病毒性心肌炎3例报告

1 病例报告 例1:患者,女,12岁,以头昏、胸闷2d为主诉入院.查体:T 36℃,P 58次/min,R 18次/min,体重32kg,神志清,精神不振,面色苍白,营养中等,皮肤黏膜无出血点.咽红,扁桃体无肿大.颈软,两肺呼吸音粗,心音低钝,心律不齐,可闻及早搏,2～3次/min,心率58次/min.腹软,肝脾无肿大,脊柱四肢正常,神经系统正常.     

和自己好好相处

有时候,我们生闷气,觉得有说不出的压力,快窒息。有时候,我们觉得生活苦闷,拿不出活力,看什么都不顺眼,好像天下倒霉事全集中在这里。有时候,内心有说不出来的慌,那种慌,会牵动最细微的神经,无所遁逃,那是说不出来的痛,说不出的虚无。有时候,我们会很生某人的气,觉得自己的不幸,全肇因于此,却是无力改变。     

八十感言

时光飞逝,不知不觉我到了80岁,在古今中外皆算长寿。回顾80年风雨岁月,耄耋之年自我鉴定,感慨颇多。在职44年,为人厚道,诚信忠实,性格直爽,能吃苦,踏实肯干,凡是领导交给我的任务,尽心尽力,锲而不舍,每件事都是有始有终,不完成任务决不罢休。所以,问心无愧,对得起人民,也对起自己的良心。但我思想观念有一定的局限性,缺点很多,性子急燥易冲动,没有城府,不太讲究     

社交恐怖症一例报告

1 一般资料 1.1 一般情况 阿霞,女性,25岁,未婚,大专文化,私人企业工作,来自农村,姐弟2人,父母健在,家庭经济状态一般.     

经典蜗牛菜肴三款

水晶蜗牛卷原料:蜗牛肉400克,豆腐皮5张,琼脂15克,荸荠50克,洋葱30克,芹菜30克,胡萝卜30克,芫荽少许,鸡蛋2个,面粉50克,清汤适量。盐2克,酱油5克,味精适量,白糖5克,绍酒20克,胡椒粉少许,桔油50克。制法:1.蜗牛肉洗净,盛入碗中,加葱、桂皮和适量的水,上笼蒸1个小时,捞出,洗净秽物,取1/5的蜗     

勿把胆囊炎当胃病

胆囊位于胁下,附于肝,与肝相连,储藏来自肝脏分泌的胆汁,注入肠中,以助消化。近年来,随着国人的饮食习惯的改变和高龄化,胆囊炎发病率明显升高。由于胆囊长期发炎,胆囊壁会发生纤维增厚,疤痕收缩,造成胆囊萎缩,囊腔可完全闭合,导致胆囊功能减退,甚至完全丧失功能。因此,有的病人可以并无胆绞痛发     

做一个半包围女人

这种女人,踏实的生活,就是她的那个半包围,而对生活进一步的向往,就是弥漫在那半包围之外的丝丝芳香。一个朋友,那天,忽然就迷茫了。她说这是人生中的常态,女人经济地位有了保障,过习惯了一种生活,追求到了一种品质,然后突然就在某一天,迷茫了,人生的意义到底在哪里?我笑她这个问题问得太大,她却说,有时候走在路上,走着走着,就觉得没有了方向感,觉得被生活束缚得紧紧的,时间都安排好了,每一刻,每一秒,再也停不下来。     

〖感恩·老师〗专题征文启事

生命中,有一些爱,有一些人,像风雨过后的泥土,先被冲刷,渐渐沉淀,直至溶入生命的最底层。儿时的老师,很多年未见,却依旧像刻石一样不曾淡去,因为爱着,所以记得!儿时,怕做错事,因为怕老师手中的教鞭,眼中威严的目光。而今,依旧怕老师,因为怕老师的担心和不再信任的眼光。原来,无论长多大,老师永远是老师,即使白发苍苍时心中还会敬着爱着。无论你是在校学生还是已参加工作,说出你的心声,分享你的故事,感念师恩,传递永恒不变的师生情。     

大蒜烧鳝段

原料鳝鱼段300克,韭菜150克,薄荷100克,大蒜10瓣,辣椒酱30毫升,白酒30毫升,炸肉皮100克,酱油15毫升,老抽15毫升,红糖15克,花椒10粒,干辣椒5个做法1.汤锅中的水烧开,放入鳝段,再用中火将水烧开     

