头孢菌素联合青霉素治疗感染性肺炎新生儿的有效性与安全性

目的探讨头孢菌素联合青霉素对感染性肺炎新生儿血清炎性因子及肠道微生态环境的影响。方法选取2014年9月-2015年8月收治的90例感染性肺炎新生儿为研究对象,根据入院时间按照病历号随机分为头孢菌素组、青霉素组、头孢菌素联合青霉素组(联合组)各30例,分别给予头孢菌素、青霉素、头孢菌素联合青霉素治疗,治疗时间均为1周,比较3组感染性肺炎新生儿临床症状改善时间、血清炎性因子、肠道微生态环境、临床疗效等指标,同时选择35例正常未使用抗生素治疗的新生儿作为对照组。结果 3组治愈率比较,差异无统计学意义(84. 85%vs. 78. 79%vs. 81. 82%)(χ2=0. 987,P0. 05);联合组感染性新生儿发热、气促、喘憋、肺部啰音及哮鸣音等消失时间均明显短于头孢菌素组、青霉素组(4. 12±0. 56 vs.4. 45±0. 65 vs. 4. 47±0. 70,4. 08±0. 52 vs. 4. 58±0. 56 vs. 4. 59±0. 60,3. 85±0. 45 vs. 4. 32±0. 58 vs. 4. 35±0. 62,3. 78±0. 52 vs.4. 26±0. 62 vs. 4. 28±0. 70) d,(t=2. 029、3. 759、3. 678、3. 408、2. 243、3. 690、3. 749、3. 294,P0. 05);血清TNF-α、IL-6、hs-CRP水平均明显低于头孢菌素组、青霉素组[(7. 31±1. 42 vs. 8. 11±1. 46 vs. 8. 24±1. 51) pmol/L,(116. 58±17. 37 vs. 126. 47±20. 13 vs. 129. 30±20. 48) pg/ml,(50. 25±7. 14 vs. 58. 67±7. 50 vs. 61. 28±8. 63) ng/L](t=2. 256、2. 137、4. 671、2. 577、2. 721、5. 657,P0. 05);乳酸杆菌、双歧杆菌、肠球菌数量明显低于头孢菌素组、青霉素组,肠杆菌数量明显高于头孢菌素组、青霉素组(8. 86±0. 18 vs. 9. 00±0. 31 vs. 9. 05±0. 27,9. 39±0. 42 vs. 9. 63±0. 38 vs. 9. 72±0. 56,8. 18±0. 42 vs. 8. 56±0. 43 vs.8. 77±0. 56,9. 69±0. 57 vs. 9. 33±0. 52 vs. 9. 24±0. 61) log10n/g,(t=2. 244、2. 434、3. 632、3. 096、3. 364、2. 708、4. 842、2. 680,P0. 05)。结论青霉素、头孢菌素均是治疗新生儿感染性肺炎的有效药物,联合用药能迅速缓解感染性肺炎新生儿炎症状态,改善临床症状,但对患儿肠道正常微生态环境的影响也随之加大。     

20条健康饮食“金标准”

1.吃饭时挺直腰背;2.特别饿时喝点粥;3.两餐间隔4~6小时;4.先吃爱吃的食物;5.饭后别马上用脑;6.吃饭时不谈扫兴的事;7.早饭吃热的保护胃气;8.饭后半小时再喝茶;9.晚上不吃冷饮;10.饭后甜点要少吃;11.多吃深绿色、红色、紫红色等深色蔬菜;12.动、植物油混着吃;     

