原发性肾病综合征继发甲状腺功能减退18例临床分析

目的探讨依诺沙星治疗老年下呼吸道细菌感染的疗效及安全性.方法依诺沙星组用量0.2g/次,2次/d;头孢噻肟组2.0g/次,2次/d,均静脉滴注,疗程7～14天.结果依诺沙星组痊愈率、有效率、细菌清除株数及副作用发生率与头孢噻肟组比较,无显著性差异(P＞0.05).结论依诺沙星是有效和安全的治疗老年下呼吸道感染抗菌药物.     

莫西沙星序贯治疗老年下呼吸道感染临床观察

目的:评价莫西沙星序贯治疗老年下呼吸道感染的疗效。方法:58例患者随机分为治疗组30例,静脉滴注莫西沙星注射液0.4 g,1次/d;对照组28例,静脉滴注头孢呋辛1.5 g,2次/d,两组症状明显改善后改同类药继续口服,疗程7~10 d。结果:治疗组和对照组的临床有效率分别为93.3%和71.4%,细菌清除率分别为94.4%和76.5%,两组临床有效率及细菌清除率比较差异均有统计学意义(P<0.05);两组不良反应发生率分别为6.7%和7.1%,差异无统计学意义(P>0.05)。结论:莫西沙星序贯治疗老年下呼吸道感染安全有效,有较高的临床价值。     

莫西沙星治疗老年下呼吸道感染疗效分析

目的:探讨莫西沙星治疗老年下呼吸道感染的疗效及安全性.方法:60例老年下呼吸道细菌感染患者,随机分为实验组(30倒)和对照组(30例).实验组给予盐酸莫西沙星氯化钠注射液250 mL,1次/d,静眯滴注;对照组给予盐酸左氧氟沙星氧化钠注射液100 mL,2次/d,静脉滴注:疗程均为7～14d.结果:实验组总有效率93.33%,对照组总有效率66.67%,2组比较差异有统计学意义(P<0.05).实验组的不良反应发生率为10.0%.对照组的不良反应发生率为13.33%,2组比较差异无统计学意义(P>0.05).结论:莫西沙星治疗老年下呼吸道感染安全、有效.     

注射用阿洛西林钠与葡萄糖酸依诺沙星存在配伍禁忌

注射用阿洛西林钠为白色或类白色粉末,属半合成青霉素;葡萄糖酸依诺沙星商品名为天君迪,为白色或类白色疏松块状物或粉末,属喹诺酮类抗菌药。临床工作中发现注射用阿洛西林钠与葡萄糖酸依诺沙星之间存在配伍禁忌,现对1例报道如下。1病历摘要女,31岁。主因尿频、尿急、尿痛4 d,遵医嘱给予生理盐水100 m l 葡萄糖酸依诺沙星0.2 g、生理盐水250 m l 阿洛西林钠6g静脉滴注。当依诺沙星组液滴完更换阿洛西林钠溶液时,输液管内即刻出现乳白色混浊液,及时给予关闭输液通路,更换输液管及液体(生理盐水100 m l)。于2种液体之间间隔输入生理盐水100 m …     

依诺沙星和保妇康栓联合治疗中老年宫颈糜烂疗效分析

目的探讨依诺沙星和保妇康栓联合治疗中老年宫颈糜烂临床疗效。方法将80例宫颈糜烂患者随机分为两组,治疗组40例,口服0.4 g依诺沙星+保妇康栓1.75 g/粒,每晚1粒,放入阴道后穹隆;对照组40例,仅给予单纯的保妇康栓1.75 g/粒,每晚1粒,放入阴道后穹隆。观察两组患者治疗前后的临床症状及疗效改变。结果治疗两个疗程后,治疗组的治愈率为67.5%,总有效率为97.5%;对照组的治愈率为40.0%,总有效率为71.7%,两组比较治疗组明显优于对照组(P<0.01)。两组患者治疗前后临床症状均有明显下降差异均有统计学意义(P<0.05);其中治疗组的白带异常、腰酸、下腹坠胀、接触性出血等症状在治疗后明显优于对照组(P<0.05)。结论依诺沙星联合保妇康栓治疗中老年宫颈糜烂效果显著,是一种有效、安全、便捷的治疗方法。     

穿琥宁与葡萄糖酸依诺沙星存在配伍禁忌

穿琥宁通用名注射用穿琥宁,具有解热和抗感染作用,常用于病毒性肺炎,上呼吸道感染.葡萄糖依诺沙星通用名称注射用葡萄糖酸依诺沙星,具有广谱的抗菌作用.临床上有时将此2种药物联合应用于呼吸道感染,我们在实际t作中发现.穿琥宁(哈尔滨三联药业有限公司)与葡萄糖酸依诺沙星(福建省闽东力捷迅药业有限公司)之间存在配伍禁忌,现报道如下.     