饮食顺口溜

1.合理膳食笑眯眯,一二三四五六七:一杯奶,二两米,三份蛋白四注意,五百克菜六克盐,七杯开水莫忘记。2.烟伤肺,酒伤肝,鱼生火,肉生痰,青菜豆腐保平安。3.丰富粮袋子,扩充菜篮子——看紧油瓶子,控制盐罐子,调整餐桌子,管好酒瓶子,缩紧烟盒子,把握好水杯子,控制好嘴巴子。     

浅谈《医学免疫学》教学中的几个结合

免疫学教学中,学生往往觉得晦涩难懂,从而产生厌学情绪,问题的症结在于学生缺乏兴趣和学习主动性,解决问题的出路在于改变单一的教学手段,紧密结合现代教学方法,加强与其他学科渗透,重视实验操作,鼓励学生参与教学互动,在各种方法相互结合取长补短中达到最佳的教学效果。     

基层医院医疗纠纷特点及防范对策

文章对基层医院医疗特点进行了分析,认为防范医疗纠纷的措施包括：强化医院内部管理、倡导医学人文精神、提高业务水平、增强法制观念、尊重患者权力、加强医患沟通、强化纠纷管理、注重解决纠纷技巧等。     

加快推进继续医学教育工作 为卫生事业发展奠定基础

探讨继续医学教育工作。结合我国继续医学教育工作的实际，应在以下方面加快推进继续医学教育工作：进一步提高认识，切实加强对继续医学教育工作的领导；进一步完善继续医学教育相关制度，加强和规范继续医学教育的监督管理；加大对农村和基层继续医学教育工作的支持力度；突出重点，加快推进医学继续教育工作：加强继续医学教育管理干部队伍建设。     

Factors related to outcome following a work hardening program

The purpose of this study was to determine factors related to a return to work following the completion of a work hardening program. Data from the Workers' Compensation Board of Alberta Millard Rehabilitation Centre for 1527 discharges, collected over 22 months, were examined retrospectively. Factors related to return to work were compared bivariately using logistic regression procedures. A multiple logistic regression model for return to work was also determined. The principle predictor of return to work was job-attached status to the pre-injury employer. Other factors related to return to work were education, primary diagnosis, injury to admission time, job attachment to the pre-accident employer, employer's annual payroll, and vocational direction. Due to the strength of the association between job-attached status to the pre-injury employer and a return to work, it was concluded that attempts to maintain this relationship should be a priority for rehabilitation providers and insurance carriers.     

Cultivating a worldly repose: the contribution of Sally Gadow's work to interpretive inquiry

This paper discusses the contribution that the work of Sally Gadow makes to understandings of interpretive inquiry and it's potential to inform and influence nursing practice, research, and education. The discussion draws on several of Gadow's published works that make explicit her understandings of what it means to be interpretive, to be open to multiple truths, to hear multiple voices, to have a history, to be experienced, and to recognize agency in language. Situating this discussion of Gadow's contribution in opposition to a metaphysics of genius is intended to move our understanding of particular work past the subjectivity that produced it, past the subjectivized responses to the work, past the reporting on myself – my thoughts, my perspectives, my experiences – to explore, to see the worthwhileness or even the possibilities of exploring the work itself and the worlds it evokes. This paper is a deliberate attempt to disrupt the call to the author to save us from the task of interpreting the questions that the work itself places us under. Gadow's work itself points us away from a valorization of the voice of the author of the work, a single voice, and towards a cultivation of a worldly repose where each interpretive account points us to some longstanding whole to which the work belongs and from which it gains its sense and significance.     

Reducing occupational exposure to chemical carcinogens

Strategies for controlling occupational exposure to chemicalcarcinogens are set out in the European Union Carcinogens Directiveand in national legislation such as the British Control of SubstancesHazardous to Health Regulations. While such legislative requirementsmust apply to all occupational chemical carcinogens, it is arguedthat priority should be given to controlling those agents thatcontribute most to the cancer burden. Examples of possible strategiesto reduce exposure to two agents (diesel exhaust particulateand paint emissions) are discussed. It is concluded that thereare no real technical difficulties in controlling exposuresto chemical carcinogens; however, for many of the key agents,we need to change attitudes to the potential risks and clearlydemonstrate to employers and employees how to reduce the exposures.     

An activity week for children with cancer: who wants to go and why?

Many children now live with cancer rather than die from it, and such children need both to continue their social, emotional and cognitive development and to make long-term psychological adjustments. This paper presents the findings of a research project set up to explore issues pertinent to the current provision of an activity week experience for a group of British paediatric cancer patients. The aims of the study included finding out which factors discriminate between families who apply for a place to attend the week for their child and families who do not, and to develop a knowledge of what factors are considered by parents and children. The findings suggest that the week appeals to children who are confident, active and able to separate from parents and whose parents are keen to encourage independence and new experiences. Children diagnosed and treated at a younger age and further away from treatment were more likely to express concerns about being homesick and safety and to not apply for the week. Issues of protection, independence and disability are discussed with reference to the importance of parental attitude on children's psychological accommodation to disease and treatment and to the experiences of adult survivors of childhood cancer.     

