一次性使用输液器外包装的妙用

静脉输液是治疗和抢救患的一个重要手段,是护理工作的重要技术操作内容。近年来,护理工作们对静脉输液的相关问题进行了大量的研究和探索,如：徐莉对传统的给药方法进行了改进;张碧淦等研究了加药刺入瓶塞的方法减少碎屑的发生率;马丽锋等对传统的排气方法进行了改良;张小群等对扎止血带时间和进针进行了对比研究;李宝军等对输液拔针后防止出血淤斑进行了临床研究;扬艳萍等对手背静脉穿刺进行了实验性对比研究。     

原子弹受害者的放射线诱发癌与受害时年龄的关系

放射线效应研究所对原子弹受害后影响的恶性肿瘤发生率是否与受到放射线而增加的问题,进行了研究。对原子弹受害者和对照者约11万人进行了固定抽样,对1950年以来的死亡者进行了追踪调查。以原发性     

PET扫描仪探测闪烁体的特性

本文对PET辐射探测器的闪烁体进行了描述说明，并对PET扫描仪对探测闪烁体的要求进行了说明。     

我干休所开展氧疗的实践及探讨

本文对干休所建立氧疗室开展氧疗情况进行了总结，并对氧疗中应注意事项进行了探讨。     

烧伤创面植皮成活率与手术时间的关系(附300例临床观察)

作者对300例烧伤创面植皮与伤后手术时间的关系进行了探讨，认为烧伤创面最佳时机为伤后≥10天＜50天。作者对三组病树进行了比较，对＜10天和＞50天者均不如此间中组，作者对其原因进行了分析。     

我国中医药治疗糖尿病的现状与展望

本文对我国中医药治疗糖尿病进行了综述。对我国治疗糖尿病中药的生产和使用情况进行了总结 ;对治疗糖尿病的单味中药及单体成分、中药复方及中西药结合治疗糖尿病研究的现状进行了重点阐述。对中药新药的研究开发及中医临床用药有指导意义     

周围性肺癌早期X线诊断的回顾性分析

本文报告了28例早期周围型肺癌,对其X线表现进行了回顾性分析。并对其中13例误漏诊的原因进行了讨论。     

烧伤创面植皮成活率与手术时间的关系（附300例I临床观察）

作者对300例烧伤创面植皮与伤后手术时间的关系进行了探讨，认为烧伤创面最佳时机为伤后≥10天<50天。作者对三组病例进行了比较，对<10天和>50天者均不如此间中组，作者对其原因进行了分析。     

500例上消化道X线钡餐与电子内镜对照检查分析

作者对500例上消化道X线钡餐与电子内镜对照检查进行了分析。上消化道X线钡餐检查诊断符合率为85％,电子内镜检查诊断符合率为98.6％。并对其误诊原因进行了分析。 自引进电子内镜以来,我们对部分患者进行了X线钡餐与电子内镜的对照检查,现对500例资料完整的病例进行分析报告如下:     

几种制备感受态细胞及质粒转化方法的比较

制备感受态细胞并进行质粒转化实验是重组 DNA 工作中的重要环节。本文就几种制备感受态细胞的方法进行了比较,对有些操作步骤做了改进,对一些影响质粒转化的因素进行了初步探讨。     

大鼠深静脉血栓形成模型建立及观察

目的建立大鼠深静脉血栓形成（DVT）模型,观察实验大鼠术前及术后不同时间凝血酶原时间、纤维蛋白原含量、D-二聚体含量及血栓长度的变化情况。 方法将30只SD大鼠用结扎阻断下腔静脉及其分支,并用微血管夹钳夹损伤静脉壁的方法诱导深静脉血栓形成。于术前第1天及术后第1、4、7、10、14、21天采静脉血检测纤维蛋白原含量、D-二聚体含量及凝血酶原时间,并行血管造影观察血栓及血管再通情况。 结果共23只大鼠深静脉血栓模型制作成功,功率76.67%（23/30）。纤维蛋白原含量、凝血酶原时间及D-二聚体含量在术前与术后之间的差异有统计学意义,但术后不同时间之间差异无统计学意义;术后血栓长度在不同时间的差异均有统计学意义。 结论凝血酶原时间、纤维蛋白原及D-二聚体可作为是否有血栓形成的重要参考指标,但在评价病情进展及严重程度方面价值有限;血栓长度随时间先增长,后又溶解,直至消失。     

Population crises and population cycles

To prevent a population irretrievably depleting its resources, mammals have evolved a behavioural and physiological response to population crisis. When a mammalian population becomes dangerously dense, there is a reversal of behaviour. Co‐operation and parental behaviour are replaced by competition, dominance and aggressive violence, leading to high mortality, especially of females and young, and a reduced population. The stress of overpopulation and the resulting violence impairs both the immune and the reproductive systems. Hence epidemics complete the crash of the population, and reproduction is slowed for three or four generations, giving the resources ample time to recover. In some mammal species, crisis and crisis response recur regularly, leading to cycles of population growth and relapse, oscillating about a fixed mean.

