作业疗法改善颅脑损伤患者的记忆功能

目的观察作业疗法中记忆、思维、心理训练颅脑损伤患者的临床过程,探讨作业疗法对改善颅脑损伤患者记忆功能的可能性。方法对43例颅脑损伤患者(损伤组)进行了作业疗法治疗,包括记忆训练、心理和思维训练,训练时间2个月以上,治疗前后用龚耀先修订的韦氏记忆量表(WMS)进行测评,并与29例正常人志愿者(对照组)进行比较。结果除瞬时记忆指标(背数)外,损伤组治疗前WMS分项评分和记忆商(MQ)平均值,治疗组和对照组分别为99±16和168±32,均明显低于对照组(t=1.997～2.994,P<0.05)。损伤组治疗后其余的WMS分项评分和MQ平均值(治疗前和治疗后分别为99±16和144±32)均明显高于治疗前(t=2.046～2.804,P均<0.05)。结论作业疗法改善颅脑损伤患者的长时和短时记忆功能是可能的。     

Hyperprolactinemia due to pituitary metastasis: A case report

BACKGROUNDPituitary metastasis is an uncommon manifestation of systemic malignant tumors. Moreover, hyperprolactinemia and overall hypopituitarism caused by metastatic spread leading to the initial symptoms are rare.CASE SUMMARYA 53-year-old male patient was admitted to our hospital with complaints of bilateral blurred vision, dizziness, polyuria, nocturia, severe fatigue and somnolence, decreased libido, and intermittent nausea and vomiting for more than 6 mo. During the last 7 d, the dizziness had worsened. Laboratory investigations revealed overall hypofunction of the pituitary gland, but the patient had an elevated serum prolactin level (703.35 mg/mL). Preoperative magnetic resonance imaging revealed a tumor in the sellar region, accompanied by intratumoral hemorrhage and calcification. Thus, transnasal subtotal resection of the lesion in the sellar region was performed. The histopathological and immunohistochemical examinations of the resected lesion revealed metastasis of lung adenocarcinoma to the pituitary gland. Oral hydrocortisone (30 mg/d) and levothyroxine (25 mg/d) were given both pre- and postoperatively. Post-operatively, the clinical symptoms were significantly improved. However, 4 mo following the surgery, the patient succumbed due to multiple organ failure.CONCLUSIONHyperprolactinemia is one of the markers of poor prognosis in patients with carcinoma that metastasizes to the pituitary gland. Exogenous hormone supplementation plays a positive role in relieving the symptoms of patients and improving quality of life.     

象皮的药物研究

象皮,主要取自亚洲象,作为1味中药始载于《医学入门》,其性温,味甘咸,具有祛腐生新、生肌敛疮之功,对创伤、溃疡、疮面久不愈合有明显疗效。现从象皮的炮制加工、实验研究及临床应用作一分析。     

高职高专《护理学基础》实训考核体系的评价与分析

目的探讨高职高专《护理学基础》实训考核的方法并进行评价。方法建立高职高专《护理学基础》实训考核体系,通过对学生的问卷调查、考核体系建立前后护生的成绩以及实习单位等对该考核体系进行评价。结果①问卷调查:95.9%的学生对该考核体系持赞成和较赞成的态度;在16项评价内容中,3个年级赞成度最高的项目是"注重护士仪表形象",达到了94%;赞成度最低的项目是"体现爱伤观念"。②成绩:考核体系建立前的3个年级的操作考核成绩为(73.41±8.61)分,建立后的3个年级学生的考核成绩为(76.73±11.54)分,二者比较有统计学意义(t=7.49,P<0.01)。③实习单位:考核体系建立后,学生在"学以致用,重视基本技能的训练"、"团队协作能力"、"人际沟通能力"、"表端庄,谈吐文雅,行为得体"等方面得分高于建立前(P<0.01)。结论建立的高职高专《护理学基础》实训考核体系具有较好的应用效果,能促进护生整体素质的提高。     

肺血管内皮损伤与肺动脉高压

肺动脉高压(PAH)是一组由不同病因和发病机制引起的以肺血管阻力持续增加为特征的临床综合征,潜在原因还不明确。越来越多的研究表明,肺血管内皮损伤是引起肺动脉收缩和特征性病理改变的首要因素,在PAH发生发展的不同时期,保护肺血管内皮细胞,改善内皮功能或恢复内源性血管活性物质之间的平衡,恢复血管内皮结构和功能的完整性,延缓或逆转肺血管的增殖重塑过程,已成为治疗PAH的重要目标之一。     

