异位妊娠保守治疗的观察及护理

目的　总结异位妊娠保守治疗及护理的经验。方法　对未破裂型异位妊娠 5 0例实行住院保守治疗 ,并予以整体护理 ,严密观察腹痛及生命体征的变化 ,定期复查血尿 β -HCG。观察用药后 β -HCG下降水平。 结果　保守治疗 5 0例患者中 ,4 4例成功 ,6例在观察过程中腹痛加剧 ,内出血增多 ,血 β -HCG下降不明显 ,及时急症手术治疗。结论　异位妊娠在保守治疗过程中 ,应给予心理支持 ,加强临床护理 ,密切观察病情变化 ,及时发现手术指征 ,以免延误病情。     

药物保守治疗宫外孕的观察与护理

目的探讨药物保守治疗宫外孕的疗效及临床观察与护理的方法。对30例宫外孕保守治疗患者的回顾。结论30例宫外孕保守治疗患者成功26例，成功率86．7％。治疗期间医护人员的严密观察病情变化和精心护理患者，对患者的早目康复十分有益。     

宫外孕保守治疗患者的护理

目的总结分析对宫外孕进行保守治疗的护理经验。方法总结在我科住院的30例宫外孕保守治疗患者的临床护理经验。结果做好宫外孕甲氨蝶呤保守治疗患者的心理护理，病情观察，药物副反应的观察，对促进患者临床康复起着至关重要的作用。结论良好的临床护理对宫外孕保守治疗的成功起着重要作用。     

宫外孕腹腔镜微创手术的护理

腹腔镜微创手术治疗宫外孕的护理方法,重点对进行腹腔镜微创治疗的54例宫外孕患者实施心理护理,术前做好各种准备,术中医护密切配合、仔细观察病情变化,术后仔细观察监测和护理,积极预防可能出现的并发症.结果 患者心理状况稳定,无严重并发症发生,手术效果满意.     

宫外孕保守治疗的临床观察

我科对45例未破裂宫外孕患者行甲氨蝶呤联合米非司酮保守治疗中,密切观察患者病情变化,做好相关护理工作,使患者积极配合治疗对病情恢复有重要意义。     

甲氨蝶呤联合米非司酮治疗宫外孕的护理体会

目的 研究运用甲氨喋呤联合米非司酮治疗未破裂型宫外孕中的护理措施,以提高保守治疗宫外孕的成功率.方法 符合保守治疗患者,完善检查后给予MTX按lmg/kg剂量单次肌注,米非司酮50mg,空腹口服,l天2次,连服3天.治疗期间严密观察腹痛、阴道流血和生命体征的改变以及监测血β-HCG的变化.结果 80例治疗的患者其成功率达93.8％.结论 甲氨蝶呤联合米非司酮治疗宫外孕疗效显著,值得推广使用.     

宫外孕患者手术前后的护理

目的探索宫外孕患者手术前后的抢救和护理方法.方法对2004年1月～2006年12月在我院妇科住院手术的534例宫外孕患者(其中27例并失血性休克),及时补充血容量,手术去除病因的抢救及护理,抢救成功的护理体会回顾性总结.结果对534例宫外孕患者,包括27例失血性休克患者,经积极抢救,配合手术治疗及护理,均痊愈出院.结论合理使用宫外孕应急护理程序,密切观察病情,是抢救和护理成功的关键.     

未婚宫外孕患者腹腔镜手术治疗的护理

目的 探讨腹腔镜手术治疗未婚宫外孕患者的护理方法.方法 126例未婚宫外孕患者采用腹腔镜保守手术治疗,围手术期给予心理护理和优质护理.结果 未婚宫外孕患者均康复出院.结论 未婚宫外孕患者腹腔镜手术治疗围手术期优质护理、心理护理有助于患者身心康复.     

双额叶脑挫裂伤与并发中央型脑疝患者的治疗分析

目的探讨双额叶脑挫裂伤并发中央型脑疝患者治疗方案及预后分析判断。方法分析统计214例双额叶脑挫裂伤患者病例、手术治疗和非手术治疗、预后。结果非手术治疗76例，手术治疗138例，214例中治愈134例，好转30例，差50例。结论双额叶脑挫裂伤患者继发中央性脑疝比率高，应适时定期复查CT，病情一旦变化应积极手术，提高患者抢救率。     

48例不典型宫外孕的治疗和护理

目的 探讨不典型宫外孕的临床特点及保守治疗的临床应用价值.总结对宫外孕保守治疗患者的护理方法与经验,以进一步提高护理工作质量.方法 选择48例我科诊治的不典型宫外孕患者,随机分为两组,对照组采用甲氨蝶呤进行治疗,观察组采用甲氨蝶呤联合米非司酮进行治疗,比较两组疗效及不良反应.结论 不典型宫外孕患者应采取甲氨蝶呤联合米非司酮,能够提高宫外孕保守治疗效果,护理工作起到举足轻重的作用,积极有效的护理有利于患者康复.     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.