Population crisis response and population cycles have been equally prominent in the history of human societies. But in man successive advances in food production have made possible growing populations, though with every such advance population soon outgrew resources again. Hence human cycles have been superimposed on a rising curve, producing a saw‐tooth graph. Because advances in food production amounted to sudden disturbances in the relations between human populations and their environments, the crisis response in man has failed to avert famine and resource damage. In the large human societies evolved since the coming of settled agriculture and cities, the basic effects of violence, epidemics, famine and resource damage have been mediated by such specifically human disasters as inflation, unemployment, and political tyranny.

An account of past crises, periods of relative relief from population pressure, and resulting cycles, is given for a number of regions: China, North Africa and Western Asia, the northern Mediterranean, and north‐western Europe. The paper ends with an account of the present world‐wide population crisis, and the solution made possible by Malthus's discovery that, unlike animals, we can choose to check population growth by reducing the birth‐rate, instead of raising the death‐rate, as in other mammals, by the population crisis response.     

一起暴发麻疹的临床特征和流行病学特征分析及防控处理

 目的 分析某学院15例聚集麻疹患者发病的流行病学和临床特征及防控处理,有利于防止麻疹暴发。方法 对15例麻疹患者聚集发病的流行病学资料和临床资料进行调查分析、采样,对聚集发病原因、流行病学特点、临床特点及采取的防控措施进行分析。结果 15例麻疹患者春季聚集发病,临床特征为发热、皮疹、咽痛、咳嗽、流涕、鼻塞,口腔黏膜斑、发热、皮疹,合并肺部感染及结膜炎1例,心肌炎1例,麻疹病毒核酸13例阳性。流行病学特征:首发病例发生于2015-04-01,疫情高峰在4月13日至4月17日,4月17日结束,二代感染病例集中于该病的最长潜伏期内。有明确的流行病学接触史11例,占73%,主要集中在同一层楼的3个宿舍,呈现聚集性分布。均为男性学员,年龄19～25岁。结论 麻疹暴发与季节、疫苗接种、发病年龄、防控措施是否及时实施有关。建议各大专院校及居住比较密集单位的临床医师注意春季麻疹散发病例,立即隔离麻疹患者,密切接触者及时进行预防接种,防止麻疹暴发。     

Working together for health and human rights*

The right to a standard of living adequate for health and well‐being is being denied to vast numbers of people all over the world through increasing disparities in income and in wealth. In the name of economic development, a number of international and national policies have increased the grossly uneven distribution of income, with ever‐growing numbers of people living in poverty as well as in increasing depths of poverty. Globalization, crippling levels of external debt, and the ‘structural adjustment’ policies of international agencies have expanded the numbers and the suffering of people living in poverty and have resulted in the neglect of government‐funded social programs, of regulations protecting the environment, and of human development. Access to medical care, an essential element in the protection of health, is difficult for many, including the 44 million people in the United States who lack insurance coverage for the cost of medical care services. Working together for health and human rights also requires promotion of the right to peace. The right to life and health is threatened not only by the existence and active deployment of weapons of mass destruction, including nuclear, chemical and biological weapons and anti‐personnel landmines, but also other weapons. The twentieth century has been the bloodiest in human history, with an estimated 250 wars, more than 110 million people killed, countless people wounded and at the least 50 million refugees. Health workers must work together with people in our communities for the promotion of health and human rights, which, in Sandwell and elsewhere, are inextricably intertwined.     

