浅谈褥疮预防及护理

目的 探讨卧床病人预防褥疮的有效护理措施,并寻找理想的治疗方法.方法通过对20例卧床病人褥疮的预防和10例不同原因所致溃疡期褥疮,采用克林霉素治疗.结果 有效降低了卧床病人褥疮的发生,采用克林霉素治疗溃疡期褥疮10例,痊愈7例,3例好转后自动出院,总有效率达100%.结论 正确有效的护理可减少卧床病人褥疮的发生,采用克林霉素治疗溃疡期褥疮方法简便,疗效显著.     

浅谈褥疮合并绿脓杆菌感染8例的护理体会

褥疮又称压迫性溃疡,褥疮是临床最常见的并发症之一,高危人群为老年人,长期卧床的偏瘫患者,年老体弱,瘫痪,大小便失禁,营养不良等均是褥疮形成的主要个体因素,特别是合并绿脓杆菌感染的褥疮，其护理非常棘手，我院于2003年3月～2009年12月间共收治褥疮合并绿脓杆菌感染8例患者，现将护理方法总结如下。     

旋转臀大肌肌皮瓣治疗重度褥疮的护理体会

骨科、泌尿外科、脑外科综合病房,长期卧床病人约占60％以上,一旦发生褥疮,将给治疗带来严重影响,因此我们对长期卧床的病人在褥疮的预防和治疗上积累了一些经验。在褥疮的预防上我们主要做到五勤:勤翻身、勤擦洗、勤按摩、勤整理、勤更换,通过加强护理,杜绝了褥疮的发生。对于入院时已经发生Ⅰ°、Ⅱ°褥疮的病人主要采用局部烤电、换药、定时翻身的治疗措施。对于Ⅳ°褥疮的患者,我们通过采用旋转臀大肌肌皮瓣手术,术后严密观察皮瓣血运和防止感染,使创面一期愈合,疗程短,减轻了病人的痛苦并且挽救了病人生命,现介绍如下。     

前置胎盘阴道流血患者的观察及护理分析

目的：探讨并研究前置胎盘阴道流血患者的观察及护理。方法选取我院自2011年2月~2013年8月收治的经我院确诊的前置胎盘阴道流血患者76例。医护人员通过电子胎儿监护仪对宫缩进行监测，密切观察前置胎盘阴道流血情况与宫缩的关系。患者应行绝对卧床休息，临床医护人员给予患者药物以抑制宫缩，同时给予患者基础护理、清洁护理、饮食护理、心理护理等措施。结果76例患者中，抑制宫缩治疗和有效的护理对前置胎盘患者的阴道流血改善情况的有效率为86.0%。结论对于前置胎盘阴道流血患者给予有效的护理，能有效的改善阴道流血情况，因此值得我们在临床上大力推荐。     

改良式封闭负压疗法在难愈性创面中的应用体会

目的探讨改良式封闭负压疗法在难愈性创面中的应用,为临床治疗提供参考。方法选择46例难愈性创面患者,针对常规负压治疗过程中容易出现海绵板结、引流不畅等并发情况进行附加冲洗、改变吸引模式等改良化处理。观察创面愈合情况。结果本组46例患者中,12例经治疗后肉芽组织生长良好,后经植皮愈合,6例感染控制后因骨或肌腱组织外露采用皮瓣修复,1例老年褥疮患者因原发病导致心肺功能衰竭死亡,其余27例经改良式封闭负压治疗后直接上皮化愈合。结论改良式封闭负压疗法可以在治疗过程中给予创面外用抗感染药物和表皮细胞生长因子,在促进创面愈合的同时可以有效地保护创面及周围皮肤组织。     

褥疮护理小组在治疗褥疮过程中的疗效观察

目的：通过对60例芋期褥疮患者的观察，了解褥疮护理小组在治疗褥疮过程中的作用。方法将60例芋期褥疮患者随机分为治疗组和对照组，治疗组30例，对照组30例，两组均予以传统治疗及外敷愈疮生肌膏，治疗组在此基础上纳入褥疮护理小组，治疗3个疗程后，观察疗效。结果治疗组在显效率及有效率等方面优于对照组，但无统计学意义(>0.05)。结论褥疮护理小组在治疗褥疮过程中具有促进褥疮愈合的作用。     

