新生儿病理黄疸928例病因及治疗分析

目的 探讨新生儿病理件黄疸的病因及其相关危险因素以及早期合理治疗对防止胆红素脑病的积极意义.方法 本文对我院2004年1月至2008年12月住院的928例新生儿病理性黄疸患儿进行病因的相关危险因素分析,并给予适当的治疗分析.结果 928例新生儿病理性黄疸病因分析中有明确病因的占68.7%(638/928),主要有新生儿感染、新生儿溶血病、新生儿窒息、母乳性黄疸、头颅血肿、早产儿、肝胆疾病及遗传代谢性疾病;与围产因素相关的占56.6%(525/928),包括宫内窘迫、新生儿窒息、剖宫产、使用催产素、镇静剂、羊水污染、妊娠高血压.糖尿病是病理性黄胆的主要危险因素,不明原因占16.4%(152/928).治疗主要以双面蓝光照射为主,补碱补液、再辅以相应病因等措施治疗,效果良好,极少使用丙种球蛋、血浆、白蛋白等血制品.结论 新生儿病理性黄胆病因多,有些患儿黄疸是多种因素共同作用,主要为感染性,围产因素及溶血病,不明原因亦占较重要地位;积极防治并处理孕期疾病,严格掌握剖宫产指征,减少人为的催产素及镇定剂使用,积极喂养,及时处理新生儿期的并发症.可以大大减少新生儿病理性黄疸发生率,早期治疗可改善预后.     

经期输卵管结扎术近,远期并发症研究

目的：论证经期施行输卵管绝育术的可行性。方法：对１９９１年６￣８月所行的１２９５例腹式输卵管结扎术者，取经期施术者２０３例为观察组，非经期施术的２０８例为对照组，对两组在术后近期并发症及术后４年随访的远期并发症发生率进行比较。结果：经期组与非经期组在结扎术时、术后近、远期并发症的发生率在统计学上均无显著性差异（Ｐ〉０．０５）。结论：在输卵管结扎术的手术时间选择上，只要排除妊娠，无常规手术禁忌证，无     

不同药物治疗下肢骨折病人围手术期寒战的效果比较

硬膜外麻醉是下肢骨折病人常用的麻醉方法，而寒战又是硬膜外麻醉中常见的并发症，本文就多沙普仑、咪唑安定、哌替啶对寒战的治疗作用进行了对比观察，现报告如下。     

转型时期部队医院改革与发展的思考

为探讨转型时期部队中心医院的改革与发展，本阐述了以保障需要为目标拓展为兵服务思路，以市场需求为导向突出经营意识；以服务理念更新为突破提高部分能力；以人才建设为根本强化发展后劲。     

Delay in simple reaction time after focal transcranial magnetic stimulation of the human brain occurs at the final motor output stage

It is known that the execution of the motor response in a simple reaction time (RT) task can be delayed by transcranial magnetic stimulation (TMS). This paper is aimed at determining the site of action where the delay in RT occurs. A delay in RT was obtained only at those TMS sites over the motor cortex contralateral to the responding hand, which produced also a muscle twitch in the responding hand. The delay in RT covaried with the TMS intensity and increased the closer the time of TMS approached the expected time of reaction onset. Visual and auditory go-signals yielded similar delays in RT, but only when TMS was applied about 40 ms later for the visual go-signal, corresponding to the modality specific difference in RT control values. TMS of the supplementary motor area (SMA) immediately prior to the expected time of reaction onset produced no delay in RT. Spinal excitability as tested by F waves showed a pre-movement facilitation in the control trials which continued seemingly undisturbed during the period of RT delay after TMS. It can be concluded that the delay in RT is not due to SMA stimulation or spinal inhibition but depends on effective stimulation of neural elements in the motor cortex which are active very late in the process of movement release from the final motor output stage.     

Heart period and variability findings in preschool children with posttraumatic stress symptoms.

