祛疣汤外洗配合微波治疗肛门尖锐湿疣58例

目的:观察清热解毒、利湿消疣类中药配合微波治疗肛门尖锐湿疣的疗效。方法:采用祛疣汤(大青叶、败酱草、板蓝根、薏苡仁、蛇床子、鸭胆子、白藓皮、苦参等)外洗AMT微波手术治疗机配合治疗肛门尖锐湿疣58例。结果:有效率100%,治愈率98.5%。提示:本方法对本病有清热解毒,利湿消疣的功效;可减少痛苦,预防复发。     

颅脑损伤患者失眠相关因素分析

失眠是指从睡眠开始的入睡障碍和睡眠的维持障碍。失眠包括入睡困难、清晨觉醒过早、睡眠时间短、睡眠中断、白昼睡眠过多。失眠给患者的身心健康带来困扰，使人的生理节律紊乱，活动能力下降，严重影响机体的修复。我们在临床护理工作中发现，颅脑损伤神志清醒的患者常常被失眠困扰。遂采用问卷调查方法了解84例颅脑损伤神志清醒住院患者失眠的相关因素，以了解他们的睡眠状况，找出具有共性的问题，探索减少患者失眠发生的应对措施，为临床护理工作的供指导。     

护理美学的应用与老年病人心理效应

为了提高护理质量，改善老年病人心理状态，我们尝试把美学教育贯穿于对护士教育管理中：通过抓护士美好心灵的陶冶，抓美好形象的塑造，抓技术的精益求精，抓优美环境的营建，提高了护士的整体素质，大家自觉地以高质量做好护理工作。病人产生了良好的心理效应，切实提高了老年病人住院期间的生活质量。     

ClO_2毒性研究

ClO_2是一种可以代替液氯的新型消毒剂。本文通过金鱼毒性实验,确定了ClO_2用于饮水消毒的安全浓度;通过小白鼠急性经口毒性实验,确定了ClO_2属实际无毒型水处理剂。     

BRL-37344对心力衰竭大鼠β肾上腺素受体表达水平的影响(英文)

目的　探讨 β3 肾上腺素受体 (β3 AR)及其激动剂BRL 37344 (BRL)在心力衰竭中的作用。方法大鼠分为对照组、异丙肾上腺素 (Iso)组和Iso +BRL组。Iso组和Iso +BRL组大鼠间隔 2 4h ,scIso 340mg·kg- 12次制作心力衰竭模型。 8周后 ,Iso +BRL组大鼠从尾静脉给予BRL 0 .4nmol·kg- 1·min- 1,10min ,每周 2次 ,给药 2或 6周。分别于给Iso后 10或 14周测定死亡率、血流动力学、左室重 /体重、心肌组织 β1 ,β2 和 β3 ARmRNA水平。结果　 14周时对照组、Iso组和Iso +BRL组分别死亡 0 / 2 0 ,3/ 18和 5 / 2 2 (P >0 .0 5 )。Iso使左室收缩末压、±dp/dtmax明显降低 ,左室等容舒张时间常数、左室舒张末压明显增高 ,左室重 /体重明显增加 ;与Iso组比 ,Iso +BRL组的心脏舒缩功能进一步下降 ,左室重 /体重进一步增加。Iso组 β1 ARmRNA水平降低 ,β3 ARmRNA水平升高 ,与Iso组比较 ,Iso +BRL组 β1 ARmRNA水平更低 ,β3 ARmRNA水平更高。β2 ARmRNA 3组均有下降趋势 ,但无统计学差异。结论衰竭心脏β1 AR水平下降及 β3 AR水平增高可导致心功能降低。β3 ARmRNA水平在衰竭心脏比非衰竭心脏明显增高 ,应用 β3 AR激动剂可明显加重心力衰竭。     

甲基强的松龙联合环磷酰胺冲击治疗儿童难治性肾病综合征

目的:观察甲基强的松龙(MP)联合环磷酰胺(CTX)冲击治疗儿童难治性肾病综合征的临床疗效。方法:将56例难治性肾病综合征患儿随机分为A、B两组,A组给予甲基强的松龙联合环磷胺冲击治疗,B组给予强的松联合环磷酰胺冲击治疗。结果:A组28例患儿中14例完全缓解,8例部分缓解,总有效率78.57%。B组7例完全缓解,8例部分缓解,总有效率53.57%。A组有效率明显高于B组(P<0.05)。两组均无严重不良反应。结论:MP和CTX联合应用冲击治疗小儿难治性肾病综合征疗效优于单用CTX冲击疗法,无严重副作用。     

