小型节能头灯的制做与应用

医院(特别是儿童医院)在日常的诊断和治疗护理工作中,需要在小局部范围、短时间光源照明.目前市场上各种医用头灯存在着价格昂贵,使用不方便;我院医护人员在加05年10月至2007年3月使用我院自行研制的节能头灯,采用现代电子技术,在夜间给病人注射、换药和其他治疗以及查房巡视等小范围用光场合,取得了良好的效果.     

Cervicogenic exophthalmos: Possible etiology and pathogenesis

BACKGROUND Unilateral exophthalmos is often caused by inflammation, neoplasm, infection,metabolic disease, vascular disorder and several other less common conditions.Reflex sympathetic dystrophy related to unilateral exophthalmos has not been reported in the past literature.CASE SUMMARY We describe a 45-year-old female with unilateral exophthalmos caused by reflex sympathetic dystrophy and its unexpected spontaneous disappearance after a standard anterior cervical discectomy and fixation operation with two PEEK interbody cages and a plate. To our surprise, the patient’s left unilateral exophthalmos improved spontaneously in the morning on postoperative day 2-with no relapse, without any further medication, as of seven years. We have named this condition "cervicogenic exophthalmos."CONCLUSION We would inform other clinicians that unilateral exophthalmos was caused not only by inflammation, vascular disorder, infection, neoplasm, or metabolic disease, but also by reflex sympathetic dystrophy related with cervicogenic spondylosis. To the best of our knowledge, ours is the first related case report and use of the term "cervicogenic exophthalmos" after reviewing previous literature.     

Photodynamic therapy as salvage therapy for residual microscopic cancer after ultra-low anterior resection: A case report

BACKGROUND The rate of positive resection margins(R1) in patients with low rectal cancer is substantial. Recommended remedies such as extended resection or chemoradiotherapy have their own serious drawbacks. It has been reported that photodynamic therapy(PDT) as a remedial treatment for esophageal cancer.Colorectal cancer and esophageal cancer has many similarities,however,PDT as a salvage therapy for rectal cancer is rare.CASE SUMMARY Here,we describe a 56-year-old man who was admitted to the hospital due to a 6-mo history of hemafecia,which had been aggravated for 1 mo. Colonoscopy revealed a 3 × 4 cm ulcerated mass in the rectum 4 cm from the anus.Preoperative pathological examination showed villous adenoma,moderate-tohigh-grade dysplasia,good differentiation,and invasion of the mucosal muscle.The patient had R1 after ultra-low anterior resection,but he refused extended resection and experienced severe liver function impairment after 3 cycles of chemotherapy. Ultimately,the patient underwent PDT to remove R1. After five years of follow-up,there was no liver function impairment,recurrence,metastasis,sexual dysfunction,or abnormal defecation function.CONCLUSION This is the first case worldwide in which R1 of rectal cancer were successfully treated by PDT.     

Endodontic management of the maxillary first molars with two root canals: A case report and review of the literature

BACKGROUND The complex anatomy of the maxillary first molars has always been a major challenge for complete root canal treatment in endodontic therapy. Here, we present two cases of maxillary first molars, each with only two root canals, which have been rarely reported. We also perform a literature review of maxillary first molar anatomy.CASE SUMMARY The two patients were referred to the hospital after 1) finding a cavity in their tooth with a color change and, 2) a toothache during mastication, respectively.Both of these cases were diagnosed as apical periodontitis by X-ray imaging and cone beam computed tomography(CBCT). Non-surgical endodontic therapy was performed with the assistance of a dental operating microscope(DOM). CBCT showed rare but accurate images of both patients, each with two root canals and two roots in their maxillary first molars. Both roots were located in the buccal in the palatal direction, and each root had only one clear root canal. In addition,each maxillary first molar in both patients was symmetrical to that on the opposing side with only two separate root canals. Non-surgical endodontic therapy was performed with the assistance of a DOM. Finally, the teeth were restored using composite resin and the patients were satisfied with the results.CONCLUSION Making full use of CBCT and DOM would contribute to helping dentists make correct diagnoses and successfully treat teeth with rare root canal morphologies.     

世界疼痛日——中国镇痛周暨建立疼痛科新闻发布会隆重召开中华医学会疼痛学分会第七届年会胜利闭幕

世界疼痛日中国镇痛周暨建立疼痛科新闻发布会、中华医学会疼痛学分会第七届年会于2007年10月12～16日在北京九华山庄隆重举行.全国人大副委员长中科院韩启德院士、原全国人大副委员长中科院吴阶平院士、卫生部陈啸宏副部长、卫生部医政司王羽司长、卫生部科教司刘雁飞司长、中华医学会吴明江常务副会长、原卫生部副部长中国医师协会殷大奎会长及有关方面的领导、专家及参加大会的疼痛医学专家代表约五百人参加了新闻发布会.     

