耳鼻咽喉科标准化病人的培训及应用

目的探讨标准化病人在耳鼻咽喉科教学及考核中的应用。方法撰写脚本并对4例标准化病人进行耳鼻咽喉科专科培训。4例标准化病人对10名学生进行每人2个病例的问诊教学,包括问诊评分及点评。分析学生及教师对标准化病人教学模式的问卷调查。比较标准化病人及临床教师对学生问诊评分的一致性。结果学生及临床教师对标准化病人表演的综合评分各项均高于4分(1~5分)。标准化病人及临床教师对学生的问诊综合评分呈高度一致性。70%(7/10)的学生认为该教学模式中获益最大的是标准化病人的即时点评。结论经过培训的标准化病人可以胜任扮演者、评估者及指导教师的角色,有效地应用于耳鼻咽喉科的临床教学及考核中。标准化病人的教育模式应在耳鼻咽喉科予以推广。     

不同移植方法对脑胶质瘤大鼠骨髓间充质干细胞迁移能力的影响

目的观察移植方法对脑质瘤大鼠骨髓间充质干细胞（BMSCs）迁移能力的影响。方法立体定向法建立大鼠C6脑胶质瘤模型。A组大鼠用小剂量缓激肽后经荷瘤侧颈内动脉灌注BMSCs组，B组经荷瘤侧颈内动脉灌注尾静脉灌注组，每组6只。免疫组化染色显示MSCs，观察其在正常脑组织和胶质瘤组织中的数量和分布规律。结果三组均可见BMSCs在胶质瘤组织中广泛分布，A组明显多于B、C组（P〈0.01）。BMSCs主要分布于肿瘤内部，在肿瘤与正常脑组织的交界处亦有分布。结论小剂量缓激肽有助于BMSCs进入胶质瘤组织。     

合并2型糖尿病脑梗死患者与未合并糖尿病脑梗死患者阿司匹林抵抗的研究

目的：探讨血小板聚集能力及阿司匹林抵抗在合并2型糖尿病的脑梗死患者中发挥的作用。方法：对105例合并2型糖尿病脑梗死患者及116例未合并糖尿病脑梗死患者服用7 d阿司匹林后血小板聚集率及生化等方面的检测,评价阿司匹林抵抗的发生率。结果：合并2型糖尿病脑梗死患者的阿司匹林抵抗高于未合并组,差异有统计学意义（P〈0.05）。结论：合并2型糖尿病脑梗死患者阿司匹林抵抗发生率明显增高,临床工作中积极监测血小板聚集率、防治阿司匹林抵抗对脑梗死的治疗有重要意义。     

医源性变态反应性脑炎2例报告——用兔脑匀浆穴位注射后引起

实验性变态反应性脑炎(EAE)及抗狂犬病疫苗接种后脑炎在国内外已屡有报道,本文报道2例兔脑匀浆作穴位注射治疗而诱发的脑炎。 临床资料 我市某卫生所用兔脑匀浆作穴位注射,治疗“支气管哮喘”等病。匀浆系将健康兔脑取出捣碎,     

面神经ENoG和EMP检查在面肌麻痹诊断及预后方面的应用

Electroneurography (ENoG), an objective electrophysiologic measurement of compound muscle action potentials (CMAPs), is used to assess the integrity of a peripheral motor nerve. This method has been used for many years. In our study using an electrophysiologic instrument (Medelec MS6), the stimulating electrode was placed over the facial nerve anterior to the tip of the mastoid process and was manipulated to obtain the maximum CMAPs amplitude from the frontal muscle. With 30 normal subjects and 20 patients with facial nerve palsy, the results showed that the latencies and amplitudes were different between the two groups. Motor evoked potential (MEP) is a new method. Ipsilateral facial muscles are excited by magnetic stimulation over the scalp when the coil is placed over the parieto-occipital region. Using a magnetic stimulator and EMG instrument (1500C4 DISA), CMAPs from the orbicularis oris and frontal muscle were measured. In 30 normal subjects, the CMAPs were similar in form but of longer latency than those obtained with electrical stimulation (ENoG). In 20 patients with lateral facial nerve palsy due to Bell's palsy, Hunt's syndrome or trauma, the latencies on the lesion sides were apparently longer and the amplitudes much lower than in the normals. Our studies suggest that magnetic stimulation will detect facial nerves in the region inside the temporal bone where they cannot be touched by electrical stimulation from in front of mastoid process. The use of both ENoG and MEP methods together allows for accurate measurement of proximal facial nerve conduction and also provides some quantitative measurement: thus, we can detect conduction block or axonal degeneration early.(ABSTRACT TRUNCATED AT 250 WORDS)     

鼻内窥镜下Nd:YAG激光烧灼筛前神经治疗常年性变应性鼻炎和血管运动性鼻炎

在鼻内窥镜下,用Nd:YAG激光烧灼筛前神经的方法治疗常年性变应性鼻炎和血管运动性鼻炎共59例。观察3～7个月,总有效率为89.83％。对筛前神经的解剖、病理生理以及手术并发症等进行了讨论。本方法是一种安全、有效的新方法。     

在基层医院开展药师查房工作的体会

随着医药科学的迅猛发展，以合理用药为中心的药学服务逐渐成为21世纪医院药学工作的重点，为了尽快适应这一发展需要，作为基层医院我们在药师配合医师查房方面开展了一些有益的尝试性工作。作为这项工作的主要参与者，现将工作中的几点体会及一些不成熟的看法做如下汇报：