急性重症病毒性心肌炎的临床特点与治疗

目的 探讨酷似急性心肌梗死的急性重症病毒性心肌炎患者的临床特点和治疗方法,以提高急性重症病毒性心肌炎的早期诊断率和治愈率.方法 选取2010年6月至2012年6月佛山市禅城区中心医院收治的酷似急性心肌梗死的急性重症病毒性心肌炎患者36例与急性心肌梗死患者40例,收集患者临床信息进行对比分析;并评价急性重症病毒性心肌炎的治疗效果.结果 急性重症病毒性心肌炎和急性心肌梗死患者在感染史、发热、胸痛、阿-斯综合症发生率以及CK峰值、CK-MB峰值、房室传导阻滞、异常Q波上存在差异,具有统计学意义(P＜0.05).治疗后,患者心功能得到显著提高,差异具有统计学意义(P＜0.05).结论 酷似急性心肌梗死的急性重症病毒性心肌炎可通过心电图表现、心肌酶检查结果与急性心肌梗死进行鉴别.早诊断、早治疗有助于提高疗效.     

137例护理干预用于病毒性心肌炎患者的临床观察

目的观察护理干预用于病毒性心肌炎的临床效果。方法将231例慢性支气管炎患者随机分为干预组137例与对照组94例。两组均给予相关对症治疗,干预组在此基础上给予护理干预。观察两组护理前后生活能力和生活质量评分及护理满意度情况。结果护理后,两组生活能力评分均增高,且干预组高于对照组,差异均有统计学意义(P<0.05);两组生活质量评分均降低,且干预组低于对照组,差异均有统计学意义(P<0.05);干预组护理满意度高于对照组,差异有统计学意义(P<0.05)。结论护理干预用于病毒性心肌炎患者可明显改善患者生活质量,提高患者生活能力和护理满意度的,值得临床推广应用。     

系统化护理干预对上消化道出血患者的临床预后影响分析

目的 探讨系统化护理干预对上消化道出血患者的临床预后影响.方法 选择我院2012年8月～2014年8月在消化内科收治的上消化道出血患者130例,随机分为对照组和干预组,各65例,路予对照组常规护理,给予干预组健康教育、饮食护理、心理护理、预见性护理等一系列系统化护理,观察两组患者并发症、出血控制及心理状态等情况.结果 干预组患者发生并发症发生率为1 2.67％;对照组发生率为42.65％.对照组65例患者中出血控制占80％;死亡率为20％,死亡原因:肿瘤9例,并发症4例.干预组65例患者中出血控制占95％;死亡率为5％,死亡原因为肿瘤2例,并发症3例.干预组护理后SAS、SDS均较对照组低.结论 系统化护理干预可以降低上消化道出血患者并发症发生率,有效控制出血且能改善患者心理状态.     

重组人脑利钠肽用于重症急性心肌炎伴 心力衰竭患者治疗的临床研究

目的 研究重组人脑利钠肽应用于重症急性心肌炎伴心力衰竭患者在临床治疗的效果。方法 选取我院2014年1月~2017年6月收治的98例急性心肌炎合并心力衰竭患者,并随机均分为实验组和对照组,每组49例。对照组行常规的抗心力衰竭治疗,实验组在对照组的基础上行静脉泵入重组人脑利钠肽。72 h后测定两组患者用药前后血清N末端脑钠肽前体水平、左室射血分数和Supper-Score的评分。结果 72 h后两组患者N末端脑钠肽前提水平均:用药前>对照组>实验组,左室射血分数:实验组>对照组>用药前,差异存在统计学意义（P<0.05）,两组患者用药前N末端脑钠肽前体水平、左室射血分数的差异,无统计学意义（P>0.05）。结论 重组人脑利钠肽应用于重症急性心肌炎伴心力衰竭患者的疗效显著,可推广应用。     

