重症手足口病合并肺水肿患儿的护理观察

目的：对重症手足口病合并肺水肿患儿的护理方法及护理效果进行分析。方法48例重症手足口病合并肺水肿患儿,对所有患儿展开对症支持治疗,同时给予精心护理干预,对护理效果进行分析。结果48例患儿中42例（87.5%）好转后转入普通病房,经进一步治疗后治愈出院;其他6例（12.5%）死亡。结论对于重症手足口病合并肺水肿患儿应展开对症治疗并对其病情予以密切观察,给予全面而有效的精心护理干预措施,从而促使患儿治愈率有效提高。     

手足口病重症患儿的血凝分析

目的研究手足口病重症患儿的血凝变化。方法对笔者所在医院所收治危重型患儿34例,重型患儿30例,入院后即测量静脉血血凝参数。结果发现两组血凝参数指标无统计学差异。结论手足口病重症患儿在疾病的早期凝血功能无特异性改变,无需早期干预治疗。需要根据病情变化实时监测血凝指标,以此来决定是否给予临床干预。     

手足口病279例临床观察与护理

目的总结儿童手足口病279例临床特点及护理经验,加深对本病的认识,提高护理水平。方法对2008年5月～2012年2月收治的279例手足口病患儿进行临床特点分析,并采取隔离、密切观察病情、皮肤护理、口腔护理、饮食护理与心理护理等综合护理策略。结果手足口病的高发季节在5～8月,高发年龄为3岁以下小儿,279例手足口病患儿中,普通病例267例（95.7%）,重症病例12例（4.3%）,除3例重症患儿死亡,其余276例均治愈。结论患儿入院后及时给予隔离并制定全面系统的护理策略能缓解患儿症状,更好地促进康复,及时发现重症病例,减少病死率;及时做好手足口病患儿的消毒隔离与合理舒适的护理能够减轻患儿的症状、缩短病程及减少并发症的发生。     

25例重症手足口病患儿的护理

目的回顾分析25例重症手足口病患儿的临床特点,总结护理对策,以提高护理水平。方法回顾分析2008年7月至2011年5月25例重症手足口病患儿的临床资料,总结护理措施。结果 25例患者痊愈24例,死亡1例。结论对手足口病患儿进行及时隔离;在疾病初期,严密观察各项监测指标和病情的变化,做到早期干预;做好重症患者高热、脑炎、肺出血、肺水肿、心功能不全等并发症的护理;重视患儿的心理护理,对患儿家属进行健康教育。以上有效的护理措施,是促进重症手足口病患儿早日康复的关键,可提高抢救的成功率,降低病死率。     

重症手足口病患儿治疗中的护理干预

目的对重症手足口病患儿治疗中的护理干预进行讨论分析。方法回顾我院2009年1月至2011年12月收治的重症手足口病患儿,在进行药物治疗的基础上,给予严密监测生命体征、消毒隔离护理、心理护理、皮肤护理、口腔护理、对症护理、合理饮食等护理方式。结果本院收治182例重症手足口病患儿经过治疗,在护理人员的精心护理下均临床痊愈出院,平均住院时间11d,无明显并发症和后遗症。结论手足口病是由多种肠道病毒引起的常见传染病,病情进展迅速,病死率高,在给予药物治疗的基础上,护理人员应严密观察患儿的病情变化,进行精心的护理,加强隔离和消毒,从心理上取得患儿的信任,使其配合做检查、治疗及护理以促进患儿的康复。     

基层医院手足口病患儿的临床观察

目的总结手足口病患儿的病情观察及护理干预措施。方法回顾性分析我院儿科2010年5月至2012年4月收治的760例手足口病患儿的临床资料,对患儿住院期间的病情观察及护理干预措施进行总结。结果针对本组患儿发病情况,住院期间采取了多种护理干预措施,12例出现重症征象转院治疗,748例治愈出院,无并发症发生,平均住院时间6．5天。结论重视手足口病患儿的病情观察和各项监测,及时识别危重患儿,通过有效的护理干预措施,提高手足口病患儿的治疗效果。     

215例重型及危重型手足口病患儿的护理干预

目的分析215例重型及危重型手足口病患儿的临床特点,总结护理经验,指导临床实践。方法通过回顾性研究,对重型及危重型手足口病患儿出现的各种临床特点进行密切观察,及时发现病情变化,实施护理干预。结果187例重型及28例危重型患儿中的24例疾病进展迅速得到中止及逆转,康复出院,而4例危重型终末患儿尽管马上上呼吸机仍无法存活。重型病例平均住院天数为（6．2±2．3）天,危重型病例平均住院天数为（13．2±3．4）天。另有5例出院时一侧或双侧肢体肌力3～4级。结论通过严密的病情观察及各项监测,及时发现病情变化,为医生提供诊断治疗依据;通过规范细致的护理干预,提高患儿生存率,降低伤残率的发生。     

