1例原发性肝癌患者合并皮肌炎的护理体会

总结了1例原发性肝癌患者合并皮肌炎的护理,包括心理护理、皮肤护理、饮食护理、用药护理、感染的预防及护理、功能锻炼,减少了患者并发症的发生,从而提高了患者的生活质量,保证了疗效.     

优质护理服务示范工程在心内科实施体会

目的:加强医院临床护理工作,为患者提供优质护理服务,提高患者满意度.方法:医院组织成立“优质护理服务示范工程”活动领导小组、对全院护士进行培训与宣传、修订及建立规章制度、改变排班模式、责任制护士提供全程、连续、无缝隙的满意护理、开展健康教育等.结果:提高了患者满意度、加强了护患沟通、改善了护患关系、提升了护士的自身价值、促进了护理团队的建设.结论:“优质护理服务示范工程”活动的开展,进一步务实了基础护理、保障了护理安全、并推动了护理工作理念、内涵、方式的改革,促进了临床护理质量的不断提高.     

中西医结合治疗前臂双骨折

作者归纳了74例伴有移位的尺桡骨骨干骨折的住院病人资料,对骨折的解剖理论基础、复位方法、夹板固定装置、固定后的体位、护理、功能锻炼等方面都做了详细的介绍。文中提出了     

纪念保罗·杨森博士——一位卓越的企业家和勇于创新、对麻醉学做出突出贡献的科学家

保罗·杨森博士是杨森制药公司的创始人，研发了80多种已被证实对人类、植物及动物都有极大帮助的药品。他和他的同事们合成了芬太尼家族，还有许多其他强效镇痛剂、氟哌啶、依托咪酯等。另外，他们还合成了许多重要药物，在精神病学、寄生虫学、胃肠病、心脏病学、病毒学和免疫学领域发挥了极大作用。杨森博士非凡的智慧、卓越的创造力、积极进取的精神推动了麻醉学及整个医学界的进步。     

腹主动脉瘤腔内隔绝术与传统术式比较

治疗腹主动脉瘤(AAA)传统的手术方式为AAA人造血管内置术。目前逐步发展的是AAA腔内隔绝术。本文通过两种术式的手术方法、临床应用和生物学反应的比较表明,从A腔内隔绝术较传统手术最主要的优点是减少了创伤程度,避免了全麻,避免了剖腹术,避免了手术中主动脉的钳夹,避免了缺血再灌注后氧自由基、TNF-2、IL-1β、IL-6等的损伤。避免了手术后常见的心、肺、肾并发症,明显降低了术后死亡率,尤其使那些有严重并存病而不能耐受AAA切除的高危病人获得了救治的希望。     

胃癌淋巴结转移规律的研究现状

本文综述了胃癌淋巴结转移规律的临床研究现状，分析了胃癌淋巴结的转移率与诸多因素的关系，包括肿瘤浸润深度、大体形态、大小、组织分型、肿瘤发生部位、患者年龄、性别等，探究了肿瘤的部位和转移淋巴结的组群分布关系。     

就医卡袋的制作与应用

目前,部分医院实行了医卡通就医模式,减少了医护人员的工作量,也为患者节省了宝贵的就诊时间。该模式由初诊患者在收费处建立就医卡,录入其基本信息(姓名、性别、出生年月日、出生地、付费方式等个人资料),并预存一定就诊费用,该卡作为患者在医院就诊的唯一身份,在挂号、就诊、检验、交费、取药过程中使用。因此,整个就医过程必须使用就医卡。在工作中发现,患者遗失或到处翻找就医卡的现象时有发生,浪费了就诊时间。鉴此,我们设计制作了就医卡袋,有效预防了卡的丢失,节省了患者的就医时间,介绍如下。     

《Ilizarov技术骨科应用进展》出版

本书主编秦泗河、李刚教授从全球视野的角度，邀请了美国、俄罗斯、欧洲、印度、土耳其、巴西、日本、韩国15位境外作者，香港、台湾3位作者以及大陆30多位在这个领域具有专长的学者、医生编写。“国际肢体延长与重建学会（ILLRS）”主席Nuno Craveiro Lopes教授；“国际ASAMI前任主席Dor Paley教授等，介绍了Ilizarov技术在世界范围内的应用及进展，论述了系统控制、应力刺激诱导组织再生、重建肢体形态与功能的最新研究成果。Ilizarov教授的女儿Svetlana Ilizarov介绍了她父亲真实的“生活、工作与创造经历”。一批对肢体延长与重建外科痴迷的学者，讲述了他们追寻、探索Ilizarov技术的个人经历，以及该技术在中国大陆引进、转化与发展的曲折故事。     

