肝硬变患者营养治疗的临床研究

目的 观察高能量植物蛋白食谱对肝炎后肝硬变患者蛋白质代谢的影响。方法 用^15N-赖氨酸为示踪剂，测定肝硬变患者营养治疗前后肝脏合成前白蛋白速率的变化。结果 营养治疗后较治疗前肝脏合成前白蛋白速率明显提高。结论 高能量植物蛋白食谱可纠正肝炎后肝硬变患者的蛋白质代谢系乱，改善肝功能。     

151例急性缺血性脑卒中患者的中医证型分布规律及与舌象的相关性分析

目的:探讨151例急性缺血性脑卒中患者的中医证型分布规律及与舌象之间的相关性.方法:回顾性分析扬州市中医院2019年7月—2020年7月的151例急性缺血性脑卒中患者的一般资料、中医证型、舌象等相关信息,总结其中医证型分布规律及与舌象的相关性.结果:中医证型为风痰瘀阻、风痰火亢、阴虚风动、气虚血瘀、痰湿蒙神、风火上扰、痰热腑实;舌质以红舌为主,舌体以歪斜舌为主,舌苔以白腻苔为主.中医证型与舌象呈正相关的为,风痰瘀阻与白腻苔,风痰火亢与歪斜舌、黄腻苔,阴虚风动与花剥苔,气虚血瘀与薄白苔,痰湿蒙神与紫暗舌,风火上扰与绛舌、黄腻苔.结论:急性缺血性脑卒中的主要中医证型为风痰瘀阻,舌质以红舌为主,舌体以歪斜舌为主,舌苔以白腻苔为主,舌象与中医证型存在相关性.     

剥苔,地图舌研究现状与进展

地图舌是指舌苔斑块状的剥落而呈现不同的形状,尤如地图,中医又称为花剥苔。现代医学研究,剥苔与地图舌虽同为良性游走性舌炎,但其状态有所不同,舌微循环障碍表现形式亦有所不同。现将剥苔、地图舌的研究现状与进展作一概述。 一、剥苔、地图舌的发病情况 １．患病率：陈氏等［１］调查了上海市１９８０例儿童的舌象,结果发现幼儿中地图舌和剥苔共占１０．２９％,显著高于学龄前（５．３０％）和学龄儿童（３．４５％）,尤其是地图舌更明显（Ｐ＜０．０１）,其性别差异不明显,提示地图舌的发病可能与小儿先天不足有关。李氏等［２…     

辨舌象与饮食调护

观察舌象是中医诊病的传统经验和特色,是审证求因、辨证论治的可靠依据。我们在中医临床实践中,认识到患者舌象的变化与饮食关系极为密切,如能辨舌调食,则可辅助疾病的治疗,收到相当满意的效果。１舌象、饮食与疾病的关系舌象包括舌质和舌苔两个方面,舌苔是附着于舌...     

舌诊与上消化道疾病内镜诊断的关连性探讨

目的:探求舌诊与上消化道疾病内镜诊断的关连性。方法:在进行胃镜检查前先舌诊,查看受检者舌质、舌苔变化并做好相关记录,然后给予电子胃镜检查,通过对胃镜下黏膜像各种改变作出的消化道疾病诊断,并与舌象改变对照后进行归纳统计分析。结果:不同的上消化道疾病其舌质舌苔变化存在一定的规律性,可反映出疾病本质,为中医诊断和治疗提供了客观依据。     

脊髓损伤尿潴留患者舌象分析

目的：探讨脊髓损伤后尿潴留的病机，为治疗提供依据。方法：对111例脊髓损伤后或手术后1－2个月，有尿潴留的患者的舌质、舌苔进行观察及分析，并进行辨证分型。结果：患者的舌质、舌苔以舌淡白腻苔、舌红黄腻苔为多见，辩证分型以湿热及湿盛为多。结论：分析脊髓损伤尿潴留患者的舌象对探讨中医尿潴留的病机及指导临床治疗有一定的参考作用。     

舌像与胃镜像及Hp的关系分析

“舌为脾胃之外候”，正常舌苔是由胃气、胃阴上蒸于舌面而生成，病理性舌苔则是胃气挟邪气上蒸而成。长期的临床实践证明，舌像能比较灵敏地反映脾胃方面的变化。近年来，不少作者观察研究慢性胃炎患者的舌像与胃镜像及幽门螺杆菌(Hp)之间的关系，观察和分析纤维胃镜直视下胃黏膜变化与舌像改变的关系，观察病例数千例。本文综合分析这些材料，比较全面评价舌像诊断慢性胃炎的意义。     

中度睡眠呼吸暂停低通气综合征患者行舌托治疗后代谢当量及呼吸睡眠监测联合观察

目的:探讨呼吸睡眠监测(PSG)及心电图运动平板试验联合观察评估中度睡眠呼吸暂停低通气综合征(OSAHS)患者行舌托治疗的可能性。方法:对2002年11月至2006年5月间41例愿接受舌托治疗的中度OSAHS患者行舌托治疗,对比观察治疗前及治疗后6个月、1年PSG[呼吸暂停低通气指数(AHI)、最低血氧饱和度]与代谢当量(METs)的变化。结果:41例患者经舌托治疗后1年治愈率17%(7/41),显效率39%(16/41),有效率34%(14/41),无效率10%(4/41)。舌托治疗前后AHI、最低血氧饱和度、METs的变化有统计学意义(P<0.05),舌托治疗后6、12个月AHI、最低血氧饱和度间差异无显著性(P>0.05)。结论:PSG和METs试验联合观察可作为中度OSAHS患者的疗效评价参数组合之一。舌托作为一种非创治疗方式可作为中度OSAHS患者首选方式之一。     

