探讨大批车祸伤员的院前急救护理对策

目的:探讨大批车祸伤员的院前急救护理对策。方法:通过对我院"120"急救中心2010年1月-2014年1月对10起重大车祸的大批伤员进行了院前急救,快速启动应急预案,评估环境和伤情,保持伤员呼吸道通畅,维持有效通气,快速建立有效静脉通路,妥善处理伤口并固定受伤肢体,在运送伤员时按先重后轻的顺序。结果:92名伤员中,84名伤员能安全转入院内。结论:科学规范的院前急救程序能够有效提高抢救率,医务人员在进行院前急救时要迅速果断、群体协作、紧张有序、忙而不乱,从而使严重车祸伤患者的救治更为迅速、准确、有效,帮助患者有更多时间来进行急诊手术,也利于后期的治疗及预后。     

车祸伤员63例的院前急救护理体会

随着社会的发展和人们急救意识的提高,院前现场急救工作在抢救伤病员过程中发挥着重要作用。院前现场急救的处理是,建立有效的呼吸与循环、并尽快使病员脱离现场,转运到就近的医疗单位进行确定救治。院前现场急救的好坏直接影响伤病员的救治成功率。我市急救中心在2009年对3起重大车祸的大批伤员进行了院前急救,现将护理体会介绍如下。     

22起重特大车祸院前院内紧急救援体会

我院急救中心自2004年1月～2008年5月，曾出车接收22起重特大车祸伤员，均采用院前急救-院内急救-病房或ICU一体化急救模式，取得了满意的效果。院前急救、院内急救、急诊ICU三者的互相配合、相互依从构成一个完整的急救生命链。各个链接环节都发挥着不可替代的作用。其中：应急系统的启动、院前急救的伤员分检、病情评估、现场急救处理、伤员转运，院内急救中伤员病情进一步评估和判断、抢救（尤其多发伤的抢救）、伤员分流在整个救援过程中是关键。同时救援中医疗纠纷等问题也不可忽视。     

车祸创伤伤员院前伤情评估、急救护理与转送措施总结

目的研究探讨对车祸创伤伤员进行院前伤情评估、急救护理以及转送措施的总结。方法选取我院从2017年至2018年4月收治的32例车祸创伤伤员进行院前急救护理转送的临床资料作回顾性分析。结果经积极的院前伤情评估、急救护理与转送措施施行后,在32例伤员中成功抢救31例,因严重多发伤及失血性休克导致现场死亡1例。结论对车祸创伤伤员进行准确的院前伤情评估、有效的急救护理、快速的转送措施是进一步提高院前抢救成功的重要方法。     

车祸创伤伤员的院前急救护理

目的 探讨车祸创伤伤员院前伤情评估、急救护理与转送措施.方法 对2005年1月-2010年12月14起车祸致伤的150例院前急救护理的临床资料进行回顾性分析.结果 经积极院前急救,150例伤员中院前急救成功100例,现场死亡50例,死亡原因为严重多发伤、失血性休克、血气胸.结论 快速准确的伤情评估,积极的组织管理,呼吸、循环支持,保温、转送等措施是院前急救成功的关键.     

院前急救在山区高速公路中车祸伤救治分析

目的近年来交通事故伤已成为了急诊救治的重点,为探讨车祸伤的伤情特点及院前急救在山区高速公路中的救治作用,现将我院5年来院前急救车祸伤作一分析：一般资料750例,伤情占前3位的是：颅脑损伤,多发伤,四肢伤。方法急救原则是先救命后治伤并尽可能在短时间内进行现场急救,批量伤员行快速预检分诊评估的同时需进行不间断的抢救,积极进行抗休克气管插管及手术治疗。结果死亡160例,伤残88例,恢复良好502例。结论认识院前急救作用中的重要性和质量,努力提高抢救技术水平是减少死亡的关键。     

交通事故伤1061例院前急救探讨

目的探讨提高院前急救的速度和救治的质量,提升交通事故伤院前急救成功率的措施。方法回顾性分析上海市宝山区医疗急救中心2005年收治的1061例道路交通伤患者的出车救护资料。结果死亡77例,病死率为7·3%,其中急救人员到达现场时患者已死亡68例,病死率为6·5%;现场抢救和护送入医院途中抢救死亡9例,病死率为0·8%。成功护送入医院984例,救治成功率为92·7%。平均出车半径8·4km;平均反应时间12·1min。结论交通事故伤病死率高、社会危害性大;通过进一步加快院前急救系统建设、缩短院前急救反应时间和半径,可进一步提高院前急救成功率、降低病死率。     

