医用X线工作者辐射剂量与效应关系的研究

<正> 小剂量电离辐射生物效应的资料是制订卫生防护标准的重要依据,尤其是人体资料更有意义。医用X线工作者辐射剂量与效应关系的研究是这方面工作的重要组成部分。长春市医用X线工作者的健康状况从未全面调查。为更好地保障人员健康,根据全国统一的要求和方法对长春市361名医用X线工作者、299名非接触射线的医务人员,做了辐射剂量估算、内科、眼科、皮肤科、口腔科检查,并对部分人员做了13项化验指标的观察。另外对1000例对象做了辐射流行病学(肿瘤和遗传效应)的调查。     

临床静脉给药中的安全隐患调查分析及对策

目的 了解临床护理人员在静脉给药中存在的安全隐患，寻求适用于静脉安全给药的对策，帮助护士及护理管理人员提高安全护理的应对能力。方法 采用自制问卷调查法，以目前护理队伍中存在的静脉给药不安全因素为内容，抽样调查3所县级以上医院222名护理人员，进行统计学分析。结果 调查内容中，各类护理人员均不同程度地存在着静脉给药中的安全隐患问题，不同年资组间差异有显著性，而不同学历组差异无显著性。结论护理人员必须加强静脉给药安全知识的学习，规范管理，坚持预防为主，建立健全静脉给药安全性应当遵循的工作方法和制度，努力建立静脉药物配置中心，将安全隐患消灭在萌芽中。     

艾曲泊帕不良反应文献分析

目的：分析艾曲泊帕所致不良反应（adverse drug reaction,ADR）的发生发展特点,为临床安全合理用药提供参考。方法：检索中国知网（CNKI）、维普（VIP）、万方、PubMed和Web of Science 数据库收载的艾曲泊帕致ADR的个案报道并进行分析。结果：收集艾曲泊帕致ADR的个案报道15篇共18例,其中男性7例（38.89%）,女性11例（61.11%）,年龄分布以50岁以上居多（13例,72.22%）,发生时间主要集中在用药90 d以内（15例,83.33%）,主要累及循环系统（7例,38.89%）和皮肤系统（6例,33.33%）。患者经停药或减量和/或对症处理后均好转。结论：应关注艾曲泊帕所致ADR,加强用药教育,避免严重ADR的发生,保证临床用药安全。     

微创经皮肾取石术治疗上尿路结石围术期护理

目的 探讨微创经皮肾穿刺气压弹道碎石取石手术治疗上尿路结石的围术期护理.方法 对320例接受微创经皮肾碎石取石手术的上尿路结石患者围术期进行专科护理.结果 本组病例均手术成功,一次取石268例,二次取石52例.结石手术取净率84.4%(270/320),所有病例无严重手术并发症,围术期无护理并发症.结论 微创经皮肾取石术的手术理念完全不同于开放手术,围术期护理也有其特殊性,术前心理护理、特殊体位准备、术后的病情观察和管道护理以及合理的出院指导,是保障患者顺利康复的重要护理措施.     

老年原发性高血压不同心血管危险分层病人维生素D与血压变异性的相关性

目的探讨老年原发性高血压不同心血管危险分层病人血清维生素D水平的差异及与血压变异性(BPV)的相关性。方法选取我院符合纳入标准的老年原发性高血压病人90例,按照原发性高血压心血管危险分层标准分为中危组25例,高危组27组,很高危组38例。选取同期健康体检者30例作为对照组。所有受试者均测定血清25羟维生素D3[25(OH) D3]水平及动态血压,以变异系数(CV)表示BPV,观察25(OH) D3水平与老年高血压心血管危险分层及BPV的相关性。结果老年高血压病人中危组、高危组、很高危组的血清25(OH)D3水平均低于健康对照组(P均0. 05),且很高危组、高危组、中危组的血清25(OH) D3水平依次降低,两两比较差异均有统计学意义(P均0. 05)。中危组、高危组、很高危组的24 h收缩压(24hSBP)、24hSBP变异系数(24hSBP-CV)、24 h舒张压变异系数(24hDBP-CV)、日间收缩压变异系数(d SBP-CV)、日间舒张压变异系数(d DBPCV)、夜间收缩压变异系数(n SBP-CV)、夜间舒张压变异系数(n DBP-CV)较对照组明显升高,差异有统计学意义(P均0. 05),中危组、高危组、很高危组上述指标依次升高,两两比较差异有统计学意义(P均0. 05)。血清25(OH)D3与24hSBP、24hSBP-CV、24hDBP-CV均呈负相关(r=-0. 312,-0. 381,-0. 421,P0. 05)。结论维生素D水平与老年原发性高血压的发病及其心血管危险分层相关,且与BPV呈负相关,维生素D可作为老年高血压病情的一个较可靠的预测因子。     

膝关节松解术后26例的康复护理

目的：促进膝关节松解术后患者关节功能的恢复。方法：对26例伸直位膝关节僵硬关节松解术后患者采用间断屈膝位石膏固定结合主动功能锻练及康复过程中的一些护理。结果：随访6个月～3a,平均20个月,关节活动度23例达到130°,3例100°～110°。结论：间断石膏固定有利于伸膝结构愈合,主动功能锻练可有效恢复伸膝装置的弹性和力量。二者结合科学合理,效果明显。     

Speckle Tracking Echocardiography Assessment of Global and Regional Contraction Dysfunction in the Mice Model of Pressure Overload

Speckle tracking echocardiography(STE) has been applied to the evaluation of cardiac contraction dysfunction. However, there were few studies on alteration of global and regional STE parameters in the process of myocardial hypertrophy and heart failure. In this study, STE was applied to evaluate the global and regional cardiac function under heart failure and hypertrophy in the mice model of pressure overload. Adult mice were subjected to mild or severe aortic banding with a 25 Gauge(G) or 27 G needle. After surgery, STE and conventional echocardiography were used in the sham group(n=10), mild trans-aortic banding(TAB) group(n=14) and severe TAB group(n=10) for 8 weeks. The results showed that the mice subjected to severe TAB showed a significant change in fractional shortening(FS), left ventricular(LV) mass, and left ventricular end diastolic diameter(LVEDD)(P<0.05 for each). Meanwhile, there were no significant differences in FS and LVEDD between the sham group and mild TAB group during the experimental procedures(P>0.05 for both). STE analysis revealed that longitudinal strain(LS) was significantly decreased in the severe TAB group as compared with the sham and mild TAB groups(P<0.05 for both) from the postoperative week 1. LS in the mild TAB group was reduced as compared to the sham group(P<0.05). Radial strain(RS) and circumferential strain(CS) were significantly decreased in the severe TAB group as compared to the sham group and the mild TAB group(P<0.05 for both) from the postoperative week 1(P<0.05 for both). Compared to the sham group, CS in the mild TAB group maintained unchanged during the test period, and RS was reduced only on the postoperative week 6(P<0.05). Finally, regional contraction dysfunction was analyzed in both hypertrophic and failing myocardium in longitudinal and radial directions. It was found that LS was largest in the apex region and RS was smallest in the apex region in the healthy and hypertrophic myocardium. It was also found that compared to the sham group, only base longitudinal strain in the mild TAB group was decreased. Each of regional strain in the severe TAB group was uniformly depressed in radial and longitudinal directions. It is concluded that STE has provided a non-invasive and highly feasible way to explore the global and regional contraction dysfunction in hypertrophic and heart failure myocardium in the murine model of pressure overload.