尾悬吊大鼠牙体、牙髓、牙周组织的变化

目的 探讨模拟失重务件下钙、磷的代谢变化及转化生长因子β1(TGF-β1)、c-fos及Ⅰ、Ⅳ型胶原蛋白在牙髓、牙周组织中的功能效应。方法 采用扫描电镜及能谱分析系统对模拟失重组、失重对抗组、正常对照组大鼠牙体、牙髓、牙周组织的Ca、P相对百分含量进行检测，同时用免疫组织化学方法对3组大鼠牙髓、牙周组织中的TGF-β1、c-fos及Ⅰ、Ⅳ型胶原蛋白的表达特征进行观察。结果 模拟失重大鼠的牙体组织Ca的相对百分含量明显下降，P稍升高；牙槽骨Ca、P的含量无显著差异。牙髓组织中TGF-β1、c-fos和胶原Ⅰ的表达均减少，胶原Ⅳ在毛细血管内的表达量增多；牙周组织中它们的含量变化不大。采用人工对抗措施后可部分恢复它们的表达量。结论 失重可能引起牙本质矿化不良，1．5G对抗措施可改善其对牙体组织矿物质代谢带来的不利影响。TGF-β1、c-fos、胶原Ⅰ分泌减少是导致矿化不良的一个重要原因。     

Image quality, lesion detection, and diagnostic efficacy in digital mammography: full-field digital mammography versus computed radiography-based mammography using digital storage phosphor plates

OBJECTIVE: To compare image quality, the lesion detection, and the diagnostic efficacy of full-field digital mammography (FFDM) and computed radiography-based mammography using digital storage phosphor plates (DSPM) in the evaluation of breast lesions. MATERIALS AND METHODS: In this prospective study, 150 patients with suspicious breast lesions underwent FFDM and DSPM. Nine aspects of image quality (brightness, contrast, sharpness, noise, artifacts, and the detection of anatomic structures, i.e., skin, retromamillary space, glandular tissue, and calcifications) were evaluated by five radiologists. In addition, the detection of breast lesions and the diagnostic efficacy, based on the BI-RADS classification, were evaluated with histologic and follow-up correlation. RESULTS: For contrast, sharpness, and the detection of all anatomic structures, FFDM was rated significantly better (p<0.05). Mass lesions were equally detected, whereas FFDM detected more lesions consisting of calcifications (85 versus 75). DSPM yielded two false-negative results. Both lesions were rated BI-RADS 4 with FFDM, but BI-RADS 2 with DSPM. Both were invasive carcinoma at histology. The sensitivity, specificity, PPV, NPV, and accuracy of FFDM were 1.0, 0.397, 0.636, 1.0, and 0.707, compared to 0.974, 0.397, 0.630, 0.935, and 0.693 of DSPM. CONCLUSION: Based on image quality parameters, FFDM is, in part, significantly better than DSPM. Furthermore, the detection of breast lesions with calcifications is favorable with FFDM. However, the diagnostic efficacy of FFDM and DSPM was equal. The interpretation of the false-negative results suggests that the perception and characterization of breast lesions is not defined solely by the digital mammography system but is strongly influenced by the radiologist, who is one of the determinants in the interpretation of breast imaging.     

大鼠肝肿瘤细胞灶性凋亡MRI表现

目的:建立大鼠肝肿瘤细胞凋亡模型并研究其磁共振成像表现.方法:选取45只肝肿瘤大鼠,随机分成放疗组,酒精注射组及对照组,每组15只,分1d、3d、7d共3个时间点观察;每组大鼠每个时间点均采集磁共振MRI、DWI、~1H-MRS图像,分析磁共振图像,并测量ADC值及~1H-MRS各代谢物波峰下面积,进行统计学处理;磁共振检查后取标本送病理学(HE,TUNEL,PCNA)及电镜检查;将病理学检查结果与磁共振图像对照分析.结果:①病理学检查结果证实放疗组肝肿瘤细胞发生凋亡;酒精注射组肝肿瘤细胞以发生坏死为主;②放疗组同未治疗组比较肿瘤体积减小,T_1 WI信号等低,T_2 WI信号稍减低,DWI信号下降,呈等高信号,内见条片状等低信号区,ADC值增加,Lip、Cho、Lae、Glx峰下降,Cr峰变化不大;③酒精治疗组体积缩小,病灶中央信号强度明显减低,旱条片状,T_1 WI等低信号,T_2 WI低信号;DWI信号不均匀片状减低,ADC值介于正常组织与残留肿瘤组织之间;Lip、Cho、Lac、Glx、Cr各峰明显下降.结论:大鼠肝肿瘤放疗可诱导细胞凋亡,凋亡后磁共振检查有特异性表现.特别是T_2WI、DWI、~1H-MRS,活体检测肿瘤细胞凋亡成为可能.     

