老年人用药原则及注意事项

老年人随着年龄的增长，容易罹患多种慢性疾病，并需要长期服药治疗。老年人由于机体的各个系统、脏器、组织细胞的功能和形态均发生了不同程度的衰变，导致了机体对药物的吸收、分布、代谢、排泄等生理生化过程以及对药物的敏感性、耐受性也发生了显著的改变，极易造成药物的蓄积中毒和导致不良反应的发生。因此，只有把握好老年人的用药原则和应该注意的事项，才能保证做到老年入用药的合理、有效和安全。     

血气分析过程中的注意事项及分析探讨

血气分析与酸碱测定是一项重要的监测技术,如不能按要求操作,就会造成结果失真,为此作者提     

临时居住帐篷的搭撤与注意事项

1搭撤方法1．1展开地点临时居住帐篷是一种可携带的轻便“房屋”,能为在野外值勤、训练或遭遇自然灾害的人员解决临时居住困难。在展开帐篷时应注意：（1）选择地势高、地面平坦,面积宽广的安全地带,严防洪水、台风和泥石流袭击。（2）搭设的帐篷应靠近道路旁,并且有丰富水源。（3）根据不同季节选择搭设帐篷的地段,     

AF系统治疗胸腰椎骨折及注意事项

目的:分析应用AF系统治疗胸腰椎骨折的方法、临床疗效及注意事项。方法:对我科1999~2004年收治105例胸腰椎骨折行AF系统内固定,其中伤椎全椎板切除减压75例,行小部分椎板开窗减压30例,观察术前、术后神经功能恢复情况、cobb角、椎体高度及需注意的若干问题。结果:随访6月~5年,其中脊髓神经功能按Frankel分级,恢复两个级差及以上者48例,恢复1个级差者41例,1例无恢复;cobb角由术前平均28.3°恢复到术后4.6°,椎体前后缘平均高度由术前43.2%和78.6%恢复到术后94.8%和96.5%。结论:后路AF系统治疗胸腰椎骨折对于神经功能、伤椎高度的恢复是肯定的,但有若干问题值得注意。     

角膜屈光手术的术中操作及注意事项

确定可以进行角膜屈光手术后,如何选择手术类型及能否正确实施手术,是对手术医师水平的最好检验。眼科医师应根据自己的经验、所使用的设备（角膜板层刀、飞秒激光、准分子激光机）正确进行手术[1]。     

维和医疗分队药品筹措及注意事项

目的探讨维和医疗分队药品筹措及注意事项。方法通过了解过去各任务区药品的平均消耗量、研究联和国关于维和医疗分队携带药品的政策规定、了解任务区当地疾病谱及用药特点、与目前任务区执行任务医疗分队沟通掌握真实数据、前瞻性预计可能出现的意外用药。结果品种宜精不宜广、效期宜长不宜短、急救药品宜全不宜多、剂型口服为主注射为辅、个人携带空运与海运药品要分清。结论科学进行维和医疗药品筹措,能够发挥药品最大效能,减少浪费,圆满完成维和任务。     

浅谈二级生物安全实验室的管理

随着对致病性微生物知识和宿主易感性的了解、实验设备的更新,特别是对其传播途径认识的不断深入,人们采取更好的操作和处理致病性微生物的方法来减少人员的暴露和感染,实验室生物安全管理更加重要。     

包皮过长包茎环扎手术效果及注意事项

目的探讨杜氏包皮环扎器对包皮环扎手术的临床疗效和注意事项。方法在无禁忌症的情况下,成人和能配合的学龄儿童采用1％利多卡因行阴茎根部阻滞麻醉,不能配合的学龄前儿童直接用氯胺酮麻醉。待麻醉生效后,用环扎器环扎过长的包皮,特长包皮或包茎可先行包皮背切,然后环扎剪除,创面涂消炎药膏。结果92例全部治愈,治愈率100％,其中85例在术后9～13d,环扎线以外的远端干性坏死包皮自行脱落,沿扎线的切缘愈合,切口外观整齐美观;另7例因包皮较厚或扎线不够紧,延迟到术后16d坏死包皮才脱落。结论该方法操作简便、费时短,一人即可完成,且微痛、微创、不出血、不缝合、不包扎,术后包皮前后左右对称,创面愈合整齐美观,并发症少,患者依从性好。     