老年痴呆症状管理评估与应用研究进展

归纳了老年痴呆症状管理的相关研究热点,指出老年痴呆症状管理相关理论、评估工具以及应用等方面的研究进展。分别介绍了评估工具的使用方法、适用人群、信效度,讨论了各评估工具的优缺点。在此基础上,对老年痴呆症状管理的识别、评估以及干预进行了展望。     

郑州市妇幼保健信息管理系统的开发及应用

结合郑州市的实际情况,建立了妇幼保健信息管理系统.改变了以往报告周期长,信息上传下达慢,时效性差、迟报漏报的现象.大大提高了妇幼卫生信息的及时性、准确性、共享性和数据分析能力.     

Spanish Guidelines on Treatment of Bronchiectasis in Adults

In 2008, the Spanish Society of Pulmonology (SEPAR) published the first guidelines in the world on the diagnosis and treatment of bronchiectasis. Almost 10 years later, considerable scientific advances have been made in both the treatment and the evaluation and diagnosis of this disease, and the original guidelines have been updated to include the latest therapies available for bronchiectasis. These new recommendations have been drafted following a strict methodological process designed to ensure quality of content, and are linked to a large amount of online information that includes a wealth of references. The guidelines are focused on the treatment of bronchiectasis from both a multidisciplinary perspective, including specialty areas and the different healthcare levels involved, and a multidimensional perspective, including a comprehensive overview of the specific aspects of the disease. A series of recommendations have been drawn up, based on an in-depth review of the evidence for treatment of the underlying etiology, the bronchial infection in its different forms of presentation using existing therapies, bronchial inflammation, and airflow obstruction. Nutritional aspects, management of secretions, muscle training, management of complications and comorbidities, infection prophylaxis, patient education, home care, surgery, exacerbations, and patient follow-up are addressed.     

Tandem Operation of a Turbo Blood Pump (BP-80-Type Centrifugal Pump) to Reduce Hemolysis

Abstract When operating turbo blood pumps in tandem, the strength of shear stress is reduced, but the exposure duration of the stress is increased. The purpose of this experiment was to compare the degree of contribution of these two factors on hemolysis as well as to evaluate the effectiveness of the tandem operation of turbo blood pumps. Tandem operation of two Bio-pumps (BP-80; Medtronics Bio-medicus, Inc., Eden Prairie, Minnesota, U.S.A.) were compared with single operation of a BP-80 in in vitro hemolysis tests in three different driving conditions, that is, pumping heads of 200, 350, and 500 mm Hg under a pump flow rate of 5 L/min. The Allen's hemolytic indexes of the tandem operation at pumping heads of 200, 350, and 500 mm Hg were 0.014, 0.020, and 0.080 mg/dl, respectively. The hemolytic indexes of the single operation at pumping heads of 200, 350, and 500 mm Hg were 0.014, 0.056, and 0.12 mg/dl, respectively. These results indicate that tandem operation is a useful method of reducing hemolysis with the BP-80 under high pumping heads and that the effect on hemolysis of exposure to higher shear stresses may be more serious than that of longer durations of exposure to shear stress in turbo blood pumps.     

Surgical treatment of ureteropyelic junction stenosis using robotic-assisted laparoscopy

Since the introduction of mini-invasive surgery approximately thirty years ago, Laparoscopic surgery has significantly evolved both in terms of its extended field of application and of the tools used which were diversified and improved. More recently, the development of robotic-assisted laparoscopy has brought, among other improvements, three-dimensional vision, dexterity, and a comfortable working position, which have reduced the surgeon's fatigability, the difficulties related to the operations and the learning curves of standard laparoscopy. Urology, which makes slightly less use of standard laparoscopy than general or gynaecological surgery, largely benefits from robotics concerning the precision of movements, and has much increased the operating indications of laparoscopy, including the treatment of pyeloureteral junction, kidney tumourectomy, living donor nephrectomy and radical prostactectomy. This chapter describes the operative technique used for the treatment of the ureteropyelic junction stenosis by robotic-assisted laparoscopy, as carried out in Nancy University Hospital with the da Vinci robot (Intuitive Surgical).     