双侧反向半圆形筋膜皮瓣修复骶部褥疮

长期卧床患者 ,骶部受压 ,易发生褥疮。 1999年以来 ,笔者采用双侧反向半圆形筋膜皮瓣修复骶部褥疮 4例 ,取得良好效果。1　临床资料本组 4例 ,年龄 17岁～ 4 5岁 ,均为男性。病因 :脑外伤后长期卧床 ,形成骶部褥疮。病灶直径 5cm～ 8cm ,深部侵及筋膜和肌肉层。经清创换药后 ,     

褥疮病人的护理体会

褥疮是长期卧床病人最易发生的并发症。随着医学科学的发展及人们生活水平的提高，社会老龄化已普遍存在，卧床的老年患者逐渐增多，褥疮的发生率也呈上升趋势，如褥疮长期不愈，不但给病人增加痛苦，还会使病情加重，引起菌血症或败血症，甚至危及生命。所以，必须采取有效的应对措施，积极予以治疗，使患者早日康复。     

浅谈褥疮合并绿脓杆菌感染8例的护理体会

褥疮又称压迫性溃疡,褥疮是临床最常见的并发症之一,高危人群为老年人,长期卧床的偏瘫患者,年老体弱,瘫痪,大小便失禁,营养不良等均是褥疮形成的主要个体因素,特别是合并绿脓杆菌感染的褥疮,其护理非常棘手,我院于2003年3月～2009年12月间共收治褥疮合并绿脓杆菌感染8例患者,现将护理方法总结如下.     

对43例褥疮的治疗体会谈褥疮的治疗

目的 通过对43例褥疮病人的治疗,总结临床外科褥疮的发生原因、易发部位、褥疮的分期和分度以及治疗方法.方法 对43例褥疮患者应用科学综合治疗,在药物、物理、饮食、外科手术治疗等几方面进行研究总结.结果 15例因原发病医治无效死亡外,其他28例褥疮患者均治愈.结论 及时采取褥疮的内、外科综合治疗,能大大降低褥疮的发生率,同时能提高治愈率.     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.     

The case for allele‐specific recognition by the TCR

There is a sharp difference in how one views TCR structure–function–behaviour dependent on whether its recognition of major histocompatibility complex‐encoded restriction elements (R) is germline selected or somatically generated. The generally accepted or Standard model is built on the assumption that recognition of R is by the V regions of the αβ TCR, which is not driven by allele specificity, whereas the competing model posits that recognition of R is allele‐specific. The establishing of allele‐specific recognition of R by the TCR would rule out the Standard model and clear the road to a consideration of a competing construct, the Tritope model. Here, the case for allele‐specific recognition (germline selected) is detailed making it obvious that the Standard model is untenable.     

The universal muscular chamber. A basic unit of the genitourinary, cardiovascular, gastro-intestinal, skeletal, cutaneous, respiratory and other systems, endocameral hypertension; and spasm, the key to their idiopathic diseases and arthropathies

Starting with the integument, we see many organs are contractile sacs or multiples thereof, which tubes or bags constitute the major part of the entire body. Recognition of this basic unit and its characteristics sheds new light, individually and collectively, on many disorders previously considered unrelated. Muscular tears and perforations develop in the walls of these chambers, being no way peculiar to those organs, wherein, hydrochloric acid occurs. So, it is not necessary to explain the absence of excessive acid from patients who exhibit holes in the gastric, uterine, aortic, duodenal, rectal, pulmonary, retina, and other walls. Muscle, not acid is the great common factor relating idiopathic disorders in the gastrointestinal tract to each other and to similar diseases in other systems. When the units are linked together, the lesions tend to appear as arthropathies, i.e. at the joints. Rephrasing common-place observations, frees us from conventional, conceptual cul-de-sacs. An observation is only as good as its interpretation, so all possibilities must be considered, otherwise, we will remain blinded by our misconceptions.