市级医院临床护士工作压力调查

目的:调查分析邯郸市第四医院141名临床护士的工作压力情况,为寻找减轻压力措施及提高护理工作质量提供实验数据。方法:2004-02-06/2004-02-10对邯郸市第四医院141名护士采用自填式问卷进行调查,问卷内容分为引起护士压力的常见因素及压力程度两部分。引起压力常见因素包括:担心差错事故、生活规律改变、晋升问题、人际关系、工作任务繁重、工资收入、学习考试。压力程度:压力很大指护理人员自我感觉疲惫心慌,对日常工作和生活造成显著的影响;压力较大指自我感觉压力较大,对日常工作和生活有一定程度的影响;压力一般指自我感觉存在一定程度的压力,但主观上能够适应,对自己不是一种负担;没有压力指工作轻松愉快,主观感觉没有任何不适应。结果:①不同科室压力分布:内科系统45名中有8名认为压力很大或较大,外科系统62名中有34名认为压力很大或较大,急诊科15名中有13名认为自己的工作压力较大。与内科系统比较,外科系统、急诊科普遍认为工作压力较大(P<0.01或0.05)。②年龄、性别、职称、学历对压力分布的影响:年龄、性别、职称、学历对护士压力分布无明显影响(P>0.05)。③各种压力因素及所占比例分析:担心差错事故的发生位居首位,高达78.01%;其次为生活规律改变及晋升问题,分别为48.94%和47.52%。结论:临床护士压力分布是不平衡的,外科系统和急诊科的工作压力相对较大,担心差错事故发生是引起护士压力的主要因素。     

抗菌药物的不良反应

抗菌药物的开发与应用使临床成功防治感染性疾病成为可能 ,使严重感染的预后大为改观。但抗菌药物的应用同时也可引起很多不良反应 ,甚至致残或致死。抗菌药物的不良反应主要包括毒性反应、变态反应、二重感染。1　毒性反应指药物引起的生理、生化等功能异常和 (或 )组织、器官     

低张结肠水灌肠CT检查诊断结肠癌的价值

目的 :探讨低张结肠水灌肠CT检查对结肠癌的CT表现及诊断价值。材料和方法 :肌注 65 4 2 2 0mg后 ,结肠灌注微温生理盐水进行CT扫描。分析经手术病理证实的 3 8例结肠癌资料。结果 :CT显示肿瘤部位准确率为 10 0 % ,CT分期与手术分期符合率为 92 % ,低张结肠水灌肠CT可见病变肠壁增厚、突出腔内的肿块、肠腔狭窄及其浆膜面毛糙 ;可见结肠癌侵犯邻近器官、淋巴结肿大及远处转移。结论 :低张结肠水灌肠CT检查对结肠癌的术前诊断有很大的价值。     

Enzymes induced by ethanol differently affect the pharmacokinetics of trichloroethylene and 1,1,1-trichloroethane.

This study was undertaken to clarify the effect of enzymes induced by ethanol consumption on the pharmacokinetics of trichloroethylene (TRI, a highly metabolised substance) and 1,1,1-trichloroethane (1,1,1-TRI, a poorly metabolised substance). Rats maintained on a control liquid diet or a liquid diet containing ethanol (2 g/day/rat) for not less than three weeks were exposed to either TRI (50, 100, 500, and 1000 ppm) or 1,1,1-TRI (50, 100, and 500 ppm) by inhalation for six hours and the concentration of each compound in the blood and the urinary excretion of metabolites (trichloroethanol and trichloroacetic acid) were measured over several hours. Ethanol, which increased the in vitro metabolism of both compounds about fivefold, enhanced the in vivo metabolism of TRI only at high levels of exposure (marginally at 500 and considerably at 1000 ppm), whereas the metabolism of 1,1,1-TRI was enhanced at all concentrations tested. Moreover, there was a definite difference in the effect of induction of enzymes between the two solvents: the enhanced metabolism of TRI in vivo was shown by a decrease in the blood concentration of TRI as well as by an increase in the urinary excretion of its metabolites, whereas that of 1,1,1-TRI was shown by an increase in the urinary excretion of its metabolites alone. These results suggest that the induction of enzymes differentially affects the pharmacokinetics of TRI and 1,1,1-TRI in human occupational exposure: TRI metabolism may be increased only at concentrations much higher than the current occupational exposure limit (mostly 50 ppm), whereas 1,1,1-TRI metabolism may be increased at an exposure similar to occupational exposure.     