新活素在重症病毒性心肌炎心力衰竭中的作用

目的 观察新活素在重症病毒性心肌炎心力衰竭中的疗效及安全性.方法 选取2010年1月至2013年12月在我科诊断的重症病毒性心肌炎患者27例,分为新活素组和对照组,新活素组在强心、利尿、扩血管基础上加用新活素治疗,观察两组患者脑利钠肽（BNP）、肌钙蛋白（cTnT）、肌酸激酶同工酶（CK-MB）、心脏彩超改变情况并比较两组的疗效.结果 新活素组能明显降低BNP [（203.1±39.8）vs.（1185.5±48.3） pg/ml]、cTnT [（13.5±9.8）vs.（24.8±13.2） μg/L]、CK-MB [（32.9±10.7）vs.（195.3 ±48.2） U/L],改善左室射血分数[（59.2±9.2）％vs.（38.1±8.8）％],并且疗效优于对照组（P＜0.05）,没有出现明显不良反应.结论 新活素对重症病毒性心肌炎心力衰竭是一个有效安全的治疗措施.     

呼吸内科中护理风险管理的探索

目的：探讨呼吸内科中护理风险管理。方法本院呼吸病房病例分组对照研究，文献回顾研究，统计学方法分析。结果经过综合强化护理后，干预组患者的血气分析指标较对照组改善明显，差异有显著意义(<0.05)；实验组患者痊愈和好转共计37例，抢救患者8例，其中成功5例，死亡3例；对照组患者痊愈和好转共计32例，抢救患者13例，其中成功6例，死亡7例。两组在治愈率、抢救成功率及死亡率方面差异有显著意义(<0.05)。结论密切留意和观察呼吸内科重症患者，实施应急护理干预措施，可明显减少患者病情加重、延误及死亡。     

急性上呼吸道感染的临床护理分析

目的对急性上呼吸道感染的临床护理展开研究分析。方法随机选取2012年3月~2014年3月接收的50例急性上呼吸道感染患者,根据不同护理方法划分为干预组和对照组,各25例。对照组接受常规护理干预,干预组接受综合护理干预,对两组护理效果进行观察对比。结果干预组总有效率92.0%,对照组总有效率76.0%,干预组总有效率显著优于对照组,数据差异具有统计学意义(P<0.05);干预组不良反应发生率4.0%显著低于对照组12.0%,数据对比差异具备统计学意义(P<0.05)。结论综合护理应用于急性上呼吸道感染护理效果显著,可有效改善患者临床症状,提升患者生活质量,具有临床推广应用价值。     

74例高血压合并冠心病患者的临床护理体会

目的探讨和总结高血压合并冠心病患者的临床护理体会。方法选取我院于2012年6月~2014年6月收治的74例高血压合并冠心病患者,将患者随机分为观察组和对照组,每组患者37例。针对对照组予以常规护理干预,观察组患者在对照组的基础上予以综合护理干预。对比两组患者的血压控制率和护理满意度。结果经过14d的护理干预,观察组患者的血压控制率为91.9%,对照组患者的血压控制率为81.1%,组间比较具有显著差异,差异具有统计学意义(P<0.05)观察组患者的满意度为97.29%;对照组的满意度为83.79%。组间比较具有显著差异,差异具有统计学意义(=5.521,P<0.05)。结论综合护理干预可有效运用于高血压合并冠心病患者,患者血压控制率和临床护理满意度都相对较高。     

重症患者实施早期活动标准化流程干预的价值研究

目的:观察早期活动标准化流程在重症患者中应用价值.方法:选取2019年3月至2022年3月我院收治的107例重症患者作为研究对象.随机分成对照组(53例)以及观察组(54例).对照组患者进行常规护理,观察组在常规护理同时实施早期活动标准化流程干预,两组均干预14d,护理干预后对比两组患者护理风险事件发生率、重症监护室时间与住院时间以及两组患者对本次护理干预的满意度.结果:与对照组患者(18.87％)相比,观察组患者护理风险事件发生率(3.70％)较低(P<0.05);观察组患者ICU时间以及住院时间均较短(P<0.05);观察组患者干预后护理满意度各项指标优于对照组(P<0.05).结论:早期活动标准化流程在重症患者中可较好地降低重症患者护理风险事件的发生,保证患者住院期间人身安全,还可缩短患者住院时间,促进患者更快康复,该护理方法切实可行,应用价值较高.     