72例小儿肺炎的用药护理效果观察

目的：探讨护理干预在小儿肺炎用药中的效果。方法：选取2014年3～12月我院收治的72例小儿肺炎患者为受试对象,在实施积极的治疗措施基础上,给予综合用药护理干预,具体措施包括密切监测病情、呼吸道清理、吸氧护理以及家属用药指导健康教育等,观察患儿预后情况。结果：69例（95.8%）患儿经积极治疗和护理后成功治愈出院;2例（2.8%）患儿病情无明显好转,后转入重症监护病房继续治疗;1例（1.4%）患儿病情严重,经救治无效死亡。结论：科学合理的综合用药护理干预措施可显著提高小儿肺炎的治疗效果,降低病死率。     

小儿手足口病的临床护理观察

目的：探讨小儿手足口病的临床护理效果。方法选取2008年6月~2013年6月期间来本院进行治疗的手足口病患儿60例,按照临床护理方式进行分组,分为干预组和对照组两组,每组各30例患儿。对照组患儿给予隔离观察病情、对症护理、急救准备等常规护理干预,干预组患儿在对照组患儿的基础上,给予心理护理、专人监护加强观察、皮肤护理、口腔黏膜护理等护理干预。结果干预组患儿的退热时间、手足皮疹消退时间、口腔溃疡消退时间以及患儿的住院时间均显著短于对照组患儿（P〈0.01）。干预组患儿的并发症发生率为6.7%显著低于对照组患儿的16.7%,结论在常规临床护理基础上,给予手足口病患儿心理护理、专人监护加强观察、皮肤护理、口腔黏膜护理、饮食护理等护理干预能够显著缩短患儿临床症状转归时间,降低患儿并发症发生率,减少发展为重症的患儿例数。     

小儿手足口病106例临床观察与护理

目的加强对手足口病患儿的观察及护理,总结手足口病的护理经验。方法对2010年4月至2011年9月收治的106例手足口病患儿,在给予隔离、抗病毒、营养心肌及对症治疗的同时,加强临床病情观察与精心护理。结果 96例治愈出院,8例重症患儿死亡,2例放弃治疗,取得较满意疗效。结论通过加强临床观察早期识别重症手足口病例并采取及时有效的治疗和护理,可大大提高治愈率,减少病死率。     

Affective and Anxiety Disorders and Alcohol and Drug Dependence:

Depression and anxiety frequently coexist in patients with substance use disorders. This clinically-oriented article examiens the relationship between these conditions and emphasizes data showing that substances of abuse can cause signs and symptoms of both depression and anxiety. These substance-related syndromes appear to have a different course and prognosis than uncomplicated, independent anxiety and major depressive disorders, and clinicians should consider the role of alcohol and other drugs in all patients presenting with these complaints. The authors will also outline an approach for diagnosing and managing patients with the combination of a substance use and depressive or anxiety disorder.     

Synthesis and anti-nociceptive and anti-inflammatory effects of gaultherin and its analogs

The synthesis of gaultherin (1) and its analogs was carried out to provide 11 glycosides under phase-transfer catalytic conditions. The activities of all synthesized compounds were evaluated by nitric oxide production inhibitory assay in vitro. Methyl 2-O-(4-O-β-d-galactopyranosyl)-β-d-glucopyranosylbenzoate (5f) showed significantly anti-nociceptive and anti-inflammatory effects by the evaluation in vivo. Structure–activity relationships within these compounds were discussed.     

Modelling and simulation of variability and uncertainty in toxicokinetics and pharmacokinetics

Two important methodological issues within the framework of the variability and uncertainty analysis of toxicokinetic and pharmacokinetic systems are discussed: (i) modelling and simulation of the existing physiologic variability in a population; and (ii) modelling and simulation of variability and uncertainty when there is insufficient or not well defined (e.g. small sample, semiquantitative, qualitative and vague) information available. Physiologically based pharmacokinetic models are especially suited for separating and characterising the physiologic variability from the overall variability and uncertainty in the system. Monte Carlo sampling should draw from multivariate distributions, which reflect all levels of existing dependencies in the intact organism. The population characteristics should be taken into account. A fuzzy simulation approach is proposed to model variability and uncertainty when there is semiquantitative, qualitative and vague information about the model parameters and their statistical distributions cannot be defined reliably.     

成骨细胞的功能与损伤和骨质疏松的防治

骨质疏松是一种全身性骨骼疾病,导致骨折风险增加。成人的骨量通过破骨细胞的骨吸收和成骨细胞的骨形成作用来维持动态平衡,治疗骨质疏松症的理想策略是抑制破骨细胞的骨吸收和/或增强成骨细胞的骨形成功能。目前针对保护成骨细胞及增强其功能的骨质疏松疗法相对较少。因此,本文针对成骨细胞相关功能蛋白、各种细胞损伤机制（内质网应激、氧化应激、机械过载、微小RNA和长链非编码RNA的影响等）及骨质疏松的治疗与预防作一综述,以期为针对增强成骨细胞功能的骨质疏松治疗策略提供新思路。     

Self-stimulation and amphetamine: Tolerance to d and l isomers and cross tolerance to cocaine and methylphenidate

The effects of the d and l isomers of amphetamine on self-stimulation responding were tested following acute and chronic administration. Tolerance and post-drug depression of responding occurred in tests with both isomers, indicating no role for p-hydroxynorephedrine (PHN) which is one of the metabolites of d-amphetamine. In the second experiment, d-amphetamine, methylphenidate and cocaine all produced quantitatively and qualitatively similar effects on self-stimulation responding following acute administration. Following chronic administration of d-amphetamine, animals showed tolerance to all three drugs, indicating cross-tolerance among them. These data are consistent with an hypothesis that tolerance and post-drug depression following chronic amphetamine treatment are the result of decreases in postsynaptic receptor sensitivity, which would lead to a decreased effectiveness of all three drugs, regardless of their pre-synaptic mechanisms.     

