下肢复杂骨折交锁髓内钉治疗粉碎骨折螺钉辅助固定的意义

[目的]探索在交锁髓内钉治疗下肢复杂骨折中粉碎骨折块辅助固定的意义。[方法]下肢复杂骨折78例根据AO分型均为C型骨折，通过交锁髓内钉内固定，辅以拉力螺钉固定。[结果]术后摄片骨折及骨折块达解剖或功能复位，随诊6～24个月，优良率为94．88％（74／78例）。[结论]四肢复杂骨折治疗中，粉碎骨折块的螺钉辅助固定能够加强交锁髓内钉的稳定性，减少断钉、断棒现象，有利于骨折愈合。     

透明质酸钠与带蒂筋膜脂肪片预防椎管粘连157例临床观察

目的:讨透明脂酸钠与带蒂筋膜脂肪片联合应用预防椎管粘连的可行性。方法:板切除减压,病灶摘除后,将透明脂酸钠2～4ml注入硬膜周围,后用带蒂筋膜脂肪片覆盖椎版缺损处。结果:57例术后随访6～64个月,优良率98%。结论:明脂酸钠与带蒂筋膜脂肪片联合应用为预防椎管粘连的有效方法。     

Is endoscopic one‐piece mucosal resection essential for early gastric cancer?

Background: Endoscopic mucosal resection (EMR) is widely accepted as a minimally invasive treatment for early gastric cancer (EGC) in Japan. However, the criteria for EMR must be strictly adhered to otherwise patients will miss the chance for additional therapy. We assess the important factor in expanding the indication of EMR. Methods: We investigated 1101 EGCs that had been resected by EMR at the National Cancer Center Hospital (NCCH), Tokyo, Japan, according to the indication recommended by Japanese Gastric Cancer Association (JGCA) and the expanded indication proposed by NCCH. Curability and local recurrence of the EMRs were assessed related to the applied indication and the number of resected specimens. Results: The recurrence rate of non‐evaluable resection was higher than that of evaluable resection (P < 0.0001). Eighty‐three lesions among 772 lesions in the JGCA group were non‐evaluable. Thirty‐seven leisons among 329 lesions in the NCCH group were non‐evaluable. There was no difference in the rate of non‐evaluable resection between JGCA and NCCH groups (P = 0.8329). However, the rate of curative resection was lower in the NCCH group than in the JGCA group (P = 0.0009). In piecemeal resection, there was no difference in the rate of non‐evaluable resection between JGCA and NCCH groups (P = 0.0527). In one‐piece resection, the rate of non‐evaluable resection was lower in the NCCH group than the JGCA group (P = 0.0137). Conclusion: Based on our series of cases, we propose one‐piece resection as a gold standard for EMR because it enables accurate histological evaluation, even in the EMR, according to the expanded indication.     

Biomonitoring of benzene exposure by trace analyses of phenylguanine

Summary From preliminary experiments it was known that radiolabelled benzene and some of its metabolites during its metabolic activation process produce different in vitro DNA-phenyladducts in mitoplasts [5, 11].As we reported previously [9] at least one of these adducts, N-7-phenylguanine, is excreted in the urine of rats in measurable amounts, probably through an excision-repair mechanism after an inhalation experiment. Now we found, after i.p. application of benzene in the urine of rats, a compound separated by cation-exchange chromatography that behaves like a synthezised N-7-phenylguanine reference substance with respect to its retention index and the UV-absorption. This finding could be confirmed by HPLC-measurements with reversed-phase carrier materials. Silylation and gaschromatographic/mass spectrometric (GC/MS) separation of the fraction, which contains the phenylguanine, revealed that these fractions contain further phenyl adducts. Furthermore we studied the time-dependent excretion of the DNA-base adduct. Surprisingly the excretion dropped to zero on the fourth day and showed a new increase thereafter.     

佛山市城区室内装修污染特征初探

目的 为了解佛山市室内装修空气污染状况，通过对佛山市室内装修污染物进行调查，掌握室内装修污染的一些基本特征并提出控制措施。方法 根据卫生部《室内空气质量卫生规范》以及《室内空气污染物的检验方法》方案，调查采用了问卷调查和现场检测的方法。结果 佛山市室内装修空气污染物主要为甲醛，苯，总挥发性有机物(TVOC)，超标率分别为86％，36％，23％。结论 目前佛山市城区室内装修污染物的特征为：有机污染较无机污染严重，室内甲醛污染严重，苯次之而氢污染相对较轻，室内空气苯污染车辆、居室高于办公室，甲醛污染居室，办公室高于车辆。     

氨氯地平与尼群地平治疗高血压的多中心平行对照研究

采用多中心、随机、单盲、组间、平行对照的方法对488例原发性高血压患者进行氨氯地平或尼群地平4周治疗观察，显示氨氯地平的降压有效率为90．4％，较尼群地平显著为高。不良反应较少，安全性好。每日只需服药1次，剂量5～10mg，方便病人。     