Nutritional quality of leaves of some genotypes of mulberry (Morus alba)

This study was undertaken to determine the proximate composition, vitamins, minerals and the antinutritional factor tannic acid in leaves of six genotypes of mulberry. The results showed that in fresh mulberry leaves the proximate composition values ranged from 71.13 to 76.68% for moisture, from 4.72 to 9.96% for crude protein, from 4.26 to 5.32% for total ash, from 8.15 to 11.32% for Neutral Detergent Fiber (NDF), from 0.64 to 1.51% for crude fat, from 8.01 to 13.42% for carbohydrate and from 69 to 86 kcal/100 g for energy. In dried mulberry leaf powder, moisture ranged from 5.11 to 7.24%, crude protein from 15.31 to 30.91%, total ash from 14.59 to 17.24%, NDF from 27.60 to 36.66%, crude fat from 2.09 to 4.93%, carbohydrate from 9.70 to 29.64% and energy from 113 to 224 kcal/100 g. Among vitamins ascorbic acid and β-carotene were found to range from 160 to 280 mg/100 g and from 10,000.00 to 14,688.00 µg/100 g, respectively, in fresh mulberry leaves and from 100 to 200 mg/100 g and from 8438.00 to 13,125.00 µg/100 g, respectively, in dried mulberry leaf powder. The minerals iron, zinc and calcium were observed in the ranges of 4.70–10.36 mg/100 g, 0.22–1.12 mg/100 g and 380–786 mg/100 g, respectively, for fresh mulberry leaves, and 19.00–35.72 mg/100 g, 0.72–3.65 mg/100 g and 786.66–2226.66 mg/100 g, respectively, for dried mulberry leaf powder. The tannic acid ranged from 0.04 to 0.08% in fresh leaves and from 0.13 to 0.36% in dried leaf powder.     

Timing of steps and reasons for delays in obtaining abortions in the United States

OBJECTIVE: We studied the steps in the process of obtaining abortions and women's reported delays in order to help understand difficulties in accessing abortion services. METHODS: In 2004, a structured survey was completed by 1209 abortion patients at 11 large providers, and in-depth interviews were conducted with 38 women at four sites. RESULTS: The median time from the last menstrual period to suspecting pregnancy was 33 days; the median time from suspecting pregnancy to confirming the pregnancy was 4 days; the median time from confirming the pregnancy to deciding to have an abortion was 0 day; the median time from deciding to have an abortion to first attempting to obtain abortion services was 2 days; and the median time from first attempting to obtain abortion services to obtaining the abortion was 7 days. Minors took a week longer to suspect pregnancy than adults did. Fifty-eight percent of women reported that they would have liked to have had the abortion earlier. The most common reasons for delay were that it took a long time to make arrangements (59%), to decide (39%) and to find out about the pregnancy (36%). Poor women were about twice as likely to be delayed by difficulties in making arrangements. CONCLUSIONS: Financial limitations and lack of knowledge about pregnancy may make it more difficult for some women to obtain early abortion.     

Community care staff attitudes towards delivering a falls prevention exercise intervention to community care clients

Millions of older people world-wide receive community care services in their home to assist them to live independently. These services often include personal care, domestic assistance and social support which are delivered by non-university trained staff, and are frequently long term. Older people receiving community care services fall 50% more often than individuals of similar age not receiving services. Yet, few ongoing community care services include exercise programs to reduce falls in this population. We conducted an earlier study to examine the feasibility of community care staff delivering a falls prevention program. A critical finding was that while some of the assessment and support staff responsible for service delivery delivered the falls prevention exercise program to one or two clients, others delivered to none. Therefore, the aim of this qualitative sub-study was to understand reasons for this variation. Semi-structured interviews were conducted with 25 participating support staff and assessors from 10 community care organisations. Staff who had successfully delivered the intervention to their clients perceived themselves as capable and that it would benefit their clients. Older clients who were positive, motivated and wanted to improve were perceived to be more likely to participate. Staff who had worked at their organisation for at least 5 years were also more likely to deliver the program compared to those that had only worked up to 2 years. Staff that did not deliver the intervention to anyone were more risk averse, did not feel confident enough to deliver the program and perceived their clients as not suitable due to age and frailty. Experienced staff who are confident and have positive ageing attitudes are most likely to deliver falls prevention programs in a home care organisation.