大肠杆菌O120 O-抗原基因簇的破译及特异分子标识的鉴定

目的完成产志贺毒素大肠杆菌O120 OO-抗原基因簇的破译，筛选和鉴定检测用特异分子标识。方法利用鸟枪法进行O-抗原基因簇序列的测定，进行生物信息学方法分析发现基因并预测基因功能，利用PCR方法筛选针对大肠杆菌O120 O特异基因和特异引物，利用基因芯片方法筛选特异探针。结果O-抗原基因簇序列全长12485bp，共含有10个基因：dTDP-鼠李糖合成途径基因（rmlB、rmlD、rmlA和rmlC），O-抗原转运酶基因（uzx），O-抗原聚合酶基因（wzy），3个糖基转移酶基因和1个功能未确定的基因。另外筛选和鉴定了2个特异基因、4对特异引物和6条特异探针，在模拟样品的鉴定中得到验证。结论多种特异分子标识可从样品中特异地检测出大肠杆菌O120 O，具有快速、灵敏和准确进行分子分型的优点。     

气管切开病人两种吸痰程序的效果观察

目的 观察两种不同吸痰程序的效果.方法 将40例气管切开病人随机分为实验组(n=20)和对照组(n=20),实验组患者吸痰方法为先湿化气道再经气管插管吸痰,对照组20例则先经气管插管吸痰再湿化气道.结果 实验组肺部感染发生时间较对照组晚,感染率、黏膜损伤发生率、吸痰次数及吸痰后30 min氧饱和度均值,与对照组比较差异有统计学意义(P<0.01).结论 先湿化气道再吸痰效果优与先吸痰再湿化气道.     

小儿急性肺损伤的短期肺功能随访

Objective To study the pulmonary functions of pediatric ALI/ARDS(acute lung injury/acute respiratory distress syndrome) survivors. Method A prospective cohort study of all survivors of ALI/ARDS in the PICU of Beijing Children's Hospital was performed. Patients were divided into three groups(0-3 years of age,3 ～ 7 years of age, and over 7 years of age) and followed up three months after diagnosis. Results There were 36 survivors in total of 44 ALl patients, three patients lost follow-up, 12 died and 21 survived. Five survivors refused to participate in the study because of asymptomatic, and one was unable to participate because of lymphoma com-bined with sepsis. A total of 15 children completed the whole survey (11 patients were less than 3 years old, andfour were over 7 years of age). Twelve patients had no discomfort in their respiratory tracts. Three months after be-ing enrolled, the pulmonary functions of all children improved, especially in terms of tidal volume and respiratory compliance (P<0.05). Conclusions The abnormal respiratory symptoms and signs in most children disap-peared three months after discharge. Most survivors still have pulmonary dysfunction at 3 monthes after discharge, but better than discharge.     

儿童多器官功能障碍综合征的研究

1 引言 MODS是指机体受到严重感染、创伤、休克、中毒及大手术等急性损害24 h后,同时或序贯性出现2个或2个以上的器官或系统功能障碍甚至衰竭,以致不能维持内环境稳定的临床综合征.MODS是儿童ICU的主要死亡原因,儿童作为一个特殊群体,其MODS的发生、发展以及临床诊疗过程与成人比较有一定差异,本文重点介绍儿童MODS的特点.     

痛风患者的护理

2002-01～2004-02我们共收治痛风18例,护理体会如下. 1 临床资料 本组男14例,女4例,年龄43～75岁,平均51.7岁.受累关节单侧拇趾9例、双侧拇趾5例,单侧柘趾关节3例,单侧拇指关节1例.血尿酸3.72～4.56mmol/L,病程10 d～8 a,均无痛风石结节及关节畸形出现.本组均经综合治疗症状控制.     

小儿急性肺损伤的短期肺功能随访

Objective To study the pulmonary functions of pediatric ALI/ARDS(acute lung injury/acute respiratory distress syndrome) survivors. Method A prospective cohort study of all survivors of ALI/ARDS in the PICU of Beijing Children's Hospital was performed. Patients were divided into three groups(0-3 years of age,3 ～ 7 years of age, and over 7 years of age) and followed up three months after diagnosis. Results There were 36 survivors in total of 44 ALl patients, three patients lost follow-up, 12 died and 21 survived. Five survivors refused to participate in the study because of asymptomatic, and one was unable to participate because of lymphoma com-bined with sepsis. A total of 15 children completed the whole survey (11 patients were less than 3 years old, andfour were over 7 years of age). Twelve patients had no discomfort in their respiratory tracts. Three months after be-ing enrolled, the pulmonary functions of all children improved, especially in terms of tidal volume and respiratory compliance (P<0.05). Conclusions The abnormal respiratory symptoms and signs in most children disap-peared three months after discharge. Most survivors still have pulmonary dysfunction at 3 monthes after discharge, but better than discharge.     

多器官功能障碍综合征（下）——儿童多器官功能障碍综合征的研究

MODS是指机体受到严重感染、创伤、休克、中毒及大手术等急性损害24h后，同时或序贯性出现2个或2个以上的器官或系统功能障碍甚至衰竭，以致不能维持内环境稳定的临床综合征。MODS是儿童ICU的主要死亡原因，儿童作为一个特殊群体，其MODS的发生、发展以及临床诊疗过程与成人比较有一定差异，本文重点介绍儿童MODS的特点。     

住院病人安全告知的做法与体会

医院应为住院病人提供一个安全的休养环境，医务人员有告知病人注意自身安全的责任，病人有遵守院规、配合医务人员完成治疗的义务。为加强住院病人安全防范，防止安全隐患，减少安全纠纷，我院自2002年8月开始对每位新入院病人使用书面安全告知，并注意履行住院期间的告知义务，同时加强了安全防范措施，2年来全院未发生一例护理安全纠纷，现将我们的做法与体会介绍如下：     

低体重婴幼儿心脏手术围手术期护理238例

2003年8月～2004年11月，我院施行了10Kg以下婴幼儿先心病心脏直视手术238例，先将护理体会报告如下。     

对正畸患者实施口腔健康教育集体培训的效果评价

[目的]探讨对正畸患者实施口腔健康教育集体培训的效果.对比实施不同的健康教育方法正畸患者出现牙龈炎和牙釉质脱矿的情况的变化,评价口腔健康教育集体培训效果.[方法]将60例正畸治疗初戴固定矫治器的患者,随机分为3组,每组各20例.第1组为对照组,对患者不进行口腔健康教育;第2组对患者进行个别简单的口腔健康教育,第3组对患者采用集体培训的口腔健康教育方式.用牙龈炎发生率和牙釉质脱矿的发生率评价口腔健康教育集体培训效果.[结果]戴固定矫治器3个月3组间的牙龈炎发生率和牙釉质脱矿的发生率差异没有统计学意义(P>0.05).戴固定矫治器6个月3组间牙龈炎发生率和牙釉质脱矿的发生率差异有统计学意义(P<0.05).[结论]固定矫正器矫治过程中出现的牙龈炎、牙釉质脱矿问题值得注意,口腔健康教育集体培训是预防正畸患者发生牙龈炎、牙釉质脱矿的有效方法.