安普贴膏剂与安普贴联合治疗Ⅲ、Ⅳ期褥疮的效果评价

目的探讨安普贴膏剂与安普贴联合治疗Ⅲ、Ⅳ期褥疮的疗效。方法治疗组15例共31处褥疮,用生理盐水清洗创面后,5%碘伏消毒创面及边缘,安普贴膏剂薄敷在创面上,安普贴封闭褥疮面至边缘2~3cm,直到创口愈合修复;对照组10例共21处褥疮,采用碘伏加TDP灯照射治疗,观察2组疗效和愈合率。结果治疗组治疗2个月Ⅲ期褥疮愈合率为91.67%,Ⅳ期褥疮愈合率为57.14%,总有效率78.79%;对照组治疗2个月Ⅲ期褥疮愈合率为53.33%,Ⅳ期褥疮愈合率为33.33%,总有效率47.62%。结论安普贴膏剂与安普贴联合治疗Ⅲ、Ⅳ期褥疮疗效优于碘伏。     

安普贴膏剂与安普贴联合治疗Ⅲ、Ⅳ期褥疮的效果评价

目的 探讨安普贴膏剂与安普贴联合治疗Ⅲ、Ⅳ期褥疮的疗效.方法 治疗组15例共31处褥疮,用生理盐水清洗创面后,5%碘伏消毒创面及边缘,安普贴膏剂薄敷在创面上,安普贴封闭褥疮面至边缘2～3 cm,直到创口愈合修复;对照组10例共21处褥疮,采用碘伏加TDP灯照射治疗,观察2组疗效和愈合率.结果 治疗组治疗2个月Ⅲ期褥疮愈合率为91.67%,Ⅳ期褥疮愈合率为57.14%,总有效率78.79%;对照组治疗2个月Ⅲ期褥疮愈合率为53.33%,Ⅳ期褥疮愈合率为33.33%,总有效率47.62%.结论 安普贴膏剂与安普贴联合治疗Ⅲ、Ⅳ期褥疮疗效优于碘伏.     

泮托拉唑钠肠溶片与泮托拉唑钠胶囊治疗消化性溃疡的临床随机对照研究

目的:比较泮托拉唑钠肠溶片与泮托拉唑钠胶囊治疗消化性溃疡的临床疗效及评价其不良反应。方法:采用随机对照和开放试验的方法治疗胃镜检查确诊的消化性溃疡病人共162例,其中泮托拉唑钠肠溶片组(试验组)62例,其中胃溃疡18例,十二指肠溃疡44例;泮托拉唑钠胶囊组(对照组)60例,其中胃溃疡16例,十二指肠溃疡44例;开放组40例,其中胃溃疡12例,十二指肠溃疡28例。结果:试验组中胃溃疡的愈合率和总有效率分别为83.3%和100.0%,十二指肠溃疡的愈合率和总有效率分别为88.6%和97.7%;对照组中胃溃疡的愈合率和总有效率分别为81.3%和100.0%,十二指肠溃疡的愈合率和总有效率分别为84.1%和97.7%;开放组中胃溃疡的愈合率和总有效率分别为91.7%和100.0%,十二指肠溃疡的愈合率和总有效率分别为85.7%和100.0%。试验组中疼痛消失率和其他消化道症状的消失率在胃溃疡为94.4%和92.3%,在十二指肠溃疡则为97.7%和98.0%。对照组中疼痛消失率和其他消化道症状的消失率在胃溃疡为93.8%和93.6%,在十二指肠溃疡则为97.7%和97.3%。两组在愈合率、总有效率、疼痛消失率和其他消化...     

碘伏配合湿润烧伤膏治疗褥疮的临床观察

目的：探讨碘伏配合湿润烧伤膏治疗溃疡期褥疮的临床疗效。方法：将48例溃疡期褥疮病人随机分为两组,观察组和对照组各24例。观察组采用碘伏配合湿润烧伤膏治疗,对照组采用常规换药配合红外线灯照射治疗。结果：观察组及对照组2周总有效率分别为100%和75%,两组治疗效果对比差别有显著意义(x~2=4．76,P＜0．05)。结论：本方法体现了中西医结合的优越性,操作简便,价格低廉,值得在临床或家庭中广泛推广使用。     

防褥疮气垫在治疗瘫痪压疮患者中的作用

目的:探讨防褥疮气垫在治疗瘫痪压疮患者中的作用。方法:将130例瘫痪患者随机分为观察组和对照组各65例,观察组使用防褥疮气垫进行护理,对照组采用常规护理,比较两组治疗效果、愈合时间以及渗出情况。结果:观察组的显效率、有效率均高于对照组(P0.05)。观察组的瘀血红润期、炎症浸润期、浅表溃疡期、坏死溃疡期愈合时间短于对照组(P0.05)。结论:在基础护理的基础上采用防褥疮气垫能够有效缓解局部的压力,对于褥疮的治疗效果良好,缩短治疗时间,减少渗出。     

