1例脊髓空洞症侧脑室延髓池内分流术的护理

1 病例介绍病人,男,34岁,左下肢步态不稳10年,加重伴酸麻、隐痛1年,于2004年4月入院.入院时精神欠佳,生活不能完全自理,左上肢肱二腱、肱三腱反射和下肢膝反射亢进,右上肢肱二腱、肱三腱反射减弱,右前臂及手部触觉消失,左下肢膝关节以下触觉、位置觉、浅感觉消失.MRI示脊髓空洞症.术前检查未发现手术禁忌证,行全身麻醉下环枕畸形减压、侧脑室延髓池内分流术.手术顺利,术中输红细胞悬液400 mL,放置皮下引流管1根,术后恢复好,无并发症发生,病人生活上基本自理,出院随访1年,情况良好.……     

对我院护士继续教育学分未达标的原因分析及对策

应用继续医学教育管理系统对我院2004年度护士学分进行审核,从继续教育管理、参加人员的认识水平、工学矛盾对学习的影响等方面分析34名护士学分未达标的原因,制定并加强政策宣传,提高认识水平;完善规章制度,加大管理力度;对上网学习者提供指导,避免错误操作;拓宽学习渠道,缓解工学矛盾等管理措施,以提高护士继续教育学分达标率.     

Bone growth patterns in Chinese children and adolescents: a 6-year follow-up study provides evidence for sexual dimorphism and tracking

Summary We prospectively examined bone growth patterns in 894 children aged 6–17 years at the baseline visit, with a 6-year follow-up. Results show bone “tracking” over a six-year interval and sexual dimorphism of bone attained levels and timing of peak bone growth. Our findings underscore childhood and adolescence as critical periods for building bone and developing gender differences. Introduction Bone growth patterns were prospectively examined in 894 Chinese children (496 males), aged 6–17 yrs, from a population-based twin cohort. Whole-body bone area (BA), bone mineral content (BMC), and bone mineral density (BMD) were measured by DEXA at baseline and a 6-yr follow-up. Methods Graphic smoothing plots and generalized estimating equations were used to model bone attained levels, growth, and “tracking”. Results Attained levels of BMC and BA increased curvilinearly with age. Male attained levels were higher than females after age ∼15 yr, but BMD was lower between 13–17 yrs (Tanner stage I to IV). In both genders, peak BMC and BMD growth lagged ∼2 yrs behind peak BA growth, which lagged 2 yrs behind peak height growth. Peak bone growth occurred 1–3 yrs later in males. Over the 6-yr follow-up, all bone measurements “tracked”, but “shifting” across ranks also occurred, and baseline tertile ranking influenced bone growth. Females with early menarche had higher attained levels than females with late menarche at age 12–13 yrs. Conclusion Our findings confirm and expand previous studies on peak bone growth conducted in Caucasian cohorts, particularly sexually dimorphic and maturational effects. The significant “tracking” of bone measurements in this 6-yr follow-up study underscores the importance that osteoporosis prevention should begin in childhood and adolescence. Fengxiu Ouyang and Binyan Wang contributed equally to this article. Source(s) of support: This study is supported in part by grant R01 HD049059, R01 HL0864619 and R01 AR045651 from the National Institute of Health and by the Food Allergy Project.     

PHS 应用在腹股沟马鞍疝无张力修补术11例分析

目的 探讨PHS在腹股沟马鞍疝无张力修补术中的治疗效果和手术经验.方法 对11例使用PHS行无张力修补术的腹股沟马鞍疝患者进行分析.结果 在局麻下完成手术,手术时间25～60 min,全组留院观察24～72 h,无阴囊积液、切口感染、血肿及其它与手术有关的并发症.随访6个月～30个月,无复发,无异物感.结论 PHS修补牢靠,对于腹股沟马鞍疝的手术治疗更有针对性.重视手术的技巧是手术成功的关键.     