数据库建设第五部分：结直肠癌的肿瘤特征——模块的设计（一）

目的对华西肠癌数据库(DACCA)中结直肠癌的肿瘤特征模块的构成、定义及解读进行阐述。方法采用文字描述的形式。结果在华西DACCA中,选择作为结直肠癌的肿瘤特征模块的项目包括:癌前病变、癌家族、肿瘤部位、缘距、肿瘤形态、大小、方位、发生、分化、肿瘤病理性质、Ki67、梗阻、套叠、穿孔、疼痛、水肿、出血,本研究中对其中癌前病变、癌家族、肿瘤部位及缘距的具体定义、癌前病变的分类、肿瘤部位划分、癌家族的填写形式以及这些项目的标签与结构化、纠错与更新以及在对DACCA中的数据进行分析时如何使用这些肿瘤特征的方式进行了详细阐述。结论通过对目前华西DACCA中已有的结直肠癌的肿瘤特征模块中的一部分项目(余下部分项目在后期相应章节内容中描述)进行了详细描述及规范,为结直肠癌的规范化治疗提供参考依据,同时为想做结直肠癌数据库建设的同行们提供经验。     

Liver transplant in patients with hepatocellular carcinoma

Liver transplant in patients with cirrhosis and hepatocellular carcinoma is indicated in the early stages of the disease, which can be achieved with early detection programs using liver ultrasound. Dynamic imaging techniques (ultrasound with contrast, magnetic resonance and tomography) are essential in the diagnosis of this tumour, being able to type the lesion clearly, and, in the majority of cases, lead to the therapy to follow. Surgery is the treatment of choice in these patients, and liver transplant, from a theoretical point of view, is the best. Currently, the size and number of nodes play an important role in the indication of a transplant. The best liver transplant results are obtained in these patients using the Milan criteria, with survivals that exceed 70% and recurrence indices of 15%, at 5 years. Nowadays we have the possibility of using neo-adjuvant treatments to transplant, such as arterial chemoembolisation, percutaneous ablation techniques, and even liver resection as a bridging technique. The survival of patients transplanted due to liver cancer is similar to that obtained for other non-tumour diseases. In Spain it is 1, 3 and 5 years and 82%, 70% and 60%, respectively. The recurrence is between 6.4% and 16%, micro- and macrovascular invasion being its highest risk variable.     

Monitoring and telemedicine support in remote environments and in human space flight

The common features of remote environments are geographicalseparation, logistic problems with health care delivery andwith patient retrieval, extreme natural conditions, artificialenvironment, or combination of all. The exposure can have adverseeffects on patients' physiology, on care providers' performanceand on hardware functionality. The time to definite treatmentmay vary between hours as in orbital space flight, days forremote exploratory camp, weeks for polar bases and months toyears for interplanetary exploration. The generic system architecture,used in any telematic support, consists of data acquisition,data-processing and storage, telecommunications links, decision-makingfacilities and the means of command execution. At the presentlevel of technology, a simple data transfer and two-way voicecommunication could be established from any place on the earth,but the current use of mobile communication technologies fortelemedicine applications is still low, either for logistic,economic and political reasons, or because of limited knowledgeabout the available technology and procedures. Criteria forselection of portable telemedicine terminals in remote terrestrialplaces, characteristics of currently available mobile telecommunicationsystems, and the concept of integrated monitoring of physiologicaland environmental parameters are mentioned in the first sectionof this paper. The second part describes some aspects of emergencymedical support in human orbital spaceflight, the limits oftelemedicine support in near-Earth space environment and mentionssome open issues related to long-term exploratory missions beyondthe low Earth orbit.      

