急性有机磷农药中毒患者的护理

目的：探讨急性有机磷农药中毒的护理要点。方法：采用回顾性研究分析26例急性有机磷农药中毒患者的护理措施。结果：26例口服有机磷农药中毒患者治愈出院24例，死亡2例，抢救成功率为92．31％。结论：对急性有机磷农药中毒患者进行争分夺秒地抢救与细心护理至关重要，可明显提高治愈率。     

84例急性有机磷农药中毒患者的抢救与护理

目的：总结急性有机磷农药中毒患者的有效抢救和护理方法。方法：回顾性分析我院急救中心2005年1月-2007年6月收治的84例急性有机磷农药中毒患者的治疗、护理经过。结果：84例急性重度有机磷农药中毒患者抢救成功81例，成功率96．4％；死亡3例，死亡率3．6％。结论：积极有效的治疗可提高急性有机磷农药中毒患者的治愈率，降低病死率及并发症发生率，严密的病情观察和用药观察，认真全面的护理是抢救成功的关键。要重视恢复期的护理工作，及时发现反跳的先兆，提高抢救治疗的成功率。     

急性有机磷农药中毒的抢救护理

目的 探讨急性有机磷农药中毒的抢救与护理，提高临床治愈率。方法 采用回顾性方法分析72例急性有机磷农药中毒的抢救护理措施。结果 72例患者中3例因反跳呼吸衰竭死亡，其余69例均治愈出院。结论 急性有机磷农药中毒具有起病急、病情发展速度快、病情重、死亡率高等特点，对患者争分夺秒地抢救与细心护理至关重要，可明显提高治愈率。     

有机磷中毒护理体会

目的：探讨有效抢救急性重度有机磷农药中毒的方法。方法：积极彻底洗胃，合理、有效地应用解毒剂及复能剂，同时进行密切观察与护理。结果：50例急性重度有机磷中毒抢救成功45例，成功率94％；死亡3例，死亡率6％。结论：系统的内科治疗可提高急性重度有机磷中毒患者治愈率，     

急性有机磷农药中毒的救治护理体会

目的:探讨急性有机磷农药中毒的急救与护理.方法:回顾性分析73例急性有机磷农药中毒的临床资料.结果:73例患者中65例轻、中度中毒者全部治愈,8例重度中毒患者死亡5例.结论:对急性有机磷农药中毒患者进行及时的抢救与护理至关重要,可提高治愈率.     

急性有机磷农药中毒48例的血液灌流治疗观察与护理

目的探讨急性有机磷农药中毒患者应用血液灌流治疗的护理经验,以提高急性有机磷农药中毒患者的抢救成功率。方法分析48例急性有机磷农药中毒患者应用血液灌流治疗的临床资料,总结急救与护理经验。结果本组48例急性有机磷农药中毒患者,死亡3例,存活45例,抢救成功率为93.75%。结论急性有机磷农药中毒属急危重症,应尽早行血液灌流治疗,配合药物解毒及对症、支持等救治,做好血液灌流前、中、后的观察与护理,可降低死亡风险,提高治愈率。     

急性有机磷农药中毒患者的抢救和护理体会

目的：探讨急性有机磷农药中毒的抢救与护理，提高抢救成功率。方法：回顾性调查分析68例急性有机磷农药中毒患者的抢救护理措施。结果：68例患者中1例因中毒反跳致呼吸衰竭而死亡，其余67例均治愈出院。结论：急性有机磷农药中毒患者具有起病急、病情变化快、病情重、死亡率高等特点，对患者争分夺秒的抢救、仔细观察病情变化及细心护理是提高患者抢救成功率的关键。     

有机磷农药中毒患者的急救与护理体会

目的探讨急性有机磷农药中毒的急救与护理。方法回顾性分析50例急性有机磷农药中毒的临床资料。结果50例患者中48例轻、中度中毒者全部治愈,2例重度中毒者死亡,抢救成功率96％。结论对急性有机磷农药中毒患者进行争分夺秒的抢救,加强心理护理,及时彻底洗胃,合理恰当应用解毒剂,防止反跳现象,可明显提高治愈率。     

急性有机磷农药中毒的急救护理

[目的]探讨急性有机磷农药中毒的急救与护理.[方法]回顾性分析76例急性有机磷农药中毒的临床资料.[结果]76例病人中轻度、中度中毒者全部治愈,重度中毒病人死亡1例,抢救成功率98.7%.[结论]对急性有机磷农药中毒病人进行争分夺秒的抢救与细心护理至关重要,可明显提高成功率和治愈率.     