深化医学教学改革为社区培养实用型医学人才的实践

为适应医学模式的转变，实现“人人享有卫生保健“的全球战略目标，培养和建设一支满足社区卫生服务急需的实用型医学人才。文章介绍了我院在深化医学教学改革过程中，采用多种综合性措施强化在校临床医学专业本科生的全科医学知识教育，为其将来从事社区卫生服务奠定基础。为满足当前我国社区卫生服务工作对实用型医学人才的急需，对于主要面向基层培养高级医学人才的地方性普通高等医学院校，应对在校学生提前有机地增加和融入社区全科医学知识教育，这有利于强化和巩固医学生的社区卫生服务观念和综合素质。     

成年大鼠神经元和星形胶质细胞细胞周期蛋白依赖性激酶抑制因子表达的差异研究

目的比较研究成年大鼠细胞周期蛋白依赖性激酶抑制因子在神经元和星形胶质细胞的表达差异。方法应用免疫荧光和激光扫描共聚焦显微镜观察成年大鼠生理状态下大脑皮层或海马CA1、CA3、DG区神经元和星形胶质细胞细胞周期蛋白依赖性激酶抑制因子(CDKI)p15Ink4b、p21cipl的表达。结果成年大鼠海马区和大脑皮层的神经元有p15Ink4b和p21cipl的表达,细胞核和细胞浆均有表达,且以胞核为主;星形胶质细胞也有上述细胞周期调控蛋白的表达,便细胞数目较少,并且表达这些指标的星形胶质细胞多聚集在海马区。结论成年大鼠大脑皮层和海马区的神经元和星形胶质细胞均表达p15Ink4b和p21cipl,而其在神经元的表达较星形胶质细胞更为普遍。     

中脑导水管周围灰质NO对大鼠血压的影响及其机制探讨

目的 探讨大鼠中脑导水管周围灰质(PAG)NO对血压的影响及作用机制。方法 采用微量注射法，观察大鼠血压的变化，放免法检测Ach含量。结果 PAG内微量注射L-NNA后，大鼠平均动脉压升高，延髓头端腹外侧区(RVLM)内Ach含量增多，且这一升压效应可被PALG内预注L-Arg或RVLM内预注东莨菪碱所阻断。结论PAG内NO可能经RVLM内Ach介导对血压有紧张性抑制作用。     

Inhibition of N-nitrosodiethylamine- and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone-induced tumorigenesis in A/J mice by green tea and black tea.

The effect of p.o. administration of tea on nitrosamine-induced carcinogenesis was investigated. Female A/J mice were given N-nitrosodiethylamine (NDEA) (10 mg/kg) p.o. once a week for 8 weeks and were killed 16 weeks after the last dose. More than 90% of the mice had forestomach and lung tumors. The animals had an average of 8.3 forestomach and 2.5 lung tumors/mouse. With 0.63 or 1.25% green tea infusion (12.5 g green tea leaves brewed with 1 liter of boiling water) as the sole source of drinking water for the entire experimental period, the pulmonary tumor incidence was decreased by 18 or 44%, and the tumor multiplicity was reduced by 36 or 60%, respectively. The treatments also decreased the forestomach tumor incidence by 18 or 26% and tumor multiplicity by 59 or 63%, respectively. Administration of 0.63 or 1.25% green tea infusion, either during the NDEA treatment period only or starting 1 week after the completion of NDEA treatment, also decreased the pulmonary tumor incidence and multiplicity and the forestomach tumor multiplicity. The inhibitory effects of green tea infusion were also observed in a similar experiment using a higher dosage of NDEA (20 mg/kg). Treatment of female A/J mice with a single dose (103 mg/kg) of 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) resulted in the formation of pulmonary adenomas in almost all of the animals with an average of 9.3 tumors/mouse after 16 weeks. When 0.6% decaffeinated green tea or black tea extract was given during the NNK-treatment period, tumor multiplicity was reduced by 67 or 65%, respectively. When the tea extract was given after the NNK-treatment period until the end of the experiment, 0.6% green tea extract decreased the tumor incidence and multiplicity by 30 and 85%, respectively. In this protocol, 0.6% black tea extract reduced tumor multiplicity by about 63% but did not significantly affect the tumor incidence. The results clearly demonstrated an inhibitory action of green tea and black tea on nitrosamine-induced tumorigenesis.     

明党参鲜根与药材饮片中精油成分和氨基酸含量比较

对明党参鲜根和饮片中的精油及氨基酸成分进行了比较分析,鉴定出27种精油成分,并发现炮制前后氨基酸成分含量变化较大。     

Buccal mucosal graft for urethral reconstruction.

Urethral reconstruction with graft substances, such as skin and bladder mucosa, has been previously used when primary anastomosis cannot be achieved. However, stricture and meatal prolapse are associated with these grafts. We report the use of buccal mucosa for the reconstruction of urethral defects in 3 patients. One patient with failed operation for hypospadias received tube buccal mucosal graft for urethral replacement. Two patients with urethral necrosis and stricture received onlay buccal mucosal graft. All patients were disease-free during follow-up (range, 12 to 49 months; mean, 36 months). One patient had a pinhole fistula that was successfully managed with simple repair. This technique appears to be useful for urethral reconstruction when a local graft is not available, even in patients with complicated conditions.