干果之王——板栗

栗，又称栗子、栗果、板栗等，与枣、柿并称铁杆庄稼、木本粮食，被冠以“干果之王”、“山中药”、“树上饭”之美名。栗是坚果类，但与其他坚果有很大不同，即含有相当多的碳水化合物，而脂肪较少，供给人体的热量比其他坚果少一半以上。栗中维生素B2、纤维素含量丰富，钾含量也比较高，它能维持酸碱平衡，参加能量代谢以及维持神经肌肉的正常功能，还有降血压的作用。在古代，人们对栗子就情有独钟，常常食栗养生，留下了许多轶闻逸事。     

胰岛素抵抗综合征的护理进展

体温是临床医护人员采集病史和资料过程中最重要的客观指标之一，其准确性和精确性直接影响到疾病的诊断和治疗。近年来，有关体温的测量及其与临床的研究日渐增多，现将其测量方法与临床疾病的关系等进行综述，现介绍如下。     

Influence of moderate hypothermia on cerebral oxygenation in pigs with intracranial hypertension

BACKGROUND: Moderate hypothermia is one of the effective therapeutic methods for head injury in recent years, there are many mechanisms of moderate hypothermia for brain protection, and its influence on cerebral oxygenation is also one of them. OBJECTIVE: To observe the influence of moderate hypothermia on cerebral oxygenation of animals with acute intracranial hypertension, and further investigate the protective mechanism of moderate hypothermia. DESIGN: A randomized controlled trial. SETTING: Department of Neurosurgery, Renji Hospital affiliated to the Medical College of Shanghai Jiao Tong University. MATERIALS: Twenty healthy little pigs, either male or female, weighing 4.5–5.5 kg, were used. Neurotrend-typed multiparameter monitoring system (Diametrics Company, British); CMA/100 micro-injection pump (Carnegie Company, Sweden). METHODS: The experiment was conducted in the Changzheng Hospital affiliated to the Second Military Medical University of Chinese PLA in November, 2001. The pigs were randomized into two groups: the normothermia group (control group, n =10) and moderate hypothermia group (n =10). ① Bilateral femoral arteries were separated, one was connected to pressometer for monitoring mean arterial pressure (MEP), and the other for analysis of blood gases [including peripheral blood pH value, arterial partial pressure of carbon dioxide (PaCO2), arterial partial pressure of carbon dioxide (PaCO2), HCO3–]. ② Rectal temperature was monitored with mercurial thermometer. ③ Intracranial pressure was monitored using Camino optic ICP probe placed in the subdural space. ④ Neurotrend multiparameter monitoring sensor was inserted into the white matter for about 4 cm to determine cerebral perfusion pressure (CPP, CPP=MAP(ICP), brain tissue partial oxygen pressure (PO2), partial pressure of carbon dioxide (PCO2), HCO3– and brain temperature. The rectal temperature of animals in the moderate hypothermia group was lowered to 34 ℃ using ice bags, and the body temperature was maintained at 33–35 ℃ for 2 hours. The changes of the parameters were observed continuously, and the pigs in the normothermia group were not treated with cooling. MAIN OUTCOME MEASURES: ① MAP, ICP, rectal temperature, CCP; Indexes of cerebral oxygenation detected with Neurotrend-typed multiparameter monitoring system; ② Results of blood gases analysis in the moderate hypothermia group. RESULTS: All the 20 pigs were involved in the analysis of results. ① MAP, ICP, rectal temperature, CCP and indexes of cerebral oxygenation: In the moderate hypothermia group, the ICP after cooling was obviously lower than that before cooling [(3.31±1.19), (5.33±0.95) kPa, P < 0.05], CCP was higher, brain tissue PCO2 [(12.03±1.73), (10.59±2.01) kPa, P < 0.05], and brain tissue pH value was higher [(7.03±1.63), (9.40±1.30) kPa, P < 0.05], whereas the brain temperature was decreased as compared with that before cooling [(34.9±0.3), (37.2±0.2) ℃, P < 0.05]. ② Results of blood gases analysis in the moderate hypothermia group: There were no significant differences in the parameters of peripheral arterial blood gases analysis before and after cooling in the moderate hypothermia group (P > 0.05) CONCLUSION: Moderate hypothermia will not impair the cerebral oxygenation, and it can reduce brain tissue CO2 and decrease brain tissue acidosis.     