临床执业助理医师资格考试测试题（三十八）

第十六单元胃、十二指肠外科疾病A1型题1.胃溃疡的好发部位是A.胃底部B.胃大弯C.贲门部D.胃后壁E.胃小弯2.治疗十二指肠溃疡欲达到消除神经性胃分泌,而不引起胃滞留、保留幽门括约肌的功能和正常胃容积,下列哪项手术方式为首选A.高选择性胃迷走神经切断术B.迷走神经干切断术C.选择性胃迷走神经切断术D.胃窦部切除加胃十二指肠吻合术E.选择性胃迷走神经切断术加幽门成形术3.下列哪项可判断为早期胃癌A.病灶局限于胃窦内B.病灶局限于黏膜或黏膜下层C.直径<2cm D.无淋巴结转移E.病灶局限于胃小弯4.下列哪项不是胃癌根治术的禁忌证A.血性…     

参考文献著录格式

1.期刊作者.文题〔J〕.杂志名称,出版年,卷(期):起止页码.例如:陈莉萍,毛红方,甘晓卫,等.农村妇女围绝经期症状的影响因素与健康行为的干预研究〔J〕.中国妇幼保健,2009,24(2):209-212.2.书籍著者.书名〔M〕.版本,出版地:出版者,出版年:页次.例如:乐杰主编.妇产科学〔M〕.第7版,北京:人民卫生出版社,2008:116-124.     

木鱼

为什么出家人都要在念经时敲打木鱼呢?木鱼木鱼.虽是木头做的鱼.但整日被人敲打岂不也是挺可怜的.出家人以慈悲为怀.为何要如此对待一条木头做的鱼?其中必有深意吧?初夏,和朋友去附近山上游玩,一路走走聊聊,欣赏着眼前的风景.不知不觉走入了一个幽静的山谷,穿过青苔铺就的小路.眼前出现了一个寺庙.寺门洞开着.主人好像知道我们的远道而来.于是我们拾级入门.带着兴致来一次唐突的拜访。这是一个小庙.里面的陈设也相对简陋.但是佛像.烛台.蒲团也算一应俱全.寺庙打理的非常干净.但转了一圈.我们却是失望了,寺庙里空无一人.除了蒲团上拈花微笑的佛祖塑像.还有就是袅袅升     

临床执业助理医师资格考试测试题（三十七）

第十四单元急性腹膜炎A1型题1.腹腔穿刺抽出凝固的血液提示A.腹膜后血肿B.出血性胰腺炎C.肝、脾破裂D.腹腔内积血E.抽出液为血管内血液2.下列哪项不是继发性腹膜炎的病因A.化脓性输卵管炎B.阑尾穿孔C.胃十二脂肠溃疡穿孔D.肝硬化继发腹水感染E.后腹膜血肿继发感染3.急性腹膜炎发生严重休克的主要因素为A.水和电解质紊乱B.血容量减少和吸收大量毒素C.腹腔内有无原发病灶D.发病年龄不同E.腹膜有无刺激征4.腹部闭合性损伤伴休克,腹穿为炎性混浊液,其处理的首要原则A.立即手术剖腹探查B.抗休克同时尽早手术治疗C.先抗休克,好转后手术D.…     

龙岩市新罗区2008-2010年城区部分中学生营养状况分析

目的 了解新罗区中学生的营养状况.为开展肥胖和营养不良防治工作提供科学依据.方法 对新罗区2008-2010年2所城区中学的体检资料进行分析.用身高标准体重法判定学生营养状况.结果 中学生以轻度营养不良为主.女生高于男生.营养不良率呈逐年降低趋势.肥胖率呈逐年升高的趋势.男生高于女生.低年级组的肥胖率高于高年级组.结论...     