标准化急救护理程序在成批车祸伤现场急救的应用

<正>车祸已成为当今社会公害,车祸伤的发生率逐日增多,严重威胁着人民的生命安全。车祸伤患者一般伤情均较重,休克发生率高,抢救难度大,病死率、伤残率高。为此,我科2010年1~2011年2月应用标准化急救护理程序对成批车祸伤患者进行现场急救,以期能降低其病死率、伤残率,提高抢救成功率现将护理工作总结如下:1临床资料本组病例均为2010年1月~2011年2月我院急诊科出诊现场救治的有5个以上伤员的车祸现场,共16起175例,最大     

基层医院在院前急救中应对救护分析

急诊医学是近年来迅速发展的一门新兴学科，院前急救是急诊医学的重要组成部分，如何做好并完善院前抢救工作及护理，是提高抢救成功率的重要措施。我院是一个二级甲等医院，设有“120”急救中心，“120”急救热线24小时全面开通，随时待命参与全市及附近三乡的急救抢救工作，设有急救车3辆，每辆车配备医、护、司各1名，市区能保证10—15分钟到达抢救现场，三乡根据路途保证30-50分钟到达抢救现场，达标于伤后1小时的“黄金抢救时问”和“10min的白金抢救时间”。     

成批高速公路交通事故伤的院前急救分析

随着社会发展,高速公路成了提高交通效率的主要方式,但因人为及自然灾害（雾、雨、冰雪等）因素,高速公路重大交通事故逐年增加。我院紧邻京沪高速公路新泰段路口,成立了科室齐全、设备比较完善、急救人员队伍固定的创伤急救中心,具有距事故现场最近,以最短时间内到达现场的优势。2004年1月-2008年11月,我院成功院前急救7批61例车祸伤员,现将院前成批车祸伤的急救临床特点及抢救经验总结如下。     

益智健脑颗粒联合针灸对阿尔茨海默病大鼠学习记忆的影响

目的观察益智健脑颗粒联合针灸对阿尔茨海默病（Alzheimers disease,AD）大鼠学习记忆的影响。方法将大鼠随机分为假手术组（A组）、模型组（B组）、针灸组（C组）、益智＋针灸组（D组）各10只,B、C、D 3组分别以海马CA1区注射β淀粉样蛋白25-35（Aβ25-35）造模,A组注射等量的双蒸水,各组分别治疗20 d后行Morris水迷宫试验,观察大鼠学习记忆能力变化。结果B组较A组的平均潜伏期明显延长,差异具有统计学意义（P〈0.05）;与B组比较,C组、D组的平均潜伏期明显缩短,过台次数增多,差异具有统计学意义（P〈0.05,P〈0.01）;与C组比较,D组的潜伏期缩短,过台次数增多,差异具有统计学意义（P〈0.05）。结论益智健脑颗粒联合针灸能够提高Aβ25-35介导的AD模型大鼠的学习记忆能力。     

表皮生长因子受体酪氨酸激酶抑制剂在非小细胞肺癌应用的瓶颈——获得性耐药

以表皮生长因子受体酪氨酸激酶抑制剂（epidermal growth factor receptor-tyrosine kinase inhibitor,EGFR-TKI）分子靶向治疗研究为肇始,转化性研究使基础实验和临床实践间的鸿沟迅速填平,改变着人们认识治疗肺癌的视角。无可否认,EGFR-TKI上市后极大地延伸了肿瘤学家治疗肺癌的手段,但不管从临床经验、临床研究数据、分子生物学层面还是文献计量学的角度,     

WHO西太区与“世界中医药学会联合会”中医名词术语国际标准比较研究：精、神、气、血、津、液部分

精、神、气、血、津、液是中医理论中6个非常重要的概念，有关术语在《WHO西太区传统医学国际标准名词术语》中一共收录了59条，“世界中医药学会联合会”（以下简称世中联）《中医基本名词术语中英对照国际标准》中收录了58条。血、津、液的内涵较为具体，有一定的物质基础，理解并不困难。翻译上虽有差异，但亦不难统一。精、神、     

Liuwei Dihuang,a traditional Chinese herbal formula,suppresses chronic inflammation and oxidative stress in obese rats

