不同缝合方式对大鼠角膜穿通伤后内皮细胞影响的研究

目的:通过手术缝合治疗大鼠角膜穿通伤,探索全层缝合、深板层缝合、及不缝合对角膜内皮细胞的影响.方法:建立大鼠角膜穿通伤模型,同一手术者对角膜切口进行全层、深板层、及不缝合操作.在裂隙灯下动态观察角膜创伤愈合情况;对不同时间点愈合角膜行内皮细胞台盼蓝-茜素红联合活细胞染色及HE染色,观察内皮细胞损伤、修复及白细胞浸润情况.结果:无论是全层缝合还是板层缝合以及不缝合组角膜内皮细胞均损伤明显.但从第1天观察至1月,三组损伤区面积大小无明显差别.结论:全层和深板层缝合及未缝合组可直接造成角膜内皮细胞受损,继发性炎症反应损伤后角膜内皮细胞的损害;伤口周围1.5 mm处角膜内皮几乎损失殆尽,内皮细胞受损可使角膜损伤区水肿迁延不愈,最终形成瘢痕愈合,所以角膜内皮损伤及最终愈合程度三组间无明显差异.     

Intussusception in a Florida manatee.

An intussusception resulting from an embedded fishhook and a mass of nylon cord, monofilament line, and wire was determined to be the cause of death in a Florida manatee (Trichechus manatus latirostris). Pathologic findings are given along with information on bacteria (Edwardsiella tarda), pesticide residues (DDE, PCB's and dieldrin), and parasites (Chiorchis fabaceus).     

The Management of Abdominal Injuries in the Presence of Head Injury

When head and blunt abdominal injuries are combined, the head injury is often afforded too much attention and the abdominal injury too little, especially when the patient is unconscious. If mismanaged, the abdominal injury is often the more serious threat to life. Except for extradural hemorrhage, neurosurgical intervention, when indicated, can be delayed until the patient has been thoroughly evaluated for the presence of extra cranial injuries with higher therapeutic priority.Abdominal examination of the unconscious or uncooperative patient is difficult. Tenderness as a sign of abdominal injury cannot be elicited. Abdominal rigidity (in the absence of rigid extremities), a silent abdomen, shock, and extreme restlessness may indicate intra-abdominal changes. Abdominal paracentesis is a valuable diagnostic aid, and the finding of blood, bile-stained fluid, intestinal contents or air is an indication for immediate laparotomy. Once all injuries are known, priorities for treatment can be assigned. Often head and abdominal injuries can be treated concomitantly.