运动神经元病33例临床分析

运动神经元病（ＭＮＤ）是一组病因未明，侵犯上、下两级运动神经元的慢性变化性疾病。为进一步探讨本病的临床特征及鉴别诊断，现将我院１９８９年１月～１９９８年４月收治的３３例分析如下。临床资料１一般资料：本组３３例按不同部位运动神经元受损分为四种疾病：进...     

分析前标本的正确采集与全程生化质量控制

目的：重视分析过程之外的质量控制,全面提高临床生化质量。方法：采用INTEGRA 400 PLUS自动生化分析仪及原装试剂盒,对住院患者不正确采集送检的标本结果与重新送检正确采集标本的结果比较。结果：不正确采集及送检的生化标本结果与重新送检正确采集标本的结果有明显的差异。结论：临床生化质量的提高,不能仅靠分析过程的质量控制,在强调分析本身质量控制的同时,必须重视分析前的质量控制。     

双侧中线旁丘脑梗死5例致残特点及生存期调查

Background:Bilateral thalamus infarction near median line is uncommon in clinic.Reports concerned with this conditions were more less.It is characterized by conscious disorder and Korsakoff syndrome.The main caused may be the injury of intralaminar nuclei,dorsomedial nuclei,and injury of cortical matter,mammalillary bodies,fasciculus thalamicus around cerebral chamer III.Comprehensing the disability characteristics in pateints with bilateral thalamus infarction near median line is important for direction of rehabilitation.While study of survival time will improve evaluation of prognosis. Design:Patients recruited from June 1997～ October 2000 were analyzed. Unit:Intraneural Department of First People's Hospital of Yunnan Province. Subjects:55 subjects with MRI proved bilateral thalamus infarction near median line entered study.These patients included 3 women,2 men(age ranging from 50 to 77 years old,mean age:68.6 years).The period from onset to admission ranged from 5 hours to 2 days.All subejcts experienced acute bilateral thalamus infarction near median line.All had hypertension previously,1 had diabetes,2 had auricular fibrillation. Intervention:All patients received management which was conducted according to protocol for treatment of ischemic cerebrovascular diseases. Patients clinical characteristics were summari-zed and analyzed.Follow up was conducted to determine the survival period. Main evaluation indexes:Survival time and conscious disorder were evaluated. Result:All patients showed different level of conscious disorder.3 cases developed thalamic dementia,2 developed vision numb,In 1 case,condition progressively deteriorated manifesting as moderate coma progressed to deep coma,and bilateral mydriasis.Finally,this patients died of central respiratory and circulatory failure after 8 days.4 cases with favorable prognosis discharged,3 out of them died within 1 year after discharge.Survival subject suffered from reduced memory was followed up till now. Conclusion:Concious or cognitive disorder ,vision bumb are common among patients with bilateral thalamus infarction near median line.Their prognosis are poor.In the current study,the number of case was samll,so further study is needed.     

机用ProTaper镍钛器械预备后牙弯曲根管的效果

目的 分析机用ProTaper镍钛器械预备后牙弯曲根管的临床效果.方法 将237例257颗需要进行根管治疗的患牙随机分为观察组和对照组,观察组采用ProTaper机用镍钛器械及冠向下技术进行根管预备,对照组采用手用不锈钢K型锉和逐步后退技术进行根管预备.根据治疗前、后的X线片评价根管预备和充填的效果,并记录操作时间、术后疼痛、器械折断情况及并发症情况.结果 与对照组比较,观察组的弯曲根管预备时间明显缩短,预备后并发症的发生率相对较低,扩通率、适充率相对较高,能维持根管的弯曲度和走向,预备后的根管形态较好.结论 机用ProTaper预备后牙弯曲根管快速、有效、安全,但仍然存在一定的局限性.     

