疗养院医疗器械的管理

随着现代基础医学研究，特别是临床实验医学研究的迅速发展，科学精密的医疗器械、实验仪器和先进的诊断技术应用于临床，使临床医疗诊断技术水平发展到一个前所未有的新阶段。当前医疗卫生单位装备管理工作中还存在着重使用、轻管理，重维修、轻保养，重硬件、轻软件等管理问题。做好医疗器械装备管理工作，是卫生事业现代化建设的重要组成部分，它对医疗卫生保健工作质量水平的提高起到重要的保证和促进作用。     

胞外囊泡作为药物传递天然纳米载体的研究进展

细胞释放膦脂膜的小囊泡在细胞交流、抗原递呈、感染物的传递等方面起关键作用。胞外小囊泡携带各种蛋白、mRNA、microRNA(miRNA),象一个卡车运载"货物"一样,将携带的各种分子运载至远端的细胞。而且,被小囊泡包裹的分子可避免被体液中的酶降解,使胞外囊泡成为天然的、新颖的药物传递系统。该文综述了胞外囊泡的分类、组成、生物药物应用、以及作为药物传递载体在临床实验应用等方面的研究进展,为寻求新的药物传递系统治疗相关疾病提供理论基础。     

护理学教育在临床实施中存在的问题及对策

就现阶段的护理学教学工作而言,仍然存在着一系列的问题,导致在具体的临床实施过程中呈现出了诸多弊端.为此,本文主要就护理学教学在临床实施中的问题进行了浅要分析,并提出了有针对性的应对措施.     

自制一次性输液袋靠垫

鼻出血行鼻腔填塞、鼻腔外伤、鼻部手术后的患者常规使用抱枕、棉被、衣物、枕头作为靠垫，以达到舒适、减轻疼痛的目的。但以上物体体积大、稳定性差、不能较长时间使患者处于舒适半坐卧位的状态，而影响了术后患者对自己病情康复的信心。为了解决这个问题，经过我科多年临床实验、应用和总结，制作了一次性输液袋靠垫，供各位同仁参考和使用。     

Experimental and clinical assessment of percutaneous hepatic quantified ethanol injection in treatment of hepatic carcinoma

AIM: To detect the relationship between absolute ethanol injection quantity, the interval and formation of fibreboard, the curative effect in treatment of hepatocarcinoma and to evaluate the clinical application of percutaneous hepatic quantified ethanol injection (PHQEI) in treatment of hepatic carcinoma (HCC).METHODS: (1) Experimental study: Twenty-four human hepatic carcinoma SMMC-7721 xenografted nude mice were randomly divided into three groups: group A injected with quantified ethanol at short intervals (QESI), group B with quantified ethanol at long intervals (QELI) and group C with a small quantity of ethanol at long intervals (SQLI). The tumor tissues were sent for patho-histology and electron microscopic examinations. The diameters of tumors were measured with high frequency ultrasound before and after therapies and tumor growth index (TGI) was calculated. (2) Clinical study: Tumors of 122 cases of pathologically proved HCC were injected with quantified ethanol guided by ultrasound every 3-5 d 4-10 times per period of treatment. The quantity of ethanol was calculated according to the regressive equations where Y = 2.885X when the mass was ≤5 cm in diameter and Y = 1.805X when the mass was >5 cm in diameter (X is the maximal diameter of the mass with the unit cm, Y is the ethanol quantity with the unit mL). The survival rates of 1, 2, 3 and 4 years and recurrent rates in situas well as dystopia in the liver were calculated.RESULTS: (1) Experimental study: TGI of QESI group (0.072:1:0.018) and QELI group (0.094:1:0.028) was apparently lower than that of SQLI group (1.982:1:0.482) (P<0.01). TGI of QESI group seemed to be lower than that of QELI group, but it was not markedly different (P>0.05) between two groups. Severe degeneration and necrosis could be seen in QESI group by patho-histology examination. Coagulative necrosis could be seen in most tumors of QESI group and there were no residual cancer cells under electronic microscope, while the residual cancer and inflammatory cells and fibre tissues could be seen around the tumors of QELI group. Infiltration of inflammatory cells could be seen and fibre tissues were formed. (2) Clinical study: B mode ultrasound showed that 62.5% of tumors shrank after PHQEI. The survival rates of 1, 2, 3 and 4 years of the group with tumors ≤3 cm in diameter were higher than those of the group with tumors >3 cm in diameter. The recurrent rates of tumors in situof the former group were apparently lower than those of the latter group. The recurrent rates of tumors in dystopia in the liver of the former group were markedly lower than those of the latter group. The 122 cases underwent a total of 1221 PEI. There were no complications such as hemorrhage and severe heart, liver and kidney functional injuries except for 1 case of melena and 4 cases of jaundice who recovered after 1-2 wk under common therapies.CONCLUSION: The experimental study shows quantified ethanol at intervals of 3-5 d could improve the curative effect of hepatocarcinoma. The clinical study shows PHQEI is an effective therapeutic method for HCC with few side-effects, and a low-cost. The treatment efficacy is more remarkable for tumors ≤3 cm in diameter.     