甲状腺功能亢进患者治疗前后血脂变化的观察

甲状腺激素(TH)是参与糖、蛋白质、脂肪、维生素和水、盐代谢的重要内分泌激素,TH水平的变化,可影响血脂的代谢.现观察32例甲亢患者治疗前后血清TH及血脂水平,报告如下:……     

SARS患者舌象与外周血象的相关性分析

目的:了解严重急性呼吸综合征(SARS)患者的临床特征及中医证候演变规律,探讨舌象特点与血象变化之间的关系及舌象在防治SARS中的作用.方法:采用前瞻性方法对入院的99例、170例次SARS患者的临床表现、舌象照片、血象检查等临床资料进行归纳总结、统计分析.结果:SARS患者白细胞计数、中性粒细胞比例与舌苔腐腻呈极显著正相关(P<0.01);淋巴细胞比例、嗜酸粒细胞比例、单核细胞比例与舌苦腐腻呈极显著负相关(P<0.01);嗜酸粒细胞比例与舌芒刺、裂纹、舌尖红呈极显著正相关(P<0.01);单核细胞比例与舌质老嫩、舌红、润燥、剥脱呈极显著正相关(P<0.01),与舌淡红呈极显著负相关(P<0.01);血小板计数与舌体瘦胖、裂纹呈显著正相关(P<0.05),与舌红、苔厚薄呈显著负相关(P<0.05).结论:SARS患者的临床表现及舌象、血象有独特的改变,且舌象与血象之间具有一定的相关性,舌象的动态观察有助于及早提示病情变化,中医舌诊在SARS诊疗中具有重要意义.     

Visiting rights only: the diplomas in nursing in the UK in the interwar period

The aim of this article is to explore the institution and organisation of the diplomas in nursing at the universities of Leeds and London, which were established in 1921 and 1926, respectively. It will be argued that the success of these courses for the individuals who undertook them, and the profession as a whole was ultimately limited. It is accepted that the purpose of the diplomas was at least in part for the nursing elite to maintain their grip on the leadership. Nevertheless, the institution of the courses, when few women in general attended university, identifies a 'radicalness' within the profession, which has rarely been considered. Moreover, that there was a body of nurses capable of university level education challenges previous assumptions.     

Pitfalls in the Care of the Psychiatric Patient in the Emergency Department

Background

Care of the psychiatric patient in the Emergency Department (ED) is evolving. As with other disease states, there are a number of pitfalls that complicate the care of the psychiatric patient.

Objective

The purpose of this article is to update Emergency Physicians concerning the pitfalls in caring for the psychiatric patient, and possible solutions to deal with these pitfalls.

Discussion

The article will address the burden of the psychiatric patient, staff attitudes, medical clearance process, treatment of the agitated patient, suicidal patients, and admission decisions.

Conclusions

Alternative care resources, collaboration with Psychiatry, staff education, improvement in the medical clearance process, proper use of restraint and seclusion, and appropriate choice of medication for agitated patients can help avoid some of the top pitfalls in the care of the psychiatric patient in the ED.     

Changes in the parameters of the rhythms of the electrolyte-excreting function of the kidneys in women in relation to the seasons of the year

The characteristics (period, mesor, amplitude) of the rhythms of urinary excretion of sodium, potassium, chlorine, calcium, magnesium, and phosphorus were examined in normal women during various seasons. The urine was collected for 5 days with 4-hour intervals. The rhythms were detected and their parameters established with the use of mathematical methods for the assessment of the tested curve fragments repetitions and by the least squares nonlinear method. The rhythms of renal urinary and electrolyte excretion were found very smooth, particularly so in the fall and winter. The circadian rhythms have been found the most stable during all the seasons. Examinations of individual electrolyte excretion have shown that Na and K excretion is more stable all the year round and therefore this parameter is the most informative for the detection of disorders in renal electrolyte excretion.     

Choosing the choices in the USA: examples in the maternity area

The concept of choice has featured prominently in both the recent united Kingdom (UK) health care reforms and in the debate relating to the care of childbearing women. An invitation to the USA facilitated contemplation of the health care system on which the recent UK reforms have been modeled. The impact of the health system on mother's choices was a source of particular interest. The implications for midwives, their practice and their relationships with their clients and colleagues emerge clearly. It may be that the United States' model of health care does not answer the needs of the UK.     

Change in the drug-metabolizing function of the liver in patients in the postoperative period in relation to the type of anesthesia]

Anesthesia-dependent changes in pharmaco-metabolic liver function have been studied in patients operated on for cosmetic facial defects. It has been established that the postoperative period in patients subjected intraoperatively to general combined anesthesia and controlled lung ventilation was characterized by inhibited drug metabolism in the liver, which required correction of the drug doses to reduce the risk of side and toxic effects of pharmacotherapy. Patients operated on under local procaine anesthesia had no considerable changes in pharmaco-metabolic liver function in the postoperative period.