1例成人活体右半肝移植术患者围手术期护理

世界首例活体肝部分移植术于1989年获得成功,因该术式具有供肝质量好、供受体组织相容性好、排斥反应轻、术后疗效优于尸体全肝移植等优点,故近年来有较大发展.我院肝胆外科于2003年2月成功实施了1例成人活体右半肝移植术,受者术后出现深静脉血栓、阴囊水肿等并发症,经过精心治疗与护理,患者康复出院.报告如下.     

Therapeutic effects of photosensitizers in combination with laser and ACNU on an in vivo or in vitro model of cerebral glioma.

This study investigated the independent and combined effects of photodynamic therapy (PDT), laser photodynamic hyperthermia (LPDH) and 1-(4-amino-2-methyl-5-pyrimidinyl) methy1-3-(2-chloroethyl) -3-nitrosourea hydrochloride (ACNU) in a rat 9L induced gliosarcoma model. The mortality rate (MR60), mean survival time (MST60), and increasing life span (ILS60) within 60 days were determined to evaluate the therapeutic effect in vivo. The MR60 and MST60 of the gliosarcoma tumor control were 100% and 16.2 days. The ILS60s of PDT and ACNU were 72.84% and 49.81%, respectively, but MR60 of both were 86.72%. All combined treatments produced significantly prolonged survival (P<0.01). The combined effects of LPDH and ACNU, MR60, MST60, and ILS60 were 60%, 43 days, and 165.4%, respectively. The ILS60 of PDT ACNU (96.48%) and PDT LPDH (98.58%) also indicated a synergistic or additive effect. The survival fraction and synthetic rate of DNA, RNA, and protein of glioma 9L tumor cells in vitro after single treatment of PD     

集束化护理在预防ICU患者导管相关性血流感染中的应用

目的:探讨集束化护理在预防重症监护室(ICU)患者中心静脉导管相关性血流感染中的应用。方法:将80例ICU患者根据护理方法不同分为观察组和对照组各40例,观察组采用集束化护理,对照组采用常规护理;比较两组导管置入时间、ICU住院时间、导管相关性血流感染发生率、白细胞(WBC)计数、C反应蛋白(hs-CRP)浓度、降钙素原(PCT)浓度、护理满意度。结果:观察组导管留置时间、住院时间均短于对照组(P 0. 05),中心静脉导管相关血流感染发生率低于对照组(P 0. 05),置管后1周WBC、hs-CRP、PCT等指标均低于对照组(P 0. 05),护理满意度高于对照组(P 0. 05)。结论:集束化护理能有效降低ICU患者中心静脉导管相关性血流感染发生率,缩短ICU住院时间,提高护理服务质量。     

1例全主动脉置换术后患者的护理体会

报告1例主动脉夹层(DeBaky-Ⅰ型)合并肾功能衰竭行全主动脉置换术患者的术后护理体会。术后护理要点包括:注意出血的观察和预防;加强机械通气的护理,保持呼吸道通畅;及早发现脑栓塞和截瘫等神经系统的并发症;维持有效的床旁血液滤过;重视无菌技术与手卫生,预防感染;加强基础护理。通过加强术后的护理,最大限度减少并发症,可以提高该类手术成功率。     

以任意放大多型性DNA之方法鉴别中药及复方中的术类

目的:藉由分子生物学的技术,鉴别中药复方中的单品药材—术类,以提升药材分析的灵敏度,进而促使药材品管升级。方法:藉由任意序列的引子,先以单品药材—术类为模板来建立该药材常用的品种,苍术及白术等之RAPD标志,以应用于复方之检测。结果:在RAPD的标志分析中,可得知引子OPF05对术类具有保留性,而引子OPF03则仅在白术有保留性,因而可以应用于区分苍术与白术。另外,白术诸种中,可由引子OPF14加以鉴别,而同种不同产地的白术,江坪上等与一等则可由引子OPF13得到区别。结论:中药材的鉴定,传统上以外型及化学方法加以区分,在本论文中,在分子层次上进行鉴定,除了灵敏度增加外,在复方及粉剂中,亦可有良好的鉴别效果。     

连续静脉-静脉血液滤过治疗中肝素抗凝的护理

连续性静脉-静脉血液滤过(CVVH)能否顺利进行抗凝是非常重要的环节,选择合理安全有效的抗凝方法进行CVVH可以降低出凝血的危险并提高治疗效果,而细致的护理观察是实施这一治疗的关键,现综述如下.     

揭秘重症监护系列“捆绑”患者是为了安全

重症监护室又名ICU，是英文intensive care unit的缩写，是指运用各种先进的医疗技术、现代化的监护和抢救设备，对各类危重病患者实施精心监测和精确治疗的单位。原则上，重症监护室只允许亲属探视，不允许患者家属陪护，因此，发生在重症监护室里命悬一线的瞬间便成了局外人的不解之谜。今天，由重症监护室的医务人员执笔，为读者们还原一个真实的ICU。     

ICU患者血乳酸水平与压疮发生风险相关性的观察

压疮形成的最根本因素是局部受压引起的微循环障碍,特别是骨性突起的部位,是压疮的易发部位[1-2].而组织低灌注可以导致细胞缺氧导致血乳酸水平升高[3],因此,我们认为ICU患者血乳酸水平可能与患者压疮发生相关.本研究着重于观察内科ICU患者血乳酸水平与压疮发生的相关性,以探讨血乳酸水平在压疮预防和治疗过程中的临床意义,现报道如下.     

Effect of berberine alone or in combination with argon ion laser treatment on 9L rat glioma cell line.

The cell-killing effect and its possible mechanism of berberine used alone or in combination with argon ion laser treatment on 9L rat glioma cells were studied. The survival fraction of 9L cells after single treatment of berberine has been investigated using both colony formation and microtitration (MTT) method, the half lethal dose of berberine (LD50) has been estimated to be 60 /μg / ml. After the addition of low energy laser treatment, the LD50 of berberine markedly decreased to 10 μg / ml. The inhibitory effect of berberine on biosynthesis for DNA, RNA, and protein of 9L cells was enhanced by argon ion laser. Moreover, when morphologic change was examined, the 9L cells showed lysis, encystation, and degeneration after berberine treatment; the laser treatment enhanced the cell-killing effect. The study proves the cell-killing effect of berberine combined with laser treatment on 9L rat glioma cell line, hence introducing the possibility of berberine as a photosensitive agent.     

解密运动内衣

产生乳头内凹的原因是文胸长度较胸围短，这样，文胸便紧紧压迫乳房，影响了乳房的血液循环，还会压迫乳头，使其平坦甚至内凹。乳头内凹会影响将来哺乳，还会发生乳腺导管炎，甚至形成痿管、窦道。