湿润烧伤膏创面换药技术中应注意的问题

目的：总结湿润烧伤膏（MEBO）换药技术中的经验，提高临床疗效。方法：分析在MEBO换药技术中换药时间、换药方法以及换药操作的细微环节。结果：换药时间早而及时，换药方法随病人病程、烧伤面积、部位、年龄、体质等具体情况而定，换药操作要注意纤维隔离膜的保护。结论：规范的换药技术能提高临床疗效。     

基层医院开展腹腔镜胆囊切除术应注意的问题

探讨基层医院开展腹腔镜胆囊切除术（LG）应注意的问题及应对措施。作者总结了306例LG术的经验，结果成功298例，中转开腹8例，全组无出血，胆管损伤及死亡病例。同时对LG手术的指征选择和时机掌握进行了探讨，提出了5点术中注意事项和对术者的4点要求，可供基层医院开展LG术时借鉴。     

平阳霉素局部注射治疗婴幼儿真性血管瘤和血管畸形应注意的问题

目的：探讨提高平阳霉素治疗婴幼儿真性血管瘤和血管畸形过程中疗效的方法。方法：在应用平阳霉素治疗婴幼儿真性血管瘤和血管畸形200余例后，对适应证的选择、药物剂量和浓度、注射方法和观察期、注药后注意事项进至了总结。结果：认为婴幼儿真性血管瘤和血管畸形应及早治疗，药物浓度最好控制在1mg/1.5ml以内，药物应注入瘤体实质内，观察周期以3周为妥。结论：使用平阳霉素局部注射治疗婴、幼儿真性血管瘤和血管畸形，应依据病变的分型、年龄、所欲达到的目的等而区别对待，方能获得理想的效果。     

Near-drowning and clinical laboratory changes

Opposite to clinical laboratory findings in experimental drowning of animals (erythrocytic lysis, hyperkalemia, and final cardial fibrillation) are the observations in drowned humans (increase of pCO2, hypoxic encephalopathy), which leads to a different pathophysiological interpretation of the drowning process. This process, however, is recently discussed again, therefore an additional study seemed to be recommended. In a retrospective study, 31 cases of near-drowning (23 cases: fresh water; 8 cases: brackish water) clinical laboratory data were analysed. While 21 of the cases were fatal with a delay of up to 180 days, 10 individuals survived the accident, four cases with severe neurological deficits. Data of pH, potassium, sodium, chloride, hemoglobin and total protein were collected during the very early post-drowning period. Nearly all cases (96%) revealed a reduction of pH due to hypoxic acidosis, and only two cases (6.5%) exhibited a slight hyperkalemia. The hemoglobin level was normal in most of the cases (83%) and slightly reduced in the others (17%) while the protein level was slightly reduced in most of the fatalities (80%). As a result of our investigation we have to state the lack of hyperkalemia as well as of an increase of the hemoglobin level indicate that there is no distinct intravascular red cell lysis due to influx of water into the vascular compartment. Therefore the death by drowning in humans in most cases is the result of a hypoxic cerebral process. A comparison with animal experiments obviously is not helpful because the drowning process in humans leads to an aspiration of only 2-4 ml water/kg, while in animal experiments more than 10 ml water/kg will be artificially aspirated leading to red cell lysis as well as to electrolyte disturbances and cardial fibrillation.     