急性重症有机磷农药中毒20例急救与护理

回顾性分析20例急性重症有机磷农药中毒患者的临床资料.本组患者死亡3例,17例痊愈,随访3例有神经麻痹等后遗症.对急性重症有机磷农药中毒患者进行积极抢救和精心护理可明显提高治愈率.     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

Dissociable correlates of two classes of retrieval processing in prefrontal cortex

Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.     

俯卧位通气对高海拔地区肺复张治疗无效急性呼吸窘迫综合征患者氧合的影响

目的 探讨俯卧位通气对高海拔地区肺复张术(RM)治疗无效急性呼吸窘迫综合征(ARDS)患者的治疗作用.方法 从海拔2260m的地区医院筛选RM治疗无效的41例ARDS患者[平均氧合指数( PaO2/FiO2)较RM前升高＜20％视为RM无效],依不同病因分为肺内源性ARDS组(ARDSp组)和肺外源性ARDS组(ARDSexp组),每组再按信封法随机分为俯卧位组和仰卧位组,即ARDSp俯卧位组(11例)、ARDSp仰卧位组(9例)、ARDSexp俯卧位组(10例)、ARDSexp仰卧位组(11例).在通气前及通气1、2、3、4h监测动脉血氧分压( PaO2)、PaO2/FiO2、静态顺应性(Cst)、气道阻力(Raw)的变化.结果 通气lh时,ARDSexp俯卧位组PaO2/FiO2( mm Hg,l mm Hg=0.133 kPa)即较通气前显著升高(157.4±40.6比129.3±48.7,P＜0.05),并随通气时间延长呈持续增高趋势,4h达峰值(219.1 ±41.1);且ARDSexp俯卧位组通气3h内PaO2/FiO2较其他3组显著增高,另3组间则差异无统计学意义.ARDSp俯卧位组、ARDSexp俯卧位组通气4h时PaO2/FiO2均较相应仰卧位组显著增高(208.8±39.7比127.4±47.1,219.1±41.1比124.9±50.8,均P＜0.05).4组通气前后Cst无显著改变,各组间差异也无统计学意义.ARDSp俯卧位组通气4h时Raw(cmH2O·L-1·s-1)较通气前显著降低(6.8±1.7比10.7±1.8,P＜0.05),且明显低于其他3组;其他3组各时间点Raw组内及组间比较差异均无统计学意义.结论 俯卧位通气作为ARDS机械通气重要策略之一,可以改善RM无效高原ARDS患者的氧合,为抢救患者赢得宝贵的时间.     

Digital imaging among medical facilities

The Department of Veterans Affairs (VA) in the USA operates a network of 172 medical centres which all utilize a hospital information system (HIS) which has been developed and is currently maintained by the VA. During the past several years, an image management and communication module has been developed, installed and clinically utilized at the Washington DC and Maryland VA Medical Centres. This image management and communication system, referred to as the decentralized hospital computer program (DHCP) imaging system, is fully integrated with a commercial picture archiving and communication system (PACS). The system is utilized to capture, archive, and display all images generated within the hospital including radiology, nuclear medicine, pathology, endoscopy, bronchoscopy, and dermatology, intraoperative photographs, ECG data, and a limited number of paper documents. The ultimate goal of the project is to have all patient text and image data available at any clinical workstation to any authorized user anywhere within the network of medical centres. Clinical requirements for an imaging workstation include ease of use, rapid and reliable access to the complete set of patient information, and images which are of acceptable quality to meet the requirements of the user and the subspecialty. Patient confidentiality and data security must be safeguarded at all times. Integration of the images with the remainder of the patient's database was found to be critical to the success of the project. The experience at the Washington and Maryland facilities suggests that an imaging system that is successfully integrated with a hospital information system can provide substantial clinical and economic benefits both within and among medical centres. Clinical acceptance and utilization of the system has been excellent, particularly in diagnostic radiology where DHCP Imaging has been interfaced to a commercial PAC system. Based upon this initial experience, the VA has begun to deploy the system throughout its large network of medical centres.     