血管性痴呆的危险因素及综合诊治的临床分析

目的研究分析血管性痴呆患者的临床危险因素以及治疗方法。方法根据2010~2013年我院的85例血管性痴呆患者来进行研究分析,探讨综合疗法的临床效果,并对患者的高血压、糖尿病、冠心病等发作和血管性痴呆之间的联系进行总结分析。使用MMSE、HDS、BDS、ADI量表来进行评价。结果研究中的患者他们在治疗后,其痴呆症状有较大的好转。患者的MMSE、HDS、ADI评分相比治疗前有较大的提升;BDS评分比治疗前有较明显的降低。结论血管性痴呆患者的危险因素有贫血、高血压、糖尿病、短暂性脑缺血发作和冠心病,临床中需要对这些危险因素引起重视,积极的预防和治疗,并且为患者提供综合疗法具有比较好的治疗效果。     

食管造影及温度监测指导环肺静脉消融治疗心房颤动

Objective Because of the severe consequences of an atrial esophageal fistula,it is vital to avoid this complication. The most safe way is to avoid ablating the segment of esophagus behind left atrium (LA). What we do is to image the relationship of esophagus to posterior LA wall and real-time esophageal tem-perature monitoring to ablate the posterior LA wall. Methods Sixty-four patients with paroxysmal atrial fibrilla-tion (PAF) were enrolled to pulmonary veins (PV) isolation. Swallowing a radiocontrast agent at the same time when imaging of LA to observe the relationship of esophagus to posterior LA wall and according to the different relationship between the segment of esophagus behind LA and PV, the esophagus were divided into type Ⅰ , type Ⅱ and type Ⅲ. A esophageal temperature probe was inserted and advanced into the esophagus directly posterior to the LA. Three steps ablation strategy and real-time esophageal temperature monitoring were applied to guide the PV isolation. The procedure was interrupted when the esophageal temperature was 39℃ until] the tempera-ture renormalized and ended when PV were isolated. Results There were 48 type ⅠI , 11 type Ⅱ and 5 type Ⅲ esophagus in the 64 patients. After three steps ablation,all PV isolations were completed. Only 18.8% of the patients needed to ablate the posterior LA close to the esophagus. Conclusion Only one PV ostiolum close to the posterior LA wall in most PAF patients and many of them can achieve complete PV isolation without ablating the posterior LA close to esophagus which could minimize the risk of esophageal injury dramatically.     

单纯环肺静脉前庭隔离术治疗持续性心房颤动:单中心三年随访结果

Objective To report the long-term outcome of catheter radiofrequency ablation treatment for patients with persistent atrial fibrillation (PerAF) and discuss the impact of PerAF duration and the termi-nation on the therapeutic outcome. Methods Eight-six consecutive PerAF patients underwent circumferential pulmonary vein antrum isolation (CPVAI) only were included in this study. Based on PerAF duration, patients were divided into two groups: short term (≤1 year, n =47) and long term (> 1 year, n =39). Results The mean follow-up period was 25-50 (36 ± 8) months. During the follow-up period, the success rate after single procedure was 30. 2% (26/86). Late recurrence phenomenon, defined as atrial tachyarrhythmias relapsed 1 year later, was observed in 9 patients (10.5%). The long-term success rate in the short term group was signifi-cantly higher than that in long term group (42.5% vs 15.4% ,P <0.01). During the first procedure, atrial fi-brillation converted into sinus rhythm or atrial tachycardia occurred in 29 patients (33.7%). Compared with the another 57 patients, the long-term outcome of these patients was much better (48.3% vs 21.1% ,P < 0.01). Redo procedures were pedormed in 24 patients (27.9%), which increased the total success rate at 3 years follow-up to 41.9% (36/86). Conclusion The long-term outcome treated with CPVAI in patients with PerAF is still unsatisfactory. In addition, the late recurrence is common. Shorter term of PerAF and terminated by ablation indicate that those patients might get more benefit from the CPVA1 treatment.     

对基层医院自然分娩实施临床路径管理评价

目的:探讨临床路径管理在基层一级医院自然临产阴道分娩中的应用效果,总结其应用体会.方法:依据我院入选标准选取2015年10月至2016年6月40例自然分娩病例进入临床路径,同时依据同样入选标准选取2015年1月至2015年9月未实施临床路径的病例40例进行对照.比较进入临床路径与未进入例临床路径的病例在以下指标是否存在差异:1.平均住院日;2、平均住院费用;3、健康知识掌握程度;4、患者及其家属对医疗护理的满意度;5、并发症的发生率;6、工作人员的满意度;7、患者产后恢复情况.结果:临床路径管理组平均住院日、平均住院费用、健康知识掌握程度、并发症的发生率、满意度及产后恢复情况明显优于常规管理对照组,两组比较P＜0.05,有显著差异性.结论:运用临床路径管理能够缩短住院日、减少住院费用,提高患者对健康知识的掌握,减少产后并发症,提高住院满意度及促进产后恢复,值得在基层医院推广运用.