Selective extractability of noncollagenous proteins from chicken bone

Quantitative analyses of a wide variety of different solvents used for the extraction of several of the noncollagenous proteins of fully mineralized chicken bone powder were carried out to compare both the effectiveness of various procedures and the distribution of specific proteins which were solubilized. Extraction procedures included solutions of 6 M guanidine-HCl, pH 7.0, 0.5 M EDTA, pH 7.4, 0.3 N citric acid, 0.3 N HCl, 0.3 N formic acid, and 0.3 N acetic acid. Chelation of calcium ions by EDTA and dissolution of the mineral phase by acid extraction released 95% or more of the total calcium content of the bone powder by 48 hours, guanidine-HCl released less than 20% or less of the total calcium content even when extraction was carried out by 168 hours. Moreover, although guanidine-HCl solubilized a significant amount of collagen as gelatin, essentially none of the phosphoproteins, osteocalcin, or the proteoglycan decorin were solubilized, as detected by immunological techniques. In contrast, extraction of the mineralized bone powder by HCl and formic acid was very efficient in selectively solubilizing osteocalcin and osteopontin, while bone sialoprotein was selectively released by EDTA, and solubilized to a lesser extent by formic acid. Similarly, EDTA selectively removed decorin compared with HCl, formic, acetic, or citric acids. Only small amounts of osteopontin and osteocalcin were detected in the acetic acid extracts. These results provide methods for the selective solubilization of several different major, noncollagenous proteins from mineralized bone which should significantly aid in maximizing the amount of the specific protein recovered, and the ease with which the various proteins can be purified. The data also provide some insight into the intrinsic solubility characteristics of collaten, the specific noncollagenous proteins, and their potential association with each other and the mineral phase.     

周细胞在泌尿生殖系统中的作用

周细胞又称为壁细胞、Rouget细胞,是构成微血管壁的主要细胞之一。它不仅对血管的成熟、稳定及功能的维持起重要作用,同时也在机体各组织器官的生长发育、创伤修复等生理病理过程中发挥重要作用。周细胞功能的研究主要集中在细胞多能性、血管功能调节、纤维化过程等方面,在泌尿外科学领域主要表现在肾纤维化、肾血流调节、肾小球滤过等,而男科学领域的相关研究较欠缺。本文就周细胞的定位和来源、分布及形态、细胞标志物和功能等进行综述,为男科学领域周细胞的进一步研究指明方向。     

Arthroscopy and Endoscopy of the Foot and Ankle: Indications for New Techniques

The scope of arthroscopy and endoscopy of the foot and ankle is expanding. New techniques are emerging to deal with diverse ankle pathology. Some of the conditions that can be dealt with arthroscopically are as follows: hallux valgus deformity, lesser toe deformity, first metatarsophalangeal instability, cock-up deformity of the big toe, peroneal tendon instability, lateral ankle and subtalar instability, hindfoot deformity or arthrosis, first metatarsocuneiform hypermobility, Lisfranc joint arthrosis, various stages of posterior tibial tendon insufficiency, foot and ankle arthrofibrosis, late complications after calcaneal fracture, acute and chronic Achilles tendon rupture, insertional Achilles tendinopathy, entrapment of the first branch of the lateral plantar nerve, Freiberg’s infarction, flexor digitorum longus tenosynovitis, flexor hallucis longus pathology, calcaneonavicular coalition or “too-long” anterior process of the calcaneus, and ganglions. With sound knowledge regarding the indications, merits, and potential risks of new techniques, they will be powerful tools in foot and ankle surgery.     

Pathogenesis of glomerulosclerosis: role of epithelial interactions

The glomerulus contains two kinds of epithelial cells, podocytes and parietal epithelial cells (PECs). Under normal conditions, each type of epithelial cell has important physiological functions. However, their interaction, namely, loss of podocytes and simultaneous compensation by PECs, has been accepted as a distinct mechanism leading to glomerulosclerosis. Additionally, epithelial hyperplasia in the cellular crescents, focal and segmental glomerulosclerosis, or collapsing glomerulopathy is a characteristic glomerular pathology of typically intractable kidney diseases. These epithelial features of glomerulosclerosis may, basically, share a common underlying mechanism, diverse control of the cell cycle in each type of epithelial cell. Knowledge of the cellular and molecular background of the epithelial cells during glomerulogenesis, and its application in kidney diseases, may provide alternative clues as to the mechanism responsible for the progression of glomerulosclerosis. Received: July 2, 2000 / Accepted: August 3, 2000