2023年继续医学教育(第2期)问题

一、选择题:1.以下不属于慢性肺源性心脏病临床症状的是:()A.呼吸困难B.乏力C.咳嗽D.呕吐2.(多选)以下属于精神障碍临床表现的是:()A.情绪不稳定B.易发生幻觉C.妄想D.行为障碍3.以下不属于参苓白术散功效的是:()A.健脾B.益气C.健脑D.渗湿止泻4.(多选)以下属于治疗糖尿病药物的是:()A.阿卡波糖B.阿司匹林C.二甲双胍D.替格瑞洛。     

简析卫生质量管理二十个关键因素

本文提出与我国卫生质量管理极为相关的二十个关键因素:1.制度因素;2.政策因素;3.现实因素;4.战略因素;5.实施因素;6.领导因素;7.质效因素;8.人才因素;9.科学因素;10.教育因素;11.文化因素;12.思想因素;13.变革因素;14.理论因素;15.技术因素;16.长远因素;17.整体因素;18.目标因素;19.控制因素;20.标准因素。     

比较两种培养液在辅助生殖中的临床结局

目的对比分析两种商品化培养液Cook和Vitrolife在辅助生殖中的临床结局。方法回顾性分析2014年5-6月在该院进行辅助生殖患者的临床资料。符合纳入标准的患者Cook组有43例,Vitrolife组有44例。比较两组的正常受精率、卵裂率、优质胚胎率、优质囊胚率、累积临床妊娠率、累积活产率、新生儿体质量和身长。结果两组患者一般资料比较,差异无统计学意义(P 0. 05)。Cook组与Vitrolife组各项临床结局数据比较,差异无统计学意义(P 0. 05),依次为正常受精率73. 26%vs. 68. 61%,卵裂率88. 89%vs. 90. 25%,优质胚胎率52. 96%vs. 48. 48%,优质囊胚率33. 59%vs. 36. 92%,累积临床妊娠率65. 12%vs. 65. 91%,累积活产率58. 14%vs. 52. 27%,单胎新生儿体质量(3. 4±0. 54) kg vs.(3. 15±0. 37) kg,双胎新生儿体质量(2. 53±0. 38) kg vs.(2. 54±0. 39) kg,单胎新生儿身长(49. 3±1. 22) cm vs.(49. 53±1. 92) cm,双胎新生儿身长(47. 1±2. 08) cm vs.(47. 00±2. 22) cm。结论两种商品化培养液的临床结局比较,差异无统计学意义。     

Trends in meningococcal disease in Italy in 1988

Meningococcal disease in Italy decreased 15% in 1988 from the previous year (290 vs. 342 cases). The decline was particularly evident in military cases (1.7/100,000 in 1988 vs. 5/100,000 in 1987) reflecting the full coverage of bivalent serogroup (A + C) meningococcal polysaccaride vaccine in army recruits, achieved since January 1988. The highest proportion of cases was seen in people older than 25 years of age (25%). Serogroup C constituted 60% of the isolates, while 19% belonged to serogroup B. The proportion of strains resistant to sulphonamides was 45%, while 15% were resistant to Minocycline and none to Rifampin. Out of the five military cases, only one (due to serogroup C) was attributable to the vaccine failure. A single coprimary case, but no secondary cases occurred among civilians. These findings are consistent with the trends reported in Italy in the previous years.     

Benzene in blood and phenol in urine in monitoring benzene exposure in industry

Determinations of benzene concentration in blood and of phenol in urine were made by head-space gas chromatography techniques on samples taken near the end of the work day from two groups of workers potentially exposed to low levels of benzene in the work-place atmosphere. Preliminary results suggest that benzene in blood is more reliable than phenol tests for assessing both exposure and uptake of benzene. Normal values of phenol in urine (10 mg/liter or less) were found in nearly all those cases in which benzene was detected in the blood.     

2015年郑州市饮用水放射性水平状况调查

目的了解郑州市不同地区、不同季节、不同水源类型的放射性水平。方法分别于丰水期和枯水期采集郑州市区黄河水源水、井水源水、丹江口水源水、出厂水和末梢水各一份;以县为单位,每单位采集出厂水、末梢水、水库水、河水、井水各1份,按《生活饮用水生活标准检验方法》(GB/T 5750.13-2006)检测饮用水中总α和总β放射性水平,依据《生活饮用水卫生标准》(GB 5749-2006)进行判定。结果丰水期、枯水期水体总α、总β放射性水平均低于国家标准限值。结论郑州市不同水源类型均处于正常的天然放射性本底水平。     

