HBV DNA与preS1抗原均阳性患者HBeAg阴性的原因探讨

目的探讨导致HBVDNA阳性、preS1抗原阳性标本ELISA检测HBeAg阴性的原因。方法筛选76例HBeAg阴性而preS1及HBVDNA阳性的血清分别进行（1）血清1：100稀释后重新用ELISA测定HBeAg;（2）用单克隆抗-HBe固相ELISA检测血清HBeAg／IC;（3）用寡核苷酸探针斑点杂交法测定HBV前C区的基因突变。结果76份血清稀释后重测5例HBeAg阳性;38例HBeAg／IC阳性;24例HBV前C区存在基因突变。结论后带效应、HBeAg／IC、前C区基因突变是HBVDNA阳性血清HBeAg阴性的主要原因;HBVDNA阳性、HBeAg阴性标本多为野生型毒株感染,只是由于形成了HBeAg／IC使常规ELISA检测不出HBeAg。     

Bariatric surgery primer for the internist: keys to the surgical consultation

The increasing prevalence of morbid obesity in North America combined with the refinement of laparoscopic techniques for the performing these operations has contributed to the exponential growth of bariatric surgery over the last 10 years. There are many important considerations for the internist who is referring a patient for bariatric surgery.     

Palliative care consultation in pediatric oncology

Purpose  

Pediatric oncology patients benefit from the involvement of palliative care. This study examined the timing of palliative care consultation.     

Use of poly(2-hydroxyethyl methacrylate) for endovascular occlusion in pediatric surgery

Embolization using poly(2-hydroxyethyl methacrylate) (PHEMA) hydrogel particles, of cylindrical spherical form, was successfully achieved in 42 children treated for non-operable haemangiomas of the liver, and angiodysplasias. Spherical PHEMA hydrogels appeared to be the only possibility for the treatment of 26 children suffering from extensive cavernous haemangiomas of face and neck. Particles were able to cover the tumour, stop its growth and allow the use of local hyperthermia with the electromagnetic field. A partial two-stage embolization using beaded PHEMA was also used as part of the multistage treatment for curing the spleen in 28 children suffering from haemolytic spherocytic anaemia, thrombocytopenic purpura and portal hypertension.     

新时代对小儿外科的挑战

当前正值生命科学革命时代,目标是为“健康天年”创造条件,保证人民身体健康精神愉快。具体到临床医学就是要彻底实现人文医学,消除长期以来生物医学的不良影响。     

日间手术在小儿外科开展的护理体会

目的：凭我院儿科接诊儿科患者资料,分析日间手术的护理体会。方法：对我院小儿外科所有患儿进行建档,抽取其中150例患儿(纳入时间2021年1月～2022年1月),采用骰子法单双数法将患儿分成两组,一般组行常规护理(n=75),护理组行日间手术护理(n=75),对两组患儿的护理及治疗情况进行探索。结果：一般组患儿恶心呕吐、创面感染、创面渗血的发生率高(P＜0.05),用Zung式心理法评估患儿的SDS(抑郁自评量表)、SAS(焦虑自评量),发现护理组的评分低,且患儿家长的护理满意度高(P＜0.05)。结论：日间手术护理具有较好的作用,对患儿预后恢复是有利的,尤其是可降低患儿术后感染的风险,并发症发生率低,患儿家长对整体护理满意度、认可度较高,值得推广。     

小儿外科发展简史、特点和四川省小儿外科现状与展望

小儿外科作为一个年轻的临床专业,于第一次世界大战以后开始成为一个独立的学科,第二次世界大战之后,逐渐普及,并迅速发展。中国的小儿外科则是在新中国建立以后创建,在改革开放以后得到迅速发展。小儿不是成人的缩影,需要根据不同特点确定处理原则和方法。现在小儿外科服务范围包括从胎儿期到18周岁之内人群中的所有外科疾病患者,其中先天性畸形占相当大的比例,而许多需要及早发现、适时治疗,治疗的时机直接关系到疾病的预后。四川省的小儿外科在80年代后开始迅速发展,目前已从最初的少数几个中心,发展出多个中心,共同推动了治疗水平的提高。目前四川的社会经济发展需要组建更多、更高水平的妇儿中心,现在已出现可喜趋势。     

加速康复外科理念在围手术期患儿中的应用进展

加速康复外科指在多学科合作基础上,采取基于循证的围手术期系列优化措施,旨在减少手术患者生理及心理的创伤应激,从而实现手术患者的加速康复.该文综述了加速康复外科理念在国内外围手术期患儿中的应用现状,包括术前护理、术中精准管理和术后护理3个方面,并指出存在的不足和未来发展方向,旨在为国内加速康复在围手术期患儿中的进一步研究...     

Modern approaches to the management of an anesthesiological support in pediatric ENT surgery

The paper deals with the topical problem of pediatric anesthesiology--current approaches to performing an anesthesiological appliance in pediatric ENT surgery. The study included 1299 children aged 3 days of life to 14 with various surgical ENT abnormalities at anesthesia risk I-III (ASA) in whom surgical intervention was performed under multicomponent general anesthesia or under local anesthesia. The paper comparatively characterizes the currently available methods for general anesthesia used during both short ENT surgery and long endonasal microendoscopic interventions. The effectiveness and safety of different procedures for maintenance of free airway patency, such as endotracheal intubation, a laryngeal mask, a COPA-airline, were compared. Since adenoid- and/or tonsillectomy, as well as tonsillotomy are the most common operations in pediatric ENT surgery, indications for and contraindications to these interventions under general anesthesia were defined. It has been shown that endonasal microendoscopic operations in children should be performed exclusively under general endotracheal anesthesia and local anesthesia is a mere one of its important constituents.     

小儿外科患儿的围手术期护理

随着科学技术的发展,近年来小儿外科的临床护理得到了迅猛的发展,小儿外科学与护理学在概念、理论、内容和方法上发生了很大的变化,许多治疗的技术和观念以及护理常规都得到了更新和发展,对临床小儿外科护理提出了更高的要求,小儿外科也逐渐从普通外科分出来.小儿正处在生长发育的活跃阶段,诸多器官的功能和构造尚不健全,对疾病、麻醉、手术创伤与成人有显著不同,是一门专业性很强的学科,围手术期的护理尤为重要,要求细致而全面.我院小儿外科成立近8年,收治从出生至12岁的患儿,成功治愈了数千例,现报道如下.     

小儿外科患儿的围手术期护理

随着科学技术的发展,近年来小儿外科的临床护理得到了迅猛的发展,小儿外科学与护理学在概念、理论、内容和方法上发生了很大的变化,许多治疗的技术和观念以及护理常规都得到了更新和发展,对临床小儿外科护理提出了更高的要求,小儿外科也逐渐从普通外科分出来.小儿正处在生长发育的活跃阶段,诸多器官的功能和构造尚不健全,对疾病、麻醉、手术创伤与成人有显著不同,是一门专业性很强的学科,围手术期的护理尤为重要,要求细致而全面.我院小儿外科成立近8年,收治从出生至12岁的患儿,成功治愈了数千例,现报道如下.