客观评价高血压随机对照临床实验及其临床价值

在过去50年中,欧美国家开展了大量高血压临床试验研究奠定了高血压的治疗基础,证明使用各种降压药物降低血压可显著减少脑卒中心肌梗死等心脑血管事件。随机对照临床试验是循证医学的基础,也是制定指南的重要依据。但临床试验的证据主要提供一些基本原则,不能替代临床实践的专业行为。临床试验都是在那些经常发生事件的人群中开展,而未纳入试验的年轻患者不经常发生事件。临床医生需要更多的证据来证明在年轻、低危人群中进行降压治疗的价值,控制血压的目标不是去努力治疗并发症,而是如何阻止疾病的进展[1-3]。1研究资金影响学术结论绝大多…     

中药"克疣灵"对尖锐湿疣病人细胞免疫水平调节作用的临床和实验研究

目的 探讨中药“克疣灵”口服液对经6Gyγ-线照射后的SD大鼠及尖锐湿疣(CA)病人外周血清白细胞介素(IL-18)、肿瘤坏死因子(TNF)-α水平、自然杀伤细胞(NK)活性，以及对局部瘤体组织IL-18、TNF-α表达水平的调节作用机理。方法 采用6Gyγ-线连续照射SD大鼠(0．6Gy／min，距^60Coγ源0．1m，15min／次／日，15日)造成细胞免疫缺陷的实验动物病理模型，并灌饲高低剂量“克疣灵”口服液。临床研究设“克疣灵”口服液治疗组45例，病人，给予“克疣灵”口服液．50ml，3次／日，口服；局部外用“克疣灵”外搽剂4次／日，共6周。对照组40例病人，肌注α-1b基因工程干扰素300万U／次，3次／周；外搽人重组α-2b干扰素凝胶4次，共6周。动物灌饲与病人疗程结束后，采用酶联免疫吸附试验(ELISA)双抗体夹心法测定外周血清IL-8、TNF-α水平，CA病人局部瘤体组织IL-18、TNF-α表达水平，采用同位素释放法测定动物脾脏：NK细胞与人NK细胞活性。结果 “克疣灵”口服液能显著提高造模动物与CA病人外周血清IL-18、TNF-α水平，增强NK细胞的活性，疗后治疗组瘤体治疗部位IL-18、TNF-α表达水平显著高于对照组。结论 “克疣灵”口服液具有显著的正向免疫调节作用，能显著改善造模动物细胞免疫缺陷，增强CA病人的细胞免疫能力。     

如何向SCI收录的优秀期刊投稿：我们的服务①本刊发展部

项目与内容1.提供翻译和语言润色服务（保证润色后为地道英语水平）。2.提供选刊服务（学科内期刊,相关交叉学科期刊）。3.提供格式规范和首次投稿服务（按所投期刊要求规范稿件格式）。4.提供临床实验注册服务（北美临床注册中心）。5.提供课题所需相关信息检索服务。     

苦参素抗肝癌作用研究

苦参素是生物碱类药物,在临床上主要用于慢性肝炎等疾病的治疗。近年来,苦参素抗肝癌的治疗已逐渐受到广大学者的关注。苦参素抗肝癌作用机制主要包括抑制肝癌细胞增殖、诱导肝癌细胞分化、促进肝癌细胞凋亡、抑制端粒酶活性、阻滞细胞周期进展、调节宿主免疫功能、抑制肝癌血管内皮细胞增殖、逆转肝癌细胞多耐药性。现就苦参素抗肝癌的作用机制、实验研究和临床应用进行综述。     

巧克力：甜蜜的阿司匹林

如果冠状动脉或者脑动脉有粥样斑块,如果在这个斑块的基础上有血栓形成,就会发生心肌梗塞或者脑卒中。所以,冠心病或者缺血性脑卒中的患者都需要口服小剂量的阿司匹林预防血栓形成。最近,一个研究阿司匹林的临床实