注射用依诺沙星与利巴韦林注射液的配伍稳定性考察

目的考察注射用依诺沙星与利巴韦林注射液配伍的稳定性。方法模拟临床将注射用依诺沙星与利巴韦林注射液在5％葡萄糖中混合，于25℃、37℃放置，在0、1、2、4、6h对混合液进行外观观察、测定pH值、扫描紫外吸收光谱及测定依诺沙星和利巴韦林的含量。结果在0-6h内，溶液外观、pH值和紫外吸收光谱基本不变，依诺沙星和利巴韦林的含量在25℃时有所下降，在37℃时基本不变。结论注射用依诺沙星与利巴韦林注射液在5％葡萄糖中可以配伍使用。     

洛美沙星治疗老年下呼吸道感染的疗效观察

目的：探讨洛美沙星治疗老年下呼吸道感染的临床疗效及安全性。方法：洛美沙星组（４８例）应用洛美沙星０．２ｇ，一日２次，静点；７～１４天。头孢曲松组（５０例）应用头孢曲松１．０ｇ，一日２次，静注，７～１４天。结果：洛美沙星组临床痊愈率、有效率，细菌清除株数及不良反应发生率与头孢曲松组比较无显著差异。结论：洛美沙星是有效和安全的治疗老年下呼吸道感染的抗菌药物。     

头孢噻肟和罗红霉素联合治疗社区获得性肺炎38例临床分析

目的 探讨社区获得性肺炎（CAP）经验性治疗的最佳方案。方法 选择CAP患者76例，随机分为头孢噻肟和罗红霉素联合组（治疗组）以及单纯用头孢噻肟组（对照组）各38例，其中头孢噻肟6g／d，分2次静滴，罗红霉素300mg／d，分2次口服，连续7～10天。结果 治疗组有效率92．1％，明显高于对照组的73.7％（P〈0．05）。结论 头孢噻肟和罗红霉素联合应用，可明显提高CAP治疗的有效率，改善预后。     

葡萄糖酸依诺沙星注射液与呋塞米注射液存在配伍禁忌

临床工作中,我们观察到患者在输入5%葡萄糖注射液加葡萄糖酸依诺沙星注射液0.2g时,通过侧壶加入呋塞米注射液10ml后,输液管中出现乳白色沉淀。立即更换输液器,患者未发生不良反应。葡萄糖酸依诺沙星注射液为喹诺酮类抗菌药(国药准字H20041799,四川美大康佳乐药业有限公司生产),0.2g/支,为几乎无色或微黄的橙色液体,适用于敏感细菌所致的中、重度急性细菌性感染(包括呼吸系统、泌尿系统、消化系统、皮肤软组织感染等)。呋塞米注射液为无色澄清液体(国药准字H12020527,天津金耀氨基酸有限公司生产),20mg/支,为磺胺类高效利尿剂。临床实践发现葡萄糖酸依诺沙星注射液与呋塞米注射液存在配伍禁忌。建议在临床用药过程中,输注葡萄糖酸依诺沙星注射液时不能直接加入呋塞米注射液。如需联合用药时,两种药物之间应用其他液体隔开或用生理盐水进行冲管。葡萄糖酸依诺沙星注射液与呋塞米注射液存在配伍禁忌@万园园$解放军白求恩国际和平医院心胸外科!石家庄050082     

Visiting rights only: the diplomas in nursing in the UK in the interwar period

The aim of this article is to explore the institution and organisation of the diplomas in nursing at the universities of Leeds and London, which were established in 1921 and 1926, respectively. It will be argued that the success of these courses for the individuals who undertook them, and the profession as a whole was ultimately limited. It is accepted that the purpose of the diplomas was at least in part for the nursing elite to maintain their grip on the leadership. Nevertheless, the institution of the courses, when few women in general attended university, identifies a 'radicalness' within the profession, which has rarely been considered. Moreover, that there was a body of nurses capable of university level education challenges previous assumptions.     