BACKGROUND: Traumatic experiences for young children might result in profound neurodevelopmental changes, compared with adults. Our aim was to examine autonomic control of heart rate in traumatized young children. METHODS: Sixty-two children who had suffered traumas and 62 nontraumatized control children, aged 20 months to 6 years, were assessed for posttraumatic stress disorder (PTSD) symptoms, interbeat interval, respiratory sinus arrhythmia (RSA), family rehearsal of the trauma, and parent-child relationship quality. RESULTS: Traumatized children with PTSD and traumatized children without PTSD both had decreased heart period in response to a trauma stimulus relative to the nontraumatized group (both p < .0167). there was no main effect for RSA change scores, however, there was a significant interaction effect between parental positive discipline with PTSD symptoms and RSA. The most sympathetic children had decreased RSA during the trauma stimulus when they had caregivers with less positive discipline during a clean-up nd family rehearsal with PTSD symptoms. CONCLUSIONS: These findings underscore that psychopathology in young children ought to be assessed in the context of psychophysiology and parent-child relationship to optimally understand the mechanisms of maladaptation during this complex developmental period.     

利福平滴眼液有效使用期限的实验观察

目的 研究0．1％利福平滴眼液有效使用期限。方法 配制以pH5．4、pH6．4、pH7．4的3种硼酸盐缓冲液为溶剂的利福平滴眼液，贮存温度为4-10℃避光条件，观察其性状、测定pH值、应用紫外分光光度法测定含量。确定最佳的pH值和有效使用期限。结果 3种pH值硼酸盐缓冲液的利福平滴眼液的性状、含量、及pH值稳定性均较好，有效使用期限均可定为6个月。结论 pH7．4的硼酸盐缓冲液配制的0．1％利福平滴眼液有效期长，稳定性好，便于临床应用。     

杰克·伦敦早期小说的创作成因

杰克·伦敦的一生 ,历经人间沧桑 ,充满传奇色彩 ,但他却偏偏选取寂静的北方作为小说创作的首选题材。当时美国文坛编辑的平庸、读者的好奇心理以及作者自身贫困的生活境遇是造成这一现象的外部原因 ;对写作的痴迷和执着 ,对生活的独特感受 ,是其内部原因。杰克·伦敦哲学思想的矛盾和迷乱导致了对其北方系列小说的争议 ,我们应从中探寻某些教训     

植入式微波治疗晚期肝癌78例探讨

原发性肝癌以手术切除为治疗首选,而晚期肝癌能切除的不足10％。如何全面地治疗晚期肝癌,仍是临床上未解决的难题。我们以最大限度降低肿瘤负荷为原则,从尽量保留正常肝组织,减少术后肝功能衰竭的发生,提高手术成活率及术后生存时间的角度出发,针对晚期肝癌的特点,通过78例晚期肝癌采用植入式微波切除治疗48例,提高了晚期肝癌的手术切除率,减少了术后肝功能衰竭的发生,有效地延长了晚期病人的生命,为过去认为无法切除的晚期肝癌开辟了一条治疗途径。     

乌司他丁对非体外循环冠状动脉旁路移植术病人围术期炎性反应的影响

目的观察乌司他丁对非体外循环冠状动脉旁路移植术(OPCABG)病人围术期炎性反应的影响。方法拟行OPCABG的病人24例,采用随机、双盲方法分为对照组(C组)和乌司他丁组(U组),每组12例。静脉注射咪达唑仑0.1mg/kg、芬太尼10～20μg/kg、哌库溴铵0.1mg/kg麻醉诱导后气管插管,机械通气,吸入1%～2%异氟烷、间断静脉注射芬太尼(2～5μg/kg,总量最高为50μg/ kg)、持续静脉输注哌库溴铵0.03～0.05mg·kg~(-1)·h~(-1)维持麻醉。U组麻醉诱导后开始恒速静脉输注乌司他丁6 000U/kg(30min内输完),然后以1 000 U·kg~(-1)·h~(-1)的速率持续静脉输注至手术结束。C组采用的同样方法输注等容量的生理盐水。分别在切皮前即刻(T_1)、冠状动脉全部吻合结束后0.5h (T_2)、术后2h(T_3)、6h(T_4)、18h(T_5)采集静脉血,测定血浆白细胞介素-6(IL-6)、IL-10、终末补体复合物(TCC)的浓度及CD11b/CD18的表达。结果与T_1比较,C组在T_(3,4)时IL-6浓度、T_3时IL-10浓度升高,T_(2-4)时CD11b/CD18表达升高,2组在T_2时TCC浓度均升高(P<0.05或0.01);与C组比较,U组在T_3时IL-6、IL-10浓度降低,在T_(2～4)时CD11b/CD18表达降低(P<0.05或0.01)。结论乌司他丁可在一定程度上抑制OPCABG病人围术期IL-6、IL-10浓度及CD11b/CD18表达的升高,具有减轻炎性反应的作用。