活血化痰法治疗脂肪肝90例临床观察

脂肪肝是由各种原因引起的脂类代谢障碍,使肝细胞中脂肪含量异常增加,可归于祖国医学中＂积证＂范畴,笔者运用中医药辨证治疗脂肪肝90例,取得了较好疗效,现汇总如下.     

Comparison between a traditional single still image and a multiframe video image along the z‐axis of the same microscopic field of interest in cytology: Which does contribute to telecytology?

The limitation of cytologic still images is one of the reasons why telecytology has not met with widespread acceptance by the cytology community. Cytologic still image only displays a single depth of field, and this is a particularly acute problem in cytology where the specimen is often much thicker than a single microscopic depth of focus. In this article, we examine the validity of a “z‐axis” video of a microscopic field of interest. After observing videos of fields of interest from 10 cases, five cytotechnologists reached suitable cytologic findings and diagnosed the fields correctly in great majority of cases. Five other cytotechnologists, who looked only at a single representative still image, could not always make a correct diagnosis. The difference between two observer groups was statistically significant by Wilcoxon's matched pairs signed‐rank test. The results indicate that “z‐axis” video of microscopic field of interest provides a similar experience to “focusing through” observation of the specimen under a microscope and may improve an accuracy of primary telecytodiagnosis. And we expect that video image telecytology will strongly influence cytology, especially in education and training. Diagn. Cytopathol. 2009. © 2009 Wiley‐Liss, Inc.     

48例小儿使用静脉留置针敷贴致皮肤炎症的护理

总结48例小儿使用静脉留置针敷贴致皮肤炎症的护理经验。护理要点包括:予0.2%安尔碘消毒液定时消毒炎症皮肤,护士长进行护理查房,及时做好与患者的有效沟通。48例患儿均好转出院,无发生护理投诉。     

Clinical value of the quantitation of average daily platelet increase during the recovery period in childhood acute lymphoblastic leukaemia

The time to platelet recovery (TPR) is becoming a predicting factor during the treatment of childhood acute leukaemia. However, the initial pre-treatment platelet count (PPC) could interfere with TPR. Here, we integrated both TPR and PPC as the average daily platelet amount increase (Ap) to predict the prognosis in childhood B-ALL during the recovery period.148 patients were enrolled. The relationship between the Ap and MRD was evaluated, and Multivariate analysis was performed to evaluate whether Ap was independently associated with a better EFS. The PPC was inversely correlated with TPR (rs = ?0.519, P = 0.021). Patients in Ap >3.9 × 10⁹/L group had better EFS (x² = 3.109, P = 0.028) than TPR ≤ 16d. Multivariate analysis indicated that Ap > 3.9 × 10⁹/L was independently associated with a longer EFS (RR = 3.468; 95%CI: 1.037–11.597, P = 0.043). However, when introducing both MRD and Ap > 3.9 × 10⁹/L as candidate variables, the Ap > 3.9 × 10⁹/L lost its independent effect (P = 0.081). The strong association between MRD on treatment day 33 and Ap > 3.9 × 10⁹/L (x² = 148.00, P = 0.000) was responsible for this phenomenon. Ap could be a valuable prognostic indicator in childhood B-ALL.     

社区卫生服务机构与医院双向转诊现状分析

【摘要】 本研究通过对社区卫生服务机构双向转诊情况的调查，从卫生服务机构，社区居民及二三级医院三方面进行分析，并根据分析结果提出解决措施。     

缬沙坦预处理对乳鼠心肌细胞缺氧/复氧损伤的保护作用

目的:探讨缬沙坦预处理对乳鼠心肌细胞缺氧/复氧损伤的保护作用及其机制.方法:常规方法培养心肌细胞,培养72小时后,分为三组:正常对照组、心肌细胞缺氧/复氧损伤组、缬沙坦预处理后心肌细胞缺氧/复氧损伤组.分别观察心肌细胞结构,测定心肌细胞存活率、乳酸脱氢酶(LDH)、丙二醛(MDA)及超氧化物歧化酶(SOD)水平.结果:与对照组比心肌细胞缺氧/复氧损伤组细胞存活率明显下降、培养液中LDH、MDA含量明显增高,SOD含量明显下降；与心肌细胞缺氧/复氧损伤组比,缬沙坦预处理组心肌细胞存活率明显提高,培养液中LDH、MDA含量明显下降、S0D含量明显上升.结论缬沙坦通过抗氧化、抗脂质过氧化反应,清除氧自由基对乳鼠心肌细胞缺氧/复氧损伤有保护作用.     