OBJECTIVE： To investigate the anti-inflammatory, anti-oxidative stress, and adipokine-ameliorating effects of Liuwei Dihuang （LWDH）, a traditional Chinese herbal formula, in obese rats. METHODS： After 2 weeks of acclimation with free access to regular rodent chow and water, obese-prone-caesarean-derived （OP-CD） rats were fed a modified AIN-93G diet containing 60% energy from fat. Treatment was performed twice daily by gavage feeding with 500, 1 500, or 3 500 mg/kg body weight LWDH suspended in water （n=12 rats per group）. Twelve obese-resistant-CD （OR-CD） rats were fed the atherogenic diet and gavaged with water, and served as the normal control. Blood biomarkers of inflammation, oxidative stress and adiponectin were measured post-sacrifice and used to determine the treatment effect of LWDH and assess the suitability of OR/OP-CD rats for studying these parameters. RESULTS： After 9 weeks of treatment, LWDH lowered serum C-reactive protein （CRP） and tumour necrosis factor-α （TNF-α） levels. Serum interleukin-6 （IL-6） levels showed a tendency towards reduction, but were not significantly different from the OP-CD control. Liver superoxide dismutase （SOD） activity was increased in response to all three doses of LWDH, while the levels of reduced （GSH） and oxidized glutathione （GSSG） and thiobarbituric acid reactive substances （TBARS） were unchanged. Serum adiponectin levels were increased in response to oral administration of LWDH at the dose of either 500 or 1 500 mg/kg body weight. In addition, comparisons between OR-CD and OP-CD rats revealed differential, and for some biomarkers, conflicting characteristics of high-fat diet-fed OP-CD rats in reference to obese human subjects in terms of inflammatory and oxidative stress biomarkers and circulating adiponectin levels. CONCLUSION： The results show, for the first time, the anti-inflammatory, anti-oxidative stress and adiponectin-ameliorating effects of LWDH in obese rats. The suitability of the OP-JOP-CD rat model as     

New Mechanism of Herb-herb Interaction between Ginseng and Trogopterus Based on CYPs in Rat Livers

The study was designed to investigate the potential mechanism of herb-herb interaction between ginseng and Trogopterus （Trg） based on Cytochrome P450 isozymes （CYPs） in rat livers. We estimated the influence on CYP1A2, CYP2E1, and CYP3A1/2 activity caused by ginseng and Trg used in combination. The CYP1A2 and CYP2E1 enzyme activity were induced by ginseng and Trg used in combination. And this induction effect was caused via inducing CYP1A2 and CYP2E1 protein expression which was supposed caused by inducing the gene expression of CYP1A2 and CYP2E1.     

中医疗法治疗运动性疲劳的研究进展

随着竞技体育的发展，运动员经常承受着大负荷、超强度的体力训练，因此极易产生运动性疲劳。疲劳的出现使肌内压增高，局部缺血，造成氧化代谢、H^＋排出率与pH值降低，血乳酸增高，从而影响肌纤维神经传导速度和肌内收缩力量，减弱了肌肉保护能力。致使较多的冲击力传到骨骼上，故易导致疲劳骨折的发生,严重影响了运动员的训练和比赛成绩，对运动员身心产生不必要的伤害。运动性疲劳消除手段的研究一直是竞技体育工作和运动医学关注和研究的焦点。     

Effects of tacrolimus and cyclosporine treatment on metabolic syndrome and cardiovascular risk factors after renal transplantation: a meta-analysis

Background The therapeutic success of renal transplantation has been largely attributable to the development of effective and balanced immunosuppressive treatment regimens.This study provides a meta-analysis of a series of randomized controlled trials that compared the effects of tacrolimus and cyclosporine on metabolic syndrome （MetS） and cardiovascular risk factors after renal transplantation.Methods We searched various electronic databases and bibliographies,including MEDLINE,the Cochrane Central Register of Controlled Trials,and EMBASE,for relevant studies published prior to October 2012.Results Our meta-analysis included five randomized controlled trials that examined a total of 923 patients.The tacrolimus group and the cyclosporine group exhibited no significant differences in MetS incidence after renal transplantation; risk ratio （RR）：1.06,95％ confidence interval （C/）：0.73-1.55,P=0.76.Cyclosporine treatment was associated with a higher incidence of hyperlipidemia （RR：0.50,95％ CI：0.39-0.64,P ＜0.01）.Although there were no statistically significant differences,cyclosporine treatment was associated with a higher incidence of hypertension （RR：0.91,95％ CI：0.83-1.00,P=0.06） after renal transplantation compared to tacrolimus treatment,and tacrolimus treatment was associated with a higher incidence of diabetes after renal transplantation （RR：1.79,95％ CI：0.98-3.27,P=0.06） compared to cyclosporine treatment.Conclusions Compared to tacrolimus treatment,cyclosporine treatment was associated with a higher incidence of hyperlipidemia.Future large-scale studies are expected to be conducted to further confirm our findings.     