烧伤患者外周血高密度脂蛋白变化的临床意义

目的探讨烧伤患者高密度脂蛋白的变化特点及其与感染并发症的关系。方法选取120例伤后24h内入院的18～59岁热力烧伤患者,其中轻中度、重度和特重度烧伤各40例,于入院时和伤后1、2、3、5、7、14、21d空腹采集外周血,检测甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、载脂蛋白A1(apoA1)、载脂蛋白B(apoB)水平,并监测感染并发症及预后情况。以40例健康体检者作为对照组。结果120例患者中有32例发生医院感染51例次,死亡6例,其中5例与感染有关。轻中度、重度和特重度烧伤患者的感染发生率分别为7·5%、20·0%和52·5%,三者比较差异显著(P<0·001)。TC、HDL、apoA1在伤后1d已明显降低(P<0·05),伤后5d降至最低水平,此三项指标的水平随伤情加重递减,其中以HDL降幅最大。与对照组比较,轻中度、重度和特重度组HDL平均降低33%、45%和70%。TG在伤后7d升至最高水平,其浓度随伤情加重递增,与对照组比较,轻中度、重度和特重度组TG平均升高30%、67%和153%。特重度组40例中有21例发生感染37例次,在入院时和伤后1d,感染者与非感染者血脂水平无显著差别,伤后2d感染者的TC、HDL、apoA1开始低于非感染者,直至伤后21d差别仍具有显著性(P<0·05)。伤后3～21d,感染者TG明显高于非感染者。结论烧伤患者TC、HDL、apoA1、LDL水平降低,TG水平升高,血脂异常程度与伤情及感染并发症有关。     

Diagnostic usefulness of FDG PET for pancreatic mass lesions

The purpose of this study was to investigate the feasibility of [18F]2-deoxy-2-fluoro-D-glucose (FDG) positron emission tomography (PET) in patients with a pancreatic mass by comparing the results with those of X-ray computed tomography (CT) and magnetic resonance (MR) imaging. METHODS: Eighty-six patients with pancreatic lesions, included 65 malignant tumors and 21 benign masses (55 masses were proven histologically and the others were diagnosed clinically), were studied. The diagnostic factors of CT and MR imaging were evaluated, and those of FDG PET were also evaluated for malignant and benign masses by visual interpretation and quantitative interpretation with the standardized uptake value (SUV) and SUVgluc which was designed to reduce the effects of a high blood sugar level. Visual interpretations were evaluated only in FDG PET images, and quantitative interpretations were evaluated by referring to CT and/or MR imaging. The correlation between SUV and the degree of histological differentiation in pancreatic ductal adenocarcinoma was investigated. RESULTS: Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy for CT imaging were 91, 62, 88, 68 and 84%, and for MR imaging 78, 70, 88, 54 and 76%, respectively. In visual interpretation of FDG PET images, the sensitivity, specificity, PPV, NPV and accuracy were 82, 81, 93, 59 and 81%, respectively. Significant differences between malignant and benign lesions existed in SUV and SUVgluc (p < 0.0001, each). With the cutoff value of SUV as 2.1 and SUVgluc as 2.2, the accuracy of diagnosis was maximal. With that cutoff value, the sensitivity, specificity, PPV, NPV and accuracy for SUV were 89, 76, 92, 70 and 86%, and for SUVgluc 91, 76, 92, 73 and 87%, respectively. The sensitivity and NPV of SUVgluc were higher than those of SUV, which suggests that SUVgluc may be more useful in reducing the number of overlooked malignant tumors. The specificity and PPV of FDG PET were superior to those of CT and MR imaging. There were no significant differences between the SUVs of moderately differentiated adenocarcinomas and those of well differentiated adenocarcinomas. CONCLUSION: To improve the diagnostic procedure for classifying masses, FDG PET with not only SUV but also SUV corrected by the blood sugar level is required in addition to morphological diagnosis by CT and/or MR imaging.     

Neurografía de alta resolución del nervio peroneo en resonancia magnética 3T

Peroneal neuropathy is the most common mononeuropathy of the lower limbs. The causes of peroneal neuropathy include trauma, tumors of the nerve and nerve sheath, entrapment, and others like perineurioma, fibromatosis, lymphoma, and intraneural and externeural ganglia. The diagnosis is based on clinical manifestations and electrophysiological studies. Nowadays, however, magnetic resonance (MR) neurography is a complementary diagnostic technique that can help determine the location and cause of peroneal neuropathy. In this article, we describe the MR anatomy of the peroneal nerve, its relations, and the muscles it innervates. We also discuss the clinical and electrophysiological manifestations of peroneal neuropathy, describe the technical parameters used at our institution, and illustrate the MR appearance of various diseases that involve the peroneal nerve.