围手术期肠外营养支持在胃癌根治术的应用

1986～1988年的胃癌扩大根治术221例及根治性全胃切除术19例非肠外营养(N-TPN)支持为对照组,与1991～1993年的198例及61例施行TPN治疗为实验组进行对比。N-TPN组术后并发症总发生率为7.2％,TPN组则为2.0％;全胃切除术并发症发生率分别为31.6％和4.9％(P<0.01)。吻合口瘘发生率N-TPN组分别为2.7％和10.5％,而TPN组则均为0.0％(P<0.01)。膈下脓肿发生率N-TPN组为31.6％和15.8％,而TPN组则为1.5％和3.3％(P<0.05)。但本研究是回顾性的,所以要有待进行前瞻性的、对照的、随机的大范围研究。     

中西医结合治疗妊娠期肝内胆汁淤积症初探

目的 评估复方丹参注射液联合熊去氧胆酸治疗妊娠期肝内胆汁淤积症的临床疗效及对新生儿预后的影响。     

一期后、前路手术治疗发育性颈椎管狭窄症合并巨大椎间盘突出

目的：评价一期后、前路手术治疗发育性颈椎管狭窄合并巨大椎间盘突出的特点及疗效。方法：回顾分析2002年2月至2006年1月接受该术式的21例患者的临床资料,对手术前后临床表现、JOA评分、MRI影像变化以及术后神经功能改善率及并发症进行总结分析。结果：术后未发生神经系统症状加重、感染及内固定失效等并发症。获得1年以上随访者21例,平均随访时间为29.2个月,术后3个月、12个月时神经功能改善率分别为：58%、66%;16例获得2年以上随访者神经功能改善率为71%。结论：一期后、前路手术治疗发育性颈椎管狭窄合并巨大椎间盘突出可缩短治疗周期,相对节省治疗费用,同时解除了硬膜囊前、后方的压迫,减压彻底,疗效满意。     

从彭勃治"暗瘀"说探索肝纤维化的中医论治

系统阐述了彭勃治"暗瘀"说的基本内涵,并以此学说为基础进一步提出了"肝纤维化期相当于暗瘀期"的新观点。并解决了肝纤维化的中医病名、病因病机、辨证论治等诸多难题,从而使肝纤维化的中医论治有了自身的系统的中医基础理论的支持和准确的切入点,并有望取得突破。     

搭建体验式沟通平台提高大学生人际交往能力

在生活节奏不断加快，竞争激烈的当今社会，大学生群体中不同程度地存在人际交往困难，影响了各种适应社会需求和自我发展能力的培养。通过搭建体验式沟通平台，形成一种团结友爱、朝气蓬勃的氛围，将有利于大学生形成和发展健康的个性品质，提高大学生的人际交往能力。     

Why Do Supportive Birth Attendants Become Directive of Maternal Bearing-Down Efforts in Second-Stage Labor?

A supportive approach to care for women during the second stage of labor that primarily relies on the laboring woman's involuntary expulsive urges has been advocated. We aimed to learn about the clinical circumstances surrounding the caregiver shift from being primarily supportive to directing women regarding their bearing-down efforts. This research analyzed the communications of 10 birth attendants and women during the expulsive phase of labor using videotapes recorded from two studies carried out between 1986 and the present. The occasions when a birth attendant shifted verbalizations were identified, and categories of the rationales that may have influenced the modification in caregiver behavior were developed. Birth attendants most frequently provided directions to help the woman push effectively, that is, to focus the woman's bearing-down efforts during maternal distress, fatigue, fear, and pain to expedite the labor process (38% of the occasions of caregiver change in verbalizations). The next most frequent clinical situations when caregivers offered directions about "pushing" were diminished urge to bear-down with epidural analgesia (10%), routine arbitrary practices (9% caregiver and 6% by supportive companion), and fetal distress (<1%). A category of "supportive direction" (20%) was identified. This care strategy has not been previously reported. It combined direction with support in a way that was supportive rather than overriding the woman's involuntary efforts.     

GraVes眼病炎性活动期与静止期血清sICAM-1水平的研究

目的:研究可溶性细胞间粘附因子-1(sICAM-1)在Graves眼病(GO)炎性活动期与静止期的水平差异及其与各项甲状腺功能指标的关系。方法:将GO炎性活动期与静止期患者,Graves病(GD)无眼病患者及正常对照,分为A、B、C、D四组,抽取空腹静脉全血,测血清sICAM-1,各组间进行比较。并分析各组sICAM-1与FT3、FT4、TG、TM的相关关系。结果:①A、B、C组患者血清sICAM-1均明显高于正常对照组(P<0.05)。A组患者sICAM-1水平最高,与B组及C组患者相比有统计学差异(P<0.01);②前三组各组内sICAM-1与FT3、FT4成直线相关关系,与TG、TM成直线相关关系;③GO炎性活动期患者sICAM-1与GO评分成正相关。结论:血清sICAM-1水平可作为反映GO活动性评判的免疫指标,长期监测sICAM-1可预示GD进展为临床活动性眼病的可能性。     

Reclaiming 'Big Nurse': a feminist critique of Ken Kesey's portrayal of Nurse Ratched in One Flew Over the Cuckoo's Nest

Reclaiming 'Big Nurse': a feminist critique of Ken Kesey's portrayal of Nurse Ratched in One Flew Over the Cuckoo's Nest Nurse Ratched or 'Big Nurse' in Ken Kesey's counter-culture novel One Flew Over the Cuckoo's Nest is one of popular culture's most arresting and memorable images of the nurse. She is, however, deemed to be remarkable primarily for her malice and authoritarianism. This paper argues that such a purely realist reading fails to fully appreciate the significance of the character of Nurse Ratched. A feminist critique of the novel contends that die importance of 'Big Nurse' is less related to how realistic/unrealistic or good/bad she is as a nurse. Nurse Ratched is important because she exemplifies all diat traditional masculinity abhors in women, and particularly in strong women in positions of power and influence. This paper explores the stereotype of 'Big Nurse' and argues that Kesey's vision of her ultimate 'conquest' is not a progressive allegory of 'individual freedom', but a reactionary misogyny which would deny women any function other than that of sexual trophy.     

第二产程时限与新生儿结局的关系

目的探讨第二产程时限对新生儿预后的影响。方法将216例单胎、足月、无阴道分娩禁忌证的初产妇按照第二产程持续时间(t)分为4组,比较4组间新生儿结局情况。结果手术产率、脐动脉酸血症发生率及新生儿转入新生儿加强监护病房(NICU)的发生率在t>90 m in组明显高于t≤30m in组、3090 m in,新生儿不良结局发生率增加,故应重视和积极处理第二产程。