老年急性心肌梗死静脉溶栓的观察与护理

目的观察利用尿激酶溶栓治疗老年急性心肌梗死患者的临床疗效,探讨其护理方法。方法选择60例老年急性心肌梗死患者,入院后给予生理盐水100mL,尿激酶100-150万U,静脉滴注,治疗期间采取相应的护理措施,观察结果。结果 39例患者血管再通;发病2h内溶栓15例,再通15例;发病2-6h内溶栓30例,再通18例;发病6-12h内溶栓15例,再通6例;全部人数死亡6例;出现穿刺部位皮下淤血1例。结论对于老年急性心肌梗死患者,利用尿激酶溶栓治疗安全有效,并且治疗中采取积极的护理措施,能够提高疗效和治愈率。     

浅谈住院医师规范化培训

临床住院医师规范化培训是提高临床住院医师素质、培养高素质人才极为重要又不可缺少的阶段。本文从六个方面对住院医师的规范化培训进行探讨:转变教育观念,培养实用型人才;强化基本理论学习,夯实理论基础;重视病历书写的训练;加强外科基本技能训练;实行导师制教育模式;加强人文思想教育,培养良好的医德医风。     

外科学临床见习教学体会

临床见习是医学的重要专业实践课程,也是培养合格医疗工作者的关键环节,抓好这一环节是提高外科学教学质量的关键所在。作者从六个方面分享外科临床见习教学的体会:①充分做好课前准备,科学制定见习计划;②准确定位学习环节;③采用合适的教学方式,培养学生的临床思维;④重视培养学生与病患沟通的技巧;⑤讨论,见习课小结;⑥加强人文科学教育,培养良好的医德医风。     

通窍止咳液增强顺铂对肿瘤细胞内p38活性的研究

目的:研究通窍止咳液增强顺铂对肿瘤细胞内p38的活性。方法:通过Western-Blot检测通窍止咳液对人鼻咽癌细胞CNE2、人肺癌细胞A549内p38活性的变化;通过MTT比色法检测通窍止咳液单用以及联合顺铂对CNE2、A549细胞生长的影响。结果:Western-Blot检测结果显示,通窍止咳液能够激活CNE2和A549细胞内p38,增高细胞内p38的磷酸化水平;MTT检测结果显示高浓度的通窍止咳液可以抑制CNE2、A549细胞的生长,通窍止咳液能增强顺铂对CNE2细胞的细胞毒作用,而对A549细胞则无此作用。结论:通窍止咳液增强顺铂的细胞毒作用可能与其激活p38有关,这一作用为逆转顺铂耐药提供了新的治疗方案。     

轻型脑外伤对大鼠空间学习记忆的影响及机制研究

目的:探讨轻型脑外伤对大鼠空间学习记忆功能的影响及可能的机制。方法:成年SD大鼠120只,雌雄各半,随机分为雌性对照组、雌性实验组、雄性对照组及雄性实验组,各30只;实验组建立侧位液压冲击轻型颅脑外伤模型;术后8d,水迷宫测试大鼠学习记忆能力;水迷宫测试结束后,放射免疫法检测血清皮质醇(COR)水平;免疫组化法检测海马脑源性神经营养因子(BDNF)及酪氨酸激酶受体(TrkB)的表达。结果:水迷宫定位航行实验第4天,同性别大鼠实验组逃逸潜伏期较对照组显著延长(P<0.01);空间探索实验中,同性别大鼠实验组寻找平台潜伏期长于对照组(P<0.05),穿越平台次数少于对照组(P<0.05);同性别大鼠实验组血清COR水平显著高于对照组(P<0.01),海马BDNF及TrkB平均灰度值均低于对照组(P<0.05)。结论:轻型脑外伤导致大鼠认知功能缺损,可能与海马BDNF及TtkB表达减少,BDNF-TrkB通路受损有关。     

高频超声诊断急性跟腓韧带损伤的临床价值

目的探讨高频超声诊断急性跟腓韧带损伤的临床价值。方法对临床单纯或合并有踝关节内翻扭伤者,使用高频线阵探头扫查踝关节外侧副韧带,重点观察跟腓韧带是否损伤。结果48例超声诊断为跟腓韧带损伤患者中,Ⅰ型30例,Ⅱ型12例,Ⅲ型6例,将跟腓韧带损伤各型的超声诊断例数与手术符合例数相比较,两者问差异无统计学意义（P〉0．05）。结论对于早期诊断跟腓韧带的损伤,高频超声是一种分辨力高、价廉、操作简便、用时短的影像学检查方法,值得临床推广运用。