日达仙稀释液治疗肿瘤化疗后口腔溃疡的疗效观察

目的观察日达仙稀释液对化疗后口腔溃疡患者的治疗作用。方法选择住院化疗后并发口腔溃疡患者68名,随机分为治疗组及对照组,治疗组用日达仙液涂抹溃疡面,对照组用锡类散涂抹溃疡面,观察两组间口腔溃疡疗效的差异。结果治疗组患者平均溃疡治愈时间(4.87±0.96)d及平均疼痛指数(3.84±1.21)分均明显低于对照组,差异均有统计学意义(t分别=7.55、5.46,P均<0.05)。结论日达仙稀释液对患者化疗后并发的口腔溃疡有较好疗效。     

复合维生素B混合液联合金因肽治疗放射性口腔黏膜炎的效果及护理

目的探讨复合维生素B混合液联合金因肽治疗放射性口腔黏膜炎的效果及总结护理要点。方法将80例肿瘤放疗患者随机分为治疗组和对照组各40例。治疗组采用自制复合维生素B混合液含服,配合用金因肽喷于口腔溃疡处,4次／d。对照组按常规漱口后,喷金因肽于口腔溃疡处,4次／d,比较两组治疗效果。结果治疗组患者口腔溃疡愈合时间较对照组患者短,疗效优于对照组,两组比较,差异具有统计学意义（P〈0．01）。结论应用复合维生素B混合液含服联合金因肽喷剂治疗放疗引起的口腔黏膜炎,能明显缩短患者溃疡愈合时间,减轻患者的痛苦,值得临床推广应用。     

护理干预在小儿恶性实体瘤围化疗期并发口腔溃疡中的应用

目的 探讨护理干预在小儿恶性实体瘤围化疗期口腔溃疡中应用。方法 选取恶性实体瘤围化疗期发生口腔溃疡患儿106例,分为对照组（60例）及实验组(46例)。对照组采用常规护理措施;实验组建立档案,根据不同程度溃疡,采取不同的护理干预措施。结果 对照组口腔溃疡感染率32.38％,Ⅰ～Ⅱ、Ⅲ级口腔溃疡愈合时间3～10 d,Ⅳ级口腔溃疡愈合时间为10～15d;实验组口腔溃疡感染率21.90％,I～Ⅱ、Ⅲ级口腔溃疡平均愈合时间3～7d,Ⅳ级口腔溃疡愈合时间为7～12 d;实验组和对照组在小儿恶性实体瘤围化疗期口腔溃疡感染率和溃疡愈合时间有显著差异(P＜0.05)。结论 护理干预能降低小儿恶性实体瘤围化疗期口腔溃疡的感染率,缩短溃疡愈合时间。     

消化系统疾病患者不同原因所致口腔溃疡70例护理

对70例口腔溃疡患者在采取心理护理、环境护理、饮食护理、预防医源性感染等一般护理措施的基础上,对单纯溃疡、不明确感染菌种溃疡、霉菌感染溃疡、厌氧菌感染溃疡、非厌氧菌感染溃疡的分别进行了预防、中西药物治疗、溃疡疼痛的治疗以及全身用药治疗,促进了患者的康复.认为患者无论何种原因引起口腔溃疡,均要及时采取有效的预防和护理及治疗措施,以防止溃疡进展及促进溃疡早期愈合减少疼痛,提高患者的生活质量.     

一枝黄花煎剂治疗一例IV期口腔溃疡护理体会

目的 对一例老年患者使用一枝黄花煎剂治疗IV期口腔溃疡的护理体会。方法 一例老年患者IV期口腔溃疡,采用一枝黄花煎剂进行口腔护理及每日分次含漱。结果 患者的口腔溃疡由IV期愈合至I期。结论 对老年患者进行口腔护理,可促进口腔溃疡愈合及预防口腔溃疡的发生。     

分级护理干预在急性白血病化疗后口腔溃疡患者中的应用

目的:观察分级护理干预在急性白血病化疗后口腔溃疡患者护理中的应用效果。方法:选取2017年1月～2019年1月进行化疗的120例急性白血病患者作为研究对象,所有患者均在化疗后出现不同程度的口腔溃疡,按照随机数字表法分为对照组和观察组,每组60例。对照组给予常规护理干预,观察组在对照组的基础上给予分级护理干预,比较两组口腔溃疡改善情况、溃疡疼痛程度、卡氏功能状态评分及住院时间。结果:干预后,两组口腔溃疡分级均明显改善,且观察组口腔溃疡分级优于对照组,差异有统计学意义,P0.05;两组溃疡疼痛评分均明显下降,卡氏功能状态评分均明显升高,且观察组疼痛评分低于对照组、卡氏功能状态评分高于对照组,差异有统计学意义,P0.05;观察组住院时间短于对照组,差异有统计学意义,P0.05。结论:针对急性白血病化疗后口腔溃疡患者给予分级护理干预,可有效改善患者溃疡症状,减轻疼痛,提高其生存质量。     