食管癌术后患者早期应用肠内营养支持的护理体会

目的探讨食管癌手术后的患者早期实施肠内营养的临床效果及护理措施。方法选择2011年1月～2012年3月食管癌手术患者36例设为观察组,选择2008年1月～2010年12月食管癌手术患者41例为对照组,观察组术后早期给予肠内营养及相应护理,对照组给予传统肠外营养并进行相应护理,比较两组术后康复指标及疗效。结果观察组患者的术后排气、排便、术后拆线等各项指标均优于对照组（P〈O．05）;并发症的发生少于对照组（P〈0．05）。结论食管癌术后早期肠内营养支持治疗安全可靠,提供优质高效的护理是肠内营养计划顺利完成的保证。     

银杏达莫注射液治疗急性脑梗死的疗效及其对血流的影响

目的探讨银杏达莫注射液在治疗急性脑梗死中的临床疗效和脑血流的改善情况。方法对我院收治的282例急性脑梗死患者进行治疗分析。结果治疗组总有效率为94.4%,对照组总有效率为84.2%,差异有统计学意义（P〈0.05）;血流方面,2组治疗后较治疗前均有明显降低,在全血黏度、血浆黏度、纤维蛋白原含量比较中治疗组效果明显优于对照组,差异有统计学意义（P〈0.05）,在红细胞压积比较中2组无明显差异（P〉0.05）。结论银杏达莫注射液可有效改善脑血流量,改善高黏状态,保护脑组织和神经功能,是治疗急性脑梗死,降低其发生危险因素和复发的有效治疗药物,值得在临床使用。     

偏头痛患者脑白质病变和事件相关电位分析

目的分析偏头痛患者脑白质病变和认知功能特点。方法偏头痛组(n=60)和健康对照组(n=46)均行头MRI和P300的检查,观察有无脑白质变性和P300潜伏期和波幅的变化。并分析脑白质变性组偏头痛患者P300的变化。结果①偏头痛组头MRI显示12例脑白质内等或稍长T1,长T2信号;对照组有3例脑白质内异常信号。②偏头痛组患者P300的潜伏期显著长于正常对照组,波幅显著低于正常对照组。③偏头痛组患者脑白质异常者P300潜伏期显著长于头MRI正常偏头痛患者,波幅显著低于头MRI正常偏头痛患者。结论偏头痛患者可能存在脑白质变性和认知功能障碍,脑白质病变加重了认知功能障碍。     

稳心颗粒治疗窦性心动过缓合并室性早搏的临床观察

目的 观察稳心颗粒治疗窦性心动过缓合并室性早搏的疗效与安全性.方法 选择窦性心动过缓合并室性早搏患者60例,给予稳心颗粒9 g/次,3次/d口服,4周后复查心电图1次及24 h动态心电图(Holter).观察治疗前后室早次数、心率、临床症状改善情况及药物不良反应情况.结果 治疗后临床症状明显改善、早搏明显减少.结论稳心颗粒治疗窦性心动过缓合并室性早搏安全有效且无明显不良反应.     

Association of IL8 -251A/T, IL12B -1188A/C and TNF-α -238A/G polymorphisms with Tourette syndrome in a family-based association study in a Chinese Han population

An earlier study indicated a possible relationship between Tourette syndrome (TS) and the cytokines. To explore this further, we analyzed the association of the polymorphisms, IL8 -251A/T, IL12B -1188A/C and TNF-α -238A/G, in the IL8, IL12B and TNF-α cytokine genes with TS in a Chinese Han population. A total of 108 patients diagnosed with TS and their parents were recruited for the study. The genetic contributions of the IL8 -251A/T, IL12B -1188A/C, and TNF-α -238A/G polymorphisms were evaluated using polymerase chain reaction and restriction enzyme digestion (PCR-RFLP) and haplotype relative risk (HRR) and transmission disequilibrium test (TDT) statistics. Our results revealed no significant associations between the IL8 -251A/T, IL12B -1188A/C and TNF-α -238A/G polymorphisms and TS (for IL8 -251A/T, TDT=0.418, df=1, P=0.518; HRR=2.17, X(2)=3.000, P=0.083, 95%CI: 0.900-5.230; for IL12B -1188A/C, TDT=1.131, df=1, P=0.288; HRR=1.27, X(2)=0.35, P=0.549, 95%CI: 0.580-2.790; for TNF-α -238A/G, TDT=2.793, df=1, P=0.095; HRR=0.27, X(2)=2.90, P=0.089, 95%CI: 0.061-1.217). This result was confirmed using haplotype-based haplotype relative risk (HHRR) which allows the two alleles in each genotype to be considered separately. Our data suggests that the IL-8 -251A/T, IL-12B -1188A/C and TNF-α -238A/G polymorphisms may not be associated with susceptibility to TS in the Chinese Han population studied. However, these results need to be replicated using larger datasets collected from different populations.