胎龄<28周早产儿动脉导管未闭的治疗进展

动脉导管未闭(PDA)是早产儿常见疾病,目前早产儿PDA的自然发展过程仍未完全明确,PDA发生的有些高危因素仍存在争议,对PDA是否进行药物、手术干预,以及何时进行药物、手术干预仍存在争议。尽管已经有相当多的证据证实动脉导管持续开放可能有害,但目前尚缺乏关闭导管治疗方案的远期益处或害处的相关证据。大多数临床试验旨在评估短期导管开放对患儿的影响。目前尚无评估动脉导管持续开放对早产儿死亡率及并发症影响的临床试验。近年来PDA治疗上最大的变化是减少对PDA的治疗。该文重点总结胎龄28周早产儿PDA的治疗策略。     

脑卒中患者心理健康教育效果分析

脑卒中是指急性起病、迅速出现局限性或弥漫性脑功能缺失征象的脑血管性临床事件。它不仅会导致躯体障碍，还会产生不同程度的心理障碍，主要表现为：焦虑不安、孤独自卑、悲观抑郁、敌对怀疑、绝望轻生。为了探索改善患的心理状况的有效方法，吉林省白城中心医院神经内科医护人员对住院患根据心理状况进行分类，并根据不同类型患采用不同的心理健康教育内容，取得了良好效果，现报告如下。     

Early rapid weight gain and current overweight in relation to asthma in adolescents born with very low birth weight

Early catch-up growth and subsequent overweight are suggested to be associated with later cardiovascular diseases and later type II diabetes. However, the impact of early catch-up growth and childhood overweight on the development of asthma has been less studied, particularly in children born with very low birth weight (VLBW). A birth cohort of 74 VLBW children (birth weight < or = 1500 g) was followed from birth and investigated on asthma at 12 yr of age. Early rapid weight gain was in one way defined as an increase of weight > or =1 standard deviation score (SDS) at 6 months of corrected postnatal age. Current overweight was defined by body mass index (BMI) exceeding 21.2 and 21.7 kg/m(2), respectively, for boys and girls at 12 yr of age. Current asthma was diagnosed by a pediatrician, according to asthma ever in combination with a positive response to hypertonic saline bronchial provocation test and/or wheeze at physical examination at 12 yr old. Being overweight at 12 yr of age was associated with an increased risk for current asthma in the VLBW children [crude odds ratio (OR): 5.5, 95% confidence interval (CI): 1.3-22.2]. After adjustment for early weight gain and neonatal risk, the OR of overweight increased nearly three times (adjusted OR: 15.3, 95% CI: 2.5-90.6). Early rapid weight gain seemed to be inversely associated with current asthma (adjusted OR: 0.49 for an increase of weight equal to 1 SDS, 95% CI: 0.23-1.02, p = 0.06). In addition, early rapid weight gain was inversely associated with the magnitude of bronchial responsiveness at 12 yr (coefficient -1.15, p < 0.01). There was a strong and positive association between overweight and asthma at 12 yr of age in the VLBW children. This strong association had been reduced by early rapid weight gain, possibly via the reduction of bronchial responsiveness.     

逆行岛状皮瓣修复手部软组织缺损

目的报道手部软组织缺损逆行岛状皮瓣修复方式的选择及临床效果。方法根据手部软组织缺损的不同部位，应用六种不同的手与前臂逆行岛状皮瓣进行修复。结果本组57块皮瓣中，除4块皮瓣远端部分坏死外，其余皮瓣成活良好，外观满意，弹性、质地良好，两点辨别觉6～12mm。结论手与前臂逆行岛状皮瓣切取简便，创伤小。根据手部软组织缺损不同部位，选择不同的逆行岛状皮瓣进行修复，可获得满意的临床效果。     

太极拳拳理与克劳塞维茨『战争论』军事艺术

克劳塞维茨《战争论》认为防御这种作战形式就其本身来说比进攻这种形式强。太极拳尤以老庄道家学说为宗，不强调进攻，而注重防御，两者有相似之处。     

血清保存方法对促甲状腺激素结果的影响观察

目的 :观察血清保存方法对促甲状腺激素 (TSH)结果的影响。方法 :将甲状腺功能正常、异常患者共 10份血清 ,采用不同血清量、不同条件分组保存后测定 TSH。结果 :保存方法对 TSH结果有一定的影响。结论 :用于 TSH血清的保存量要多、要密封管口、低温保存。     

Impaired cellular host defence in peritoneal dialysis by two granulocyte inhibitory proteins

Bacterial and fungal peritonitis is associated with a high riskof morbidity and mortality in patients undergoing continuousambulatory peritoneal dialysis (CAPD). Impaired cellular hostdefence in the peritoneal cavity underlies this risk. Two granulocyteinhibitory proteins with a molecular weight of 28000 dalton(GIP I) and about 9500 dalton (GIP II) with homology to light-chainproteins and beta respectively, were isolated from peritonealdialysis effluents. In vitro, both granulocyte inhibitory proteinsinhibit PMNL glucose uptake, phagocytosis and intracellularkilling of bacteria. The IC₅₀ of GIP I or GIP II required forinhibition of half-maximal FMLP-induced or PMA-stimulated PMNLfunction was found to be in the nanomolar range, suggestingvery specific inhibition. These data may explain, at least inpart, defective local cellular host defence in CAPD patients.     

Effect of Ureaplasma urealyticum infection on IL-laand IL-6 secretion by rat Sertoli cells

Objective: To observe the effect of Ureaplasma urealyticum (UU) infection on the IL-1α and IL-6 secretion by rat Sertoli cells. Methods: Eight 20-day-old UU-free male SD rats (average weight 40 g) were used. Under sterile condition, the testes were removed and separately digested with collagenase typeⅡand hyaluronidase. High purity Sertoli cells were then isolated and adjusted to a concentration of 8×105/mL with DMEM/Ham's F-12. In the infected group, 1 mL Sertoli cell suspension and 100 mL UU (serotype 8, T960) were introduced into one well of a 24 well culture plate. In the control group, 1 mL Sertoli cell suspension and 100 mL medium were introduced. IL-1αand IL-6 were determined in the culture supernatant with ELISA. Results: The production of IL-1αwas significantly lower and of IL-6 significantly higher in the infected than those in the control groups (P<0.01). Conclusion: UU infection reduces the IL-1αand increases the IL-6 secretion by rat Sertoli cells. UU infection is probably involved in     

西脉式环抱器用于骨折内固定术护理配合要点

目的:探讨西脉镍钛形状记忆合金环抱器用于骨折内固定术有关的护理配合问题。方法:12例不同部位骨折病人(其中男性8例、女性4例、年龄15～62岁)采用西脉镍钛(TiNi)形状记忆合金环抱器人实施内固定手术,观察术中护理配合要点和实际效果。结果:骨折复位满意,手术持续时间<2h。所有病人术后均无感染迹象,手术切口愈合良好。结论:围术期护理配合质量(如器械选择、塑形准备、无菌操作等)的优劣,是手术成功与否的重要因素之一。