益生菌与肿瘤防治

益生菌广泛存在于自然界中,通过维持宿主体内菌群平衡、影响肠屏障功能和调节免疫应答等作用,提高宿主健康水平,被公认为"肠道健康卫士".一些益生菌可以增强机体的免疫功能,抑制致癌物质,影响肿瘤细胞的基因表达,对肿瘤具有拮抗作用.大量研究表明,益生菌在未来的肿瘤防治中有很好的应用和发展前景.     

Acamprosate and naltrexone treatment effects on ethanol and sucrose seeking and intake in ethanol-dependent and nondependent rats

Rationale  Two pharmacotherapies are approved for treating alcohol craving (acamprosate and naltrexone), but both have shown mixed findings in animals and humans. Objectives  The present experiments utilized a “reinforcer blocking” approach (i.e., rats were able to consume ethanol during treatment) to better understand the efficacy of these treatments for ethanol seeking and drinking using ethanol-dependent and nondependent rats. Materials and methods  In “nondependent” experiments, drugs (acamprosate 50, 100, and 200 mg/kg; naltrexone 0.1, 0.3, and 1.0 mg/kg) were administered over 3-week periods prior to operant sessions with a low response requirement to gain access to reinforcers for 20 min. For “dependent” experiments, rats were made dependent in vapor/inhalation chambers. Results  Acamprosate and naltrexone had similar effects on intake in nondependent and dependent rats; neither drug was selective for ethanol over sucrose drinking. In nondependent animals, naltrexone was more efficacious at more doses than acamprosate, and acamprosate’s effects were limited to a dose that also had adverse effects on body weight. Both pharmacotherapies showed more selectivity when examining reinforcer seeking. In nondependent rats, acamprosate and naltrexone had response-attenuating effects in ethanol, but not sucrose, groups. In dependent animals, acamprosate had selective effects limited to a decrease in sucrose seeking. Naltrexone, however, selectively decreased ethanol-seeking in nondependent rats. Conclusions  The naltrexone-induced decreases in seeking suggested a change in incentive motivation which was selective for ethanol in nondependent rats. The “nondependent” paradigm may model early stages of “problem drinking” in humans, and the findings suggest that naltrexone could be a good intervention for this level of alcohol abuse and relapse prevention.     

Antiinfective and encrustation-inhibiting materials--myth and facts

Catheters, urethral and ureteral stents and other urological implants are frequently affected by encrustration and infection due to their permanent contact with urine. Indwelling urinary catheters provide a haven for microorganisms and thus require extensive monitoring. Several surface modification techniques have been proposed to improve the performance of devices including the immobilization of biomolecules, the incorporation of hydrophilic grafts to reduce protein adsorption, the creation of hydrophobic surfaces, the creation of microdomains to regulate cellular and protein adhesion, new polymers and antimicrobial coatings. Physico-chemical explanation to elucidate the mechanism of such encrustation or infection inhibiting materials is still not available. Our series of experiments showed a marked decrease of silver-activity in biological fluids which corresponds with the controversial clinical results obtained with silver coated urinary catheters. Rifampicin/minocycline coated catheters had very low activity against Gram-negative rods, enterococci and Candida spp., the main causing organisms of urinary catheter infection. Surface engineered materials and antimicrobial drug delivery systems will be the next generation of sophisticated urinary catheters and stents, if both efficacy as well as efficiency has been proved clinically.     

Alprazolam and lorazepam single and multiple-dose effects on psychomotor skills and sleep

Summary The effects of alprazolam 0.5 mg and lorazepam 2 mg on cognitive and psychomotor skills were assessed in twelve normal volunteer subjects in a randomised, double-blind, crossover design. Single and multiple dose effects were monitored using a battery of tests comprising critical flicker fusion threshold (CFFT), choice reaction time (CRT), simulated car tracking, and subjective ratings of perceived sedation (LARS) and of sleep behaviour (LSEQ). Compared with placebo baseline scores, treatment with lorazepam 2 mg (both single and multiple doses) resulted in a widespread impairment of CRT, tracking accuracy, and CFFT. Single doses of alprazolam 0.5 mg reduced CFFT with respect to the placebo baseline. Single and multiple dose treatment with both drugs resulted in subjective reports of sedation, a reduction of sleep onset latency, and improved sleep quality. Only lorazepam 2 mg significantly disrupted the integrity of behaviour on waking from sleep. These results suggest important pharmacodynamic differences between the two drugs in the doses used.