Choosing the choices in the USA: examples in the maternity area

The concept of choice has featured prominently in both the recent united Kingdom (UK) health care reforms and in the debate relating to the care of childbearing women. An invitation to the USA facilitated contemplation of the health care system on which the recent UK reforms have been modeled. The impact of the health system on mother's choices was a source of particular interest. The implications for midwives, their practice and their relationships with their clients and colleagues emerge clearly. It may be that the United States' model of health care does not answer the needs of the UK.     

Changes in the parameters of the rhythms of the electrolyte-excreting function of the kidneys in women in relation to the seasons of the year

The characteristics (period, mesor, amplitude) of the rhythms of urinary excretion of sodium, potassium, chlorine, calcium, magnesium, and phosphorus were examined in normal women during various seasons. The urine was collected for 5 days with 4-hour intervals. The rhythms were detected and their parameters established with the use of mathematical methods for the assessment of the tested curve fragments repetitions and by the least squares nonlinear method. The rhythms of renal urinary and electrolyte excretion were found very smooth, particularly so in the fall and winter. The circadian rhythms have been found the most stable during all the seasons. Examinations of individual electrolyte excretion have shown that Na and K excretion is more stable all the year round and therefore this parameter is the most informative for the detection of disorders in renal electrolyte excretion.     

Pitfalls in the Care of the Psychiatric Patient in the Emergency Department

Background

Care of the psychiatric patient in the Emergency Department (ED) is evolving. As with other disease states, there are a number of pitfalls that complicate the care of the psychiatric patient.

Objective

The purpose of this article is to update Emergency Physicians concerning the pitfalls in caring for the psychiatric patient, and possible solutions to deal with these pitfalls.

Discussion

The article will address the burden of the psychiatric patient, staff attitudes, medical clearance process, treatment of the agitated patient, suicidal patients, and admission decisions.

Conclusions

Alternative care resources, collaboration with Psychiatry, staff education, improvement in the medical clearance process, proper use of restraint and seclusion, and appropriate choice of medication for agitated patients can help avoid some of the top pitfalls in the care of the psychiatric patient in the ED.     

On the Mechanism of the Splay in the Glucose Titration Curve in Advanced Experimental Renal Disease in the Rat

Glucose titration studies were performed in rats with unilateral chronic pyelonephritis before and after removal of the contralateral control kidneys. Identical studies were performed in animals with unilateral partial renal infarction in which the experimental kidneys had a marked reduction in nephron population but no anatomic deformation in the surviving nephrons. In the initial studies, both groups of animals were free of clinical and chemical abnormalities of uremia. In the follow-up studies uremic abnormalities were present. Minimal splay was observed in the titration curves in the initial studies; marked splay was present in the group data from the same kidneys in the subsequent studies. Thus a marked reduction in the nephron population was associated with the evolution of splay in both groups of animals. In association with the increase in splay, the mean values for maximal glucose transport increased; thus a defect in glucose transport can be excluded as the basis of the splay. Glomerular filtration rate increased proportionately more than the maximal transport of glucose; hence the ratios of glomerular filtration rate to maximal glucose transport increased consistently. The possibility of asymmetric hypertrophy of glomerular and tubular functions among the nephron population imposed by scar tissue or other anatomic deformities was considered, but the results in the animals with partially infarcted kidneys militate against this explanation. The splay also could reflect an asymmetric alteration in the distribution of glomerulotubular balance among the residual units initiated by functional adaptations. Finally, the splay could relate to an alteration in the kinetics of glucose transport without any change in the level of functional homogeneity. The possible nature of these has been considered in the text.     

Change in the drug-metabolizing function of the liver in patients in the postoperative period in relation to the type of anesthesia]

Anesthesia-dependent changes in pharmaco-metabolic liver function have been studied in patients operated on for cosmetic facial defects. It has been established that the postoperative period in patients subjected intraoperatively to general combined anesthesia and controlled lung ventilation was characterized by inhibited drug metabolism in the liver, which required correction of the drug doses to reduce the risk of side and toxic effects of pharmacotherapy. Patients operated on under local procaine anesthesia had no considerable changes in pharmaco-metabolic liver function in the postoperative period.