioural observation analysis; fourthly, to examine the interaction between the 5-HT_1Areceptors mediating the behavioural effects and dopamine (DA) receptors. NDL-249 was found to bind in vitro to rat hippocampal 5-HT_1A receptors with high affinity and selectivity. In second messenger studies, it was devoid of agonist-like effects. In the locomotor activity studies, each antagonist significantly increased the incidence of horizontal activity, peripheral activity and rearing. 8-OH-DPAT, while significantly increasing peripheral and horizontal activities, decreased the incidence of rearing. PCPA blocked the motor effects of NDL-249 but did not affect those of 8-OH-DPAT. Observational analyses indicated that NDL-249 induced significant increases at one or more doses in sniffing, rearing and locomotion together with a significant reduction in stillness. WAY-100 635 significantly increased the incidence of rearing, intense grooming and vacuous chewing. The significant increases in sniffing, grooming and intense grooming and the significant decrease in stillness induced by the DA D₁ agonist, SK&F 38393 [(±)-1-phenyl-2,3,4,5-tetrahydro-(1H)-3-benzazepine-7,8-diol hydrochloride], were not altered by concomitant pre-treatment with NDL-249. Pre-treatment of rats with either the DA D₁ antagonist SCH-23390 (2,3,4,5-tetrahydro-3-methyl-5-phenyl-1H-3-benzazepin-7-ol) or the DA D₂ antagonist, raclopride, blocked the reduced stillness and increased sniffing and rearing induced by NDL-249. In conclusion, 5-HT_1A antagonists including the new selective antagonist, NDL-249, induce mild behavioural activation in rats, which is mediated probably indirectly via DA systems. Received: 3 April 1997/Final version: 23 February 1998     

Patellofemoral joint cartilage restoration with particulated juvenile allograft in patients under 21 years old

BackgroundPatellofemoral joint cartilage defects are difficult to treat due to their unique thickness and topography.PurposeTo report the postoperative outcomes of patients age 21 and younger treated with particulated juvenile allograft cartilage (PJAC) for full-thickness cartilaginous defects of the patellofemoral joint. The primary aim was to report surgical outcomes and complication rates, as well as return to sport activity. A secondary aim was to provide objective scores of defect restoration by magnetic resonance imaging (MRI) assessment.MethodsA retrospective review of all PJAC cases conducted between 2012 and 2019 at a single tertiary care urban musculoskeletal institution was conducted. Patients 21 years old or younger with minimum clinical follow up of 1 year and postoperative MRI at a minimum of 6 months were included. Cartilage restoration by MRI was independently assessed using the International Cartilage Repair Society’s (ICRS) standardized system.ResultsThirty four patients, 36 knees, were included, with mean age 16.1 ± 3.1 years old. Return to sport rate among patients who participated in a sport preoperatively was 100%. On independent MRI assessment, two thirds of defects achieved an overall grade of normal or nearly normal, while 28 patients (78%) had majority defect fill. Primary graft failure occurred in two cases and one patient experienced a surgical complication.ConclusionRestoration of patellofemoral chondral defects in young patients with particulated juvenile allograft results in satisfactory short-term outcomes and postoperative MRI appearance, along with high rates of return to sport and low rate of complications and graft failure.What is known about the subject: Patellofemoral joint cartilage defects are difficult to treat due to their unique thickness and topography. Several cartilage restoration techniques are available, but these rarely achieve the same mechanical properties as native hyaline cartilage. PJAC is a cell-based technique that has demonstrated promise since its introduction in 2007.What this study adds to existing knowledge: This series of patients adds the largest single cohort of pediatric and adolescent patients who receive PJAC for defects of the patellofemoral joint. Surgeons treating patients in this age group should be aware of every technique, and their respective outcomes.     

评“McCall观察方法”——对一种色谱系统分配效果观察方法的商榷

本文通过理论分析和文献数据的分析,对McCall提出的色谱系统分配效果的观察方法提出了不同的看法,认为McCall方法中的所谓logK并不是常数。McCall的方法无论在理论上和实践上都是不妥的。     

胞二磷胆碱治疗轻度脑梗塞急性期52例的疗效分析

目的　探讨在轻、中度脑梗塞急性期使用胞二磷胆碱的临床疗效。方法　本文选择轻度脑梗塞急性期5 2例 ,在使用抗凝、溶栓治疗的基础上加用胞二磷胆碱作治疗组 ,另选择 31例不加用胞二磷胆碱作对照组进行临床疗效观察。治疗组使用胞二磷胆碱 0 .5加入 10 %葡萄糖注射液 2 5 0ml,一日一次 ,静滴 ,十天为一疗程 ,连用 1-3个疗程。结果　治疗组有效率为 92 .31% ,其中显效率 36 .5 4% ;对照组 5 4.84% ,显效率 16 .13% ,显著低于治疗组 (P <0 .0 1)。疗程观察以第三个疗程为宜 ,其有效率占治疗组有效率的 5 8.33%。结论　胞二磷胆碱在脑梗塞急性期使用 ,主要是促进脑梗塞可逆性组织损伤的恢复 ,防止脑缺血后改变的加重 ,使脑细胞活化 ,促进脑细胞机能的修复 ,是一种既安全可靠 ,又经济实用的脑细胞活化剂。     

肠内引流式胰十二指肠肾联合移植术后患者的观察

目的：对胰肾联合移植治疗胰岛素依赖型糖尿病合并肾功能衰竭患者进行术后观察。方法：为1例胰岛素依赖型糖尿病合并肾功能衰竭的患者施行胰液肠内引流式胰十二指肠肾一期联合移植术。结果与结论：通过细致严密的临床观察,可早期发现移植胰血管检塞、消化道出血、胰腺炎及肠瘘等术后并发症,及时治疗,改善预后。     

病毒唑治疗成人麻疹临床疗效观察

目的 了解病毒唑治疗成人麻疹的效果及安全性。方法 随机对照试验。结果 治疗组退热时间较对照组缩短２天,有显著性差异（Ｐ＜０．０１）,治疗组开始退疹时间较对照组缩短０．７天,差异有统计学意义（Ｐ＜０．０５）,治疗组住院时间对照组缩短２天,无血液学、肾脏或肝脏方面的毒副反应。结论 病毒哇治疗成人麻疹有改善成人麻疹患者病情和缩短退热时间和病程的作用,且无毒副作用。     

手掌部浅血管神经层与屈肌支持带关系的观测

目的：为腕管松解术及掌中间隙引流术提供解剖学基础。方法：１８例（男１２、女６）３６侧成人固定上肢标本上对手掌部屈肌支持带、正中神经、尺神经在胱掌部分支点和掌浅弓最高点与屈肌支撑带下缘的距离以及足动脉终末支与正中神经间距观察。结果：正中神经掌部分支点距屈肌支持下缘９±３ｍｍ。尺神经掌部分支点距屈肌支持带下缘５±２ｍｍ。正中神经于与尺动脉终末间距为１０±２ｍｍ。结论：在手掌部裳托肌腱与第三指蹼尺侧缘