石蜡疗法预防压疮效果观察

目的 探讨较传统按摩更为简便有效、节时省力的预防压疮的护理方法.方法 将具有压疮发生危险的94例患者随机分成对照组和观察组各47例.对照组采用传统按摩法进行护理.观察组采用石蜡疗法进行护理,观察两组压疮发生率.结果 观察组压疮发生率为4.26%,对照组为27.66%,两组比较,差异有显著性意义(P＜0.01).结论 石蜡疗法应用于预防压疮简便易行,效果明显,且节时省力.     

苯乙酸对人结直肠癌细胞HCT-8的G1细胞周期阻滞及增殖抑制作用

摘要：目的 探讨诱导分化剂苯乙酸（PA）对人结直肠癌细胞系HCT 8细胞周期及增殖的影响。 方法 应用MTT比色法，以1.0，2.0，3.0，4.0，5.0 mmol/L的PA作用于体外培养的HCT 8细胞，分别于24，48，72h后对细胞增殖进行检测；流式细胞术分析细胞周期。结果 随着PA浓度的增加（1～5 mmol/L）或药物作用时间的延长（24～72h），肿瘤细胞生长抑制率明显增加。PA1~5mmol/L作用24h细胞生长抑制率为5.1%-24.3%，48h为16.7%-72.3%，72h为30.2%-93.4%。PA作用细胞72h后，G0/G1期比例显著下降，S期比例相对升高，组间差异显著（P＜0.05）。结论 PA在诱导分化结直肠癌HCT 8细胞过程中，可诱导G1细胞周期阻滞，抑制细胞增殖。     

针灸对血管性痴呆患者相关量表积分的影响

目的 :观察针灸治疗血管性痴呆 (VD)的疗效。方法 :选用针灸百会、人中、涌泉、神门、大钟等穴治疗血管性痴呆患者 17例 ,并于治疗前后测定MMSE R、ADL R及BBS量表。结果 :针灸对痴呆患者的MMSE R、ADL R以及BBS中生活能力量表积分有明显改善作用 (P <0 .0 1) ,而对BBS中日常习惯及个性改变的量表积分影响不显著 (P >0 .0 5 )。结论 :针灸治疗VD疗效确切 ,能提高VD患者生活质量     

红袍胃安主要药效学的拆方研究

目的 观察中药复方红袍胃安通过正交设计法按方药组成君、臣、佐、使拆分出的部分组方对小鼠胃排空、肠推进的影响和对大鼠胃液分泌等指标的影响,评价出该复方拆方后的最有效的精简组方,为进一步研发打下基础.方法 采用综合法造成大鼠慢性胃炎模型,大鼠幽门结扎法分析胃液,蛋清毛细管法,小鼠胃排空及肠推进等实验方法.结果 造模动物经给药后,除方10(厚朴+马蹄香+甘草)外,胃液分泌量均显著降低;方3(延胡索+隔山消+陈皮+苍术)、方4(甘草)和方9(厚朴+马蹄香+延胡索+隔山消+陈皮+苍术)能显著降低胃液的总酸度,方2(厚朴+马蹄香)和方11(延胡索+隔山消+陈皮+苍术+甘草)降低胃液总酸度的作用次之;方5(全方)有增强的趋势,方7(大红袍+白术+延胡索+隔山消+陈皮+苍术)和方8(大红袍+白术+甘草)有降低胃蛋白酶活性的趋势;给药组方2(厚朴+马蹄香)、方5(全方)、方6(大红袍+白术+厚朴+马蹄香)的作用与香砂平胃组相当,能增强小鼠对酚红的排空率,方3,7,9,10,11能减慢小鼠的胃排空率;给药组方5、方6与香砂平胃阳性药组比,其作用相当,能显著促进小肠推进运动.结论 综合以上实验结果得出,方6(大红袍+白术+厚朴+马蹄香)药效作用与全方最为接近.