读片窗及答案

病例 男,62岁.以"发现尿黄5天"为主诉入院.无发热、恶心及厌食等伴随症状.查体:血压150/100mmHg,巩膜轻度黄染,腹软无压痛,肝区无叩击痛,肝肋下未触及.实验室检查:血WBC 13.1×109/L,EO 5.2×109/L,占39.7%.TBIL 36.6μmol/L,DBIL 21.5μmol/L,UDBIL 15.1μmol/L.ALT 88U/L,GGT 201U/L.AFP及CEA阴性.HBsAb阳性,其余4项均阴性.     

结合中医理论对上呼吸道感染的护理

上呼吸道感染一年四季均可发病,但以冬春季节为多.此类病人病程一般在10 d以上,易反复,有的甚至迁延不愈达1个月以上,造成门诊输液量增加、交叉感染机会增多,在医治过程中医护人员也易感染.此病虽然不像癌症使人恐惧,但它的发病率高,有的1年内可发病3次～5次,给身体和生活造成很大的不便.此类病人的症状为鼻塞、流涕、喷嚏、咳嗽、咽干、咽痛、头痛、发热、乏力、全身不适等,护理一般采取对症施护:休息、保持室内空气清新、多饮水、清淡饮食等,而应用中医理论施护则更具体、更有效,对于疾病的痊愈会有极大的促进作用.     

伸缩式垂直升降护理机的适用性探讨

昏迷病人、截瘫病人、慢性消耗性疾病及脑卒中后遗症病人常伴有肢体瘫痪而长期卧床,生活不能自理,大小便失禁,易发生压疮,给病人带来极大痛苦,给家属带来繁重的负担[1].为解决这一难题,人们研究了一些护理器械,如"升降护理装置",这种护理装置由铁床、软布带、支架杆、绑绳钢筋、软网布、定滑轮组件、动滑轮组件、万向节连接件和钢丝绳组成.     

Seroconversion of HBsAG coincides with hepatitis A superinfection: A case report

BACKGROUND Hepatitis B virus(HBV)is a hepatotropic virus that can cause acute and chronic liver damage.According to the world health organization 257 million people are infected with chronic HBV infection worldwide.Super-infection with other hepadnaviruses,including hepatitis A virus(HAV),hepatitis C virus,hepatitis D virus,and hepatitis E virus is associated with increased risk of acute liver failure in patients with chronic HBV.CASE SUMMARY Here,we report a case of a 47-year old male patient with HBV-related compensated Child A cirrhosis,who presented with general fatigue,malaise and laboratory signs of acute hepatitis.Although the patient was regularly seen at a specialized university liver unit,the HAV vaccination status was unclear.Acute HAV super-infection was diagnosed by positive serological and polymerase chain reaction analysis.Following acute HAV super-infection,spontaneous HBsAg elimination and development of an anti-HBs titer were observed.CONCLUSION This case illustrates the importance of carefully checking the vaccination status.In our patient,unspecific immunological responses to HAV led to functional cure of HBV.     

Combined surgical and interventional treatment of tandem carotid artery and middle cerebral artery embolus: A case report

BACKGROUND The 2018 American Heart Association/American Stroke Association guidelines for early management of acute ischemic stroke recommend the use of retrievable stents for mechanical thrombectomy in patients with acute internal carotid artery or middle cerebral artery M1 occlusion that can be treated within 6 h from onset.For cases of carotid artery with ipsilateral middle cerebral artery tandem embolization, the operation is more complicated and challenging. We here report a case of a tandem embolism, and the anatomy of the aortic arch was complex.Direct carotid artery incision and thrombectomy can not only prevent the escape of the carotid embolus but also save time during establishment of the thrombectomy access.CASE SUMMARY The patient was a 70-year-old man. He was admitted to hospital due to sudden inability to speak and inability to move his right limb for 3 h. Imaging confirmed a diagnosis of a tandem embolism in the left carotid artery with left M1 occlusion.Carotid artery incision thrombectomy combined with stent thrombectomy was performed. The operation was successful, and 24 h later the patient was conscious and mentally competent but had motor aphasia. His bilateral limb muscle strength level was 5, and his neurologic severity scores score was 2.CONCLUSION Carotid artery incision thrombectomy combined with stenting for carotid artery plus cerebral artery tandem embolization is clinically feasible. For patients with a complicated aortic arch and an extremely tortuous carotid artery, carotid artery incision can be chosen to establish the interventional path.     

某血站员工的培训现状及培训需求分析

目的通过问卷调研对血液中心员工进行培训现状及需求调研,从而发现培训中存在的问题、并为未来开展员工培训提供参考。方法设计血液中心员工培训现状及需求评估问卷,征得同意后对血液中心179名员工进行调查,并对比不同岗位员工对现状及需求的评价。结果卫技人员和非卫技人员对培训的实际效果都有较为正面的评价(4. 16±0. 94 vs 3. 95±1. 04,P>0. 05),都较为迫切的希望接受培训(3. 78±0. 72 vs 4. 00±0. 60,P>0. 05);但相比于卫技人员,非卫技人员认为血液中心为他们提供的培训并不充足(3. 05±0. 82 vs 2. 45±1. 11,P<0. 05)。员工的公共知识和技能培训需求没有差异,主要包括采供血行业相关法律政策、伦理问题、提升自我管理能力和与外界沟通交流的技能和能力。但卫技人员和非卫技人员的专业培训需求差异显著,都与自身业务工作内容密切相关。结论卫技和非卫技人员对培训现状的评价和专业培训需求都存在差异,应根据不同岗位的培训目标和培训需求来进行培训方案设计,从而确保培训效果。     