程丑夫教授论治情志病验案举隅

程丑夫是国家级名老中医,湖南中医药大学第一附属医院主任医师、教授、博士生导师,享受政府特殊津贴专家,出身于中医世家,从医40余年,经验丰富,对于内科系统及疑难杂症的治疗颇有心得,笔者有幸跟师学习,聆听教诲,受益匪浅,现将程师论治情志病的经典验案略陈一二。1思虑伤脾案患者肖某,女,27岁。初诊：2014年5月20日。半年前因婚变后出现忧心忡忡,多思多虑,近1月来反复腹部胀满,刻诊：腹胀,食后为甚,呃逆,无反酸,通气后可减轻,无腹痛,不欲食,夜寐不安,二便调。舌红苔厚白腻,脉弦,BP：110／70mmHg。     

补肾活血方对PCOS大鼠模型卵巢中PAI-1mRNA表达的影响

目的探讨补肾活血方对大鼠PCOS模型卵巢局部纤溶酶原激活物抑制因子-1（PAI—1mRNA）表达的影响。方法选用未成年24d龄SD雌性大鼠60只,随机分为模型组、克罗米酚组、补肾活血方高剂量组、补肾活血方低剂量组、正常对照组5组。用Bogovich法建立大鼠多囊卵巢病理模型。以克罗米酚为对照。用原位杂交法观察补肾活血方对多囊卵巢大鼠局部PAI—1mRNA的影响。结果模型组卵巢局部PAI—1mRNA存在卵泡膜间质细胞显著增高,用补肾活血方高、低剂量与克罗米酚药后,卵巢局部PAI-1mRNA的表达明显降低．差异具有统计学意义（P〈0．05、P〈0．01）。补肾活血方高剂量组与克罗米酚组比较,差异具有显著统计学意义（P〈0．01）;低荆量组与克罗米酚组比较差异无统计学意义（P〉0．05）,补肾活血方高、低剂量组比较,低剂量组卵泡膜间质细胞上PAI-1的基因表达增高更明显,但二者差异无统计学意义（P〉0．05）。结论PAI-1mRNA可能与多囊卵巢综合征的发病机制有关。以补肾活血立法的补肾活血方能降低多囊卵巢大鼠局部PAI—1mRNA的显著增高表达．降低PAI—1mRNA卵巢局部的作用。提示补肾活血方可能通过PAI—1mRNA途径促进卵巢排卵的机制。     

UniPron is A Fully Effective Non-hormonal Reversible Contraceptive in Baboon Model （Papio Anubis）

Objective To determine the safety and efficacy of UniPron as a reversible contraceptive.
Methods Vaginal swabs were obtained before and after UniPron administration, cultured onto appropriate culture media and bacteria identification was done based on type of media used, Gram stain reactions, colony morphology and biochemical tests. Vaginal biopsy tissues were processed using paraffin wax method, stained with hematoxylin and eosin and examined under light microscopy to determine the effect of the product on vaginal tissues. The effect of UniPron on sperm was examined by mixing the product with electroejaculated spermatozoa in vitro at different concentrations. For efficacy studies, male baboons of proven fertility were mated with UniPron treated or untreated females of proven fertility during the fertile stages.
Results All the five females （100%） that were treated with UniPron did not conceive and they regained total fertility when the treatment was stopped while all the controls conceived. At a concentration of 40%, UniPron completely immobilized spermatozoa in an in-vitro system. UniPron mechanism of action was by lowering the vaginal pH and on application in baboon, the pH was lowered for at least 3 h after which it went back to normal.
Conclusions As we plan for a study to test UniPron as a microbicide to prevent STIs including HIV, our current study has established that this novel product is effective in contraception and harmless to vaginal tissues and vaginal microbial flora in a baboon model （Papio anubis）.