碘伏配合湿润烧伤膏治疗褥疮的临床观察

目的 探讨碘伏配合湿润烧伤膏治疗溃疡期褥疮的临床疗效。方法 将48例溃疡期褥疮随机分为两组，观察组采用碘伏配合湿润烧伤膏治疗，对照组采用常规换药配合红外线灯照射治疗。结果 观察组及对照组治疗2周后总有效率分别为100％和75％，两组治疗效果对比差异有显著性（X^2=4．76，P〈0．05）。结论 本方法体现了中西医结合的优越性，操作简便、价格低廉，值得在临床或家庭中广泛推广使用。     

百多邦软膏治疗浅度溃疡期褥疮的疗效观察及护理

目的:探讨百多邦软膏治疗浅度溃疡期褥疮的疗效及护理。方法:将38例褥疮患者随机分成两组,治疗组19例其发生部位27处,对照组19例其发生部位23处,分别用百多邦软膏和湿润烧伤膏涂抹于创面 暴露疗法,观察褥疮创面的愈合与好转情况,同时,配合相关的护理措施。结果:将两组的疗效结果进行评价,显示治疗组的治愈率为70.37%,时间为(7±2)d,显效率29.62%,有效率为100%;对照组治愈率为34.78%,时间为(10±2)d,显效率43.47%,有效率为78.26%。结论:百多邦软膏具有抗炎及收敛创面的作用,可以有效地促进溃疡的修复与愈合。     

双料喉风散应用于褥疮的研究

目的探讨双料喉风散虚用于褥疮护理。方法100例褥疮患者分为治疗组和对照组，治疗组用双料喉风散喷涂在褥疮疮面上，而对照组用庆大霉素湿纱布敷盖在褥疮疮面上。结果治疗组瘀血红润期总仃效率为100％、炎症渗出期总有效率为100％，溃疡期总有效率为95．8％，而对照组分别为95．4％、84．2％、72．1％。结论双料喉风散应用于褥疮有效好的疗效，且成本低廉，使用方法简便，易于掌握。     

消炎生肌散治疗褥疮临床观察

目的探讨消炎生肌散治疗溃疡期褥疮的效果.方法将40例病例随机分为2组,观察组溃疡面用消炎生肌散治疗,对照组溃疡面用甲硝唑治疗,并经统计学分析.结果观察组的治愈率、有效率分别为85%、100%,对照组分别为50%、75%,差异均有显著性意义(p＜0.05).结论观察组的疗效明显优于对照组,加速了愈合时间.     

复方烧伤酊用于炎性浸润期褥疮的疗效观察

目的　观察复方烧伤酊用于治疗炎性浸润期褥疮的疗效。方法　对炎性浸润期褥疮患者 2 0例采用复方烧伤酊治疗 (观察组 ) ,并与对照组 10例患者进行比较。结果　观察组治愈 17例 3 2处 ( 86.49% ) ,有效 3例 5处 ,无效 0 ,总有效率 10 0 % ,疗效与对照组比较 ,有统计学意义 (P <0 .0 1)。结论　应用复方烧伤酊治疗炎性浸润期褥疮 ,效果显著 ,方法简便 ,经济高效     

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.     

手转胎头术失败的原因与分娩结局临床分析

目的 探讨手转胎头术失败的原因与分娩结局.方法 选择2008年1月至2010年12月于我院住院分娩的持续性枕横位、枕后位产妇198例,根据行手转胎头术后结果分为成功组126例、失败组72例.比较两组分娩结局,对比分析失败原因.结果 失败组胎儿体质量≥3500 g的发生率[76.4％(55/72)]明显高于成功组[31.7％(40/126)],差异有统计学意义(x2=30.177,P=0.001)、失败组宫缩乏力发生率[58.3％(42/72)]高于成功组[38.1％ (48/126)],差异有统计学意义(x2=7.569,P=0.006)、失败组骨盆临界或轻度狭窄发生率[38.9％ (28/72)]高于成功组[23.8％(30/126)],差异有统计学意义(x2 =5.030,P=0.002)、失败组手转胎头时机不当(宫口开大＜6 cm、胎头位于坐骨棘上及宫口开大8～10 cm、胎头位于坐骨棘下≥2 cm)发生率[61.1％(44/72)]高于成功组[38.9％(49/126)],差异有统计学意义(x2=9.084,P=0.003).失败组母儿并发症(产后出血、产褥病率、胎儿窘迫、新生儿窒息)发生率高于成功组(x2 =9.586,P=0.002、x2=9.334,P=0.002、x2=5.910,P=0.015、x2=5.240,P=0.022)、失败组剖宫产发生率[72.2％(52/72)]明显高于成功组[34.1 ％(43/126),x2=26.641,P=0.001)].结论 手转胎头术能使难产变顺产,降低剖宫产率,减少母儿并发症,但须积极预防、处理导致手转胎头术失败的原因,对矫正失败后继续矫正及试产应慎重.