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Experimental Study of Dexamethasone Treating in Non-freezing Cold Injury of Sciatic Nerves

ObjectiveTo observe the changes of microstructure of rats'sciatic nerves with non-freezing cold injury after treated with dexamethasone. MethodsTwelve male Wistar rats were randomly divided into cooling group and treating group.Unilateral sciatic nerves of the rats in the cooling group received cooling treatment with 3-5℃ for 2 hours;while unilateral sciatic nerves of the rats in the treating group received cooling treatment with 3-5℃ for 2 hours and underwent the celiac injection with dexamethasone in addition.The other sciatic nerves were exposed,as the control.The bilateral sciatic nerves of rats in each group were harvested after 24 hours.The microstructure of nerves was examined under the light microscope and electron microscope. ResultsLight microscopic examination revealed extensive myelinated fibre degeneration in form of giant empty axons or shrunken dark axons on the first day after cooled.And the endoneurial capillary lumen was narrowed because of swollen endothelial cells.After the treatment,myelinated fibre degeneration was still similar to that before the treatment,but the endoneurial capillary lumen and endothelial cells were normal.By electron microscopy,sciatic nerves showed extensive myelinated fiber degeneration,and swollen endothelial cells.But unmyelinated fibers and tight junction were preserved on the first days after cooled.Aggregated red cells and platelet thrombus were not found.After the treatment,myelinated fibre degeneration was still similar to that before the treatment.Unmyelinated fibers and tight junction were preserved.The endoneurial capillary lumen and endothelial cells were normal. ConclusionAfter the treatment,the damage of endoneurial capillary had improved,but myelinated fiber degeneration was similar to that before the treatment.It suggested that dexamethasone may only improve the vascular system in non-freezing cold injury of sciatic nerve.

黏蛋白1与卵巢癌关系的研究进展

卵巢癌是女性生殖系统的第二大恶性肿瘤，在各类女性生殖系统恶性肿瘤中病死率居于首位。黏蛋白（MUC）1是近年来引起广泛关注的用于诊断早期卵巢癌的标志物之一。研究发现，MUC可以充当细胞表面受体和传感器，传递信号刺激细胞反应，如细胞增生、分化和凋亡，异常的MUC表达提示卵巢癌的发生和发展。MUC在卵巢上皮性肿瘤是潜在的肿瘤标志物，在卵巢癌的诊断、治疗及预后判断中可能发挥重要作用。MUC1为一种膜结合型MUC，目前关于MUC1和卵巢癌的研究较多，现就MUC1与卵巢癌关系研究进展进行综述。

乳腺癌根治术后3种包扎方法比较

胆道术中发现门静脉海绵样变1例报告

Analysis and Strategy of Working Pressure of Neurosurgical Nurse

目的:调查分析神经外科护士工作压力因素,采取相应对策以减轻压力,积极应对工作。方法:采用问卷调查法,对在神经外科工作的护士工作压力程度,工作压力源,压力源前五位,与其它科室护士进行比较,并通过统计学方法进行分析。结果:神经外科护士工作压力程度以重度压力为主。排序前5位的压力源为:工作量大,担心工作出差错,社会地位低,上班护士数量少,护理的患者病情过重。结论:正确分析神经外科护士工作压力因素,采取有效的对策,对于提高护理质量,保障护理安全,具有十分重要的意义。

除了酒驾和毒驾，还有病驾−癫痫与驾驶

创伤性脾破裂90例报告

两种消毒法在颈内静脉置管中的效果比较

目的研究对比安尔碘皮肤消毒剂在颈内静脉置管患者中喷雾消毒和涂擦消毒的效果。 方法2013年5月－6月选取颈内静脉置管患者100例，将其随机分为试验组和对照组各50例。试验组采用先喷雾消毒，再打开颈内静脉穿刺包铺手术巾穿刺；对照组采用先打开颈内静脉穿刺包后涂擦消毒，再铺手术巾穿刺。两组分别在消毒前后进行皮肤采样，并就采样结果进行比较。 结果两组患者消毒后细菌数均为0 cfu/cm2，在穿刺后皮损情况的发生率差异无统计学意义（P＞0.05）；在消毒液用量、消毒时间、操作时间上，试验组明显优于对照组（P＜0.05）。 结论对于需颈内深静脉置管的患者，安尔碘皮肤消毒剂喷雾消毒与涂擦消毒后检测结果均合格，两种消毒方式效果无明显差异，且喷雾消毒所用消毒液量明显比常规涂擦消毒少，操作所用时间短。

原发于中枢神经系统淋巴瘤的眼内淋巴瘤1例

股前外侧皮瓣在口腔肿瘤术后缺损修复中的初步应用

目的 总结股前外侧皮瓣（anterolateral thigh flap，ALT）修复口腔肿瘤切除术后缺损的临床效果。方法 2005 年6 月－ 2007 年6 月，采用ALT 修复14 例口腔癌术后缺损。男8 例，女6 例；年龄21 ～ 69 岁。下牙龈鳞癌3 例，侧口底鳞癌3 例，上腭或上牙龈鳞癌3 例，上腭黏液表皮样癌不全术后1 例，舌根鳞癌4 例。病程1 ～ 5 个月。分别采用单纯手术6 例，诱导化疗、手术联合放疗5 例，手术联合放疗3 例。肿瘤切除后缺损范围6 cm × 4 cm ～ 12 cm × 9 cm，皮瓣切取范围7 cm × 5 cm ～ 14 cm × 10 cm。供区直接缝合。术中1 例发现穿支血管缺如，1 例损伤穿支血管改用前臂皮瓣。 结果 术后14 例皮瓣均成活，供、受区切口均Ⅰ期愈合。14 例均获随访，随访时间5 ～ 29 个月。皮瓣外形均满意，吞咽、发音等功能恢复良好。1 例上腭癌术后6 个月复发，放疗后至今带瘤生存8 个月；1 例上腭癌术后5 个月出现第3 原发癌，化疗后生存8 个月；其余12 例无瘤生存。 结论 ALT 手术成功率较高，组织量丰富，适用于较大缺损修复，对供区影响小，修复后受区功能良好，可安全地用于口腔软组织缺损修复。