接触乙烯类或苯类对孕妇及新生儿姊妹染色单体交换和微核的影响

取因职业而接触乙烯类或苯类的孕妇静脉血和他们新生儿脐带血进行ＳＣＥ和ＭＮ测定。发现接触乙烯类或苯类的母血ＳＣＥ（８．５５±０．８４，９．４４±１．１２）均高于对照组（７．６８±１．４０），他们新生儿脐带血ＳＣＥ（８．９４±１．４３，８．７５±０．８８）也高于对照组（６．７１±１．２７）。接触乙烯类和苯类的母血微核率（０．８３３‰，０．７２７‰），高于对照组（０．２６７‰），他们新生儿脐血微核率（０．７５‰，０．８１８‰）也高于对照组（０．２６７‰）。我们还发现母亲孕期被动吸烟增强了这两类诱变剂对他们后代的遗传毒性。     

天津市和平区苯作业场所空气中苯浓度调查

目的：了解苯作业场所空气中苯浓度,推测苯作业发展趋势,方法：采用和平区1993－1999年39家工业企业,220个苯作业点,660个空气样品中的苯浓度值,按不同作业工种分为油漆组,化工（原料）组,粘胶组及印刷组,通过成组设计的多个样本比较的秩和检验进行分析。结果：1997年内不同作业组空气中苯平均浓度差异有显著性（H＝8．00000 P＜0．05）,印刷组苯平均浓度高于其它作业组,其余年度中差异无显著性（P＞0．05）,1993－1999年,印刷组苯作业场所的苯平均浓度差异无显著性（P＞0．05）,结论：和平区苯作业开始由较低浓度过渡到较高浓度,以油漆业为主过渡到以印刷业为主,并且,1997年印刷组苯平均浓度超过国家卫生标准,应引起重视。     

Immediate rehabilitation of a rheumatoid arthritis patient with single-piece implants

Introduction and importanceThe aim of this article is to report the long-term outcome of full mouth rehabilitation with single piece, smooth surface implants following immediate loading protocol on a patient suffering with RA and severe unilateral condylar resorption.Case presentationHere, we present a challenging case of a patient suffering from Rheumatoid Arthritis who was stabilized and completed successfully with a 4 year follow-up period. Prosthetic management optimized the inter-occlusal relationship to maintain both function and esthetic integrity. Single piece implants are designed to engage and take support from the cortical bone low in metabolic activities thus promoting the force transmission through apical threads that are engaged in the cortical bone.DiscussionRheumatoid Arthritis [RA] is an auto-immune inflammatory condition in which the inflamed and hypertrophic synovial membrane grows into the articulation surfaces. The Temporomandibular Joints [TM] are frequently involved in rheumatoid arthritis. According to the literature on RA, due to frequent periodontitis, decreased salivary secretion, medication, as well as decrease in bone regenerative potential, RA is often considered as a relative contraindication in the use of implants. Atrophic jaws and cases with comorbidities like osteoporosis, diabetes, rheumatoid arthritis, periodontally infected cases are restored with high success by single piece smooth surface.ConclusionTo the best of our knowledge, this may be the first case of immediate functional loading by bi-cortical single piece implants.     

氨氯地平与非洛地平缓释剂治疗原发性轻、中度高血压的随机、双盲平行对照研究

目的:对比氨氯地平与非洛地平缓释剂治疗轻中度原发性高血压的疗效和安全性;每日1次服药对24小时动态血压的影响;并对比药物漏服对血压控制的影响。方法:76例轻、中度高血压患者被随机、双盲分成两组,分别每日口服1次氨氯地平5～10mg(Ⅰ组)或非洛地平缓释剂5～10mg(Ⅱ组),治疗12周,并用24小时动态血压监测评价用药前后24小时血压变化情况及漏服48小时的血压变化。结果:氨氯地平治疗组舒张压降低15.1mmHg(治疗末为84.8mmHg),非洛地平缓释剂治疗组舒张压降低15.3mmHg(治疗末为85.0mmHg)。总有效率Ⅰ组病人为83.8％,Ⅱ组为87.9％(P=NS)。在药物的初始剂量下即能达到有效血压控制的病人数Ⅰ组为76％,Ⅱ组为52％(P<0.01)。药物漏服24和48h后,Ⅰ组临床血压仍低于140/90mmHg,24小时动态血压与漏服前相比无显著性差异,而Ⅱ组的临床血压高于140/90mmHg,临床血压和24小时动态血压与漏服前相比具有显著性差异。两治疗组的副作用发生率均较低。结论:氨氯地平与非洛地平缓释剂均能有效降低轻、中度高血压病人的血压,安全、疗效可靠,病人耐受性好,但漏服试验表明漏服24与48h氨氯地平仍能较好的控制血压。Ⅰ组的血压波动明显低于Ⅱ组。