颌面部骨折的螺旋CT三维重建应用价值

目的　评价三维重建在颌面部骨折中的应用价值。方法　对临床怀疑有骨折的 48例颌面部外伤患者进行螺旋CT扫描和三维重建 ,分析对比三维图像和二维图像的表现。结果　三维图像显示骨折线的方向、骨折范围、位置、类型及骨折块移位等空间信息方面优于二维图像。结论　三维重建对颌面部骨折的诊断和临床处理起着重要的指导作用     

Health,healing, and the myth of the hero journey

The purposes of this article are to examine the epistemic nature of myth and its relationship to nursing ontology, practice, and knowledge development, and to interpret the myth of the hero journey as it relates to the meaning of health and healing within the unitary-transformative paradigm. A discussion of the qualities of myth as a path toward understanding is followed by an analysis of the relationship of myth to nursing's ontology within the unitary-transformative paradigm. Joseph Campbell's depiction of the myth of the hero journey is elaborated and related to literature on health and healing. Reflections on possible implications for nursing practice and knowledge development are shared. The mythic hero journey calls for a particular way of being a nurse. Nurse as guide, sojourner, and midwife are offered as metaphors for this way of being.     

The good, the bad, and the ugly of sunscreens

Sunscreens protect against sunburn, but there is no evidence that they protect against basal cell carcinoma or melanoma. Problems lie in the behavior of individuals who use sunscreens to stay out longer in the sun than they otherwise would. Vitamin D inhibition is, at this stage, unlikely due to insufficient use by individuals. Safety of sunscreens is a concern, and sunscreen companies have emotionally and inaccurately promoted the use of sunscreens.     

Cancer, pancreatitis, and the detection of the isoenzymes of DNAase, RNAase and amylase.

Substrate films of starch, RNA, and DNA were used to identify the isoenzymes of amylase, RNAase, and DNAase found in human ductal pancreatic juice subjected to isoelectric focusing. The pancreatic secretions from 15 patients were shown to contain as many as four isoenzymes of RNAase; the two major forms had isoelectric points of 7.87 and 7.52, and the two minor forms, of 7.25 and 6.90. Six DNAase bands were detected; the major bands had pI values of 4.86 and 4.79, and sometimes appeared as one band. The minor bands had pI values of 5.08, 5.00, 4.68, and 4.58. Purified bovine DNAase I, analyzed similarly, showed four bands (5.29, 5.19, 5.04 and 4.96). Nine isoenzymes of alpha-amylase were observed in the secretions from 15 patients. The major alpha-amylase isoenzyme had a pI value of 6.84 in 14 patients and of 7.04 in 1 patient. Secondary bands were seen with pI values of 6.23, 6.53 and 6.69. Additional isoenzymes were found with pI values of 7.16, 6.39, 6.00 and 5.78. The amylase isoenzyme with a pI value of 6.39 was found in 7 of the 8 patients with a normal pancreas or carcinoma of the pancreas, and in only 1 of 7 patients with acute or chronic pancreatitis.     

淡水淹溺致兔肺水肿模型肾素丙二醛心钠素一氧化氮血气等变化的研究

目的研究淡水淹溺致兔肺水肿模型(PE-W)发病后30 min动脉血浆肾素(AT1)、丙二醛(MDA)、心钠素(ANP)、一氧化氮(NO)、呼吸频率(RR)、血气多点变化.方法将淡水灌入兔肺内复制出淡水淹溺肺水肿模型,于灌水前后30 min取股动脉血查AT1、MDA、ANP、NO、血气,并记录RR.结果 AT1、MDA、NO、RR显著异常(P<0.05),酸碱平衡及血氧正常,ANP无显著异常(P>0.05).结论淡水淹溺致兔肺水肿早期,AT1增加并不导致ANP增加;尽管MDA增加较早,但由于机体自身调节能力,尚能维持血氧的正常,NO可能起到重要作用.     

Burn epidemiology: the patient, the nation, the statistics, and the data resources

Throughout the years, bum care treatment in the United States has made major strides in the ability to save the lives of those once rendered helpless as a result of an extensive bum injury. Bum care professionals are able to assist these individuals to live as normal a life as possible as they heal from one of the most devastating injuries a human being can endure. The only way to remedy the suffering and the costs in health care resources and in productivity is to reduce the incidence of bum injuries and death. Communities must be concerned with consistently establishing preventive measures and with the proactive treatment of bums to help decrease incidence. Activities on the community, state, and national level to obtain accurate data regarding the epidemiologic characteristics must be implemented to provide a more accurate picture of bum injuries in the United States. Addressing issues surrounding the persons at high risk of bum injury will help to decrease the incidence of bum trauma. Funding must be strengthened to ensure the continued existence of bum programs that truly provide high-quality standards of care. In these programs, the burn victim is given every opportunity to become a survivor. In light of the recent terrorist activity in the United States, the nation must address another area that might affect the history of bum care and treatment, the multiple-trauma victim with an extensive burn injury caused by massive explosions, chemical warfare,missiles, and weapons of mass destruction. One out-come from the recent terrorist attack was recognition of the need for facilities to be capable of providing care for this type of patient. Efforts to strengthen these programs and bum care facilities must be continued to maintain and strengthen the care needed for bum patients of the future.     

Antibacterial activity of cefotaxime, desacetylcefotaxime, and the combination of the two

Cefotaxime (CTX) is metabolized to desacetylcefotaxime (dCTX), which is antibacterially active. The combination of CTX and dCTX is synergistic in a 1:1 ratio, but in this study, a combination of CTX:dCTX in a fixed ratio of 5:1 was not found synergistic when tested on 120 recently isolated clinical strains. Zone diameters of disks containing pure CTX or dCTX 30 micrograms or the combination of CTX/dCTX in micrograms: 25/5, 20/10, 15/15, and 10/20, were compared. The correlation between the zone size of the pure CTX disk and the 25/5, 20/10, and 15/15 disks were high with correlation coefficients (r) 0.98 to 0.96. Regardless of the metabolism and the potential synergy, no differences were found in the zone sizes comparing the pure CTX disk with the combination with a ratio from 5:1 to 1:1. The clinical microbiological laboratory can go on using the pure 30 micrograms CTX disk for routine susceptibility testing.