Compliance with recommended prophylaxis for venous thromboembolism: improving the use and rate of uptake of clinical practice guidelines

Summary.  Although several authoritative, evidence-based, guidelines for the prevention of venous thromboembolism (VTE) have been published, the use of VTE prophylaxis in routine clinical practice varies markedly. Even in orthopedic surgery, the indication for which prophylaxis is used most often, a significant proportion of surgeons do not use routine prophylaxis. When prophylaxis is used, guideline recommendations are often not followed. A number of factors may contribute to the under-use of guidelines. Physician-related factors include: a lack of awareness of, or familiarity with, the guidelines; a perception that VTE is not a significant problem or that VTE prophylaxis is ineffective; and concern about potential bleeding risks. The guidelines may also be perceived to be too complicated or difficult to apply in a routine manner. In addition, a lack of facilities or resources may also present a barrier to implementation of the guidelines. A number of strategies are being investigated in an attempt to improve compliance with guidelines for VTE prophylaxis. For example, the Investigators Against Thromboembolism (INATE) initiative has developed a simplified pocket guideline on VTE prophylaxis in orthopedic and trauma surgery in order to raise awareness of the current guideline recommendations.     

针刺治疗前列腺痛疗效观察

目的评价针刺治疗前列腺痛的疗效。方法选用前列腺痛患者60例,随机分成针刺组（n=30）和药物组（n=30）,观察两组疗效。结果针刺组治愈5例,显效12例,有效11例,无效2例,总有效率93.3%;药物组治愈2例,显效8例,有效13例,无效7例,总有效率76.7%。针刺组总有效率优于药物组（P〈0.05）,且针刺组在降低NIH-CPSI总积分及疼痛症状、尿路症状、生活质量各亚评分方面均优于药物组。结论针刺是治疗前列腺痛的有效方法。     

Recto-colonic reflex is impaired in patients with irritable bowel syndrome

Motor and sensory dysfunction of the gut are present in a subset of patients with irritable bowel syndrome (IBS). Recent studies have demonstrated the presence of a recto-colonic inhibitory reflex in healthy humans. It is not known whether this reflex exists in IBS. We studied rectal compliance, perception and the recto-colonic reflex by measuring volume responses of the descending colon to rectal distentions by barostat in 26 IBS patients and 13 healthy controls under both fasting and postprandial conditions. In the fasting state, rectal distention inhibited colonic tone and phasic motility to a similar extent in health and IBS. After a meal, rectal distention inhibited colonic tone and phasic motility to a lesser degree (P < 0.05) in IBS than health. Under postprandial but not fasting conditions, rectal distentions of increasing intensity were associated with higher pain scores in IBS than in health. Rectal distention inhibits tonic and phasic motility of the descending colon in healthy controls and in IBS patients. Postprandially this recto-colonic inhibitory reflex is impaired and attenuated in IBS patients compared with controls. These findings point to an altered reflex function in IBS and have implications for pathophysiology and therapy.     

基于BIS指数的麻醉给药系统研究设计

麻醉给药研究的关键问题之一是如何保证麻醉药品在人体效应室中的理想浓度。以药代动力学为基础的靶控输注（TCI）是一种可实现的方法,基于BIS指数的实时闭环麻醉给药系统实时控制靶控输注给药可以获得理想的麻醉效果。本文对这一麻醉给药系统的研究提出临床工程设计方案,并加以实现。     

正确饮水与安全用药

目的：探讨服药时饮水量及水的成分对所服药物的影响。方法：通过文献查阅和总结．对服药时需多饮水的药物、服药时需少饮水及不需饮水的药物、服药时对水的成分要求分别进行阐述。结果：服药时正确饮水，才能发挥最大治疗作用。结论：药师和医生应重视服药时饮水对疾病治疗的影响，给予患者正确的指导，保证患者用药安全、有效达到预期的治疗目的。     

Dixyrazine premedication for cataract surgery. A comparison with diazepam

Peroral dixyrazine (15–30 mg, n = 50) and diazepam (4–10 mg, n = 50) were used as premedicants for geriatric patients having cataract surgery under regional block. Compared to the diazepam patients, a larger number of the dixyrazine medicated patients appeared anxious, and there was a statistically significant difference between the groups, when summing up changes in anxiety throughout the study period. The dixyrazine patients needed more frequent supplementation with intravenous sedative drugs, compared with their diazepam counterparts. Peroral dixyrazine is an applicable choice for calm patients, when only slight sedation, or avoidance of somnolence are required.     

地塞米松对冷藏离体肺表面活性物质和顺应性的影响

目的:观察地塞米松对冷藏离体肺表面活性物质和顺应性的影响.方法:32只家兔肺随机均分为对照组、地塞米松冷藏(4℃)保存24h、72h、120h3个组.对照组:测定室温条件下的肺表面活性物质及顺应性.冷藏组:肺离体后立即置于含有地塞米松台式液中冷藏,在相应时间取出肺,室温条件下复温后,置入生理盐水中,测定肺表面活性物质,并测定注气(生理盐水)和抽气(生理盐水)过程中,肺容积在10ml、20ml、30ml时的肺顺应性.结果:冷藏24h组注水、抽水;72h组肺容积在10ml、20ml抽气、冷藏120h组在肺容积为10ml、20ml抽气的肺顺应性同对照组比较,差异无显著性(P>0.05).其余各组、项与对照组比较差异具有显著性(P<0.05),伴有表面活性物质的减少.结论:地塞米松冷藏离体肺顺应性增大,其影响程度随冷藏时间的延长而增加,同时伴有肺表面活性物质的减少.     

短期化疗对兔腹主动脉顺应性的影响

目的 比较短期化疗前后兔腹主动脉顺应性的变化，了解化疗药物对血管力学特性的影响。方法将15只新西兰兔随机等分为5组，其中4组接受1周期化疗（卡铂100mg／m^2，第1、3、5天；异环磷酰胺1500mg／m^2，第1、3、5天；足叶乙贰100mg／m^2，第l～3天），另1组为对照组。分别测量各组兔腹主动脉比顺应性（化疗组分为化疗后第2、7、14、21天进行观察）。结果短期化疗前后兔腹主动脉顺应性显著变化，化疗后第14天下降最明显，而第21天则基本恢复。结论短期化疗能够降低兔腹主动脉比顺应性，降低的程度与化疗后时间相关，并具有可逆行性。