颅脑损伤基础及临床研究的一些进展

本文复习最新国内外文献，并结合自身的研究，对目前颅脑损伤的主要研究进展作一述评。（1）弥漫性脑损伤临床意义日益受到重视，其中对弥漫性轴索损伤的研究已经取得了重大进展。对弥漫性轴索损伤与脑震荡，原发性脑干损伤的关系进行了探讨。（2）保护神经细胞骨架对维护神经结构具有重要意义，脑损伤后的一系列病理，病理生理改变可能具有双重性，基因型影响脑组织对损伤的分子反应机制受到重视。（3）对脑保护剂的实验研究结果与临床试验之间的差异进行了分析，并提出处理对策。     

检验中心医源性感染的控制与管理

目的预防检验中心内医源性感染事件的发生。方法增强自我保护意识，健全合理的规章制度，严格技术培训，建立工作人员健康记录，配置防护设备、检验器具和废弃物的消毒处理、环境的消毒以及报告单的消毒等措施，加强医院内感染的管理。结果通过上述各项措施和管理，最大限度控制了检验中心内的医源性感染，保障了工作人员的安全和身体健康。结论建全各种规章制度，加强培训和管理，可以预防检验中心内医源性感染事件的发生。     

The good laboratory practice and good clinical practice requirements for the production of radiopharmaceuticals in clinical research

Radiopharmaceuticals account for more than 95% of the group of sterile pharmaceutical products and should therefore be handled and produced with care. Since the introduction of the European directive, all pharmaceuticals used in clinical studies must be prepared under good manufacturing practice (GMP) conditions. This review aims to give an overview of the basic principles and guidelines for the preparation of radiopharmaceuticals. Special attention is given to the production area environment and personnel, the two basic requirements for GMP productions. Especially for the production area, two philosophies have to be combined: the cascade system of over-pressure for the production of pharmaceuticals and the under pressure system for the manufacturing of radioisotopes. Personnel should be selected based on education and regularly given special training for the handling of radioactive material. Compared to pharmaceuticals, radiopharmaceuticals have their own labels, taking into account their specific nature. Besides the standard quality control, other items for quality control of radiopharmaceuticals are also discussed in this article.     

生物安全实验室活毒废水处理工艺研究

目的在借鉴吸收国外生物安全实验室(BSL)活毒废水处理工艺技术的基础上,结合我国国情,研究开发节能、环保、安全型成套处理技术工艺和设备,实现关键技术和产品国产化。方法处理系统采用序批式工艺,通过高温高压方式消毒灭菌。结果该处理工艺的技术指标:灭菌温度100～150℃(可调),加热时间≤30 min,灭菌时间30～120 min(可调);处理后排放指标:活微生物为0,温度≤40℃,pH=6～9。结论该处理工艺整体设计简便灵活,符合BSL设计越简单越安全的理念,适合我国国情,可用于生物安全三级、四级实验室(BSL-3,-4)活毒废水处理。     

Percutaneous cecostomy for Ogilvie syndrome: laboratory observations and clinical experience

Percutaneous cecostomy (PCC) was evaluated in dogs and cadavers and by means of review of intraperitoneal contrast material-enhanced computed tomographic (CT) scans and clinical experience in five patients with Ogilvie syndrome. It was shown that PCC can be accomplished with a variety of techniques (e.g. Seldinger or trocar puncture, tacking) and instruments (various types and sizes of retention and nonretention catheters). Anatomic studies revealed that the cecum is surrounded by the peritoneum for as much as 270 degrees of its circumference, so that a retroperitoneal approach to PCC would probably be unfeasible in most patients. PCC was effective in treating all five patients in this study, despite their advanced age and complicated medical conditions. Decompression of colonic gas was achieved with 8-12-F catheters, and no major complications occurred. Endoscopic decompression had been unsuccessfully attempted in four of the patients previously. It is concluded that PCC may be an important option in the treatment of Ogilvie syndrome and that the procedure may obviate surgery and be lifesaving in certain high-risk patients.