Myocardial elastography at both high temporal and spatial resolution for the detection of infarcts

Myocardial elastography is a novel method for noninvasively assessing regional myocardial function, with the advantages of high spatial and temporal resolution and high signal-to-noise ratio (SNR). In this paper, in-vivo experiments were performed in anesthetized normal and infarcted mice (one day after left anterior descending coronary artery [LAD] ligation) using a high-resolution (30 MHz) ultrasound system (Vevo 770, VisualSonics Inc., Toronto, ON, Canada). Radiofrequency (RF) signals of the left ventricle (LV) in longitudinal (long-axis) view and the associated electrocardiogram (ECG) were simultaneously acquired. Using a retrospective ECG gating technique, 2-D full field-of-view RF frames were acquired at an extremely high frame rate (8 kHz) that resulted in high-quality incremental displacement and strain estimation of the myocardium. The incremental results were further accumulated to obtain the cumulative displacements and strains. Two-dimensional and M-mode displacement images and strain images (elastograms), as well as displacement and strain profiles as a function of time, were compared between normal and infarcted mice. Incremental results clearly depicted cardiac events including LV contraction, LV relaxation and isovolumetric phases in both normal and infarcted mice, and also evidently indicated reduced motion and deformation in the infarcted myocardium. The elastograms indicated that the infarcted regions underwent thinning during systole rather than thickening, as in the normal case. The cumulative elastograms were found to have higher elastographic SNR (SNR(e)) than the incremental elastograms (e.g., 10.6 vs. 4.7 in a normal myocardium, and 6.0 vs. 2.4 in an infarcted myocardium). Finally, preliminary statistical results from nine normal (m = 9) and seven infarcted (n = 7) mice indicated the capability of the cumulative strain in differentiating infracted from normal myocardia. In conclusion, myocardial elastography could provide regional strain information at simultaneously high temporal (>/=0.125 ms) and spatial ( approximately 55 microm) resolution as well as high precision ( approximately 0.05 microm displacement). This technique was thus capable of accurately characterizing normal myocardial function throughout an entire cardiac cycle, at the same high resolution, and detecting and localizing myocardial infarction in vivo.     

手转胎头术失败的原因与分娩结局临床分析

目的 探讨手转胎头术失败的原因与分娩结局.方法 选择2008年1月至2010年12月于我院住院分娩的持续性枕横位、枕后位产妇198例,根据行手转胎头术后结果分为成功组126例、失败组72例.比较两组分娩结局,对比分析失败原因.结果 失败组胎儿体质量≥3500 g的发生率[76.4％(55/72)]明显高于成功组[31.7％(40/126)],差异有统计学意义(x2=30.177,P=0.001)、失败组宫缩乏力发生率[58.3％(42/72)]高于成功组[38.1％ (48/126)],差异有统计学意义(x2=7.569,P=0.006)、失败组骨盆临界或轻度狭窄发生率[38.9％ (28/72)]高于成功组[23.8％(30/126)],差异有统计学意义(x2 =5.030,P=0.002)、失败组手转胎头时机不当(宫口开大＜6 cm、胎头位于坐骨棘上及宫口开大8～10 cm、胎头位于坐骨棘下≥2 cm)发生率[61.1％(44/72)]高于成功组[38.9％(49/126)],差异有统计学意义(x2=9.084,P=0.003).失败组母儿并发症(产后出血、产褥病率、胎儿窘迫、新生儿窒息)发生率高于成功组(x2 =9.586,P=0.002、x2=9.334,P=0.002、x2=5.910,P=0.015、x2=5.240,P=0.022)、失败组剖宫产发生率[72.2％(52/72)]明显高于成功组[34.1 ％(43/126),x2=26.641,P=0.001)].结论 手转胎头术能使难产变顺产,降低剖宫产率,减少母儿并发症,但须积极预防、处理导致手转胎头术失败的原因,对矫正失败后继续矫正及试产应慎重.