老年糖尿病并低血糖87例临床分析

目的 探讨老年糖尿病患者发生低血糖的原因。方法 对87例老年糖尿病人的低血糖症进行回顾性分析。结果 分析资料发现：磺脲类药物不合理投用占低血糖发生率的51．7％，用降糖药同时对饮食摄入不足而引发的低血糖症占10．3％，糖尿病肾功能不全引起药物不正常排泄而发生低血糖症占17．2％，胰岛素的投用过量占20．6％。结论 老年糖尿病病人，特别那些有伴存病的病人应尽量选用半衰期短，血药浓度积蓄较小的降糖药，并宜从小剂量开始，注意个体化，及时随访血糖，治疗上应防止再次低血糖症状发生，减少病死率。     

我国霍乱防治策略的可行性分析及对策

霍乱由于起病急,传播快,影响人民生活、生产及旅游、外贸等正常交往,因而被WHO规定为必须实施国际卫生检疫的三种传染病之一,也是我国法定管理传染病之一.本文试就我国霍乱的防治目标、策略和措施的科学性、可行性及实际工作中存在的问题进行初步探讨,并提出相应的建议和对策与同志们共同讨论.     

老年人测量腹股沟温度40例分析

我们2003—05-2003—08及2004—03-2004—05分别对40例随机抽取的已康复老年人进行了口温、腋温、腹股沟温的自身对照测量，现报告如下。     

正常者瞳孔间距与咬合垂直距离关系的研究

目的：研究正常[牙合]者瞳孔间距（Interpupillary Distance，IPD）与咬合垂直距离（Occlusal Vertical Dimension，OVD）的关系。方法：对116名福建籍青年正常[牙合]者测量其OVD与IPD，并进行两者相关回归分析。结果：总样本的OVD均值为65．35mm±4．70mm，IPD均值为63．98mm±3．26mm，男性正常[牙合]者OVD均值为68．16mm±4．23mm，IPD均值为65．46mm±2．96mm，女性正常[牙合]者的OVD均值为63．22mm±3．86mm，IPD均值为62．86mm±3．05mm;总样本的IPD与OVD的相关系数r=0．633，男性样本的IPD与0VD的相关系数r=0．563，女性样本的IPD与OVD的相关系数r=0．531。结论：IPD与OVD间存在显著相关性，IPD可以作为需咬合重建患者确定其OVD的参考指标。     

加温措施对腹腔镜卵巢囊肿切除患者体温的影响（附60例报告）

腹腔镜卵巢囊肿切除术是微创外科手术，具有切口小、痛苦小、出血少、愈合快等优点，腹腔镜手术极易发生低体温。手术过程中由于麻醉、身体暴露、输入冷液体、腹腔冲洗液、CO2气体等因素作用，病人普遍存在体温下降现象。而术后低体温与患者术后多种并发症的发生有关，对机体多个系统产生影响，从而影响患者的术后康复。因此，保持患者术中正常体温非常重要，笔者选取60例2008年1月～2009年10月在我院进行腹腔镜卵巢囊肿切除术患者，     

高压氧综合治疗急性CO中毒迟发性脑病一例

病例资料:患者,男,66岁。于2002年12月11日晚睡觉时,将封好的蜂窝煤炉放在室内取暖,第二天晨8时许,被发现昏迷在床上,当时呼之不应,推之不醒,口边有大量呕吐物,大小便失禁。遂诊断为急性CO中毒送我院急诊,抢救后病情基本稳定。行高压氧治疗,查体温36.5℃,脉博86     

阿德福韦酯 目前公认的一线用药

目前我国上市的核苷类药物主要有拉米夫定、阿德福韦酯、替比夫定和恩替卡韦四种，它们都是有效的抗病毒药物。作用机理也是相似的，各有各的优缺点。我们认为阿德福韦酯具有三大无可争辩的优点，其一，效果稳定。在长期治疗的过程中，其疗效能够随着治疗时间的延长进一步增加；第二，不良反应少，其每日10mg的剂量对于肾功能正常的慢性乙型肝炎患者实际上无明显不良反应，