Occupational stress in nurses in psychiatric institutions in Taiwan

Nurses are known to be exposed to occupational stress. However, occupational stress is not well documented for nurses in psychiatric institutions in Taiwan. A cross-sectional study was conducted to explore the work-related stress and risk factors of nurses in psychiatric institutions in Taiwan. A structured questionnaire was distributed to nurses at five state-owned psychiatric hospitals in Taiwan in 2001. Demographic information, working environment, and personal health status were inquired. Occupational stress was assessed based on the Chinese version of Job Content Questionnaire (JCQ). General health status and mental health were evaluated by the International Quality of Life Assessment Short Form-36 (IQOLA SF-36). A total of 573 questionnaires were disseminated to nurses and 518 (90.4%) were satisfactorily completed by nurses, including 408 female full-time nurses who had been in their current work for more than 6 months. In the past one month, 17.2% of nurses reported being under significant stress often or always. Assault episodes were reported by 45.1% of nurses in the past 6 months. Among the nurses, 16.9%, 25.2%, 50.0%, and 7.8% belong to the "High strain", "Low strain", "Active", and "Passive" groups, respectively. Perceived occupational stress was associated with young age, widowed/divorced/separated marital status, high psychological demand, low workplace support, and threat of assault at work. Lower general health score was associated with low job control, high psychological demand, and perceived occupational stress. A lower mental health score was associated with low job control, high psychological demand, low workplace support, and perceived occupational stress. We concluded that nurses in psychiatric institutions are under significant stress related to work factors.     

Changes in nursing administration in supporting transplantation in Brazil

This historical and bibliographic study aimed to understand how Nursing was organized to support care in transplantation. The HISA, LILACS, BDENF, PERIENF and DEDALUS databases were consulted, and thirteen references were found, ten of which were scientific articles, two were master's dissertations and one was a doctoral thesis. The span of time chosen for study ranges from the date of the first kidney transplant in Brazil (1965), to the date of publication of the last scientific article found in the databases mentioned above (2003). After reading these articles, the ones that were similar in topic were grouped together, thus creating the thematic axis for the presentation of the results. The results showed that the Nursing profession has played an important and active role in transplants ever since the first procedure in 1965.     

2019年中国肿瘤流行病学研究进展

恶性肿瘤已成为中国居民的主要死因之一。近些年来,中国政府积极推进肿瘤预防和控制领域的研究工作,取得了很大的进步。本文简要汇总中国在肿瘤流行病学领域的研究进展,具体包括2019年的肿瘤负担、癌症危险因素及其干预、筛查和早期发现、癌症防治专项行动(2019-2022年)方案等方面,以期为我国肿瘤防治工作的有效开展提供技术支撑和理论依据。     

2012年绵阳市蔬菜中农药残留状况

目的 了解绵阳市2012年市售蔬菜中农药残留情况,为食用蔬菜监管提供依据.方法 全部样品均按照GB/T 5009-2003的方法进行农药的残留检测.依据GB 2763-2005《食品中农药最大残留限量》进行判定.结果 2012年共检测蔬菜165份,农药检出率和超标率分别为72.12％和23.64％.豆类、根茎类、叶菜类、瓜果菜类和食用菌类蔬菜检测农药残留超标率分别为8.00％、23.53％、36.00％、5.26％和27.03％,差异有统计学意义(x2=11.41,P＜0.01).不同种类农药超标率差异有统计学意义(x2 =62.42,P＜0.01).夏季和冬季蔬菜农药超标率差异无统计学意义(x2=3.44,P＞0.05).结论 绵阳市叶菜类蔬菜中农药残留情况较为严重,应采取有效措施,加强蔬菜的监督管理,从源头禁止高毒农药的使用,加大蔬菜种植、销售环节的监测,确保市民食用蔬菜的安全.