慢性阻塞性肺炎重症患者行综合护理干预的价值分析

目的 探讨慢性阻塞性肺炎重症患者行综合护理干预的临床应用效果。方法 选取我院2017年1月~2018年6月收治的60例慢性阻塞性肺炎重症患者,按照随机数字法分为对照组和研究组,各30例。对照组采用常规护理干预,研究组进行综合护理干预,比较两组患者氧分压（PO2）、二氧化碳分压（PCO2）、呼吸频率、心率、pH值、突发抢救情况、死亡情况及护理满意。结果 研究组PO2、pH值均高于对照组,PCO2、呼吸频率、心率均低于对照组,差异有统计学意义（P＜0.05）;研究组死亡率（33.33%）较对照组（63.33%）低,突发抢救次数（7次）较对照组（18次）少,差异有统计学意义（P＜0.05）;研究组护理态度及护理效果得分[（90.25±3.46）分、（92.25±3.41）分]均较对照组高[（80.26±3.49）分、（79.69±3.58）分] ,差异有统计学意义（P＜0.05）。结论 慢性阻塞性肺炎重症患者行综合护理干预可减少突发抢救次数,避免病情被延误,降低死亡率,患者具有较高的满意度。     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.     

The universal muscular chamber. A basic unit of the genitourinary, cardiovascular, gastro-intestinal, skeletal, cutaneous, respiratory and other systems, endocameral hypertension; and spasm, the key to their idiopathic diseases and arthropathies

Starting with the integument, we see many organs are contractile sacs or multiples thereof, which tubes or bags constitute the major part of the entire body. Recognition of this basic unit and its characteristics sheds new light, individually and collectively, on many disorders previously considered unrelated. Muscular tears and perforations develop in the walls of these chambers, being no way peculiar to those organs, wherein, hydrochloric acid occurs. So, it is not necessary to explain the absence of excessive acid from patients who exhibit holes in the gastric, uterine, aortic, duodenal, rectal, pulmonary, retina, and other walls. Muscle, not acid is the great common factor relating idiopathic disorders in the gastrointestinal tract to each other and to similar diseases in other systems. When the units are linked together, the lesions tend to appear as arthropathies, i.e. at the joints. Rephrasing common-place observations, frees us from conventional, conceptual cul-de-sacs. An observation is only as good as its interpretation, so all possibilities must be considered, otherwise, we will remain blinded by our misconceptions.     

Der Einfluß von Nahrungsmitteln und Rauchen auf die klinisch-chemische Diagnostik von Phäochromozytom,Neuroblastom und Karzinoid-Syndrom

Zusammenfassung Der Einfluß von verschiedenen Nahrungsmitteln auf Methoden zur Bestimmung von Adrenalin (AD), Noradrenalin (NA), Vanillinmandelsäure (VMS), Metanephrinen (MN), Homovanillinsäure (HVS) und 5-Hydroxyindolessigsäure (5-HIE) im 24 h-Harn zur Diagnose des Phäochromozytoms bzw. Karzinoid-Syndroms wurde untersucht. Die in die Untersuchung einbezogenen Nahrungsmittel waren: Tee, Kaffee, Mandeln, Ananas, Käse, Walnüsse, Vanillepudding, Bananen, Tomaten und Milchschokolade. Außerdem wurde der Einfluß des Zigarettenrauchens auf die Bestimmung von AD, NA, VMS und MN untersucht.Walnüsse führten zu einer starken Erhöhung der 5-HIE-Ausscheidung. Bananen erhöhten die Ausscheidung von AD, NA, VMS, MN und 5-HIE. Kaffee und Ananas bewirkten eine geringe Zunahme der MN-Werte. Rauchen von 20–30 Zigaretten/Tag beeinflußte keine der vier Variablen.Wenn die beschriebenen Methoden benutzt werden, sollte lediglich auf den Verzehr von Bananen und Walnüssen vor und während der Harnsammelperioden verzichtet werden, da die oberen Normgrenzen im Harn überschritten werden könnten. Ein Verzicht auf Kaffee und Ananas in normalen Mengen ist nicht erforderlich. Es besteht kein Anlaß, weiterhin die bisherigen umfangreichen Restriktionen der übrigen Nahrungsmittel beizubehalten.