维生素C片剂外用治疗血液病合并口腔溃疡的疗效观察

目的：观察维生素C片剂外用治疗血液病合并口腔溃疡的效果。方法：将我院2009年10月～2012年6月132例血液病合并口腔溃疡患者随机分为对照组和观察组,对照组57例患者在常规口腔护理的基础上给予洗必泰含漱,观察组75例在溃疡处加用维生素C片剂粉末外敷治疗。结果：干预治疗10 d后,观察组治愈率高于对照组,两组比较差异有统计学意义（P〈0.05）。口腔溃疡治愈所需时间及疼痛持续时间观察组少于对照组,两组比较差异有统计学意义（P〈0.05）。结论：维生素C片剂外敷对血液病合并口腔溃疡的治疗效果较好,可缩短疼痛持续时间及治愈时间,且操作简单方便、价格低廉、安全可靠。     

剖宫产术后下肢静脉血栓形成27例临床护理

对70例口腔溃疡患者在采取心理护理、环境护理、饮食护理、预防医源性感染等一般护理措施的基础上,对单纯溃疡、不明确感染菌种溃疡、霉菌感染溃疡、厌氧菌感染溃疡、非厌氧菌感染溃疡的分别进行了预防、中西药物治疗、溃疡疼痛的治疗以及全身用药治疗,促进了患者的康复。认为患者无论何种原因引起口腔溃疡,均要及时采取有效的预防和护理及治疗措施,以防止溃疡进展及促进溃疡早期愈合减少疼痛,提高患者的生活质量。     

晚期乳腺癌合并肿瘤溃疡创口10例临床护理

目的:探讨10例晚期乳腺癌合并肿瘤溃疡创口患者的临床护理方法及效果。方法:对10例晚期乳腺癌合并胸壁溃疡创口患者给予术前护理、术后护理、溃疡创口护理,观察临床效果。结果:本组10例患者术后顺利康复,皮瓣恢复良好,无并发症发生,平均住院时间为29 d。10例术后2 d疼痛数字评分法(NRS)评分3~6分,术后1周NRS评分1~3分。结论:围术期护理及创口、心理护理对乳腺癌合并恶性肿瘤创口患者的治疗有非常重要的影响。     

维生素B12加金因肽治疗放疗口腔黏膜炎的疗效观察与护理

目的探讨放疗引起口腔黏膜炎的治疗效果。方法将84例肿瘤放疗患者随机分为治疗组43例和对照组40例。治疗组采用自制维生素B12混合液漱口,再加用金因肽喷剂喷于口腔溃疡处,4次/d。对照组按常规方法用维生素B12混合液漱口4次/d。结果治疗组患者口腔溃疡愈合时间较对照组患者短,疗效优于对照组,两组差异有极显著性意义(P=0.001)。结论应用维生素B12混合液漱口和金因肽喷剂治疗放疗引起的口腔黏膜炎,明显地缩短了溃疡愈合时间,提高了病人的生活质量。     

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.     

Clinical Pharmacokinetics of Morphine

Morphine, the most widely used mu-opioid analgesic for acute and chronic pain, is the standard against which new analgesics are measured. A thorough understanding of the pharmacokinetics of morphine is required in order to safely and effectively use this analgesic in a wide variety of patients with different levels of organ function. A MEDLINE search was conducted to identify literature published between 1966 and January 2002 relevant to the pharmacokinetics of morphine. These publications were reviewed and the literature summarized regarding unique and clinically important elements of morphine disposition relative to its parenteral administration (including intravenous, intramuscular, subcutaneous, epidural and intrathecal administration), absorption profile (immediate release, controlled release, and sublingual/buccal, and rectal administration), distribution, and its metabolism/ excretion. Special populations, including infants, elderly, and those with renal/liver failure, have a unique morphine pharmacokinetic profile that must be taken into account in order to maximize analgesic efficacy and reduce the risk of adverse events.