急诊护理组长夜间值班制的实施与进展

自2005年7月开始，我院急诊科增加了一档新的班次，由急诊护理组长参与夜间急诊的值班工作，全面负责夜间高峰时段各部门之间的协调工作。实施一年多下来，收到良好效果．现报道如下。     

住院病人与护理人员对优质护理的认知调查

[目的]探讨住院病人与护理人员对优质护理的认知情况。[方法]自行设计的优质护理认识调查问卷，对2所市级二级甲等医院的住院病人和护理人员各200名进行调查。[结果]知识技能、服务态度及健康指导在住院病人和护理人员认知上存在统计学意义（P〈0．01），而在对病人的关爱与沟通及病人的感受比较差异无统计学意义（P〉0.05）。[结论]住院病人和护理人员对优质护理的认识有共同的观点，也有其独特的见解。     

中药治疗绝经后妇女慢性盆腔痛的临床观察

本文总结了应用中药治疗绝经后妇女慢性盆腔痛的疗效。18例停经半年以上的绝经后妇女，除了有不同程度常见绝经期综合征症候群外，还出现持续存在或反复发作慢性盆腔痛等的症状。经自拟方安度更年汤加减治疗3个疗程后，随着绝经期征候群的改善，慢性盆腔痛的症状也得到明显控制，治愈率占61％，有效率达89%。治疗结果表明：绝经后尤其以往患过盆腔炎的妇女由于雌激素缺乏，生殖泌尿系日趋萎缩，其周围支持组织变硬而失去弹性、或因抵抗力下降而易伴发慢性盆腔炎症等，因此部分妇女可以表现为慢性盆腔痛，实属绝经期综合征症状之一。所以应用调补肝肾，强壮冲任为主的安度更年汤加减治疗绝经后妇女表现为盆腔痛者，疗效显著，不易复发，无副作用，效果明显优于抗生素及其他疗法。     

治本截源辨治难治型乳儿黄疸的临床经验

乳儿黄疸属于中医“胎疸”范畴，发病率逐年上升，难治型乳儿黄疸属其重症，由多种疾病引发，多见于现代医学的肝后阻塞陛黄疸，如先天性胆道囊肿或结石、先天性胆道闭锁、胆汁瘀积征等。该病黄疸深重，病程长，退黄难，预后差，实验室检查血清胆红素可超过正常值的10倍以上，肝功能损害严重。西医多采用抗感染、光照、酶诱导、换血甚至手术疗法，花费昂贵，疗效不确切。众多患儿初期生长发育迟缓，后期则致胆汁性肝硬化，随后出现门脉高压、脾机能亢进、恶病质衰竭而死亡。北京儿童医院特级专家裴学义是国家级名老中医、北京四大名医孔伯华的关门弟子，在治疗乳儿黄疸方面造诣颇深，堪称京城一绝。笔者有幸侍诊2年，学用裴老师辨证施治、治本截源的独特方法，与小儿外科医生合作治疗本病收到奇效。现举验案2则报告如下，借以体现老师宏富经验之一斑。     

脑立体定向术治疗震颤麻痹76次临床分析

我院从1985年4月至1989月10月采用立体定向丘脑腹外侧核毁损术治疗震颤麻痹58例,76次手术(18例为双侧手术),取得了满意效果,现报告如下。临床资料本组男39例,女19例,年龄22～68岁,41岁以上共50例,占86.2％。能问出诱发原因者有:脑外伤6例,汞中毒1例,高烧后发病2例,脑炎1例,精神创伤1例,其余47例均     

CALCIUM ANTAGONISTS IN PREVENTION OF HYPERTENSION AND STROKE IN STROKE-PRONE SPONTANEOUSLY HYPERTENSIVE RATS

To investigate the effect of Calcium antagonists (Ca-An) with different tissue specificity in the devel- opment of hypertension and stroke in salt-loading SHRSP, three experiments were conducted. In exper- iment I (1), 50 8-week-old male SHRSP were divided into three groups and given nifedipine (NF, 32mg / kg /day), menidipine (MN 32mg / kg / day)and placebo (control group)respectively. In the controJ group 83.3%(15 / 18)died of stroke and 17 showded renal vascular sclerosis. Their average lifespan was 84 days. NF and MN significantly re- duced systolic blood pressure (SBP), and no stroke of renal vascular sclerosis developed.ln experiment I(2), 54 7-week-old male SHRSP were divided into three groups (18 in each group). They were treated with nimodipine (NM)20mg / kg / day, 2mg / kg / day and placebo respectively. NM (20mg / kg / day) markedly lowered SBP and postponed the onset of stroke. Only 11% died in 17 weeks. NM (2mg / kg / day did not lower SBP but postpond the onset of stroke. In exper- iment 11 (1), 29 10-week-old female SHRSP were di- vided into three groups: Group A was given NF 32mg / kg / day, group B was parathyoidectomized (PTX) and group C served as control. PTX group did not lower SBP but could postpone the onset of stroke. In experiment Ⅱ (2), 33 male SHRSP were divided into three groups and ticated as desctibed above :in experiment Ⅱ (I)(ll in each group). Seven weeks after the experiment, the brain blood flow of NF group was significantly greater (67.5%)than that of the control and PTX groups. In experiment II, 27 7-week-old male SHRSP were divided into three groups as described above in experiment I(2). Two weeks after the treatment, significant difference was found in norepinephrine (NE)contents of the anterior hypothalamic region (AHR)between NM (20mg / kg / day)group and control group (2 870 vs 2 304 pg / mg tissue). Our results show that Ca-An (nimodipine)can re- verse the NE depletion by high salt in SHRSP, thus lower SBP and prevent stroke.