武警部队战士新训期体能训练特点和结构研究

目的:采用心率和血乳酸两类指标对新训期战士的体能训练课进行监测调查,并对不同训练日的体能训练课的结构安排进行分析,以期能够为战士体能训练计划的制定提供基础数据和资料。方法:2003年新训战士209名,年龄(19±1)岁,身高(168±5)cm,体质量(65±6)kg。按照战士实际训练的课次安排,连续进行37个课次的生理负荷(生理负担量)检测,训练课中主项练习负荷结束即刻测定血乳酸和心率。结果:通过计算运动量指数表明,大量课和最大量课的负荷安排占了37个体能训练日的58.5%,训练课的平均心率为(143±10)次/min,平均最高心率为(177±10)次/min,170次/min以上的心率占18.2%,对于新训战士来说,这样的负荷安排会对机体产生较大刺激,运动负荷较高。由于训练方式的不同血乳酸和心率值变化较大,血乳酸为:(3.22±0.46)～(11.89±0.91)mmol/L,心率为:(130±10)～(189±11)次/min。结论:武警战士新训期体能训练课的负荷强度较大,大量课和最大量课安排较多,体现发展有氧运动能力的训练内容和手段相对较少。     

聘用护士的合理管理与培养

聘用护士是一个特殊的群体,是一支不可忽视的力量,缓解了护士严重缺编的问题,保证了护理工作的正常运转。通过对49名聘用护士进行规范化管理,严把用人关,做好岗前、岗位培训,重视继续教育工作,提高其综合素质。建立激励机制,优胜劣汰,调动其主观能动性和工作积极性,在临床护理工作中发挥了积极作用。     

培养与发展急诊专科护士的探讨

本文介绍了急诊专科护士培养的必要性和可行性,并针对我国目前对急诊专科护士的需求和护理人员的知识结构情况,从急诊专科护士的培养对象、方法、时间、内容等方面进行了讨论.     

年轻护士封闭式集中培训与分散式阶段培训效果观察与比较

目的:探讨年轻护士封闭式集中培训与分散式"阶段培训的效果"。方法:将2009年入院的108名年轻护士设为对照组,采用传统的"集中示范-科室培训-集中考核"的分散式阶段培训模式;将2010年新入院的62名年轻护士设为实验组,采取"集中示范-集中培训-集中考核-末位淘汰轮岗-随机抽考"的封闭式集中培训模式。观察并比较两种培训模式的效果。结果:封闭式集中培训模式,在护理人员的操作考核成绩、培训时间、操作培训效能、沟通能力、主动学习热情、创新思维能力、规范自身操作等方面均优于传统的分散式阶段培训模式。结论:对护理人员采取封闭式集中培训,可提高其临床适应能力,增强其技能操作水平及与患者沟通能力,培训效果事半功倍。     

规范化培训模式在省级手术室专科护士培养中的实践及效果分析

目的：观察规范化教学及管理在省级手术室专科护士培训中的临床实践效果,建立并完善省级手术室专科护士培训的新模式。方法根据手术室的专科特点,进行问卷调研,运用德尔菲法设计与实施专科教学及管理方案,对手术室专科护士进行规范化培训。结果规范化培训模式实施后手术室专科护士的岗位胜任力和职业认可度显著提升,对培训的满意度明显提高。结论规范化培训模式的建立及应用对保证省级手术室专科护士的培训质量具有重要的意义。     

运动训练时间和患者的治疗参与性与脑卒中患者运动功能预后的影响

目的探讨运动训练时间和患者的治疗参与性对脑卒中患者运动功能预后的影响。 方法将60例脑卒中患者随机分为常规训练组和强化训练组，每组30例，2组患者均接受运动训练，但常规训练组患者每次运动训练时间为30~45 min，强化训练组患者每次运动训练时间为45~60 min。所有患者在入院时和治疗4周后进行功能独立性评定量表（FIM）中的运动功能评定，同时每次运动训练时通过Pittsburgh康复参与量表(PRPS)记录患者的治疗参与情况。 结果2组患者治疗前FIM运动功能评分差异无统计学意义（P&rt;0.05），但治疗后强化训练组患者的FIM运动功能评分明显高于常规训练组患者，差异有统计学意义(P<0.05)，强化训练组治疗前、后FIM运动功能评分改变值明显高于常规训练组(P<0.01)，而且常规训练组和强化训练组患者PRPS评分均与治疗前、后FIM运动功能评分的改变值明显相关（分别为r=0.787,P<0.01和r=0.573,P<0.05)。 结论运动训练时间能对脑卒中患者的近期运动功能的改善产生影响，患者的主动参与性亦能明显影响其运动功能预后。     

Training,training and more training

The International Journal of Cardiovascular Imaging -