Assessment of cerebral oxygenation during prolonged simulated driving using near infrared spectroscopy: its implications for fatigue development

Information on cerebral oxygenation during prolonged driving in healthy humans may help to explain the cause and development of central fatigue and its effects on cortex activities. The objective of this study is to investigate the time course of cerebral oxygenation during a prolonged driving task. Forty healthy male subjects were randomly divided into two groups: task group (Task) and control group (CNL). All subjects were required to rest well prior to the experiment. For the task group, subjects were required to perform the simulated driving task for 3 h. Cerebral oxygenation signal was monitored from the left frontal lobe using near infrared spectroscopy throughout the entire experiment. Significant increases in the concentrations of HbO₂ (ΔCHbO₂) and HbT (ΔCHbT) were recorded at the start of driving task compared with the resting value (p < 0.01). The cerebral oxygen saturation in the Task group was found to be significantly lower following three hours of driving compared with that in the CNL (F = 16.95, p < 0.001). In addition, a significant difference in selective reaction time was observed between the Task group and CNL during the post-task period (p = 0.023). The results demonstrated that the cerebral oxygenation is closely related to the mental stress. The decrease in the cerebral oxygen saturation may indicate reduced cerebral oxygen delivery, and this may be an important factor affecting central fatigue development during prolonged driving.     

A refined surgical treatment modality for bromhidrosis: Subcutaneous scissor with micropore

Axillary bromhidrosis has a strong negative effect on one's social life. A high success rate and few complications are criteria for a surgical treatment. The objective of this study was to evaluate a new surgical treatment modality for bromhidrosis: subcutaneous scissor with micropore. Twenty patients with bromhidrosis were treated. Patients were placed in a supine position with their treated arms abducted to 110°. After injection of 60 mL of tumescent solution into each axilla, one small incision was made at the middle axillary of the hair‐bearing area. The whole hair‐bearing skin was undermined at the level of the superficial fat to obtain adequate skin eversion. The flaps were everted to offer full exposure of the apocrine glands, and meticulous excision of each gland was performed. Both sides were punctured with scalpel. The micropore was used for drainage, and whose width was just 3 mm. Finally, the incisions were re‐approximated, and bulky compressive dressings were applied to the area for 72 hours. Of the 40 axillae (20 patients), 34 (85.0%) showed excellent results, and six (15.0%) had good results. Malodor was significantly decreased. There were no serious complications. This technique can produce excellent results with a lower complication rate than most other surgical modalities and can be performed without costly equipment.     

Professional Commitment, Patient Safety, and Patient-Perceived Care Quality

Purpose: To examine how professional commitment influences patient safety and patient-perceived care quality.
Design: Investigators for this study used a cross-sectional design with questionnaires. A total of 348 pairs of nurses and inpatients were contacted at two medical centers in Taiwan during the period from August 2007 to January 2008, yielding 284 pairs of completed questionnaires.
Methods: Frequencies of six adverse patient events were used to measure patient safety; and the Service Quality Scale was used to measure patient-perceived care quality. Four items of the Professional Commitment Questionnaire were used to measure professional commitment. Regressions were used for the analyses.
Findings: Professional commitment positively influenced overall patient safety (ß=.19, p =.00) and overall patient-perceived care quality (ß=.13, p =.03). Furthermore, professional commitment positively influenced all patient safety indicators (ß≥.12, p ≤.04), except frequency of nosocomial infections, the coefficient of which reached borderline significance (ß=.11, p =.07). Professional commitment also positively influenced care quality in terms of responsiveness (ß=.16, p =.01) and empathy (ß=.14, p =.03).
Conclusions: Professional commitment may enhance patient safety and patient-perceived care quality.
Clinical Relevance: This study indicates that nurse professional commitment can enhance patient safety and patient-perceived care quality.